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Remembering H.M.

Henry Moliason (H.M.)

Henry Moliason (H.M.)

On December 5, Henry Gustav Molaison died in a Windsor Locks, Connecticut nursing home at age 82. At the age of 27, Mr. Molaison had experimental surgery for epilepsy. After the surgery, Mr. Molaison was never again able to lay down long-term memories.

He knew his name. That much he could remember.

He knew that his father’s family came from Thibodaux, La., and his mother was from Ireland, and he knew about the 1929 stock market crash and World War II and life in the 1940s.

But he could remember almost nothing after that.

Mr. Molaison was internationally famous as one of the most intensively studied psychological subjects ever–known by the initials H.M. Through research with H.M., knowledge of human memory has been revolutionized. What was a terrible tragedy in the life of this man made it possible for psychologists to gain invaluable insights into the role of the brain in memory, learning, and personality. He was the subject hundreds of studies by numerous researchers over the course of five decades.

Every psychology undergraduate hears about H.M.–most likely in the first psychology course they take. I’ll never forget the sense of wonder I felt when I first learned about him and how much has been learned from him. In the history of psychology his is one of the most important cases–even more so than Phineas Gage, whose terrible accident revealed the role of the frontal lobes in personality.

From the Hartford Courant:

Molaison was born in Hartford in 1926, moved to East Hartford as a teenager and graduated from East Hartford High School. His father, Gustave, worked as an electrician at Baldwin Stewart Electrical Co.

An only child, he suffered from seizures. The cause of the seizures was never clear; he was hit by a bicyclist when he was 9, but such accidents would not typically have such devastating results….

Molaison was smart, but his seizures and the medications he took for them held him back. He had a job fixing motors, but had to give it up because the seizures made it difficult for him to work, Corkin said.

By the time he was 27, he was having up to 10 minor seizures a day and at least one major seizure a week.

That was when he underwent the experimental surgery, intended to relieve epilepsy. Hartford Hospital surgeon William Beecher Scoville, an internationally known expert in lobotomies, planned to remove a larger area of brain tissue than had been taken from patients in similar surgeries. He removed most of Molaison’s medial temporal lobe, including all or parts of the hippocampus and amygdala.

After the surgery, Molaison had profound amnesia–he had severe anterograde and partial retrograde amnesia. He could not lay down new long-term memories (anterograde) and he had lost some memories from his life before the surgery (retrograde). He still retained his procedural memories–the body memories that enable you to remember physical skills like riding a bike, swimming, or shifting gears on a manual transmission. In addition, he could gradually learn new physical tasks and form new procedural memories, even though he had no verbal memories to tell him he had done a particular task before. But for the rest of his life, each daily event, each person he encountered, he experienced as if for the very first time. In his short-term memory he could only retain any new information for a about 20 seconds. If you have seen the movie Memento, you have some sense of what it may have been like for H.M.

It was through studies of H.M. that psychologists learned about the different memory systems. Because of H.M., we now know that memory functions are dependent on the hippocampus and that the amygdala adds emotional content to our memories. Together these two parts of the brain are vital for the laying down of long-term memories along with the emotions that give them meaning.

For years, Dr. Brenda Milner of McGill University in Canada worked with H.M.

“He was a very gracious man, very patient, always willing to try these tasks I would give him,” Dr. Milner, a professor of cognitive neuroscience at the Montreal Neurological Institute and McGill University, said in a recent interview. “And yet every time I walked in the room, it was like we’d never met.”

At the time, many scientists believed that memory was widely distributed throughout the brain and not dependent on any one neural organ or region. Brain lesions, either from surgery or accidents, altered people’s memory in ways that were not easily predictable. Even as Dr. Milner published her results, many researchers attributed H. M.’s deficits to other factors, like general trauma from his seizures or some unrecognized damage.

“It was hard for people to believe that it was all due” to the excisions from the surgery, Dr. Milner said.

[....]

“The study of H. M. by Brenda Milner stands as one of the great milestones in the history of modern neuroscience,” said Dr. Eric Kandel, a neuroscientist at Columbia University. “It opened the way for the study of the two memory systems in the brain, explicit and implicit, and provided the basis for everything that came later — the study of human memory and its disorders.”

