The lobotomy, one of the most brutal surgical procedures of the modern world, had a complex and controversial history. This article delves into the dark past of this procedure that began with good intentions but ultimately resulted in widespread controversy and bans worldwide.
The Origins of the Lobotomy
The history of the lobotomy traces back to Egas Moniz, a Portuguese neurologist who developed the procedure in the 1930s. Moniz believed that disruptions in brain circuits were linked to mental illnesses like schizophrenia, severe depression, bipolar disorder, and obsessive-compulsive disorder. He aimed to alleviate patient suffering by severing these connections through surgery.
Moniz’s theory was rooted in the observation that certain mental illnesses appeared to be associated with disturbances in the brain’s neural pathways. This observation was not entirely baseless, as subsequent research has shown that some psychiatric conditions involve abnormalities in brain structure and function. However, Moniz’s proposed solution was both radical and controversial.
The Lobotomy Procedure
Moniz’s procedure, known as the “leucotomy” or lobotomy, involved drilling holes in the skull to access and manipulate the brain. The idea was to disconnect neural pathways responsible for mental illness, with the hope of improving patients’ emotional well-being and behavior.
The procedure was based on the theory that disruptions in specific neural connections in the brain were responsible for mental illness. By severing these connections through surgery, proponents of the lobotomy believed that it could alleviate emotional distress and improve behaviour in patients.
Early Experiments with the Lobotomy
Moniz and his collaborator, Pedro Almeida Lima, embarked on daring experiments in 1935. They focused on the frontal lobes, the brain regions associated with fundamental aspects of human behavior. By injecting ethanol into the brain and targeting specific fibers, they believed they could achieve positive outcomes.
During these early experiments, Moniz and Lima were driven by the hope of finding a treatment for individuals who had not responded to other forms of therapy. The lobotomy was initially designed as a last resort for patients who were deemed untreatable by other means. Moniz believed that this procedure had the potential to offer hope and relief to those who had previously been considered beyond help.
Patient Trials and Mixed Results
Over a few months, Moniz and Lima performed leucotomies on twenty patients suffering from various mental disorders. The results were mixed, with some patients showing improvement in their symptoms, while others experienced complications and side effects.
Among those who showed improvement, Moniz declared them “cured.” However, the reality was far more complex. Many patients did not leave the confines of mental hospitals, and some experienced lingering side effects of the procedure.
Spread of the Lobotomy Procedure
The lobotomy’s popularity spread rapidly across the globe. Walter Freeman and James Watts performed the first prefrontal lobotomy in the United States at George Washington University Hospital in 1936. Freeman’s interest in psychiatry was sparked during his appointment as medical director of the Research Laboratories of the Government Hospital for the Insane.
Freeman’s enthusiasm for the lobotomy procedure led to its widespread adoption in the United States. However, his methods faced criticism for becoming overly routine. He wanted to simplify the procedure so that it could be provided to patients in state mental hospitals without the need for specialized operating rooms, neurosurgeons, or anaesthesia.
Ethical Concerns and Controversies
As the lobotomy became more widespread, disturbing patterns emerged. Shockingly, an estimated 40% of Freeman’s patients were gay men who were tragically subjected to lobotomies in an ill-conceived attempt to change their sexual orientation. This revelation cast a dark shadow over the already contentious history of this procedure, highlighting the complex ethical dilemmas and human impact involved.
The lobotomy had a significant impact worldwide, with around 40,000 procedures performed in the United States, 17,000 in England, and approximately 9,300 in the Nordic countries of Denmark, Norway, and Sweden combined. Sweden alone conducted at least 4,500 lobotomies between 1944 and 1966, mainly on women, including young children. Japan’s majority of lobotomies targeted children with behaviour problems.
Critics and Skeptics
Critics of the lobotomy procedure raised concerns about its effectiveness and safety. Swedish psychiatrist Snorre Wohlfahrt, evaluating early trials in 1947, warned, “It is distinctly hazardous to leucotomize schizophrenics,” casting doubts on the procedure’s effectiveness for chronic mental disorders.
Norbert Wiener, author of “Cybernetics: Or the Control and Communication in the Animal and the Machine,” couldn’t help but remark, “Prefrontal lobotomy…has recently been having a certain vogue, probably not unconnected with the fact that it makes the custodial care of many patients easier. Let me remark in passing that killing them makes their custodial care still easier.” The cold reality of lobotomy’s growing popularity shook the medical world.
Bans and Controversy
As ethical concerns continued to mount, the Soviet Union took a bold stand in 1950, officially banning the procedure and denouncing it as “contrary to the principles of humanity.” They lamented that “‘through lobotomy,’ an insane person is changed into an idiot.” The echoes of that decision reverberated across the globe.
In 1951, Freeman posed for a photograph while performing a lobotomy, which tragically led to the surgical instrument accidentally penetrating too far into the patient’s brain, resulting in their death.
In 1967, Freeman performed his final lobotomy on longstanding patient Helen Mortensen, who was receiving her third lobotomy from Freeman. Following the procedure, Mortensen suffered a brain hemorrhage, as did as many as 100 of his other patients, leading to tragic outcomes. As a result, Freeman was finally banned from performing further surgeries.
