Just so you all know, when we talk about lobotomizing people we mean severing connections in the
frontal lobe parts of the brain. We guess you could compare it to deleting some major
files in a computer’s operating system, but not messing with the motherboard. According
to an article in Live Science, doctors might still do this today to switch off parts of
the brain of patients with a mental illness that is beyond other forms of treatment, but
it’s not common and the procedure, said one doctor, is “much more elegant.” What
he meant by that is these days you won’t find doctors shoving an icepick through a
patient’s eye to get to the that bit of fleshy wiring doing the damage.
Before we get into someone who could be called the king of this procedure, or perhaps overlord
of lobotomy, we’ll give you a quick rundown about the history of snipping wires in the
frontal lobes.
As we said, after a lobotomy the motherboard is mainly left intact. The frontal lobes are
where much of the hard thinking goes on in the brain. Other parts of the brain help you
to stand, breathe, to notice what’s going on around you or warn you of impending pain,
but the complex processing gets done at the front. This is how we differ from other animals,
and perhaps why dogs don’t have existential crises. As one doctor said back in the day,
the emphasis on lobotomy was to reduce “the complexity of psychic life.” They wanted
to shut you down, and we might recall that as far back as the 19h century and early 20th
century doctors didn’t really know what to do with patients suffering some serious
psychosis, often a danger to themselves or others. R D Laing they were not, and there
was a term called “therapeutic nihilism”, which basically espoused the theory that some
people were broken beyond repair. You couldn’t just turn those folks off, that would be murder,
so doctors of the brain decided the next best thing was to cut those wires where they believed
the mental storm was being brewed. You will soon see that these storms were maybe the
kind you might find in a teacup, and doctors were at times perhaps a little too trigger-happy
when it came to lobotomies.
In modern times this procedure gained momentum in the 19th and 20th century as we said, and
we are sure many of you have watched the harrowing scene in the movie, “One flew over the cuckoo’s
nest”, which was based on the book of the same name written by Merry Prankster, Ken
Kesey. He knew what he was talking about because he had talked with mental patients while working
in hospitals, while the movie depiction of electroconvulsive therapy has been called
by doctors very realistic. But while that might look utterly brutal, things had been
worse. Now we have to go back to the 1880s and introduce
a Swiss physician called Gottlieb Burckhardt. He had noted that giving patients with schizophrenia,
those often experiencing frightening hallucinations, a lobotomy had made them rather calm. He also
noted that one of his patients took their own life after the procedure and another died
during it. He would basically go under the hood of patients and surgically remove the
parts of the brain that he believed caused those “excitations”, the over stimulation.
He claimed he had a 50 percent success rate, with the failures sometimes becoming epileptic
or suffering from sensory aphasia, which means severely limiting comprehension and the ability
to communicate.
Despite these mishaps, physicians all over Europe were jumping on the lobotomy train.
It wasn’t until 1935 that a Portuguese neurologist called António Egas Moniz targeted only the
frontal lobes, so he’s the one who is mainly responsible for inventing what we might call
the modern lobotomy. He started with chimps and then rolled-out his procedure to humans.
He said he had made unruly chimps, aggressive ones that threw their own dung around the
lab, into nice and calm chimps, adding that he believed the effect would be the same in
humans. Many other experts in the field were doubtful, but others were not. The procedure
then usually consisted of trephining (using a hole-saw drill) into the skull and injecting
alcohol into the white matter of the brain in the frontal lobe. It was crude, and as
Jeffrey Dahmer found out some years later, it wasn’t always successful. Physicians
tried this on many patients, going into different parts of the frontal lobe. They then used
another bit of apparatus which was like a drill with a wire loop on the end. When the
loop was pulled tight it removed a bit of the brain. The patients chosen might be suffering
from depression, mania, schizophrenia or panic disorders.
Lobotomy soon took off in the USA, UK, and other parts of Europe, but was often called
leucotomy. The procedures differed, but let’s just say they usually involved injecting something
into the brain or removing a bit of the brain. In the USA, one physician had remarked on
the "sheer genius" of the Portuguese doctor, and so soon insanity or mere mental illness
of a less severe kind, was dealt with using similar methods. Except in the U.S. a rather
novel way of lobotomizing patients was soon introduced, and this was called the transorbital
lobotomy. You see, the former procedure was quite the
difficult surgery, it was time-consuming, costly, required anesthesia, and the Americans
wanted a way to disconnect a mental patient that was fast, cheap and convenient. And so
what could be better than just shoving an icepick through someone’s eye (trans means
through, orbital means of the eyes). It was a doctor called Walter Freeman that first
has this eureka moment, and to practice this kind of Drive-Thru frontal lobe invade-and-destroy
method he practiced in his kitchen on grapefruits before moving on to cadavers. It was simple
enough. Position the icepick, really called an orbitoclast, pointing slightly upwards
at the eye socket. You then needed to bring in a mallet to hit the spike through some
bone and then a bit of fiddling about and voila, you were mixing it with the frontal
lobe. This wasn’t about taking bits of the brain out, or imbuing white matter with strong
alcohol, but about severing neural pathways. The old loop and scoop method was seen as
a bit old school and it took way too much effort. It’s said the transorbital lobotomy
only took about 10 minutes and was about as cheap as getting a tooth pulled.
