That was a stupid excuse. He had already told us the band saw was strictly off-limits. We weren’t allowed to be anywhere near it. So I got thrown out of wood shop, and I had to attend home economics. That wasn’t so bad—it was all girls—but it was kind of embarrassing.
There were other incidents. I stole switchblade knives from lockers in the gymnasium, and got caught with them in my shoes.
But I didn’t get caught for the most serious thing I did. One day I slipped into the girls’ bathroom. It was empty. I had watched the door. I knew no one was in there. So I went in, and slipped into one of the stalls. I sat down and lit a cigarette, and waited. Girls started coming in. I think I had this idea that I would see things, and hear things, that would be sexy and exciting.
I didn’t. I heard girls gossiping about stupid girl stuff, and I heard girls going to the bathroom. That’s not what I was interested in. I wasn’t kinky. I had healthy things in mind with girls. After a while I realized nothing good was going to happen. When the bathroom was empty again, I slipped back out.
But someone saw me, and reported me. I got called in and questioned. Of course I denied it. And since no one had actually caught me, or even seen me, in the girls’ bathroom, they couldn’t really do anything to me. But I’m sure it went into my files. Did Lou and my dad ever know about it? I don’t think so. If Lou had been aware of it, she would certainly have used it against me. She never mentioned it.
Things were bad at school. They were no better at home. I knew I was driving Lou crazy, and she was driving me crazy, too.
What I didn’t know was that Lou had decided to do something about the problem. She had already spent a lot of time that fall visiting with doctors—talking about me, and trying to figure out what to do with me.
Sometime around 1958 or 1959, Lou had started taking classes at Foothill College, the local junior college in Mountain View. She had decided to become a medical assistant. What she learned in her classes started giving her ideas about what was wrong with me.
Brian remembers that she’d come home from school and tell him her theories. One of his jobs in the house was helping Lou wash and dry the dinner dishes. While they stood at the sink, she’d tell him her ideas. One of the first ones was that I had an extra chromosome. She told Brian there was something wrong with my brain.
Brian, even then, knew I wasn’t retarded, or crazy. He did say that it seemed like I was always trying to get attention, and that my behavior was sometimes bizarre. He said I didn’t take care of myself, and didn’t care how I dressed or looked. He knew this bothered Lou. But he knew I wasn’t sick, or crazy.
Lou didn’t see it that way. She thought there was something wrong with me. She was determined to find out what it was and fix it.
Like I said before, Lou ran a tight ship. She was tough. She wasn’t a quitter. She was probably what you’d call a control freak today. She wanted things her way. She insisted on having things her way.
But with me, she couldn’t get her way. I was impossible to control. I was always in trouble at school and at home. I was big, and I had a lot of energy, and I made a lot of noise. If you ask me, I was just a kid. I was doing pretty much what kids that age do. But with me there was just a lot more kid stuff than there is with most kids. With me, it was all the time.
Lou was determined to make me act right. So she started talking with doctors, and taking me to see doctors.
I don’t remember much about all that. I know that she had consulted with psychiatrists or psychologists before, because years later I saw some paperwork on it. She took me to a University of California clinic when I was seven, which I don’t remember. She spoke to a Mr. Beal at the Family Services Department in Palo Alto, and spoke to someone at the Children’s Health Council when I was nine or ten, which I also don’t remember. When those visits ended, either the doctors weren’t interested in me or she wasn’t interested in them, I don’t know which. And when she didn’t get what she wanted from them, she started consulting with psychiatrists.
According to some of the doctors’ notes and from what my dad told me later, Lou met with six psychiatrists during the spring and summer of 1960. She wanted to know what was wrong with me and what she should do about it.
But all six of the psychiatrists, I found out later, said my behavior was normal. Four of them even said the problem in the house was with her. They said she was the one who could benefit from treatment. Years later, Brian’s wife told him that Lou had complained about this—that she had seen all those psychiatrists to get treatment for Howard, and some of them had said she was the problem. Could you believe the nerve of those doctors?
