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Henry M: The Day One Man's Memory Died

The Hartford Courant

Henry M. was awake as the surgeon inserted a metal straw deep within his brain and suctioned out a piece of tissue the length of an index finger.

The surgeon, William Beecher Scoville of West Hartford, talked to the 27-year-old Hartford man during the experimental operation, which he hoped would end his patient's epileptic seizures.

But a reduction in seizures came at a catastrophic cost: Henry no longer could make new memories.

From that summer day in 1953, Henry M. never again retained a conscious recollection of people, places or things he encountered. His intelligence remained intact, but his memory turned into a sort of Etch A Sketch, perpetually erased seconds after he turns his attention elsewhere.

Today, Henry M. is by most accounts a genial old man who lives in a Hartford area nursing home, unable to recognize aides who have cared for him for years. His most recent memories date to when Eisenhower was president. His full name and residence are secrets, jealously guarded by a few neuroscientists who have dubbed him H.M. and built their careers studying his profound loss.

The precisely carved hole in Henry's brain has turned out to be a treasure trove of information about the multiple facets of memory. Over the decades, dozens of scientists have made a pilgrimage to meet Henry, seeking to mine meaning from the man who lost his ability to hold a half-century of his personal history.

Henry is unaware that he has become one of the most famous subjects in the history of psychology -- a textbook example of the importance of memory in the formation of identity -- or that his story still spurs questions about medical ethics and patients' rights.

Dr. James Duffy, an associate professor of psychiatry at the University of Connecticut and director of psychiatric consultation services at Hartford Hospital, says he has not met Henry but suspects the man has become an afterthought in science's relentless pursuit of knowledge.

``Scientists are good at slicing off pieces of patients and manipulating them under a microscope,'' Duffy said, ``but we don't want to take responsibility for their well-being.''

Wiped Away

What the world knows of Henry M. is limited mostly to lifeless prose of psychology textbooks and scientific papers, which devote many more pages to the incisions that removed most of Henry's medial temporal lobe than to his likes and dislikes, his hopes and dreams.

Scientists who have worked with Henry say his memories of childhood, adolescence and young adulthood -- the only conscious memories he has -- have a brittle, worn quality to them. For Henry, the people he talks with are always strangers. And his stories are invariably the same, lacking the sinew, blood and muscle with which memory infuses experience.

``The stories he tells are incredibly similar each time he tells them,'' said John Gabrieli, a neuroscientist at Stanford University who studied Henry extensively during the 1980s. ``There is a bland, stereotyped quality to his conversations. What are you going to say when everyone is a stranger?''

Henry is a big man who has become bigger and softer after years of a sedentary lifestyle. He likes to eat. He is going bald and wears glasses. He still takes medication to control epileptic seizures, which were reduced but not eliminated by the operation. Today, he has osteoporosis and recently has had to depend on a wheelchair to get around. He will need cataract surgery soon.

Apparently, Henry was always good-natured, which makes it difficult to determine just how much his gentle, agreeable demeanor is the result of his operation.

Henry seldom expresses any interest in the topic of sex, but he also had no serious girlfriends before the operation. So scientists don't know if Henry's sex drive, like his memory, was a casualty of the surgery.

There is little biographical information available on Henry and much of it he has supplied himself.

Henry M.'s father was an electrician who migrated from Louisiana in the 1920s to Hartford, where Henry was born in 1926. The family attended church in Hartford and moved to East Hartford by the time Henry was a teenager. Later, they moved to a more rural part of Hartford County.

Henry remembers roller-skating. He remembers shooting his father's gun in the woods. But unless he is coached, he doesn't remember that his parents are dead.

Unofficial Guardian

The person who knows as much about Henry as anyone is Suzanne Corkin, a neuroscientist at the Massachusetts Institute of Technology who has worked with Henry since 1962. Corkin acts as a sort of unofficial guardian of Henry's interests, along with Montreal scientist Brenda Milner. It was Milner who, with Scoville, in 1957 co-authored the first scientific paper describing the extent of Henry's memory loss.

Corkin and Milner decided that instead of conducting tests on Henry in Montreal, it would be easier to work with Henry at MIT, closer to his Hartford home.

