Rose was a married woman in her late twenties. When relatives responded with horror at her condition, Freeman suggested that if she misbehaved she might be in need of “a good old fashioned spanking … followed by a dish of icecream [sic], then a kiss and make up.”20
If people had been vibrant creators prior to their lobotomies, well, that creativity was gone afterward. Dyne and Poppen explained:
As an example, one patient was an inventor, and although after lobotomy he was euphoric and restless and showed no distinct intellectual or memory deficit, he was totally incapable of creative work or the visualization of a problem. He was unable to concentrate or to plan for the future. He seemed to lack interest or actually to be able to maintain an interest for more than a few minutes at a time.21
It seemed the best possible outcome of a lobotomy was the patient’s retention of at least some personality. Freeman’s son later scoffed, “You could never talk about a successful lobotomy. You might as well talk about a successful automobile accident.”22
In 1949 Freeman took to the road to demonstrate his procedure at hospitals across the country. He traveled in a custom-fitted Lincoln Continental he dubbed the lobotomobile—like an ice cream truck manned by a demon. In the vehicle Freeman carried with him a portable electroshock machine, a tape recorder for his notes, and his instruments. He toured eight states over five weeks and performed 111 operations.23
Freeman was a consummate showman. His partner James Watts described him as “a barker at a carnival.” He had a theatrical disposition that might even have been evidenced by his attire. At one point Freeman had cut a ring off a man’s penis, which he engraved with his family crest and wore around his neck for years afterward. In the course of demonstrating his lobotomy procedure, he would sometimes wield carpenter’s mallets in both hands so as to drive icepicks into both eye sockets simultaneously. One person who observed him at work recalled: “He looked up at us, smiling. I thought I was seeing a circus act. He moved both hands back and forth in unison, cutting the brain identically behind each eye. It astonished me that he was so gay, so high, so ‘up.’”24
If you are thinking, Whoa, that is not the measured behavior I expect from a doctor! you are right. This was a nightmare carnival. Someone who was traveling from place to place doing dozens of these operations week after week was probably not taking this surgery as seriously as … basically any medical procedure deserves.
According to one of Freeman’s assistants, a patient got cold feet and decided not to go ahead with a lobotomy. Freeman went to his hotel, presumably to reason with him, and brought along his electroshock machine, planning to administer a few volts to calm him. The patient began running away, screaming, from a man who had shown up at his hotel room to lobotomize him. That reaction seems extremely sane. Freeman was not deterred. The assistant claimed, “The patient was … held down on the floor while Freeman administered the shock. It then occurred to him that since the patient was already unconscious, and he had a set of leucotomes in his pocket, he might as well do the transorbital lobotomy then and there, which he did.”25 He cut into an unwilling man’s brain in an unsterilized hotel room. After wrestling him to the ground.
Freeman didn’t worry about what he referred to as “all that germ crap.”26 I tried to think of a medical procedure that could reasonably be treated so cavalierly, and honestly, I think I’d show more bedside manner bandaging a child’s scraped knee.
In spite of these downsides, which, again, seem utterly horrific, people lined up for lobotomies, especially since it was possible to get it done without skull drilling and instead with that nifty ice pick. For some perspective on how many of these operations Freeman was performing, you can look at some of his notes as he traveled across the country:
29 June, Little Rock, Arkansas, 4 patients
30 June, Rusk, Texas, 10 patients
1 July, Terrell, Texas, 7 patients
2 July, Wichita Falls, Texas, 3 patients
9 July, Patton, California, 5 patients
14 July, Berkeley, California, 3 patients27
That’s thirty-two lobotomies in about two weeks. Two lobotomies a day.
Now, why would so many people want a lobotomy?
