case study of h m

Henry Gustav Molaison: The Curious Case of Patient H.M. 

Erin Heaning

Clinical Safety Strategist at Bristol Myers Squibb

Psychology Graduate, Princeton University

Erin Heaning, a holder of a BA (Hons) in Psychology from Princeton University, has experienced as a research assistant at the Princeton Baby Lab.

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Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

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Henry Gustav Molaison, known as Patient H.M., is a landmark case study in psychology. After a surgery to alleviate severe epilepsy, which removed large portions of his hippocampus , he was left with anterograde amnesia , unable to form new explicit memories , thus offering crucial insights into the role of the hippocampus in memory formation.

• Henry Gustav Molaison (often referred to as H.M.) is a famous case of anterograde and retrograde amnesia in psychology.
• H. M. underwent brain surgery to remove his hippocampus and amygdala to control his seizures. As a result of his surgery, H.M.’s seizures decreased, but he could no longer form new memories or remember the prior 11 years of his life.
• He lost his ability to form many types of new memories (anterograde amnesia), such as new facts or faces, and the surgery also caused retrograde amnesia as he was able to recall childhood events but lost the ability to recall experiences a few years before his surgery.
• The case of H.M. and his life-long participation in studies gave researchers valuable insight into how memory functions and is organized in the brain. He is considered one of the most studied medical and psychological history cases.

Who is H.M.?

Henry Gustav Molaison, or “H.M” as he is commonly referred to by psychology and neuroscience textbooks, lost his memory on an operating table in 1953.

For years before his neurosurgery, H.M. suffered from epileptic seizures believed to be caused by a bicycle accident that occurred in his childhood. The seizures started out as minor at age ten, but they developed in severity when H.M. was a teenager.

Continuing to worsen in severity throughout his young adulthood, H.M. was eventually too disabled to work. Throughout this period, treatments continued to turn out unsuccessful, and epilepsy proved a major handicap and strain on H.M.’s quality of life.

And so, at age 27, H.M. agreed to undergo a radical surgery that would involve removing a part of his brain called the hippocampus — the region believed to be the source of his epileptic seizures (Squire, 2009).

For epilepsy patients, brain resection surgery refers to removing small portions of brain tissue responsible for causing seizures. Although resection is still a surgical procedure used today to treat epilepsy, the use of lasers and detailed brain scans help ensure valuable brain regions are not impacted.

In 1953, H.M.’s neurosurgeon did not have these tools, nor was he or the rest of the scientific or medical community fully aware of the true function of the hippocampus and its specific role in memory. In one regard, the surgery was successful, as H.M. did, in fact, experience fewer seizures.

However, family and doctors soon noticed he also suffered from severe amnesia, which persisted well past when he should have recovered. In addition to struggling to remember the years leading up to his surgery, H.M. also had gaps in his memory of the 11 years prior.

Furthermore, he lacked the ability to form new memories — causing him to perpetually live an existence of moment-to-moment forgetfulness for decades to come.

In one famous quote, he famously and somberly described his state as “like waking from a dream…. every day is alone in itself” (Squire et al., 2009).

H.M. soon became a major case study of interest for psychologists and neuroscientists who studied his memory deficits and cognitive abilities to better understand the hippocampus and its function.

When H.M. died on December 2, 2008, at the age of 82, he left behind a lifelong legacy of scientific contribution.

Surgical Procedure

Neurosurgeon William Beecher Scoville performed H.M.’s surgery in Hartford, Connecticut, in August 1953 when H.M. was 27 years old.

During the procedure, Scoville removed parts of H.M.’s temporal lobe which refers to the portion of the brain that sits behind both ears and is associated with auditory and memory processing.

More specifically, the surgery involved what was called a “partial medial temporal lobe resection” (Scoville & Milner, 1957). In this resection, Scoville removed 8 cm of brain tissue from the hippocampus — a seahorse-shaped structure located deep in the temporal lobe .

Bilateral resection of the anterior temporal lobe in patient HM.

Further research conducted after this removal showed Scoville also probably destroyed the brain structures known as the “uncus” (theorized to play a role in the sense of smell and forming new memories) and the “amygdala” (theorized to play a crucial role in controlling our emotional responses such as fear and sadness).

As previously mentioned, the removal surgery partially reduced H.M.’s seizures; however, he also lost the ability to form new memories.

At the time, Scoville’s experimental procedure had previously only been performed on patients with psychosis, so H.M. was the first epileptic patient and showed no sign of mental illness. In the original case study of H.M., which is discussed in further detail below, nine of Scoville’s patients from this experimental surgery were described.

However, because these patients had disorders such as schizophrenia, their symptoms were not removed after surgery. In this regard, H.M. was the only patient with “clean” amnesia along with no other apparent mental problems.

H.M’s Amnesia

H.M.’s apparent amnesia after waking from surgery presented in multiple forms. For starters, H.M. suffered from retrograde amnesia for the 11-year period prior to his surgery.

Retrograde describes amnesia, where you can’t recall memories that were formed before the event that caused the amnesia. Important to note, current research theorizes that H.M.’s retrograde amnesia was not actually caused by the loss of his hippocampus, but rather from a combination of antiepileptic drugs and frequent seizures prior to his surgery (Shrader 2012).

In contrast, H.M.’s inability to form new memories after his operation, known as anterograde amnesia, was the result of the loss of the hippocampus.

This meant that H.M. could not learn new words, facts, or faces after his surgery, and he would even forget who he was talking to the moment he walked away.

However, H.M. could perform tasks, and he could even perform those tasks easier after practice. This important finding represented a major scientific discovery when it comes to memory and the hippocampus. The memory that H.M. was missing in his life included the recall of facts, life events, and other experiences.

This type of long-term memory is referred to as “explicit” or “ declarative ” memories and they require conscious thinking.

In contrast, H.M.’s ability to improve in tasks after practice (even if he didn’t recall that practice) showed his “implicit” or “ procedural ” memory remained intact (Scoville & Milner, 1957). This type of long-term memory is unconscious, and examples include riding a bike, brushing your teeth, or typing on a keyboard.

Most importantly, after removing his hippocampus, H.M. lost his explicit memory but not his implicit memory — establishing that implicit memory must be controlled by some other area of the brain and not the hippocampus.

After the severity of the side effects of H.M.’s operation became clear, H.M. was referred to neurosurgeon Dr. Wilder Penfield and neuropsychologist Dr. Brenda Milner of Montreal Neurological Institute (MNI) for further testing.

As discussed, H.M. was not the only patient who underwent this experimental surgery, but he was the only non-psychotic patient with such a degree of memory impairment. As a result, he became a major study and interest for Milner and the rest of the scientific community.

Since Penfield and Milner had already been conducting memory experiments on other patients at the time, they quickly realized H.M.’s “dense amnesia, intact intelligence, and precise neurosurgical lesions made him a perfect experimental subject” (Shrader 2012).

Milner continued to conduct cognitive testing on H.M. for the next fifty years, primarily at the Massachusetts Institute of Technology (MIT). Her longitudinal case study of H.M.’s amnesia quickly became a sensation and is still one of the most widely-cited psychology studies.

In publishing her work, she protected Henry’s identity by first referring to him as the patient H.M. (Shrader 2012).

In the famous “star tracing task,” Milner tested if H.M.’s procedural memory was affected by the removal of the hippocampus during surgery.

In this task, H.M. had to trace an outline of a star, but he could only trace the star based on the mirrored reflection. H.M. then repeated this task once a day over a period of multiple days.

Over the course of these multiple days, Milner observed that H.M. performed the test faster and with fewer errors after continued practice. Although each time he performed the task, he had no memory of having participated in the task before, his performance improved immensely (Shrader 2012).

As this task showed, H.M. had lost his declarative/explicit memory, but his unconscious procedural/implicit memory remained intact. Given the damage to his hippocampus in surgery, researchers concluded from tasks such as these that the hippocampus must play a role in declarative but not procedural memory.

Therefore, procedural memory must be localized somewhere else in the brain and not in the hippocampus.

H.M’s Legacy

Milner’s and hundreds of other researchers’ work with H.M. established fundamental principles about how memory functions and is organized in the brain.

Without the contribution of H.M. in volunteering the study of his mind to science, our knowledge today regarding the separation of memory function in the brain would certainly not be as strong.

Until H.M.’s watershed surgery, it was not known that the hippocampus was essential for making memories and that if we lost this valuable part of our brain, we would be forced to live only in the moment-to-moment constraints of our short-term memory .

Once this was realized, the findings regarding H.M. were widely publicized so that this operation to remove the hippocampus would never be done again (Shrader 2012).

H.M.’s case study represents a historical time period for neuroscience in which most brain research and findings were the result of brain dissections, lesioning certain sections, and seeing how different experimental procedures impacted different patients.

Therefore, it is paramount we recognize the contribution of patients like H.M., who underwent these dangerous operations in the mid-twentieth century and then went on to allow researchers to study them for the rest of their lives.

Even after his death, H.M. donated his brain to science. Researchers then took his unique brain, froze it, and then in a 53-hour procedure, sliced it into 2,401 slices which were then individually photographed and digitized as a three-dimensional map.

Through this map, H.M.’s brain could be preserved for posterity (Wb et al., 2014). As neuroscience researcher Suzanne Corkin once said it best, “H.M. was a pleasant, engaging, docile man with a keen sense of humor, who knew he had a poor memory but accepted his fate.

There was a man behind the data. Henry often told me that he hoped that research into his condition would help others live better lives. He would have been proud to know how much his tragedy has benefitted science and medicine” (Corkin, 2014).

Corkin, S. (2014). Permanent present tense: The man with no memory and what he taught the world. Penguin Books.

Hardt, O., Einarsson, E. Ö., & Nader, K. (2010). A bridge over troubled water: Reconsolidation as a link between cognitive and neuroscientific memory research traditions. Annual Review of Psychology, 61, 141–167.

Scoville, W. B., & Milner, B. (1957). Loss of recent memory after bilateral hippocampal lesions . Journal of neurology, neurosurgery, and psychiatry, 20 (1), 11.

Shrader, J. (2012, January). HM, the man with no memory | Psychology Today. Retrieved from, https://www.psychologytoday.com/us/blog/trouble-in-mind/201201/hm-the-man-no-memory

Squire, L. R. (2009). The legacy of patient H. M. for neuroscience . Neuron, 61 , 6–9.