Corkin's connection to Henry's case actually reaches back into her childhood. She was Scoville's neighbor growing up on North Steele Road in West Hartford and remains friends with the surgeon's daughter.

Corkin said she and Milner decided long ago not to allow the media to interview Henry and actively discouraged efforts to write about him. She said that it would be unethical to discuss his medical records and that there are few details of his life before the surgery.

Misinformation about Henry is rampant, including reports that he may suffer from depression, she added.

But other scientific researchers say that when it comes to controlling information about Henry, Corkin is as zealous with them as she is with reporters.

Endel Tulving, a memory researcher and retired professor of psychology at the University of Toronto, said Corkin refused to allow him to tape-record an interview with Henry.

``It's just silliness,'' said Tulving. He said he has worked with a Canadian amnesiac with a similar devastating memory loss who has been interviewed on several television shows.

Corkin said more than 100 scientists have worked with Henry during the past 50 years.

One fact is almost universally reported about Henry. At the age of 9, Henry was knocked unconscious after he was hit by a bicyclist. Soon after, he experienced his first minor epileptic seizures. On his 16th birthday, he suffered a grand mal seizure.

James Bond In Scrubs

Henry was 27 -- and having as many as 10 minor seizures a day and at least one major seizure a week -- when his case came to the attention of Dr. William Beecher Scoville, a flamboyant descendant of the illustrious Connecticut family that produced ``Uncle Tom's Cabin'' author Harriet Beecher Stowe.

Scoville was a fearless -- some say reckless -- pioneer in developing surgical remedies for a variety of intractable psychological conditions. He was best known internationally for his technical improvements in the performance of lobotomies, which then were regularly conducted at Hartford Hospital and the Institute of Living, one of the world's top centers for the treatment of mental illness.

He received many awards for his work. He founded an international society of brain surgeons that still gives out an annual award in his name. The University of Connecticut Health Center has an endowed chair that bears his name.

No one who met Scoville forgot him.

While Henry M. is genial, meek and eager to please, Scoville was a sort of James Bond in scrubs who loved fast, expensive cars and motorcycles, a demanding dynamo in the operating room, brilliant at his craft.

``Bill drove fast, lived hard and operated where angels feared to tread,'' said Dr. David Crombie, former chief of surgery at Hartford Hospital who met Scoville in the early 1960s as an intern at the hospital and became friends with his son.

Scoville was an early advocate of helmets for motorcyclists, but never wore one himself, despite riding at speeds that terrified friends and colleagues, Crombie recalled.

``He said you had to wear a helmet -- unless you were keenly aware,'' Crombie said. ``He had a sense of invincibility about him.''

Scoville typically operated on people with intractable schizophrenia or severe depression. But in 1953, Scoville thought he might be able to alleviate Henry's epilepsy. Epilepsy can originate within the medial temporal lobe, a structure that extends on both sides of the brain roughly under the temples.

Scoville decided to remove a greater area of brain tissue from Henry than had been removed from patients who had undergone similar surgeries.

A half-century ago, doctors did not need to get a hospital's permission to try innovative operations. They were under no obligation to conduct trials before they tried new procedures on a patient. Henry and other patients did not have to sign informed-consent papers saying they knew the risks involved, although it is unlikely Henry or his working-class parents would have questioned the advice of a famous surgeon.

``In those days, the doctor's word was God,'' said Al Herzog, a psychiatrist and vice president of medical affairs at Hartford Hospital. ``In an odd way, people like Scoville helped create the ethical standards in use today. By pushing the boundaries of surgical practice, Scoville and others led hospitals to establish institutional review boards, patient protocols, things like that.''

A `Successful' Operation

Late in the summer of 1953, either at Hartford Hospital or at the nearby Institute of Living in the single operating room where lobotomies were performed, Scoville took out most of Henry's medial temporal lobe, including all or parts of the hippocampus and amygdala.

Scoville originally dubbed the operation a success, although Henry couldn't remember the way to the bathroom or the names of the nurses who cared for him.

A few years later in a research paper, Scoville would strongly urge surgeons not to duplicate his ``experimental'' operation because of its devastating effects on Henry's memory.

