9 ms·

My Lobotomy: Howard Dully's Journey (2005)

92 points by Red_Tarsius 3y ago

tetris11 3y ago
I wonder if medical journals took their origins from this tragedy. I also wonder if it's still a viable treatment for the violently suicidal.
- vore 3y ago
  Given that lobotomy was putting a large needle in someone's eye socket and swinging it around in their brain to destroy a bunch of tissue at random, I would hope not.
- burnished 3y ago
  It was never a viable treatment. It was a horrorshow inflicted on the powerless and inconvenient.
  - tetris11 3y ago
    The article gives one case where it had the desired outcome. Indeed it is just one, but given how it was administered willy-nilly for all kinds of ailments, it does make one wonder if the other violent suicidal cases had improvements.
    - vore 3y ago
      I would think we know more about the brain now to have better treatments than random stabbing. Would you like to get stabbed literally randomly in the brain to treat suicidal tendencies?
      - tetris11 3y ago
        Good question. In much the same way that cancer patients literally have to poison themselves with chemo drugs to fight a greater ailment with sporadic success rates, I'd argue that if there was no other alternative and that the road I was on would lead to a violent death, then... yes?
        vore 3y ago
        I don't know why you are so insistent on this. With chemotherapy, we have literally have so much empirical evidence that the benefits far outweigh the risks. We understand the mechanism of action of chemotherapy enough to assess its risk profile. With lobotomies, we understand enough about the brain now to know that the risk profile is extremely bad. Additionally, empirical evidence has shown that outcomes are pretty bad anyway! We have better tools and ways to understand the brain now to not give people a brain-destroying "treatment" that is basically a random, low chance of success. Would you reasonably prescribe getting shot in the head as a treatment if it had worked on one person?
        tetris11 3y ago
        (Sorry, I'm not trying to be beligerent, only to keep an open mind.) It's kind of why I wanted to know more about the stories of the people the procedure worked for, just in case there really is some evidence it provides a benefit in some niche category. Though, yeah, I'm not betting on it.
        burnished 3y ago
        You aren't wrong to be curious, but you are going to get unhelpful and emotional answers when asking about this. You should genuinely read the wikipedia page on this topic: https://en.m.wikipedia.org/wiki/Lobotomy https://en.m.wikipedia.org/wiki/Lobotomy it will answer your questions and reveal the horror of what you are asking about and why people respond the way they do. To sum up though; the procedure was mostly performed on women and children, who were also frequently not aware of what was being done to them (not consenting), on men it was mostly performed on homosexuals. The best case outcomes came at the cost of 'decreased psychic complexity', a sort of 'permanent childhood'. The worst cases don't bear repeating here. I would also like to caution you, when reading on this, note whose voice is present; is it ever the subject who reports positive outcomes?
    - burnished 3y ago
      No, the article gives one case where someone had reported success, do we get the words of the person who had the spike in their brain? I would caution you against assuming best intent in this context because describing her as being at peace.. it describes some one as going from difficult to control to compliant. We don't have reason to believe it was a miracle cure, except possibly from the perspective of her caregivers.
isoprophlex 3y ago
That reminds me of the deeply troubling lobotomy storyline in Bojack Horseman. 2500 lobotomies by a single doctor. Makes you wonder how many were used to conveniently silence difficult people -- people whose mental illnesses were seen to be a burden to their surroundings. https://medium.com/the-dot-and-line/we-need-to-talk-about-bojack-horseman-season-4s-most-shocking-scene-2d9f2ff9bf45 https://medium.com/the-dot-and-line/we-need-to-talk-about-bo...
- kelseyfrog 3y ago
  ABA gets much the same criticism today.
BossingAround 3y ago
Absolutely insane, that someone believes that randomly destroying parts of the brain will "cure one's depression", or other illnesses (like mental health issues or migraines). This is an insanely depressing read.
- quickthrower2 3y ago
  Snake oil! He had to believe it to make money.
- bowsamic 3y ago
  [flagged]
  - gus_massa 3y ago
    From Wikipedia: > by 1951, almost 20,000 lobotomies had been performed in the United States > On average, there was a mortality rate of approximately 5% during the 1940s. > He described one 29-year-old woman as being, following lobotomy, a "smiling, lazy and satisfactory patient with the personality of an oyster" who could not remember Freeman's name and endlessly poured coffee from an empty pot. It helped in many cases, but it was bad in many cases. I'd like to see an statistic and also read carefully what is the definition of a "success" case.
  - 221qqwe 3y ago
    Define worked. Turning a 'violently suicidal' person into a zombie might seem like a success from the perspective of those who have to live with/take care of them/etc. Then again euthanasia should also be very effective if that's your only goal.
  - BossingAround 3y ago