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Key Study: HM’s case study (Milner and Scoville, 1957)

Travis Dixon January 29, 2019 Biological Psychology , Cognitive Psychology , Key Studies

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HM’s case study is one of the most famous and important case studies in psychology, especially in cognitive psychology. It was the source of groundbreaking new knowledge on the role of the hippocampus in memory. 

Background Info

“Localization of function in the brain” means that different parts of the brain have different functions. Researchers have discovered this from over 100 years of research into the ways the brain works. One such study was Milner’s case study on Henry Molaison.

The memory problems that HM experienced after the removal of his hippocampus provided new knowledge on the role of the hippocampus in memory formation (image: wikicommons)

At the time of the first study by Milner, HM was 29 years old. He was a mechanic who had suffered from minor epileptic seizures from when he was ten years old and began suffering severe seizures as a teenager. These may have been a result of a bike accident when he was nine. His seizures were getting worse in severity, which resulted in HM being unable to work. Treatment for his epilepsy had been unsuccessful, so at the age of 27 HM (and his family) agreed to undergo a radical surgery that would remove a part of his brain called the hippocampus . Previous research suggested that this could help reduce his seizures, but the impact it had on his memory was unexpected. The Doctor performing the radical surgery believed it was justified because of the seriousness of his seizures and the failures of other methods to treat them.

Methods and Results

In one regard, the surgery was successful as it resulted in HM experiencing less seizures. However, immediately after the surgery, the hospital staff and HM’s family noticed that he was suffering from anterograde amnesia (an inability to form new memories after the time of damage to the brain):

Here are some examples of his memory loss described in the case study:

• He could remember something if he concentrated on it, but if he broke his concentration it was lost.
• After the surgery the family moved houses. They stayed on the same street, but a few blocks away. The family noticed that HM as incapable of remembering the new address, but could remember the old one perfectly well. He could also not find his way home alone.
• He could not find objects around the house, even if they never changed locations and he had used them recently. His mother had to always show him where the lawnmower was in the garage.
• He would do the same jigsaw puzzles or read the same magazines every day, without ever apparently getting bored and realising he had read them before. (HM loved to do crossword puzzles and thought they helped him to remember words).
• He once ate lunch in front of Milner but 30 minutes later was unable to say what he had eaten, or remember even eating any lunch at all.
• When interviewed almost two years after the surgery in 1955, HM gave the date as 1953 and said his age was 27. He talked constantly about events from his childhood and could not remember details of his surgery.

Later testing also showed that he had suffered some partial retrograde amnesia (an inability to recall memories from before the time of damage to the brain). For instance, he could not remember that one of his favourite uncles passed away three years prior to his surgery or any of his time spent in hospital for his surgery. He could, however, remember some unimportant events that occurred just before his admission to the hospital.

Brenda Milner studied HM for almost 50 years – but he never remembered her.

Results continued…

His memories from events prior to 1950 (three years before his surgery), however, were fine. There was also no observable difference to his personality or to his intelligence. In fact, he scored 112 points on his IQ after the surgery, compared with 104 previously. The IQ test suggested that his ability in arithmetic had apparently improved. It seemed that the only behaviour that was affected by the removal of the hippocampus was his memory. HM was described as a kind and gentle person and this did not change after his surgery.

The Star Tracing Task

In a follow up study, Milner designed a task that would test whether or not HMs procedural memory had been affected by the surgery. He was to trace an outline of a star, but he could only see the mirrored reflection. He did this once a day over a period of a few days and Milner observed that he became faster and faster. Each time he performed the task he had no memory of ever having done it before, but his performance kept improving. This is further evidence for localization of function – the hippocampus must play a role in declarative (explicit) memory but not procedural (implicit) memory.

Cognitive psychologists have categorized memories into different types. HM’s study suggests that the hippocampus is essential for explicit (conscious) and declarative memory, but not implicit (unconscious) procedural memory.

Was his memory 100% gone? Another follow-up study

Interestingly, HM showed signs of being able to remember famous people who had only become famous after his surgery, like Lee Harvey Oswald (who assassinated JFK in 1963). (Image: wikicommons)

Another fascinating follow-up study was conducted by two researchers who wanted to see if HM had learned anything about celebrities that became famous after his surgery. At first they tested his knowledge of celebrities from before his surgery, and he knew these just as well as controls. They then showed him two names at a time, one a famous name (e.g. Liza Minelli, Lee Harvey Oswald) and the other was a name randomly taken from the phonebook. He was asked to choose the famous name and he was correct on a significant number of trials (i.e. the statistics tests suggest he wasn’t just guessing). Even more incredible was that he remembered some details about these people when asked why they were famous. For example, he could remember that Lee Harvey Oswald assassinated the president. One explanation given for the memory of these facts is that there was an emotional component. E.g. He liked these people, or the assassination was so violent, that he could remember a few details. 

HM became a hugely important case study for neuro and cognitive Psychologists. He was interviewed and tested by over 100 psychologists during the 53 years after his operation. Directly after his surgery, he lived at home with his parents as he was unable to live independently. He moved to a nursing home in 1980 and stayed there until his death in 2008. HM donated his brain to science and it was sliced into 2,401 thin slices that will be scanned and published electronically.

Critical Thinking Considerations

• How does this case study demonstrate localization of function in the brain? (e.g.c reating new long-term memories; procedural memories; storing and retrieving long term memories; intelligence; personality) ( Application )
• What are the ethical considerations involved in this study? ( Analysis )
• What are the strengths and limitations of this case study? ( Evaluation )
• Why would ongoing studies of HM be important? (Think about memory, neuroplasticity and neurogenesis) ( Analysis/Synthesis/Evaluation )
• How can findings from this case study be used to support and/or challenge the Multi-store Model of Memory? ( Application / Synthesis/Evaluation )

Exam Tips This study can be used for the following topics: Localization – the role of the hippocampus in memory Techniques to study the brain – MRI has been used to find out the exact location and size of damage to HM’s brain Bio and cognitive approach research method s – case study Bio and cognitive approach ethical considerations – anonymity Emotion and cognition – the follow-up study on HM and memories of famous people could be used in an essay to support the idea that emotion affects memory Models of memory – the multi-store model : HM’s study provides evidence for the fact that our memories all aren’t formed and stored in one place but travel from store to store (because his transfer from STS to LTS was damaged – if it was all in one store this specific problem would not occur)

Milner, Brenda. Scoville, William Beecher. “Loss of Recent Memory after Bilateral Hippocampal Lesions”. The Journal of Neurology, Neurosurgery and Psychiatry. 1957; 20: 11 21. (Accessed from web.mit.edu )

The man who couldn’t remember”. nova science now. an interview with brenda corkin . 06.01.2009.       .

  Here’s a good video recreation documentary of HM’s case study…

Travis Dixon is an IB Psychology teacher, author, workshop leader, examiner and IA moderator.

HM, the Man with No Memory

Henry molaison (hm) taught us about memory by losing his..

Posted January 16, 2012 | Reviewed by Jessica Schrader

Henry Molaison, known by thousands of psychology students as "HM," lost his memory on an operating table in a hospital in Hartford in August 1953. He was 27 years old and had suffered from epileptic seizures for many years.

William Beecher Scoville, a Hartford neurosurgeon , stood above an awake Henry and skilfully suctioned out the seahorse-shaped brain structure called the hippocampus that lay within each temporal lobe. Henry would have been drowsy and probably didn't notice his memory vanishing as the operation proceeded.

The operation was successful in that it significantly reduced Henry's seizures, but it left him with a dense memory loss. When Scoville realized his patient had become amnesic, he referred him to the eminent neurosurgeon Dr. Wilder Penfield and neuropsychologist Dr. Brenda Milner of Montreal Neurological Institute (MNI), who assessed him in detail. Up until then, it had not been known that the hippocampus was essential for making memories, and that if we lose both of them we will suffer a global amnesia. Once this was realized, the findings were widely publicized so that this operation to remove both hippocampi would never be done again.

Penfield and Milner had already been conducting memory experiments on other patients and they quickly realized that Henry's dense amnesia, his intact intelligence , and the precise neurosurgical lesions made him the perfect experimental subject. For 55 years, Henry participated in numerous experiments, primarily at Massachusetts Institute of Technology (MIT), where Professor Suzanne Corkin and her team of neuropsychologists assessed him.

Access to Henry was carefully restricted to less than 100 researchers (I was honored to be one of them), but the MNI and MIT studies on HM taught us much of what we know about memory. Of course, many other patients with memory impairments have since been studied, including a small number with amnesias almost as dense as Henry's, but it is to him we owe the greatest debt. His name (or initials!) has been mentioned in almost 12,000 journal articles, making him the most studied case in medical or psychological history. Henry died on December 2, 2008, at the age of 82. Until then, he was known to the world only as "HM," but on his death his name was revealed. A man with no memory is vulnerable, and his initials had been used while he lived in order to protect his identity .

Henry's memory loss was far from simple. Not only could he make no new conscious memories after his operation, he also suffered a retrograde memory loss (a loss of memories prior to brain damage) for an 11-year period before his surgery. It is not clear why this is so, although it is thought this is not because of his loss of the hippocampi on both sides of his brain. More likely it is a combination of his being on large doses of antiepileptic drugs and his frequent seizures prior to his surgery. His global amnesia for new material was the result of the loss of both hippocampi, and meant that he could not learn new words, songs or faces after his surgery, forgot who he was talking to as soon as he turned away, didn't know how old he was or if his parents were alive or dead, and never again clearly remembered an event, such as his birthday party, or who the current president of the United States was.

In contrast, he did retain the ability to learn some new motor skills, such as becoming faster at drawing a path through a picture of a maze, or learning to use a walking frame when he sprained his ankle, but this learning was at a subconscious level. He had no conscious memory that he had ever seen or done the maze test before, or used the walking frame previously.

We measure time by our memories, and thus for Henry, it was as if time stopped when he was 16 years old, 11 years before his surgery. Because his intelligence in other non-memory areas remained normal, he was an excellent experimental participant. He was also a very happy and friendly person and always a delight to be with and to assess. He never seemed to get tired of doing what most people would think of as tedious memory tests, because they were always new to him! When he was at MIT, between test sessions he would often sit doing crossword puzzles, and he could do the same ones again and again if the words were erased, as to him it was new each time.

