Eksperyment. Opowieść o mrocznej godzinie w dziejach medycyny

by Luke Dittrich, Łukasz Müller (Translator)

Wstrząsająca opowieść o cienkiej granicy między medycznym eksperymentem a zbrodnią.

„Człowiek nie jest z pewnością gorszy jako zwierzę doświadczalne, tylko dlatego że umie mówić”. Paul Bucy, amerykański neurochirurg

Historia tego, jak nauka korzystała z nieetycznych narzędzi, jest długa. Zbrodnia często służyła rozwojowi medycyny, a medycyna czasem pomagała w zbrodni. Przejmująca książka Luke’a Dittricha podejmuje aktualny temat granic, których nauka nie powinna przekraczać, ale nieustannie robi to w imię postępu.

Henry każdego dnia zaczynał życie od nowa. Miał tylko dwadzieścia siedem lat, kiedy odebrano mu pamięć. Poddano go eksperymentalnej terapii, mającej wyleczyć epilepsję. Lekarze wycięli mu część mózgu, w wyniku czego utracił możliwość zapamiętywania i tym samym tożsamość. Przez następne kilkadziesiąt lat był tylko bezwolnym przedmiotem badań. Nawet po śmierci nie zaznał spokoju: sekcja jego mózgu była w 2006 roku transmitowana w sieci, gdzie obejrzało ją ponad 3 miliony widzów. Henry przeszedł do historii jedynie jako „Pacjent H.M.”, nie jako człowiek, a to jemu zawdzięczamy podstawy współczesnej wiedzy o mózgu. Książka Luke’a Dittricha opowiada jego historię i przywraca mu człowieczeństwo.

Bestseller „New York Timesa” uznany za jedną z najlepszych książek roku przez m.in. „The Washington Post”, „New York Post”, „Wired”, NPR, „The Economist”, „New York” i „Kirkus Reviews”.

Genres: Nonfiction, Science, Psychology, History, Medicine, Biography, Medical

496 pages, Hardcover

First published April 7, 2016

About the author

Luke Dittrich is a National Magazine Award–winning journalist, and a contributing editor at Esquire. He is a contributing writer at The New York Times Magazine and a contributing editor at Esquire.

Reviews

[Will Byrnes · Rating 4 out of 5]

On December 5, 2008, the front page of the New York Times included an unusual item: H. M., Whose Loss of Memory Made Him Unforgettable, Dies. It was hardly the first time that an obit piece had appeared on the front page, but it is unlikely that many with quite so little public recognition had ever appeared there. The “H.M.” in question was one Henry Gustave Molaison. He has been the inspiration for many books, at least one play and a major motion picture. Mostly, though, while he had never studied medicine, or practiced in any medical field, Molaison had made a huge contribution to our understanding of the human brain.


Luke Dittrich -From PRHSpeakers.com

Young Henry was seriously concussed in a biking accident when he was a kid. As a teenager he began having grand mal seizures. His symptoms increased and seriously affected his ability to function in the world. Drug treatments had proved unsuccessful. It was a new thing for such a procedure to be done for someone who was not considered mentally ill, but in 1953, when he was 27 years old, Henry was given a lobotomy. From that day on, he would no longer be able to form new memories. He would also be unable to fend for himself. But he was perfectly lucid, and able to have a life, albeit a restricted one. Because of his unusual condition, Henry became the primary neurological test subject of his time. He was examined, interviewed, and studied by untold numbers of researchers until his death. He was the subject of countless professional papers, in which he was always referred to in professional literature by his initials, in order to protect his privacy. Anyone working in the field would know well the initials HM. William Beecher Scoville was the doctor who had performed the risky surgery. He was Luke Dittrich’s grandfather.


Dr William Beecher - from Dittrich’s Esquire article

Patient H.M. is both a medical and personal history, as Dittrich looks at the scientific advances that took place over a 60 year period, the history of his grandfather, and the life of Henry. It is perfectly accessible for the average reader, with a minimum of technical jargon. You will definitely learn some things, like the difference between episodic and semantic memory.

Memory scientists often speak of the important difference between knowing that a certain fact is true and knowing how you came to learn it. For example, here’s a simple question: What’s the capital of France? The answer probably leapt to your mind in an instant. Now, here’s another question: When did you learn that Paris is the capital of France? If you’re like most people, you have no idea. That particular fact twinkles in your mind amid an enormous constellation of other facts, most of them forever disconnected from the moment they first sprang to life. The store of mostly disconnected facts is known as your semantic memory.

Your semantic memory is contrasted with your episodic memory, which is your memory of fleshed-out narratives rather than merely facts. When you engage your episodic memory, you engage in a form of mental time travel, bringing yourself back to a particular place and time, reimagining a scene you’ve already lived. When you engage your semantic memory you are doing the mental equivalent of flipping through an encyclopedia or photo album, plucking out bits of information whose origins might be unclear.

This gives you a taste of how fluidly Dittrich writes of a subject that, in lesser hands, could easily have become dense.

Gramps was not exactly mister nice guy. He had a reputation for fast living and was very successful and ambitious, maybe to the point of excessive risk-taking. The state of mental health understanding and care in the 1950s is fascinating, and the stuff of nightmares. Nurse Ratched would have been right at home. Part of this tale is the fumbling from step to step that took place in trying to understand how the brain works. It makes one very thankful that we have technology today that can look at the brain with non-invasive machines instead of scalpels. It was news, for instance, that there were at least two kinds of memory, as noted above, and that they might reside in different parts of the brain. We learn how Henry came to be afflicted in his special way, how he lived, and how he was treated, both as a human being and a test subject.


Henry as a young man - from The Telegraph

There are significant human rights issues here. Henry was and remained a human being, yet he was regarded by some researchers in a very proprietary way, in one instance being referred to in a legal document as “An MIT research project entitled “The Amnesic Patient H.M.” Not exactly warm and fuzzy. Academic turf-guarding comes in for a look. One researcher, in particular, goes so far as to destroy original data that might have jeopardized her career-long published findings. Access to Henry was guarded as energetically as the formula for real Coke, and not always for the purpose of looking after Henry’s best interests. Dittrich raises ethical issues, noting similarities between what was considered respectable medicine in the 20th century and barbaric behavior of the then recent past in how people had been used as test subjects for medical research.

And there is a particularly existential question that comes into play. If we are our memories, who and what are we if we can no longer make any? And it makes one wonder about new science that may offer us a way to erase traumatic memories, in the vein of the 2004 film Eternal Sunshine of the Spotless Mind.

Dittrich had an in, of course, but sometimes the family connection gets in the way. He tends to wax nostalgic about his grandfather, and wanders off topic for stretches. Some may enjoy these, and they were ok, I guess, but I found myself getting irritated at what seemed an excessive levels of detail, particularly in imagined scenarios. Thankfully, the eye-rolling portions of the book do not detract too much from the rest.


Suzanne Corkin doggedly guarded her access to HM

There are clear similarities to be found between this book and two others that deal with medical history. The obvious comparison is to Rebecca Skloot’s best-seller The Immortal Life of Henrietta Lacks. In that cells that had been taken from a patient, and found to have remarkable qualities, were subsequently used, without permission, to support vast amounts of research. Ethical considerations raised in the book are considerable. But the much less well known Open Wound: The Tragic Obsession of Dr. William Beaumont, by Jason Karlawish, is the book that seems the most directly comparable. In that one, Dr. Beaumont of the title takes advantage of an unusual medical condition to keep a patient available for his research for a prolonged period. It raises similar ethical issues to the ones raised in Patient H.M..