The popularity of the procedure was due to the fact that, at the time, there were very limited treatments available to help the mentally ill. “When I visited mental hospitals,” recalled the retired neurosurgeon Jason Brice, attempting to explain the popularity of the lobotomy during these years, “you saw straitjackets, padded cells, and it was patently apparent that some of the patients were, I’m sorry to say, subjected to physical violence.”28 Asylums, prior to the rise of medications that could help or at least subdue patients, often acted as little more than holding pens where ill and sometimes violent people were kept. Treatments at the time included electroshock therapy—which is still used to treat some severe cases of depression today—but it could result in memory loss. The drug Metrazol induced convulsions so intense that patients broke their bones, in some cases their spines and jaws. Insulin comas kept patients unconscious for weeks. These treatments offered a bit of relief in some cases, but not at the rate doctors might have hoped.
The physicians performing lobotomies were so desperate for a cure that they were easily susceptible to false hope. In desperate times, who isn’t? Suddenly, there seemed to be a procedure that offered patients at least the possibility of relief. There was a fix that was supposed to be permanent and quick and easy to perform. No harder than a dental procedure, really!
In the late 1940s many Americans were suffering from mental afflictions. World War II had ended, and soldiers were having difficulties readjusting to civilian life. Many were suffering from post-traumatic stress disorder (PTSD)—many still do—probably because they had been to war. There was no medical term for their condition yet, but Veterans Affairs (VA) hospitals were bursting at the seams. A 1955 National Research Council study claimed that during World War II 1.2 million soldiers had been admitted for psychiatric and neurological problems.29 For comparison, 680,000 were admitted for physical injuries from battle. One treatment, among others popular at the time, consisted of spraying the soldiers with alternating hot and cold water under extremely high pressure. It was nicknamed a “Scotch Douche and Needle Shower.”30 There’s no time when being thrown unexpectedly into water of an uncomfortable temperature has really calmed anyone down or cheered anyone up, which gives the strong impression that people were just trying things at random and hoping one would work.
This was the twentieth century, not the Dark Ages. Einstein and Frank Sinatra were walking around.
In 1946 VA chief Frank Hines received a memo that declared: “Approximately 6 years ago a French surgeon, Egas Moniz, described an operation on the pre-frontal lobes of the brain … the operation has been found of value in eliminating apprehension, anxiety, depression and compulsions and obsessions with a marked emotional component … Reports of the result are almost uniformly good when the patients are chosen carefully.”31
Now—and this is the least important problem with the memo—Egas Moniz was Portuguese. He was not French. I know that seems like such an easy slipup, especially at a time before Internet searches were commonplace. I’d never normally mention it, but in this case I’m bringing it up because Moniz was the most Portuguese man in the history of Portugal. He was born in Portugal, worked in Portugal, was in the Portuguese parliament, served as an ambassador for Portugal, became Portugal’s minister of foreign affairs, attended the Paris Peace Conference in 1919 on behalf of Portugal, was a professor at the largest university in Portugal, and died, also, in Portugal. If he was known for one thing other than inventing the lobotomy, it was being Portuguese.
So I don’t think whoever was writing this memo was very familiar with the players in the lobotomy game.
If you are more bothered by the remark that “results were almost uniformly good,” you are the kind of person who can see the forest for the trees, so good for you.<
br />
Frank Hines approved the procedure in the memo despite the fact that much of this note is vague, and wherever it is not vague, it’s incorrect. Between April 1, 1947, and September 30, 1950, 1,464 veterans were lobotomized at VA hospitals by VA doctors.32
There were other victims of the lobotomy’s popularity. Mentally ill women were generally institutionalized by their husbands or fathers—without consent required—and, until the 1960s, doctors were not obliged to reveal their treatments or risks to the patients. “I usually asked the family to provide the patient with sunglasses [for their black eyes postoperation] rather than explanations,” Freeman joked.33 Somewhere between 60 and 80 percent of lobotomies were performed on women, despite a greater percentage of men being institutionalized.34 Women often went into the surgery thinking the risks were radically less serious than they actually were. For instance, one of Freeman’s patients was worried that the operation would mean having her head shaved and losing her beautiful hair. He promised her they would try to avoid cutting off her curls, but they cut her hair anyway. Freeman found her vanity hilarious considering the fact that afterward she would “go about or talk with others quite oblivious to the fact” that she was bald.35
What a jokester! As far as I can tell, every single one of Dr. Freeman’s witticisms hinged on how you could rip away someone’s higher functioning skills and they would not even know. Isn’t that hilarious? Sometimes I make jokes about topics that seem scary and dark and people’s monocles pop right off—just fly across the room—but American husbands sure did seem to love this man who was driving around in a van chopping up their wives’ brains.