Henry gave science the ultimate gift: his memory. Thousands of people who have suffered brain damage, whether through accident, disease or a genetic quirk, have given similar gifts to science by agreeing to participate in psychological, neuropsychological, psychiatric and medical studies and experiments, and in some cases by gifting their brains to science after their deaths. Our knowledge of brain disease and how the normal mind works would be greatly diminished if it were not for the generosity of these people and their families (who are frequently also involved in interviews, as well as transporting the "patient" back and forth to the psychology laboratory). After Henry's death, his brain was dissected into 2,000 slices and digitized as a three-dimensional brain map that could be searched by zooming in from the whole brain to individual neurons. Thus, his tragically unique brain has been preserved for posterity.

Jenni Ogden, Ph.D. , clinical neuropsychologist and author of Trouble in Mind, taught at the University of Auckland.

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The Curious Case of Patient H.M.

• Reviewed 28 Aug 2018
• Author Deborah Halber
• Source BrainFacts/SfN

On September 1, 1953, time stopped for Henry Molaison. For roughly 10 years, the 27-year-old had suffered severe seizures. By 1953, they were so debilitating he could no longer hold down his job as a motor winder on an assembly line. On September 1, Molaison allowed surgeons to remove a thumb-sized section of tissue from each side of his brain. It was an experimental procedure that he and his surgeons hoped would quell the seizures wracking his brain.

And, it worked. The seizures abated, but afterwards Molaison was left with permanent amnesia. He could remember some things — scenes from his childhood, some facts about his parents, and historical events that occurred before his surgery — but he was unable to form new memories. If he met someone who then left the room, within minutes he had no recollection of the person or their meeting.

What was a tragedy for Molaison led to one of the most significant turning points in 20th century brain science: the understanding that complex functions such as learning and memory are tied to discrete regions of the brain.

In 1955, scientists William Beecher Scoville and Brenda Milner began studying Molaison — referred to as H.M. to protect his privacy — and nine other patients who had undergone similar surgery. Only patients who had specific portions of their medial temporal lobes removed experienced memory problems. And, the more tissue removed, the more severe the memory impairment. The researchers noted patients’ amnesia was “curiously specific to the domain of recent memory.”

Scoville and Milner’s observations pointed to a particular structure within the medial temporal lobe that was necessary for normal memory — the hippocampus. Over the next five decades, neuroscientists studying Molaison learned that the hippocampus and adjacent regions transform our transient perceptions and awareness into memories that can last a lifetime.

For Molaison, this transformation could no longer take place. He experienced every aspect of his daily life — eating a meal, taking a walk — as a first. Yet his intellect, personality, and perception were intact, and he was able to acquire new motor skills. Over time, he became more proficient at tasks such as tracing patterns while watching his hand movements in a mirror, despite the fact that he could never recall performing the task before.

Studies of Molaison paved the way for further exploration of the brain networks encoding conscious and unconscious memories. Even after his death in 2008 at the age of 82, neuroscientists continue to learn from him.

This article was adapted from the 8th edition of Brain Facts by Deborah Halber.

About the Author

Deborah Halber

Deborah Halber is a Boston-based author, science writer and journalist. Her work has appeared in The Atlantic, Time.com, The Boston Globe, MIT Technology Review, Boston magazine, and university publications.

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The Legacy of Patient H.M. for Neuroscience

Larry r. squire.

1 Veterans Affairs Healthcare System, San Diego, CA 92161, USA

2 Departments of Psychiatry, Neurosciences, and Psychology, University of California, San Diego, La Jolla, CA 92093, USA

H.M. is probably the best known single patient in the history of neuroscience. His severe memory impairment, which resulted from experimental neurosurgery to control seizures, was the subject of study for five decades until his death in December 2008. Work with H.M. established fundamental principles about how memory functions are organized in the brain.

In 1952, Brenda Milner was completing her doctoral research at McGill University under the direction of Donald Hebb. At about this time, she encountered two patients (P.B. and F.C.) who had become severely amnesic following unilateral removal of the medial structures of the left temporal lobe for the treatment of epileptic seizures ( Penfield and Milner, 1958 ). This unfortunate outcome was entirely unexpected, and it was proposed that in each case there had been a preexistent, but unsuspected, atrophic lesion in the medial temporal lobe of the opposite hemisphere. In that way, the unilateral surgery would have resulted in a bilateral lesion, an idea that was confirmed at autopsy some years later for patient P.B. After the two cases were presented at the 1955 meeting of the American Neurological Association, Wilder Penfield (the neurosurgeon in both cases) received a call from William Scoville, a neurosurgeon in Hartford, Connecticut. Scoville told Penfield that he had seen a similar memory impairment in one of his own patients (H.M.) in whom he had carried out a bilateral medial temporal lobe resection in an attempt to control epileptic seizures. As a result of this conversation, Brenda Milner was invited to travel to Hartford to study H.M.

H.M. had been knocked down by a bicycle at the age of 7, began to have minor seizures at age 10, and had major seizures after age 16. (The age of the bicycle accident is given as 9 in some reports; for clarification see Corkin, 1984 .) He worked for a time on an assembly line but, finally, in 1953 at the age of 27 he had become so incapacitated by his seizures, despite high doses of anticonvulsant medication, that he could not work or lead a normal life. Scoville offered H.M. an experimental procedure that he had carried out previously in psychotic patients, and the surgery was then performed with the approval of the patient and his family.

When Milner first visited H.M., she saw that the epilepsy was now controlled but that his memory impairment was even more severe than in Penfield’s two patients, P.B. and F.C. What she observed was someone who forgot daily events nearly as fast as they occurred, apparently in the absence of any general intellectual loss or perceptual disorder. He underestimated his own age, apologized for forgetting the names of persons to whom he had just been introduced, and described his state as “like waking from a dream ... every day is alone in itself...” ( Milner et al., 1968 , p. 217).

The first observations of H.M., and the results of formal testing, were reported a few years later ( Scoville and Milner, 1957 ). This publication became one of the most cited papers in neuroscience (nearly 2500 citations) and is still cited with high frequency. H.M. continued to be studied for five decades, principally by Brenda Milner, her former student Suzanne Corkin, and their colleagues ( Corkin, 1984 , 2002 ; Milner et al., 1968 ). He died on December 2, 2008, at the age of 82. It can be said that the early descriptions of H.M. inaugurated the modern era of memory research. Before H.M., due particularly to the influence of Karl Lashley, memory functions were thought to be widely distributed in the cortex and to be integrated with intellectual and perceptual functions. The findings from H.M. established the fundamental principle that memory is a distinct cerebral function, separable from other perceptual and cognitive abilities, and identified the medial aspect of the temporal lobe as important for memory. The implication was that the brain has to some extent separated its perceptual and intellectual functions from its capacity to lay down in memory the records that ordinarily result from engaging in perceptual and intellectual work.

The Medial Temporal Lobe Memory System

The early paper is sometimes cited incorrectly as evidence that the hippocampus is important for memory, but this particular point could not of course be established from a lesion that, by the surgeon’s description, included the hippocampus, amygdala, and the adjacent parahippocampal gyrus. As Milner subsequently wrote, “Despite the use of the word ‘hippocampal’ in the titles of my papers with Scoville and Penfield, I have never claimed that the memory loss was solely attributable to the hippocampal lesions” ( Milner, 1998 ). Indeed, the original paper ends, quite appropriately, with the statement:

It is concluded that the anterior hippocampus and hippocampal gyrus, either separately or together, are critically concerned in the retention of current experience. It is not known whether the amygdala plays any part in this mechanism, since the hippocampal complex has not been removed alone, but always together with uncus and amygdala. ( Scoville and Milner, 1957 , p. 21).

The findings from H.M. were initially met with some resistance, especially because of the difficulty for many years of demonstrating anything resembling his impairment in the experimental animal. Efforts to establish an animal model in fact began almost immediately when Scoville himself came to Montreal and did the same surgery in monkeys that he had done with H.M. But these monkeys and others with medial temporal lesions seemed able to learn tasks that H.M. could not learn. Only much later did it become understood that apparently similar tasks can be learned in different ways by humans and monkeys. For example, the visual discrimination task, which is learned gradually by the monkey over hundreds of trials, proved to involve what one would now call habit learning. In the monkey, this kind of learning depends on the basal ganglia, not the medial temporal lobe. Eventually, tasks were developed for the monkey that were exquisitely sensitive to medial temporal lobe lesions (for example, the one-trial, delayed nonmatching to sample task), and an animal model of human memory impairment thereby became available ( Mishkin, 1978 ).

Cumulative work with the animal model over the next decade, together with neuroanatomical studies, succeeded in identifying the anatomical components of what is now termed the medial temporal lobe memory system ( Squire and Zola-Morgan, 1991 ): the hippocampus and the adjacent perirhinal, entorhinal, and parahippocampal cortices that make up much of the parahippocampal gyrus. This information showed which structures within H.M.’s large lesion were important for understanding his impairment and, more broadly, what structures are important for memory. A few years later, an improved description of H.M.’s lesion was obtained with magnetic resonance imaging (MRI) ( Corkin et al., 1997 ). MRI had been delayed because of concerns that clips placed on the dura during surgery made H.M. ineligible for imaging. However, thorough inquiry revealed that the dural clips constituted no risk.

At this juncture, several points became clear. First, H.M.’s lesion was less extensive than described originally by the surgeon in that it extended a little more than 5 cm caudally from the temporal pole (not 8 cm). As a result the posterior parahippocampal gyrus was largely spared (specifically, the parahippocampal cortex or what in the monkey is termed area TH TF). Second, the reason that H.M.’s memory impairment was so severe was that the bilateral damage included the parahippocampal gyrus (anteriorly) and was not restricted to the hippocampus. Damage limited to the hippocampus causes significant memory impairment but considerably less impairment than in H.M. Third, memory impairment more severe than H.M.’s could now be understood, as when the damage includes the structures damaged in H.M. but also extends far enough posteriorly to involve the parahippocampal cortex (patients E.P. and G.P.; Kirwan et al., 2008 ).

In the early years, the anatomy of the medial temporal lobe was poorly understood, and terms like hippocampal zone and hippocampal complex were often used to identify the area of damage. With the elucidation of the boundaries and connectivity of the structures adjacent to the hippocampus and the discovery that these structures are important for memory, vague terms like hippocampal complex became unnecessary (though one can still find them in contemporary writing). It is now possible to achieve careful descriptions based on anatomical measurement and modern terminology.

H.M. not only motivated the development of an animal model of human memory impairment and the subsequent delineation of the medial temporal lobe memory system. As described next, the study of H.M. also led to fundamental insights into the function of the medial temporal lobe and the larger matter of how memory is organized in the brain.

