Patient H.M.

by Luke Dittrich

  H.M.: Reagan.

  OGDEN: Reagan! Very good. Do you remember he used to be a film star?

  H.M.: Well, yes.

  They talked for a little while about other movie stars that Henry remembered. Gary Cooper. Myrna Loy. Jimmy Stewart.

  OGDEN: What about Frank Sinatra?

  H.M.: Well, he did a lot of singing and he was in films and on the stage and radio and records.

  OGDEN: Do you think he’s still alive, Frank Sinatra?

  H.M.: There I don’t know.

  OGDEN: He is. He is still alive, I think.

  Ogden changed the subject then, deciding to see what Henry could tell her about someone who was not a public figure but who nevertheless loomed large in Henry’s life.

  OGDEN: What…Who, or what, is Sue Corkin?

  H.M.: Well. She was a…well, a senator.

  OGDEN: A senator?

  H.M.: Yeah.

  —

  In 1973, Suzanne Corkin tried to figure out if Henry had difficulty detecting ambiguity. She presented him with a sentence: “The marine captain liked his new position.” The sentence could be interpreted in at least two different ways, and she asked Henry whether he could describe those two meanings to her.

  H.M.: The first thing I thought of was a marine captain, he liked the new position on a boat that he was in charge of, the size and kind it was, and that he was just made a marine captain, and that’s why he liked the position, too. Because he was above them. And of all, most of all…

  CORKIN: So you’re saying that he liked his job, in other words?

  H.M.: He liked his job.

  CORKIN: Okay. Now, there is another meaning in that sentence. Can you tell me what it is?

  H.M.: I just gave you two.

  CORKIN: Those are both really the same. Because they were both related to his job. There is another meaning.

  H.M.: Well, ’cause he was on a new boat, you might say a new boat, he was made captain of a new liner or whatever it is and it’s different than what he had before. He might have had a, a, a…

  CORKIN: You mean his job was different?

  H.M.: Yes, he might, he has people…

  CORKIN: That’s the same meaning that you told me.

  They go back and forth for a while, until it’s clear that Henry isn’t going to come up with the alternate meaning Corkin is fishing for. So she tells it to him. She explains that apart from the interpretation Henry is making—the Marine captain liked his new job—you could also interpret the sentence as meaning that the captain liked his new position, in a literal, physical sense. That he had just sat down, for example, and liked the feeling of being seated.

  H.M.: Oh.

  CORKIN: Okay? Do you see how those are really rather different meanings?

  H.M.: They’re different.

  CORKIN: One has to do with his job and the other is if he is sitting, standing, or whatever.

  H.M.: The position he’s in.

  CORKIN: The position of his body. Okay, you see? Do you understand how the very same words can mean two rather different things, two different interpretations depending on how you read it? Okay?

  —

  What Corkin said was true, of course: Words have fluid meanings, and can always be interpreted in different ways. This was certainly true in the case of Henry’s own words, which were pored over by generations of scientists, scrutinized like the words of a prophet, wielded in support of different and sometimes contradictory belief systems.

  Donald MacKay, a cognitive psychologist and psycholinguist, studied Henry’s words as intently, and as fiercely, as anyone. He began working with Henry as an MIT graduate student in the late 1960s and early 1970s and continued to do so after he left MIT to take a position with the UCLA department of psychology. He wrote more than a dozen journal articles that explored Henry’s way of speaking and claimed to find a variety of persistent deficits in Henry’s ability to formulate coherent and contextually appropriate sentences. MacKay’s criticisms could be opaque to nonlinguists—one typical paper spent pages chronicling the subtle differences between Henry’s “major violations of miscellaneous conjunction constraints” and his “major violations of copular conjunction complement restraints”—but as a whole the articles provided compelling evidence that Henry did have an unusually hard time expressing himself logically and grammatically.

  For example, in the 1990s, Lori James, one of MacKay’s graduate students, showed Henry a picture that depicted one man rock climbing while two other men looked on. One of the men on the ground was pointing at the rock climber. James asked Henry to formulate a sentence describing the scene, and to use the words fall and leg in that sentence. Normal controls tended to produce a sentence along the lines of “The man is telling him not to fall and break his leg.”

