Walter Freeman: The Man Who Popularized the Lobotomy

Editor’s Note: Viewer discretion is advised. This article describes the process of performing a lobotomy, an outdated brain-altering procedure that some may find disturbing.

You’ve most likely heard of the lobotomy, a now discredited medical procedure that involves destroying brain tissue as a quick fix-all for mental health issues, and taking away the patient’s personality in the process. No matter how much time has passed, the lobotomy endures as a widely-remembered symbol of the horrific treatments for mental illness in the past.

What you may not know, however, is the complicated story of how this procedure became so widespread, and how much of that can be attributed to the influence of a single man. That man is neurologist Walter Freeman.

Walter Freeman initially started researching lobotomies with the intention of getting individuals out of institutions and back into homes. In the 1920s and 30s, mental health institutions in cities were crowded and in poor condition, with patients rarely receiving the care they required. Many had spent years in such hospitals with no way out. When Freeman witnessed this, he was appalled, viewing it as a waste of life. Throughout this period, he attempted many different methods of psychiatric treatment (albeit with questionable results).

In 1936, Freeman heard word of Portuguese neurologist Egas Moniz’s work with taking out small amounts of patient’s frontal lobe tissue, which Moniz claimed could cure them of mental illness. Inspired by these findings, Freeman set out to modify this surgery and perform it in the United States. He recruited James Watts, a neurosurgeon, to aid him. The two performed the surgery, named the prefrontal lobotomy, for the first time that same year. Following what they considered to be a successful surgery, the duo performed lobotomy after lobotomy.

The prefrontal lobotomy involved drilling holes into the patient’s skull, through which the frontal lobes could be accessed and cut through. Freeman believed that this was effective because it severed connections between the frontal lobe and thalamus, which halted the “overactive emotions” which caused mental illness (we now know this to be, frankly, a load of utter baloney).

Freeman also didn’t ever properly test or verify the safety of his surgery using the scientific method. While he kept statistics on a supposed success rate, there was no actual way to identify what that success looked like for something so subjective and with such wide-ranging patient symptoms. He had no sort of control group to see what the base level of improvement was without his surgery.

That’s not to mention the lobotomy’s chilling effects on a large number of Freeman’s patients. Some died during or after surgery, while others were left completely unable to perform basic functions, such as eat or walk. But even if they weren’t as severely affected, something was fundamentally changed within most of them. They seemed to have lost their personalities. Patients may have been more subdued, but they behaved like shells of their former selves. Wolfhard Baumgartel, a physician who watched Freeman perform multiple lobotomies, said of what he observed afterwards: “There was something missing – emotions, I would say. You know, if you were to converse with somebody, there’s always emotion with it. Just take all of your emotion out of a conversation with somebody and what’s left?”

In spite of this, Freeman doubled down on the success of his surgery. It began to get lots of media coverage, being marketed as a “miracle cure” for any sort of mental illness. However, the prefrontal lobotomy as it stood was inefficient and slow. Hungry for further recognition, he needed to devise a way to make it quicker and less costly.

The solution he landed on became known as the transorbital lobotomy. Instead of cutting holes in the skull for precision, he would access the brain by inserting something through the eye sockets. The very first item he used for this version was an icepick, which became synonymous with the procedure. He began performing the transorbital lobotomy without Watts’ knowledge in their shared office. The new surgery took less than ten minutes and left patients with only two black eyes (and a sliced up brain) after operation.

Watts, finding Freeman’s modification to be extremely imprecise and unsanitary, ended their partnership a couple years later. For Freeman though, this marked the beginning of a new chapter in the spread of his surgery. He marketed the transorbital lobotomy as an inexpensive fix that could be easily taught to anyone within a few hours.

Freeman embarked on trips around the country, demonstrating the lobotomy to crowds of onlookers. He taught doctors at hospitals all over how to replicate it. Freeman seemed to revel in the attention he received, purposely doing irresponsible stunts during surgery in order to shock his colleagues. In one case, he left the leucotome in a patient’s brain while he stopped surgery to get a photo. It slipped further in, irreversibly damaging the midbrain and causing her to die. Freeman began to draw more and more criticism from the medical field but one thing remained indisputable: he had brought the lobotomy to the masses.

Eventually, the era of lobotomies drew to a close. In the mid 1950s, lobotomies came under more criticism than ever before for their bad results. In addition, psychiatric medications such as chlorpromazine took over as the primary treatment in most institutions. Though they weren’t perfect, they were considered a far safer alternative to the invasive and irreversible lobotomy.

In 1967, Freeman performed his last surgery. Helen Mortensen, one of his very first transorbital recipients, was back for a third lobotomy. While doing the surgery, Freeman hit a blood vessel and caused her to die. His surgical privileges were revoked, and he didn’t operate again. This marked the last recorded time that a lobotomy was performed in the United States. Freeman died five years later.

Today, the lobotomy is scorned by neuroscientists. Freeman is largely remembered as a completely reckless physician who sought mainly to create a name for himself, even at the expense of the well-being of thousands of people. Nevertheless, his influence is undeniable. It’s estimated that over the span of just a few decades, more than 50,000 lobotomies were performed in the US alone, altering the lives of countless patients and families. Decades later, the harm that Freeman perpetrated still remains a grave reminder of the danger of turning a blind eye to medical ethics.

Sources

NAVA TABATA

Editor at The City Voice

Nava is currently a senior at City. She has been writing for The City Voice since her sophomore year and now serves as an editor. Although she enjoys covering a wide range of subjects, her favorite topics to write about are history and ecology. Outside of the newspaper, you can usually find her playing violin in City’s pit orchestra, volunteering at her local library, or going on walks to observe the antics of her neighborhood squirrels.