A Textbook Case

 

Hartford, Connecticut, is a traffic-choked city today, but in the 1930s it was a sleepy town where kids could play in the streets for hours without having to move aside for a passing car. One day in 1934, an eight-year-old boy named Henry Gustav Molaison fell off his bike and struck his head. He wasn’t wearing a helmet, since it wouldn’t occur to anyone for another half century that children needed that kind of protection. Or maybe it happened a little differently: maybe he was on foot and another bike knocked him over. His parents didn’t remember which it was, when they thought about the incident years afterward.

Henry might have lost consciousness for a few minutes, or perhaps not. Concussions were considered a normal part of growing up back then, so nobody would have paid much attention. After the accident, whatever it was, he seemed perfectly normal. If you’d told Henry’s parents at the time that their only child would one day become the most celebrated neuroscience patient in history, and that his obituary would appear on the front page of the New York Times, Gus and Lizzie Molaison—he was an electrician, a Cajun who came originally from Thibodaux, Louisiana; she was a stay-at-home mother whose parents had emigrated from Northern Ireland—would have been convinced you’d lost your mind.

A couple of years after he hit his head, Henry began to have epileptic seizures, and his parents wondered if the bike accident might have been responsible. At first, they were mild, petit-mal seizures. Henry would go into what seemed like a trance for a couple of minutes, then return to normal. By the time he was in his mid-teens, however, he was having grand-mal seizures, in which he would fall to the floor, go into convulsions, foam at the mouth, and bite his tongue. These episodes were so disruptive and so embarrassing that he dropped out of one high school, waited several years, then started again at another school as a seventeen-year-old freshman. He didn’t take the college-prep track, choosing instead the school’s vocational course. After he graduated, at twenty-one, he got a job with a company that built electric motors, then moved on to work at an assembly line, making typewriters.

Throughout his early twenties, Henry’s epilepsy kept getting worse. By the time he was twenty-six, he was taking four powerful medications, any one of which by itself would have kept most patients’ seizures in check. He’d had a series of tests to rule out a brain tumor or some other physical abnormality. The most unpleasant of them, called a pneumoencephalogram, involved draining the cerebrospinal fluid, which normally cushions the brain, then forcing air into Henry’s skull to replace it, which allowed an X-ray to look for any unusual gaps in his brain tissue. That showed nothing. Neither did a much less invasive electroencephalogram, or EEG.

At a loss for how else to proceed, Henry’s doctor, an eminent neurosurgeon named William Beecher Scoville, suggested an operation as a last resort. Scientists understood by this time that neurons, the cells that process and store information in the brain, communicate with one another through tiny electrical signals. They also knew that seizures are caused when these signals go out of control, sending spasms of electrochemical energy bouncing chaotically through the brain. In some cases, the chaotic signals originated in areas that had been damaged by illness or injury. Henry’s parents were right to suspect that his bike accident might have been the cause of his epilepsy.

The tests found no such injuries, but epilepsy can also be caused by much subtler brain abnormalities, which are often genetic. Several relatives on Henry’s father’s side had had epilepsy as well, so maybe that was the explanation. No one knew where these abnormalities were located, but tests on both animals and humans had shown that deliberately stimulating the brain’s medial temporal lobes with mild jolts of electricity could trigger seizures. Scoville himself had removed medial temporal tissue from patients with schizophrenia, hoping to cure their psychosis. It didn’t work, but one patient who also had epileptic seizures saw significant improvement in that illness.

So Scoville proposed to remove large parts of Henry’s medial temporal lobes. “This frankly experimental operation was considered justifiable,” he would write several years afterward, “because the patient was totally incapacitated by his seizures and these had proven refractory to a medical approach.” Scoville made it clear to Henry and his parents that the operation was risky. He thought it was likely to relieve the epilepsy, but there might be side effects. But the seizures were so awful that the Molaisons decided it was worth the risk. Even if the surgery didn’t cure him, Henry said, in giving his consent, it might help others.

On August 25, 1953, orderlies wheeled Henry into an operating room at Hartford Hospital, his skull newly shaved, and the surgery began. Scoville drilled two large holes in Henry’s forehead, each about an inch and a half across, and reached in with an instrument called a brain spatula, which he used to lever the frontal lobes—one on each side—out of the way. This gave him access to the hippocampus. Then he worked the spatula in and down, and began to apply suction to the soft, spongy brain tissue. By the time he was done, Scoville had sucked out big chunks of Henry’s two hippocampi, one on each side of the brain. He’d also removed much of the neighboring amygdalae, which are involved in the processing of emotions. And he’d taken out tissues from the entorhinal, perirhinal, and parahippocampal cortices, which border the hippocampi. He didn’t get all of the hippocampus out on either side, because the far ends curved away, out of reach of his straight, inflexible suction tube. The remaining chunks of hippocampus, however, were now largely disconnected from the rest of the brain. They might as well not exist.

