Lobotomy

A lobotomy (Greek: lobos: Lobe of brain, tomos: "cut/slice") is a form of psychosurgery, also known as a leukotomy or leucotomy (from Greek leukos: clear or white and tomos meaning "cut/slice"). It consists of cutting the connections to and from, or simply destroying, the prefrontal cortex. These procedures often result in major personality changes and possible mental retardation. Lobotomies were used in the past to treat a wide range of severe mental illnesses, including schizophrenia, clinical depression, and various anxiety disorders.

History

In 1890, Dr. Gottlieb Burckhardt removed pieces of the frontal lobes of six patients in a psychiatric hospital in Switzerland. One died after the operation, and another was found dead in a river 10 days after release (whether by accident, suicide, or crime is unknown). The others exhibited altered behavior. These experiments marked one of the first forays into the field of psychosurgery.

The Portuguese physician and neurologist António Egas Moniz pioneered a surgery called prefrontal leucotomy in 1935. The procedure involved drilling holes in the patient's head and destroying tissue in the frontal lobes by injecting alcohol. He later improved the technique using a surgical instrument called a leucotome that cut brain tissue with a retractable wire loop. Moniz won the Nobel Prize for medicine in 1949 for this work.

The American neurologist and psychiatrist Walter Freeman was intrigued by Moniz's work, and with the help of his close friend, a neurosurgeon named James W. Watts, he performed the first prefrontal leucotomy in the U.S. in 1936. Freeman and Watts gradually refined the surgical technique, and created something known as the Freeman-Watts procedure (the "precision method," the standard prefrontal lobotomy). The Freeman-Watts prefrontal lobotomy still required drilling holes in the scalp, so it had to be performed in an operating room by trained neurosurgeons. Walter Freeman believed that this surgery would be unavailable to the patients who needed it most: those that lived in State mental hospitals with no operating rooms, no surgeons, no anesthesia, and very little money. Freeman wanted to simplify the procedure so that it could be carried out by psychiatrists in mental asylums, which housed roughly 600,000 American inpatients at the time.

Freeman decided to access the frontal lobes through the eye sockets, instead of through drilled holes in the scalp. In 1945, he took an icepick from his own kitchen and began to test the new surgical technique on cadavers. The technique was called transorbital lobotomy, and it involved lifting the upper eyelid and placing the point of a thin surgical instrument (often called a leucotome or orbitoclast) under the eyelid and against the top of the eyesocket. A hammer or mallet was then used to drive the leucotome through the thin layer of bone and into the brain. The leucotome was then moved from side to side, to sever the nerve fibers connecting the frontal lobes to the thalamus. In selected patients, the butt of the leucotome was pulled upward, sending the tip farther back into the brain and producing a "deep frontal cut," a more radical form of lobotomy. The leucotome was then withdrawn, and the procedure was repeated on the other side. Walter Freeman first performed a transorbital lobotomy on a live patient in 1946. This new form of psychosurgery was intended for use in State mental hospitals that often did not have the facilities for anesthesia, so Freeman suggested using electroconvulsive therapy to render the patient unconscious.

Concerns about lobotomy steadily grew. Numerous countries, including Germany and Japan banned it, as did several U.S. states. Lobotomy was legally practiced in controlled and regulated U.S. centers and in Finland, Sweden, Norway (2005 cases), the United Kingdom, Spain, India, Belgium and the Netherlands.

In 1977, the U.S. Congress created a National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery — including lobotomy techniques — was used to control minorities and restrain individual rights. It also investigated after-effects of the surgery. The committee concluded that some extremely limited and properly performed psychosurgery could have positive effects.

By the early 1970s the practice had generally ceased, but some countries continued small-scale operations through the late 1980s. In France, 32 lobotomies were performed between 1980 and 1986 according to an IGAS report; about 15 each year in the UK, 70 in Belgium, and about 15 for the Massachusetts General Hospital of Boston.

Scale

Lobotomy procedures were done most frequently in the United States, where approximately 40,000 persons were so treated. Great Britain performed procedures on 17,000 people, and the three Scandinavian countries had a combined figure of approximately 9,300 persons treated.

