The Lobotomist: A review

First, physician Walter Freeman would peel open the patient's eyelid and insert an ice pick between the eyeball and the lid. He would tap the ice pick with a surgical hammer - or even a carpenter's mallet, if he was performing for a crowd and wanted to shock them - and break through the orbital cavity of the eye to the prefrontal lobe. He would wiggle the ice pick to sever the frontal lobes, then remove the ice pick. The lobotomy was complete.The Lobotomist, a new PBS documentary written and co-directed by Barak Goodman, explores this surgical method developed by Walter Freeman to treat the mentally ill.In 1936, Walter Freeman stumbled upon a study by Portuguese neurosurgeon Egas Moniz, who cored into the brains of mentally ill patients and removed small portions from the frontal lobe. Moniz observed a positive change in his patients' behavior, although he did not understand the mechanism. He believed that he was removing "fixed ideas" from the frontal lobes.Freeman adapted this method, and eventually developed the quick and easily-reproduced process of using ice picks."In our home on Connecticut Avenue, we didn't have a refrigerator," says Freeman's son Franklin. "We had an ice box. The first ice picks came right out of our kitchen drawer."Freeman met with initial criticism for applying an untested procedure, but ploughed ahead, earning the approval of the press - the New York Times called it a surgery of the soul - and eventually the medical community, when Moniz earned the Nobel Prize in 1949. The effects of lobotomies included decreased motivation, inhibition, overeating and the loss of various cognitive skills, but the procedure did, sometimes, decrease anxiety, fear and violent or suicidal tendencies. Lobotomies also provided doctors with a tangible tool: Confronted with problem X, they could offer a solution. It gave patients' families a choice between a lifetime of institutionalization and a life at home, albeit greatly altered. If colleagues confronted Freeman at a meeting with the negative effects or mixed outcomes of lobotomies, Freeman would respond, "What can you do for a patient like this?"Alice Forester, the daughter of Freeman's first patient, Ellen Ionesco, says in the film that her mother "changed so radically, for the better, once [Freeman] had seen her. She never mentioned suicide again ... I think he really wanted to do something when no one was willing to do anything."Other patients, however, reported negative results. Janice Jones-Thomson, daughter of patient Beulah Jones, says that after her mother received a lobotomy, there was "no change in her behavior except that she lost her higher intellect."By the 1950s, lobotomies began to lose favor with the medical community, as long-term observations became available. In 1954, the spread of the new drug thorazine provided a popular and non-surgical alternative. Freeman, however, could not forsake the procedure that made him famous. He moved to Los Altos, California, and performed lobotomies on a broader range of patients: depressed housewives or misbehaving children.Howard Dully, who received a lobotomy at age 12, says in the film: "I've always felt that something was taken from me, that there was a piece missing, because my life has never gone well." By 1967, Freeman had performed about 2,900 lobotomies, but he finally laid down his ice pick after a patient died and he was stripped of his hospital privileges. Soon after, he retired and spent his remaining days traveling the country, looking for his former patients. He died on May 31, 1972.The Lobotomist airs on PBS on January 21, 2008. Jonathan Scheff mail@the-scientist.comImage: Walter Freeman (left), provided by The Saturday Evening Post, Courtesy George Washington University Archives, Freeman-Watts Collection.Links within this article:M. Bucci, "Being young means feeling young," The Scientist, February 16, 2004. http://www.the-scientist.com/article/display/14440/Public Broadcasting Service, American Experience: The Lobotomist http://www.pbs.org/wgbh/amex/lobotomist/program/The Scientist's supplement on Schizophrenia, December, 2007. http://www.the-scientist.com/supplement/2007-12-1/Nobel Lectures, Physiology or Medicine 1942-1962, Elsevier Publishing Company, Amsterdam, 1964. http://nobelprize.org/nobel_prizes/medicine/laureates/1949/moniz-bio.html

The Lobotomist: A review

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