Once Henry came out of the anesthesia, it quickly became clear that Scoville’s invasion of his brain had been largely successful in treating the epilepsy. Henry’s seizures weren’t eliminated completely, but they were dramatically reduced in both frequency and intensity. It was also clear, however, that something else had happened, something awful. Henry recognized his parents. His intelligence, which was above average according to presurgical testing done in the hospital, was intact. So was his personality. He’d been shy, friendly, and good-natured before the operation. He was the same afterward.

But Henry had no clue about who the doctors, nurses, and other hospital staff who came to his room were, even after seeing them repeatedly. He could remember new information for a minute or two—if you said, “Good morning, Henry, my name is John,” and then, right afterward, “What’s my name?” he had no problem giving the right answer. If you asked him again fifteen minutes later, however, he couldn’t do it. He couldn’t navigate his way to the bathroom even after having been there several times. He didn’t know why he was in the hospital. An hour after he’d had lunch, he couldn’t remember eating. He’d eat a second lunch if you put it in front of him, and then a third. He couldn’t remember much of anything about his past—the condition known as retrograde amnesia. And he also had anterograde amnesia: he couldn’t convert his everyday experiences into new memories to be recalled in the future. Until his death fifty-five years later, he never would.

Scoville was appalled. The operation was, he would later acknowledge, a tragic mistake. He’d had no idea that this might happen. He didn’t know at the time that Wilder Penfield, in Montreal, had had a similar outcome with two other patients, known only by their initials, F.C. and P.B. Both men had epilepsy, like Henry (who himself would be known simply as H.M., to protect his privacy, until after he died). Penfield had operated on them in an attempt to cure it. He’d removed medial temporal lobe tissue, including the hippocampus, from one side of their brains only. Penfield had done the same surgery on many other patients; these two were the only ones who developed profound amnesia. It turned out that, unlike the others’, the mirror structures on the opposite sides of F.C.’s and P.B.’s brains weren’t normal. Both men had suffered injuries to those tissues long before Penfield performed his surgery—possibly as early as birth. Penfield’s other patients had backup. They could use the undamaged lobes on the other sides of their brains to take up the slack of memory formation and retrieval.

Scoville read about these two cases not long after he’d performed his surgery on Henry. He was naturally intrigued, and contacted Penfield, who suggested that a young colleague of his named Brenda Milner should come down from Montreal to test H.M., along with some of Scoville’s schizophrenia patients who had also had medial temporal lobe surgery. Milner, born in England and educated at Cambridge, had been a graduate student in the laboratory of Donald Hebb, a pioneer in the attempt to understand how the brain creates and maintains memory. When Penfield began his campaign to cure epilepsy through surgery, he had recruited Milner to help him test patients to see how the operations might have affected their cognitive abilities. She had helped him figure out why F.C.’s and P.B.’s memory functions had been so severely affected, and she was eager to see how this new patient down in Connecticut might fit into the story.

The testing took place in 1955. Milner showed rigorously what Scoville had understood only in general terms: Henry’s intelligence, language, and other higher mental functions were unaffected by the operation. His personality was essentially unchanged. He was described by the scientists who studied him as “gentle, goodhearted and altruistic.” But his memory had been profoundly damaged, in both the past and future direction.

Unlike Scoville’s schizophrenia patients, Henry wasn’t mentally ill before his operation, which would have made it more difficult to disentangle memory problems caused by the surgery from any memory problems that might have been caused by the schizophrenia instead. And unlike Penfield’s patients P.B. and F.C., who still had some function in the memory structures that had been damaged naturally rather than surgically, Henry had virtually none on either side of his brain. Milner and Scoville wrote up the results in a paper that appeared in the Journal of Neurology, Neurosurgery, and Psychiatry. It’s no exaggeration to say that this article, which first established the crucial role of the medial temporal lobe in memory, changed the course of neuroscience.

As Milner and her colleagues found during later rounds of testing, Henry did retain some memories of his past, but they were almost invariably general, not specific. They were along the lines of “I remember that I went to X high school,” in contrast to “I remember that crazy time in French class when Jimmy let the hamster loose and Monsieur Picard screamed ‘sacre bleu!’ ” The former are what neuroscientists now call semantic memories; the latter are episodic memories, since they record specific episodes in our lives rather than generalities. Henry knew where he’d grown up and where he’d gone to high school. He knew that his mother and father used to take him on vacations along the Mohawk Trail, a scenic highway that cuts across the Berkshires in western Massachusetts. But he couldn’t remember a single specific event from one of those Mohawk Trail vacations, for example, or something unusual that happened in high school, or a gift he’d gotten on a particular birthday.

There were just two exceptions. In 1939, when Henry was thirteen, Gus and Lizzie bought him a ride in a small plane as a junior high school graduation present. This adventure was so profoundly exciting, it was as though it had burned itself into Henry’s memory too deeply for even surgery to cut it out. Decades after the operation, he could still recall and describe the flight—what it looked like, what it sounded like, how it felt—almost moment by moment, in detail. Henry also retained a vivid memory of the first time he ever smoked a cigarette, which happened when he was ten. Presumably, it was as unpleasant as the plane ride was thrilling.

