Review: Permanent Present Tense by Suzanne Corkin

I reviewed Suzanne Corkin's book on the famous amnesiac HM for the Literary Review's May 2013 edition:

Total Lack of Recall 
Permanent Present Tense: The Man with No Memory, and What He Taught the World
By Suzanne Corkin
(Allen Lane/The Penguin Press 384pp £20)

In February 2009, a pair of neuroscientists carried an icebox through gate security at Logan Airport in Boston, under the gaze of a PBS film crew sent to document the event. Bypassing the security scanner so as not to expose the contents of the cooler to radiation, one of the researchers carried the box onto a waiting plane while the other, the neuropsychologist Suzanne Corkin, waved goodbye to her life’s work. Packed in ice inside the cooler was a human brain – possibly the most famous brain in history. It belonged to the amnesiac Henry Molaison, whose recent death had allowed his identity (for so long shrouded behind the initials ‘HM’) to be released to the world.

Corkin, who probably knew Henry better than anyone else, worked with him from 1962, when she was a graduate student, to his death in 2008. Over the decades, neuropsychologists, psychologists and neuroscientists probed his short- and long-term memory, his language abilities and reasoning skills, with Corkin as the gatekeeper to this precious scientific resource. Although he found her face familiar, he never really understood who she was, and tended to assume that she was an old classmate from his high school in Hartford, Connecticut.

Henry’s amnesia stemmed from a psychosurgical procedure intended to alleviate severe epilepsy. In the psychology textbooks, there is sometimes a suggestion that this was a cruel and unnecessary procedure, akin to the abhorrent lobotomies that were current at the time. Corkin is at pains to show that this was not a random act of cruelty or medical neglect, and that Henry’s debilitating fits provided good reason for conducting the surgery. William Beecher Scoville’s ‘frankly experimental’ procedure involved the removal of structures in the medial temporal lobes (deep in the brain above each ear), with devastating and unforeseen effects on Henry’s memory.

Henry’s amnesia was so profound, and so neatly sparing of his other cognitive abilities, that he quickly became the most famous amnesia case study of them all. There will hardly be a psychology graduate alive who doesn’t know the details: HM’s inability to form new memories was coupled with a preserved capacity to acquire new skills, such as learning to use a walking frame. After the operation, Henry’s grip on the past amounted to a total of two genuine autobiographical memories: an aeroplane flight taken when he was 13 and the taste of his first cigarette when he was 10. For the 55 years until his death, he created no new memories.

Most importantly of all, HM taught scientists about the importance of medial temporal lobe structures (predominantly the hippocampus) in converting short-term memories into long-term ones. Scientifically this is a hugely important story, and many will be excited that here, at last, is a chance to see the man behind the initials. In the right hands, this could have been a story of where the brain ends and the person begins, of the ethics of the close study of one individual. But readers who hope to understand Henry as a person will be disappointed. We rarely get to witness any of the human details that might bring him alive as a character. In one sense this is easily understandable: the observations of Henry were made for scientific, not biographical, purposes, and so the human element is largely unrecorded. But it is a scientifically informed biography that we are promised, and this worthy, detailed and ultimately rather lifeless book fails to meet that expectation in a number of ways.

Part of the problem is a predictable neuro-reductionist arrogance. Because Henry had a damaged brain, his brain becomes the cause of everything. We are told that Henry could not have had normal dreams, for example, because the necessary regions of his brain had been replaced by fluid-filled spaces. Anything that might have shaped his character beyond the effects of drugs or psychosurgery is left unexplored. No one would attempt to write a biography of an intact or more ordinarily damaged person by relating everything to brain structure. If they did, the results would be as dull as this.