    Yes; in the article, there were some lucky cases, some not so lucky: > Anna Ruth Channels suffered from severe headaches and was referred to Freeman in 1950. He prescribed a transorbital lobotomy. The procedure cured Channels of her headaches, but it left her with the mind of a child, according to her daughter, Carol Noelle. On the whole, I'd say it's an utterly barbaric, even idiotic, procedure. As I said, believing that random tissue damage has "healing properties" is so idiotic I cannot believe it. At least if it was specific to some parts of the brain, e.g. "for depression, destroy this part of the brain," it'd be a bit more understandable (not by much though).
davidthewatson 3y ago
To the credit of the poor adjunct who taught my freshman psych 101 course in college, and assigned reading Thomas Szasz as part of it, what I've learned is that Thomas Szasz, while outspoken, was not wrong: https://www.google.com/books/edition/Coercion_as_Cure/hYdLS6qyTwUC?hl=en&gbpv=1&dq=cerebral+spaying+&pg=PA151&printsec=frontcover https://www.google.com/books/edition/Coercion_as_Cure/hYdLS6...
CafeRacer 3y ago
Technically, if you think about that, we're doing neurosurgeries to remove parts of the brains when necessary. I could imagine that severing the connection between lobes could affect someone's mental state in a positive way. However, 2500 surgeries, some of them with great results, some of them resulted in deaths and many in between. It's a game of chances, not a science. Seems like this dude did not understand what is it exactly he is doing and randomly poked holes in people hoping it would work. It would have been interesting to read a journal of someone who had the procedure.
- Mistletoe 3y ago
  I’m reminded of this article. There are very rarely placebo surgeries done, so it is an entire arm of medicine that is running wild without proper controls being done. https://www.skepdoc.info/ian-harris-on-surgery-the-ultimate-placebo/m https://www.skepdoc.info/ian-harris-on-surgery-the-ultimate-... If you’ve had a lobotomy surgery, you have a huge tendency to believe it maybe did something positive. An interesting study would have been just tell people that they had a lobotomy. If I had to guess, I bet the success rate would be much higher that actual lobotomy.
  - jprete 3y ago
    You’re writing as though lobotomy is a legitimate procedure that might be a placebo, instead of a nonsensical operation of random brain destruction.
- belk 3y ago
  I think the only think he knew was that he was offering a procedure to turn problematic family members into vegetables, that was the whole business model
quickthrower2 3y ago
Lobotomy, or attempted murder by a stepmother? Hard to guess.
xattt 3y ago
> As those who watched the procedure described it, a patient would be rendered unconscious by electroshock. This makes me think that something akin to electroconvulsive therapy would have caused remission.
- smeej 3y ago
  Electroshock therapy was also a common treatment for mental illness. My grandma received it several times...to try to deal with her emotions about my abusive alcoholic grandfather. For as much as older generations criticize Millennials and Gen Z for being "snowflakes," I'm not sure my grandma's "Greatest Generation" actually handled things better.
  - bowsamic 3y ago
    Electroshock therapy is still common in some places, such as Australia
    - defrost 3y ago
      FWiW modern ECT is much much milder than 1960s light dimming electroshock treatments. https://www.healthdirect.gov.au/electroconvulsive-therapy-ect https://www.healthdirect.gov.au/electroconvulsive-therapy-ec...
      - funnym0nk3y 3y ago
        It's still highly controversial. Effects don't last that long (long enough though to get someone out of debilitating depression or mania and time for proper treatment) and need repeated courses to sustain. There are still issues with memory, where one looses maybe a few days, but also could loose years.
    - coolvision 3y ago
      novadays it's done with general anesthesia and muscle relaxants, so it is quite different from what people know from the movies. good ted talk about it: https://www.ted.com/talks/sherwin_nuland_how_electroshock_therapy_changed_me https://www.ted.com/talks/sherwin_nuland_how_electroshock_th...
Borrible 3y ago
After Rosemary was mildly sedated, "We went through the top of the head," Dr. Watts recalled. "I think she was awake. She had a mild tranquilizer. I made a surgical incision in the brain through the skull. It was near the front. It was on both sides. We just made a small incision, no more than an inch." The instrument Dr. Watts used looked like a butter knife. He swung it up and down to cut brain tissue. "We put an instrument inside", he said. As Dr. Watts cut, Dr. Freeman asked Rosemary some questions. For example, he asked her to recite the Lord's Prayer or sing "God Bless America" or count backward... "We made an estimate on how far to cut based on how she responded." When Rosemary began to become incoherent, they stopped. https://en.wikipedia.org/wiki/Rosemary_Kennedy https://en.wikipedia.org/wiki/Rosemary_Kennedy
- dav_Oz 3y ago
  If you have a hard time understanding what type of rigor thinking guided this; one on-the-fly "theory" from Freeman is offered by the wiki article on lobotomy[0]: Walter Freeman coined the term "surgically induced childhood" and used it constantly to refer to the results of lobotomy. The operation left people with an "infantile personality"; a period of maturation would then, according to Freeman, lead to recovery. In an unpublished memoir, he described how the "personality of the patient was changed in some way in the hope of rendering him more amenable to the social pressures under which he is supposed to exist." He described one 29-year-old woman as being, following lobotomy, a "smiling, lazy and satisfactory patient with the personality of an oyster" who could not remember Freeman's name and endlessly poured coffee from an empty pot. When her parents had difficulty dealing with her behaviour, Freeman advised a system of rewards (ice cream) and punishment (smacks). [0]https://en.m.wikipedia.org/wiki/Lobotomy https://en.m.wikipedia.org/wiki/Lobotomy