The fact that there are situations where it might be advantageous to control an unruly wife or daughter is probably obvious to anyone who has seen Suddenly, Last Summer. (Spoiler: to be fair, absolutely no one was ever lobotomized for the very specific cannibalism-related reasons noted in that 1958 Tennessee Williams play.) Some of the women on Dyne and Poppen’s list of patients were listed simply as “menopausal” or “hysterical.” The historian Kate Clifford Larson wrote: “Freeman would later describe potential patients as society’s ‘misfits.’ Women, in particular, made up the largest group of lobotomy patients. Women who were depressed, had bi-polar illness or were sexually active outside the range of socially and culturally acceptable limits of the day—including single women exhibiting typical sexual desire—were considered candidates.”36 So if you are a standard, twenty-first-century woman who likes reading about diseases rather than … well, I am not entirely sure what wholly inoffensive book a woman could read—a cookbook, maybe? One of those books where movie stars tell you to do yoga? Just take it as a given that if you were a married woman who lived during the height of the lobotomy’s popularity, your husband would have been able to have you institutionalized and lobotomized if he felt like it. To my married female readers: of course I do not mean your husband. I am sure your husband is a really cool guy. But still. He could have.
Unlike your husband, Freeman was deeply uncool. He never ceased to believe that the lobotomy was something of a miracle cure, and continually presented it as such. He was a master at working with the press from the very beginning. As early as 1937 he described the procedure to the New York Times in such a way that the paper published an article poetically declaring it “Surgery Used on the Soul Sick.” Freeman claimed, “Watts and I had made the headlines even though we did not get an award. He and I worked hard on that one and talked ourselves hoarse.”37 Meanwhile an article in the Washington Evening Star after Freeman’s sixth operation described the procedure as one that “probably constitutes one of the greatest surgical innovations of this generation.”38 He had an amazing catchphrase—“Get them home!”—in regard to his patients, which certainly preyed on distressed family members’ sensibilities.
After these articles appeared, Freeman would hear from many people who wanted lobotomies. He recalled that there “was a man who complained of asthma and wanted to know if a brain operation would relieve that.”39 I worry that people will read this and think, Ha-ha, that guy sure was dumb in addition to being asthmatic. First of all, okay, that’s possible, but I am inclined to say the fault is with Freeman. If the man who invented lobotomies couldn’t explain the procedure well enough to make it clear that it has nothing to do with a lung disease, he was advertising it in a dangerous way. He made lobotomies sound like a cure-all for everything.
To my knowledge, he didn’t operate on that man with the asthma. Which is shocking, as Freeman often lobotomized people who wrote to him, claiming in 1946, “If we waited for psychiatrists to send patients to us we’d still be on our first hundred cases instead of our fifth hundred.”40 Seemingly, that wheezy fellow and the actress Frances Farmer were the only people Freeman didn’t enthusiastically lobotomize. (Her parents refused to give their consent to the operation. Nevertheless, some people still believe that the movie star might have been lobotomized. She wasn’t. We should focus on the people who were. God knows there are enough of them.)