Immediate Memory and Long-Term Memory

H.M.’s intact intellectual and perceptual functions, and similar findings in other patients with large medial temporal lesions, have been well documented. A key additional finding was that H.M. had a remarkable capacity for sustained attention, including the ability to retain information for a period of time after it was presented. Thus, he could carry on a conversation, and he exhibited an intact digit span (i.e., the ability to repeat back a string of six or seven digits). Indeed, information remained available so long as it could be actively maintained by rehearsal. For example, H.M. could retain a three-digit number for as long as 15 min by continuous rehearsal, organizing the digits according to an elaborate mnemonic scheme. Yet when his attention was diverted to a new topic, he forgot the whole event. In contrast, when the material was not easy to rehearse (in the case of nonverbal stimuli like faces or designs), information slipped away in less than a minute. These findings supported a fundamental distinction between immediate memory and long-term memory (what William James termed primary memory and secondary memory). Primary memory [immediate memory]

...comes to us as belonging to the rearward portion of the present space of time, and not to the genuine past ( James, 1890 , p. 647).

Secondary memory [long-term memory] is quite different.

An object which has been recollected. is one which has been absent from consciousness altogether, and now revives anew. It is brought back, recalled, fished up, so to speak, from a reservoir in which, with countless other objects, it lay buried and lost from view. ( James, 1890 , p. 648).

Notably, time is not the key factor that determines how long patients like H.M. can retain information in memory. The relevant factors are the capacity of immediate memory and attention, i.e., the amount of material that can be held in mind and how successfully it can be rehearsed. The work with H.M. demonstrated that the psychological distinction between immediate memory and long-term memory is a prominent feature of how the brain has organized its memory functions.

Multiple Memory Systems

Perhaps the most unexpected discovery about H.M., given his profound and global memory impairment, came when Brenda Milner tested his ability to acquire a visuomotor skill ( Milner, 1962 ). H.M. was shown a five-pointed star, with a double contour, and asked to trace its outline with a pencil, but in a condition when he could only see his hand and the star as reflected in a mirror. H.M. acquired this mirror-drawing skill during ten trials and exhibited excellent retention across 3 days. Yet at the end of testing, he had no recollection of having done the task before. This demonstration provided the first hint that there was more than one kind of memory in the brain and suggested that some kinds of memory (motor skills) must lie outside the province of the medial temporal lobe.

For a time, it was rather thought that motor skills were a special case and that all the rest of memory is impaired in patients like H.M. Later it became appreciated that motor skills are but a subset of a larger domain of skill-like abilities, all of which are preserved in amnesia. The demonstration of a fully preserved ability to learn the perceptual skill of mirror reading suggested a distinction between two broad classes of knowledge: declarative and procedural ( Cohen and Squire, 1980 ). Declarative memory is what is meant when the term “memory” is used in everyday language, i.e., conscious knowledge of facts and events. Procedural memory refers to skill-based knowledge that develops gradually but with little ability to report what is being learned.

In the years that followed, other preserved learning abilities began to be reported for amnesic patients, and the perspective shifted to a framework that accommodated multiple (i.e., more than two) memory systems. As Endel Tulving wrote:

But even if we accept the broad division of memory into procedural and propositional forms ... there are phenomena that do not seem to fit readily into such a taxonomy ( Tulving et al., 1982 , p.336).

Subsequently, the terms declarative and nondeclarative were introduced with the idea that declarative memory refers to the kind of memory that is impaired in H.M. and is dependent on the medial temporal lobe. Nondeclarative memory is an umbrella term referring to additional memory systems. These include systems that support skill learning, habit learning, simple conditioning, emotional learning, as well as priming and perceptual learning. The structures with special importance for these kinds of memory include the basal ganglia, the cerebellum, the amygdala, and the neocortex. The starting point for these developments was the early discovery that motor skill learning was preserved in H.M. This finding revealed that memory is not a single faculty of the mind and led ultimately to the identification of the multiple memory systems of the mammalian brain.

Remote Memory

H.M.’s memory impairment has generally been taken as reflecting a failure to convert transient, immediate memory into stable long-term memory. A key insight about the organization of memory, and medial temporal lobe function, came with a consideration of his capacity to remember information that he had acquired before his surgery. The first exploration of this issue with formal tests asked H.M. to recognize faces of persons who had become famous in different decades, 1920-1970 ( Marslen-Wilson and Teuber, 1975 ). As expected, H.M. was severely impaired at recognizing faces from his postmorbid period (the 1950s and 1960s), but he performed as well as or better than age-matched controls at recognizing faces of persons who were in the news before his surgery. This important finding implied that the medial temporal lobe is not the ultimate storage site for previously acquired knowledge. The early descriptions of H.M. conform to this view. Thus, H.M. was described as having a partial loss of memory (retrograde amnesia) for the 3 years leading up to his surgery, with early memories “seemingly normal” ( Scoville and Milner, 1957 , p. 17). Similarly, about 10 years later it was remarked that there did not appear

to have been any change in H.M.’s capacity to recall remote events antedating his operation, such as incidents from his early school years, a high-school attachment, or jobs he had held in his late teens and early twenties ( Milner et al., 1968 , p. 216).

Subsequently, a particular interest developed in the status of autobiographical memories for unique events, which are specific to time and place, and methods were developed to assess the specificity and the detail with which such recollections could be reproduced. In the earliest efforts along these lines, as summarized by Suzanne Corkin ( Corkin, 1984 ), H.M. produced well-formed autobiographical memories, from age 16 years or younger. It was concluded that H.M’s remote memory impairment now extended back to 11 years before his surgery. The situation seemed to change further as H.M. aged. In an update prepared nearly 20 years later ( Corkin, 2002 ), H.M. (now 76 years old) was described as having memories of childhood, but his memories appeared more like remembered facts than like memories of specific episodes. It was also said that he could not narrate a single event that occurred at a specific time and place. Essentially the same conclusion was reached a few years later when new methods, intended to be particularly sensitive, were used to assess H.M.’s remote memory for autobiographical events ( Steinvorth et al., 2005 ). These later findings led to the proposal that, whatever might be the case for fact memory, autobiographical memories, i.e., memories that are specific to time and place, depend on the medial temporal lobe so long as the memories persist.

There are reasons to be cautious about this idea. In 2002-2003, new MRI scans of H.M. were obtained ( Salat et al., 2006 ). These scans documented a number of changes since his first MRI scans from 1992-1993 ( Corkin et al., 1997 ), including cortical thinning, subcortical atrophy, large amounts of abnormal white matter, and subcortical infarcts. These findings were thought to have appeared during the past decade, and they complicate the interpretation of neuropsychological data collected during the same time period. Another consideration is that remote memories could have been intact in the early years after surgery but then have faded with time because they could not be strengthened through rehearsal and relearning. In any case, the optimal time to assess the status of past memory is soon after the onset of memory impairment.

Other work has tended to support the earlier estimates that H.M.’s remote memories were intact. First, Penfield’s two patients described above, P.B. and F.C., were reported after their surgeries to have memory loss extending back a few months and 4 years, respectively, and intact memory from before that time ( Penfield and Milner, 1958 ). Second, methods like those used recently to assess H.M. have also been used to evaluate autobiographical memory in other patients, including patients like E.P. and G.P. who have very severe memory impairment ( Kirwan et al., 2008 ). In these cases, autobiographical recollection was impaired when memories were drawn from the recent past but fully intact when memories were drawn from the remote past.

Memory loss can sometimes extend back for decades in the case of large medial temporal lobe lesions (though additional damage to anterolateral temporal cortex may be important in this circumstance). In any case, memories from early life appear to be intact unless the damage extends well into the lateral temporal lobe or the frontal lobe. These findings are typically interpreted to mean that the structures damaged in H.M. are important for the formation of long-term memory and its maintenance for a period of time after learning. During this period gradual changes are thought to occur in neocortex (memory consolidation) that increase the complexity, distribution, and connectivity among multiple cortical regions. Eventually, memory can be supported by the neocortex and becomes independent of the medial temporal lobe. The surprising observation that H.M. had access to old memories, in the face of an inability to establish new ones, motivated an enormous body of work, both in humans and experimental animals, on the topic of remote memory and continues to stimulate discussion about the nature and significance of retrograde amnesia.

Perspective

H.M. was likely the most studied individual in the history of neuroscience. Interest in the case can be attributed to a number of factors, including the unusual purity and severity of the memory impairment, its stability, its well-described anatomical basis, and H.M.’s willingness to be studied. He was a quiet and courteous man with a sense of humor and insight into his condition. Speaking of his neurosurgeon, he once said, “What he learned about me helped others, and I’m glad about that.” ( Corkin, 2002 , p. 159).

An additional aspect of H.M.’s circumstance, which assured his eventual place in the history of neuroscience, was the fact that Brenda Milner was the young scientist who first studied him. She is a superb experimentalist with a strong conceptual orientation that allowed her to draw from her data deep insights about the organization of memory. Because he was the first well-studied patient with amnesia, H.M. became the yardstick against which other patients with memory impairment would be compared. It is now clear that his memory impairment was not absolute and that he was able to acquire significant new knowledge ( Corkin, 2002 ). Thus, memory impairment can be either more severe or less severe than in H.M. But the study of H.M. established key principles about how memory is organized that continue to guide the discipline.

ACKNOWLEDGMENTS

Supported by the Medical Research Service of the Department of Veterans Affairs, The National Institute of Mental Health (MH24600), and the Metro-politan Life Foundation. I thank Nicola Broadbent, Robert Clark, Christine Smith, Ryan Squire, and Wendy Suzuki for their helpful comments.

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Research News

H.m.'s brain and the history of memory.

Brian Newhouse

In 1953, radical brain surgery was used on a patient with severe epilepsy. The operation on "H.M." worked, but left him with almost no long-term memory. H.M. is now in his 80s. His case has helped scientists understand much more about the brain.

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SCOTT SIMON, host:

Fifty years ago this month, the Journal of Neurology, Neurosurgery and Psychiatry published the findings of a remarkable case. A young man who had undergone an experimental brain operation had lost his ability to retain new memories. He could remember things from his life before the operation but any new face or fact, he completely forgot within minutes. Researchers at that time studied him. And it turns out their discoveries opened the modern era of memory research, what's involved every time we say I remember. That young man is now in his 80s. And as Brian Newhouse reports, scientists are still learning from him.

(Soundbite of crickets)

BRIAN NEWHOUSE: If you close your eyes and just listen for a moment, you may find yourself going somewhere, back in memory. Back maybe to a farm or a park or a lake. Other sounds may make those memories sharpen or change. Add still more and you may start to see particular faces or even smell wood smoke. Remember?