  - mynameishere 3y ago
    I like how lobotomies ended, not because the professionals decided to quit being barbaric, but because Thorazine got you the same results on a subscription basis.
    - 3y ago
phatskat 3y ago
Behind the Bastards has a good couple episodes about Walter Freeman[1]. If you want a good review of exactly how fucked up lobotomies are and what kind of person decides “yeah I could jam an ice pick in a brain”, take a listen. [1] https://spotify.link/rS6ePKIXvDb https://spotify.link/rS6ePKIXvDb
jdietrich 3y ago
We're still doing psychosurgery - far more precise and advanced than Freeman and Watts's lobotomies, but not fundamentally different. Today the most common targets are in the cingulate gyrus rather than the prefrontal cortex, but we're still basically cutting or burning out bits of brain. It has become comparatively rare due to the wide array of treatment options now available for severe mental illness, but psychosurgery may still be the least-worst option for people with debilitating and intractable depression, OCD or chronic pain where all other treatments have failed. Freeman was undoubtedly a cowboy, but his poor practice has warped our understanding of psychosurgery. Freeman didn't invent the lobotomy and was widely condemned by many of his contemporaries, including his former surgical partner James Watts. We overlook the extraordinary suffering caused by severe mental illness and forget just how few treatments existed prior to the great pharmaceutical revolution of the 1950s. Freeman's more conservative contemporaries were, for the most part, responsible clinicians trying to do their best for patients who were experiencing unbearable suffering and had no better options. https://en.wikipedia.org/wiki/Psychosurgery https://en.wikipedia.org/wiki/Psychosurgery
- goodluckchuck 3y ago
  That’s horrifying.
- bigger_inside 3y ago
  Before we make idealizing comparisons between "barbaric pasts" and seemingly enlightened presents (the "arrogance of the present" in which we assume that whatever we do now is knowledgable, good, just, right, at the end point of progess), let's remember that today's "medications" were largely chance discoveries, where the "chance" consisted of the recognition that they would calm patients and make them more manageable - and in this light, they were praised, in their time, as "chemical lobotomy". Joanna Moncrieff makes this explicit in her book, "The Bitterest Pills". Also elaborated on here: https://www.psycovery.com/images/Postpsychiatrys-challenge-Olga-Runciman-2013.pdf https://www.psycovery.com/images/Postpsychiatrys-challenge-O... We're still doing the same thing, just without knives (and, as the comment noted, often also WITH knives).
  - 3y ago
cj 3y ago
> Newspapers described it as easier than curing a toothache. In a way, it's comforting to know that newspapers back in the 1950's were as susceptible to BS as modern day TikTok influencers. Maybe the technology / form factor isn't the underlying issue afterall.
- bigger_inside 3y ago
  > In a way, it's comforting to know that newspapers back in the 1950's were as susceptible to BS as modern day newspapers. fixed it.
emmelaich 3y ago
What terrifies me is the possibility of psychosurgery only removing the ability to express inner turmoil. Imagine the despair of a mind unable to express itself through voice or other action.
- bmulcahy 3y ago
  [dead]
questinthrow 3y ago
[flagged]
- funnym0nk3y 3y ago
  Psychiatric diseases did exist thousands of years ago. OCD is a disease I know of. Yes, medication does not cure the underlying illness. And yes, it allows a patient to function in society. Which is, considering everything, a good thing. Being so depressed that you are bed ridden and your body hurts, or so agitated that you could not sleep for days puts a temporary chemical lobotomy in relation.
- 221qqwe 3y ago
  > inhumane society we have now Arguably still more 'humane' than it ever was.
  - deleted 3y ago
    [deleted]
boringuser2 3y ago
There's a lot to be morally repulsed by in this article, but shockingly little scientific discussion of the actual procedure. Kind of feels like a "wow, just wow" article.
clnq 3y ago
There's a memoir Dully co-authored and published not too long after this article. There was also another article where, if memory serves me right, where he spoke about what it felt shortly after the lobotomy. Although I might be misremembering and it could also be another patient's account. Regardless, it is horrific. Another atrocity is the reason a Freeman colluded with a controlling and abusive step-mother to lobotomize her son. > According to Freeman's notes, Lou Dully said she feared her stepson, whom she described as defiant and savage looking. "He doesn't react either to love or to punishment," the notes say of Howard Dully. "He objects to going to bed but then sleeps well. He does a good deal of daydreaming and when asked about it he says 'I don't know.' He turns the room's lights on when there is broad sunlight outside." I cannot possibly imagine a physician being so incompetent. It really feels like he was the contrarian Ivermectin proponent of his time. This is an interesting read: https://en.wikipedia.org/wiki/Walter_Jackson_Freeman_II#Medical_practice https://en.wikipedia.org/wiki/Walter_Jackson_Freeman_II#Medi...
- chasil 3y ago
