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IN 1950, Freeman wrote a book titled Psychosurgery. In it, he reported the outcomes of several hundred lobotomies. Freeman concluded that his invention had not only relieved America of its burden in state psychiatric facilities, it had also cured many other citizens of their anxieties and neuroses. A closer look at Freeman’s book, however, shows just how low he had set his bar for success.
During the first few weeks after their lobotomies, almost all patients suffered similar symptoms. They would lie in their beds like “wax dummies” and have to be turned constantly by visiting nurses or family members to keep from getting bedsores. All were profoundly indifferent to their surroundings. They didn’t seem to care about anything. Worse, they had lost any sense of decorum. One well-bred woman defecated in a wastebasket, thinking it was a toilet. Other patients would “vomit into their soup plates and start eating out of the plate again before the nurse [could] take it away.” But to Freeman the bottom line was that virtually all of these patients were less disruptive on the wards, much easier to handle. He had created, in his own words, a “surgically induced childhood.” About 25 percent of lobotomy patients never progressed beyond this stage and remained institutionalized. Some became disruptive again and were forced to have second and even third lobotomies.
Most lobotomy patients were able to leave the wards and return to their families. However, all lacked energy, were lethargic, and, according to Freeman had “lost interest in themselves.” Families had to dress and undress the patient. And patients typically lost any sense of shame. They would present themselves naked to strangers, take food off of other people’s plates at the dinner table, and spend hours “like little children” in the bathtub, “squirting water around.” Patients became outspoken, unrestrained, and silly; nothing was taken seriously. They would get lost while traveling. One woman, who used to read Victorian novels, still read them, but could no longer remember what they were about. Freeman described these patients as “adjusting to the level of a domestic invalid or household pet.” Still, he reasoned that lobotomies had virtually eliminated their anxieties and neurosis.
Some lobotomy patients were able to leave home and go to work, but never at the level of performance seen before the operation. Professors waited on tables. Cashiers couldn’t keep numbers straight. Saleswomen could no longer give correct change. Musicians could still play, but their music had become mechanical and heartless. Most of those who tried to go back to work were fired.
Side effects from the procedure were also grim. As James Watts had feared, three of every hundred people died from their ice pick lobotomies, always from uncontrolled bleeding after tearing a cerebral artery. Another three of every hundred suffered permanent, unremitting seizures. Many others were unable to control their bowels or bladder. Perhaps most outrageous, Freeman had operated on children, 11 of whom were described in his book. One was only four years old. Two of the 11 died from cerebral hemorrhages.
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AS THE NUMBER OF LOBOTOMIES INCREASED, many physicians became critical, calling the procedure “medical sadism,” “mutilation,” and “partial euthanasia,” arguing that Freeman had merely replaced one awful disorder with another. When John Fulton—the Yale researcher who had inspired Egas Moniz to perform the first human lobotomy—heard about Freeman’s ice pick lobotomies, he said, “What are these terrible things I hear about you doing with lobotomies in your office with an ice pick? I have just been to California and Minnesota and heard about it in both places. Why not use a shotgun? It would be quicker!”
Despite these protests, no professional, medical, or ethical society, including the American Medical Association and the American Psychiatric Association, stood up to oppose lobotomies. Worse, the media continued to misinform the public. Headlines like “Surgeon’s Knife Restores Sanity to Nerve Victims,” “No Worse Than Removing a Tooth,” and “Wizardry of Surgery Restores Sanity to Fifty Raving Maniacs” routinely appeared in newspapers across the country. One cartoon in the American Weekly published in 1946 told the story of a “shy, mousy little bookkeeper, the kind that is the butt of all office pranksters,” who, following a lobotomy, became a “gregarious hail-fellow-well-met type, who could sell anything to anybody”—a captain of industry.
In 1941, one of the most influential articles on the procedure, titled “Turning the Mind Inside Out,” appeared in the Saturday Evening Post. The article was written by Waldemar Kaempffert, who was also an editor at the New York Times: “There must be at least two hundred men and women in the United States who have had worries, persecution complexes, suicidal intentions, obsessions, indecisiveness, and nervous tensions literally cut out of their minds with a knife by a new operation on the brain.” Walter Freeman later said that without the press, lobotomies would never have been so widely accepted.