Cases

* Rosemary Kennedy, the sister of President John F. Kennedy, was given a lobotomy when her father complained to doctors about the 23-year-old's moodiness. Dr. Walter Freeman personally performed the procedure. Rather than any improvement, however, the lobotomy reduced Rosemary to an infantile mentality including incontinence. Her verbal skills were reduced to unintelligible babble. Her father hid the nature of Rosemary's affliction for years and described it as the result of mental retardation. Rosemary's sister Eunice Kennedy Shriver founded the Special Olympics in her honor in 1968.[citation needed]
* Howard Dully had a lobotomy at 12, after his stepmother was simply tired of his "youthful defiance". At the age of 56 he said, "I've always felt different -- wondered if something's missing from my soul. I have no memory of the operation". Late in his life, Dully uncovered the story of his lobotomy. Crown Publishers published Dully's memoir (co-written by Charles Fleming), My Lobotomy, in September 2007.
* New Zealand author and poet, Janet Frame was due to have a lobotomy because of a diagnosis of mental illness. She was saved from this procedure by receiving a literary award the day before her operation was to take place.
* French Canadian singer Alys Robi was renowned worldwide during the 1940s. In the 1950s, following many cases of violence and disturbance, she was interned in a Quebec mental hospital where she underwent a lobotomy. She was later released and pursued her career.

In popular culture

* Transorbital lobotomy is discussed in a scene from the 2001 horror movie, Session 9. The post-operative treatment is described as "a pair of sunglasses". Later, a character is seen lobotomized in such a fashion, walking around in sunglasses.
* The Simpsons episodes 7F24 Stark Raving Dad where Bart daydreams of his father undergoing the operation and 2F03 Treehouse of Horror V where Ned Flanders performs lobotomies on the Simpson family.
* The Velvet Underground song, "Lady Godiva's Operation", depicts a lobotomy.
* A lobotomy is mentioned in the song "Paralyzed" by Kiss off of their album Revenge. "Don't see nothin' in my eyes, 'cause man I've been lobotomized"
* A lobotomy is mentioned in the song "Leper Friend" by Dog Fashion Disco from their album "The Embryo's in Bloom". "The cure for clinical depression is a lobotomy."
* In the 1947 radio play "Dark Curtain", Veronica Lake portrays a paranoid schizophrenic bride-to-be who receives a failed series of convulsive electroshock treatments followed by a successful lobotomy. The shock treatments and the brain surgery are described in clinical detail. The glowingly positive light in which these "advances in modern medicine" were depicted make it difficult for a contemporary audience to listen to it.
* In Tennessee Williams's play, Suddenly, Last Summer, Catharine, the protagonist, is threatened with a lobotomy to stop her from telling the truth about her cousin Sebastian.
* In the Pink Floyd song Brain Damage, the second verse includes the lines "You raise the blade/You make the change/You rearrange me till I'm sane", discussing lobotomy.
* In the 1962 book One Flew Over the Cuckoo's Nest (and the 1975 film based on it), McMurphy was lobotomized after he angrily attacked Nurse Ratched.
* The novel All the King's Men by Robert Penn Warren described a lobotomy.
* In the 1968 film Planet of the Apes, Taylor was separated from his fellow astronauts. He later finds that the apes gave astronaut Landon a lobotomy.
* The 1982 biopic Frances included a fictional scene of the titular actress Frances Farmer undergoing transorbital lobotomy.
* In the DCAU Justice League two part episode, "A Better World", Justice Lord Superman uses his heat-ray ability to lobotomize his most powerful enemy, Doomsday, defeating him.
* The Ramones song titled "Teenage Lobotomy" as well as the book "Lobotomy: Surviving the Ramones" written by Dee Dee Ramone.
* The Iron Maiden album "Piece Of Mind" depicts the character Eddie after having a lobotomy. Therefore they have taken a piece of Eddie's mind.
* The track "Lobotomy Gets 'em Home" by The Men They Couldn't Hang, is about the enforced treatment of the American actress Frances Farmer
* Karen from the US localization of "The Office" sarcastically mentions giving herself a lobotomy with a corkscrew after a difficult day at work.
* British rock band "Bullamakanka" have a song called "lobotomy" about a boy with suicidal tendencies.
* Zebrahead has a song entitled "Lobotomy for Dummies", which is about a man who's girlfriend broke up with him, and wishes to undergo lobotomy so he doesn't have to deal with it.
* Sylvia Plath's novel "The Bell Jar" mentions a young woman Valerie, whom Plath met in the mental institution, who was lobotomized.
* In the Playstation 2 video game Timesplitters Future Perfect, the announcer may exclaim "Lobotomy!" if a headshot is performed in arcade mode.
* In the 1996 X-Files episode entitled "Unruhe", the villain performs trans-orbital lobotomies on his victims.
* The Scouting for Girls song Elvis Ain't Dead includes the line "I think I need a love lobotomy", referring to the narrator's anguish over his girlfriend leaving him.
* The Duckman episode "A Room With a Bellevue" contains a scene where Duckman gets a lobotomy, though Cornfed is able to reverse its effects.
* The Brazilian heavy metal band Sepultura features the song, "Lobotomy" on their 1989 album, Beneath the Remains.