That wasn’t the answer she was looking for. I’m sure it made her furious, too. So she kept looking for a doctor who would agree with her.
Sometime that fall, someone referred her to a doctor named Walter Freeman.
Walter Freeman was a nice looking, well educated, upper-class sort of guy. He was born in Philadelphia, one of seven children, into a family that traced its roots back to the Mayflower. (According to Freeman’s biography, the excellent The Lobotomist by Jack El-Hai, one ancestor got drunk and fell off the Mayflower, and was saved by a boat hook.) Freeman’s grandfather was a surgeon who had operated on President Grover Cleveland, and who became the first American surgeon to remove a brain tumor. (He did it with his fingers, without benefit of X-rays, in an operating theater that had no electric lighting. The patient lived another thirty years.) Freeman’s father was a gifted surgeon as well.
Freeman grew up surrounded by money. He was tutored in dancing and riding, and cared for by a governess who spoke French, German, and Spanish. As a boy, he was called “Little Walter Wonder Why,” because he was curious about everything.
His father was cold and strict. When Walter got in trouble at school, his father took out a leather whip—and beat himself with it for being a bad father. When Walter was given a gold coin for winning a prize at church, his father praised him—and then made him put the gold coin in the collection plate.
Freeman’s mother was strict, too. Freeman later said that he admired her, but he never loved her.
Freeman attended Yale, where he was a dandy and dressed strangely. A friend remembered meeting him for the first time. Freeman was wearing a wide Mexican sombrero and swinging a cane. He studied poetry, and used his grandfather’s limousine and driver to take him and his friends to school dances. He decided to study medicine as a senior, and after Yale enrolled at Pennsylvania Medical School. He became fascinated with the brain.
After medical school, Freeman left America to study neurology and psychiatry at universities in Europe. He visited asylums in London and Paris, and worked with psychiatrists in Vienna and Rome. He came home depressed because he saw no real treatment for the insane. He wrote, “I looked around at the hundreds of patients and thought, ‘What a waste.’” When he came back to America he opened a private practice and joined the faculty of George Washington University as a professor of neurology.
It was an exciting time in neurology. Millions of servicemen had been wounded in World War I and returned to England, Germany, France, and the United States with brain damage. In earlier wars, because there was no penicillin, soldiers like that would have died from their wounds. Now many of them came home alive, but brain-damaged. So scientists had this gigantic group of wounded men to study.
At the same time, there were huge advances in the new field of psychotherapy. Sigmund Freud had published his groundbreaking theories on the workings of human emotions. Those theories were beginning to find widespread acceptance.
But Freeman wasn’t interested in Freud or psychoanalysis. He thought that approach could actually be dangerous: “When we realize, really get to know what stinkers we are, it takes only a little depression to tip the scales in favor of suicide,” he wrote. Freeman believed instead that there were biological explanations for depression and schizophrenia, and that there had to be surgical treatments for them.
Over
the next decade, attached to George Washington University, and working with George Washington Hospital and St. Elizabeth’s Hospital, Freeman experimented on mental patients with a variety of radical new treatments. He subjected them to massive doses of insulin and the stimulant drug Metrazol, or hit them with giant volts of electroshock.
As a doctor he wasn’t very successful. But as a teacher he was a big hit. His university lectures were like vaudeville shows, and drew huge audiences of medical students. Among other things, Freeman liked to write notes on the blackboard using both hands simultaneously.
He had a great sense of humor—even if it was sometimes a little weird. When he was a young doctor, he was asked to treat a young man whose girlfriend had placed a gold ring around his you-know-what. The young man got excited. Then he couldn’t get the ring off his you-know-what, which started to turn blue. Freeman had the ring cut off, but then told the young man it would have to be kept as a “specimen.” Freeman had the ring repaired and engraved. He wore it for years afterward, hanging from his watch chain, using it as a conversation starter.