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WHEN WALTER FREEMAN INVENTED the ice pick lobotomy, his goal was to relieve state institutions of the financial burden of caring for the indigent. But Freeman also lobotomized the rich and famous. Tennessee Williams’s sister, Rose, the subject of his plays The Glass Menagerie and Suddenly Last Summer, was lobotomized. As was beat poet Allen Ginsberg’s mother. But Freeman’s most famous victim was Rosemary Kennedy, the daughter of Joseph and Rose Kennedy, and the sister of President John F. Kennedy, Attorney General Robert F. Kennedy, and Senator Ted Kennedy.
Rosemary Kennedy suffered from mild developmental delay, quickly falling behind her eight brothers and sisters. In a family that took pride in its physical and intellectual prowess, Rosemary was an embarrassment. But she was certainly functional. Before her lobotomy, Rosemary had traveled overseas without a chaperone, participated in sailboat races, and, although it was a struggle, learned to read and write. When she was 15 years old, she sent a letter to her father: “I would do anything to make you so happy,” she wrote. As she got a little older, however, she would occasionally suffer from mild outbursts of anger, raising her voice and flailing her arms. Today, Rosemary Kennedy would likely be diagnosed with mild developmental delay and treated with occupational and behavioral therapies. But to Joseph Kennedy, his daughter’s behavior was intolerable—a threat to his and his other children’s political futures. He wanted Rosemary fixed. So he took her to a prominent Boston neurologist, asking about this new surgery. The neurologist advised against it. Mild mental retardation, he argued, was not a reason to get a lobotomy. Then Kennedy sought out Walter Freeman, who diagnosed Rosemary with “agitated depression.” Freeman was convinced he could treat her. Joseph Kennedy never told his wife about his plan.
In November 1941, Walter Freeman lobotomized Rosemary Kennedy. She was only 23 years old. Jackson cut two holes on the sides of Rosemary’s head, inserted his lobotomy knife, and asked her to count, sing songs, tell stories, and name the months of the year to judge how many cores to remove from the brain. This way, Freeman could determine whether her intellectual functions were still intact. But Freeman went too far. After he removed his fourth and final core, Rosemary emerged from the surgery physically and mentally disabled. The nurse who had attended the operation was so upset that she quit the profession.
Joseph Kennedy, however, remained optimistic. He had his daughter admitted to the Craig House, a private psychiatric hospital in Beacon, New York. Situated on 380 acres of rolling countryside, the Craig House had an indoor swimming pool, a golf course, stables, an arts and crafts center, and a highly trained medical staff. Care at the Craig House cost the equivalent today of $250,000 a year. After several months of intense therapy, Rosemary regained her ability to walk. But she could no longer read, spoke only a few words, was unable to take care of herself, and had lost all memory of her friends and family.
Rose Kennedy, who periodically sent out long letters to her children updating the family’s activities, never mentioned Rosemary again. And she didn’t visit her daughter for 20 years. Joseph Kennedy, who later transferred Rosemary to the St. Coletta School for Exceptional Children in Jefferson, Wisconsin, didn’t visit
Rosemary for the last 25 years of his life. Indeed, the only person to visit Rosemary before she died in 2005 was her brother John, who privately visited her during a campaign stop in Wisconsin in 1958. Rose Kennedy later wrote, “Rosemary’s was the first of the tragedies that were to befall us.”
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BY THE MIDDLE OF THE 20TH CENTURY, lobotomies had become such an integral part of American culture that they found their way into books like Robert Penn Warren’s All the King’s Men (1946), plays like Tennessee Williams’s Suddenly Last Summer (1958), movies like A Fine Madness (1966), Planet of the Apes (1968), A Clockwork Orange (1971), Terminal Man (1974), One Flew Over the Cuckoo’s Nest (1975), Frances (1982), Repo Man (1984), A Hole in One (2004), and Asylum (2008), and songs like the Ramones’ “Teenage Lobotomy” (1977).
