Turning to Books to Understand the Most Insoluble Disease

Suzanne Corkin’s 2013 book “Permanent Present Tense” falls into this category. Corkin, a research psychologist, presents a fascinating case study of his patient, Henri Molaison, a man with no memory. Molaison – or HM, 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 to correct his incurable seizures in 1953. His Yale surgeon, William Scoville, made two holes in his skull just above his eyes and removed a small cup of tissue from both of his medial temporal lobes. Stimulated tissue included the olfactory lobes, which control smell, the amygdala, which controls emotions, and half of the hippocampus, whose function was not well understood at the time.

Although Molaison’s seizures subsided substantially after the operation, she developed an even greater problem, which manifested itself almost immediately after her surgery. He could not remember who his hospital caregivers were, no matter how many times he was introduced to them. He got lost on the way to the bathroom, no matter how many times he was shown where he was. As soon as they happened, daily events disappeared from his mind. This condition was called anterograde amnesia.

His amnesia was eventually traced to damage to the hippocampus, a structure “severely concerned in the retention of current experience”, as Scoville and a colleague later wrote. His present memories remained largely intact. He could still miss vacations with his parents, had a job as a teenager, went to shoots with his father and did other shows from his childhood. Yet, like most patients with dementia, he could not form any new long-term memories. With no new memory, he lived in a perpetual present, separate from his past (or at least his post-surgery past) and his future. It was “like waking up from a dream,” he told Corkin. “Every day is lonely

on one’s own.”

Although dementia is better understood today than it used to be, the medical landscape for the condition has recently become a little less bleak. In early June, the FDA First new drug approved for Alzheimer’s disease in almost two decades. And although the approval process has been a matter of controversy and it’s unclear how well the drug actually works, the decision represents some movement after hundreds of experimental treatments failed in hundreds of clinical trials. Yet it is still true to say that dementia is the only chronic and widespread medical crisis for which there is virtually no effective treatment.

A recent book that explores this Sisyphean quest for a cure is “In Pursuit of Memory: The Fight Against Alzheimer’s”, by Joseph Jebelly, published in 2017. A British neuroscientist, Jebelie travels around the world to discover the latest in dementia research. He travels to Papua New Guinea, Japan, India, and China to learn about experimental (but mostly fruitless) treatments, including stem cells, blood transfusions, and cancer drugs. In the end, he acknowledges how little medicine currently has to offer patients with dementia, even though he holds hope (in my view far-fetched) for a cure in 10 years.

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