In the movie “Groundhog Day,” the TV weatherman Phil Connors finds himself living the same day again and again. This has its advantages, as he has hundreds of chances to get things right. He can learn to speak French, to sculpt ice, to play jazz piano, and to become the kind of person with whom his beautiful colleague Rita might fall in love. But it’s a torment, too. An awful solitude flows from the fact that he’s the only one in Punxsutawney, Pennsylvania, who knows that something has gone terribly wrong with time. Nobody else seems to have any memory of all the previous iterations of the day. What is a new day for Rita is another of the same for Phil. Their realities are different—what passes between them in Phil’s world leaves no trace in hers—as are their senses of selfhood: Phil knows Rita as she cannot know him, because he knows her day after day after day, while she knows him only today. Time, reality, and identity are each curated by memory, but Phil’s and Rita’s memories work differently. From Phil’s point of view, she, and everyone else in Punxsutawney, is suffering from amnesia.

Amnesia comes in distinct varieties. In “retrograde amnesia,” a movie staple, victims are unable to retrieve some or all of their past knowledge—Who am I? Why does this woman say that she’s my wife?—but they can accumulate memories for everything that they experience after the onset of the condition. In the less cinematically attractive “anterograde amnesia,” memory of the past is more or less intact, but those who suffer from it can’t lay down new memories; every person encountered every day is met for the first time. In extremely unfortunate cases, retrograde and anterograde amnesia can occur in the same individual, who is then said to suffer from “transient global amnesia,” a condition that is, thankfully, temporary. Amnesias vary in their duration, scope, and originating events: brain injury, stroke, tumors, epilepsy, electroconvulsive therapy, and psychological trauma are common causes, while drug and alcohol use, malnutrition, and chemotherapy may play a part.

There isn’t a lot that modern medicine can do for amnesiacs. If cerebral bleeding or clots are involved, these may be treated, and occupational and cognitive therapy can help in some cases. Usually, either the condition goes away or amnesiacs learn to live with it as best they can—unless the notion of learning is itself compromised, along with what it means to have a life. Then, a few select amnesiacs disappear from systems of medical treatment and reappear as star players in neuroscience and cognitive psychology.

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No star ever shone more brightly in these areas than Henry Gustave Molaison, a patient who, for more than half a century, until his death, in 2008, was known only as H.M., and who is now the subject of a book, “Permanent Present Tense” (Basic), by Suzanne Corkin, the neuroscientist most intimately involved in his case. Born in 1926 near Hartford, Connecticut, Molaison enjoyed what seems to have been a normal working-class childhood until, at about the age of ten, he began suffering from epilepsy, possibly as a result of a head injury sustained in a bicycle accident. The seizures grew more severe and, by his mid-teens, he would foam at the mouth and bite his tongue, while his limbs convulsed rhythmically. At high school, the teasing was cruel, and Molaison apparently responded by developing a blandly polite outward manner and becoming withdrawn. He enjoyed listening to Sousa marches and Arthur Godfrey on the radio, delighted in collecting guns and going shooting with his father. In a period when eugenic theories still circulated, Molaison’s doctors reportedly told him that he shouldn’t have sex, since he would likely reproduce children who were similarly damaged.

Graduating from school, Molaison worked for some years at low-level mechanical jobs, but, despite a cocktail of maximum-dose anti-epileptic drugs, he had little in the way of an autonomous working or social life. By the early nineteen-fifties, an eminent local neurosurgeon named William Beecher Scoville worried that the medications might be reaching dangerous levels and began thinking about a more direct way of controlling the seizures. Scoville had previously performed thirty partial lobotomies, but the precise form of the procedure on Molaison’s brain was what the surgeon later called “a frankly experimental operation,” meant to locate and excise the bits thought to be responsible for his seizures. On August 25, 1953, with a cheap jury-rigged hand drill, Scoville carved two holes in Molaison’s skull, one just above each of his eyes. Molaison was given only a local anesthetic, so that he could be awake to report on his sensations when different cerebral areas were stimulated. Scoville lifted up Molaison’s frontal lobes with a spatula and reached far into the center of his brain. Then, using a silver straw, Scoville sucked out fist-size chunks of the medial temporal lobes on both sides of Molaison’s brain. The excised tissue included most of the sea-horse-shaped structure called the hippocampus, as well as the parahippocampal gyrus, the uncus, the anterior temporal cortex, and the almond-shaped amygdala.

The operation relieved the severity and the frequency of Molaison’s seizures, but there was a disastrous side effect. As Scoville and a colleague noted, Molaison could no longer “find his way to the bathroom, and he seemed to recall nothing of the day-to-day events of his hospital life.” Molaison’s testable intelligence remained normal; his basic personality seemed unchanged; and he could remember quite a lot of his past, but he was no longer able to form new memories. He could remember how to get to the house in which his family previously lived, but not to the one to which they moved ten months before the operation was performed. He would use the lawn mower one day and not have a clue where it was the next. He could read the same magazine day after day without showing any sign that he had encountered it before. H.M. had become a stunningly pure case of anterograde amnesia.

Read the full story in the New Yorker.



October 21, 2013