Living at his parents’ house, and later with a relative through the 1970s, Mr. Molaison helped with the shopping, mowed the lawn, raked leaves and relaxed in front of the television. He could navigate through a day attending to mundane details — fixing a lunch, making his bed — by drawing on what he could remember from his first 27 years.

He also somehow sensed from all the scientists, students and researchers parading through his life that he was contributing to a larger endeavor, though he was uncertain about the details, said Dr. Corkin, who met Mr. Molaison while studying in Dr. Milner’s laboratory and who continued to work with him until his death.

Suzanne Corkin of the Massachusetts Institute of Technology began working with H.M. in 1962. She reports that he had “gist memories” from his early life. For example he could recall hiking on the Mohawk trail and a trip he took with his parents, but couldn’t recall much detail or exactly when these events happened.

Corkin equated Molaison’s death with losing a member of her family. He never remembered who she was, but he always greeted her like a friend. He told her he thought he knew her from high school.

Corkin described Molaison as an easygoing, soft-spoken, polite man with a good sense of humor. He did not typically begin conversations, but if someone prompted him, he would talk and talk, sometimes telling the same story three times in 15 minutes.

Much of what he talked about, Corkin said, reflected his desire to do whatever he could to help people.

H.M. came to understand that he was contributing to an important project, but he never truly understood the magnitude of his contribution to science.

Many times, Corkin said, she would tell Molaison how important he was. “I’d say, ‘You know, you’re really famous, you’re more famous than all the doctors who study you.’ He’d sort of smile,” she said. “He knew. For an instant.”

Thank you H.M. Rest in peace.

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40 Responses

  1. I remember in my Psych 101 class reading the story of some guy in the early 19th Century who was setting an explosive charge and it exploded early, sending a tamping rod through his frontal lobes.

    He miraculously survived, but his personality was dramatically changed.

  2. H.M. and me. My memory is going but I’m encouraged by the fact that my husband’s is worse than mine.

    That was very interesting, BB.

    I’d also like to say I just got back from seeing “Milk” with Sean Penn and we all thought it was great (daughter and friend). Also enjoyed SlumDogMillionaire – might not be for everyone but we liked it.

  3. Myiq,

    That was Phineas Gage. I mentioned him in my post and linked to information about him. He had a steel bar go right through his head and destroy his frontal lobe. But psychology wasn’t able to study him as scientifically as they did H.M.

  4. It’s interesting that his initials are coincidentally H. M. which will make it easy to remeber that his contributions are to (H)uman (M) emory.

  5. After those two cases, probably the most famous case in the recent history of psychology is the woman who was the subject of “The Three Faces of Eve.”

  6. There are some memories I’d like to erase. LIke the bathroom scene from Trainspotting and one-third of my childhood.

  7. That is interesting CWaltz. I didn’t know a lot of the details about H.M.’s early life or his real name until I read the obits. I actually cried reading about him. It’s so sad to think of losing your autobiographical memories. They are what create your identity.

  8. BB:

    Sorry, I was fighting with my “move your feet, lose your seat cat” and missed that.

  9. IIRC it was BF Skinner who thought each baby was a “tabula rasa” who’s personality was dtermined by nurture rather than nature.

    But I think a lot of what makes us who we are is hardwired into us.

    H.M. had his hardwiring short-circuited.

  10. Thank your for sharing this fascinating story with us, BB. While I took some Psych courses way back as an undergrad, I don’t ever remember hearing about this gentleman.

    My 18-year-old son, who is autistic, suffers from a seizure disorder which first manifested itself about three years ago. It is quite common for autistic kids to develop seizure disorders in adolescence. Fortunately, my son’s seizures are now well-contr0lled with medication, but finding the right meds and dosages took some time, and it was really scary for a while not knowing when the next episode would hit.

    I can understand how someone suffering multiple seizures a day would consent to experimental surgery. How sad it was not successful, and yet his contribution to science will far outlive him.

    Rest in peace, indeed.