There is nothing to suggest that Suzanne Corkin was anything other than a kind, attentive carer who wanted the best for her patient, as well as being an extremely thorough scientist (though her excitement at finally getting a chance to ‘harvest’ Henry’s brain will prove chilling for many readers). This is a human tragedy, and it deserves an approach that goes beyond the mere enumeration of clinical findings. Although we get plenty of ethics-committee discussion of the rights and wrongs of Henry’s story, along with tantalising flashes of the man’s personality (he had a quirky tendency to refer to Corkin as ‘Doctress’, for example), we get little insight into what Henry might have gone through or what emotions he would have grappled with. Corkin’s account has none of the richness of, say, Joshua Foer’s brief encounter with an amnesiac in his recent Moonwalking with Einstein, or (switching to a case of excessive rather than defective memory) of A R Luria’s classic portrait of S V Shereshevsky in The Mind of a Mnemonist. A more skilful writer might have saved us from learning what a human being becomes when he is boiled down to clinical data. HM’s personal tragedy had immensely valuable consequences; the disappointment of this book is that an individual has been reduced to an interesting brain.

Published in the Literary Review, May 2013 (reproduced with permission).

Longlisted: Royal Society Winton Prize for Science Books

Pieces of Light has been longlisted for the 2013 Royal Society Winton Prize for Science Books. The Guardian has covered the announcement in this blogpost from GrrlScientist.

GrrlScientist writes:

"This may be a golden age of science writing -- we had to choose from well over a hundred wonderful books covering a huge range of topics. Many of them would have deserved a place on the list", said Professor Uta Frith, Chair of the judges.

"We happily and unanimously agreed on the long list, but we each had favourites that we were sad not to be able to include." 

The wide variety of subjects covered by these books is exciting -- there's something here for everyone! 

"We are very pleased that almost all of our selected books are ambitiously grounded in several subjects at once, be it biology, physics, psychology, or technology" continued Professor Frith. "The judges all commented on how much they enjoyed the process. It was an inspiring task." 

The judges on this year's panel are Jon Culshaw, impressionist and comedian; Dr Emily Flashman, Royal Society Dorothy Hodgkin Fellow at University of Oxford; Professor Uta Frith DBE FBA FRS (Chair), Emeritus Professor of Cognitive Development at University College London; Joanne Harris, novelist and author of Chocolat; and Lucy Siegle, journalist and writer on environmental issues. 

Besides providing the reading public with an excellent list of science books to read whilst on holiday at the beach, the longlist announcement coincides with a panel discussion at the World Science Festival held right now my fair city, New York. This festival is hosting a panel discussion entitled "Science and story: cutting-edge discovery for a literary public", with James Gleick, winner of the 2012 Royal Society Winton Prize for Science Books and two of the 2012 shortlisted authors Lone Frank and Brian Greene.

I'm delighted to be on such an illustrious list, and am looking forward to catching up with the other longlisted titles. I haven't read nearly enough of them, but I'm pleased to see Caspar Henderson's amazing Book of Barely Imagined Beings on there.

A Box of Birds at the Hay Festival

On Monday 27 May I'll be at the Hay Festival talking about A Box of Birds at a special Unbound event.  Several Unbound authors will be pitching new projects or talking about books that have already been funded. Here's the full blurb:

JOHN MITCHINSON AND GUESTS
Unbound Live 1
The award-winning crowd-funded publisher offers the Hay audience a chance to choose what gets published. Mixing authors whose books have already been funded with others pitching their ideas for books they want to write, this is a literary Dragons’ Den with a difference. Legendary writer and performer Salena Godden pitches her childhood memoir, Red Dwarf star Robert Llewellyn presents his science fiction sequel, novelist Charles Fernyhough asks whether neuroscience changes love, Strangler Hugh Cornwell and archaeologist-turned-crimewriter Francis Pryor compete for your support with a little help from publisher and QI Elf-master John Mitchinson. Light poetic relief from performance poet George Chopping.

Hope to see some of you there.

Unboxed!

A Box of Birds is published in its trade paperback edition today, which means it will be available from bookshops and online retailers as well as from the website of the publisher Unbound.

Several hundred people pledged support to help this book see publication, and I'm grateful to every one of them.

Today I am travelling to London to give a talk at the Art and Mind Symposium at GV Art in London, where I'll be discussing how neuroscience figures in literary fiction, and expanding on the themes of my recent Guardian Review piece on the topic.

You can find out more about the book by reading this blog post and this one. It's my first novel since The Auctioneer was published, fourteen years ago. If you've read the book already, you must be a subscriber. Thank you.