Aside from these two events, the only memories he had were semantic. That applied not just to memories of his own life, but also to his general knowledge about the world, which is also part of semantic memory. You almost certainly know that Paris is located in France, but you probably don’t know when you first learned that fact. There’s no specific experience, no episode you can point to where the information first entered your head. Similarly, you probably also know where your parents grew up. You know what an orange tastes like. You know that the United States fought against Germany and Japan in World War II. But you probably don’t know exactly when or how you came by these bits of information.

Semantic and episodic memories are different, but they both share this feature: you can describe them in words. Other memories are impossible to articulate, since they don’t involve conscious thought. Riding a bicycle, hitting a tennis ball, driving a nail, and playing a musical instrument are all things you remember how to do after you’ve learned, but you can’t really explain what it feels like to do them. People sometimes call this sort of thing “muscle memory,” because it seems as though your muscles, not your brain, are doing the remembering.

Neuroscientists now call those two broad categories of memory declarative, which refers to things you can describe in words, and procedural or implicit, things you simply know or know how to do without being able to describe them (retrieving the words to construct a sentence is another example). Until Henry came along, nobody really knew whether procedural and declarative memories were formed or stored or retrieved from the same part of the brain, or different parts, or how the whole process worked.

Thanks to the purity of his memory loss, however, which was untainted by any accompanying mental illness or loss of other cognitive abilities—understanding speech, for example, or recognizing objects—H.M. became what Suzanne Corkin, the MIT neuroscientist who worked under Brenda Milner and went on to study Molaison for more than four decades, calls the “gold standard for the study of amnesia…the yardstick against which other amnesic patients were judged.” In the scientific literature, she writes, they were typically referred to as being “ ‘as bad as H.M.’ or ‘not as bad as H.M.’ ”

Over decades of careful study, Corkin, who died in the spring of 2016, either performed or directed hundreds of research studies to probe the tiniest nuances of Henry’s memory loss. Once a month or so, on average, starting in 1966 and continuing until the mid-2000s, Henry would be driven from Hartford up to MIT, where Corkin had settled after doing graduate work with Milner in Montreal. Corkin herself, one of her graduate students or postdocs, or one of dozens of independent scientists who worked with Henry over those decades would put him through a battery of tests. Many of the tests had been created just for him.

Over that time, Henry became more than just a subject. “He was a friend,” Corkin told me, sitting in her MIT office one afternoon. “And not just to me. He was a member of our lab family.” For the first few years after the operation, Henry continued to live with his parents—and then, when his father died, in 1966, with his mother. After she came down with dementia, he moved in with a relative and, finally, in 1980, into a nursing home near Hartford. After that, Corkin said, he had nobody to visit him or look after him. “We sort of filled in the gaps as best we could. We used to send him presents for Christmas and we’d send him pictures of our dogs and stuff like that.” When a health issue came up, Corkin had the nursing home call her. “I don’t do this with other patients,” she said. “If something happens with them, they go and see their doctor, but with Henry, I wanted to make sure that he was well taken care of and that his needs were met, medical and otherwise.” She meant this literally. The last time she visited Henry, in the fall of 2008, she asked his caregivers what he needed. White socks, they told her. So this eminent neuroscientist at one of the most prestigious universities in the world drove over to Costco, bought a pack of socks, and mailed them to Connecticut. She would never see Henry alive again.

The Perpetual Now

By Michael D. Lemonick

You are what you remember...

Unaware—and indifferent. He seemed bland, placid, emptied of all feeling—it was this unnatural serenity that his Krishna brethren had perceived, apparently, as “bliss,” and indeed, at one point, Greg used the term himself. “How do you feel?” I returned to this again and again. “I feel blissful,” he replied at one point, “I am afraid of falling back into the material world.” At this point, when he was first in the hospital, many of his Hare Krishna friends would come to visit him; I often saw their saffron robes in the corridors. They would come to visit poor, blind, blank Greg and flock around him; they saw him as having achieved “detachment,” as an Enlightened One.
*
His tumor, a slow-growing one, was huge when it was finally removed in 1976, but only in the later stages of its growth, as it destroyed the memory system in the temporal lobe, would it actually have prevented the brain from registering new events. But Greg had difficulties—not absolute, but partial—even in remembering events from the late sixties, events that he must have registered perfectly at the time. So beyond the inability to register new experiences, there had been an erosion of existing memories (a retrograde amnesia) going back several years before his tumor had developed. There was not an absolutely sharp cutoff here, but rather a temporal gradient, so that figures and events from 1966 and 1967 were fully remembered, events from 1968 or 1969 partially or occasionally remembered, and events after 1970 almost never remembered.
*
This narrowed down the extent of his amnesia. He remembered songs vividly from 1964 to 1968. He remembered all the founding members of the Grateful Dead, from 1967. But he was unaware that Pigpen, Jimi Hendrix, and Janis Joplin were all dead. His memory cut off by 1970, or before. He was caught in the sixties, unable to move on. He was a fossil, the last hippie.

