The next day, Eugene started vomiting and writhing with stomach cramps. Within twenty-four hours, his dehydration was so pronounced that a panicked Beverly took him to the emergency room. His temperature started rising, hitting 105 degrees as he sweated a yellow halo of perspiration onto the hospital’s sheets. He became delirious, then violent, yelling and pushing when nurses tried to insert an IV into his arm. Only after sedation was a physician able to slide a long needle between two vertebrae in the small of his back and extract a few drops of cerebrospinal fluid. The doctor performing the procedure sensed trouble immediately.
The fluid surrounding the brain and spinal nerves is a barrier against infection and injury. In healthy individuals, it is clear and quick flowing, moving with an almost silky rush through a needle. The sample from Eugene’s spine was cloudy and dripped out sluggishly, as if filled with microscopic grit.1,3 When the results came back from the laboratory, Eugene’s physicians learned why he was ill: He was suffering from viral encephalitis, a disease caused by a relatively harmless virus that produces cold sores, fever blisters, and mild infections on the skin. In rare cases, however, the virus can make its way into the brain, inflicting catastrophic damage as it chews through the delicate folds of tissue where our thoughts, dreams—and according to some, souls—reside.
Eugene’s doctors told Beverly there was nothing they could do to counter the damage already done, but a large dose of antiviral drugs might prevent it from spreading. Eugene slipped into a coma and for ten days was close to death. Gradually, as the drugs fought the disease, his fever receded and the virus disappeared. When he finally awoke, he was weak and disoriented and couldn’t swallow properly. He couldn’t form sentences and would sometimes gasp, as if he had momentarily forgotten how to breathe. But he was alive.
Eventually, Eugene was well enough for a battery of tests. The doctors were amazed to find that his body—including his nervous system—appeared largely unscathed. He could move his limbs and was responsive to noise and light. Scans of his head, though, revealed ominous shadows near the center of his brain. The virus had destroyed an oval of tissue close to where his cranium and spinal column met. “He might not be the person you remember,” one doctor warned Beverly. “You need to be ready if your husband is gone.” Eugene was moved to a different wing of the hospital. Within a week, he was swallowing easily. Another week, and he started talking normally, asking for Jell-O and salt, flipping through television channels and complaining about boring soap operas. By the time he was discharged to a rehabilitation center five weeks later, Eugene was walking down hallways and offering nurses unsolicited advice about their weekend plans. “I don’t think I’ve ever seen anyone come back like this,” a doctor told Beverly. “I don’t want to raise your hopes, but this is amazing.”
Beverly, however, remained concerned. In the rehab hospital it became clear that the disease had changed her husband in unsettling ways. Eugene couldn’t remember which day of the week it was, for instance, or the names of his doctors and nurses, no matter how many times they introduced themselves. “Why do they keep asking me all these questions?” he asked Beverly one day after a physician left his room. When he finally returned home, things got even stranger. Eugene didn’t seem to remember their friends. He had trouble following conversations. Some mornings, he would get out of bed, walk into the kitchen, cook himself bacon and eggs, then climb back under the covers and turn on the radio. Forty minutes later, he would do the same thing: get up, cook bacon and eggs, climb back into bed, and fiddle with the radio. Then he would do it again.
When Squire received the images of Eugene’s brain, he marveled at how similar it seemed to H.M.’s. There were empty, walnut-sized chunks in the middle of both their heads. Eugene’s memory—just like H.M.’s—had been removed. As Squire began examining Eugene, though, he saw that this patient was different from H.M. in some profound ways. Whereas almost everyone knew within minutes of meeting H.M. that something was amiss, Eugene could carry on conversations and perform tasks that wouldn’t alert a casual observer that anything was wrong. The effects of H.M.’s surgery had been so debilitating that he was institutionalized for the remainder of his life. Eugene, on the other hand, lived at home with his wife. H.M. couldn’t really carry on conversations.
Eugene, in contrast, had an amazing knack for guiding almost any discussion to a topic he was comfortable talking about at length, such as satellites—he had worked as a technician for an aerospace company—or the weather. Squire started his exam of Eugene by asking him about his youth. Eugene talked about the town where he had grown up in central California, his time in the merchant marines, a trip he had taken to Australia as a young man. He could remember most of the events in his life that had occurred prior to about 1960. When Squire asked about later decades, Eugene politely changed the topic and said he had trouble recollecting some recent events. Squire conducted a few intelligence tests and found that Eugene’s intellect was still sharp for a man who couldn’t remember the last three decades. What’s more, Eugene still had all the habits he had formed in his youth, so whenever Squire gave him a cup of water or complimented him on a particularly detailed answer, Eugene would thank him and offer a compliment in return.
Whenever someone entered the room, Eugene would introduce himself and ask about their day. But when Squire asked Eugene to memorize a string of numbers or describe the hallway outside the laboratory’s door, the doctor found his patient couldn’t retain any new information for more than a minute or so. When someone showed Eugene photos of his grandchildren, he had no idea who they were. When Squire asked if he remembered getting sick, Eugene said he had no recollection of his illness or the hospital stay. In fact, Eugene almost never recalled that he was suffering from amnesia. His mental image of himself didn’t include memory loss, and since he couldn’t remember the injury, he couldn’t conceive of anything being wrong.