Neurologist Walter Freeman strapped 29-year-old Ellen Ionesco to the operating table and delivered coma-inducing jolts of electroshock to her brain. Depressed, manic, violently suicidal, Ionesco was just the sort that was thought to benefit from traditional shock therapy—only Freeman wanted to do more than just shock her.¹

Holding an ice pick to Ionesco’s tear duct, the doctor began chiseling into her eye socket. With an audible crack the thin layer of bone separating Ionesco’s brain gave way, and the ice pick sunk deep into her frontal lobe. Freeman then swished the metal rod back and forth, severing the neural pathways he believed were the root of Ionesco’s illness.¹

This was in 1946 people. “Ain’t Nobody Here But Us Chicken’s” was tearing up the jukebox charts. Future sitcom legend Ed O’Neil was born amid thunderous hooting and canned applause. And Walter Freeman, who would go on to perform thousands of similar operations in the coming years, was well on his way to garnering one of the more sinister nicknames in modern medicine—The Ice Pick Lobotomist.

Lobotomy: A surgical operation where connections between the frontal lobes and the rest of the brain are cut in order to alleviate mental illness.²

Here’s a fun experiment. Tell your friend you’re going to give them a lobotomy. Tell ’em you just read this great article in O Magazine and you’re convinced this simple procedure is the only way to cure their mild anxiety / seasonal depression / Game of Thrones withdrawal. “Yessss,” they will say, “sure thing buddy,” as they slowly back out of the room and your life forever. You see, the very concept of a lobotomy seems so barbaric that modern man, with his vape cigarettes and vegan cheese substitutes, simply cannot fathom it.

But in the 1940s, a mere Ed O’Neil’s lifetime ago, lobotomies were cutting edge psychiatric therapy. By severing connections in the frontal lobe, many believed they could also sever the connections between a mentally ill person’s thoughts, and the intense negative emotions associated with them.² And what’s even weirder is it sometimes worked.¹

Freeman’s surgeries were so brutal to behold that during one filmed screening at a Bristol high school 5 students fainted and had to be dragged out¹…care to see for yourself?

After Ellen Ionesco’s surgery, her depression and suicidal thoughts vanished completely. She was able to hold down a job, take care of her daughter, and actually lived a long healthy life.¹ In fact Freeman, who kept tabs on nearly all his 3,000+ patients,³ claimed that 40% of the state hospital patients he operated on were later released.⁴

But success was hard to predict. A botched lobotomy by Freeman left JFK’s sister Rose Kennedy with the mental capacity of a 2 year old.¹ Another experiment permanently shattered the mind of a 6 year old child, who was left “gazing into space…rocking back and forth, showing no affection for anybody.”¹ In case you’re wondering by the way, the youngest lobotomy patient in the US was only 4 years old!⁵ And you thought giving grade schoolers Ritalin was crazy.

Your frontal lobe is the command centre of your brain. If you’re anything like Dave from the movie Meet Dave and your brain is controlled by a tiny version of yourself (played by Eddie Murphy), this is where you sit. Mess with your frontal lobe, and you mess with your ability to plan and self-motivate. If you damage a troubled person’s frontal lobe, they might stop caring about what’s troubling them, but they could just as easily stop caring about their appearance, their job, their family. And they often did.

But don’t take my word for it. “Rose is a smiling, lazy and satisfactory patient with the personality of an oyster,” Freeman cheerfully notes in one post-lobotomy follow up, “She pours and pours from an empty coffee pot. She can’t remember my name.”²

Ummmm “personality of an oyster?!” “Pours from an empty coffee pot?!” If brain surgery turned someone you cared about into a memory impaired mollusk you’d be pissed. It’s hard for us today with our newfangled conceptions of “medical ethics” and “human rights” to understand how a brain surgery that literally damages your brain and dulls your personality could be seen as a good thing.

What you’ve got to understand is that psych hospitals in Freeman’s day were seriously overcrowded.¹ We’re talking Tokyo subway overcrowded here. And once you were committed there was very little psychiatrists could actually do for you. People were desperate for any treatment that could restore even a small amount of function to the locked up and hopeless. If surgery got Rose out of four point restraints and back to her family Freeman would argue that’s a good thing.

But you have to wonder who benefitted more, the patients or the caregivers?

In any case, frontal lobotomies grew quite popular in the 40s and 50s, with around 100,000 lobotomized worldwide over that period.⁶ And Freeman’s maniacal zeal for slicing open peoples’ brains played no small part in the procedure’s success.