  You must understand that families of these times endured the mentally ill with no hope of improvement for the entirety of their lives. Yes, reading the article makes me gasp with the information and experience that is enabled by a century of neuroscience, but people in that period had no such option. The particular subject of the article, a normal child who was lobotomized by a "wicked stepmother" (who later rendered him homeless), was enabled by profound medical malpractice. The surgeon cannot have doubted that the child was completely normal, and the procedure uncalled-for, equivalent to performing a triple bypass on a healthy heart. Even in modern epilepsy, there is sometimes recourse for "resective surgery" in the hope of quelling seizures, but this is far more informed and exact than the subject of this article. Unfortunately, it had to start somewhere. https://en.m.wikipedia.org/wiki/Epilepsy_surgery https://en.m.wikipedia.org/wiki/Epilepsy_surgery
  - clnq 3y ago
    Thanks for some nuanced thoughts. I do understand the usual arguments for these surgeries at the time, which often overlap with arguments for why Freeman should have been absolved of accountability for his actions: Other methods were not available, the broader medical community did not seem to object, the medical standards were less developed, it was more acceptable for physicians to experiment and learn as they went, some good came out of it, and Freeman did seem to believe in the efficacy of the procedures. Some of these arguments are stronger than others. Freeman's showmanship (including a death of a patient for a photo-op in the middle of a surgery), and refusal to wear sterile gloves were against medical standards at the time. The broader community was misinformed, as anecdotal evidence of successful procedures was spread by supporters of the procedure, while the atrocious consequences of it were under-reported. Freeman believing that the procedures were effective is difficult to disprove, but we know that such an assumption depends on veracity of a man who has shown to not be a trustworthy professional, and we do know that Freeman knew that the majority of his procedures had significant negative consequences. Some good came out of not only Freeman's work, but also work of the regime-aligned Nazi scientists, especially in the fields of birth control, medical imaging, and aerospace; and this very extreme case illuminates that invention doesn't always justify the means. The argument about the evolution of medicine in the US is more convincing - indeed, the current evidence-based medical approach evolved over time from a much more experimental one. This can be seen in the change of Hippocratic oaths medics would take throughout history. The argument for no better treatment being available is also a strong one - we have a framework around compassionate use or compassionate access to experimental treatments when nothing else is available today. But overall, the arguments, except for a few, are weak with hindsight. It is important to acknowledge that Freeman faced no repercussions for his actions while he was alive - neither legal nor the widespread moral condemnation he is associated with today. People truly did not know what to make of it. But I ask - if a crime against humanity is committed but it takes humanity some time to recoil and it goes unpunished, is it not a crime? It's definitely a very interesting topic. I personally don't believe that Freeman didn't know what he was doing, or that he had no reason to know his work was unethical. A man of his age and education shouldn't be as naive. It's more difficult to blame the families, though in this case, the memoir and other recollections do say that the stepmother was probably motivated by a hatred for her son.
euos 3y ago
[flagged]
- iancmceachern 3y ago
  I was told by a leader and pioneer in the radiotherapy space that he believed that in 10 years we would view radiation therapy like this, caveman technology with a big blunt hammer. He believes biologics will take over. If you dig into them, radiotherapy is largely archaic 60s and 70s technology other than a few shining g stars like Proton Therapy, etc. Look at the gammaknife for God's sake: https://en.m.wikipedia.org/wiki/Radiosurgery https://en.m.wikipedia.org/wiki/Radiosurgery Even the big fancy new Cyberknife, etc. were all designed and architected decades ago and are relics of another age.
  - euos 3y ago
    I always thought radio was less damaging overall. I had been a caregiver for a family member with cancer and I recall radiation was causing burns, nausea, fatigue - but chemo was 100x all that. Chemo accumulates over weeks (she had one session/week) - first month is "ok, we will make it through it". Then it becomes unbearable.
    - iancmceachern 3y ago
      Agreed. I hope chemo gets replaced by biologics too
- spondylosaurus 3y ago
  Do you refer to all medical procedures as "mutilation," or just the ones that trans people get?
  - euos 3y ago
    1950s: "This teenager girl is "hysterical", let's put an ice pick through her eye socket" 2020s: "This teenager girl is depressed, lets cut off her breasts and pump her full of testosterone"
fuzzfactor 3y ago
It's not only the alcoholics that used to say "I'd rather have a bottle in front of me than a frontal lobotomy".
telesilla 3y ago
An author I admire greatly, Janet Frame, has a brush with this - "After a suicide attempt she spent eight years in mental hospitals in New Zealand, receiving 200 electroshock treatments. She was about to have a lobotomy when a hospital official read that she had won a literary prize. She was released. Later, a panel of psychiatrists determined that she had never had schizophrenia.. she was not mentally ill, just different from other people." https://www.nytimes.com/2004/01/30/books/janet-frame-79-writer-who-explored-madness.html https://www.nytimes.com/2004/01/30/books/janet-frame-79-writ... Her book Faces in the Water describes the experience, it's chilling.

