Reddit reviews The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness

So who would like to talk about everybody's favorite morbid but yet unfamiliar medical topic: Lobotomies!!

I'll preface this by saying that all of the information I share here can be found in the seminal work on early psychiatric treatment Great and Desperate Cures by Elliot Valenstein. I did my master's research on the subject of psychosurgery so I have several heavily marked-up copies floating around my house. A less comprehensive but more approachable (and more widely available) option is The Lobotomist by Jack El-Hai.

The first place to start is by saying that lobotomies weren't initially lobotomies. The man who won the Nobel Prize in Medicine for his pioneering invention of the procedure the leuchotomy was an abrasive Portuguese neurosurgeon who stole the original basis of the idea from someone else. Egas Moniz was already late in his academic life when he came across the pioneering surgical research done by John Fulton on the frontal lobectomy at an academic conference. A frontal lobectomy is a procedure in which you completely remove an individual's frontal lobes. That's a rather drastic thing to do, which Fulton clearly understood because he had only performed the procedure on a chimpanzee. Moniz took note of the surgery's results - a quieter, less psychotic subject/patient - and thought that results like that might help human patients with severe psychotic disorders. He had an in with the local mental hospital, so he had access to test subjects. And so Moniz began performing frontal-freaking-lobectomies on human subjects without their consent. After a handful of lobectomies, he determined that turning patients into complete zombies wasn't the ideal outcome. It certainly didn't help that most of them died within months of surgery. So instead he tried eliminating just some brain tissue by removing just some tissue in a procedure called a leucotomy. This procedure showed promise early, which was a good thing because the sanatorium where he was getting hist test subjects caught on to what he was doing and cut off his access to test subjects. Having refined the procedure he began offering it to private clients. And that is where a third-generation American doctor named Walter Freeman comes in.

Dr. Walter Freeman was a hardworking but rather unremarkable neurologist in Washington DC who had big shoes to fill. His grandfather was a very well-respected and widely known physician and his father had a great degree of medical respect himself. Unlike Moniz, Freeman wasn't callous and barbaric and, while certainly hoping to be the equal of his father and grandfather, he really truly cared about the welfare of his patients.

The picture was bleak for the mentally ill during this time and wasn't much different than centuries before. If you were lucky, you were well enough to be cared for at home. If not, you were more or less warehoused. Psychological treatment was essentially nonexistent at the time. Your family's economic means determined just how nice of a facility you were warehoused in. Given the greater disparity between classes then, chances are you were abused and abjectly neglected. Even if you weren't, you were at the mercy of your psychological demons. You suffered, and your physicians were more or less powerless to help you. And like many neurologists at the time, Dr. Freeman did not like seeing his patients suffer. This made the recent developments in the field of psychosurgery seem especially promising to doctors at the time. More on that later.

Dr. Freeman trained with Moniz and made the procedure more precise, with the goal of severing connections in the prefrontal region of the brain by removing corings of the patient's brain, rather than just removing giant swathes of tissue. He hit a stumbling block though - he lost his license to practice neurosurgery when a patient died on his operating table. So he partnered up with neurosurgeon James Watts and together they sought to provide relief from patients with a huge variety of mental, behavioral, and/or developmental problems. Freeman, however, decided that the process of anesthesia was too much a risk and that he could get the same results faster by streamlining the process. And so Dr. Watts walked into their office suite one day to find Freeman jamming what looked very much ice picks into the corners of the eyes of an unconscious (due to electro-shock) but un-anesthetized patient and sweeping them back and forth blindly, severing neural connections willy nilly. Thus ended Dr. Watts' partnership with Dr. Freeman.

Dr. Freeman now had what he thought to be a way to finally alleviate some of his patients' torment and he traveled across the country via an RV called "The Lobotomobile", sharing this method with other clinicians in an effort to do something other than warehouse them.

Ultimately doctors and scientists realized that the newly founded field of psychopharmaceuticals was the solution to the mental health illness crises and even the most severe cases will respond to at least some form of medication. That was the end of the era of surgical psychological treatment (mostly).

So, any questions?

Whenever lobotomies come up, I like to point to two books that are great, educational reads:

My Lobotomy, by Howard Dully. An autobiography by a guy who had a lobotomy performed on him at age 12. This was in 1960, when lobotomy had largely fallen out of practice due to the introduction of psychotic meds mid 50s.

The Lobotomist, by Jack El-Hai. This is the story of Dr. Walter Freeman, the man who really brought the lobotomy to main stream medicine (at least in the US), by pioneering the transorbital (or "ice pick") lobotomy method. This is the man that performed Mr. Dully's lobotomy. The practice was essentially driving an ice pick through the corner of the eye into the front of the brain and swishing it back and forth to sever the connections between the lobes just above the nose.

They're both fascinating stories from opposite sites of what we now see as a totally barbaric and completely dangerous and unnecessary practice, that even at the height of it's popularity really had no consistency to how it was applied.

I recently read The Lobotomist by Jack El-Hai, a biography of Dr. Walter Freeman. It was an interesting story of how ambition can land one in a bad position (like creating a procedure that horrifies people to this day). It is one of the few biographies I have thoroughly enjoyed. It was pretty horrifying since it really happened.

For a nice piece of historical perspective, perhaps for a look at the complexity of ethical issues, or even for morbid curiosity, I strongly recommend reading The Lobotomist.

It's a biography of Dr Walter Freeman, the man who invented the trans-orbital lobotomy, and his quest to cure mental illness by destroying parts of the brain. It's a nicely balanced view, taking care to explore his motives and personal life against how he is now perceived.

"The Lobotomist" is excellent but grisly. Recommended for anyone with an interest in the history of medicine.

1.Cake Related. Gotta have that butter!


3 [A book I am eager to read!](http://www.amazon.com/The-Lobotomist-Maverick-Medical-Illness/dp/0470098309/ref=wl_it_dp_o_pC_S_nC?ie=UTF8&colid=2ECIJJQQ9NLB8&
coliid=I3C6N0VUIQEABZ)

4 Eating Utinsils

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10 Something from my childhood

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This was fun! Thanks for the contest!!!

Read a book about Walter Freeman, The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness It is a stark and unnerving documentation of what led up to the cult of frontal transorbital lobotomy as a treatment for almost anything.

For some unknown reason several years ago I felt it would be good bedtime reading, that ended quickly. I've since read a much less in-depth book about it, but it still makes me really squicky.