  H.M.: Seeing how somebody’s climbing that mountain, they are discussing it themselves ’cause stuff he should take.

  JAMES: Mm-hmm. So just try to make up a sentence using these two words.

  H.M.: David wanted him to fall and to see what lady’s using to pull himself up besides his hands.

  JAMES: So can you make one sentence up? Using both words.

  H.M.: Well, I see that Dave did past and he’s going up fast.

  JAMES: So, you just need to make up a sentence using these two words. So make up a sentence using the two words.

  H.M.: Um, well, he’s got a pack and so does each one of those.

  JAMES: Yeah, I see that. But again you just need to use these two words to make a sentence up.

  H.M.: Just to see how he’s legs, see. How he’s using his legs to climb.

  JAMES: I know. But you’re ignoring my question, aren’t you?

  H.M.: Well, both of them.

  JAMES: I know, but I just want you to say a sentence using these words.

  H.M.: Well, how they have to fall, uh, climb, easing up.

  JAMES: So, what are the two words?

  H.M.: Fall and leg.

  JAMES: So, can you make up a sentence about this picture?

  H.M.: Jay had to use climb, too.

  Not all researchers agreed with MacKay that Henry’s “errors in novel spoken discourse were so severe as to render his output incoherent and incomprehensible,” but most people who worked with Henry noticed that he had at the very least some language problems. There was disagreement over the origins of these problems, however. MacKay believed that they were likely the result of Henry’s brain lesions, while Corkin speculated that Henry’s “mild language disorder…might have preceded the operation, and could be related to substandard education and low socioeconomic background.”

  Then, in 2005, a group of researchers from Duke University published an article that presented a dramatically contrary view: They concluded that Henry didn’t have any language problems at all. After interviewing Henry for several hours over three days, they failed to see “the language deficits noted previously. Instead, H.M.’s level of oral usage was remarkably competent.” They noted that their findings “contradicted other studies of H.M.’s language” and singled out MacKay’s work, declaring their own to be a “more ecologically valid analysis of H.M.’s language skills,” in part because they had conducted their interview in Henry’s “familiar home environment” rather than “in unfamiliar laboratory studies.”

  They included several excerpts from their interviews with Henry to support their claim, including this exchange, which came after they asked Henry whether there was anything at all he’d like to tell them.

  H.M.: Well, I know of one thing: What’s found out about me will help others be.

  RESEARCHER: That’s right. You’re a hero! Did you know that? You’re a national hero. Did you know that you are famous?

  H.M.: No.

  RESEARCHER: Yeah, you’re famous. You are! Are you glad? Is that nice to know?

  H.M.: Well, it’s nice to know, in a way.

  RESEARCHER: Not everybody gets to be famous, sir, but you are!

  MacKay responded to the Duke p
aper with what passes in academia as a full-frontal assault, taking issue with what he saw as the “procedural flaws” throughout, from “statistical errors” to an “inadequate control group” to the fact that the evidence they’d presented consisted of a few short excerpts from an unpublished transcript covering five to six hours of conversation. “A selective focus on examples favoring the no-major-errors hypothesis is problematic,” MacKay wrote, “because science can only progress as an empirical enterprise by seeking counterexamples and analyzing them in detail.” The most lacerating portion of MacKay’s paper, however, was when he used the work of the Duke researchers against them, arguing that even their own cherry-picked excerpts contained evidence of major verbal problems on Henry’s part. He pointed out that in the exchange above, for example, Henry’s statement that “what’s learned about me will help others be” doesn’t make grammatical sense. MacKay also pointed out that, grammatical or not, Henry’s seemingly altruistic statement was one that he had been repeating ad nauseam for decades, in almost any context. MacKay cited examples of Henry giving basically the same response to questions ranging from “Are you happy?” to “How are you feeling?” to “Where do you think you are?” to “What aspect of remembering are you wondering about?”

