Thursday, June 6, 2013

Review: Permanent Present Tense by Suzanne Corkin

I reviewed Suzanne Corkin's book on the famous amnesiac HM for the Literary Review's May 2013 edition:

Total Lack of Recall 
Permanent Present Tense: The Man with No Memory, and What He Taught the World
By Suzanne Corkin
(Allen Lane/The Penguin Press 384pp £20)

In February 2009, a pair of neuroscientists carried an icebox through gate security at Logan Airport in Boston, under the gaze of a PBS film crew sent to document the event. Bypassing the security scanner so as not to expose the contents of the cooler to radiation, one of the researchers carried the box onto a waiting plane while the other, the neuropsychologist Suzanne Corkin, waved goodbye to her life’s work. Packed in ice inside the cooler was a human brain – possibly the most famous brain in history. It belonged to the amnesiac Henry Molaison, whose recent death had allowed his identity (for so long shrouded behind the initials ‘HM’) to be released to the world.

Corkin, who probably knew Henry better than anyone else, worked with him from 1962, when she was a graduate student, to his death in 2008. Over the decades, neuropsychologists, psychologists and neuroscientists probed his short- and long-term memory, his language abilities and reasoning skills, with Corkin as the gatekeeper to this precious scientific resource. Although he found her face familiar, he never really understood who she was, and tended to assume that she was an old classmate from his high school in Hartford, Connecticut.

Henry’s amnesia stemmed from a psychosurgical procedure intended to alleviate severe epilepsy. In the psychology textbooks, there is sometimes a suggestion that this was a cruel and unnecessary procedure, akin to the abhorrent lobotomies that were current at the time. Corkin is at pains to show that this was not a random act of cruelty or medical neglect, and that Henry’s debilitating fits provided good reason for conducting the surgery. William Beecher Scoville’s ‘frankly experimental’ procedure involved the removal of structures in the medial temporal lobes (deep in the brain above each ear), with devastating and unforeseen effects on Henry’s memory.

Henry’s amnesia was so profound, and so neatly sparing of his other cognitive abilities, that he quickly became the most famous amnesia case study of them all. There will hardly be a psychology graduate alive who doesn’t know the details: HM’s inability to form new memories was coupled with a preserved capacity to acquire new skills, such as learning to use a walking frame. After the operation, Henry’s grip on the past amounted to a total of two genuine autobiographical memories: an aeroplane flight taken when he was 13 and the taste of his first cigarette when he was 10. For the 55 years until his death, he created no new memories.

Most importantly of all, HM taught scientists about the importance of medial temporal lobe structures (predominantly the hippocampus) in converting short-term memories into long-term ones. Scientifically this is a hugely important story, and many will be excited that here, at last, is a chance to see the man behind the initials. In the right hands, this could have been a story of where the brain ends and the person begins, of the ethics of the close study of one individual. But readers who hope to understand Henry as a person will be disappointed. We rarely get to witness any of the human details that might bring him alive as a character. In one sense this is easily understandable: the observations of Henry were made for scientific, not biographical, purposes, and so the human element is largely unrecorded. But it is a scientifically informed biography that we are promised, and this worthy, detailed and ultimately rather lifeless book fails to meet that expectation in a number of ways.

Part of the problem is a predictable neuro-reductionist arrogance. Because Henry had a damaged brain, his brain becomes the cause of everything. We are told that Henry could not have had normal dreams, for example, because the necessary regions of his brain had been replaced by fluid-filled spaces. Anything that might have shaped his character beyond the effects of drugs or psychosurgery is left unexplored. No one would attempt to write a biography of an intact or more ordinarily damaged person by relating everything to brain structure. If they did, the results would be as dull as this.

There is nothing to suggest that Suzanne Corkin was anything other than a kind, attentive carer who wanted the best for her patient, as well as being an extremely thorough scientist (though her excitement at finally getting a chance to ‘harvest’ Henry’s brain will prove chilling for many readers). This is a human tragedy, and it deserves an approach that goes beyond the mere enumeration of clinical findings. Although we get plenty of ethics-committee discussion of the rights and wrongs of Henry’s story, along with tantalising flashes of the man’s personality (he had a quirky tendency to refer to Corkin as ‘Doctress’, for example), we get little insight into what Henry might have gone through or what emotions he would have grappled with. Corkin’s account has none of the richness of, say, Joshua Foer’s brief encounter with an amnesiac in his recent Moonwalking with Einstein, or (switching to a case of excessive rather than defective memory) of A R Luria’s classic portrait of S V Shereshevsky in The Mind of a Mnemonist. A more skilful writer might have saved us from learning what a human being becomes when he is boiled down to clinical data. HM’s personal tragedy had immensely valuable consequences; the disappointment of this book is that an individual has been reduced to an interesting brain.

Published in the Literary Review, May 2013 (reproduced with permission).

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