At first I did not want to confront Greg with the enormity of his time loss, his amnesia, or even to let involuntary hints through (which he would certainly pick up, for he was very sensitive to anomaly and tone), so I changed the subject and said, “Let me examine you.”
*
I had already had some sense of this when testing his memory, finding his confinement, in effect, to a single moment—“the present”—uninformed by any sense of a past (or a future). Given this radical lack of connection and continuity in his inner life, I got the feeling, indeed, that he might not have an inner life to speak of, that he lacked the constant dialogue of past and present, of experience and meaning, which constitutes consciousness and inner life for the rest of us. He seemed to have no sense of “next” and to lack that eager and anxious tension of anticipation, of intention, that normally drives us through life.

Some sense of ongoing, of “next,” is always with us. But this sense of movement, of happening, Greg lacked; he seemed immured, without knowing it, in a motionless, timeless moment. And whereas for the rest of us the present is given its meaning and depth by the past (hence it becomes the “remembered present,” in Gerald Edelman’s term), as well as being given potential and tension by the future, for Greg it was flat and (in its meager way) complete. This living-in-the-moment, which was so manifestly pathological, had been perceived in the temple as an achievement of higher consciousness.

Greg seemed to adjust to Williamsbridge with remarkable ease, considering he was a young man being placed, probably forever, in a hospital for the chronically ill. There was no furious defiance, no railing at Fate, no sense, apparently, of indignity or despair. Compliantly, indifferently, Greg let himself be put away in the backwater of Williamsbridge. When I asked him about this, he said, “I have no choice.” And this, as he said it, seemed wise and true. Indeed, he seemed eminently philosophical about it. But it was a philosophicalness made possible by his indifference, his brain damage.
His parents, so estranged from him when he was rebellious and well, came daily, doted on him, now that he was helpless and ill; and they, for their part, could be sure, at any time, that he would be at the hospital, smiling and grateful for their visit. If he was not “waiting” for them, so much the better—they could miss a day, or a few days, if they were away; he would not notice, but would be cordial as ever the next time they came.
*
Damage to the frontal lobes, in contrast, does not affect these, but produces a subtler and profounder disturbance of identity.

And it was this—rather than his blindness, or his weakness, or his disorientation, or his amnesia—that so horrified his parents when they finally saw Greg in 1975. It was not just that he was damaged, but that he was changed beyond recognition, had been “dispossessed,” in his father’s words, by a sort of simulacrum, or changeling, which had Greg’s voice and manner and humor and intelligence but not his “spirit” or “realness” or “depth”—a changeling whose wisecracking and levity formed a shocking counterpoint to the fearful gravity of what had happened.
*
If Greg was alone, in a corridor, he seemed scarcely alive; but as soon as he was in company, he was a different person altogether. He would “come to,” he would be funny, charming, ingenuous, sociable. Everyone liked him; he would respond to anyone at once, with a lightness and a humor and an absence of guile or hesitation; and if there was something too light or flippant or indiscriminate in his interactions and reactions, and if, moreover, he lost all memory of them in a minute, well, there were worse things; it was understandable, one of the results of his disease. Thus one was very aware, in a hospital for chronic patients like ours, a hospital where feelings of melancholy, of rage, and of hopelessness simmer and preside, of the virtue of a patient such as Greg—who never appeared to have bad moods, and who, when activated by others, was invariably cheerful, euphoric.

He seemed, in an odd way, and in consequence of his sickness, to have a sort of vitality or health—a cheeriness, an inventiveness, a directness, an exuberance, which other patients, and indeed the rest of us, found delightful in small doses. And where he had been so “difficult,” so tormented, so rebellious in his pre-Krishna days, all this anger and torment and angst now seemed to have vanished; he seemed to be at peace.
*
It seemed natural, at this time, given Greg’s blindness and the revelation of his potential for learning, that he should be given an opportunity to learn Braille. Arrangements were made with the Jewish Institute for the Blind for him to enter intensive training, four times a week. It should not have been a disappointment, nor indeed a surprise, that Greg was unwilling to learn any Braille—that he was startled and bewildered at finding this imposed on him, and cried out, “What’s going on? Do you think I’m blind? Why am I here, with blind people all around me?” Attempts were made to explain things to him, and he responded, with impeccable logic, “If I were blind, I would be the first person to know it.” The institute said they had never had such a difficult patient, and the project was quietly allowed to drop.

Oliver Sacks
An Anthropologist on Mars

Henry Molaison, a life cut short

The fact that Molaison suffered from anterograde amnesia does not mean that his memories of the time before the operation were unaffected. The months immediately preceding the operation had vanished entirely. Even the death of a favourite uncle in 1950 was wiped from his memory. Recollections of times further back in the past – his schooldays, holiday jobs, childhood – quickly became scraps and fragments, refusing to fit themselves together into stories. Or perhaps it would be more accurate to say they were just that – endlessly repeated anecdotes, episodes dished up again and again. After the operation, old memories continued to present themselves, but Molaison would be completely unaware of having shared them with someone 15 minutes earlier, or even just a few moments before. They became a repertoire that contracted as the years went by. Interaction with Molaison demanded a great deal of patience.

