Directors Notes

The published text of 2401 Objects contains the following notes from Analogue's Artistic Directors, reflecting on HM's story and the process of turning it into theatre.

Liam Jarvis

On 2 December, 2009 a ground-breaking procedure took place live on the internet to a global audience of around 400,000 people; as the world looked on, Dr. Jacopo Annese and his team at The Brain Observatory, San Diego (University of California) sliced a human brain into thousands of giant histological sections. I was one of those spectators, and this is where our relationship with Henry’s story began.

In life, the brain belonged to Henry Gustav Molaison (1926-2008), more famously known as ‘Patient H.M.’. Amongst the scientific community, H.M. and the research surrounding his condition are rigorously documented in over 11,900 published scientific journals. Meanwhile if you were to conduct a quick Google search for ‘Patient H.M.’ you would discover that the search produces in excess of 33 million results; he is one of the most written about amnesic case-studies in the history of neuroscience.

Since a young age, Henry had suffered from partial epileptic seizures, largely attributed to a bicycle accident he had had at the age of nine. Following his sixteenth birthday, Henry’s illness became progressively further debilitating, suffering with several tonic-clonic seizures. By the time he reached his twenties he was living at home with his parents, with little or no social life, barely able to hold down a job at the local garage and taking maximum dosages of several prescribed anticonvulsants, none of which worked.

In 1953, Henry and his parents resorted to drastic measures in an attempt to improve his quality of life; on August 25, 1953 Henry underwent experimental brain surgery to contain the intractable seizures. Neurosurgeon, Dr. William Beecher Scoville (1906 - 1984) removed approximately two-thirds of his hippocampus, parahippocampal gyrus, and amygdala. The intervention brought some relief from the convulsions, but these benefits were greatly outweighed by an unforeseen and irreversible side effect. Soon after the operation, it became clear that Henry could no longer recognise hospital staff, he could not remember having solved the crossword puzzle he had just completed and entire events leading up to the time of the operation had vanished.

Henry was left with retrograde amnesia, and could not remember most events in the 2 year period prior to the surgery. But perhaps even more disconcerting was the fact that Henry was also left with severe anterograde amnesia; a loss of the ability to create any new memories.

For all that has been written about him, since we initiated this research project our relationship with Henry has remained illusively virtual; but the idea of him has been a tangible presence in our rehearsal room over the two years this project has been developing. The extensive documentation that already exists made it apparent to us that what we did not want to make was a documentary piece about H.M. – given the readily available materials this would make the process feel rather reiterative; our aim was rather to consider the question of what could the experience of a theatre piece offer to the telling of this story?

Formally, theatre is perhaps more reliant on the hippocampus within the brains of its audience than any other medium, since memory is the only place where theatre truly lives beyond the immediate circumstance of the performance. Therefore, it is perhaps the form that best articulates the value of our own hippocampus; after all, what would the experience of a theatre performance mean for an audience of anterograde amnesics (knowing that within minutes of the curtain call the experience would have ceased to exist for that audience)?

It is through theatre and its unique properties that we understood the true gravity of Henry’s loss, and found an affinity with Dr. Jacopo Annese in his desire for face-to-face encounters; for us the key encounter is with the audience during the performance event. For Jacopo, the most significant encounters are with his patients; the opportunity to meet them in life before carrying out such procedures in death represents a radical shift away from viewing patients as anonymous specimens, and rather seeks to connect the organs with the complex stories and human beings behind them. Dr. Jacopo uses science to help tell the story of a subject and their body, we use the theatre, with the belief that these different disciplines can usefully speak to one another.

Hannah Barker

“What would you lose if you lost the last two years of your life?”

It was during rehearsals in October 2010 when the question was posed. The room was heavy with the weight of the subject we were tackling and, in that way that happens in a devising room, we had exploded out ideas to an intimidating scale.

The question silenced everyone as they scanned the last two years to assess their potential losses.

The entire creation of a piece of work, the birth of a child, two or three relationships, all vanished. A couple of influential interactions, a few flashes of pleasure and moments of pain, some seemingly inconsequential details that changed someone's mind or enforced an opinion, all disappeared.

The question referred to the two years that were wiped from Henry Molaison's memory preceding his operation in 1953. But, in fact, it also applied to the 55 years that followed it, until his death in December 2008.

Of course the question is flawed. For people in Henry's orbit, the world continued to turn during those years, and those who played supporting cast to his story had stories of their own which did not disappear.

And yet what is a relationship that is only remembered by one person? What losses do loved ones suffer by being partly or completely erased from the minds of those they care about?

By imagining the loss of my own history, I began to see beyond the countless medical journals, the phenomenal headlines and extraordinary science surrounding 'Patient HM’ that had come to define Henry's story.

What emerged in their place was the human being at the centre. How a simple thing like turning short-term into long-term memory not only allows us to keep hold of precious moments and people and experiences that make up who we are, but also what we want to be. And how, without it, we are nowhere and we are incredibly vulnerable.

We found very few records of Henry’s life before 1953. Consequently, we can only guess the events that led to Henry agreeing to undergo that fateful surgery in 1953, which even the surgeon who performed it described as 'frankly experimental’. We don’t even know whether he or his family were fully aware of the level of risk involved in the procedure and who made the final decision.

Regardless, the choice they made led to an extraordinary situation, and meant others were responsible for deciding what was best for Henry for the rest of his life.

So what does it mean to decide something for someone's 'own good'? How do we determine what is right for an individual in relation to what is best for the greater good? Can our motivations be separated from a seemingly innate human instinct to progress? We tend to plot our successes by our advances – In business terms: If you're not moving forwards, you're moving backwards. So where does that leave Henry?

Henry’s story provokes a vast entanglement of ethical dilemmas, which we have attempted to engage with by creating a fictional story of Henry’s life leading up to the procedure.

Throughout our process, we have sought extensive advice from neuroethics experts who have said that while good practice guides boast clear technical answers, in reality this is undeniably a messy area, especially with patients whose mental capacity is compromised.

Henry was visited by close to 100 scientists during his lifetime. His guardians signed waivers to allow them to run their experiments and while he appeared to happily consent, for him each one appeared as an isolated request. Was he even aware of what he was consenting to?

By presenting in the show the voice of the neuroscientist responsible for cutting Henry's brain into 2401 Objects, it is not our aim to say we agree or disagree with his work or the work of the countless scientists conducting tests on Henry – after all, who are we to enforce our opinion when we are equally complicit in using Henry for our own gain?

But in staging this story and in offering the voice of one such neuroscientist, we hope 2401 Objects will open a discussion that both addresses this subject's complexity, and also tells Henry’s story not as 'the most famous neuroscientific brain of all time', to which he is mostly referred in the numerous case studies, but as a human being with aspirations, desires and potential he was tragically never able to enjoy.

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