Permanent present tense: The unforgettable life of the amnesic patient, H. M.
Reviewed by Sue Frantz, MA, Highline Community College, Wash.
Author: Suzanne Corkin
Publisher: Basic Books
Copyright year: 2013
Number of pages: 364
"It's a funny thing — you just live and learn. I'm living, and you're learning."
— Henry Gustav Molaison, aka H.M.
Little Albert, Phineas Gage, and H.M. — a student would be hard-pressed to complete an Intro Psych course without being able to identify the three most well-known, and unwitting, research participants in psychology. H.M.’s identity was a closely guarded secret for five decades, only revealed upon his death in December 2008.
Suzanne Corkin, the author and neuroscientist, began working with Henry Molaison in Brenda Milner’s lab in the early 1960s, a working relationship she kept with Molaison for the rest of his life. In a plot twist that would not be believable in a work of fiction, Corkin grew up across the Hartford, Conn., street from William Scoville, the surgeon who removed Molaison’s hippocampi. Molaison was largely unable to form new memories, living in a permanent present of about 30 seconds, and all but two of his pre-surgery episodic memories were lost: A plane ride over Hartford in 1939 and his first cigarette.
Opening with a history of psychosurgery and Molaison’s own history with seizures that were worsening as he aged, the reader sees the rationale for his radical surgery. The rest of the book is a history of memory research with Molaison providing the thread that holds the narrative together. The author had some difficulty with audience. At times she writes for a lay audience, and other times she slips into writing as the neuroscientist that she is. Intro Psych students will find themselves stretched at times. Advanced psychology students will be pleased to discover that they are understanding the science.
You are guaranteed to find fodder for your neuroscience and memory lectures. Molaison, for example, was able to develop a sense of familiarity even if he lacked episodic memory. While he did not meet Corkin until well after his surgery, over time he found her familiar, eventually deciding that he must have known her in high school. As Molaison aged, he did not find his own older face in the mirror surprising. With the death of his father, for four years he was repeatedly distraught each time he was told of his death, but seven years later he was speaking of his father in the past tense.
Scoville removed not only Molaison’s hippocampi but also both amygdalae and areas around those amygdalae, areas important to the sense of smell. While Molaison could smell and could say which odors were stronger, he could not identify the odor itself save one: distilled water. It smelled like “nothing,” he said. The amygdalae also play a role in our senses of hunger, thirst and pain, all senses Molaison seemed to lack to some degree.
Corkin and her team conducted a fascinating series of experiments designed to get at what semantic knowledge Molaison could learn. In short, he was able to add knowledge to existing schemas but unable to create new ones. He knew who John F. Kennedy was before his surgery. Over time he added to his schema knowledge such as he “became president; somebody shot him, and he didn’t survive; he was Catholic.”
There is no question that Henry Molaison contributed immeasurably to what we know about memory and the brain. From his interactions with Corkin you get the sense that he grasped his contributions. Corkin describes Molaison not as a research participant but as a member of the research team, and she protected him to the end.
Molaison lived with his mother until her dementia made that arrangement untenable. A family friend took them both in. After his mother was moved to a full-care facility and the family friend developed terminal cancer, Molaison moved into a nursing home where he spent the last 28 years of his life. Knowing that Molaison lacked family and friends, Corkin’s team sent photos of themselves to be put up on his bulletin board, people he found familiar. Knowing his love for crossword puzzles, the research team gave him a monthly subscription to a crossword puzzle publication.
Near the end of the book as Molaison is nearing the end of his life, Corkin writes, “We knew it would be vital to harvest Henry’s brain as soon as possible after he died.” This language brought me up short. Through the book I felt I had come to know Molaison as a person, and with this one sentence, I was reminded that he was first and foremost a research participant. In the final chapter, “Henry’s Legacy,” Corkin describes what happened to Molaison after his death. She walks us through the arrival of his body, the post-mortem brain scans and then the autopsy. His brain was later frozen then shaved into 2,401 slices in a process that took 53 hours. (Visit the Brain Observatory website for more information about Molaison’s brain.) While Corkin and her team certainly felt sadness at his death, their excitement at having his brain was palpable.
Upon finishing this chapter, I had to pause. Molaison’s surgery resulted in tragedy; was 50+ years of research on him exploitive? Was it wrong to benefit from his loss? Molaison, by all accounts, enjoyed participating in the tests. He had a sense he was contributing to science in a unique and valuable way. Would it have been more tragic had researchers like Brenda Milner and Suzanne Corkin not worked with him at all?
And then I read the epilogue. Through most of the book, Corkin keeps Molaison at arm’s length. That makes sense since she is Corkin-the-researcher describing Molaison-the-research-participant. In the last 10 pages, we see Corkin and Molaison on more equal footing as long-time collaborators — a very different lens. If you read nothing else in this book, read the epilogue. It will help you understand exactly what Henry Molaison gave to psychology.