Forgetting
Douwe Draaisma

She didn't understand any of it

The wind was cold. The feeling was icy blue with brown specks. Anything that is cold is not love. Love is warm. Love is Grandma.

Love is being committed to the ground.

The glimmer of the metal casket in the streak of sun momentarily superseded the gray of the day. The casket was in the hands of the men who had come to do a terrible thing. They had lifted the casket and were beginning to lower it. Inch by inch, moment by moment, they were pushing her grandmother down deep, more deep into the earth. They were burying love.

Everyone was weeping now, but still Sybil's eyes were dry, dry as the barren world that stretched before her, a world in which nobody said, "Sybil, Sybil, Sybil," a world without anyone to listen when she tried to talk, a world without love.

Propelled by powerful feelings, galvanized into locomotion, Sybil found herself moving forward. It was one or two slow steps at first, but then there were more steps, faster steps toward the banks of flowers over the lowered casket. She was at the grave, her body poised to jump into it, to join her grandmother forever.

Then there was that hand grabbing her arm with a swift, sharp movement. The restraining hand was pulling her, dragging her away from the grave, away from her grandmother.

The wind howled. The sky grew dark. There was nothing.

That hand with its overwhelming force was still pulling her. Its pressure was deeply embedded in her flesh. Her arm ached with the soreness engendered by the sharp, jerky movement.

Sybil turned to see who it was who had so forcibly removed her from her grandmother. Was it her uncle Roger, her father? They were not there.

There was no grave. There were no banks of flowers. No wind. No sky. Daddy and Mother, Uncle Roger and Aunt Hattie, Aunt Clara and the rich old man she married, the minister, all those other people were not here.

Instead of a grave there was a desk. The banks of flowers were blackboards. Instead of a sky there was a ceiling. Instead of a minister there was a teacher.

The teacher, who talked quickly in short nervous sentences, was tall and thin. She wasn't Sybil's teacher. Miss Thurston, her teacher, spoke slowly and deliberately and was stout and of medium height. The third-grade teacher was Miss Thurston. This should be Miss Thurston, but it was Miss Henderson. Sybil knew Miss Henderson as the fifth-grade teacher. What has happened? Sybil wondered. It was no dream. The room, a regular classroom in the school she had attended since kindergarten, seemed normal between its four walls. Only it wasn't her classroom. The windows of the room faced the east, not the west, as they did in the third-grade classroom. She knew all the rooms in the school, and this, she knew, was the fifth-grade classroom.

Somehow she had gotten into this fifth-grade classroom. She had done something wrong, a terrible thing. She had to get out, had to get back to the third grade where she belonged, where Miss Thurston had probably marked her absent. She had to apologize to Miss Henderson for being here, had to explain to Miss Thurston for not being there. But what was the explanation?

Then she began to notice the other children. There was Betsy Bush across the aisle, Henry Von Hoffman in front of her, Stanley, and Stuart and Jim and Carolyn Schultz and all the rest. Well, she thought, the whole third grade is in here.

Most of these children had started with her in kindergarten, and she knew them well. They were the same children, yet they were not the same as when she had seen them last. They were dressed differently from when they were in the third grade. They looked bigger than they had been before she left for her grandmother's funeral. How could that be? How could all these children get bigger in a moment?

Betsy Bush, assured and confident as always, was waving her hand as usual to answer the teacher's question. She acted as if she belonged here. All the other children did, too. None of them seemed to think there was anything wrong about being here. Why should Betsy be answering questions when Miss Henderson was not her teacher?

Sybil's eyes turned next to the page of the notebook open on her desk. She thought of concentrating on the page and forgetting all the nonsense. But it could not be done, for the page made no sense to her, and in her present state of mind the notebook only induced more terror. There were lots of notes, but she hadn't taken them. There was completed homework, which she hadn't done, but she noted that the homework was consistently graded A. However urgently she forced herself to minimize the meaning of all this, the more terrified she became.

She tried hard to shut her eyes to this teacher who wasn't hers, to this classroom with the windows on the wrong side, these children, blown up beyond their normal size and dressed in strange clothes they hadn't worn before. It didn't work.

Sybil began to feel a strange compulsion to examine herself. were her clothes "different"? Was she bigger, too? Her eye descended to her own dress. It was of yellow voile with green and purple embroidery, as totally unfamiliar as those of the other children. She hadn't owned it, didn't remember her mother's buying it for her, hadn't worn it before, and hadn't put it on this morning. She was wearing a dress that didn't belong to her in a classroom in which she didn't belong.

Nobody seemed to think that anything unusual was happening. The third-grade children kept on answering questions about things she'd never studied with them. She didn't understand any of it.

Sybil
Flora Rheta Schreiber

As we build up our personal store of memories, our minds become sharper

Socrates was right. As people grew accustomed to writing down their thoughts and reading the thoughts others had written down, they became less dependent on the contents of their own memory. What once had to be stored in the head could instead be stored on tablets and scrolls or between the covers of codices. People began, as the great orator had predicted, to call things to mind not “from within themselves, but by means of external marks.” The reliance on personal memory diminished further with the spread of the letterpress and the attendant expansion of publishing and literacy. Books and journals, at hand in libraries or on the shelves in private homes, became supplements to the brain’s biological storehouse. People didn’t have to memorize everything anymore. They could look it up.