(Soundbite of laughter)

NEWHOUSE: This is the power of memory, the system that captures pictures, smells, sounds, events, directions - endless amounts of information every day and then seconds or decades later calls it up for us. Memories - what we've learned and what we've done - in a large sense make us who we are. To appreciate this, think if your ability to form any new memories were suddenly cut off.

Who would you be? By studying people who've lost their memories, scientists have learned enormous amounts about how learning and memory work in healthy brains. And what they used to think was relatively straightforward they've since found it's fascinatingly complex, thanks in large part to one man.

He's the most famous patient in the study of the human brain today. He's written up in textbooks and dozens of scientific papers. The modern era of memory research essentially began with him, yet very few people know his name or have ever seen him, despite the efforts of journalists, filmmakers and TV networks, all of whom have asked to photograph, film or interview him. Outside the circle of his family and caregivers, he's known only by his initials, H.M. His guardians recently agreed to release audio recordings made of him in the early 1990s talking to scientists. This is the first time a wide audience has been able to hear his voice.

Dr. BRENDA MILNER (McGill University) : When you're not at MIT, what do you do during a typical day?

H.M. (Patient): See, that's what I don't - I don't remember things.

Dr. MILNER: Uh-huh.

H.M. was a very pleasant normal young man, but he had suffered from very severe epilepsy all his life, really. It made him unable to hold down his job as an assembly worker. It made him very late in finishing high school, although he was quite intelligent.

NEWHOUSE: Brenda Milner is a British-born neuroscientist at McGill University in Montreal who first met H.M. in the mid-1950s.

Dr. MILNER: He had huge major and minor seizures, you know, huge convulsions, and also many, many lapses of consciousness every few minutes. He was in a very, very hopeless condition with his epilepsy.

NEWHOUSE: Dr. Milner came to know H.M. after Connecticut neurosurgeon William Beecher Scoville performed an experimental operation to help relieve H.M.'s seizures. Dr. Scoville thought if he could remove the part of H.M.'s brain where the seizures originated, it might stop them.

Dr. MILNER: And this operation was carried out when - in '53, 1953, September - when H.M. was 27. The operation did have an enormously beneficial effect on the epilepsy so that H.M. has maybe now one big seizure a year, and so the clinical hunch about the epilepsy was justified. But at obviously a horrendous price.

(Soundbite of piano)

Dr. MILNER: Who is the president of the United States now?

H.M.: That I don't - I couldn't tell you. I don't remember exactly at all.

Dr. MILNER: Is it a man or a woman?

H.M.: I think it's a man.

Dr. MILNER: His initials are G.B. Does that help?

H.M.: No, it doesn't help.

NEWHOUSE: The horrendous price that H.M. paid was a severe case of amnesia. Not the amnesia of Hollywood, where a person forgets everything about his past, but in H.M. it's his ability to acquire new memories, to commit to memory even the simplest events of his day or the world around him, and then to effectively retrieve those memories. Put a finger above your ear. If you were able to push that finger into your head about two inches, you'd be in the area called the medial temporal lobe. There's one on each side of the brain. In the 1950s, Dr. Scoville theorized that these were the general areas involved in H.M.'s epilepsy. But in trying to alleviate H.M.'s seizures, Dr. Scoville removed most of the medial temporal lobes, including much of the hippocampus. This unintentional experiment showed that the hippocampus and medial temporal lobes are where the brain converts short term memory into long term memory.

Dr. MILNER: Do you know what you did yesterday?

H.M.: No, I don't.

Dr. MILNER: How about this morning?

H.M.: I don't even remember that.

Dr. MILNER: Could you tell me what you had for lunch today?

H.M.: I don't know, to tell you the truth.

NEWHOUSE: H.M.'s condition has also helped scientists understand how and where the brain processes different types of memory. Scientists now know that some brain structures are involved in things like phone numbers we keep only for a few seconds, while others deal with the day's appointments. And still others determine which childhood experiences will stay with us until we die. Now, when you can't remember what you did yesterday or had for lunch today, how do you build a life? Unfortunately, there's been no silver bullet for H.M. Holding a job or even having friends, normal things for most of us with working memories, have been beyond him. H.M. is now in his early 80s and living in a Connecticut nursing home. And he is still what doctor's call profoundly amnesic.

Dr. Brenda Milner studied and tested H.M.'s memory for years after his surgery. In the early 1960's she asked Suzanne Corkin, a young American neuroscientist working in her lab, to help. Dr. Corkin, now at MIT in Cambridge, Massachusetts, has interview H.M. many times since then.

Dr. SUZANNE CORKIN (MIT): He is in my PhD thesis and I have followed his progress for the last 43 years. And he still doesn't know who I am.

NEWHOUSE: Despite H.M.'s difficulties with creating new memories, his old ones from his childhood are intact, especially about major world events.

Dr. MILNER: What happened in 1929?

H.M.: The stock market crashed.

Dr. MILNER: It sure did.

NEWHOUSE: H.M.'s clear memory of events before his surgery showed that although the hippocampus was necessary to make new long term memories, it wasn't needed to retrieve old ones. In the mid-1950's the surgeon Dr. Scoville was mortified to discover that his operation had ruined so much of H.M.'s memory, even though it did relieve H.M.'s epilepsy and probably saved his life. Afterward, Dr. Scoville campaigned widely against the procedure. So H.M. is what scientists call an N(ph) of one. He is the only patient whose had this operation. That makes H.M. unique in science today. But that's not the only thing, or even the most important. Again, Dr. Corkin.

Dr. CORKIN: One thing that still fascinates us today is the fact that in real life, in spite of his profound amnesia, he is able to learn a meager amount of semantic information, knowledge about public figures, people who became famous after his operation. The fact that he can remember anything at all is just enough to make the experimenter fall right off her chair.

Dr. MILNER: How about 1963? Someone was assassinated.

H.M.: He'd been a president.

Dr. MILNER: That's right.

H.M.: And he was assassinated.

Dr. MILNER: What was his name?

H.M.: He had been, like you said, he had been a president.

Dr. MILNER: His initials are JFK.

H.M.: Kennedy.

Dr. MILNER: That's right. What was his first name?

H.M.: John.

Dr. CORKIN: The other day, I was talking to a nurse in his nursing home, just asking her a few questions about him. And after we talked, she went into his room and she said, Oh, I was just talking to a friend of yours from Boston, Dr. Corkin. And H.M. said, Suzanne?

Dr. CORKIN: Now, this is really astonishing. Now, he doesn't know who I am. He doesn't know what I do or what my connection is with him. But he has learned to associate my first name and my last name. And that was another surprise for all of us.

NEWHOUSE: Somehow the man who couldn't form new memories had found a way to learn new things. It was a remarkable discovery that radically altered our understanding of how learning and memory work. Before H.M., doctors believed there was a single memory store through which all information moved and was processed, and that it all resided in one spot in the brain, what you might call a single address.

Now, based on what they've learned from H.M., doctors understand memory to be much more dynamic than that. They found that the brain has several different memory systems. We use what's called declarative memory any time we say I remember, and then recall that we had cereal for breakfast, or that the capital of Illinois is Springfield, or that these two notes on the piano are C and D.

NEWHOUSE: The other kind of memory is non-declarative. It's what we use to tie our shoes, ride a bike, or how to play the C-scale smoothly without thinking of the individual notes.

Again, Dr. Corkin.

Dr. CORKIN: We believe that when you remember something it's really an active process. You're not tuning into a few cells in your brain where a particular memory is stored. What you're really doing is creating a memory based on information that you have stored in many parts of your brain. Now, since H.M.'s operation, we know that there are multiple long term memory systems in the brain that have different addresses. I think his case inspired clinicians and scientists all over the world to find their H.M. and to make amazing discoveries. So it's sort of an ongoing adventure of the human mind and the human brain.

NEWHOUSE: Despite those discoveries, scientists admit they still don't know how it all works, how memories are culled from different parts of the brain and fused together. What they have learned, though, is that the brain's processes are far more intricate than they ever thought. And much of the credit for that goes to patient H.M. Even though H.M. can't look back over a lifetime of rich memories, his spirit seems untouched by that deficit in his brain.

Dr. CORKIN: What do you think you'll do tomorrow?

H.M.: Whatever is beneficial.

Dr. CORKIN: Good answer. Are you happy?

H.M.: Yes. Well, the way I figure it is, what they find out about me helps them to help other people.

NEWHOUSE: For NPR News, this is Brian Newhouse.

Copyright © 2007 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

The Whole Package

A global fashion brand pairs sustainability and growth..

The fashion industry exploded over the past two decades. Garment production has doubled since 2000, and plastics use has multiplied along with it. H&M, one of the largest apparel manufacturers in the world, wanted to grow more sustainably. One of its goals: eliminate plastic from its packaging. Together we developed a new paper packaging system that’s cutting thousands of tons of plastic from H&M’s operations, helping the company and its customers meet their sustainability goals.

100 million plastic-free packages

Shipped in 2022, 2,000 tons of plastic eliminated, from h&m operations.

Packaging accounts for 26% of plastics produced globally every year.

Fashion e-commerce is estimated to grow by 10% annually through 2024, requiring even more packaging.

Fast fashion keeps getting faster. But if the industry is to meet its climate commitments, its use of plastics has to slow down.

H&M chief executive Helena Helmersson set ambitious sustainability goals when she stepped into her role. She wanted to reduce the fashion giant’s impact on the environment and enable meaningful growth. But change is tough for any company, let alone one with eight brands operating across 74 markets. Together IDEO and the H&M Group created new plastic-free packaging, rallying around a more sustainable packaging solution that’s easily customizable.

By applying a design-led approach that went far beyond hiring a sustainability consultant, the H&M Group managed to reduce its use of plastic. But it didn’t stop there. A small team called Design Studio took what it learned and grew into an established strategic capability that pioneers new ways of working in the organization, tackling complex challenges in circularity, inclusion, supply chain, and customer experience. Sustainability isn’t a passing trend for H&M. It’s moving fashion forward.

“Sustainable packaging was our first beacon project for using a design-led approach to deliver on big shifts as a company. Today we’ve built a design capability tackling challenges in key strategic areas while unleashing human-centered ways of working across our organization.”

The Next-Generation Bike Saddle

An award-winning bike seat made of a revolutionary new material that's immediately broken in for instant comfort.

Giving Every Kid the Freedom to Roam

A design process focuses on children with physical disabilities to produce a portable chair that works better for all families.

