A week before his 23rd birthday, Max Meehan and his boyfriend went to a party at one of their favorite gay dive bars in the Back Bay of Boston. Max had a lot to drink. They danced until they were sweaty and smoked too many cigarettes. At some point, Max left the bar, met his dealer around the corner, and bought some heroin.
Hours later, after getting home, Max went to the bathroom to shoot up, as he had done countless times before. Drunk and high, he passed out on the couch.
The next morning, when he tried to get up, he collapsed onto the floor. His leg wasn’t working, somehow. I must have slept weirdly on my leg, he thought. Scared and in pain, he started to cry.
His boyfriend ran in, helped him back to the couch, and asked him what was wrong. Max stood up, only to sink to the floor again. His leg felt paralyzed. Again the thought struck him, as if brand new: I must have slept weirdly on my leg. He started crying.
Some minutes later, the seemingly new thought flew into his mind. I must have slept weirdly on my leg. He started sobbing frantically.
Many hours and two hospitals later, a slew of tests had failed to find a cause of Max’s leg pain and extreme confusion. His family was terrified.
“He was just kind of laying in bed, wondering what was going on,” said Max’s mom, Laura Frongillo, who was at his side at Lahey Hospital and Medical Center, not far from her home. “It was 21 hours really of not getting any information. It was just really shocking and scary.”
She and Max’s sister would try to cheer him up by showing him one of his favorite YouTube memes, “Sweet Brown.” Even though he had no idea of his surroundings, he was still his goofy self. “We just kept playing the video for Max, and he kept thinking it was the funniest video ever,” his mom recalled. “He would laugh again and again like it was brand new.”
The next day, Max saw Yuval Zabar, one of the hospital’s neurologists. Zabar gave Max a few standard memory tests, like asking him to draw three words and three shapes on a piece of paper. Minutes later, Max could only remember one of the words and one of the shapes. In another test, Zabar hid objects in various parts of the exam room and then asked Max to point where they were. “Sometimes he couldn’t really even tell what I was talking about,” Zabar recalled.
“It was clear to me that he was not just confused,” Zabar said. “This was a more specific problem — the kid was amnestic.”
Zabar ordered an MRI scan, which highlights brain areas that have been damaged by a lack of oxygen, or “ischemia.” Inside Max’s skull, he could make out the gray, jello-like silhouettes of various brain regions. But clustered near the center were two glowing orbs of white.
Zabar was shocked. The spots were perfectly localized, on each side of the brain, to the hippocampus, the seahorse-shaped region that encodes new memories. In his 20 years of treating patients with neurological problems, Zabar said, he had never seen anything like it.
That was 2012. Since then, Max’s case has turned out to be the first of an alarming cluster. In Massachusetts alone, doctors have identified 14 people with damaged hippocampi who suddenly lost the ability to form new memories — and 12 of them had a history of using heroin or other opioids.
Next week, Massachusetts public health officials will officially recognize this as a “reportable disease.” That means that for the next year, doctors will alert the state of any new cases, just as they do for infectious diseases like Ebola or Zika, in the hopes of collecting enough data to figure out how many addicts are suddenly losing their memories, and why.
Is it tainted drugs? Or an unknown side effect of the cheap and powerful heroin alternative, fentanyl? A piece of Max’s genetic makeup that made him susceptible to brain damage? Or perhaps something much simpler: a tragic, if unmysterious consequence of exposing the brain to opioids, again and again.