Bottom line is that Luke Dittrich has given us a fascinating look at an obscure figure, bringing to life what medical progress actually looks like, and how much like sausage-making it really can be. He raises some very important ethical concerns not only about how Henry was treated as a person, but how access to Henry was handled, and how the information gleaned by researchers was guarded, and in at least one instance, destroyed. If you are at all interested in the brain and in the history of advances in medical knowledge, and do not take a look at Patient H.M. you should probably have your head examined.

Review Posted – 8/5/16

Publication date - 8/9/16

=============================EXTRA STUFF

More Material From Luke Dittrich
-----All Dittrich’s writings for Esquire, including a piece that takes aim at a neurosurgeon who claims he had gone to heaven.
-----A short version of Henry’s Story
-----Dittrich’s original Esquire article, The Brain that Changed Everyting
-----The Brain That Couldn’t Remember- NY Times Magazine – August 7, 2016

Jacopo Annese, oversaw the slicing of Henry’s brain post-mortem and digitizing of every bit into an image database. His institute created a 3D virtual model of Henry’s brain. Check out his site here.

This video shows HM’s brain being sliced at Dr. Annese’s facility. This process has been applied to many brains. Images of the slices are then digitized, and made available to researchers. Annese’s project has been referred to as the Google Earth of neuroscience. Find out more in this article about the work in ArsTechnica - To digitize a brain, first slice 2,000 times with a very sharp blade by Kate Shaw

If you want to know how one goes about removing a brain from a skull, the following article might prove mind-expanding. Cubed, Ground, Frozen or Marinated? 4 Scientists Talk Brain Dissection Styles by Linda Zeldovich on Braindecoder.com. No. Hannibal, not you.

Obit of Suzanne Corkin

An interesting article on research being done on the brain, noting just how little we really know - Probing Brain’s Depth, Trying to Aid Memory by Benedict Carey – July 9, 2014

A video on mapping the brain

An interesting op-ed on how mental health research resources are distributed - There’s Such a Thing as Too Much Neuroscience - by John Markowitz - October 14, 2016

[Lynn · Rating 2 out of 5]

This is a story about H. M., the world's most famous neuroscience case study. Henry had debilitating epilepsy. In his 20s he had a medial temporal lobectomy to reduce his symptoms. The surgery was a success but H. M., was left with catastrophic amnesia. H. M. could meet you ten different times and never remember the interlude. Henry was studied for decades and the data he produced would revolutionize our understanding of memory. Interestingly, the grandson of the man who did the psychosurgery wrote this book.

The book had tons of interesting information but on the whole it was disjointed, repetitive, and often lost its own train of thought. My diagnosis is that the author could not decide what the book was about: himself, his ancestor, H. M., or neuroscience as a whole, I was hoping this was a good book to assign to my students but alas it is not.

[Carol]

Curiosity.

Patient H.M. may in fact be the most famous amnesia patient in history but frankly I knew nothing about him. After reading a few reviews regarding the book of same name, I became curious to know more, not only due to the nature of Patient H.M.’s illness but also because much of the story takes place in institutions in Connecticut that I have visited and have familiarity. I was also curious about H.M himself, and what motivated the author, the grandson of Dr. William Scoville, a noted psychosurgeon who performed some of the first controversial lobotomies in the world, to write this book. It seemed to me a risk for the author, Luke Dittrich, a journalist, to open this can of worms. Not only does the word lobotomy strike a chord in the medical science world but to delve into and then print the best and worst of your family’s history seems to hit so close to the heart.

As is often the case a seemingly minor event can change a person’s life. In the case of Patient H.M., once known as Henry Molaison, a seven or eight year old boy, a fall, while walking home on July 3, either in 1933 or 1934, changed his life forever. No one quite knew what exactly happened but a bicyclist, coasting down the hill in Colt Park, didn’t see Henry and hit him causing Henry to fall suffering a bang to his head. Dittrich orchestrates the opening chapters with expertise, grabbing our attention, as he takes us into Henry’s skull and describes the trauma of this fall to Henry’s brain. As with many accidents of this nature all seems well for a time until the seizures begin. It is not possible to prove that Henry’s epilepsy is caused by the fall but many believe it was. So how does Henry Molaison lose his identity and become Patient H.M.? How does a boy suffering epileptic seizures become an experimental patient of lobotomy?

To get to this answer we take a labyrinth of a route.

If the story Dittrich tells were only in relation to his grandfather, Dr. William Beecher Scoville and his most famous patient, it might a little easier to follow and not the complicated multi-layered outing it becomes. But Dittrich had many questions and a great deal to explore to come to answers, if not only for himself but for his family and his readers. There were times when my head spun.

Sidetracking a bit, as the book does, I was very interested in the structure of the first asylums in Connecticut. Dittrich goes into great detail about The Hartford Retreat for the Insane. One of the in depth sidebars that Dittrich researches is the treatment of his grandmother who suffers from some mental state, never quite given a name. It is this asylum, one hundred years after it’s beginning, renamed, where his grandfather brings his wife. At first it seems a welcoming place.

” Its first superintendent, in a report stated “It aspired to be “the reverse of everything which usually enters into our conceptions of a madhouse.” Instead of just being a sort of jail where “the unfortunate maniacs are confined, “ his asylum would be dedicated to the “moral management” of the inmates.

”it was beautiful, that much remained the same” but it was not the same place/ The Institute of Living. The name and the game were new. On the surface it seemed lovely,

”When my grandmother flipped through the pages of The Chatterbox, she would have found pictures of a place that looked more like a country club than anything else. There was an outdoor swimming pool, a small putting green next to the Golf House, a volleyball court, even an indoor ten-pin bowling alley. She’d see advertisements for some of the goods available at Vauxhall Rox, the asylum’s own shopping mall: She could buy artisanal Ajell candles and Easter greeting card at the Here-It-Is shop, purchase a variety of different corsages—starting a at ninety cents apiece—at the Vauxhall Row Flower Shop, or browse a selection of newly arrived bestsellers at Ye Roayle Booke. She would find photographs of the guest-created handicrafts on display at “our little arts and crafts salon in Center Building,” a collection of “avocational shops”—Ye Glaziery, Ye Silver Smith, Ye Bindery, and Costume à la Main----known collectively as Pomander Walk.”

Yet the creed of the institution was to keep your troubles to yourself and only discuss your mental state with the doctors and nurses, in an effort to maintain a normal appearance. Dittrich’s grandmother on the first evening became a problem patient, removing her clothes, pounding on her locked door and ranting in a loud voice. She was taken to another building, South One, which like a scary movie about asylums, contained five large tubs. One was waiting for his grandmother. Filled with cold water, she was stripped, her body coated with oil, then forcefully placed in the tub, where a large sheet of heavy fabric was strapped over the tub, only her head visible, for hypothermia therapy. She could have remained here for a few hours or many days.

This is the woman that grew up in Manchester, CT in a privileged upbringing. Her family owned The Cheney Brothers Silk Manufacturing Company that once was the largest producer of silk outside of China. Women rarely had much to do with the business and by the time his grandmother met Bill Scoville, the mills were in decline.

Dittrich is never able to determine whether his grandmother had a lobotomy under the hands of her husband. She eventually divorces the doctor, moves to NY and starts over.

By page 102 we are at last in attendance at Dr. Scoville’s first lobotomy. In 1946 Dr. Scoville arrives at Connecticut State Hospital – similar in appearance to his wife’s asylum. Dittrich states

”Both made good first impressions, and although the grounds of the asylum in Middletown weren’t designed by Frederick Law Olmsted, they too were beautiful.” I would agree as I lived near this hospital as a young girl and used to play on its grounds. It was here that a vote was taken, and passed, and the Connecticut Cooperative Lobotomy Study was born. The next day, the Hartford Courant heralded the event, declaring, “Connecticut thus becomes the first state to undertake a scientific, controlled study and practice of the brain operation know as prefrontal lobotomy.”