The Future Guest Experience

Designing new guest and employee journeys that reward curiosity and spark artistic exploration.

Get updates from IDEO

• Name of CEO/Founder: Helena Helmersson
• State | Country : Stockholm, Sweden
• Date of incorporation: 1947

Vision and Mission Statement

To lead the change towards circular and renewable fashion while being a fair and equal company.

H&M is currently working on making its packaging completely recyclable and compostable. They also want to make their product range 100% recyclable by 2030.

Achievements in Sustainability

Anna Gedda, Head of Sustainability, quoted, “Big change requires bold actions and the courage to aim high. At the same time, we have to be humble to the challenges our planet is facing. So if we want to make a real change, we have to be brave, push the boundaries and not be afraid to fail.”

H&M has always stood by this statement. Over the years, it has set an example for many other leading companies with its astonishing sustainability plans and projects.

In June 2018, H&M launched Afound. Afound works towards giving unsold products across 300+ brands, including H&M, a new life cycle. You can find past and present season products inclusive of used and vintage commodities possessing the range of discount of 25-70% on their platform. Currently, Afound is only available in Sweden and the Netherlands.

H&M also started the take care concept. The take care concept offers direction on how to do small repairs and fixes by yourself, which prolongs the product’s life. Through the H&M’s app, users can access methods and advice like how to remove lipstick stains or how to reattach buttons and many more. They also offer a variety of products, for instance, sewing kits, environmental-friendly detergents, washing bags that collect microfibres, plus more.

H&M has its recycling service too. Customers can return products they no longer want to the store. About 50-60% of the second-hand items are resold. The next 35-45% of the collected items are remade into something new. The remaining proportion of 3-7% is used as combustibles for energy production. 

The company is also experimenting with new and productive ideas. For example, H&M built one of its stores in Stockholm, Sweden, primarily out of existing store materials or previous purchase leftovers. This maximized the utilization of resources and minimized the environmental impact.

More than 57% of its supply chain consists of recycled materials. In addition to recycling materials like cotton, polyester, nylon, wool, cashmere, and numerous other things, they also are collaborating with people to tackle the problem of recycling blended fibers. 95% of the cotton in their products is sustainable or recycled.

H&M’s value chain is connected to innumerable people and businesses around the globe, who together are creating a positive impact on the world.

Quick pointers:

• H&M was launched in 1947 in Sweden.
• In June 2018, H&M launched Afound. Afound works towards giving unsold products across 300+ brands, including H&M, a new life cycle, at a discount of 25-70% on their platform. Currently, Afound is only available in Sweden and the Netherlands.
• H&M also started the take care concept. The take care concept offers an app that gives direction to users on how to do small repairs and DIY fixes, which prolongs the product’s life.
• H&M has its recycling service too. Customers can return products they no longer want to the store. About 50-60% of the second-hand items are resold. The next 35-45% of the collected items are remade into something new. The remaining proportion of 3-7% is used as combustibles for energy production.
• The company is also experimenting with new and productive ideas. H&M built one of its stores in Stockholm, Sweden, primarily out of existing store materials or previous purchase leftovers. This maximized the utilization of resources and minimized the environmental impact.
• More than 57% of its supply chain consists of recycled materials. In addition to recycling materials like cotton, polyester, nylon, wool, cashmere, and numerous other things, they also are collaborating with people to tackle the problem of recycling blended fibers.
• 95% of the cotton in their products is sustainable or recycled.
• Their vision is to lead the change towards circular and renewable fashion while being a fair and equal company.

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Case Study of The Growth Of H&M

Erling Persson established the business in Sweden in 1947 under the name "Hennez," which translates as "hers" in the local tongue, because at the time it solely offered clothing for women. After ten years, the business began to expand in Norway, a neighbouring nation, and began making clothing for men as well. His sons, Stefan Persson and Helena Helmersson, currently oversee the business.

Historical Background and Development

It can be studied under the following sub-headings

History − H&M (Hennes & Mauritz) is a Swedish multinational retail clothing company founded in 1947. It initially started as a women's clothing store and has now expanded to offer a wide range of clothing, accessories, and home textiles for men, women, and children.

Expansion Strategy − H&M has adopted an aggressive expansion strategy, opening new stores in new markets and entering new product categories. The company has also made strategic acquisitions, such as the 2007 purchase of the high-end fashion brand Cos.

E-commerce − H&M has also made a strong push into e-commerce, launching its online store in 1998 and now offering online sales in 64 markets around the world.

Sustainability − H&M has made sustainability a key part of its growth strategy, focusing on reducing its environmental impact, improving working conditions in its supply chain, and promoting a circular economy.

Fast Fashion − H&M is known for its fast fashion model, which allows it to quickly respond to changing trends and consumer preferences. The company has also invested in technology to improve the efficiency of its supply chain, enabling it to get new products to market faster.

Brand Recognition − H&M has become one of the most recognisable fashion brands in the world, thanks in part to its celebrity collaborations and partnerships with high-end designers.

Financial Performance − H&M has consistently posted strong financial results, with sales and profits growing steadily in recent years. The company reported revenue of more than SEK 230 billion (approximately USD 25 billion) in 2022.

Challenges − Despite its success, H&M has faced challenges, such as increased competition from fast-fashion and online-only retailers, changing consumer preferences, and the impact of the COVID-19 pandemic. The company has responded by focusing on improving the customer experience, expanding into new markets, and investing in sustainability and digital technologies.

Business Model

With more than 4,500 stores throughout 62 countries, H&M and its affiliated businesses employed about 132,000 employees as of 2015. It is barely behind Spain-based Inditex as the second-largest clothes retailer in the world (the parent company of Zara). With online shopping accessible in 33 countries, the corporation has a sizable online presence. Their business model includes the following 

Direct Selling − Products from H&M are only sold through its chain of physical stores, catalogues, and online shop. As a result, the business is able to profit from capturing the entire retail margin and maintaining complete control over their value chain.

E-Commerce − In addition to its physical storefronts, the business also maintains an online store where clients can place direct orders and have their purchases delivered to their homes. Customers can shop for items in sizes that are out of stock in the physical store using the company's online store, as both offer the same selection.

Design − All H&M locations have the same straightforward, uniform store design. Simple racks and shelves are used to store clothes. Staff is there, but their primary purpose is to replenish racks and shelves rather than help clients with their shopping experiences.

Retail Stores − H&M has moved beyond just selling clothing to include accessories and shoes. Its clothing selection includes professional and casual items. As a result, H&M provides a comprehensive selection that enables clients to buy whole outfits from a single location.

Target Customer − All of H&M's products are quite affordably priced. This includes formal and business attire, for example, allowing retailers to reach a sizable consumer base with little purchasing power.

Marketing Strategy

H&M employed numerous marketing techniques that enabled the company to excel in the clothing retail industry.

Product Strategy − The business is known for its "fast-fashion clothing boutiques," which implies that they consistently present amazing apparel and accessories that are in step with current trends. Additionally, they are constantly ready to launch new product lines on schedule and offer European-influenced clothing in the American market because it promotes cross-cultural trends in this population. The goal of H&M's product strategy is to offer fashionable, high-quality apparel at competitive prices. The business maintains four product lifecycle stages: introduction, growth, maturation, and decline. During each step, a product manager studies supply and demand for H&M products and works to develop an efficient marketing strategy for the new product to help it compete in the market.

Price Strategy − Customers claim that some H&M clothing is extremely expensive to purchase since it is high fashion. H&M, on the other hand, concentrates on meeting customer needs by keeping labour and transportation costs as low as possible while still providing high-quality apparel. H&M clothing costs between Rs 399 and Rs 7999.

Promotional Plan − H&M created a multi-channel promotion strategy that includes advertising, sales promotion, and online promotion in order to increase brand awareness globally. Additionally, the business attracts clients by enhancing brand recognition and advertising discounted prices on the goods.

Place Strategy − By operating stores in numerous locations throughout the globe, H&M created a solid connection with its clientele. H&M manufactures its low-end products in Asia while producing its high-end products in Turkey, and it sells them in its 5000+ owned stores across 73 nations.

Cost leadership strategy − H&M delivers stylish clothing to large markets at a cheap price that is set in accordance with the going rate for a particular specialty. Instead of setting a high price to generate a large profit margin, the cost leadership strategy concentrates on working effectively to increase their market share.

People Strategy − H&M consistently places a focus on the demands of the client and offers them stylish things that are popular at the time.

Secret To Its Success

The fast-fashion business model of H&M is largely responsible for its growth. Fast fashion depends on transferring a sizable quantity of goods from the designer table to the showroom floor in the shortest amount of time and at an affordable price. Their items are hip and affordable, almost throwaway, and are marketed to young, urban consumers that care about fashion. They have unsurprisingly received some criticism for this from proponents of ethical and sustainable consumerism.

High product turnover and continuous restocking of the product pipeline with the newest trends are how fast fashion shops generate their revenues. The business model of H&M also depends on a strong marketing group that can swiftly ascertain what the target market wants and get it into the supply chain. After Inditex, the company that owns the Zara stores, H&M has developed into the second-largest fashion retailer in the world. The sustained success of both companies hinges on their use of "fast fashion," which is based on recognising trends as they emerge and producing low-cost versions of them as soon as feasible.

H&M is a massive global player in the fashion industry with a huge market share. They already have a fantastic business strategy and marketing plans in place, and they are doing a great job putting those plans into practise with digital marketing. H&M has enhanced its strategy and continuously changed its business model to keep up with the times in response to the escalating rivalry and rise of microbrands and websites. All of this has contributed to H&M's spectacular growth.

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Scoville and Milner (1957)

Last updated 22 Mar 2021

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Effect of hippocampal damage on memory.

Background information: Scoville performed experimental surgery on H.M.’s brain to stop the severe epileptic seizures he had been suffering since a fall off his bicycle many years previously. Specifically, he removed parts of HM's temporal lobes (part of his hippocampus along with it). The seizures reduced drastically but H.M. suffered from amnesia for the rest of his life. Milner, who was a PhD student of Scoville’s, followed up the surgery with cognitive testing for fifty years after the original operation. Hers is a cognitive longitudinal case study of H.M.’s anterograde (after the surgery) and partial retrograde (before the surgery) amnesia. The biological part of the H.M. study is the correlation between the brain damage and the amnesia, which was assumed in the 1950s, and not verified until later brain scans in the 1990s (see Corkin, 1997)

Aim: In 1953 Scoville performed surgery on the then 27-year-old H.M. to cure him of his epileptic seizures. [Note: this is a surgical procedure – it only became a study later when the memory damage was noted].

