Patient H.M. A Story of Memory, Madness, and Family Secrets
While recently rereading Stigma: Notes on the Management of Spoiled Identity by Erving Goffman I was reminded of George Santayana’s observation that “sanity is a madness put to good uses.” Writers who seriously engage with mental illness or disability must necessarily aim for a forthrightness that’s unnecessary for “kiss and tell” biographies. (There’s no pensive candor in The Diana Chronicles by Tina Brown.) Goffman details the circumstances of outliers and with strict passion. Defectives are among us. What does their presence say about the limits of social tolerance and the unspoken rules of normalizing engagement? Goffman notes:
“The attitudes we normals have toward a person with a stigma, and the actions we take in regard to him, are well known, since these responses are what benevolent social action is designed to soften and ameliorate. By definition, of course, we believe the person with a stigma is not quite human. On this assumption we exercise varieties of discrimination, through which we effectively, if often unthinkingly, reduce his life chances. We construct a stigma-theory, an ideology to explain his inferiority and account for the danger he represents, sometimes rationalizing an animosity based on other differences, such as those of social class. We use specific stigma terms such as cripple, bastard, moron in our daily discourse as a source of metaphor and imagery, typically without giving thought to the original meaning.”
Luke Dittrich’s book is about varieties of bias and concerns social class, neurology, madness, and oh yes, family secrets. (If Patient H.M. isn’t quite The Diana Chronicles, it will still hold considerable appeal for Oprah.) Dittrich relates the story of Henry Molaison who underwent brain surgery and lost nearly all his capacity for memory and became an invalid. Moreover H.M. as he was known by neurological researchers spent his adult life as the subject of medical inquiry. (Picture a man deprived of recollection spending his days answering questions in a neurology ward.)
The plot thickens as Dittrich’s grandparents are introduced. His grandfather was Molaison’s surgeon one Dr. William Beecher Scoville who Dittrich tells us: “removed some small but important pieces of Henry’s brain.” Set against Molaison’s post-operative life is another dark narrative—Dr. Scoville’s wife, Dittrich’s grandmother, finds herself committed to the “Institute of Living” formerly the “Hartford Retreat for the Insane.” The book gives a paratactic summary of two main victims and many secondary ones as H.M. was a medical experiment, the story a scandal and therefore ripe for a conspiracy of silence. This is a memoir about cover ups; the suborning of honesty and the destruction of desire. Dittrich notes that when Henry loses his memory he becomes asexual:
“The holes my grandfather dug in Henry’s brain caused many deficits, some brutal and stark, some more subtle. Among the things he lost, according to the scientists who studied him, was a capacity for desire. As far as they could tell, in the six decades between his operation and his death he never had a girlfriend, or a boyfriend, never had sex, never even masturbated. The returning strangers who flitted in and out of his life, the movie stars who flickered on his television, he received them all with perfect neutrality, and they left behind neither traces of memory nor pangs of lust.
“The operation,” one of the scientists who studied him concluded, “rendered him asexual.”
This is a book of stigma—hidings—neither brain surgery nor the asylum ameliorates or softens the realities of of abnormality. The story is familiar enough but Dittrich highlights the gradations of repression necessary if disclosures about mental illness are to be contained both within families and institutions. H.M. is poked and prodded for years at the Massachusetts Institute of Technology without informed consent. Mrs. Scoville undergoes a host of brutal therapies (electro-shock, fever inducing baths, hydrotherapy) without any significant communication with her family—a matter that parallels Dr. Scoville’s indifference to H.M.’s suffering. Is it the destruction of desire or it’s absence altogether we’re observing? In the end Dittrich isn’t so sure. He does tell us that H.M. and Mrs. Scoville are much like the syphilis victims at Tuskegee—clear victims of a post-war medical industrial complex that still haunts the disabled today.
Dittrich’s prose is at its best when he’s either reimagining the past or using a journalist’s lens to show how lives can be reduced and squandered by medical and professional indifference. Less compelling are the moments when he buttresses the book with his own backstory—how he climbed ruins in Egypt—came down from the heights possessed of a desire to be a writer. The memoir is sufficiently compelling without the well written but sophomoric marginalia.