92 points by Red_Tarsius 3y ago

I wonder if medical journals took their origins from this tragedy. I also wonder if it's still a viable treatment for the violently suicidal.

vore 3y ago
Given that lobotomy was putting a large needle in someone's eye socket and swinging it around in their brain to destroy a bunch of tissue at random, I would hope not.
burnished 3y ago
It was never a viable treatment. It was a horrorshow inflicted on the powerless and inconvenient.
- tetris11 3y ago
  The article gives one case where it had the desired outcome. Indeed it is just one, but given how it was administered willy-nilly for all kinds of ailments, it does make one wonder if the other violent suicidal cases had improvements.
  - vore 3y ago
    I would think we know more about the brain now to have better treatments than random stabbing. Would you like to get stabbed literally randomly in the brain to treat suicidal tendencies?
    - tetris11 3y ago
      Good question. In much the same way that cancer patients literally have to poison themselves with chemo drugs to fight a greater ailment with sporadic success rates, I'd argue that if there was no other alternative and that the road I was on would lead to a violent death, then... yes?
      - vore 3y ago
        I don't know why you are so insistent on this. With chemotherapy, we have literally have so much empirical evidence that the benefits far outweigh the risks. We understand the mechanism of action of chemotherapy enough to assess its risk profile. With lobotomies, we understand enough about the brain now to know that the risk profile is extremely bad. Additionally, empirical evidence has shown that outcomes are pretty bad anyway! We have better tools and ways to understand the brain now to not give people a brain-destroying "treatment" that is basically a random, low chance of success. Would you reasonably prescribe getting shot in the head as a treatment if it had worked on one person?
        tetris11 3y ago
        (Sorry, I'm not trying to be beligerent, only to keep an open mind.) It's kind of why I wanted to know more about the stories of the people the procedure worked for, just in case there really is some evidence it provides a benefit in some niche category. Though, yeah, I'm not betting on it.
        burnished 3y ago
        You aren't wrong to be curious, but you are going to get unhelpful and emotional answers when asking about this. You should genuinely read the wikipedia page on this topic: https://en.m.wikipedia.org/wiki/Lobotomy https://en.m.wikipedia.org/wiki/Lobotomy it will answer your questions and reveal the horror of what you are asking about and why people respond the way they do. To sum up though; the procedure was mostly performed on women and children, who were also frequently not aware of what was being done to them (not consenting), on men it was mostly performed on homosexuals. The best case outcomes came at the cost of 'decreased psychic complexity', a sort of 'permanent childhood'. The worst cases don't bear repeating here. I would also like to caution you, when reading on this, note whose voice is present; is it ever the subject who reports positive outcomes?
  - burnished 3y ago
    No, the article gives one case where someone had reported success, do we get the words of the person who had the spike in their brain? I would caution you against assuming best intent in this context because describing her as being at peace.. it describes some one as going from difficult to control to compliant. We don't have reason to believe it was a miracle cure, except possibly from the perspective of her caregivers.

isoprophlex 3y ago

That reminds me of the deeply troubling lobotomy storyline in Bojack Horseman. 2500 lobotomies by a single doctor. Makes you wonder how many were used to conveniently silence difficult people -- people whose mental illnesses were seen to be a burden to their surroundings. https://medium.com/the-dot-and-line/we-need-to-talk-about-bojack-horseman-season-4s-most-shocking-scene-2d9f2ff9bf45 https://medium.com/the-dot-and-line/we-need-to-talk-about-bo...

kelseyfrog 3y ago
ABA gets much the same criticism today.

BossingAround 3y ago

Absolutely insane, that someone believes that randomly destroying parts of the brain will "cure one's depression", or other illnesses (like mental health issues or migraines). This is an insanely depressing read.

quickthrower2 3y ago
Snake oil! He had to believe it to make money.
bowsamic 3y ago
[flagged]
- gus_massa 3y ago
  From Wikipedia: > by 1951, almost 20,000 lobotomies had been performed in the United States > On average, there was a mortality rate of approximately 5% during the 1940s. > He described one 29-year-old woman as being, following lobotomy, a "smiling, lazy and satisfactory patient with the personality of an oyster" who could not remember Freeman's name and endlessly poured coffee from an empty pot. It helped in many cases, but it was bad in many cases. I'd like to see an statistic and also read carefully what is the definition of a "success" case.
- 221qqwe 3y ago
  Define worked. Turning a 'violently suicidal' person into a zombie might seem like a success from the perspective of those who have to live with/take care of them/etc. Then again euthanasia should also be very effective if that's your only goal.
- BossingAround 3y ago
  Yes; in the article, there were some lucky cases, some not so lucky: > Anna Ruth Channels suffered from severe headaches and was referred to Freeman in 1950. He prescribed a transorbital lobotomy. The procedure cured Channels of her headaches, but it left her with the mind of a child, according to her daughter, Carol Noelle. On the whole, I'd say it's an utterly barbaric, even idiotic, procedure. As I said, believing that random tissue damage has "healing properties" is so idiotic I cannot believe it. At least if it was specific to some parts of the brain, e.g. "for depression, destroy this part of the brain," it'd be a bit more understandable (not by much though).