Method: The surgery involved what was called a partial medial temporal lobe resection. Scoville removed 8 cm of brain tissue from the anterior two thirds of the hippocampus, and believed he “probably destroyed …. the uncus and amygdala” as well (Scoville and Milner, 1957). Once the extent of the memory loss was realised, Scoville and Milner wrote about this, along with the results from this type of surgery on nine other patients, in a prominent neurosurgical journal, and Milner started her cognitive studying of H.M.

Results: H.M. lost the ability to form new memories. This is called anterograde amnesia. He could do a task, and even comment that it seemed easier than he expected, without realising that he had done it hundreds of times before. His anterograde procedural memory was totally affected. He also lost his memory for events that had happened after his surgery: he could not remember moving house, nor that he had eaten a meal thirty minutes previously. He had also suffered some retrograde amnesia of events preceding the surgery, such as the death of his uncle three years before. However, his early childhood memories remained intact. His intelligence also remained as before, at slightly above average.

Conclusion: The surgery to remove part of the hippocampus, the uncus and the amygdala resulted in total anterograde amnesia and partial retrograde amnesia.

Evaluation:

This is the assumption, based on the results with other patients as well as H.M. In the absence at that time of brain-scanning equipment, other possibilities were also present. The high doses of anti-epileptic drug he was taking before, and the lower doses after the surgery, may have resulted in some memory loss. Also, so far as we can see, no memory tests were conducted on H.M. before the surgery, and the initial memory loss was largely reported by his mother, with whom he lived.

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H&M Foundation: Creating fashion with purpose

Strategy and solution, transformation.

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Making the fashion industry more sustainable is a massive paradigm change, and one best made via an ecosystem of partners and open innovation.

The non-profit H&M Foundation teamed up with KTH Royal Institute of Technology and Accenture to create the Global Change Award (GCA) to help accelerate the fashion industry on this journey.

Now in its sixth year, the GCA continues to drive change through the innovations of today and the solutions of tomorrow. Across the first five years of the GCA, 25 winners were chosen from 20,000+ entries across 200+ countries. This year, H&M Foundation collaborated with Accenture on The Billion Dollar Collection , a virtual fashion collection presenting 10 of the GCA winners working to change the face of the fashion industry.

Every year, the world uses more resources than our planet can sustain. With fashion as one of the most planet-intensive industries, the non-profit H&M Foundation, wanted to shift from “take-make-waste” production and consumption models to a “take-make-take-make-take-make” economy that eliminates waste.

How could the global foundation help the industry create fashion for a growing population while protecting the planet? It knew it needed strong partners to help reinvent the fashion industry. As a result, H&M Foundation collaborated with Accenture and KTH Royal Institute of Technology in Stockholm to apply and accelerate innovation at scale through the Global Change Award.

The Global Change Award is one of the world’s biggest challenges for early stage innovation and the first initiative of its kind in the fashion industry. It identifies ideas that apply disruptive technology and new business models to change the way garments are designed, produced, shipped, bought, used and recycled.

Accelerating innovation

The H&M Foundation, KTH and Accenture co-developed the GCA accelerator concept and overall program structure using an open innovation approach. Since 2015, all three organizations continue to develop the program together, for example, contributing:

An innovation accelerator and coaching to help the winners turn their ideas into reality. Accenture offers knowledge and insights into the future of fashion and retail.

Analytics and thought leadership to identify the trends shaping sustainable fashion. Accenture creates a report on the trends in circular fashion and open innovation to share with the broad industry.

Accenture also helps the five winners each year to build bridges in the broader ecosystem, bringing in other start-ups and more established businesses to help create partnerships for innovation.

Seize the moment—Responsible and resilient retail

H&M Foundation and its partners, KTH and Accenture, are helping to make the fashion industry more sustainable. Shifting to a circular economy presents a paradigm change for the industry—modernizing fashion’s global production and consumption in a way unseen since the Industrial Revolution. With H&M Foundation’s help and direction, fashion start-ups in the circular economy are acquiring the knowledge and skills to develop and scale their ideas into fully fledged businesses. The award program helps the winners to accelerate results and make a lasting change on the industry—and the world.

Creating more sustainable fashion is helping to attract future customers and employees who increasingly demand greater transparency and clothes with a conscience. The shift toward circular fashion is bringing new benefits for the industry, such as reduced material costs, improved customer relationships and reduced risk of resource exhaustion. Together, the H&M Foundation, KTH and Accenture are pushing the boundaries of what’s possible by nurturing green, disruptive ideas and technology that will shape the future of fashion.

Selected success stories The 2016 winner, Orange Fiber, worked with Accenture and other partners in the accelerator to learn how to move from a small start-up with lab production to scale its business model and marketing to meet demand. Orange Fiber repurposes leftovers from citrus fruit production to create a silk-like, biodegradable fiber with fantastic sturdiness, shine and drape. Since working with H&M Foundation, KTH and Accenture, the Salvatore Ferragamo group launched a capsule collection using Orange Fiber fabric.

One of the 2017 winners, EON-ID, creates tiny RFID threads with a digitalized “ingredients list.” The threads, which can be sewn into garments, aim to make the recycling process more efficient and less wasteful by proactively identifying the garment’s materials. The Global Change Award helped the team move beyond proof of concept to commercialized technology, as well as build partnerships with large global brands that are purchasing and introducing EON-ID RFID Thread technology into their value chains. Just one year later, the company has moved from having five sample threads to producing significant amounts.

Shifting to a circular economy presents a paradigm change for the industry— modernizing fashion’s global production and consumption in a way unseen since the Industrial Revolution. Fashion start-ups are acquiring the knowledge and skills to develop and scale their ideas into fully fledged businesses.

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You are in: Home » RXEU » CASE STUDY H&M: engaging with customers

CASE STUDY H&M: engaging with customers

By chloe rigby.

Screenshot of hm.com/se

As a global fashion brand, H&M aims to reach existing and potential customers around the world, both online and through its stores. From its website it offers customers a range of ways to engage with the brand as it works towards a strategy of doubling its sales by 2030, while reducing its emissions to zero by the same date. 

H&M is the original brand in an H&M Group that now includes eight brands and turned over SEK 198.97bn (€19.02bn) in 2021. H&M itself was founded in 1947 when Erling Persson opened a womenswear shop called Hennes in Västerås, Sweden. Now H&M, ranked Elite in the RetailX Top1000 Europe, takes a multichannel approach to selling clothing and footwear for men and children as well as women, with 4,157 shops in 76 markets and 56 market-specific local language and local currency online websites.

Building customer relationships

From its home page, H&M offers shoppers the opportunity to sign up to its newsletter, while also linking to its social media channels – Facebook, Twitter, Instagram YouTube and Pinterest. The retailer has more than 40.4m followers on Facebook, where it shares fashion advice and inspiration. H&M’s demographic may be more likely to want to engage via mobile – the retailer offers both iOS and Android apps. Signed in shoppers can save items to a ‘favourites’ list, or in their shopping bag for later. 

The retail brand encourages shoppers to become a member of the free H&M.com club, in exchange for special prices, exclusive discounts, free click and collect and free delivery when spending £20 or more. Shoppers collect points by joining, shopping and once they have collected 300 points they qualify for free delivery and returns as well as surprise offers and early access to collections. All of these approaches are part of developing a data-driven relationship with customers, that enables H&M to send more relevant messages and discounts to shoppers. The retailer also shares features from its customer magazine on the website, with recent features covering Pride 2022 and the crochet trend.

Shoppers can browse the website using a comprehensive navigation that filters by clothing type, by current trends, named occasions, by brands and by rental and sustainable shopping options.

Delivery and payment options

From the checkout shoppers can see reviews, delivery options, and also have the option of finding the item in their local store, using a stock checker.

On H&M’s Swedish website, standard delivery, in two to four days, is free when shoppers spend at least SEK 200, or costs SEK 39.90 for smaller orders. Collection and locker delivery are also available. A variety of express delivery services which deliver in one to two days are available for an extra charge. Payment methods include Klarna – available to registered members – PayPal and Apple Pay as well as credit and debit cards. Returns can be made within 30 days, and are free to a shop or for members, but cost SEK 39.90 for returns via a courier or a locker service. 

In the UK, the cost of standard, two to four day delivery or collection is £3.99, while next day delivery is also available on orders placed by 7pm for an extra charge. Returns are free and must made within 28 days. Standard fulfilment services are free to HM.com members.

This first appeared in the RetailX Top1000 Europe . Download here to see the full listing and analysis of Europe’s leading retailers

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H&M and Zara Case Study – Comparing the Fast Fashion Giants

• Written by 440 Industries
• Case Study , H&M , Zara
• November 17, 2021

Introduction

Today, when we discuss fashion, we usually focus on clothes and other accessories. The days when people wore cloth for coverage are long gone. Fashion has taken clothing to a whole different level where it does more than cover our bare bodies. 

Everyone now desires to stand out in what they wear. This is because many of us know what we wear can help us reveal a lot about our personality. This could be our style or affluence. When making outfit choices, several brands come to mind. These could be brands like H&M vs Zara. 

These clothing brands are known for quality and style. Also, they are fast fashion brands , meaning a vast population is drawn to them for their quick offering of new trends, especially at cheaper rates. Therefore, let’s look at the H&M vs Zara case study in this article and compare these two fast fashion giants.

H&M Brand

• H&M vs Zara Case Study

Key Differences Between H&M vs Zara Brand

Among similar brands like Uniqlo and Zara, “ Hennes and Mauritz ” is the oldest. Sweden was the birthplace of this retail brand. This was as far back as 1947. Hence, it’s amazing how this brand has become such a recognizable giant in fashion. 

Besides Sweden, that’s native to them, this brand also operates in the United States. It was in 1974 that their public trade in Sweden began. Over the years, this brand has grown more prominent as it stretched out across the globe.

The H&M brand has established over 4000 stores in several countries globally; A number that’s way bigger than that of Zara.

This brand has gotten an edge over its competitors as they’ve been more productive in the US market. It’s just amazing how they got into this enormous market and gained so much success. In the US alone, they have up to 559 physical stores.

However, they haven’t stopped yet and are working towards expanding more throughout the globe. They aim to open more stores, about thousands of them, in the years to come.

Meanwhile, the brand made a broader shift to e-commerce sales from physical ones. This happened because they began receiving most of their purchases online. This also resulted in the brand closing down some physical stores.