The gradual change in American attitudes toward lobotomies was evident in these works. In the 1959 movie Suddenly Last Summer, which starred Elizabeth Taylor and Katharine Hepburn, the lobotomist was played sympathetically by Montgomery Clift. By the 1970s, however, the attitude toward lobotomies had changed. Now they were portrayed as a means to punish nonconformity. For example, in the 1975 movie One Flew Over the Cuckoo’s Nest, based on the novel by Ken Kesey, the main character, Randle Patrick McMurphy, played by Jack Nicholson, fakes a mental illness to escape a rape conviction. In the ward, he rallies a group of submissive men to rise up against the hospital matriarch, Nurse Ratched, who emasculates them with drugs and faux therapy sessions. During the final confrontation, when McMurphy tries to strangle Nurse Ratched, he is lobotomized into submission: a tragic figure.
By the early 2000s, lobotomies were no longer seen as a tool for institutional control, but rather as a subject of horror movies. In Asylum (2008), six freshmen college students discover that their newly renovated dorms were originally a private mental hospital. Flashbacks include a seizing boy strapped to a bed, a girl wearing a straitjacket made of barbed wire, and a boy with an ice pick sticking out of his eye socket, lorded over by a tall man with a small hammer. The last image was perhaps the most frightening. Not because it was the most gruesome, but because it wasn’t fictional. The boy was Howard Dully, who later wrote a book about his experiences, and the lobotomist was Walter Freeman. Movies like Asylum show how, according to one critic, “it requires only a small shift in our credibility for the surgeon to become the slasher.”
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ALTHOUGH LOBOTOMIES WERE eventually reviled, nothing hastened their demise more than psychoactive drugs. In 1954, the Food and Drug Administration licensed Smith, Kline & French’s chlorpromazine, the first drug offered for the treatment of schizophrenia. The drug was called Thorazine, in honor of Thor, the hammer-wielding Norse god of thunder responsible for protecting humankind. Thorazine worked, clearly reducing the hallucinations and delusions of people with schizophrenia (something that lobotomies never did). By 1955, Tofranil, an antidepressant, and Miltown, an antianxiety drug, had also become available. Now psychiatrists could prescribe mind-numbing drugs whose side effects could be reversed by simply stopping the medication—instead of mind-destroying surgeries, whose side effects were irreversible.
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WALTER FREEMAN’S career didn’t end well.
In 1954, the same year that Thorazine was introduced, Freeman decided to leave George Washington University and move to northern California, where a friend had offered him a position in the Palo Alto Clinic. Freeman asked the medical faculty of George Washington University to make him a professor emeritus, which it refused, offering only that he could take a one-year leave of absence at the end of which he could resign.
When Freeman arrived in California, he found that other doctors in the Palo Alto Clinic had changed their minds, finding him too controversial. Still, there were plenty of other clinics and hospitals in the area where he could perform his lobotomies. In 1961, in front of a large group of neurologists and psychiatrists at the Langley Porter Clinic, Walter Freeman presented three of the seven adolescents he had lobotomized between 1958 and 1960. He wanted those in attendance to see how well his patients performed. Like a ringmaster in a circus of the absurd, Freeman urged the children to demonstrate their mental and physical skills. When one boy was slow to respond, Freeman raised his voice. The child, clearly frustrated, screamed, “I’m doing the best I can!” This exchange didn’t exactly win the crowd’s sympathy; Freeman was practically booed off the stage. He responded angrily, taking a box of Christmas cards that he had received from his patients and throwing them onto a table. “How many Christmas cards did you get from your patients!?” he yelled. No longer a respected neurologist, Walter Freeman had become a pariah. Freeman still traveled across the country doing lobotomies and training others to do them, but he was clearly slowing down, performing only eight lobotomies in 1965.
In 1967, when he was 72 years old, Walter Freeman performed his last lobotomy. When the woman died of cerebral hemorrhage, he lost his license to practice medicine.