Again, why does Henry have a lobotomy if he is not mentally ill?
We do find out but it takes until pgs. 208-216 to get to the description of Henry Molaison’s lobotomy beginning with consultation with his parents, and eventual permission of Henry and his parents to have the operation. “The surgery was scheduled for August 25, 1953.” In testing before the lobotomy Henry’s IQ score was 104, surprisingly lower than after his surgery. Though Henry was experiencing severe seizures, which were greatly interfering with his life, no one, knew what the outcome of this elimination of the matter in the temporal lobes would cause. He retained some of his mental competency but lost much of his memory, particularly short-term. Six weeks after the operation Dr. Scoville sent off a paper to the Journal of Neurosurgery. Partially it stated:

”resulted in no marked physiologic or behavioral changes, with the one exception, a very grave, recent memory loss, so severe as to prevent the patient from remembering the locations of the rooms in which he lives, the names of his close associates, or even the way to toilet or urinal.”.

Dittrich sums this up with these words:
“It was the birth announcement of Patient H.M.
It was the obituary of Henry Molaison.”

Patient H.M. and his brain were studied over sixty years and even after his death in 2008, his brain was harvested and became a pawn in a bitter legal battle over its ownership. Sad.

At book’s end I felt drained, sad and forlorn for Henry Molasion and those like him, the experiments of medicine and what in the end is gained. I question this.

Where are we today in the treatment of the mentally ill? Lobotomy and shock treatment are out of favor, yet not totally non-existent. Has therapy and medication truly “cured” anyone? Certainly we have come along way from an ancient Egyptian physician who chanted these words over his patient at the beginning of treatment:

“Repelled is the enemy that is in the wound / Cast out the evil that is in the blood/ The adversary of Horus, on every side of the mouth of Isis/ This temple does not fall down / There is no enemy of the vessel therein / I am the protection the Isis / My rescue is the son of Osiris!”

The Hippocratic Oath cautions ”abstain from doing harm” and yet I continue to wonder just what good have we done for our mentally ill? Or for the boy hit by a bicyclist who fell?

You could say Henry’s fall sealed his fate. His brain was already broken but the question remains, was more harm done by the intentional operation, which left Henry as the amnesiac Patient H.M? Was the contribution of the understanding of the brain worth what Henry Molaison lost?

[Joy · Rating 5 out of 5]

I was on my predoctoral internship when H.M. died, and I remember watching the brain cutting as it streamed live over the internet. H.M. was one of the first case studies I learned about in graduate school, and I use him frequently in my own teaching to illustrate basic neuroscience concepts. In my mind, he is a legend, almost mythical in status. Dittrich's book provides another layer to the story of H.M. and the many neuroscientists and neurosurgeons that worked with him. H.M.'s is not the only life chronicled in this fascinating book. We also learn about the work of Dittrich's grandfather - Bill Scoville - who performed H.M.'s surgery but who also served as a controversial figure in the realm of psychosurgery (e.g. lobotomies, etc. used to treat mental illness) and Suzanne Corkin - the MIT professor who spent decades studying H.M. Sadly, Dr. Corkin died as I was reading the book that merely touched on her life's work.

While I went into my reading knowing neuroanatomy and the basics of H.M.'s case, Dittrich's book provided such rich details that I felt I was learning anew. My only criticism is that the narrative does jump around, jarringly at times, and it is obvious that the author's knowledge of neuropsychology is occasionally lacking. Otherwise, a wonderful read. I'm even considering making it required reading for my undergraduate neuropsychology class!

[Britta Böhler · Rating 5 out of 5]

Absolutely fantastic read. If you are interested in the story of modern brain/memory research, this book is a must-read.
Excellent (the research, the writing), riveting (the story), heartbreaking (H.M. and all the other patients mentioned, including the author's grandmother), sickening (most of the doctors and researchers mentioned).

[DeB · Rating 4 out of 5]

"Lobotomy." This psycho- surgical term is one which has returned to the public's consciousness very recently, with a spotlight on the famous Kennedy family. A book, newspaper accounts, magazine features such as the one in People's Weekly described Rosemary Kennedy and her perceived unmanageable "flaw" which led the parents to lobotomy. This has reignited interest in a procedure that was controversial in its merits when practiced through the 1930’s to the 1970’s; the opportunity to learn more is now here with the newly published "Patient H.M." by Luke Dittrich.

Henry Gustave Molaison, born in 1926, was never a member of any famous family. He was the only son of poor hardworking parents and at fourteen had a run-in with a vehicle with his bicycle. The accident left him with head injuries that caused epileptic seizures, where he blanked out for minutes or severely convulsed frequently every day. In 1953, he became the patient of author Luke Dittrich's grandfather, Dr. Bill Beecher Scofield who was a ground- breaking neurosurgeon using experimental techniques on his patients. In an effort to alleviate the then untreatable symptoms of many mental illnesses, Scofield expanded the brain research of those prior, created his own surgical tools, drilled into the skulls and removed parts of the brain theoretically linked to volatility, psychoses and disrupted mood.

Henry was a unique case because he was "normal", aside from the seizures. Very little was known about how the brain functioned, aside from wounded soldiers who returned with diminished function but no certainty where in the brain the damage lay. If other functions were affected by Henry's surgery, it was theorized, that his "normal" brain could lead to the physical location of their purpose. Even though he was unable to locate a focal area, which could be found through technology, Dr. Scofield went ahead with the surgery. The seizures did not stop.

In 1953 Patient H.M. was "born". The surgery had grossly impaired Henry's memory, classifying him as amnesiac. Patient H.M. was the most highly studied medical case ever recorded. No one knew his identity. The concepts of memory and its the variations became a new field of study created by the research done on Patient H.M. The biographical contents about H.M. are prolific with summaries of extensive research, the findings which then generated more intensive probing into other areas, accounts of experiments and data done by former scientists somehow linked and the ongoing exploration with lobotomy by Dr. Bill Scofield and other neurosurgeons like him.

Author Dittrich alluded to a "darkness" in his own family history, early in this medical history and a certain grimness shadows much of the writing, with reason. He writes about his single-minded surgeon grandfather logically and carefully, yet tinges of disrespect for the man's narcissistic thought process concerning the mentally ill patients so casually used in his lobotomy surgeries show that Dittrich is conflicted about his famous relative. His mother remembers her father fondly, the bedtime storyteller and family man on wonderful vacations.

The ugly side of medical research, on living things - the chimpanzees with partial brains, the little monkeys operated on time and again, the memory tasks shaped, then more bits of brain dug out - saddened even as they illuminated. Scofield's surgeries graphically recalled with bone dust flying and brain tissue suctioned left me squeamish as the author detailed the now-understood brain functions that had been so cavalierly removed - just to see how the patient would recover. Underlying everything was the knowledge that his very dear grandmother had been institutionalized a number of times and subjected to the brutal hyperthermic, hypothermic and violent electric shock treatments of the era for psychosis, eventually a muted version of herself returned to her family. And more...the darkness of loss...

A few drawbacks- there were times that I found myself skimming through the many, many of Patient H. M.'s recorded conversations, which changed little from their first presentation. The administrative politics by possessive university researchers around H.M.'s data are diplomatically reported, but overlong in relation to the important substance of this story. Just a note, not a negative- The quantity of scientific information is substantial; you must have some interest in this area to appreciate it.

