Excerpted from The Perpetual Now: A Story of Amnesia, Memory and Love, by Michael D. Lemonick. Published by arrangement with Doubleday, an imprint of The Knopf Doubleday Publishing Group, a division of Penguin Random House, LLC. Copyright © 2017 by Michael D. Lemonick. Reprinted with permission.
I pulled the New York Times out of its plastic delivery bag on the morning of December 5, 2008, unfolded the paper, and read this headline on the front page: “H.M., an Unforgettable Amnesiac, Dies at 82.”
He was certainly unforgettable to me. I’d first read about H.M. in my freshman psychology textbook at college, in the fall of 1971, less than twenty years after the experimental surgery that robbed him of most of his existing memories and also of ability to form new ones. The idea of living in a perpetual “now” seemed appalling, and, along with the two hundred or so other students in the class, I tried to imagine what such an existence might be like. Naturally, I failed.
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I would come back to H.M.’s case several times as a science journalist, whenever I wrote a story that touched on the science of memory. I never knew his name, though, thanks to the absolute insistence of Brenda Milner and Suzanne Corkin, the scientists who studied him for five decades, that he remain anonymous while he lived. But there it was at last, in paragraph seven: “On Tuesday evening at 5:05,” the story read, “Henry Gustav Molaison—known worldwide only as H.M., to protect his privacy—died of respiratory failure at a nursing home in Windsor Locks, Conn.”
In the summer of 2015, I sat in Suzanne Corkin’s office at MIT, talking with her about her long relationship with Henry, both as a scientist and as the closest thing he had to a relative after his mother died. I was now writing about Lonni Sue Johnson, another amnesia victim with a condition very similar to Molaison’s. (Johnson’s mother and sister, her prime caretakers, had decided to make her full name public, in order to help publicize the need for research into the brain).
I was asking about Molaison’s death, and the postmortem research that she’d been planning for decades in anticipation of his passing. “We’ve barely begun that research,” she said, and then looked at me expectantly. I looked back, blankly. “Your next question,” she prompted me, “should be ‘Why?’” I still didn’t get it. “Why … what?” I asked, baffled. “Why,” she continued, “seven years later, we do not know anything about the details of his brain?” Seven years did seem like a long time, now that she mentioned it. I assumed that this simply represented the slow and careful process of science.
I was wrong.
Immediately after Molaison died, his body was rushed to Massachusetts General Hospital, where his brain was carefully removed and preserved. Thanks to surgical notes, X-rays, CAT scans, and MRIs, neuroscientists and neuroanatomists had a good idea of which parts of his brain had been destroyed in the surgery meant to cure his intractable epilepsy. The surgeon, William Scoville, had removed the front sections of both of Henry’s hippocampi, along with much of his entorhinal, perirhinal, and hippocampal cortices, now understood to be crucial to memory. Scoville had also taken out the amygdalae, which process the experience of emotion.
Extensive memory tests, meanwhile, had probed the extent of his memory loss (which was enormous). But without knowing precisely how much of which organs had been taken out—and, crucially, what the untouched parts of his brain looked like in fine detail—Corkin and other scientists couldn’t know whether his brain was abnormal to begin with. Perhaps his severe epilepsy had caused some damage that might have contributed to his memory problems.
So Molaison’s brain was gently separated from his body and given into the care of Jacopo Annese, a neuroscientist at the University of California, San Diego, who had created an entire lab devoted to preparing it for future study. Annese understood how important it was to preserve Henry’s brain in as pristine a state as possible. “I remember the unfortunate fate of other illustrious brains,” he told me in an interview. “You know what happened with Einstein’s, right?”
I did know that bizarre story. When Albert Einstein died in 1955, the hospital pathologist, William Harvey, removed the brain and cut it up into more than two hundred small chunks. Harvey doled out a few chunks to researchers, but kept most of them in a couple of Mason jars, swimming in alcohol. He ended up in Wichita, Kansas, where journalist Steven Levy tracked him down in 1978. Einstein’s pickled brain was still in the jars, under a pile of boxes in Harvey’s basement. Eventually, some pieces were acquired by the Mütter Museum of medical oddities, in Philadelphia. You can visit them there, where you can also see a tumor removed from Grover Cleveland’s mouth; a slice of tissue from the chest of John Wilkes Booth; the shared liver of the famous conjoined (“Siamese”) twins Chang and Eng Bunker; and a collection of cysts, tumors, and deformities of all sorts. The research that came out of the few specimens of Einstein’s brain that Harvey gave to actual scientists was sparse, and some of it turned out to be questionable.
