The Lobotomy Of Patient H.M: A Personal Tragedy And Scientific Breakthrough
The story of Henry Molaison is a sad one. Known as Patient H.M. to the medical community, he lost the ability to create memories after he underwent a lobotomy to treat his seizures.
He did earn a place in history, though. His case taught scientists a lot about how the brain creates and stores memories.
"A lot of what we know about how memory work came from more than a half-century of experimentation that was conducted on Patient H.M.," says Luke Dittrich, author of the book Patient H.M. : A Story of Memory, Madness and Family Secrets.
Dittrich, who is also the grandson of William Scoville, the doctor who performed Patient H.M.'s lobotomy, tells NPR's Allison Aubrey that the story is one of both personal tragedy and scientific breakthrough.
"It's hard to argue that it was a good outcome for him. But it's one of those sort of murky cases that you find in the history of medicine, in the history of science, where his tragedy — it was a boon to science," Dittrich says. "We're still learning from him now."
Interview highlights contain web-only extended answers.
On Patient H.M.'s backstory and his contributions to medicine
Before he was Patient H.M., he was a man named Henry Molaison. He grew up in the Hartford area in Connecticut, and his story really begins when he was 8 or 9 years old, in the mid-1930s.
He was walking home from the park late one night, got knocked down by a bicyclist and hit his head. And shortly after that, he began experiencing seizures.
His seizures got worse and worse over the years, until by the time he was 27 years old, he was deeply and almost catastrophically epileptic. He would have these major seizures, sometimes multiple times a day, and it had a terrible impact on sort of all aspects of his life — his social life, his professional life.
His high school principal wouldn't let him walk across the stage during graduation because he worried that Henry would have a seizure and cause a scene. And so in the midst of this terrible and debilitating epilepsy, my grandfather, who was a renowned neurosurgeon, offered Henry's family hope in the form of an experimental brain operation.
He told them that he might be able to take Henry's epilepsy away by removing several mysterious and and deep-seated structures in Henry's brain. And they, in their desperation, said yes.
So my grandfather went in and he removed a significant portions of Henry's hippocampus, amygdala ... and what happened was that although it may have had some effect of alleviating the seizures, the main thing that the surgery did was render Henry completely and profoundly amnesiac.
He lived the rest of his life, a half-century or so, in more or less 30-second increments. You could meet him and have a conversation with him and then walk out of the room and come back in and, you know, introduce yourself to him for the first time all over again.
On his grandfather, the neurosurgeon William Scoville
He died when I was 9 years old, and so I knew him, but I didn't know him very well. But he always loomed large, even when I was a kid, as this sort of charismatic and dashing character. He had this rotating fleet of sports cars. He was a world traveler.
His passion was neurosurgery, and he was this gifted surgeon. He was one of the leading proponents in America of so-called psycho-surgery, which we commonly think of as lobotomy — that is, surgical treatment for mental illness.
One of the things I discovered during the course of researching my book was that his sort of passion for psycho-surgery, for the lobotomy, grew out of a sort of a personal desperation for my grandmother. His wife was herself mentally ill and institutionalized.
On the treatments that his grandmother — and many other mental health patients — endured in asylums
My grandmother was institutionalized at ... the Institute of Living in Hartford Conn., and it was, at the time, a very assertive, upscale asylum. It had an almost country club environment on the surface.
That asylum had its own operating room devoted exclusively to surgery. And then, once you had your surgery, you were put in a special sort of education ward, where the idea was that your personality had been wiped clean and then the doctors could sort of build you up again and create a new personality for you in that ward.
I had to go to dig deep into the records of this one particular asylum that she was institutionalized at to come up with information about all the treatments that she endured back then. ... What she endured was really terrifying.
I mean, to be to be a woman in a mental institution in the 1940s was, in some ways, to be living a horror story. She underwent something called pyretotherapy, for example, which I hadn't even heard of. It's otherwise known as fever therapy, and in the early days of fever therapy, they would they would literally inject you with the malaria parasite in order to induce high fevers, which were supposed to bring about some sort of mental clarity.
But by the time she was institutionalized, they had what they considered to be a more modern version of it, where they would lock you into like a brass coffin and then heat up the inside until you developed a fever of as high as 105 degrees. And they would keep you there for eight hours a day, sometimes for a week straight, and that was thought to have somehow a pacifying effect on patients who were mentally disturbed.
A lot of the treatments of the time, looking back on them, you can't help but be horrified by them.
On the kinds of people who received lobotomies
If you break down the patients by sex, the vast majority were women. It's an open question as to why that was, but one possible answer is that the side effects of the consequences of lobotomy — tractability, passivity, docility — were in some senses viewed by certain men of that era as being almost ideal feminine characteristics.
Anyway, it was a way of changing personality. It was done with the intent of addressing mental illness
Some people operated on people as young as 7 years. They would do it for what we would consider to be almost a normal childlike behavior, to treat juvenile delinquency, hyperactivity, misbehavior. It was definitely extreme, it was definitely irreversible, and it was also used to treat "conditions" that were not conditions at all. People were lobotomized for homosexuality.
On whether or not the patients consented
Notions of informed consent really did not exist in the 1940s. ... So it's safe to say that that a lot of these patients who were submitted to surgical procedures did not consent in any sense of the word that we would I understand now.
Probably the most prolific lobotomist then, Walter Freeman, argued that the more a patient fought against being lobotomized, the more that indicated that that patient should be lobotomized.
On what it was like to research and publish his own family secrets
It was a unique experience and a hard experience in a lot of ways. I have done a lot of investigative journalism in the past. Some of the stories you write are going to cause some level of pain to people, but I'm not used to causing pain to the people closest to me, the people that, you know, I love most of all. I came up with information that ultimately was not only shocking to me but hard to process for my own mother.
I'm having to sort of confront and decide that, well, the story is worth telling, and so I can't keep anything really off-limits. I mean, there's a few things I kept off-limits, but I put a lot in there that certain members of my family probably would wish that I would not.
This is a book that I wrote about memory and how memory works, and one of the one of the strange sort of side effects of working on this book is that it has in some ways I have shifted and change some of my own memories from my childhood.
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