Interestingly, aside from the H&M brand, the H&M group has seven other brands under them. They are COS, H&M Home Weekday, Monki, ARKET, & other stories and Afound.

H&M also collaborates with known figures, like Versace, in the products they offer their customers. This is one of the sales-boosting strategies that has helped boost their reputation.

The Zara brand is the latest compared to retail giants like H&M and Uniqlo. The year 1975 was when this brand started. The birthplace was Spain, and the founder, Amancio Ortega.

Zara is the largest brand under the Inditex group. It ranks number one in the apparel industry, particularly fast fashion. They deal in a wide range of products, including clothing, shoes, fragrances, and other accessories. 

The brand has also stretched out over the world in about 96 countries, where they have a total of about 2200 stores. Just in the US, the brand has established up to 99 stores. 

However, you’ll find most of their stores in their birth country, Spain, where it’s over 400.

The founder improved the brand’s design, production, and distribution process around the 1980s. This improvement led to a faster reaction to the new fashion that came up. 

In fact, their distribution is remarkable. They can start selling a product a month after they’ve designed it. Their product turnover is impressively quick! 

When they created their first store, they began making similar products as the more high-end fashion brands. As they did this, they offered them at low prices. Interestingly, they then influenced the term “fast fashion” due to this speedy feedback. 

Zara offers a lot more products to their customers. In fact, it’s much bigger than the number that other competitors like H&M offer. 

They can produce more than 10,000 pieces in a year, unlike the 2000-4000 pieces most other retail brands do. This is one of the brand’s exceptional strategies that have attracted customers with different tastes and styles, especially in the US.

H&M vs Zara Case Study 

Looking at the H&M vs Zara fast-fashion business, it’s been very lucrative for them. No matter what these companies focus on, they have one thing in common as a competitive advantage: the customers’ preferences.

As people want what’s trending and at the same time desire to have it quick, these companies have to employ a speedy process. Both H&M and Zara seem to offer low-end market apparels that are alike with high fashion standards. They make these very fast and at a low price. 

It’s common with fast fashion for trends not to stay for long. New designs keep coming up, and many people want to try out what’s new. Therefore, these fast fashion brands have to keep making these products available to meet the customers’ continuous demands. 

Zara, in particular, is at the top of the game when it comes to reducing the time between designing and production. In addition, both brands ensure that their supply chain effectively responds to demands quickly. When supply doesn’t come quick, it can badly affect sales. 

A common one is when the customers lose interest in the apparel they waited so long for because of the new trends that might have come up. Therefore, the cost of the goods, buying cycle, and, more importantly, market timing build up the fast-fashion concept of H&M vs Zara brand. 

Let’s compare these two brands with different marketing categories. This way, we can know what makes them different, especially in their strategies to boost sales.

Pricing System for H&M vs Zara

The H&M brand emphasizes offering their quality products cheaper as a means to keep customers trooping into their shops. They are known to offer huge discounts very often, unlike most of their competitors. 

On the other hand, Zara offers their products at a reasonable price as long as they match the quality. They don’t underprice to keep people trooping in. Similarly, they give discounts but not as much as the H&M brand. Instead, they focus more on the quality of what they offer. 

They create value around their product,s which stirs the feeling that what you’re buying is worth the price. 

Target Market for H&M vs Zara

These two fashion giants create their target market based on psychographics and demographics. Focusing on an individual’s lifestyle, interests, and social status falls under the psychographic segment. However, considering their customers’ gender, age, income, class, etc., is a demographic way of segmenting their market. 

H&M’s brand targets primarily women, particularly those aged between 20-34 years. 

These are the younger, working females that still have so much love for what’s trending. On the other hand, Zara still targets the younger population but expands more demographically. 

They offer clothing and accessories for both genders, particularly about 18-40 years of age. However, this is just their target market, and this brand offers both articles of clothing for younger kids.

Promotion for H&M vs Zara

H&M is always making regular promotions for their products. Their advertising is quite versatile. They reveal a lot about their products through various means including, TV commercials, prints, billboards, banners, social media, and many more. The brand puts a lot of emphasis on promotion. 

A common thing about the Zara brand is that they don’t fancy advertising. You’ll see no banners, no billboards, and no form of promotion. They consider investing in building more stores far more important than advertising their goods. 

However, the company employs the system they call evangelism. So, instead of taking their brand to their consumers as advertisements, they bring their consumers into their brand. They nurture their customers as brand influencers, allowing them to boost operations and, more importantly, do the storytelling.

Product Distribution for H&M vs Zara

Zara gets goods on its shelves much faster than H&M. The brand doesn’t have any factory of its own. Instead, they buy from other distributors. About 60% of H&M products come from places like Cambodia or Bangladesh, which are cheaper. 

However, these places are far from them, so leading times are always longer. This makes this brand have several orders from customers pending. This situation creates problems for the brand, especially in sales. 

This also makes them have more unsold goods in stock, unlike Zara. These goods’ value is more than $4 billion. This could also be why the H&M company focuses more on giving discounts as one of their pricing strategies. Interestingly, the gross profit made by both brands is almost the same, despite H&M making cheaper purchases. So, in essence, they lose the advantage that comes with buying from cheaper places. 

Also, the distribution system has made them famous in the fast- fashion world as they can control the number of goods they produce and the supply. Therefore, they don’t have issues with numerous unsold goods in stock. It takes about a day to distribute to their stores in Europe due to their robust distribution network. Moreover, it will take about 40 hours to deliver to the US branches.  

Both brands, H&M vs Zara, have grown successfully over the years more than other fast fashion brands. The progress of the Zara brand explains why price isn’t everything. Unlike H&M, they tend to focus more on the value they can place on their products. H&M has still suffered many losses despite its underpricing strategies. 

However, in fast fashion, the constant change in trends keeps the demand alive, but what’s more important is that these fast fashion brands make these products available.

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More From Forbes

H&m case shows how greenwashing breaks brand promise.

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A recent exposé on fast-fashion retailer H&M alleges that the company’s environmental promise is undermined by greenwashing.

H&M was using a scorecard system to inform customers about the environmental soundness of each product, but a report by Quartz claims that more than half of the scorecards portrayed products as being better for the environment than they actually were. The report also found some instances in which H&M’s scorecards allegedly gave information about the sustainability of a product that was completely opposite from the truth.

H&M has removed the scorecards in the wake of Quartz’ s report. The scorecards were created based on the Higg Material Sustainability Index (MSI) by the Sustainable Apparel Coalition (SAC). The trade group has paused the use of the consumer-facing transparency scorecards in response to a complaint by the Norwegian Consumer Authority and is reassessing their methodology. (It has not paused the full use of the Higg MSI.)

A watchdog group found that the scorecards use only averages of the environmental impact of types of textile, rather than giving the full environmental impact of the manufacture and sale of a particular finished piece of clothing, Just Style reported.

H&M’s transgressions may go beyond that, though, with some of the product information shown on Quartz mixing up data — touting products that used 30 percent more water as using 30 percent less water, contradicting the SAC version of the scorecard.

For many of the experts on the RetailWire BrainTrust in an online discussion last week , the issue at H&M appeared to be part of a longstanding, alarming trend.

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“Retailers have been greenwashing for years,” wrote Paula Rosenblum , co-founder of RSR Research. “At least a decade, maybe more. They often mask cost-savings initiatives with ‘green ones.’ The answer is simple. Get real.”

PALM SPRINGS, CALIFORNIA: FEBRUARY 28, 2019: An H&M store in Palm Springs, California. (Photo by ... [+] Robert Alexander/Getty Images)

And the BrainTrust did not see retailers who fudge the numbers on environmental matters getting off easy.

“While the financial calculation of merely greenwashing away environmental issues may seem acceptable, this is a real threat to the long term success of companies like H&M who target a younger consumer,” wrote Mark Ryski , CEO of HeadCount Corporation. “I believe that H&M has already sustained brand damage as a result of their past greenwashing activities.”

“There is nothing worse for a brand than breaking the brand promise,” wrote Lucille DeHart , principal at MKT Marketing Services/Columbus Consulting. “Claiming to be ‘green’ is not enough today, consumers are savvy and will demand transparency.”

The fast-fashion industry has begun to make changes to its model in response to a perceived emerging customer focus on environmental and sustainability concerns. BrainTrust members had some advice on how best to make that happen, and avoid charges of greenwashing and the damage that comes with it.

“As retailers race to adhere to ESG practices, they will encounter not only issues with measurement accuracy, but with profit compromise,” wrote Ms. DeHart. “The best first step for every manufacturer/retailer is to establish a more sophisticated end to end supply chain. Having a strong planning, merchandising and allocation system will better ensure that the right amount of products get made and go to the right places to the right consumers. Produce less waste upfront.”

“Firms should treat sustainability reporting the same as they do their financial reporting,” wrote David Spear , senior partner, industry consulting, retail, CPG and hospitality at Teradata TDC . “These data ought to be of high integrity and be able to pass an audit by any third-party accounting firm. Lately there are more firms that are starting to integrate their ESG reporting into their annual financial reports. I expect to see much more of this in the near term. H&M would be well advised to get their house in order or face consumer backlash at the register and on social media.”

“The industry cannot rely on trade associations as the arbiters of sustainability or eco-impact scoring,” wrote Nikki Baird , vice president of strategy at Aptos. “Huge conflict of interest, in my opinion. If brands want to avoid more of this kind of investigation in the future, they need to engage directly with organizations exclusively focused on reducing environmental impact and increasing the sustainability and reuse of products.”

Developments elsewhere in the fast-fashion world have called into question the extent to which customers truly care about the environmental posture of the retailers they patronize. Most notable is the emergence of Chinese fast fashion app Shein as the most searched for apparel app, and most downloaded app, in the U.S. The $800 billion company has been thriving despite drawing the ire of environmentalists and even competitors like ThredUP .

But Shein’s popularity with customers was a moot point for BrainTrust member Ken Morris , managing partner at Cambridge Retail Advisors.

“Shoppers have every right to lie to themselves; fast-fashion retailers shouldn’t have the right to lie to everyone else,” wrote Mr. Morris. “When corporations lie, they will eventually lose respect, loyalty and business.”

And one BrainTrust member pointed out that, when it comes to demonstrating environmental commitment, the proof is in the pudding — not the press release.

“Saying you’re ‘green’ is a little like saying you’re a ‘cool’ brand,” wrote Lee Peterson , EVP of thought leadership, marketing at WD Partners. “Don’t say it, just do it. We’ll be the judges of those two attributes, thank you.”

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