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IN THE FINAL PAGES OF HIS autobiography, Walter Freeman hoped that one day the hospitals of West Virginia would stand as a “monument to the success of lobotomy.” He picked West Virginia because of the large number of lobotomies he had performed at Weston State Hospital in the early 1950s. In a sense, Freeman has gotten what he wanted.
In 2008, Weston State Hospital reopened as a tourist attraction under the name Trans-Allegheny Lunatic Asylum. The asylum has now been featured on Syfy Channel’s Ghost Hunters and the Travel Channel’s Ghost Adventures. Apparently, it’s haunted. And the ghost doing the haunting is Walter Freeman. At the entrance to the asylum is a picture of Freeman and a plaque describing his work: “Freeman was discredited by the medical profession and lost his license to practice in hospitals. He spent the remainder of his life seeking redemption, pathetically traveling around the country trying to locate his former patients to prove he improved their lives. He died of colon cancer in 1972 at the age of 77. Today Freeman is regarded by many as a monster, an American Mengele.”
Not exactly the monument Walter Freeman had been hoping for.
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THE LESSON FROM LOBOTOMIES IS far easier to make than to follow: Beware the quick fix.
When Joseph P. Kennedy wanted to cure his daughter’s mild developmental delay, he sought the counsel of Walter Freeman, who told Kennedy that a simple fix was at hand. The procedure would take only a few minutes, wouldn’t require general anesthesia, and would restore his daughter to a level of emotional maturity similar to her brothers and sisters. All the money and time Kennedy had spent on tutors and private schools trying to get Rosemary up to speed hadn’t been necessary. All she really needed was one carefully placed surgical knife in her brain. Even though a noted surgeon had recommended Rosemary’s lobotomy, the reason that it sounded too good to be true was that it was too good to be true. A healthy skepticism by Kennedy could have spared his daughter a life of severe physical and mental disability. All Kennedy had to do was ask to see others who had been lobotomized. But he didn’t want to see them. He wanted to believe in the magic. And for that, his daughter paid an enormous price. As did the thousands of other patients and their families who wanted to believe that complex psychiatric disorders could be treated with a five-minute surgery.
As we’ll see in the final chapter, when it comes to children with autism, the lesson of the quick fix remains unlearned.
CHAPTER 6
THE MOSQUITO LIBERATION FRONT
Hey farmer, farmer
Put away that DDT now
Give me spots on my apples
But leave me the birds and the bees
Please!
—Joni Mitchell, “Big Yellow Taxi”
Olga Huckins was angry. On January 29, 1958, she wrote a letter to the Boston Herald.
The previous summer—in an effort to kill growing numbers of gypsy moths, tent caterpillars, and mosquitoes—state authorities had sprayed DDT over large areas of Pennsylvania, New York, and New England. Huckins, who li
ved near a bird sanctuary in Duxbury, Massachusetts, was horrified by what happened next. “We picked up three dead [robins] the next morning,” she wrote. “They were birds that had lived close to us, trusted us, and built their nests in our trees year after year…All these birds died horribly and in the same way. Their bills were gaping open, and their splayed claws were drawn up to their breasts in agony.”
Huckins wasn’t alone in her anger. Many residents had written letters, sickened by the aftermath of the spraying. Health officials were unbowed. But Olga Huckins refused to be ignored. She sent a copy of her Boston Herald letter to her friend, Rachel Carson. Four years later, Carson published a book about it. Called Silent Spring, it became an international best seller, alerting the world to the dangers of pesticides, landing Carson on national television programs and in front of congressional hearings, winning praise from people as diverse as President John F. Kennedy, Supreme Court Justice William O. Douglas, and singer-songwriter Joni Mitchell, and making Carson one of the most famous and most influential women in the United States. Unfortunately, Rachel Carson had made one tragic mistake.
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RACHEL LOUISE CARSON was born on May 27, 1907, in Springdale, Pennsylvania, the third of three children. Her father, Robert, was variously an electrician, an insurance salesman, and a night watchman. Her mother, Maria, gave up teaching to raise the children.
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