"Patient H.M" is a serious, accomplished history of the zealous doctor who believed that his refined brain corrective surgery technique- the Lobotomy- would bring emotional peace to his era's deeply disturbed mentally ill patients. It is an unflinching record of the man, Patient H.M. and the amnesia created by that surgery, his personal loss and the unprecedented human test case which was his life for nearly six decades. It is a reflection on medical ethics, compassion and in author Luke Dittrich's case, a weighty personal legacy that he has shared intimately.

I received this book as an ARC from NetGalley for an honest opinion. Think you to Random House Publishers and author Luke Dittrich as well.

[Quo · Rating 4 out of 5]

"Have you been here before?" These words are a kind of elegy that end Patient H.M.: A Story of Memory, Madness & Family Secrets by Luke Dittrich, a most remarkable tale that represents a search that is at times clinical, anatomical and genealogical, an investigation into the nature of memory but also the life of the author's grandfather, Dr. William Beecher Scoville and his most famous patient, Henry Molaison.


The book examines the nature of various attempts to deal with mental illness through lobotomy, labelled "Psychosurgery" by those who specialized in it, chief among them being Dr. Scoville, an accomplished surgeon with credentials from Yale, the Univ. of Pennsylvania Medical School, Bellevue & Johns Hopkins. However, there were other medical practitioners who lacked any background in surgery but who also practiced lobotomy without much insight into what the end result might be for the patient.

Patient H.M. is best viewed as a mystery story and not merely an extended case study of mental illness with lobotomy as an attempted cure. The author initially searches for details about his grandmother, Lisa Scoville Dittrich, the wife of Dr. Scoville and oddly enough also treated for behavior viewed as abnormal by Wm. Scoville after being incarcerated at an asylum called "The Institute for Living".


Luke Dittrich's pathway involves a series of personal excavations that include his grandparents but also distinguished researchers at McGill & MIT who studied the after-effects of lobotomy, particularly the one performed on Henry Molaison, whose life was altered when struck on his bicycle and who was prone to epileptic seizures. It is this case that takes precedence over all others in this book because H.M. was not suffering from mental illness when the lobotomy was performed by Dr. Scoville.

One of the odd coincidences is that Scoville himself lost a brother who died after a bike accident. Another is that the author's grandmother Lisa (Dr. Scoville's wife) & a close friend named Suzanne Corkin who becomes the primary researcher at MIT on the impact of the lobotomy on H.M., went to the same private high school in West Hartford & they attended Smith College together.

Patient H.M. gradually becomes an exploration into the nature of memory and it is this that fascinated me as various clues unfold about Luke Dittrich's family connections and the work of Dr. Scoville & others. A colleague and non-surgeon, Dr. Walter Freeman, conducts "trans-orbital" lobotomies inserting an ice pick just below the eye in another attempt to deal with mental illness. At that time, it seemed accepted by Freeman & others that any psychiatrist could perform a lobotomy, even without any surgical training.

At one point, the author asks: "Were the men in charge of asylums as mad as the inmates?" His conclusion is that so long after the lobotomies, one can't put ghosts on the couch or the witness stand, as the main lobotomy practitioners have long since passed away, at the time when Luke Dittrich is conducting his "postmortem" into the long-term impact of lobotomy, once considered a possible cure for homosexuality as well.

It was not that long ago that the procedure was seen by some as a panacea but our comprehension of the many sub-regions of the brain and their interrelation with memory and other aspects of life was at a rather primitive early stage at that point. The unfolding scientific research that ultimately caused a much fuller understanding into H.M.'s post-lobotomy amnesia causes Dittrich's book to resemble a detective story.

In reading Patient H.M, I was reminded of some of the neurological case studies done by the late Dr. Oliver Sachs but it also prompted me to recall an excellent documentary film, My Architect where the film's director, Nathaniel Kahn, pieces together a string of details that help him to better understand who his father, distinguished architect Louis Kahn, really was. (During the architect's lifetime, Nathaniel was kept in the shadows because his father had a primary, recognized family, while he was the child of Louis Kahn's mistress.)

I suspect that in reading a few of the reviews, some readers became impatient with Patient H.M.. However, if one regards the book as a mystery story about the frontiers of memory, the linkage between brain & behavior, as well as the unraveling of clues about Luke Dittrich's colorful family, it seems easier to remain focused with a tale that ends up being quite non-linear. After all, with a mystery story, one doesn't require that the solution be revealed early on, long before the clues have been assembled.



Here is just one of the aspects of Patient H.M. that I found compelling:

Prior to 1950, memory was not associated with a particular structure of the brain but was thought to be distributed equally or "equipotentially" across the cerebral landscape. According to this early view, attempting to locate the seat of memory was the neurological equivalent of a snipe hunt: it simply did not exist. Eventually, it was discovered not only that this was a false conclusion but that whenever a normal person is paying conscious attention to something, he is simultaneously recording it in the temporal cortex of each hemisphere. Every conscious aspect of the experience seems to be included in these records.

It was as Wilder Penfield would later describe it, as though there were a "tape recorder" in the brain, activated at the moment of birth & stopping only at death. Each event in a person's life is stored away as a distinct "nuerone pathway." Even later events that people might later have no ability to recall of their own volition, the ephemera of everyday life, were all carefully preserved. It would appear, Penfield said, that the memory record continues intact even after the subject's ability to recall it disappears.

Much of the book is of course about post-lobotomy Henry Molaison, on whom the operation was performed by Dr. Scoville, not to deal with mental illness but as an experiment to treat his epilepsy, making him just by chance, a "pure subject". There are some who treat H.M. almost as a commodity but Brenda Milner, educated at the University of Cambridge & working at McGill University in Montreal, is easily the heroine of this tale, someone who while conducting meticulous research on Henry, always treated him as a person rather than merely as a "subject". It is said that the most compelling moments were those when Henry, "the most studied human research subject in history" would attempt to explain what it was like to be him.

Some aspects of the study appear ghoulish at times, such as when there is a legal fight over the access to dissected images of Henry's brain after he dies, causing the author to comment: "My grandfather had cut a hole in Henry's memory & now one of the many people who had profited from that was cutting another hole, this one in our memory of Henry."

But there are also wonderful touches such as when the author examines some of the personal debris left behind in a box by his grandfather, Dr. Wm. Scoville, including a pair of specialized glasses he used when performing lobotomies, concluding that the spectacles were symptomatic of a special myopia that may have been analogous with the surgeon's worldview or his perspective with regard to patients, H.M. & his own wife among them.

The ending is eloquent & almost resembles a dialogue in a Harold Pinter play at times, when an esteemed scientist named Dr. Karl Pribram comes to visit Henry Molaison. Pribram is 92, weakened by chemotherapy for cancer & suffering from memory loss himself. At a point during the visit Karl Pribram & Henry Molaison are left alone & Pribram reflects:

And I was left with H.M. And I remember vividly. What happened was. Something like. Whatever was going on. Someone was called out of the room. Came back in. And H.M. said, "Have you been in here before?"

There are some aspects of Patient H.M. that could have used additional support. Among them, I think a brief diagram of the brain regions would have been enormously helpful, as would a glossary of some of the many anatomical terms that the author tosses about within the book. However, while this book is probably not of interest to everyone, I found it quite enthralling, in spite of the listed minor misgivings.

*Within my review are photos of the author, Luke Dittrich, Dr. Wm. Beecher Scoville & lastly the image of H.M's brain as compared with a normally functioning brain.

