But by far the most prolific lobotomist in the country, and indeed the world, was the neurosurgeon Sir Wylie McKissock, based at the Atkinson Morley hospital in Wimbledon. He believes his former boss performed around 3, lobotomies, as part of his famously speedy approach to surgery. Very quickly done," says Dr Gould. As well as operating at Atkinson Morley, McKissock would travel across the south of England at weekends, performing extra leucotomies at smaller hospitals.
He says the operation could have dramatic benefits for some patients, including one who was terrified of fire. However, he had increasing doubts about lobotomy, especially for patients with schizophrenia.
He found that around a third benefited, a third were unaffected and a third were worse off afterwards. Although he himself had authorised lobotomies, he later turned against the practice.
In , Egas Moniz won the Nobel Prize for inventing lobotomy, and the operation peaked in popularity around the same time. Although Moniz would share the Nobel Prize in medicine for his pioneering work in psychosurgery, the lobotomy had not only fallen out of favor by the s but was being excoriated as a barbaric practice.
The Soviet Union banned the surgery in , arguing that it was "contrary to the principles of humanity. The United States performed more lobotomies -- roughly 40, -- than any other nation.
Some very conspicuous failures, including a lobotomy that reduced John F. Robert Lichtenstein, a neurosurgeon who performed lobotomies for treatment of severe pain. Lobotomy was a welcome treatment based on the premise that symptoms of mental illness were caused by faulty connections between the frontal lobes and another part of the brain -- the thalamus.
The idea was that severing those connections and regrowing them could treat symptoms of the mental illness. At the time, it was practically the only effective treatment for severe depression, schizophrenia, suicidal tendencies and other mental disorders. Over the years, lobotomies were done on about 40, to 50, people in the United States in mental institutions and hospitals, El-Hai says.
About 10, of those procedures were transorbital or "ice pick" lobotomies, as Freeman himself referred to the procedure. Doctors used a long, ice pick-like device inserted above the eye through the thin layer of bone, penetrating into the brain's frontal lobe. Freeman performed about 3, transorbital lobotomies himself, according to El-Hai; many others were done by psychiatrists trained by Freeman as he traveled across the country.
While the older, far more invasive prefrontal lobotomy involved anesthesia, then drilling into the skull, the transorbital lobotomy was performed in 10 minutes without any major incisions. According to El-Hai, Freeman performed an all-time high of 24 lobotomies in one day in West Virginia.
According to estimates in Freeman's records, about a third of the lobotomies were considered successful. One of those was performed on Ann Krubsack, who is now in her 70s. Freeman helped me when the electric shock treatments, the medicine and the insulin shot treatments didn't work," she said.
But the majority of patients did not do well -- some died, many were paralyzed and in the cases in which patients were well enough to leave the hospital after the procedure, many were left childlike and devoid of personality. Mainly it meant getting out of the hospital, and these people who returned home from the hospital came home with severe disabilities from their lobotomies," El-Hai says.
I was assured by the psychiatrists involved that the operations were a success. I ask him how he feels about these operations now. In the early s, about lobotomies were carried out each year in the UK, down from 1, at its peak.
By the mids this number had dropped to around a year, nearly always involving smaller cuts and more precise targeting. The introduction of the Mental Health Act introduced tighter controls and more oversight. Today psychosurgical operations are rarely carried out. Howard Dully, who was given a lobotomy by Walter Freeman at the age of 12, says he tries to avoid thinking about how different his life might have been if he hadn't had it, for fear that anger would overwhelm him.
It took a long time," he says. It's very hard to do. Dully feels that the operation, carried out because he had been clashing with his stepmother, cast a shadow over every aspect of his life. Sixty years on, he can remember the operation in vivid detail. I mean you're talking about a brain. Shouldn't there be some precision involved? Lobotomy had had its critics from the outset, and the chorus of opposition grew louder as the poor results became apparent. And when doctors investigated long-term outcomes for his patients they found that just one-third could be regarded as experiencing some improvement, while another third were significantly worse off.
One former advocate for lobotomy in America stated: "Lobotomy was really no more subtle than a gunshot to the head. Fifteen years ago, a group of doctors and lobotomy victims and their families campaigned to have Egas Moniz stripped of the Nobel Prize for Medicine he won in for devising lobotomy. But the Nobel Foundation, whose charter states that its awards may not be withdrawn, refused to comply.
Looking back, how should we view the people who carried out this most controversial medical procedure?
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