A brain surgeon’s legacy — through a grandson’s eyes
As a boy growing up in Massachusetts, Luke Dittrich revered his grandfather, a brain surgeon whose home was full of exotic instruments. Later, he learned that he was not only a prominent doctor but had played a significant role in modern medical history.
In 1953, at Hartford Hospital, Dr. William Scoville had removed two slivers of tissue from the brain of a 27-year-old man with severe epilepsy. The operation relieved his seizures but left the patient — Henry Molaison, a motor repairman — unable to form new memories. Known as H.M. to protect his privacy, Molaison went on to become the most famous patient in the history of neuroscience, participating in hundreds of experiments that have helped researchers understand how the brain registers and stores new experiences.
By the time Dittrich was out of college — and after a year and a half in Egypt, teaching English — he had become fascinated with H.M., brain science and his grandfather’s work. He set out to write a book about the famous case but discovered something unexpected along the way.
His grandfather was one of a cadre of top surgeons who had performed lobotomies and other “psycho-surgeries” on thousands of people with mental problems. This was not a story about a single operation that went wrong; it was far larger. The resulting book — “Patient H.M.: A Story of Memory, Madness, and Family Secrets” — describes a dark era of American medicine through a historical, and deeply personal, lens.
Q: Why should scientists and the public know this particular story in more detail?
A: The textbook story of Patient H.M. — the story I grew up with — presents the operation my grandfather performed on Henry as a sort of one-off mistake. It was not. Instead, it was the culmination of a long period of human experimentation that my grandfather and other leading doctors and researchers had been conducting in hospitals and asylums around the country.
In my grandfather’s case, his passion for tinkering with the human brain was driven in part by a very private goal: He was desperate to find a surgical cure for mental illness, because his wife, my grandmother, was mentally ill.
Taking a hard look at the past can help provide a clear-eyed view of the present. It’s easy to condemn what we were doing even 10 years ago, let alone 60, but even terrible things once made perfect sense. I do wonder what we’re doing today that we’ll regret tomorrow.
Q: What was the most unsettling thing you learned about medicine of that era?
A: The lobotomy is usually remembered as a brutal treatment for mental illness that was ultimately abandoned. It was certainly that, but what’s been ignored is that many of the leading doctors and scientists of the era — including my grandfather, who taught at Yale and was the director of neurosurgery at Hartford Hospital — viewed the lobotomy as having not just therapeutic potential, but also great experimental utility.
The rise of psychosurgery gave doctors and researchers license to perform on human beings the same sorts of brain-cutting experiments once limited to chimpanzees. As one lobotomist put it, “Man is certainly no poorer as an experimental animal merely because he can talk.”
Q: H.M.’s story has been exhaustively documented in the medical literature. Why tell it again?
A: Much of our understanding of how the brain works has come through studies of people whose brains didn’t work. Henry is the prime example. His loss was our gain. For most of his life, though, Henry was just a pair of initials floating in front of a constellation of clinical and experimental data. His story was tightly controlled by the researchers who’d built their careers on him and who had an interest in presenting his story in a particular way.
I believe Henry’s story is important not only because of what he contributed to our understanding of memory, but also because of what his case can teach us about our sometimes ruthless pursuit of knowledge.
Q: How do you think Molaison’s story should inform the practice of psychosurgery, which continues in more precise form to this day?
A: The newest psycho-surgical procedures are apparently less “blunting” than the ones my grandfather and his colleagues practiced. Still, any time we tinker with the human brain — either pharmacologically, electrically, or physically — we obviously need to be careful. You’re messing with our primal material, what makes us, us.
Apart from psychosurgery, I think the recent fad for over-the-counter electrical brain-stimulating devices needs to be looked at closely and skeptically. The long-term effects of those things are entirely unknown.
While researching my grandfather’s career as a lobotomist, it struck me that a great majority of the people he lobotomized were women. When you consider that the side effects of the lobotomy — tractability, passivity, docility — overlap nicely with what many men considered to be ideal feminine traits, that disparity is perhaps not surprising. Doesn’t mean it’s not horrifying, though.