But that wasn’t the whole story. The proliferation of printed pages had another effect, which Socrates didn’t foresee but may well have welcomed. Books provided people with a far greater and more diverse supply of facts, opinions, ideas, and stories than had been available before, and both the method and the culture of deep reading encouraged the commitment of printed information to memory. In the seventh century, Isidore, the bishop of Seville, remarked how reading “the sayings” of thinkers in books “render[ed] their escape from memory less easy.”1 Because every person was free to chart his own course of reading, to define his own syllabus, individual memory became less of a socially determined construct and more the foundation of a distinctive perspective and personality. Inspired by the book, people began to see themselves as the authors of their own memories. Shakespeare has Hamlet call his memory “the book and volume of my brain.”

In worrying that writing would enfeeble memory, Socrates was, as the Italian novelist and scholar Umberto Eco says, expressing “an eternal fear: the fear that a new technological achievement could abolish or destroy something that we consider precious, fruitful, something that represents for us a value in itself, and a deeply spiritual one.” The fear in this case turned out to be misplaced. Books provide a supplement to memory, but they also, as Eco puts it, “challenge and improve memory; they do not narcotize it.”
*
Erasmus, who as a schoolboy had memorized great swathes of classical literature, including the complete works of the poet Horace and the playwright Terence, was not recommending memorization for memorization’s sake or as a rote exercise for retaining facts. To him, memorizing was far more than a means of storage. It was the first step in a process of synthesis, a process that led to a deeper and more personal understanding of one’s reading. He believed, as the classical historian Erika Rummel explains, that a person should “digest or internalize what he learns and reflect rather than slavishly reproduce the desirable qualities of the model author.” Far from being a mechanical, mindless process, Erasmus’s brand of memorization engaged the mind fully. It required, Rummel writes, “creativeness and judgment.”4Erasmus’s advice echoed that of the Roman Seneca, who also used a botanical metaphor to describe the essential role that memory plays in reading and in thinking. “We should imitate bees,” Seneca wrote, “and we should keep in separate compartments whatever we have collected from our diverse reading, for things conserved separately keep better. Then, diligently applying all the resources of our native talent, we should mingle all the various nectars we have tasted, and then turn them into a single sweet substance, in such a way that, even if it is apparent where it originated, it appears quite different from what it was in its original state.”5 Memory, for Seneca as for Erasmus, was as much a crucible as a container. It was more than the sum of things remembered. It was something newly made, the essence of a unique self.

Erasmus’s recommendation that every reader keep a notebook of memorable quotations was widely and enthusiastically followed. Such notebooks, which came to be called “commonplace books,” or just “commonplaces,” became fixtures of Renaissance schooling. Every student kept one.6 By the seventeenth century, their use had spread beyond the schoolhouse. Commonplaces were viewed as necessary tools for the cultivation of an educated mind. In 1623, Francis Bacon observed that “there can hardly be anything more useful” as “a sound help for the memory” than “a good and learned Digest of Common Places.” By aiding the recording of written works in memory, he wrote, a well-maintained commonplace “supplies matter to invention.”7 Through the eighteenth century, according to American University linguistics professor Naomi Baron, “a gentleman’s commonplace book” served “both as a vehicle for and a chronicle of his intellectual development.”8The popularity of commonplace books ebbed as the pace of life quickened in the nineteenth century, and by the middle of the twentieth century memorization itself had begun to fall from favor. Progressive educators banished the practice from classrooms, dismissing it as a vestige of a less enlightened time. What had long been viewed as a stimulus for personal insight and creativity came to be seen as a barrier to imagination and then simply as a waste of mental energy. The introduction of new storage and recording media throughout the last century—audiotapes, videotapes, microfilm and microfiche, photocopiers, calculators, computer drives—greatly expanded the scope and availability of “artificial memory.” Committing information to one’s own mind seemed ever less essential. The arrival of the limitless and easily searchable data banks of the Internet brought a further shift, not just in the way we view memorization but in the way we view memory itself. The Net quickly came to be seen as a replacement for, rather than just a supplement to, personal memory. Today, people routinely talk about artificial memory as though it’s indistinguishable from biological memory.