Other doctors at the time were using many strange methods to treat patients who were depressed or mentally ill. Psychiatrists used electrotherapy, where they ran varying amounts of electricity through people’s brains and bodies. They used hydrotherapy, where they gave their patients baths, douches, wet packs, steam, spritzers, and shots from hoses. Most of these were with cool or cold water, but another doctor used heat—hot baths, hot air, infrared lightbulb cabinets, and electric “mummy bags.” A German psychiatrist developed something called the “electric shower.” The patient was fitted into a helmet that gave his brain a “shower” of electricity.
One doctor used something called the “rest cure.” That involved “isolation from family, quiet, diet, and massage.” Another doctor used “sleep therapy.” He would induce a deep sleep, almost a coma, and keep the patient there—for four to six weeks!
Some of the treatments were brutal. With hydrotherapy, doctors sometimes packed their patients in ice water, hoping that the freezing temperature would shock them into recovery. The insulin and Metrazol “therapies” caused such violent convulsions that patients broke their arms, legs, hips, and even jaws.
Some of the treatments seem just plain crazy now. One nut believed all mental illness was caused by infections. He said all psychotic patients had infected teeth. He started his campaign against mental infection by having all his patients’ infected teeth removed. Then he decided to go further, and have all the other teeth removed, too. Then he started in on their tonsils. He was quoted at the time as saying that if all children had their tonsils removed, mental illness could be eliminated in a single generation. When the tonsillectomies didn’t solve the problem, he started removing the colon, the cervix, and the uterus. He didn’t cure any mental illness, but 30 percent of his patients were killed by the surgeries. He sounds like a guy who should have been locked up himself. Instead, he was the director of the New Jersey State Hospital in Trenton.
These doctors weren’t just doing experiments in dark basements somewhere, hidden from the American Medical Association, or from the public eye. They were the subjects of articles in magazines and newspapers that applauded their efforts. Time, Newsweek, Scientific American, Science Digest, and Reader’s Digest all published stories about the success rates of doctors working with insulin, hydrotherapy, and electrotherapy. (Most of them left out the details, like the stuff about the broken legs and fractured jaws.)
In 1935, visiting London, Freeman witnessed a presentation on chimpanzees whose frontal lobes had been operated on. No one knew why exactly, but the monkeys all became passive and subdued after the operation.
Another doctor attending the presentation was a Portuguese neurologist named Egas Moniz. He returned to Lisbon, and in late 1935 began performing similar frontal lobe experiments on human beings. Moniz called the process “psychosurgery.” He drilled holes in his patients’ heads, and made cuts in their frontal lobes, using a tool he called a “leucotome.” He called the procedure itself a “leucotomy.”
Moniz believed this was a promising treatment for mental illness. He published a paper stating that patients suffering from severe anxiety or depression seemed to respond best. Patients suffering from schizophrenia, he said, didn’t respond at all.
Freeman read about Moniz’s experiments in a French medical journal, and decided this was the answer. He contacted the company that supplied Moniz’s leucotomes and ordered some for himself.
When the instruments arrived, Freeman and his partner, a surgeon named James Watt, began practicing on cadaver brains from the George Washington Hospital morgue. Watt was surprised to find that the human brain had the consistency, under a knife, of “soft butter.” Shortly after, Freeman performed his first leucotomy. He and Watt drilled six holes into the shaved head of a sixty-three-year-old Kansas woman who had insomnia and fits of hysteria. Freeman and Watt used a coring tool to sever the connections between the body of her brain and its frontal lobes. The last thing the patient said before the anesthesia took hold was, “Who is that man? What is he going to do to me? Tell him to go away. Oh, I don’t want to see him.” Then she screamed and passed out.
The doctors said the surgery was a success. The patient lived only another five years, but Freeman said they were the happiest years of her life.