He took pains to portray lobotomy as a simple, quick, and painless operation. And the popular press followed suit. “Brain operation to cure worry,” wrote The Brisbane Worker.⁷ In 1941 the Associated Press called the procedure a “personality rejuvenator” that cuts the brain’s “worry nerves,” and “is only a little more dangerous than an operation to remove an infected tooth.”¹ Another story claimed it’s less painful than “having a corn removed from your little toe.”¹

You didn’t need to be a brain surgeon to do an ice pick lobotomy, Freeman claimed.¹ Any two bit field psychiatrist capable of hanging his own wall art was more than qualified. And at a mere 10 minutes in length,⁸ the whole operation is over in less time than it takes Mr. Bean to shame himself in a public pool.

But there was something about the doctor’s casual attitude towards brain surgery that rubbed medical folks the wrong way. For starters, he wasn’t even a brain surgeon. He actually had no formal training in surgery.¹ But what he lacked in credentials, he more than made up for in bizarre theatrical antics—like using a regular carpenter’s hammer in lieu of a surgical mallet, or nailing two ice picks at once.¹

Student nurse Patricia Derian described her experience watching Freeman as a living nightmare, “I thought I was watching a circus act.”¹ There are numerous tales of doctors fainting as Freeman operated,⁹ and one report of a nurse who was so disgusted with Freeman’s work that she quit medicine entirely.¹

Still, other psychiatric treatments in Freeman’s time were just as queasy. Insulin shock therapy saw psychiatrists forcing patients into medically induced hypoglycemic comas for months on end.¹⁰ Metrozol shock therapy, elecroshock’s primitive cousin, involved medically induced seizures so severe they caused spine fractures 43% of the time!¹¹ In these cases, the idea was to “shock” the patient out of insanity, much in the way a well timed BOO! can cure your hiccups.

Ultimately lobotomy’s deathblow came not from some grand ethical awakening, but from Thorazine, a powerful anti-psychotic that was initially advertised as a “chemical lobotomy.”¹ At least you didn’t have to crack open someone’s brain, but Thorazine was no beach picnic, with all sorts of evil sounding side effects like akathisia, dystonia, and irreversible tardive dyskinesia.

Compared to a frontal lobotomy, psychiatric drugs were just way more efficient to administer. Even 1,000 Walter Freemans amped up on Rockstar Energy beverages lobotomizing without sleep for months on end couldn’t come close to matching the power of Thorazine.

This should have been obvious to Freeman. But no! He stubbornly insisted this whole drug thing was just a passing fad until his death in 1972.¹² “They’ll be back,” Freeman presumably scowled from his window, as the last lobotomy patient (again I’m presuming here) shuffled away in his hospital gown towards a complimentary Thorazine IV drip.

Perhaps someday brave microscopic robots will roam the inner reaches of our brains, zapping away misfiring neurones before we even notice a problem. Is this really so far fetched? After all we don’t give our cars drugs when they’re acting funny. We don’t shove klonopin tablets into our laptops when they freeze up. If scientists can actually pinpoint brain abnormalities that cause mental illness, why shouldn’t they go in there and fix them? But maybe don’t use an ice pick next time. Just sayin’.

Sources:
1. El-Hai, J. (2005). The lobotomist: A maverick medical genius and his tragic quest to rid the world of mental illness. Hoboken: John Wiley & Sons, Inc.
2. Raz, M. (2013). The lobotomy letters: The making of American psychosurgery. University of Rochester Press.
3. Freeman, W. (1957). Frontal Lobotomy 1936-1956 A follow-up study of 3000 patients from one to twenty years. American Journal of Psychiatry, 113(10), 877–886.
4. Freeman, W. (1958). Psychosurgery; present indications and future prospects. California Medicine, 88(6), 429–434.
5. Lutz, P. L. (2002). The Rise of Experimental Biology: An Illustrated History. Humana Press.
6. Knowles, S. (1974). Beyond the Cuckoo’s Nest: A Proposal for Federal Regulation of Psychosurgery.
7. Brain Operation To Cure Worry. (1945, October). Worker (Brisbane, Qld. : 1890 – 1955). Retrieved from http://nla.gov.au/nla.news-article71460390
8. Tranøy, J., & Blomberg, W. (2005). Lobotomy in Norwegian psychiatry. History of Psychiatry, 16(61 Pt 1), 107–110. http://doi.org/10.1177/0957154X05052224
9. Youngson, R., & Schott, I. (2012). A Brief History of Bad Medicine. Running Press Book Publishers. Retrieved from https://books.google.ca/books?id=-5MmYAAACAAJ
10. Braslow, J. (1997). Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century. University of California Press.
11. P, P., MM, F., MM, H., & WA, H. (1939). Vertebral fractures produced by metrazol-induced convulsions: In the treatment of psychiatric disorders. Journal of the American Medical Association, 112(17), 1684–1687. http://doi.org/10.1001/jama.1939.02800170030010
12. Freeman, W. (1958). Psychosurgery; present indications and future prospects. California Medicine, 88(6), 429–434.