[Lauren · Rating 5 out of 5]

This book is much more than the title suggests. Yes, a biography of Henry Molaison "Patient H.M.", the most studied brain in documented history, but also a history of neuroscience and neurosurgery in the mid-twentieth century, a personal family history of the author, a psychiatric case study of amnesia, and finally a bitter legal/ professional feud that cost careers and reputations. Luke Dittrich is a journalist, but he is also the grandson of William Scoville, one of the preeminent neurosurgeons of the 20th century. Scoville performed hundreds of lobotomies on patients, including one on a severely epileptic young man, Henry.

Patient H.M. is the theme in this book, but he comes in an out of focus. Introduced early on, Dittrich then veers into his own family's history, his grandmother's schizophrenia and institutionalizations, his grandfather's development of surgical tools, and his practice of lobotomizing patients. I was critical of this family section at first, thinking we would get this personal veneer. However, Dittrich does not deify his larger than life family member. While realizing his skill and immense knowledge, he also portrays Scoville as brash, sometimes reckless, and even shares some of the accidents that happened on his operating table.

The book again shifts course, delving into a medical and scientific history, referring back to Patient H.M. and Scoville throughout. We learn about the developments in this burgeoning field of neuroscience and mental health, and the things that lead to what we now know about the brain - including the atrocities of medical experimentation on living subjects, vivisections, and all sorts of other procedures through history performed on slaves, the disabled in mind and body, and people in various detainment camps. This is a hard section to read, but one that can't be ignored.

Dittrich turns back to Patient H.M., now a middle-aged man living with debilitating amnesia due to Scoville's procedure on his brain. He is the most studied patient case at Massachusetts Institute of Technology. Here Dittrich looks at the unique case of consent, and what that means with a patient with amnesia, and the loose ethics of the researchers who claimed to have Henry Molaison's best intentions in mind.

Molaison died in 2008 at the age of 82. Dittrich writes about his life with empathy and curiosity, imagining what an intelligent man (who scored high in IQ tests) lived with everyday, with this profound amnesia. Along with some of the descriptions of the medical atrocities, this was a very unsettling chapter. There were gross professional and scientific ethics violations on the part of several researchers after his death. Dittrich doesn't gloss over this fact, and it is upsetting to read, especially realizing that Molaison was taken advantage of in this way. This controversy continued through 2016 between Dittrich and Suzanne Corkin, the neuroscientist who had worked with Molaison for 40 years.

This is a book that I will think about for a long time. So much of what we know about how the brain works - specifically how memories are formed and recalled - are thanks to Henry Molaison.

[Sandra Deaconu · Rating 4 out of 5]

3,5 steluțe. ,,Pacientul H.M.'' a fost un pretext folosit de Luke Dittrich pentru a ne vorbi despre mult mai multe lucruri: despre cum a început ,,prietenia" dintre neurochirurgie, neurologie și psihologie, despre progresul lent, dar revoluționar, în descoperirea funcțiilor creierului, despre ambițiile cercetătorilor și cum aceștia au distrus iremediabil vieți de dragul științei. Din când în când, s-a oprit și să vorbească despre familia lui, dar nu prea des și am apreciat asta.

A fost o lectură care mi-a plăcut destul de mult, dar mi-a consumat o grămadă de răbdare, din cauza scriiturii dezorganizate. Începea un subiect, apoi spunea că, pentru a-l înțelege, trebuie să mergem în anul x. Mă ducea acolo, apoi uita să mă aducă înapoi. A fost ca un soi de anacolut lung de 400 și ceva de pagini. Dar am învățat multe lucruri noi, așa că nu sunt prea supărată pe autor, deși talentul lui ca jurnalist de investigații îl depășește pe cel de scriitor de mare anvergură. Recenzia aici: https://bit.ly/3p8U4Il.


,,[...] «atunci când dezorientarea apare pe masa de operații suntem mulțumiți că s-a făcut o intervenție eficientă. Dacă pacientul este încă alert, orientat și reacționează adecvat, procedura obișnuită este să extindem incizia în cadranele superioare și inferioare, de teamă ca nu cumva să fie insuficientă eliberarea obținută prin operație.» În general, el (Freeman) adera la o strategie simplă: «Desigur, cea mai bună metodă este pur și simplu să tăiați până când pacientul devine confuz».
Totuși, dificultatea consta în a tăia suficient de mult din creierul pacientului pentru a provoca o stare de confuzie, dar nu atât de mult încât acesta să moară sau să rămână permanent nefuncțional. În cazul operațiilor de succes, pacienții deveneau imediat dezorientați, poate sufereau și de incontinență, dar apoi, după câteva săptămâni sau luni, deveneau din nou lucizi într-o anumită măsură, recunoscându-i pe cei din jurul lor și amintindu-și trecutul anterior operației. Totuși, nu mai erau la fel. Până la urmă, asta și era ideea. Să facă din câteva mișcări de lamă ceea ce nu reușeau să facă ani de zile petrecuți pe canapeaua unui analist sau în celula unui ospiciu.'' 

[Jeanette · Rating 3 out of 5]

Interesting and full of historical progression to the study and surgery of the brain during the last century USA. How in and out of institutional care or hospital settings, the occasion and purpose of the surgical interventions to mental health or emotive issues lead to mapping for function brain knowledge.

All of this is in minutia detail to place, time frame, historical precedents too, in most cases. It is not an easy read book, and takes tangents barely related, or clearly off subject through the familial Dittrich ancestor history. Again and again.

The way it is told is never linear. Quite beyond that, it circumvents the globe to most groupings to subject in particular, or continuity.

This is immersed within the author's Grandfather's life story. Dr. Scoville of lobotomy fame. The same.

H.M. is the patient of more than 50 year amnesic testing who featured so strongly within the territories of his particular deficits after his Scoville surgery. His case is legend and his answers after surgery pushed the study of MEMORY in humans.

It's instructive. Some of the various histories are horrific. And former "ethics" of other ages as quoted and recorded, hard to equate within the "eyes" of this current time's medical morals and legal perimeters.

The life history of his Grandmother, and her many and different institutional stays, and various therapeutic "cures" was enthralling. It was memorable to think all of that occurred less than 100 years ago. And most less than 50 years ago.

But on the whole, the quality for the tracts of direction for the wider scientific information (re H.M's life and others) was obscured by the writing style, organizational pattern, and opinions (almost all anecdotal and not clinical count supported) by the author. Still, I'm glad that I read it.

None of it surprised me at all. Surgeons are still treading on unknown ground for 100's of reasons and are often entirely less honest than Dr. Scoville about the mistakes, on top of it. But I don't think they venture quite so often, and not for these levels of wider reasons deemed acceptable as "surgeon's choice" then.

It seems epilepsy, OCD, any obstructive to normal behaviors condition as deemed objectionable, was reason to incur this kind of drastic lottery for a "change". It seems some post-voids were actually "happier". There was a scale of zero to 4 for interpretations of change to "better" afterwards. In most cases, but not all, "better" equates to "passive". The definitions have changed, as well.

H.M. experienced life outside of any mainstream or individual "choices" before his surgery because of his medical condition. Yet, it is a rationalization if he was better or happier afterwards. Regardless, his case for decades, did illuminate and display what occurs when entire brain locations are siphoned away.

[Angus McKeogh · Rating 5 out of 5]

This was an ARC from NetGalley.com. Phenomenal read. As a scientist and secondary to the supposed fame of the main character of the book, I was mildly surprised to find out I'd never heard of him. So the story overall was fascinating. The author's personal connection to the story was gripping. And ultimately the book finished on a whole side piece which revolved around scientific research, intrigue, and ethics that was extremely engaging. There were definitely some devious characters who dealt with the research on this individual. Really calls into question their results. Overall, I imagine it sheds doubt on tons of research that was performed on this man. And if it doesn't...it should. Great read.