In contrast, Annese would freeze Molaison’s brain, then slice it into more than two thousand thin sheets, each just seventy microns thick. (A micron is equal to .000039 inches; a human hair is about one hundred microns thick.) Scientists would then be able to look at the slices with microscopy and other techniques to learn precisely what the brain looked like, right down to the cellular level.
The painstakingly careful slicing, which lasted fifty-three hours (and which was both filmed and webcast), happened almost precisely a year after Molaison died. “The brain was cut very well,” David Amaral, a neuroscientist at the University of California, Davis, told me. “There was no problem with that. But ….” He hesitated, then continued: “From my scientific perspective, there was a lot of unnecessary showmanship.” Amaral felt that Annese was using the event as a way to attract donations for what he was calling the Brain Observatory. On the organization’s Web site it says: “The Brain Observatory is committed to maintaining the highest standards in open science, sharing all the images and data that are created in our laboratories with other researchers and the public.”
It didn’t quite turn out that way, however, at least according to Amaral and also to Corkin, who died last year. A number of the slices were mounted on slides, just as Annese had promised, with the rest preserved for future mounting. But that was evidently pretty much it. Normally, Amaral said, a scientist in Annese’s position would go on to develop collaborations with other neuroscientists to study such a valuable specimen. “For example,” he said, “my expertise is on the hippocampus, so either I or people like me should have been approached to carry out those studies.” Other parts of the brain should have been examined by other experts. But in fact, Amaral said, “nothing happened, nothing happened, nothing happened.”
Corkin spoke with Amaral and others in an effort to see what might be done. “We tried to intercede,” Amaral said, “and still nothing happened.” Annese, Corkin said, “turned out to be a bad collaborator. He basically brought the science to a screeching halt by not living up to his agreements.” Annese did publish a paper in Nature Communicationsin 2013 that described the structural damage to Henry’s brain, along with “diffuse pathology in the deep white matter and a small, circumscribed lesion in the left orbitofrontal cortex.” According to Corkin, however, who was listed as a coauthor on the paper, this did not amount to a full pathology report.
Annese rejects these accusations. “It is regrettable,” he said by email, “that some colleagues have been led to have this impression about my work with H.M. The question of the neuropath examination, which was only a portion of the overall planned work, has been brought up several times over the years and there’s ample evidence of my good will and concrete actions to facilitate the process.” At the institutional level, he wrote, “there have been many delays that were beyond my control. In my opinion, difficulties were spurred by a failure to communicate expectations and intents directly, effectively and in a transparent way. This was very frustrating at times, but I did my very best in being very open about my prerogatives throughout.” All of the money for cutting and preserving Henry’s brain, he said, came from his own grants, without any contribution from MIT or Mass General. He asked for assurances that the Brain Observatory would receive proper credit in any scientific publications, and that it would have a long-term role in the science. “Oddly,” he wrote, “I wasn’t able to obtain a suitable response. In fact, I personally had very minimal if any response at all after a certain point.”
That’s not how Corkin saw it. Finally, she said, she simply got fed up with trying to pry information out of Annese. She enlisted administrators at MIT, Mass General, and the University of California, San Diego, to help force the issue. In the end, the higher-ups agreed that Henry’s brain should be transferred to another institution—specifically, to Amaral’s lab at the University of California, Davis. “It took a very long time to negotiate that,” Amaral said, “and the whole process was not facilitated by Dr. Annese.”
Annese’s lab at UCSD was shut down, and when he and I spoke by phone, before I learned any of this backstory, he told me he was looking for funding to secure a new home for the Brain Observatory. After I’d heard Corkin’s and Amaral’s accusations, I asked Annese by e-mail why his university agreed to give custody of Henry’s brain and other materials over to another lab. He didn’t really answer. “The transfer of the collection,” he wrote, “without concrete scientific or logistic reasons followed negotiations at the institutional level, well above my jurisdiction. I resigned from UCSD in February of this year [2015] because while I respected the fact that UCSD’s delegated leadership felt that this solution was in the University’s best interest, their decisions were ultimately not aligned with the long-term success of my lab and projects, which are now governed by an independent non-profit organization.”
Now that the brain has been relocated, the research is finally getting under way in earnest. Amaral and his colleagues have begun digitizing the slides Annese prepared, creating high-resolution images that will go up on the Web. They’ve concluded an agreement with someone Amaral calls “a very well respected neuropathologist” to scrutinize the tissue for diseases that might have caused Henry’s cognitive decline. And they’ve begun putting together several consortia of experts who will look at specific parts of the brain to try to understand precisely what happened when Molaison’s memory-making apparatus was destroyed more than sixty years ago. “We will be able to provide a very definitive description,” Amaral said, “of what has been removed, what’s intact.”
And with that, the brain that launched the modern study of memory in the 1950’s will make its final, crucial contribution to science.