ISBN: 0470098309
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Jack El-Hai discusses lobotomy, Walter Freeman, and how a
single man can embody both good and bad.
What is lobotomy?
Walter Freeman and his neurosurgeon partner James Watts coined the term lobotomy
in 1936 and championed the procedure. Lobotomy is a brain operation intended
to relieve the symptoms of mental illness by severing some of the neural connections
between the frontal lobes and the thalamus. Throughout his career, Freeman
experimented with several different methods of accessing the brain to make
the cuts. Initially he and Watts used a traditional approach of anesthetizing
the patient, boring holes in the top or the sides of the skull, and entering
the brain through those holes. Later Freeman pioneered an alternative procedure,
the transorbital lobotomy, in which he inserted a sharp tool — initially an
ice pick — through
the eye orbit of the skull and past a thin bony plate to access the brain.
Between the mid-1930s and the end of the 1970s, 40,000 to 50,000 Americans
underwent the operation. Freeman was personally involved in about 3,400 lobotomies.
How did you first become interested in Walter Freeman and lobotomy?
In 1996, I met a woman whose uncle had a lobotomy while he was a patient in the Minnesota state hospital system. His case intrigued me, so I wrote an article for Minnesota
Medicine magazine about the practice of psychosurgery in the Upper Midwest. As I reported that story, I grew aware of Walter Freeman’s role in the development and promotion of lobotomy as a treatment for psychiatric illness. But some aspects of Freeman’s career puzzled me from the start. I did not understand why an undeniably gifted and respected physician like Freeman was drawn to lobotomy, and I couldn’t fathom why he stubbornly remained faithful to the treatment for so long. Those became the central questions of my book.
Did your opinion of Freeman change as you worked on The Lobotomist?
Absolutely. I began writing The Lobotomist thinking of Freeman as a
monster, at worst, and as a seriously misguided physician working at the fringes
of medicine, at best. Over time, as I absorbed the content of the mountain of
journals, memoirs, correspondence, articles, books, and patient records he left
in the wake of his long career as a neurologist and psychiatrist, I started to
see him differently. I learned about his upbringing as the grandson of America’s
first brain surgeon, as well as his early solitary behavior. I came to understand
that many of his colleagues and patients respected him. I saw evidence of the
terrible state of psychiatric care in the early decades of the twentieth century
and the desperation that many doctors and patients felt. I read surprisingly
eloquent letters from Freeman’s lobotomy patients and their family members. Gradually,
I understood that by the standards of the time, lobotomy sometimes produced results
that could be seen as an improvement. Walter Freeman was the product of his environment,
his impulse to innovate, and personal demons.
So Walter Freeman was a good doctor, not a villain?
Freeman was a man of many faults, and his faults fascinate me. Arrogance, egotism, and stubbornness are just a few of them. He had a troubling urge to collect “trophies” of his most memorable patients. Yet he was also a brilliant and completely original scientist who cared about his patients. The
Lobotomist is my attempt to understand Freeman, not to defend him. It’s a book about how good and bad qualities converged within a single man, with good and bad results.
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