Clive Thompson, the Wired writer, refers to the Net as an “outboard brain” that is taking over the role previously played by inner memory. “I’ve almost given up making an effort to remember anything,” he says, “because I can instantly retrieve the information online.” He suggests that “by offloading data onto silicon, we free our own gray matter for more germanely ‘human’ tasks like brainstorming and daydreaming.” 9 David Brooks, the popular New York Times columnist, makes a similar point. “I had thought that the magic of the information age was that it allowed us to know more,” he writes, “but then I realized the magic of the information age is that it allows us to know less. It provides us with external cognitive servants—silicon memory systems, collaborative online filters, consumer preference algorithms and networked knowledge. We can burden these servants and liberate ourselves.”10
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As the Web “teaches us to think like it does,” he says, we’ll end up keeping “rather little deep knowledge” in our own heads.11 Don Tapscott, the technology writer, puts it more bluntly. Now that we can look up anything “with a click on Google,” he says, “memorizing long passages or historical facts” is obsolete. Memorization is “a waste of time.”12

Our embrace of the idea that computer databases provide an effective and even superior substitute for personal memory is not particularly surprising. It culminates a century-long shift in the popular view of the mind. As the machines we use to store data have become more voluminous, flexible, and responsive, we’ve grown accustomed to the blurring of artificial and biological memory. But it’s an extraordinary development nonetheless. The notion that memory can be “outsourced,” as Brooks puts it, would have been unthinkable at any earlier moment in our history. For the Ancient Greeks, memory was a goddess: Mnemosyne, mother of the Muses. To Augustine, it was “a vast and infinite profundity,” a reflection of the power of God in man.13 The classical view remained the common view through the Middle Ages, the Renaissance, and the Enlightenment—up to, in fact, the close of the nineteenth century. When, in an 1892 lecture before a group of teachers, William James declared that “the art of remembering is the art of thinking,” he was stating the obvious.14 Now, his words seem old-fashioned. Not only has memory lost its divinity; it’s well on its way to losing its humanness. Mnemosyne has become a machine.

The shift in our view of memory is yet another manifestation of our acceptance of the metaphor that portrays the brain as a computer. If biological memory functions like a hard drive, storing bits of data in fixed locations and serving them up as inputs to the brain’s calculations, then offloading that storage capacity to the Web is not just possible but, as Thompson and Brooks argue, liberating. It provides us with a much more capacious memory while clearing out space in our brains for more valuable and even “more human” computations. The analogy has a simplicity that makes it compelling, and it certainly seems more “scientific” than the suggestion that our memory is like a book of pressed flowers or the honey in a beehive’s comb. But there’s a problem with our new, post-Internet conception of human memory. It’s wrong.
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The growth and maintenance of new synaptic terminals,” writes Kandel, “makes memory persist.”21 The process also says something important about how, thanks to the plasticity of our brains, our experiences continually shape our behavior and identity: “The fact that a gene must be switched on to form long-term memory shows clearly that genes are not simply determinants of behavior but are also responsive to environmental stimulation, such as learning.”22
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The old botanical metaphors for memory, with their emphasis on continual, indeterminate organic growth, are, it turns out, remarkably apt. In fact, they seem to be more fitting than our new, fashionably high-tech metaphors, which equate biological memory with the precisely defined bits of digital data stored in databases and processed by computer chips. Governed by highly variable biological signals, chemical, electrical, and genetic, every aspect of human memory—the way it’s formed, maintained, connected, recalled—has almost infinite gradations. Computer memory exists as simple binary bits—ones and zeros—that are processed through fixed circuits, which can be either open or closed but nothing in between.

Kobi Rosenblum, who heads the Department of Neurobiology and Ethology at the University of Haifa in Israel, has, like Eric Kandel, done extensive research on memory consolidation. One of the salient lessons to emerge from his work is how different biological memory is from computer memory. “The process of long-term memory creation in the human brain,” he says, “is one of the incredible processes which is so clearly different than ‘artificial brains’ like those in a computer. While an artificial brain absorbs information and immediately saves it in its memory, the human brain continues to process information long after it is received, and the quality of memories depends on how the information is processed.”28 Biological memory is alive. Computer memory is not.

Those who celebrate the “outsourcing” of memory to the Web have been misled by a metaphor. They overlook the fundamentally organic nature of biological memory. What gives real memory its richness and its character, not to mention its mystery and fragility, is its contingency. It exists in time, changing as the body changes. Indeed, the very act of recalling a memory appears to restart the entire process of consolidation, including the generation of proteins to form new synaptic terminals.29
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The proponents of the outsourcing idea also confuse working memory with long-term memory. When a person fails to consolidate a fact, an idea, or an experience in long-term memory, he’s not “freeing up” space in his brain for other functions. In contrast to working memory, with its constrained capacity, long-term memory expands and contracts with almost unlimited elasticity, thanks to the brain’s ability to grow and prune synaptic terminals and continually adjust the strength of synaptic connections.

 “Unlike a computer,” writes Nelson Cowan, an expert on memory who teaches at the University of Missouri, “the normal human brain never reaches a point at which experiences can no longer be committed to memory; the brain cannot be full.”31 Says Torkel Klingberg, “The amount of information that can be stored in long-term memory is virtually boundless.”32 Evidence suggests, moreover, that as we build up our personal store of memories, our minds become sharper. The very act of remembering, explains clinical psychologist Sheila Crowell in The Neurobiology of Learning, appears to modify the brain in a way that can make it easier to learn ideas .