[Tanya · Rating 2 out of 5]

While this book had interesting information about the history of lobotomy and mental health treatment over the past 150 years, it jumped around quite a bit and felt a bit jumbled. The attempts to weave together Henry M.'s story and the history of the surgeon who performed his lobotomy was not entirely successful. There were too many other patients and other surgeons muddled the story and made it hard to follow.

(Thank you to NetGalley and Random House for a copy of this book in exchange for an honest review.)

[Jenni Ogden · Rating 4 out of 5]

Luke Dittrich, the author, and a prize-winning journalist, has written a fascinating, well-researched, and brave book about patient H.M. and Dittrich’s own grandfather, William Beecher Scoville, the neurosurgeon who performed the bilateral hippocampectomy that resulted in H.M’s dramatic and global amnesia, and precipitated him into his future as the most famous and studied medical case of all time. Of course, H.M. was never aware of his fame, although his comments sometimes hinted that he had a fleeting knowledge of his role as a experimental participant in thousands of memory experiments, mostly carried out at MIT in Cambridge, Boston. Dittrich delves into the ethics of psychological research (and indeed the much more controversial ‘experimental’ neurosurgical procedure performed by his grandfather), as well as the historic memory findings of the small number of researchers allowed access to H.M. The neurosurgical procedure, even viewed through a historical lens, was probably unethical, but the 50 + years of research following the discovery of H.M.’s amnesia, was not. Consent , as far as this was possible given H.M.’s amnesia, was sought, as were psychiatrist’s assessments of H.M.’s willingness to participate. Basically, once H.M. became amnesic, if he had not become an experimental participant he would probably have had a much more terrible life, forgotten and possibly neglected or abused in a back ward of a nursing home or a psychiatric institution somewhere. As Dittrich implies, he could have been treated more generously by MIT, especially in terms of money for his everyday needs, but anyone who knew H.M. would realise that perhaps his everyday needs were catered for in spite of these being very modest. For a man with no memory it is difficult to conceive of what else to supply to improve his existence. Again, for those who knew him, he did seem, almost always, in the moment, content. The occasional displays of brief annoyance are somewhat over-emphasised, and in the short but intense periods I worked with him, I certainly never saw one. It is hard to be angry when one can’t remember what one is being angry about.

Would a patient like H.M. be treated differently today? I suspect not, except in the sense of a more careful and thoughtful consideration of who should make decisions regarding his treatment, both as an experimental participant and regarding his medical treatment. There is no evidence that he had anything other than the best medical treatment in any case, but perhaps these decisions today would be overseen by an independent ethical committee, rather than the scientists and medical practitioners associated with MIT and one good friend of the family who became his trustee. From the testimony of many patients who are unambiguously able to give fully informed consent to participating in all manner of experiments, medical or psychological, knowing full well that the results will not benefit them, they willingly participate because they hope the experiment will benefit others, and often it also prevents boredom, or at least takes their minds off their own problems for a while. There is every reason to believe this is how H.M. felt as well, if only in the moment each time he was asked. This is certainly something he expressed. In today’s world there would of course be a much more formal and probably repeated written consent process to go through, but in the 1950s and 60s, informed consent was very much up to individual researchers, and medical ethics and patient rights not well understood. In H.M.’s case, one might even speculate that for someone else, or some trust, to have made a decision on his behalf that he should NOT contribute in this way could also have been seen as unethical. And of course, participants in these experiments tend to get the very best medical care, simply because they are part of a carefully controlled and well-funded study.

So the tragedy of H.M. was that he had intractible epilepsy, and that he was a guinea pig in a neurosurgical procedure that should never have been conducted, even given the knowledge at the time. Removing both hippocampi rather than just one (as is done today) is a neurosurgical decision difficult to comprehend, and suggests that Scoville was treating H.M. in a way that was unethical and disrespectful. The triumph of H.M. was the research that occurred later; its immense importance to neurosciences and thousands of patients since at the very least made the terrible sacrifice of his memory and independence less horrifying. This is how I believe the H.M. I knew would want to be remembered, not as a victim of a cowboy neurosurgeon. To give Scoville his due, he did campaign widely after he realised what damage his surgery had done, to ensure that this operation would never be done again.

The protection of H.M. throughout his research life is given considerable space in the book, and probably to the reader this protection seems extreme, and more for the benefit of the scientists than H.M. However, it is always considered ethical to ensure that experimental participants remain anonymous (and if they do not, they must give fully informed consent to this). So H.M. had to be protected during his life. It is amazing that, in spite of his many caregivers and 100 researchers knowing who he was and where he lived, no-one, including Dittrich, who tried very hard to track him down, ever found him! Professor Suzanne Corkin should be commended rather than blamed for this incredible feat. As H.M.’s importance to neuroscience grew, so did the likelihood that he would be exploited and tested constantly (rather than two or three periods of a few weeks each year on his visits to MIT) if his identity had been known and his access to researchers poorly monitored.

The final chapter in the H.M. story, at least as told in this book, concerns the acrimonious disagreements about the “ownership” of his brain following the sectioning of it. It is a story I hadn’t heard before, and it certainly raises questions about the ethics of science. However, Dittrich’s book presents only one side in detail, that of the outstanding neuroanatomist who sectioned the brain. It wasn’t for lack of effort on Dittrich’s part; he persistently tried to also hear and report the side of the scientists and administrators at MIT and MGH. But scientists and universities are wary of journalists, and protecting their own policies, and this is not especially surprising. Of course this is a brain that was given by H.M. (or his ‘trustee’ —whether or not we think this trustee was properly selected for the job and had H.M.’s best interests at heart) to science, and where it resides, or whether it is scattered between different institutions and for whose benefit, is a difficult issue. It perhaps will never be an issue the public will be able to debate as it has been kept close to the universities involved. Let us hope that this squabble between scientists does not detract from the amazing science they have all done, and future discoveries that continue to rely on the thousands of peer-reviewed scientific articles already published about H.M’s working brain, and the new findings still hidden in that hard-working sectioned and only partly studied dead brain. Only in that way can H.M.’s incredible and willing contribution (if his own comments can be believed) be maximised and H.M.'s sacrifice be respected.

Thank you to Netgalley and the publisher for providing me an advanced reader copy of this elegantly written book.

[Rafal · Rating 4 out of 5]

Znakomita książka.
To pozycja popularno-naukowa, ale napisana z temperamentem powieściowym. Lekko sensacyjnym.
Tematem jest słynny (podobno) pacjent H.M. Czyli człowiek, który padł ofiarą lobotomii, której skutkiem była amnezja. W czasie operacji doznał uszkodzenia mózgu, którego skutkiem było to, że był w stanie zapamiętać niemal wyłącznie to, nad czym się w danym momencie skupiał.
Książka - choć popularno-naukowa - ma wiele bardzo wciągających zwrotów akcji. A to dlatego, że jest w niej wiele niuansów. Nie będę o nich pisał, bo to byłyby spoilery, ale ważne są relacje autora z chirurgiem, który wykonał wspomnianą wyżej lobotomię, ważne są historie rodzinne i ujawniane tajemnice. Ważna jest historia tytułowego bohatera oraz dzieje jego i jego mózgu. Warto przeczytać tę książkę. Podobno badania pacjenta H.M. były kamieniem milowym w tworzeniu wiedzy o ludzkiej pamięci. Warto się dowiedzieć, jakim kosztem tę wiedzę zdobywano. Niewątpliwie pojęcie etyki w nauce, jest jednym z najważniejszych tematów tej książki.