Neuroscience in fiction

Publication day for A Box of Birds is just around the corner, so it was good to get a chance to set out some of the motivations behind the novel in last weekend's Guardian Review. As I explained in the piece, fiction gives us an unparalleled opportunity to understand the value of neuroscientific accounts of behaviour and experience. A lively comment thread has been building: you can join in here. The poet Helen Mort has written a thoughtful response on her blog, including a wonderful poem about Phantom Limb Syndrome.

A reminder that you can order the trade paperback edition of the novel here.

I've reproduced the article below with a few additional links:

We are in the middle of a debate about the status of neuroscience. Against the deceptive allure of neuroimaging and reported sightings of ‘brain centres’ for everything from sarcasm to religious experience, there are stern reassurances that, if we were ever to work out the scientific basis of consciousness, it would be too complicated for us to understand. We use lazy neurospeak and stock up on brain porn, but do we draw from it knowledge we can use? Is neuroscience really changing the way we understand ourselves?  

It might sound like an unlikely source of evidence, but we can find out something about the proper treatment of neuroscience by looking at how it functions in fiction. If tracing behaviour and experience to its neural underpinnings really offers a new understanding of humanity, novelists are bound to draw on it in revealing how their characters understand themselves. And writers’ use of neuroscientific ideas will tell us something about how we consume such explanations and what meaning we extract from them.  

In one sense, neuro-explanations seem to challenge the mechanisms by which novels work. Neuroscientists warn us that we may have no freewill, no ‘self’ at the helm of our behaviour; their work shows that our memories are leaky reconstructions and that even our visual perception of the world is a system of illusions. How do these messages change what we do, how we feel, how we decide to live? Fiction is a perfect medium for exploring these questions.  

Which makes it slightly surprising that the neuro doesn’t actually feature all that prominently in literary fiction. A 2009 article by Marco Roth pointed out that bookish neuroscience is often connected with atypical and pathological behaviour. For example, Gary Lambert’s depression in Jonathan Franzen’s The Corrections gives a central role to his screwy neurotransmitters, but we don’t get neuro-explanations for the (debatably) more sane members of the Lambert family. Richard Powers’ The Echo Maker is more interested in the brain-damaged patient, Mark Schluter, than with the science-inflected self-descriptions of his neuropsychologist, Gerald Weber. 

If neuroscientific ideas are really going to prove their worth to novelists, they need to be able to provide satisfactory accounts of ordinary, non-pathological experience. One novel to attempt that is Ian McEwan’s Saturday, which tells the story of the neurosurgeon, Henry Perowne, and his run-ins with the violent, chromosomally-disordered Baxter. Intimate with the workings of the brain, Perowne sees his own experience in terms of the bioelectrical processes that underlie it. Feeling a ‘sustained, distorting euphoria’, for example, he speculates that ‘there’s been a chemical accident while he slept—something like a spilled tray of drinks, prompting […] a kindly cascade of intracellular events’.

Perowne’s professional familiarity with neuroscience certainly colours his reflections on himself, but it’s not clear that it changes his relationships with his own experience and behaviour: it doesn’t make him less trusting of his own memory or visual perception, for example. More importantly, this immersion in neuroscience doesn’t change the story. Setting aside a couple of episodes where Perowne’s medical knowledge is directly exploited, the plot of Saturday would not unfold any differently if he had been ignorant of brain science. Baxter’s wild behaviour ultimately has a genetic rather than a neurological cause (he suffers from Huntington’s disease). When Baxter’s course of action is violently altered, it is poetry—a recital of Matthew Arnold’s ‘Dover Beach’—rather than neuroscience that is effective in changing behaviour. Brain is a correlate of action, not a driver of it.  

Other novelists are less optimistic about neuroscience’s capacity to make a difference. In Sebastian Faulks’ recent A Possible Life, the neuroscientist Elena pins the human capacity for self-awareness to a particular junction between ‘Glockner’s Isthmus’ (a fictional nexus of selfhood) and ‘the site of episodic memory’. While the neuroscience of Faulks’ tale fails to withstand close scrutiny, more interesting is the discovery’s lack of effect on the protagonist. Fêted internationally for her momentous breakthrough, Elena can’t connect her new neuroscientific reality to her own experience—or she won’t let herself. ‘She knew it to be truthful, valid and endlessly provable, but she didn’t allow the implications to affect the way she lived’.  