davidthewatson 3y ago

To the credit of the poor adjunct who taught my freshman psych 101 course in college, and assigned reading Thomas Szasz as part of it, what I've learned is that Thomas Szasz, while outspoken, was not wrong: https://www.google.com/books/edition/Coercion_as_Cure/hYdLS6qyTwUC?hl=en&gbpv=1&dq=cerebral+spaying+&pg=PA151&printsec=frontcover https://www.google.com/books/edition/Coercion_as_Cure/hYdLS6...

CafeRacer 3y ago

Technically, if you think about that, we're doing neurosurgeries to remove parts of the brains when necessary. I could imagine that severing the connection between lobes could affect someone's mental state in a positive way. However, 2500 surgeries, some of them with great results, some of them resulted in deaths and many in between. It's a game of chances, not a science. Seems like this dude did not understand what is it exactly he is doing and randomly poked holes in people hoping it would work. It would have been interesting to read a journal of someone who had the procedure.

Mistletoe 3y ago
I’m reminded of this article. There are very rarely placebo surgeries done, so it is an entire arm of medicine that is running wild without proper controls being done. https://www.skepdoc.info/ian-harris-on-surgery-the-ultimate-placebo/m https://www.skepdoc.info/ian-harris-on-surgery-the-ultimate-... If you’ve had a lobotomy surgery, you have a huge tendency to believe it maybe did something positive. An interesting study would have been just tell people that they had a lobotomy. If I had to guess, I bet the success rate would be much higher that actual lobotomy.
- jprete 3y ago
  You’re writing as though lobotomy is a legitimate procedure that might be a placebo, instead of a nonsensical operation of random brain destruction.
belk 3y ago
I think the only think he knew was that he was offering a procedure to turn problematic family members into vegetables, that was the whole business model

quickthrower2 3y ago

Lobotomy, or attempted murder by a stepmother? Hard to guess.

xattt 3y ago

> As those who watched the procedure described it, a patient would be rendered unconscious by electroshock. This makes me think that something akin to electroconvulsive therapy would have caused remission.

smeej 3y ago
Electroshock therapy was also a common treatment for mental illness. My grandma received it several times...to try to deal with her emotions about my abusive alcoholic grandfather. For as much as older generations criticize Millennials and Gen Z for being "snowflakes," I'm not sure my grandma's "Greatest Generation" actually handled things better.
- bowsamic 3y ago
  Electroshock therapy is still common in some places, such as Australia
  - defrost 3y ago
    FWiW modern ECT is much much milder than 1960s light dimming electroshock treatments. https://www.healthdirect.gov.au/electroconvulsive-therapy-ect https://www.healthdirect.gov.au/electroconvulsive-therapy-ec...
    - funnym0nk3y 3y ago
      It's still highly controversial. Effects don't last that long (long enough though to get someone out of debilitating depression or mania and time for proper treatment) and need repeated courses to sustain. There are still issues with memory, where one looses maybe a few days, but also could loose years.
  - coolvision 3y ago
    novadays it's done with general anesthesia and muscle relaxants, so it is quite different from what people know from the movies. good ted talk about it: https://www.ted.com/talks/sherwin_nuland_how_electroshock_therapy_changed_me https://www.ted.com/talks/sherwin_nuland_how_electroshock_th...

Borrible 3y ago

After Rosemary was mildly sedated, "We went through the top of the head," Dr. Watts recalled. "I think she was awake. She had a mild tranquilizer. I made a surgical incision in the brain through the skull. It was near the front. It was on both sides. We just made a small incision, no more than an inch." The instrument Dr. Watts used looked like a butter knife. He swung it up and down to cut brain tissue. "We put an instrument inside", he said. As Dr. Watts cut, Dr. Freeman asked Rosemary some questions. For example, he asked her to recite the Lord's Prayer or sing "God Bless America" or count backward... "We made an estimate on how far to cut based on how she responded." When Rosemary began to become incoherent, they stopped. https://en.wikipedia.org/wiki/Rosemary_Kennedy https://en.wikipedia.org/wiki/Rosemary_Kennedy

dav_Oz 3y ago
If you have a hard time understanding what type of rigor thinking guided this; one on-the-fly "theory" from Freeman is offered by the wiki article on lobotomy[0]: Walter Freeman coined the term "surgically induced childhood" and used it constantly to refer to the results of lobotomy. The operation left people with an "infantile personality"; a period of maturation would then, according to Freeman, lead to recovery. In an unpublished memoir, he described how the "personality of the patient was changed in some way in the hope of rendering him more amenable to the social pressures under which he is supposed to exist." He described one 29-year-old woman as being, following lobotomy, a "smiling, lazy and satisfactory patient with the personality of an oyster" who could not remember Freeman's name and endlessly poured coffee from an empty pot. When her parents had difficulty dealing with her behaviour, Freeman advised a system of rewards (ice cream) and punishment (smacks). [0]https://en.m.wikipedia.org/wiki/Lobotomy https://en.m.wikipedia.org/wiki/Lobotomy
- mynameishere 3y ago
  I like how lobotomies ended, not because the professionals decided to quit being barbaric, but because Thorazine got you the same results on a subscription basis.
  - 3y ago

