Lobotomy

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A human brain that has undergone lobotomy.
A human brain that has undergone lobotomy.
Close up of "ice picks"
Close up of "ice picks"

A lobotomy (Greek: lobos: Lobe of brain, tomos: "cut/slice") is a form of psychosurgery, also known as a leukotomy or leucotomy (from Greek leukos: clear or white and tomos meaning "cut/slice"). It consists of cutting the connections to and from, or simply destroying, the prefrontal cortex. These procedures often result in major personality changes and possible mental retardation. Lobotomies were used in the past to treat a wide range of severe mental illnesses, including schizophrenia, clinical depression, and various anxiety disorders.

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In 1890, Dr. Gottlieb Burckhardt performed partial leucotomies on six patients of a psychiatric hospital in Switzerland. He drilled holes into their heads and extracted sections of their frontal lobes. One died after the operation, and another was found dead in a river 10 days after release (whether by accident, suicide, or crime is unknown). The others exhibited altered behavior.

Based on his research about brain function, the Portuguese physician and neurologist António Egas Moniz in 1936 developed a technique for leucotomy in humans. His method involved drilling holes in patients' heads and destroying the tissue connecting the frontal lobes by injecting alcohol into them. Moniz won the Nobel Prize for medicine in 1949 for this work. It was intended to give relief to patients who were hopelessly ill and severely agitated. The procedure was refined by British psychiatrists including Eric Cunningham Dax. Drs. Walter Freeman and James W. Watts refined Moniz's procedure, brought the surgery to the US, and changed its name from leucotomy to lobotomy.

Freeman later developed a simplified procedure to reach frontal lobe tissue through the tear ducts. In his trans-orbital lobotomy, he used a mallet to force a thin surgical instrument through the thin layer of skull at the top of the eye socket. The pick was then moved to sever connections between the frontal lobes and rest of the brain. Because of the appearance of the instrument, it was termed an "ice pick lobotomy." This technique could be performed in a doctor's office rather than in an operating room, and required only a few minutes to perform. Watts sharply disagreed with him over using this procedure and their partnership ended.

Concerns about lobotomy steadily grew. Numerous countries, including Germany and Japan banned it, as did several U.S. states. Lobotomy was legally practiced in controlled and regulated U.S. centers and in Finland, Sweden, Norway (2005 cases[1]), the United Kingdom, Spain, India, Belgium and the Netherlands.

In 1977, the U.S. Congress created a National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery — including lobotomy techniques — was used to control minorities and restrain individual rights. It also investigated after-effects of the surgery. The committee concluded that some extremely limited and properly performed psychosurgery could have positive effects.

By the early 1970s the practice had generally ceased, but some countries continued small-scale operations through the late 1980s. In France, 32 lobotomies were performed between 1980 and 1986 according to an IGAS report; about 15 each year in the UK, 70 in Belgium, and about 15 for the Massachusetts General Hospital of Boston.[2]

Lobotomy procedures were done most frequently in the United States, where approximately 40,000 persons were so treated. Great Britain performed procedures on 17,000 people, and the three Scandinavian countries had a combined figure of approximately 9,300 persons treated.[3]

  • Rosemary Kennedy, the sister of President John F. Kennedy, was given a lobotomy when her father complained to doctors about the 23-year-old’s moodiness. Dr. Walter Freeman personally performed the procedure. Rather than any improvement, however, the lobotomy reduced Rosemary to an infantile mentality including incontinence. Her verbal skills were reduced to unintelligible babble. Her father hid the nature of Rosemary's affliction for years and described it as the result of mental retardation. Rosemary's sister Eunice Kennedy Shriver founded the Special Olympics in her honor in 1968.[citation needed]
  • Howard Dully had a lobotomy at 12, after his stepmother was simply tired of his "youthful defiance". At the age of 56 he said, "I've always felt different -- wondered if something's missing from my soul. I have no memory of the operation". Late in his life, Dully uncovered the story of his lobotomy. Crown Publishers published Howard Dully's memoir (co-written by Charles Fleming), My Lobotomy [1], in September 2007.[4][5]
  • New Zealand author and poet, Janet Frame was due to have a lobotomy because of a diagnosis of mental illness. She was saved from this procedure by receiving a literary award the day before her operation was to take place.

  • Article on the Lobotomy and its effects: ""Mental cruelty"", The Sunday Times, 2006-02-19. 
  • For an example of the personality changes associated with damage to the frontal lobe not related to a surgical leukotomy, see the famous case of Phineas Gage.
  • Elliot Valenstein, author of Great and Desperate Cures: The Rise and Decline of Psychosurgery and Other Radical Treatments for Mental Illness

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