Luke Dittrich, “Patient H.M. A Story of Memory, Madness and Family Secrets”

 – e-book

 Read from October 2^nd to 24^th 2021

My rating: 

 

 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 lobotomythat 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.”