There really is nothing else like it. The human brain creates the human mind, and then the human mind tries to understand the human brain, however long it takes and whatever the cost.
Drawing from his family’s intimate history, Patient H.M by Luke Dittrich chronicles, both anecdotally and factually, the story of how our understanding of neuroscience- more specifically memory, came to be.
Memories make us. Everything we are is everything we were. This has always been true and is so obvious that it hardly needs to be said. But though memories make us, we’ve only recently begun to understand how we make memories. The story of how we’ve gained this understanding is the story I’m telling in this book. It’s a story with heroes and villains, tragedy and romance, violence and tenderness. My grandfather plays a part, but it’s much bigger than my grandfather. It’s a story about science, and about nature, human and otherwise.
Dittrich delineates the rich and shocking history of discoveries that lead to our current understanding of neuroscience- from an ancient Egyptian hieroglyphic text containing surprisingly astute descriptions of the brain and spine to the controversial period of the frontal lobotomy and other psychosurgeries. At the forefront of this surgical movement was none other than the author’s own grandfather. A prominent neurosurgeon, William Beecher Scoville, spent his career doing many things- the most controversial of those being perfecting his lobotomy technique on patients committed to asylums as well as unsuspecting individuals in the general public.
Human beings were no longer off-limits as test subjects in brain-lesioning experiments. This was a fundamental shift. Broken men like Phineas Gage and Monsieur Tan may have always illuminated the unbroken, but in the past they had always become broken by accident. No longer. By the middle of the twentieth century, the breaking of human brains was intentional, premeditated, clinical.
The common thread the runs throughout the story is that of Henry Molasion. Henry was a unique and vital part of how we came to understand brain function as it relates to memory for two reasons: the first being that he was not insane and the second being that he suffered bilateral lesions to a specific portion of his brain which were the result of a surgery meant to relieve the epilepsy that plagued him throughout most of his life. The loss of these portions of his brain left Henry with profound amnesia which attracted a multitude of psychologists and neurologists as they were able to study a living human to gain a true, in vivo understanding of all things memory. Hence, Henry Molasion became Patient H.M.- the name by which he was known in the plethora of published works he was featured in throughout the majority of his adult life.
In other words, the location of the seat of memory, that ancient mystery, had been revealed. And it is that revelation, borne out by more than a half century of subsequent research, which made this paper the single most cited paper in memory science. It is in many ways the field’s founding text.
Dittrich explores the range of ethical dilemmas in medical research. How far is too far? Are all lengths justified if the outcome benefits the greater good? While many of the stories in Patient H.M. will create a viseral reaction, some cause the reader to consider just how vast the results of medical breakthroughs are, but at what cost?
For example, in 1796, after noticing that workers on dairy farms almost never contracted smallpox, the British physician Edward Jenner decided to test a theory that this was because they had previously been exposed to the relatively benign disease known as cowpox. He made a series of small incisions in the arm of his gardener’s son, eight-year-old James Phipps, then introduced the pus from a local milkmaid’s cowpox blisters under Phipps’s skin. During the following week, Phipps developed the mild fever, aches, and pains characteristic of cowpox, then recovered fully. Six weeks later, Jenner lanced his arm again and this time administered him smallpox, at the time the most deadly disease known to man. Phipps did not develop any symptoms, so Jenner exposed him again and again, twenty times in all, to no effect. Finally, Jenner concluded that he had discovered a smallpox vaccine. His discovery would change the world, leading not just to the eradication of smallpox but to the creation of modern immunology and the subsequent development of vaccines for hundreds of other diseases. Today it’s possible to make a persuasive argument that Edward Jenner saved more human lives than any single person in history. Taking this into account, perhaps it’s easy to argue that jeopardizing the life of an eight-year-old boy was acceptable. In other cases, however, the experiments that led to medical breakthroughs were more troubling, and the calculus becomes murkier. For most of human history, our attitudes toward human experimentation were strictly utilitarian. If the scientific benefits were great enough, then almost any cost was justified.
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