Freeman used lobotomies to treat everything from “excessive eating” to drug addiction to alcoholism. Freeman’s fifteenth patient was an alcoholic. The doctor was convinced a lobotomy would stop his cravings. It didn’t work. Immediately following the operation the patient escaped and went to a bar, where Freeman later found him extremely intoxicated. In the 1950s Freeman lobotomized a woman suffering from nothing more than severe headaches. According to her daughter, Carol Noelle, the procedure left the patient with the mind of a small child. She described her mother’s lobotomized condition:
Did she worry about stuff? Nope, didn’t worry. Just as Freeman promised, she didn’t worry. She had no concept of social graces … The only outlet she had was beating every pinball machine in town and knowing how many pennies were in the jar at the carnival, you know. She was the greatest playmate we ever had and the best friend, and we loved her to death. But I never remember calling her mama or mommy or anything. I never even thought of my mother as my daughter’s grandmother, and I never even took my daughter to see her, not one time. So she never even got to have that.41
I imagine if she had known that she would never have a chance to be with her granddaughter, she would have suffered with the headaches. (Especially had she known that acetaminophen [used in Tylenol] and ibuprofen [found in Advil] would be introduced in 1955 and 1974, respectively.)
One bright spot: Freeman’s cavalier attitude toward the downsides of the procedure at least enraged his fellow scientists. James Poppen wrote in 1949: “I do hope that in the future we will not be informed initially through the weekly popular magazines. Any procedure which is instituted for such a serious condition should be thoroughly tried and proved to a certain degree before it is advised. Premature information through weekly magazines (not always accurate) has a tendency to give patients or relatives false hopes or impressions.”42 That remark was relatively polite. My favorite story about Freeman-hate involves him going up to the psychiatrist Henry Stack Sullivan at a cocktail party in 1948 and cheerfully remarking, “How goes it, Harry?” Sullivan raised his hands heavenward in a fury and shouted, “Why do you persist in annoying me?” before, still enraged, he was dragged away by his friend.43 If I had been at that event, Dr. Sullivan and I would have formed a firm and lasting friendship, but that is beside the point.
Dr. Florence Powdermaker, chief of the VA’s psychiatric-education section, wrote a reference note in 1948, wondering, “Has Dr. Freeman shown any disposition to modify his idea that lobotomy is useful for practically everything from delinquency to a pain in the neck?”44 I am delighted that a female doctor would express some hesitation about this particular treatment. Meanwhile the neurologist (and later president of the American Neurological Association) Lewis Pollock declared almost immediately after Freeman’s first operation that lobotomies were “not an operation but a mutilation.”45
By 1950 the Soviet Union banned lobotomies as “contrary to the principles of humanity.”46
&
nbsp; And did everyone in the United States agree? No. Not really. This was an era when we loved everything the Soviets hated and might well have been referring to vodka as “Freedom Whiskey.” Moniz had just won the Nobel Prize for pioneering the surgery in 1949. That same year 5,000 lobotomies were performed in the United States.47 Altogether, approximately 40,000 lobotomies were performed in the United States between the 1930s and 1970s; Freeman would singlehandedly perform 3,500 of them.48
The decline of the lobotomy’s popularity took just about as long as its rise. The change in public opinion required a group of people as passionate about discrediting lobotomies as Freeman was about defending them. Fortunately, as early as the 1950s, journalists and artists began portraying lobotomies in a skeptical light. In 1951 the journalist Irving Wallace wrote an article in the Saturday Evening Post titled “The Operation of Last Resort.” It was originally called “They Cut Away His Conscience,” but that title was judged a bit too controversial (although it appears under that name in Wallace’s collection, The Sunday Gentleman). In the story, the journalist profiled an exceptionally intelligent man. (He had an IQ of 150! He never stopped reading! He went to Princeton! Good stuff all around!) However, that man was also severely depressed. He had a mental breakdown after being discharged from the army and, after trying a number of psychiatric treatments, was lobotomized. He was happier afterward, but, as Wallace reported—and I don’t think this is a surprise given the article’s title—they cut away his conscience. Wallace wrote: “Prefrontal lobotomy converts patients into docile, inert, often useless drones, stripping them of their old powers, giving them convulsive seizures, making them indifferent to social amenities, filling them with aggressive misbehavior and impairing their foresight and insight. There are those who feel the operation tampers with God’s substance, who feel that if it cuts out a man’s cares, it also cuts out his soul and his conscience.” 49
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