Dec 18th 2008
From The Economist print edition
Molaison, a man without memories, died on December 2nd, aged 82
EACH time Suzanne Corkin met H.M. during one of his visits to the Massachusetts Institute of Technology, she would ask him if they had met before. He would smile and say yes, and when she asked him where he would reply, “In high school.” They did not actually meet until he was in his late 30s, but they worked together for nearly five decades, and the last time they met he still failed to recognise her. The most she ever elicited in him was a sense of familiarity.
More extraordinary still, a sense of familiarity was all his own face elicited in him. People were fascinated by H.M., for whom life came to a standstill in 1953, and one of the questions they always asked about him was what happened when he looked in the mirror. Dr Corkin reports that there was no change in his facial expression, his conversation continued in a matter-of-fact tone and he did not seem upset-though this could have been because of the damage done to his amygdalas, brain structures that are important for processing emotion. Once, in the later years, when she asked him what he was thinking as he gazed at his reflection, he replied, “I’m not a boy.”
更離奇的是，看著鏡子裏的自己，H.M.絞盡腦汁也只能勾起一份熟稔。1953年，H.M.的人生陷入靜止，引發人們的濃厚興趣，常常問他從鏡子裏 看到了什麼。在柯林的報告中，H.M.的表情一如往常，語調平穩，看不出沮喪的情緒–不過這可能因為杏仁體受損，導致腦組織中這個負責處理感情的重要部位 無法工作。後來，柯林問H.M.照鏡子時做何感想，他答道”：我不小了”。
H.M., or Henry M.-his family name was kept secret until he died-grew up in the countryside outside Hartford, Connecticut. He was 16 when he suffered his first grand malepileptic seizure. The fits became more frequent, delaying his graduation from high school and, later, preventing him from holding down a job, though he tried to work on an assembly line.
By the time he was 27 he was having as many as 11 seizures a week and was on near-toxic doses of anti-convulsants. His desperate parents were referred to William Beecher Scoville, a neurosurgeon at Hartford Hospital. It was 1953 and psychosurgery-which was later to be banned, or at least restricted, in many countries-was at the height of its popularity. Scoville himself had performed frontal lobotomies, though he was dissatisfied with the way they blunted his patients’ emotions.
In some ways H.M. was a product of that dissatisfaction, because Scoville had been working on a new, experimental operation, and he decided to try it on H.M. He would remove his medial temporal lobes (one on each side of the brain), the presumed origin of his seizures. Each lobe includes an amygdala and a seahorse-shaped structure called the hippocampus.
The operation was successful: H.M. experienced only two serious seizures during the subsequent year. But this happy outcome came at a terrible price. From the date of the operation he was unable to form new memories, and he also lost many of the memories he had laid down before it. Although he could recall the Wall Street crash and the second world war, he was left with no autobiographical memories at all. Having seen the effects of his handiwork, a shocked Scoville began to campaign against the operation. This meant that H.M. was the only person ever to undergo it.
手術成功了，H.M.的癲癇只重犯了兩次，而H.M.卻付出了慘痛的代價。H.M.的大腦自手術之日起停止了記憶構成，許多術前的記憶如今也不復存 在。雖然對金融危機、二次世界大戰仍然保有印象，H.M.腦海中關於自己的一切記憶已經煙消雲散。看著一手釀成的結局，斯考維勒震驚之下開始抵制內側顳葉 摘除手術。從此，H.M.成為唯一接受過這項手術的病人。
Two years later Scoville invited Brenda Milner, a neuropsychologist who had been studying post-operative amnesia, to come and study H.M. Her work had led her to suspect that the hippocampus was important for forming memories, and that it might be the place where they are stored. In the decades that followed, the experiments that first she and then her student Dr Corkin conducted with H.M. produced a more complex picture.
One of the most striking experiments had H.M. tracing a star between two parallel lines, when he could see his drawing hand only in a mirror. With practice his performance improved, though he always denied having attempted the task before. This led Dr Milner to propose a distinction between procedural memory (memory for a skill) and declarative memory (conscious recall of having used that skill), and to suggest that the two are stored in different places. Thanks to H.M., the scientists also learned that the hippocampus is crucial in forming some long-term memories, but not for maintaining or retrieving them.
在各項試驗中，最令人震驚的要數繪星試驗。按照要求，H.M.只能通過鏡子裏反射的影像來描繪兩條平行線之間的一顆星形圖案。幾次練習之後，他雖然 畫得像模像樣了，卻不承認自己曾經挑戰過這項任務。由此米爾納推測，程式性記憶和陳述性記憶分別存儲在不同部位，並提出了它們的區別。通過H.M.的案 例，科學家們得知海馬回雖然對部分長期記憶的形成具有重要作用，卻沒有保持或恢復功能。
It has often been said that a man with no memory can have no sense of self. Both Dr Milner and Dr Corkin disagree. H.M. had a sense of humour, even if he was capable of telling the same anecdote three times in 15 minutes. He was polite, and would cup Dr Corkin’s elbow as they walked around MIT. Everybody liked him, though it was a temptation for those who knew him to patronise him, to treat him like a favourite child or pet, such was the inequality of his and their knowledge about his life. It was a temptation, Dr Milner says, that they struggled against daily.
人們常說，一個人沒有記憶就不具備自體感受。對此，米爾納和柯林博士不以為然。H.M.就具有幽默感，儘管一刻鐘之內他能把同一個笑話講上三遍。 H.M. 舉止有禮貌，在校內散步時會挽著柯林博士的手臂。大家都喜歡H.M.，雖然這是出於看客的嘲弄喜好，像逗狗或逗小孩兒一樣。不公平的是，H.M.對自己的 情況還不如外界瞭解得多。米爾納說，她們每天都要抵制這樣的嘲弄喜好。
H.M. held no grudge against Dr Scoville. In fact, he dreamed of becoming a neurosurgeon, though he always said that could never happen, because blood spurting from the incision would cloud his glasses, preventing him from doing his best for the patient. By the time this obituary appears he will have gone under the knife again, this time for an autopsy. Before long his brain will appear in three digitised dimensions on the internet, for researchers to pore over. He never knew how much he contributed to science, says Dr Corkin, but if someone had told him it would have given him a warm, fuzzy feeling-for a few seconds, at least.
H.M.對斯考維勒並無芥蒂。事實上，他曾夢想成為一名神經外科醫生。不過他也總說這不現實，因為從傷口噴湧而出的血液會佈滿面罩，妨礙他全力施 救。完稿之時，他必已再次躺在刀鋒之下，這回是解剖刀。不久他的大腦就會以3D形式上傳至網路，供研究人員詳細觀察。柯林博士說，對於科學做出了多大貢 獻，H.M.自己從不知道。但若有人告訴他這件事，那將是一段溫暖、模糊的記憶–哪怕只有幾秒。