Lobotomy: The medical solution for those who don't fit in.
Outdated medical practices: Chapter 1
Imagine it's November of 1941. You are a young 23-year-old woman from one of the wealthiest families in the United States. This morning, Walter Freeman, one of the most famous doctors in the country, was called by your father and diagnosed you with agitated depression. Now, you find yourself in an operating room, undergoing a leucotomy, your skull being drilled into, unaware that your life is about to change forever. Your name is Rosemary Kneedy, and you are about to become one of the thousands of victims of lobotomy.
Lobotomy was one of the most notorious treatments for mental illness, disappearing in the late 1960s but remaining etched in our cultural imagination when we think about the horrors of outdated medical procedures.
This chapter will be the first in a series of posts about outdated medical practices in psychiatry and neurology, aiming to understand why they were created and why they are no longer used.
In the early 20th century, mental illness was still a major taboo. We didn’t have the specific solutions we have today, and in many cases, the families of patients would lock them away in asylums, where they were treated as if they weren't human, locked in cages, deprived of food, and subjected to deplorable conditions. In some instances, patients were even subjected to exorcisms in attempts to "cure" them.
But everything changed when neurologists discovered that the brain had different parts, each dedicated to specific processes or functions. More specifically, they found that there was a certain area, the prefrontal cortex, that acted as an emotional regulator. It helps control our emotions, memory, and even our attitudes. In fact, damage to this area can cause shifts in political ideology, religion, or even the way we think. This discovery was further supported by the famous case of Phineas Gage, whose frontal lobe was completely destroyed by a tube in a work accident, leaving him alive but drastically altering his personality. He changed from a kind man to a very grumpy one.
After the World Neurology Congress, many experiments began to emerge around this phenomenon, with numerous patients being lobotomized, cutting off the connections between the frontal lobe and the rest of the brain, causing significant changes to their personalities.
A new idea took root: severing the connection of a specific part of the brain (the prefrontal cortex) to cure mental illness. They called it lobotomy.
There were many premature versions of lobotomy, starting with Dr. Egas Moniz, who tried to remove part of the frontal lobe or inject alcohol into it to destroy the tissue. Most of his patients, of course, didn’t survive the procedure. The technique was refined until 1939, when Moniz was shot by one of his patients.
But the story doesn't end there. Walter Freeman became fascinated by this process and decided to continue and improve it until he developed the lobotomy we recognize today. With just an ice pick and a small hammer, the ice pick was inserted through the eye socket to reach the frontal lobe. The doctor would then move it inside the brain to destroy the connections. This technique became particularly popular among the wealthiest families in the United States. It was quick and didn’t involve much in the way of brain or skull destruction. Around 50,000 people were lobotomized, and Freeman even toured the country in what he called "The Lobotomobile."
The reasons for lobotomy ranged from psychotic illnesses to homosexuality and even feminine hysteria. In fact, most of the victims of lobotomies were women. One of the symptoms of this "illness" included:
Not obeying your husband.
Being aggressive.
Being melancholic.
Not wanting to have children.
Being single.
If you exhibited any of these symptoms, you were probably going to be lobotomized.
Although the process seems terrifying (and it is), it’s important to understand that, at the time, there were very few other options for treating severe mental illness, just lobotomy or an asylum. Most of the victims were left in a vegetative state, and if they did improve, it was often only in a benign way. They all ended up with severe sequelae.
The last lobotomy was performed in 1967 on a patient who had already undergone two lobotomies and died during her third operation. So yes, you could have been listening to The Ronettes and being lobotomized on the same day.
As a fun fact, lobotomy is actually still used today, but not as it once was. The process is now performed under very extreme circumstances with patients suffering from severe mental illness, and obviously, it is no longer done with an ice pick. Modern doctors know exactly what they are doing.
The sad reality of lobotomy is that most patients didn't even want to undergo the procedure, but their families forced them into it, effectively killing them. In many cases, this was simply because they were women who wanted to feel free in a world of oppression.