WHAT DETERMINES WHAT we remember and what we forget? The key to memory consolidation is attentiveness. Storing explicit memories and, equally important, forming connections between them requires strong mental concentration, amplified by repetition or by intense intellectual or emotional engagement. The sharper the attention, the sharper the memory. “For a memory to persist,” writes Kandel, “the incoming information must be thoroughly and deeply processed. This is accomplished by attending to the information and associating it meaningfully and systematically with knowledge already well established in memory.”35 If we’re unable to attend to the information in our working memory, the information lasts only as long as the neurons that hold it maintain their electric charge—a few seconds at best. Then it’s gone, leaving little or no trace in the mind.
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37The influx of competing messages that we receive whenever we go online not only overloads our working memory; it makes it much harder for our frontal lobes to concentrate our attention on any one thing. The process of memory consolidation can’t even get started. And, thanks once again to the plasticity of our neuronal pathways, the more we use the Web, the more we train our brain to be distracted—to process information very quickly and very efficiently but without sustained attention. That helps explain why many of us find it hard to concentrate even when we’re away from our computers. Our brains become adept at forgetting, inept at remembering. Our growing dependence on the Web’s information stores may in fact be the product of a self-perpetuating, self-amplifying loop. As our use of the Web makes it harder for us to lock information into our biological memory, we’re forced to rely more and more on the Net’s capacious and easily searchable artificial memory, even if it makes us shallower thinkers.
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One thing that sets us apart from other animals is the command we have been granted over our attention. “‘Learning how to think’ really means learning how to exercise some control over how and what you think,” said the novelist David Foster Wallace in a commencement address at Kenyon College in 2005. “It means being conscious and aware enough to choose what you pay attention to and to choose how you construct meaning from experience.” To give up that control is to be left with “the constant gnawing sense of having had and lost some infinite thing.”38 A mentally troubled man—he would hang himself two and a half years after the speech—Wallace knew with special urgency the stakes involved in how we choose, or fail to choose, to focus our mind. We cede control over our attention at our own peril. Everything that neuroscientists have discovered about the cellular and molecular workings of the human brain underscores that point.

Socrates may have been mistaken about the effects of writing, but he was wise to warn us against taking memory’s treasures for granted. His prophecy of a tool that would “implant forgetfulness” in the mind, providing “a recipe not for memory, but for reminder,” has gained new currency with the coming of the Web. The prediction may turn out to have been merely premature, not wrong. Of all the sacrifices we make when we devote ourselves to the Internet as our universal medium, the greatest is likely to be the wealth of connections within our own minds. It’s true that the Web is itself a network of connections, but the hyperlinks that associate bits of online data are nothing like the synapses in our brain. The Web’s links are just addresses, simple software tags that direct a browser to load another discrete page of information. They have none of the organic richness or sensitivity of our synapses. The brain’s connections, writes Ari Schulman, “don’t merely provide access to a memory; they in many ways constitute memories.”39 The Web’s connections are not our connections—and no matter how many hours we spend searching and surfing, they will never become our connections. When we outsource our memory to a machine, we also outsource a very important part of our intellect and even our identity. William James, in concluding his 1892 lecture on memory, said, “The connecting is the thinking.” To which could be added, “The connecting is the self.”
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The offloading of memory to external data banks doesn’t just threaten the depth and distinctiveness of the self. It threatens the depth and distinctiveness of the culture we all share. In a recent essay, the playwright Richard Foreman eloquently described what’s at stake. “I come from a tradition of Western culture,” he wrote, “in which the ideal (my ideal) was the complex, dense and ‘cathedral-like’ structure of the highly educated and articulate personality—a man or woman who carried inside themselves a personally constructed and unique version of the entire heritage of the West.” But now, he continued, “I see within us all (myself included) the replacement of complex inner density with a new kind of self—evolving under the pressure of information overload and the technology of the ‘instantly available.’” As we are drained of our “inner repertory of dense cultural inheritance,” Foreman concluded, we risk turning into “pancake people—spread wide and thin as we connect with that vast network of information accessed by the mere touch of a button.”42Culture is more than the aggregate of what Google describes as “the world’s information.” It’s more than what can be reduced to binary code and uploaded onto the Net. To remain vital, culture must be renewed in the minds of the members of every generation. Outsource memory, and culture withers.

The shallows: what the Internet is doing to our brains
Nicholas Carr

Thinking requires space in which to forget, to select, to delate

Memory by itself can only accumulate data, pointlessly and meaninglessly. Remember Jorge Luis Borges’s philosophical parable “Funes the Memorious.” Funes is a young man who, falling on his head from a horse, becomes strangely crippled: his memory hyper-develops, he is deprived of any ability to forget, he remembers everything; his mind becomes a monstrous garbage dump cluttered and clogged with irrelevant data, a gigantic heap of unrelated images and disconnected instants; he cannot evacuate any fragment of past experiences, however trifling. This relentless capacity for absolute and continuous recollection is a curse; it excludes all possibility of thought. For thinking requires space in which to forget, to select, to delete and to isolate what is significant. If you cannot discard any item from the memory store, you cannot abstract and generalise. But without abstraction and generalisation, there can be no thought.

Simon Leys
The Hall of Uselessness