Faulks’ story seems to be telling us that, even if the scientific message turned out to be manageably simple, being able to reduce quintessentially human mental capacities to neural processes would not add much to our understanding. Perhaps neuroscience will continue to be most useful in accounting for disorder; indeed, perhaps its way of working will be to turn everything into the pathological. Roth’s complaint about the fictional dominance of neuro-dysfunction mirrors a wider trend, evidenced in the recent outcry about the psychiatry manual DSM-V, to see clinical symptoms where once we would have seen ordinary human variation.  

Another reason for not expecting to see too many neuro-explanations in fiction is that they may just be too complex. Novels give us manuals for living, accounts of who we are that we can use as human beings, and neuroscience may be working at the wrong level of explanation. The kind of neuro-explanations that we might one day arrive at might be too complicated for most of us to understand. If that’s the case, we’re unlikely to see novelists trying to weave them into a narrative. Fiction might function as a litmus test: not of what is true, but of what is useful. 

It’s also possible that we won’t always privilege neuro-truth above other kinds. Just as genetic explanations seemed less seductive once the human genome (with its surprisingly small complement of genes) was described, so our enthusiam for the brain might wane as we recognise that much of its work actually translates into the functioning of a disappointingly small number of ‘core’ networks. There is still mind-bogglingly complexity—subsidiary neural centres ‘plug in’ to core networks in all sorts of complicated ways—but it might be of a more boring kind than that promised by a tally of 86 billion neurones.

Fiction exists for its own purposes, and writers and readers will rightly resist attempts to turn it into ‘evidence’ for or against anything. It’s possible that neuroscience is just too new for its ideas to have permeated literary fiction in the way that those other paradigm-changers, Darwinism and psychoanalysis, did. As a novelist, I am interested in exploring characters for whom the networks of the cortex are a real, charged presence. How does this understanding affect what you do when things start happening, when you have to make moral choices? Because of the way it puts subjectivity, character and moral action at its heart, the novel is the ideal crucible for the experiment.  

Charles Fernyhough’s literary thriller A Box of Birds, about brains and those who work with them, is published by Unbound on 7 May.

Shortlisted!

Pieces of Light has been shortlisted for the 2013 Best Book of Ideas Prize. The prize is sponsored by Foyles and administered by the Bristol Festival of Ideas. The winner will be announced at a ceremony on 20 May.

Here's the full press release:

The shortlist for the 2013 Foyles/ Festival of Ideas Best Book of Ideas was announced today. The prize – worth £5,000 – is awarded to the book first published in the UK by a British author in 2012 which presents new, important and challenging ideas, which is rigorously argued, and which is engaging and accessible.

The six shortlisted books are:

Nick Cohen You Can’t Read This Book: Censorship in an Age of Freedom (Fourth Estate)
Charles Fernyhough Pieces of Light: The New Science of Memory (Profile Books)
Eliane Glaser Get Real: How to Tell it Like it is in a World of Illusions (Fourth Estate)
Ben Goldacre Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients (Fourth Estate)
Robert Macfarlane The Old Ways: A Journey on Foot (Hamish Hamilton)
Ali Smith Artful (Hamish Hamilton)

The winner will be announced on 20 May 2013 at the awards evening that forms part of the ninth Bristol Festival of Ideas.

Jasper Sutcliffe, Head of Buying for Foyles, sponsor of the award, said today:

‘This list reflects the tremendous quality of contemporary British non-fiction, the type of writing that will keep the gears of your brain working long after you have absorbed the arguments. These writers are not afraid to engage with their subject from a personal level, and to use an imaginative approach to their work that challenges even the best writers of narrative fiction.’

The judges for the award are writer and broadcaster Bidisha, Andrew Kelly, director of Bristol Festival of Ideas, writer and broadcaster Sian Norris, and Professor Peter Rawlings, Head, Department of Arts, University of the West of England.