By the 1970s, other countries and several US states followed suit, joining the chorus of those banning lobotomy, seeking to protect patients from its potential harm.
In 1977, during President Jimmy Carter’s tenure, the US Congress formed the National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research. Their investigation into psychosurgery, including lobotomy techniques, was shrouded in controversy. Though the committee recognized limited benefits, they urged restraint, wary of overstepping ethical boundaries.
Rosemary Kennedy’s Lobotomy
Rosemary Kennedy was the third child of Joseph P. Kennedy Sr. and Rose Fitzgerald Kennedy, and she was born in 1918. Unfortunately, Rosemary suffered from intellectual disabilities and behavioural challenges, which became more apparent as she grew older. As she reached her late teens, her parents sought a solution to help her live a more manageable life.
In 1941, at the age of 23, Rosemary underwent a prefrontal lobotomy, performed by Dr. Walter Freeman and Dr. James Watts.
The procedure, which was intended to calm Rosemary’s emotional outbursts and make her more manageable, had devastating consequences. Instead of improving her condition, the lobotomy left Rosemary severely disabled and unable to care for herself. She lost her ability to speak, walk, and function independently, with her mental capacity diminished to that of a two year old child.
The lobotomy performed on Rosemary Kennedy was shrouded in secrecy for many years. The Kennedy family went to great lengths to keep the details of Rosemary’s lobotomy hidden from the public and shielded her from the media spotlight.
After the lobotomy was performed on Rosemary in 1941, the Kennedy family did not disclose any information about the procedure to the public or even to their closest friends and associates. Instead, they chose to maintain an aura of secrecy around Rosemary’s condition and whereabouts. The family’s main concern was likely protecting the Kennedy name and reputation, as they were a prominent and influential political family.
Rosemary’s parents decided to place her in an institution, the St. Coletta School for Exceptional Children in Wisconsin, where she received round-the-clock care for the rest of her life. The school staff and administrators were instructed not to disclose any information about Rosemary to the public or the media.
Rosemary’s siblings were also kept in the dark about the full extent of her condition. Her sister, Eunice Kennedy Shriver, was one of the few family members who had regular contact with Rosemary. Eunice later became a champion for the rights of people with intellectual disabilities and founded the Special Olympics in Rosemary’s honour.
It wasn’t until many years later, in the 1960s and 1970s, that some details about Rosemary’s lobotomy began to emerge. Biographers and historians started investigating and writing about the Kennedy family, and stories of Rosemary’s lobotomy slowly came to light. However, the full extent of the procedure and its impact on Rosemary’s life remained largely hidden from the public until after her passing in 2005 at the age of 86.
Howard Dully’s Lobotomy
Another notable lobotomy was that of Howard Dully, one of the youngest recipients and survivors of the transorbital lobotomy. Walter Freeman diagnosed Dully with childhood schizophrenia since age four, despite numerous other medical and psychiatric professionals not detecting a disorder.
In 1960, Freeman carried out a transorbital lobotomy on 12 year old Dully on the instruction of his father and stepmother, who paid $200 for the procedure. Following the lobotomy, Dully was institutionalised for years as a juvenile due to behaviour problems, later incarcerated and eventually became homeless and an alcoholic before cleaning up his act and getting a college degree.
It wasn’t until his 50s that Dully sought to find out the details of what happened to him as a child. Due to the after effects of the surgery, Dully was unable to recall the memories of what happened, and by this time, his stepmother and Freeman were both dead. In 2007, he published a memoir, My Lobotomy, detailing how the procedure impacted his life and his search for the truth.
Legacy of the Lobotomy
The lobotomy remains a dark chapter in medical history, sparking debates about ethics, patient consent, and the dangers of unchecked medical procedures. While it may have had a limited impact on some patients, its widespread use and ethical controversies led to its eventual ban in many parts of the world.
In summary, the lobotomy’s history is a cautionary tale of medical experimentation gone awry, highlighting the importance of ethical considerations in the field of medicine. It serves as a stark reminder of the potential harm that can result when medical procedures are embraced without sufficient evidence and ethical safeguards. The legacy of the lobotomy continues to shape discussions about the intersection of medicine, ethics, and the welfare of patients.
Further Reading
If you’re interested in learning more about the Lobotomy I have included links to further reading below. The first is a copy of the Howard Dully’s memoir, My Lobotomy, which has been published into print, and the second is a book delving into the history of the Lobotomy and Dr Walter Freeman in more detail.
My Lobotomy: A Memoir by Howard Dully
UK: https://amzn.to/3RIrEmG
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The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness by Jack El-Hai
UK: https://amzn.to/3ryHzcv
US: https://amzn.to/45dywvA
CANADA: https://amzn.to/459S5EN
FRANCE: https://amzn.to/3ryHBB9
GERMANY: https://amzn.to/3LLynbQ
NETHERLANDS: https://amzn.to/45dkoSW
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