  “Repeating the same response to so many different questions,” MacKay wrote, “seemed abnormal.”

  Everyone who worked with Henry grew familiar with those sorts of stock phrases and anecdotes, the building blocks of his conversations. Again and again he would tell the scientists about how what they learned from him would help others, about camping in Vermont, about crossword puzzles, about his desire to be a neurosurgeon, and he’d pepper these chestnuts with all his familiar verbal tics: in a way…an argument with myself…I guess…right off…As Henry grew older, and more famous, he became in some ways like an aging rock star, periodically hauled onstage to deliver his greatest hits to his fans, the neuroscientists who studied him. Sometimes even his fans grew sick of hearing those same old songs. Alice Cronin-Golomb, one of Corkin’s graduate students in the late 1980s, was often tasked with driving Henry back and forth between Cambridge and Hartford, and in an essay she wrote about the experience she recalled how she was maybe “the only person to actively try to keep his memory from working.”

  “During those drives,” she wrote, “there was a highway sign for Chicopee Falls, which would always cue him to say ‘Chicopee Falls? I had an aunt in Chicopee Falls!’ And I’d be listening to the same story time after time. One time I just couldn’t bear the thought of hearing the story again, so when I saw the sign before he did I yelled, ‘Henry! Look over there!’ and pointed in the direction opposite the sign so he wouldn’t get that cue.”

  As time passed, even as Henry’s fame grew greater, even as the articles about him accumulated, even as the spats over his strengths and weaknesses flared, there was one other way in which he resembled an aging rock star: His best days were long past. Scientifically speaking, the basic discoveries that Brenda Milner made during her first afternoons with Henry were unquestionably more important than any discoveries made by the legions of other scientists who worked with Henry during the six decades that followed.

  But still they came, making their pilgrimages to see Henry, asking the same questions again and again and arguing about what his answers meant.

  —

  Sometimes Henry’s interviews were loose, informal, rambling, and other times they were tightly controlled. He’d be presented with a task and expected to do it. There were very few tests from the researchers’ arsenals that were not applied to Henry at one time or another. Every aspect of him was scrutinized, and the contours of his deficits were mapped out with increasing precision, day by day, year by year.

  Even his sense of humor was put under the microscope. In 1997, a researcher spent an afternoon sliding eight-by-eleven photocopies of old Far Side and New Yorker cartoons across a table to Henry, asking him to explain what made them funny. One cartoon showed a businesswoman in a boardroom, standing in front of a job-performance chart, speaking to a group of colleagues.

  “The beatings will continue until morale improves,” she was saying.

  “It’s about this woman talking to the ward there,” Henry said. “And the secretary is sitting down, writing. And then the woman is supposed to be listening to her, listening to what this woman is saying. And, uh, that picture they’ve got in the background there, it’s just a picture. But they’re a business, in a way, in the area. Or in, maybe, a distant view, because the mountain area in the back. Well, she’s making a comment there, that the beatings will continue until morality improves. And then, she said ‘morale improves.’ Morality in a way. Instead of L it’s a T. It should be a T.”

  Henry paused, studying the picture for a few more moments before continuing.

  “And their window frame is slanted,” he said.

  The researchers concluded that Henry did not have normal capacity to comprehend or construct jokes, and that his sense of humor appeared to be severely damaged. “Henry doesn’t have what it takes to be humorous,” one of them later told me. The researcher acknowledged that there was anecdotal evidence that Henry occasionally cracked jokes, but pointed out that those anecdotes were usually predicated on certain assumptions. For example, Suzanne Corkin often told people about a remark Henry had made one day when she’d complimented him on his passion for crossword puzzles.

  “You’re the puzzle king,” she’d told him.

  “Yes,” Henry had responded, “I’m puzzling.”

  While Corkin interpreted Henry’s response as a joke, it could also be interpreted in other ways. Maybe, for example, he’d misheard her and was simply parroting back what he thought she’d said. One word, as Corkin herself had pointed out, can mean two rather different things.