  11. Nell,

    Unfortunately a lot of research on the brain has been made possible by people who have had surgery to control seizures. A less terrible surgical technique that is still used for extreme cases, is severing the corpus callosum (the connection between the left and right sides of the brain). People who have had that surgery have taught us about hemispheric specialization. For example, the left side of the brain is specialized for language and the right side is involved with visual and spatial abilites and emotion. But people who have their corpus callosum severed can still learn to function pretty normally.

    I’m so glad your son is doing well with his meds. Of course there have been a lot of advances in those too.

  12. Wow! Murphy has new photoshops that are outrageous!!

    http://pumapac.org/

  13. BB

    Gotta love photoshop- It’s a great way to “let off some steam” as the boyz say.

  14. Thanks BB for a spectacular post and a great eulogy.

    I have actually begun to appreciate The Confluence more when we get outta play by play of politics, not that we should get out completely. It’s only that after 2 very intensive years of electoral politics, I’m exhausted and need a break.

    Moreover, I learned so much from this post because I’m fascinated with the brain as organ. I read as much available for the layman as I can find. For those who are also interested in the brain and who need good books for joe schmoe, I’d recommend:

    “Mapping The Brain” by Rita Carter
    and
    “How The Mind Works” by Steve Pinker

    The more qualified Conflucians can let me know if I’m off and I welcome some recommendations.

  15. Thanks, MABlue. You’ve probably already read Oliver Sachs, but I would recommend “The Man Who Mistook HIs Wife for a Hat” to anyone.

  16. About Caroline Kennedy….

    I hope the NY Governor appoints someone HIllary wants. (Isn’t this what is happening with Biden’s seat, and others in the past?) But if he appoints Caroline Kennedy and she does a bad job — then she should be easy to defeat in 2010.

  17. CWaltz,

    It sure helped me a lot last night. I hope SOD feels the same way. I haven’t seen much of her today.

  18. BB
    thank you for sharing H M’s story.
    So many people contribute to our well being and are never even known to us.
    May he rest in peace.

    WOMEN,MEN WHO SUPPORT THEM AND COUNTRY BEFORE PARTY ALWAYS

    PUMAS,BUBBAS AND THOSE PEOPLE RULE

  19. What must it be like to always be living in the moment?
    Have you ever seen that lecture by the neurophysicist who witnessed her own stroke and flipped between the ability to verbalize and complete right brain thinking? It sounds like bliss. But if you don’t have long term memory, us it possible to appreciate that state when you are confronted with it or was it not possible for HM to get there?
    BTW, for some equally bizzare manifestations of the brain I recommend The Man Who Mustook His Wife For A Hat by Oliver Sacks.

  20. RD,

    Interestingly, H.M. was still able to experience affection for people he knew, even though he didn’t *know* who they were in left brain terms. The NYT article also says that he was still self conscious. They gave an example of a time when an insensitive research talked about him as “an interesting case” right in front of him. H.M. blushed and walked away saying, he didn’t think he was all that interesting.

    One of the most heartbreaking things I experienced when my mother in law was in a nursing home was having Alzheimer’s patients look at me hopefully, thinking I had come to see them. One woman still haunts me. She used to cry out, “have you seen my son?” I want to die before I lose my memories.

  21. RD:

    I saw that’s Jill Bolte Taylor. Her video lecture on the whole thing was in NY Times a while ago.

    She just wrote what by all accounts is one of the best books of the year:

    “My Stroke of Insight.”

    Thanks to you and BB, in fact I haven’t read Oliver Sacks’ book. I’ll order before going to bed.

  22. You’ll love it, MABlue. The story about the aphasics watching Ronald Reagan’s speech is a classic!

  23. I have attention deficit disorder. It’s always interesting when losing my car keys for the 10th time in an afternoon or becoming frustrated with my endless list of tasks? It could always be worse.

    Thanks to H.M. and others like him, without whom a lot of people like me would be suffering needlessly.

  24. the Jill Bolte Taylor book was a featured selection at Quality Paperback Book Club – qpb.com – this month. I didn’t order it but this post is fascinating BB, and I may go back and change my order. thank you.

    by the way, if anyone is interested and doesn’t already belong to QPB, you get a bunch of books when you join, and I’m pretty sure you don’t have to order any more. not positive about that though, I do order because they have great sales.