Over the next six weeks they did five more surgeries. After the first or second, Freeman proposed changing the name of the procedure from leucotomy to lobotomy. A month later, Freeman presented his findings at a psychiatry conference in Baltimore. In all of his patients, Freeman told his audience, there had been “worry, apprehension, anxiety, insomnia, and nervous tension.” Now the patients were “more placid, content, and more easily cared for by their relatives.”
He didn’t tell his audience that his first patient, that Kansas woman, was comatose for a week after her surgery. For a week after that she couldn’t speak, and for a week after that couldn’t say her own name. A month later, she could recite the days of the week. Freeman reported that her “symptoms” were all gone. She wasn’t hysterical, or frightened. She was looking forward to going home, he said.
Later, when asked about patients whose brains appeared to be damaged by the surgery, Freeman had this optimistic spin: “Maybe it will be shown that a mentally ill patient can think more clearly and constructively with less brain in actual operation.”
Freeman started, with his first surgery, not quite telling the whole truth about his patients. He would continue to do this for the rest of his career. He often visited patients after their surgeries and pronounced them “cured” or “improved” because their worst symptoms had disappeared. But he made these visits four or five days after the surgery, when they were still barely conscious. Many of them would experience a complete return of their anxiety, or their hysteria, or their depression, but Freeman wouldn’t know that, or wouldn’t make note of it in his published papers or presentations at medical conventions.
Encouraged by the Kansas woman’s surgery, Freeman and Watt conducted many more prefrontal lobotomies. In that early period, Freeman’s statistics said that out of his first 623 surgeries, 52 percent of the patients received “good” results, 32 percent received “fair” results, and 13 percent received “poor” results. The remaining 3 percent died, but they weren’t included in the “poor” results category. Freeman would later get closer to the truth when he admitted that his fatality rate was almost 15 percent.
The surgeries sometimes went badly. A Washington, D.C., police officer hemorrhaged after his lobotomy and became a vegetable. Leucotomes broke off in patients’ heads. One patient died on the operating table when Freeman stopped, mid-surgery, to take a photograph.
This was part of Freeman’s routine. He would always stop twice in the middle of the procedure to take his pictures. He’d stop once after he administered the electroshock, to take a “before” photo. He’d stop again in the middle of the lobotomy itsel
f, to get a “during” photo. He’d sometimes take an “after” picture, too.
Later in his career, after another patient died during the photography session, Freeman started asking an assistant to hold the leucotomes for the “during” photograph, or he’d hold them himself and have someone else take the picture. But he never stopped documenting the procedure this way.
Many of Freeman’s patients were so damaged by the surgery that they needed to be taught how to eat and use the bathroom again. Some never recovered. One of Freeman’s most famous patients was Rosemary Kennedy, sister of future president John F. Kennedy. Rosemary was born slightly retarded, but she lived an almost normal life until she was twenty-three. Then Freeman went to work on her. He performed a prefrontal lobotomy in 1941. Rosemary wound up in a Wisconsin mental hospital, where she stayed until her death more than sixty years later.
Another famous lobotomy patient—but not one of Freeman’s—was the actress Frances Farmer. She was a troubled woman but a great talent and a great beauty when she was hospitalized in Washington State for schizophrenia. She never acted again.
And she may never have had a lobotomy at all. The movie about her life, Frances, which was based on a book about her life, said she did. But I’ve read that her biographer admitted that he fictionalized many parts of her life. There is no record of her undergoing a lobotomy during her time as a mental patient.
The funny thing is, during all these surgeries, no one really knew why the lobotomies were successful. They only knew that for some reason interrupting the flow of energy in the brain seemed to interrupt the progression of anxiety or depression. They didn’t know why. And they didn’t know why it worked in some patients and not in others.
In an attempt to learn more about what happened during a lobotomy, Freeman tried performing them with the patient wide awake, under local anesthesia. During one of these procedures, Freeman asked the patient, while cutting his brain tissue, what was going through his mind. “A knife,” the patient said. Freeman told this story with pleasure for years.
My Lobotomy Page 7