``It bothered him. You could see it in his eyes,'' recalls Dr. Robert Correll, director of psychology testing services at Hartford Hospital who came to Connecticut from Iowa University in 1958 to try with Scoville to duplicate the effects of the operation in monkeys. ``Bill's goal was to be perfect. He didn't make mistakes.''

In the decades that followed, Henry often told researchers that as a child he had wanted to be a brain surgeon. Henry seems to mingle the recollection of his childhood dream and his own operation, the last memory he would ever preserve, in a sort of never-ending loop.

During one interview, Henry told a researcher that he nixed the idea of becoming a surgeon because he wore glasses, ``and you could make the wrong movement then ... and that person could be dead, or paralyzed.''

He was then asked if he remembered his own operation.

``Well, I think I was, ah, well, I'm having an argument with myself right away. I'm the third or fourth person who had it, and I think that they, well, possibly didn't make the right movement at the right time, themselves. But they learned something.''

They did, indeed, the researcher told Henry, who then again brought up Henry's childhood.

``A funny part, I always thought of being a brain surgeon myself. ... And then I said no to myself. ... An attendant might move your glasses over and you would make the wrong movement.''

Do you remember who the surgeon was who did your operation, the researcher asked.

``No, I don't.''

``Sc--,'' the researcher hinted.

``Scoville,'' Henry said.

Understanding The Mind

Scoville was killed in 1984, at the age of 78, when he backed up his car on the highway to get to an exit he had missed. Renowned in his time for innovative improvements to a surgical procedure now held in disrepute, the confident, perfectionist surgeon is best remembered for obliterating the memory of a young working-class Hartford man.

Science's understanding of the brain changed dramatically after Scoville and Milner published their paper in 1957 describing the effects of the operation.

It had been impossible for scientists to determine how specific areas of the brain created the richness of the human mind -- most often understood in abstract terms, such as Sigmund Freud's id, ego and superego.

``Freud was stuck; he couldn't make those connections,'' Herzog said. ``But with cases like H.M., the connections became more obvious. You can't run away from the importance of H.M.''

One of the first lessons Henry taught scientists was that intelligence and memory are separate entities.

Henry would have flunked out of any class in which he had to learn new information because of his inability to recall new facts. Yet his IQ remained slightly above average and his ability to solve problems was unaffected by the operation.

``We now know from 30 years of animal studies that it was the most devastating surgical resection you can possibly make, but it also stopped at the border of all the important areas of the brain associated with intelligence,'' Gabrieli said.

And because Henry could retain memories for very short periods of time, it became clear that different structures of the brain perform different functions in the storage and retrieval of memories.

The brain structures removed by Scoville turned out to be crucial in converting experience into long-term memories, but not in storing them.

``Until H.M., memory was viewed as essentially a unitary faculty,'' said Larry Squire, a neuroscientist at the University of California at San Diego and a leading memory researcher.

Scientists knew during the 1950s, for instance, that motor and muscle skill memories were processed differently than, say, how we recall that Bismarck is the capital of North Dakota. ``But that proved to be tip of the iceberg,'' Squire said.

One of the major hurdles that confronted scientists studying Henry is that the medial temporal lobe contains several brain structures. In the decades since Scoville operated, scientists such as Squire have worked with animals to try to tease out the specific function of each of these individual structures. The discipline known as cognitive neuroscience emerged to describe how various parts of the brain cooperate and allow humans to accomplish complex tasks such as memorization.

``He is the most dramatic example of a patient who tragically became an experiment of nature,'' said Eric Kandel, Nobel laureate and professor of physiology and psychology at Columbia University. ``That single case enlightened a whole body of knowledge.''

Learning Vs. Remembering

Scientists became so infatuated with Henry, Tulving said, that they missed evidence that other areas of the brain also contribute to memory.

``I think H.M. was a bad thing for our science. Everyone got mesmerized by H.M.,'' Tulving said. ``The whole world revolved around one case, and other cases were not followed up.''

Experiments with Henry and other amnesiacs and, more recently, various brain-imaging studies have revealed that memory is a multilayered set of processes. In some cases, such as in our recall of emotionally charged events, those processes can be at work without our conscious awareness.

