Suzanne Corkin’s 2013 book “Permanent Present Tense” falls into this category. Corkin, a research psychologist, presents a fascinating case study of her patient, Henry Molaison, a man with no memory. Molaison — or H.M., as he was known in the scientific literature until his death in 2008 — was a 27-year-old with severe epilepsy when he underwent radical brain surgery in 1953 to cure his intractable seizures. His Yale surgeon, William Scoville, drilled two holes in the skull just above his eyes and suctioned out a small cupful of tissue from both his medial temporal lobes. The excised tissue included the olfactory lobes, which regulate smell, the amygdala, which controls emotions, and half of the hippocampus, whose function was not properly understood at the time.
Though Molaison’s seizures largely abated after the operation, he developed an even bigger problem, which manifested almost immediately after his surgery. He couldn’t remember who his hospital caregivers were, no matter how many times he was introduced to them. He got lost going to the bathroom, no matter how many times he was shown where it was. Daily events vanished from his mind almost as soon as they had occurred. The condition was called anterograde amnesia.
His amnesia was eventually traced to damage to the hippocampus, a structure “critically concerned in the retention of current experience,” as Scoville and a colleague later wrote. His existing memories remained largely intact. He could still remember vacations with his parents, jobs he’d held as a teenager, going target shooting with his father and other events from his childhood. Yet, like most patients living with dementia, he could form no new long-term memories. With no new memories, he lived in a perpetual present, disconnected from his past (or at least the past after his surgery) and his future. It was “like waking from a dream,” he told Corkin. “Every day is alone in
itself.”
Though dementia today is better understood than ever before, the therapeutic landscape for the condition has only recently gotten a bit less bleak. In early June, the F.D.A. approved the first new medication for Alzheimer’s disease in nearly two decades. And though the approval process has been subject to controversy and it’s not clear how well the drug actually works, the decision represents some movement after hundreds of experimental remedies have failed in hundreds of clinical trials. Yet it’s still accurate to say that dementia remains the only chronic and widespread medical scourge for which there are literally no effective treatments.
A recent book that explores this Sisyphean search for a cure is “In Pursuit of Memory: The Fight Against Alzheimer’s,” by Joseph Jebelli, published in 2017. A British neuroscientist, Jebelli travels around the world to discover the latest in dementia research. He goes to Papua New Guinea, Japan, India and China to learn about experimental (but mostly futile) treatments, including stem cells, blood transfusions and repurposed cancer drugs. In the end, he acknowledges how little medicine currently has to offer patients living with dementia, even as he holds out hope (far-fetched, in my view) for a cure in 10 years.