phatskat 3y ago

Behind the Bastards has a good couple episodes about Walter Freeman[1]. If you want a good review of exactly how fucked up lobotomies are and what kind of person decides “yeah I could jam an ice pick in a brain”, take a listen. [1] https://spotify.link/rS6ePKIXvDb https://spotify.link/rS6ePKIXvDb

jdietrich 3y ago

We're still doing psychosurgery - far more precise and advanced than Freeman and Watts's lobotomies, but not fundamentally different. Today the most common targets are in the cingulate gyrus rather than the prefrontal cortex, but we're still basically cutting or burning out bits of brain. It has become comparatively rare due to the wide array of treatment options now available for severe mental illness, but psychosurgery may still be the least-worst option for people with debilitating and intractable depression, OCD or chronic pain where all other treatments have failed. Freeman was undoubtedly a cowboy, but his poor practice has warped our understanding of psychosurgery. Freeman didn't invent the lobotomy and was widely condemned by many of his contemporaries, including his former surgical partner James Watts. We overlook the extraordinary suffering caused by severe mental illness and forget just how few treatments existed prior to the great pharmaceutical revolution of the 1950s. Freeman's more conservative contemporaries were, for the most part, responsible clinicians trying to do their best for patients who were experiencing unbearable suffering and had no better options. https://en.wikipedia.org/wiki/Psychosurgery https://en.wikipedia.org/wiki/Psychosurgery

goodluckchuck 3y ago
That’s horrifying.
bigger_inside 3y ago
Before we make idealizing comparisons between "barbaric pasts" and seemingly enlightened presents (the "arrogance of the present" in which we assume that whatever we do now is knowledgable, good, just, right, at the end point of progess), let's remember that today's "medications" were largely chance discoveries, where the "chance" consisted of the recognition that they would calm patients and make them more manageable - and in this light, they were praised, in their time, as "chemical lobotomy". Joanna Moncrieff makes this explicit in her book, "The Bitterest Pills". Also elaborated on here: https://www.psycovery.com/images/Postpsychiatrys-challenge-Olga-Runciman-2013.pdf https://www.psycovery.com/images/Postpsychiatrys-challenge-O... We're still doing the same thing, just without knives (and, as the comment noted, often also WITH knives).
- 3y ago

cj 3y ago

> Newspapers described it as easier than curing a toothache. In a way, it's comforting to know that newspapers back in the 1950's were as susceptible to BS as modern day TikTok influencers. Maybe the technology / form factor isn't the underlying issue afterall.

bigger_inside 3y ago
> In a way, it's comforting to know that newspapers back in the 1950's were as susceptible to BS as modern day newspapers. fixed it.

emmelaich 3y ago

What terrifies me is the possibility of psychosurgery only removing the ability to express inner turmoil. Imagine the despair of a mind unable to express itself through voice or other action.

bmulcahy 3y ago
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questinthrow 3y ago

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funnym0nk3y 3y ago
Psychiatric diseases did exist thousands of years ago. OCD is a disease I know of. Yes, medication does not cure the underlying illness. And yes, it allows a patient to function in society. Which is, considering everything, a good thing. Being so depressed that you are bed ridden and your body hurts, or so agitated that you could not sleep for days puts a temporary chemical lobotomy in relation.
221qqwe 3y ago
> inhumane society we have now Arguably still more 'humane' than it ever was.
- deleted 3y ago
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boringuser2 3y ago

There's a lot to be morally repulsed by in this article, but shockingly little scientific discussion of the actual procedure. Kind of feels like a "wow, just wow" article.

clnq 3y ago

There's a memoir Dully co-authored and published not too long after this article. There was also another article where, if memory serves me right, where he spoke about what it felt shortly after the lobotomy. Although I might be misremembering and it could also be another patient's account. Regardless, it is horrific. Another atrocity is the reason a Freeman colluded with a controlling and abusive step-mother to lobotomize her son. > According to Freeman's notes, Lou Dully said she feared her stepson, whom she described as defiant and savage looking. "He doesn't react either to love or to punishment," the notes say of Howard Dully. "He objects to going to bed but then sleeps well. He does a good deal of daydreaming and when asked about it he says 'I don't know.' He turns the room's lights on when there is broad sunlight outside." I cannot possibly imagine a physician being so incompetent. It really feels like he was the contrarian Ivermectin proponent of his time. This is an interesting read: https://en.wikipedia.org/wiki/Walter_Jackson_Freeman_II#Medical_practice https://en.wikipedia.org/wiki/Walter_Jackson_Freeman_II#Medi...