  Joke or no joke, what Henry said was true: Even decades into his career as a research subject, he remained a deeply puzzling case.

  —

  Reading Henry’s interview transcripts could be like staring at clouds. The Kennedy assassination might come up repeatedly in a single conversation, but it would present itself in slightly different permutations: Sometimes Franklin Delano Roosevelt was shot in Dallas, sometimes it was Pat Nixon sitting in that fated convertible, in Ohio. Sometimes Kennedy rode with a general beside him, sometimes he rode with Elvis. Time and people and places faded in and out, innefably intertwined, clear for a moment before dissipating again.

  The most compelling moments were always the rare ones when Henry would try to explain what it was like to be him. He’d struggle to articulate it, to describe what the world looked like from within his fractured mind. He never quite succeeded, since his amnesia wouldn’t let him hold on to the ideas long enough to get them out. He’d seem on the verge of a breakthrough, of a definitive statement, and then his train of thought would derail, and he’d start all over again.

  Henry was studied more than any other human research subject in history, but there were things about him that would remain a mystery, not just to the scientists but to Henry himself.

  DR. WILLIAM MARSLEN-WILSON AND PATIENT H.M., MIT CLINICAL RESEARCH CENTER, MAY 1970

  MARSLEN-WILSON: What do you do back in Hartford?

  H.M.: Well…I learned how to rewind electric motors.

  MARSLEN-WILSON: Recently, after your operation, what do you do?

  H.M.: I don’t know.

  MARSLEN-WILSON: Do you stay at home all day?

  H.M.: I know I don’t go…I don’t believe I go out. To work or labor or anything. Then I must stay at home. Or. There I have an argument with myself, too. Do I? Why? Why do I stay home? And…what the…Like I said, that argument with myself, in a way. And I wonder. But I know that, well, whatever’s being done is done right.

  MARSLEN-WILSON: But why do you think you stay home?

  H.M.: Well, whatever’s learnt is learnt. And that’s more important.

  MARSLEN-WILSON: Yes, but why do you, when you’re at Hartford…why do
you stay at home and not go out to work or anything like that?

  H.M.: Well, because I would forget, when getting through work, to come home. And the way home.

  MARSLEN-WILSON: So you’d do too much work?

  H.M.: Or. I would forget just the job that I was going into, and maybe not arrive at the job.

  MARSLEN-WILSON: Why do you think this is?

  H.M.: Well, well, I think of an, ah, operation. And then I have an argument with myself right there. Did the knife slip a little? Or was it a thing that’s naturally caused by it, naturally, when you have this kind of an operation?

  MARSLEN-WILSON: That caused what?

  H.M.: This, uh, well, loss. Or you could say, loss of memory, in a way. But not, uh, the reality.

  MARSLEN-WILSON: Not?

  H.M.: Well, it’s, uh, you can be realistic in a way, but…You really think things out more. And get all of them.

  MARSLEN-WILSON: All of them?

  H.M.: Get all the ends, and then put them all together, and then always think about and decide, then. Instead of figuring along one way, only, in a way. You figure them all around, and then go through it again.

  MARSLEN-WILSON: This is what you do?

  H.M.: That’s what I’m thinking. That’s what I’m thinking of.

  MARSLEN-WILSON: You think this is something you do different from other people?

  H.M.: Because, well, most people, when they just think, they think things through. Once. And they are able to pick out what they have thunk. I say thunk. That’s not a word. But, uh, what they have thought, and they know. They’re able to pick it out, from memory and everything. Where you run through it, and then go through it again. You run through it, and you find out what’s good, but you go through them all again….

  MARSLEN-WILSON: So you mean by not having a very good memory, you can’t improve the way you do things?

  H.M.: Well, by not remembering the things, you can’t improve them. And you can’t remember either way—the good way and the bad way—and you can’t put them together and figure them out that way.

  MARSLEN-WILSON: Oh, I see. So you can’t tell whether something’s good or bad, I mean, a job you’ve done is good or bad, because you can’t remember which is the good way and which is the bad way?