Patient H.M.

The term “scope creep” may as well have been invented for this book. The core concept is fascinating: Luke Dittrich, the grandson of Dr. William Scoville, the neurosurgeon who performed the temporal lobotomy on patient H.M., who inspired the movie Memento writes a book about all of that. The problem seems to be that Dittrich couldn't decide which book to write.

Therefore, he includes fascinating bits like the admission of his own grandmother – Scoville's wife – to the inpatient psychiatric facility were Scoville performed lobotomies. He departs into memoir at times. He explores the entire history of frontal lobotomy (at some length) and digresses into this history of psychiatry. These subjects come with no form of organization and many of them don't really reach a satisfying conclusion as they get discarded for something else. I found myself anxious to finish but disinterested in actually picking up the book. Frustratingly, Dittrich concludes the book with a brief synopsis of the ways that H.M.'s brain was anatomically different than expected – a fascinating topic that he left basically untouched.

Also, usually an author's closeness to a subject makes it an ideal topic, but in this case I felt very uncomfortable with Dittrich's relationships to the scientists in this story. He is profoundly unhappy with his grandfather's work, calling his surgery on H.M. unforgivable and rash despite quoting experts who disagree. I think that there's a lot more nuance to performing a surgery on a patient with intractable epilepsy before the invention of modern antiepileptics. Similarly, Dittrich's mother's best friend, the psychiatrist who had scientific custody of H.M. in his later life, is painted as a territorial and vindictive villain.

The parts that are there, that are reflective and that are relevant are fascinating. So, three stars for content and concept.

This book is full of science; both wondrous and extremely gruesome. The author portrays each of the professional's perspective with honesty and without taking sides. Considering my reactions to parts of the story, I think he did a masterful job.

Stick with this book; there are some amazing insights to be found.

Between 1/3 and 1/2 of the way through, the pacing changed and the author seemed to take more detours before arriving back at the narrative. While some reviewers dinged the author for including seemingly off-topic information, I realized at the end that Mr. Dittrich had been extremely open about his investigation into Patient H.M., his family, and the ways memory does and does not function; the book is a chronicle of that investigation. Perhaps some editing may have been in order, but some of Mr. Dittrich's observations may have been dulled. With that said, I found Mr. Dittrich's writing to be clear and understandable.

Henry Molaison, known to the scientific community as Patient H. M., is an interesting man with an above average IQ, no mental illness, and who lives in the moment. Some of the most poignant moments in the book are the transcripts from researcher's interviews with Henry. There are even moments where he knows that he can't remember things, but could at one time.

When questioned about career aspirations, Henry mentioned wanting be a brain surgeon. But, what if his glasses got smeared and his hand skipped? This exchange shows up a few times during interviews, making one wonder if his concern was a memory. Henry was conscious during his lobotomy, and we don't learn until well into the book that Henry had a lesion in his frontal temporal lobes which appeared to be man made and not part of Dr. Scoville's plan, most likely occurring during the lobotomy.

Yet, the researchers lead by Suzanne Corkin had Henry sign consent forms for 12 years with no guardian, which is disturbing in that he was unlikely to remember instructions or explanations about an experiment minutes into the process. Then Corkin's team pulled in Henry's landlady's son as conservator to sign consent forms with no attempt to contact any of Henry's living cousins to step into the role. It is here that the courts failed Henry, although the blame is ultimately on Corkin, who did not provide accurate information in the filing. Henry was never paid, unlike most research subjects, for all of the time he spent being studied. And, after his death, Corkin simply shredded materials about decades of research, which is unusual and likely unethical. Henry's conservator also bequeaths Henry's brain to MIT

Like “The Immortal Life of Henrietta Lacks,” this book calls into question the use of a research subject's biological and personal data without disclosing how the data will be used and with no financial benefit for the subject.

Beyond Patient H.M., Mr. Dittrich delves into his grandparents' intertwined history, from case notes from the “treatments” (shock therapy, hypothermia sessions, etc.) to whether or not his grandmother received a lobotomy by his grandfather so she would become less of a problem following what appear to be schizophrenic episodes. However, Mr. Dittrich is never able to find an answer to his grandmother's actual diagnosis nor to whether she had any sort of lobotomy. It is in the family history explanations that the author does his utmost to be transparent with what really happened (as far as he can determine).

I listened to the audiobook version narrated by George Newbern, who I remember from “Father of the Bride” and “Adventures in Babysitting). He has a nice narrating style that fits well with the voice of the author and especially with Henry Molaison's voice.

For that reason, I cannot reproduce a few paragraphs at the end of the last chapter (before the Epilogue). But, it was so affecting that I went back and listened to it three times.

While this book had interesting information about the history of lobotomy and mental health treatment over the past 150 years, it jumped around quite a bit and felt a bit jumbled. The attempts to weave together Henry M.'s story and the history of the surgeon who performed his lobotomy was not entirely successful. There were too many other patients and other surgeons muddled the story and made it hard to follow.

(Thank you to NetGalley and Random House for a copy of this book in exchange for an honest review.)