chasil 3y ago
You must understand that families of these times endured the mentally ill with no hope of improvement for the entirety of their lives. Yes, reading the article makes me gasp with the information and experience that is enabled by a century of neuroscience, but people in that period had no such option. The particular subject of the article, a normal child who was lobotomized by a "wicked stepmother" (who later rendered him homeless), was enabled by profound medical malpractice. The surgeon cannot have doubted that the child was completely normal, and the procedure uncalled-for, equivalent to performing a triple bypass on a healthy heart. Even in modern epilepsy, there is sometimes recourse for "resective surgery" in the hope of quelling seizures, but this is far more informed and exact than the subject of this article. Unfortunately, it had to start somewhere. https://en.m.wikipedia.org/wiki/Epilepsy_surgery https://en.m.wikipedia.org/wiki/Epilepsy_surgery
- clnq 3y ago
  Thanks for some nuanced thoughts. I do understand the usual arguments for these surgeries at the time, which often overlap with arguments for why Freeman should have been absolved of accountability for his actions: Other methods were not available, the broader medical community did not seem to object, the medical standards were less developed, it was more acceptable for physicians to experiment and learn as they went, some good came out of it, and Freeman did seem to believe in the efficacy of the procedures. Some of these arguments are stronger than others. Freeman's showmanship (including a death of a patient for a photo-op in the middle of a surgery), and refusal to wear sterile gloves were against medical standards at the time. The broader community was misinformed, as anecdotal evidence of successful procedures was spread by supporters of the procedure, while the atrocious consequences of it were under-reported. Freeman believing that the procedures were effective is difficult to disprove, but we know that such an assumption depends on veracity of a man who has shown to not be a trustworthy professional, and we do know that Freeman knew that the majority of his procedures had significant negative consequences. Some good came out of not only Freeman's work, but also work of the regime-aligned Nazi scientists, especially in the fields of birth control, medical imaging, and aerospace; and this very extreme case illuminates that invention doesn't always justify the means. The argument about the evolution of medicine in the US is more convincing - indeed, the current evidence-based medical approach evolved over time from a much more experimental one. This can be seen in the change of Hippocratic oaths medics would take throughout history. The argument for no better treatment being available is also a strong one - we have a framework around compassionate use or compassionate access to experimental treatments when nothing else is available today. But overall, the arguments, except for a few, are weak with hindsight. It is important to acknowledge that Freeman faced no repercussions for his actions while he was alive - neither legal nor the widespread moral condemnation he is associated with today. People truly did not know what to make of it. But I ask - if a crime against humanity is committed but it takes humanity some time to recoil and it goes unpunished, is it not a crime? It's definitely a very interesting topic. I personally don't believe that Freeman didn't know what he was doing, or that he had no reason to know his work was unethical. A man of his age and education shouldn't be as naive. It's more difficult to blame the families, though in this case, the memoir and other recollections do say that the stepmother was probably motivated by a hatred for her son.

euos 3y ago

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iancmceachern 3y ago
I was told by a leader and pioneer in the radiotherapy space that he believed that in 10 years we would view radiation therapy like this, caveman technology with a big blunt hammer. He believes biologics will take over. If you dig into them, radiotherapy is largely archaic 60s and 70s technology other than a few shining g stars like Proton Therapy, etc. Look at the gammaknife for God's sake: https://en.m.wikipedia.org/wiki/Radiosurgery https://en.m.wikipedia.org/wiki/Radiosurgery Even the big fancy new Cyberknife, etc. were all designed and architected decades ago and are relics of another age.
- euos 3y ago
  I always thought radio was less damaging overall. I had been a caregiver for a family member with cancer and I recall radiation was causing burns, nausea, fatigue - but chemo was 100x all that. Chemo accumulates over weeks (she had one session/week) - first month is "ok, we will make it through it". Then it becomes unbearable.
  - iancmceachern 3y ago
    Agreed. I hope chemo gets replaced by biologics too
spondylosaurus 3y ago
Do you refer to all medical procedures as "mutilation," or just the ones that trans people get?
- euos 3y ago
  1950s: "This teenager girl is "hysterical", let's put an ice pick through her eye socket" 2020s: "This teenager girl is depressed, lets cut off her breasts and pump her full of testosterone"

fuzzfactor 3y ago

It's not only the alcoholics that used to say "I'd rather have a bottle in front of me than a frontal lobotomy".

telesilla 3y ago

An author I admire greatly, Janet Frame, has a brush with this - "After a suicide attempt she spent eight years in mental hospitals in New Zealand, receiving 200 electroshock treatments. She was about to have a lobotomy when a hospital official read that she had won a literary prize. She was released. Later, a panel of psychiatrists determined that she had never had schizophrenia.. she was not mentally ill, just different from other people." https://www.nytimes.com/2004/01/30/books/janet-frame-79-writer-who-explored-madness.html https://www.nytimes.com/2004/01/30/books/janet-frame-79-writ... Her book Faces in the Water describes the experience, it's chilling.