In one early study, Henry showed that he could learn new skills, even though he had no conscious recollection of having previously performed the task. Henry got better at copying shapes he viewed through a mirror, even though he told researchers he had never done it before.

Gabrieli's research showed Henry can do the same thing with some word tasks. Gabrieli provided Henry with a list of words such as tangerine, apple and bazooka. When asked minutes later, Henry could not remember any of the words on the list.

``But when you ask him, `Can you name a weapon?' he will say, `Bazooka.' And then he says, `Why, that's an odd weapon. I wonder why I picked that one?''' Gabrieli said.

Such studies have shown that different types of memory are compartmentalized in different areas -- and also that the brain has the flexibility to compensate for some deficits.

For instance, Lawrence Weiskrantz of the experimental psychology department at Oxford University has studied a phenomenon he calls ``blindsight.'' Weiskrantz, who coincidentally was working at Hartford Hospital on his thesis when Scoville operated on Henry, worked with subjects who are blind because of damage in their brain. Despite the damage to their visual cortex, they can ``see'' objects. When asked to grab for flashing bars projected onto a screen, the subjects protested they could not see the bars. But, when asked to ``guess,'' they reached toward the flashing bars with great accuracy.

Henry knows nothing of his legacy. Time essentially stopped for him 50 years ago.

His last conscious memories are of the years before 1953, although his image in the mirror and other evidence seem to convince him that time has passed which he can't account for. Asked where he lives, Henry often gives the address of a house where he lived before the operation. Pressed to recall if he had met a visitor before, he might guess he or she was someone he knew in his youth.

``He thinks we went to high school together,'' Corkin said.

Since 1980, Henry has lived in a nursing home, where he likes to do crossword puzzles.

While doctors have treated Henry for a variety of ailments, Corkin said, ``there is no treatment for memory impairment.''

As Kandel said: ``It's hard for us to conceive what he really experiences.''

Waking From A Dream

Henry used to travel three times a year to MIT, where scientists conducted experiments on him. But Henry has become frail enough in recent years that the scientists now come to him, Corkin said.

When Henry is asked whether he is willing to participate in such studies, he invariably agrees, always saying other people may be helped by such knowledge.

Where does that belief come from?

``That's puzzled me, too,'' Gabrieli said.

Henry has no way of knowing that the research of the past 50 years has helped people. And such an idea couldn't be planted in his mind because he lacks the parts of his brain necessary to store and retrieve such a suggestion.

Gabrieli speculates that Henry might be reaching back to one of his last memories, when Scoville or another doctor might have told him that other epileptics could benefit from the lessons learned from his surgery. So, again and again for the past half-century, Henry has agreed to be the subject of experiments, just as he did before surgery robbed him of his memory.

Corkin offers a different explanation: ``I think he was just well brought up.''

Today, Henry is still the subject of experiments, although other amnesiacs with related memory deficits have been discovered and studied. New imaging technologies also have revolutionized the study of memory by allowing scientists to view the brain working in healthy subjects.

Yet Henry's life continues to fascinate.

``Whenever I give a talk about H.M., the questions never stop,'' Corkin said. ``The audience asks questions; people come up and ask me questions afterwards. It happens every time. He is a national treasure.''

As the 50th anniversary of the operation approaches, Dr. James Duffy has come to believe that society, which has learned so much from Henry, owes him something more.

``What is my responsibility as a scientist? Is it to just generate knowledge, or is it something else?'' Duffy asked. ``Henry presents us with questions larger than the mechanics of the memory system. We need to understand what he has become in the absence of memory.

``Why is it that we only ask about his memory,'' Duffy said, ``not about who he has become?''

Corkin cautioned against drawing any universal conclusions from Henry's situation.

``Henry is an `n' of one,'' she said, using a mathematical symbol to stress his singularity. ``It is not clear how his experience can generalize to anyone.''

Every moment, as his past disappears into an abyss, Henry asks his own set of questions.

``Right now, I am wondering if I have done or said anything amiss,'' Henry once told a researcher. ``You see, at this moment everything looks clear to me, but what happened just before, that's what worries me. It's like waking from a dream I just don't remember.''

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