[Mircea Petcu · Rating 5 out of 5]

Am vazut acum cativa ani pe youtube documentarul "The Man With The Seven Second Memory".
Afectiunea este similara, dar nu si povestea. Cazul lui Henry Molaison este mult mai interesant si mai trist, In plus, exista o legatura intre familia autorului si Henry, acele "secrete de familie" din subtitlu.

[Marjorie · Rating 4 out of 5]

This is a non-fiction book about Patient H.M., whose name was Henry Molaison. It’s a tragic story of a man used as a human guinea pig for decades. He was only 27 years old when he received a radical new lobectomy to cure him of epilepsy, which left him with short-term amnesia. He then became a live research study for the rest of his life, until his death at age 82. Interestingly, the author of this book is the grandson of William Beecher Scoville, the man who performed the lobectomy on Henry. Dr. Scoville went on to perform surgery on thousands of other patients. As the author delves into the work of his grandfather, he learns of his own family’s dark secrets of madness. And last but not least, there’s even a battle for poor dead Henry’s brain and who it belongs to.

This non-fiction book reads like a horror story. It not only covers the story of Henry Molaison but it also tells of the beginnings of studies on the human brain in ancient times, takes you into insane asylums when they were at their worst with patients being tortured in the name of a cure and tells of the horrendous experiments done by the Nazis. It’s an interesting book but tough to read. The author doesn’t hold back anything and explicitly details the experiments and surgeries performed.

Luke Dittrich has written a very brave and personal book. He has turned Patient H.M. from a research object into a human being. He bares the ruthlessness of the scientific world in this well-researched and humane study of medical research.

This book was given to me by the publisher through NetGalley in return for an honest review.

[Kuba ✌ · Rating 3 out of 5]

Mega ciekawa, ale myślę, że mogłaby być krótsza o co najmniej 100 stron, gdyby nie było wplecione tyle nic nie wnoszących anegdotek i historii.

[Andreea Ursu-Listeveanu · Rating 5 out of 5]

Even if this book had already two attributes that appealed to me (medical book and memory) I was hooked right from the start. I immediately admired the style, the rhythm, the structure. I could say this is the perfect nonfiction for my taste: biography, medicine, history, reportage, personal opinion.

The fact that the book is written by the grandson of the neurosurgeon who performed ‘that’ surgery on Henry Molaison was even more enticing for me.

What I learned from it? The most surprising thing: you can live without a part of your brain. Damaged, but alive. I really didn’t know that. Then I learned about how people experimented on people (not that I didn’t know that, but everytime I read about it, it makes me sick). How many doctors operated without knowing how the brain worked, how they tried things and which discoveries they made. (Here and there fine sarcasm and irony can be depicted, but we have to remember that even if what those doctors did back then was indeed experimental and immoral, a God play, how could the medicine evolve the way it did without these trials and errors?) I learned about the Nuremberg Code which was set up after the attrocities that the Nazis inflicted on people during WW2. And I also learned about other bad guy in the story, who acted out of ego, of recognition desire and who destroyed a lot of evidence of the experiments and trials H.M. was subject to.

Jason’s story was the answer to my questions: how far did the medicine and research get to? How would Henry be treated today, with all the new technology and knowledge? Even if it wasn’t human mistake that made Jason similar to Patient H.M., even if Jason was more independent and aided by the sci-fi world we live in, both of them are the same: they live(d) in a present blink of an eye, without a future.

This book taught me so much, I read it with Google Images and Wikipedia next to me and also read a lot of articles about the main characters. It’s definitely a win for me.

[Nancy Regan · Rating 5 out of 5]

Unputdownable nonfiction is a joy to find and read. I savoured every thread of this story, including the one that takes a backseat to Patient H. M.: the story of the author's grandmother, and his grandfather's concerns and actions that she should become a "healthy" (read "tractable") woman. Bambam deserves a biography of her own. I hope that Patient H. M. and Henrietta Lacks are comparing stories somewhere in the afterlife.

[Olivia · Rating 5 out of 5]

"Patient H.M." is a beautifully and lyrically written work of nonfiction about H.M., the history of medicine and neuroscience, the doctors who treated H.M. and the author's own life (the author is the grandson of the doctor who treated H.M.). All medical, science, and psychology students know the immortal patient H.M. whose experiences taught us so much about the brain and memory.

As a doctoral student, I remember hearing about the death of H.M. and learning his identity in awe of this individual who had given so much to science despite his unfortunate circumstances. Later, as researchers began preserving and slicing his brain, we were able to view over webcam the careful process. This book is a necessary accompaniment to the textbook description of H.M.

The respect for patient H.M. is enormous as we would not be where we are today without the knowledge he has kindly helped us to attain. Dittrich writes about H.M. in depth, discussing his past and his conversations with researchers, as well as information about the brain and history of what we know to compete the story. Indeed, I believe this book will become a staple for anyone who wishes to learn about memory and a necessary book in many college courses.

The inclusion of stories about Dittrich and his grandfather flesh out the book to keep readers engaged and interested in all aspects of the story of H.M. including the doctors and scientists who worked with him.

This book is written in an approachable and understandable way. I think even non-science majors will find it interesting and educational. It is a must for scientists and those in the medical field.

Please note that I received this book from netgalley in exchange for my honest review.

[Montzalee Wittmann · Rating 3 out of 5]

Patient H.M. by Luke Dittrich is a book about the history of brain surgery in general but I was more hoping it was about the patient HM. The writing was excellent and the information of the history of the the various treatments used on people with "mental illness" was interesting and appalling at the same time but very little was about this particular patient really. There was a great deal about the authors family, other patients, POW's, etc. It was very interesting but just a little misleading in the title. I received this book from NetGalley for a honest review.

[christina milani · Rating 1 out of 5]

Sadly this book isn’t really about Patient HM. It’s written by the grandson of the neurosurgeon who lobotomized HM and a lot of the narrative is focused on the upbringing of his grandfather and what made him go into medicine. The book also doesn’t follow a cohesive timeline - too many tangents (for me) that go into the history of neurosurgery and asylums. Just never felt like there was a clear direction to this one. Disappointed :(

[Katherine · Rating 5 out of 5]

This story skips around a lot. I remember thinking if I had been listening to the audiobook I would have thought for sure the file was messed up.

Despite being an unconventional method of storytelling, I can't imagine the story being told any other way. The author makes it work.

The story itself is horrifying and brings into question the ethics of medical research. Is it ok to use psychiatric patients to perform experimental brain surgery? I would think the obvious answer is no.

The author's grandfather was a neurosurgeon who performed lobotomies and who over the years perfected his unique technique on countless psychiatric patients. Patient H.M. was an epileptic and his first 'normal' patient to receive a lobotomy.

The damage this surgery caused to Patient H.M.'s brain and memory was a major turning point in H.M.'s life and for memory science. He became the most studied human research subject in history. Most of what we know about how memory works is based on studies done with H.M.

The big question: was it worth it? The answer: I suppose that depends on whom you ask.

Thanks negalley.com for providing me with a copy of this book.

[Práxedes Rivera · Rating 3 out of 5]

This interesting book was fragmented in several ways: a depiction of Dittirch's family history, a study about memory loss, a biography of the famous patient H.M., etc. It is a methodically researched and well-written volume. A bit long, perhaps, but never dull or uninteresting. A worthwhile read.

[Rachel · Rating 5 out of 5]

Most excellent. Horrifying, fascinating, educational. Keep a modern medical dictionary handy if you are not a neurologist, however.
That said, it is very approachable and is very engaging; even humorous, at times.
A darkly intriguing true tale, very much worth the read.

[Jamie · Rating 5 out of 5]

4.5 Stars.
Loved it.

My only gripes were I wish it had included more on Henry and at times I had trouble piecing the whole story/timeline of everything together.