  25. God speed H.M. What a tragic fate, but at least his life was of service to the study of psychology.

  26. Thanks for reading, fif.

  27. Henry Molaison’s story is incredibly interesting. I had never heard of him.

    it’s also sad, but it doesn’t seem like he experienced it as sad. so that’s good.

    funny, with all the talk about the Kennedys, this made me think of Rosemary’s lobotomy

  28. Nijma’s Free Advice reposted from downstairs:

    Q: myiq–I have an overweight and emotionally needy cat that jumps in my chair everytime I get up and doesn’t want to move when I get back. She’s not the type you pick up and move against her will.

    Any suggestions?

    A: Getting another chair won’t help you any–she sits in it because it’s warm.

    The cat will sit in the same place a 300 pound gorilla will sit–wherever it wants.

    When you return to your chair and want to sit down pick her up, sit on your chair, and put her on your lap. Wear long sleeves. Pet her to death. Encourage her to be a lap cat. Give her even more attention than her neediness can possibly tolerate. Lay it on thick. She will probably either purr and become a lap cat, in which case you get a warm lap, sometimes with little kneading claw marks in your thigh, or she will assert her independence and leap down to check her food bowl after accepting a brief amount of homage.

    You have to be firm. Whether she sits in the chair while you’re gone is negotiable (and unenforceable), but it’s your chair, you’ve got dibs.

    If it’s a yellow cat, don’t wear black wool slacks.

  29. Kiki,

    H.M. couldn’t remember anything that happened to him even 30 seconds before. He was living pretty much in the moment. One sad story: he had a favorite uncle who had died 3 years before H.M. had the surgery. Unfortunately he didn’t remember this event, and every time he asked about his uncle, he would have to reexperience the shock of learning of his death.

  30. I would push the cat off the chair with something long that wouldn’t hurt her. Like take a long shoehorn and lift her butt with it until she jumps down. Cats always do that because the spot where you were sitting is warm.

  31. Back when I was working hospice I had a few patients with severe memory loss. Their families usually wrote something on a piece of paper to cover all the questions they kept asking over and over.

    So if you could choose to forget all the nasty romances in your lives, would you do it? Would it make it easier to try again, or would you rather be forewarned?

  32. What about getting the cat a heating pad?

  33. Nah, they never like anything you do for them. They have to be the ones to think of it themselves.

  34. BB,

    What a wonderful post and honorific for Mr. Moliason.

    I’ve watched Alzheimers rob memory from my father and the only thing I can liken it to is a water bucket with a very slow drip. With everyday the memories slowly, irretrievably slip away and no matter how many pills, MRIs, and neuropsychiatrists try and stop the leak, it never stops, maybe slows, but never stops.

    As much as I have studied and researched, the only thing of which I am certain — there is no end to how much we don’t know about our brains.

  35. Nijima,

    I want to be forewarned. At my age, I’ve lost practically all ability to remember proper names (that starts to go after about 35) and sometimes I have trouble finding the word I want. I think I’m pretty normal, and at least I do things to stimulate my brain. But I don’t want to lose my autobiographical memories. I’d rather keep the painful ones along with the happy ones.

    I’m at the point in my life where I’d much rather remember my old romances than start another one. I like my own company and I like the freedom to be myself and come and go as I please.

  36. Thanks for that Prolix. My dad has early Alzheimers, but he’s 86. I think he’ll be gone before it gets really bad. I hope so.

  37. Nijma,

    I’m married, so I guess I’m answering academically. that’s a really tough question. I think I’d obviously like to approach relationships drawing on the wisdom of my years and experience. except…..there’s something so attractive about the openness and innocence of first relationships. and honestly, I feel that we so often sabotage relationships based on what went wrong with previous ones. the idea of forgetting nasty relationships from the past is an intriguing one.

  38. Yes, a lot of romances are much better in retrospect, aren’t they. And before you have a chance to develop an allergy to commitment.

  39. Thanks BB, this is very interesting to know. I hope all of that good H.M. inadvertently through personal tragedy did for humanity adds lots of good karma for him. Cheers.

  40. what a fascinating and tragic story.

    kind of depressing to think that truly living in the moment would mostly entail “fixing lunch and relaxing in front of the TV.”

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