Now, you wouldn’t wish this on your worst enemy, and one can only imagine the look on
the face of the first live patient when the doctor waltzed into the room with an icepick
and mallet and told him some work needed to be done behind his eyes. It is Freeman who
is the star of today’s show, but star might be too good of a term for him. As we said,
thousands of transorbital lobotomies took place in America and more beyond, but it’s
said that Freeman did the procedure himself at Athens State Hospital (formerly Athens
Lunatic Asylum) at least 200 times and around 3,400 times across the United States. According
to CNN he did 24 in one day at a hospital in West Virginia. That’s why we’ve chosen
him as our overlord of the lobotomy. As people might say, he had his technique down.
According to NPR, this lobotomy did make patients rather calm, if not bovine to a fault. Although
according to one writer, "Some patients seemed to improve, some became 'vegetables,' some
appeared unchanged and others died.” Hmm, one might suggest it wasn’t a total success.
Still, lobotomies were all the rage in America, with the New York Times in 1937 writing that
they were a miracle cure for, “Tension, apprehension, anxiety, depression, insomnia,
suicidal ideas, delusions, hallucinations, crying spells, melancholia, obsessions, panic
states, disorientation, psychalgesia (pains of psychic origin), nervous indigestion and
hysterical paralysis.” You heard that right, too much crying and you might have Dr. Icepick
come knocking at the door. It’s a good job E.T. hadn’t been written yet. We are told
from 1940 to 1944 there were only 684 lobotomies performed in the USA, but in 1949 there were
5,074 procedures alone. By 1951, 18,608 Americans had had their brains done, and according to
NPR around 10,000 of those were with an icepick. While lobotomies did eventually fall from
grace in the U.S., it wasn’t until around 50,000 folks had been through the procedure.
Did it hurt? Well, one former patient called Howard Dully told The Guardian in 2008 that
he had gotten a Walter Freeman special when he was 12. He said he didn’t remember anything
of the actual procedure because the modus operandi of the day was to give the patient
electric shocks until they were out of it. He said he woke up the next day with black,
swollen eyes and a terrible headache. “I was like a zombie; I had no awareness of what
Freeman had done,” he said. The thing was, the kid was only a bit naughty, but his parents
didn’t like that. Freeman remarked of the boy, “He has a vicious expression on his
face some of the time.” And that was that, he was incorrectly diagnosed as being schizophrenic.
Dully said later that while he could live a normal life, it always felt to him like
something was missing. Sources differ, but we are told for the procedure Freeman might
charge around $200-$250 in today’s money. That must have felt like quite the bargain
for parents tired of telling their child off.
This wasn’t only happening in the USA. One guy in Leeds, England, told The Guardian about
his transorbital lobotomy in 1962, “It felt like a broom handle was being pushed in my
brain and my head was splitting apart.” Doctors didn’t even sedate him, and that
was common within the milieu of tough-love medicine back then in the UK. Apparently,
he had showed signs of aggression in childhood and doctors thought an icepick to the brain
was the cure. The Guardian writes that after his run-in with the metal spike he became,
“homeless, drug-addicted and alcoholic, a petty criminal with little concept of how
to live a normal life.” You might think that’s bad, but as we have said, others
just died. We are told some of Freeman’s patients lost their personality altogether
and others were left paralyzed. And believe it or not, in a book about Freeman it’s
written that the doctor had an idea for his version of a Brave New World without mental
illness. Instead of waiting for a patient to completely lose it, why not get them when
they first start showing signs of mental illness, nip the problem in the bud, so to speak. “He
began advocating lobotomies for patients like Howard Dully who, if they had psychiatric
disorders at all, were not seriously ill, and he began advocating it as an early intervention,”
said one writer who wrote a book about the history of lobotomies.
Not long after lobotomies fell out of fashion in the 1950s anti-psychotic and anti-depression
drugs came to the market. While brains might still have been frazzled by electric shocks,
the drugs won for the most part. One doctor did tell Live Science that you might have
bit of your brain removed these days if all other treatments have failed. But he said,
“You're not going in with an ice pick and monkeying around.” That’s good to know,
and to think back in the day, not even that far back in the day, crying a lot or having
a bad temper might have resulted in Dr. Freeman sharpening his icepick, maybe thinking, “I’ll
teach him to sometimes have a vicious expression on his 12-year old face.”
What do you think about this? Tell us in the comments. Also, be sure to check out our other
show The Crazy Nazi Doctor. Thanks for watching, and as always, don’t forget to like, share
and subscribe. See you next time.