Andrew Kelly said today:

‘This is an exceptional list which shows that British writers remain at the forefront of debate: from nature writing to bad medicine, the way we live today to death and immortality, from the natural world to the freedom to write and speak, these books fizz with ideas and deserve wide reading and debate.’

The previous winners of the award are:

2009 Nick Davies Flat Earth News
2010 Kate Pickett and Richard Wilkinson The Spirit Level: Why More Equal Societies Almost Always Do Better 
2011 Dan Hind The Return of the Public
2012 Michael Symmonds and Paul Farley Edgelands

Pieces of Light in America: the first week

Pieces of Light was published in the US last Tuesday. Here's a roundup of what's happened to the book in its first week of publication.

The book was a PW Pick in the trade magazine Publishers Weekly, meaning that it was picked by the editors as one of the ten best new books of the week:

In this refreshingly social take on a personal experience, psychologist Fernyhough aims to debunk the myth that memory is purely retrospective—memories, he argues, are not “heirloom[s] from the past” summoned back for display in the present; they are momentary reconstructions.

The Huffington Post ran a piece on the cover art, which was designed by Profile's art director Peter Dyer. Peter says:

The author talks about memory as a collage, coming from lots of different places in the brain. I liked the idea of using silver foil to illuminate some of the dots on the cover design – it gets across the idea that some memories burn really bright in our heads, while others are more blurred. As the book catches the light, the dots either shine or fall back – just like memories at certain points in our lives.

I did a Q&A with Jeff Glor of CBS News, who asked me about the inspiration behind the book, and to whom I confessed about what I might be doing if I wasn't a writer and academic:

I have a part-time academic post, and I conduct research on topics such as hallucinations and child development as well as memory. If I had to give up all the bookish stuff completely, I'd be trying to make it as a progressive rock guitarist. Yeah, I know.

I was delighted to be chosen as Editors' Choice (best book of the week) on Apple's iBookstore, which gave the book this lovely review:

Durham University professor Charles Fernyhough offers an absorbing guidebook to the mysterious terrain of human memory with his second nonfiction work, Pieces of Light. In the tradition of Oliver Sacks’ casually shrewd scientific writing, the book blends dispatches from the frontiers of science with compassionate human anecdotes. Although this exploration never shies away from formidable science and challenging psychological concepts (like contextual “flashbulb memories,” which can be startlingly vivid and completely false), Fernyhough reinforces his lessons with elegant personal memoirs and pop-culture references. (Harry Potter, Princess Diana, and Andy Warhol all make cameos.) For a topic so elusive—discussed in methods that range from the allegorical “crazy woman” to the brain’s mysterious mechanics—Fernyhough’s enthralling narrative delivers gripping insight on the way memories shape our lives. 

On Sunday I was interviewed by Rachel Martin for NPR's Weekend Edition. We talked about early memories, the faulty memories of couples, and quality vs quantity:

Thinking about this book made me realize that remembering more stuff isn't necessarily better. Being able to recall every card in a pack of playing cards or recall pi to the thousandth decimal place — why? Why would you want to do that? It's no use to me. For some people it might be important, but it's no use at all for me. What I would like to do is remember the stuff that I remember better, in more detail, more vividly.

In this new post for my Psychology Today blog, I argue for a multidisciplinary approach to memory:

In all of these inquiries one thing has been clear to me. To understand autobiographical memory in its full richness, you need to get at it from the inside: as a subjective experience, as well as something that can be studied in the psychology or neuroscience lab. You need to ask what having a memory is like, and not be satisfied with purely objective descriptions of the phenomenon.

Finally, I wrote a piece for TIME Ideas about how the distortions of memory reveal a truth about the self:

Bracing as it might be, this new way of thinking about memory does not have to lead to self-doubt. It simply requires that we take our memories with a pinch of salt, and forge new relationships with them. They may be a kind of fiction, but the manner of their making speaks volumes about those who create them. In the Obama-Ahmadinejad study, the researchers found that events were more likely to be falsely recalled if they fit the individual’s political affiliations (conservatives were more likely than liberals to ‘remember’ the Ahmadinejad handshake, for example). Whether the events happened or not, your biases and beliefs shape the kind of memories you form, and thus reveal the kind of person you are.