However, overall, it was a great book!

[Stela]

The first part of Luke Dittrich’s study-cum-(auto)biography-cum-history of lobotomy was interesting enough, although I was a little amused, a little put off of by what Steven Rose maliciously called, in his Patient HM review – a botched lobotomy that changed science, a „rather florid American style”. Unfortunately, the last hundred pages or so seemed to me unjustifiably long and slightly boring.

The big plus, however, is that I’ve learned a lot of interesting things (and even remembered some I had forgotten, like the story of Herophilus and Erasistratus from Alexandria, who, around 300 B.C., were the first to perform human dissection, on dead, but also on some alive).

I have now in my vocabulary some new words I hope will stay there 😊, like “hypnopompia”, the sensation between dream and reality you have when waking up, or “ecphory”, a term used by memory scientists to describe the way something in the present make us remember something in the distant past.

Furthermore, I found out how and why lobotomy was performed (although I cannot say this knowledge let me less horrified regarding the whole procedure). Initially it was called leucotomy (from the Greek leuco – “white matter” and tome – “to cut”) and the first to perform it was the neurosurgeon Almeida Lima, who, in 1935, “drilled two holes in the forehead of a patient suffering from a deep depression, then inserted a long, narrow metal tube through the opening to a depth of approximately eight centimeters”, tube that had inside a loop-shaped wire used to extract four small core of tissues from the frontal lobes. Three years later, this kind of “psychiatric surgery” gained in precision, the surgery being made through the sides of the skull – hence the name lobotomy (from the Greek lobo – “lobes”). The most famous surgeon in the field was Walter Jackson Freeman, who, believing he could cure the “social misfits” world was full of, operated not only the extreme cases he found in asylums but also “the housewife who displayed ‘affective incontinence’ and descended into crying jags every afternoon, the premature spinster ‘gradually drifting into seclusiveness’, the obsessive-compulsive who washed his hands ‘so excessively that the skin was dry, rough, and cracking’, boys and girls who had a tendency to misbehave, throw excessive tantrums, or display an excessive preoccupation with masturbation.”

Finally, it was fascinating to learn not only how “the broken illuminated the unbroken” but also how often those who broke them, often on purpose, got rewarded for it.

It is the case of the British physician Edward Jenner, who (in 1796) verified the theory that diary workers almost never contracted smallpox because they were exposed to the more benign cowpox on his gardener’s son, by infecting the eight-year-old boy first with cowpox and six weeks later, after his full recovery, with smallpox, a successful experiment that conducted to the discovery of the smallpox vaccine.

Today it’s possible to make a persuasive argument that Edward Jenner saved more human lives than any single person in history. Taking this into account, perhaps it’s easy to argue that jeopardizing the life of an eight-year-old boy was acceptable.

More than a half century later (1845), this time in South Carolina, the physician J. Marion Sims bought fourteen black slave women in order to repeatedly perform surgery on them (thirty times on each one, without anesthesia), for he wanted to develop a treatment for vesicovaginal fistula, a deadly common complication of childbirth at that time.

Sims went on to become president of the American Medical Association and is widely considered the father of modern gynecology. To this day, visitors to Central Park in New York City can see the larger-than-life bronze statue of him standing right across the street from the New York Academy of Medicine.

And last but not least, in 1932, the U.S. Public Health Service (!) initiated the Tuskegee Syphilis Experiment, which would be conducted for four decades (so long after the world found out about the Nazis experiments in the concentration camps): the experiment consisted of monitoring the effects of syphilis on a group of black Alabaman men, who had been infected deliberately and without their knowledge, and let suffer and die even though there was a treatment, because researchers were eager to study the disease.

For most of human history, our attitudes toward human experimentation were strictly utilitarian. If the scientific benefits were great enough, then almost any cost was justified. In an 1895 article called ‘The Relative Value of Life and Learning,’ a prominent University of Chicago chemist named E. E. Slosson summed up this attitude when he wrote that ‘a human life is nothing compared with a new fact in science.’

All these pieces of information and many others are gathered around the most famous “broken” of them all, patient H.M., lobotomized by the author’s own grandfather (also a famous surgeon in the field), who accidentally destroyed the memories area in his patient’s brain, thus making scientists aware that such an area exists.

I will finish my review by quoting Seth Mnookin, who stresses the scientific consequences of this surgery gone wrong in his NYTimes article while discretely pointing out that the line between scientific discoveries and ethics has always been very thin indeed:

Before H.M., scientists thought that memories originated and resided in the brain as a whole rather than in any one discrete area. H.M. proved that to be false. Before H.M., all memories were thought of in more or less the same way. H.M.’s ability to perform dexterous tasks with increasing proficiency, despite having no recollection of having performed the tasks before, showed that learning new facts and learning to do new things happened in different places in the brain. It’s no exaggeration to say that Molaison is one of the most important patients in the history of neurology; it’s likely he was also the most studied experimental subject of all time.

[Donna · Rating 4 out of 5]

As a psychology student coming across H.M. and his story for the first time, one might be hit by the overwhelming tragedy of his case. Briefly, Patient H.M. is one of the most famous and well-studied individuals in the field of psychology, due to a lobotomy that was supposed to reduce or eradicate his epileptic seizures, and that instead took away his ability to form new memories. That wallop of heartbreak begins to fade as you come across his initials in the literature time and time again. He becomes a study subject, and you become numb to his humanity. This book makes that tragedy real again.

The author Luke Dittrich, a working journalist, is the grandson of the man who performed that fateful "psychosurgery" on Henry Molaison more than half a century ago, and this book is a unique blend of medical history (of the brain, mental illness, and memory), biography (an attempt, at least, at making Henry more than just his test results), and family discovery, as the author's research leads him to uncomfortable revelations about his grandfather, William B. Scoville.

This book is not sensationalist, but neither is it completely unbiased (though it doesn't pretend to be). Dittrich does make his opinions fairly clear, and the reader is free to agree or disagree (it is difficult, though, for me to come up with a charitable interpretation of Sue Corkin's behaviour), so full marks for information and story. It loses a little bit of a star because of his over-reliance on certain literary tricks. Around 85% of the chapters begin like this:
"The [noun] was in the [room] on [place and or time]."
After a paragraph of scene-setting, an informative historical detour, and a personal anecdote, we then finally get to the meat of the chapter. This is fine once or twice, but there are THIRTY-ONE CHAPTERS IN THIS BOOK. Enough is enough. This constant back-and-forth also makes it difficult to keep track of the historical timeline, and as Dittrick refuses to hold the reader's hand as the time/place/story changes multiple times in a given chapter, it can also be tricky to remember who we were originally reading about when, near the end of the chapter, we finally return to the scene set in the beginning.

So 4 stars, HIGHLY recommended, has some problems, and I don't even care.


"Maybe the human brain is an object beyond the reach of metaphor, for the simple reason that it is the only object capable of creating metaphors to describe itself. There really is nothing else like it. The human brain creates the human mind, and then the human mind tries to understand the human brain, however long it takes and whatever the cost."

[Elena · Rating 3 out of 5]

Some memorabilia. I've always envied those in possession of good memories because mine is pretty bad. I started to really enjoy the book from the section about procedural/ declarative memory (mirror drawing task, motor skills, etc.). Smiled during the "sun-of-a-bitch episode. Not an even read (some parts seemed to be just a filler) but still, overall, i am not regretting spending time with this story. 3.6 stars from me.

[PamM · Rating 4 out of 5]

A chilling look into 20th century psychiatric medicine and “psychosurgery”, when lobotomies (and lots of other barbarisms) were the treatments du jour. A fascinating read.