by jdietrich on 9/30/23, 12:26 PM
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
by isoprophlex on 9/30/23, 8:58 AM
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-bo...
by phatskat on 9/30/23, 11:56 AM
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
by clnq on 9/30/23, 10:27 PM
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#Medi...
by cj on 9/30/23, 12:52 PM
> 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.
by emmelaich on 9/30/23, 2:05 PM
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.
by telesilla on 10/1/23, 5:56 AM
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-writ...
Her book Faces in the Water describes the experience, it's chilling.
by BossingAround on 9/30/23, 9:51 AM
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.
by CafeRacer on 9/30/23, 10:04 AM
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.
by xattt on 9/30/23, 10:16 AM
> 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.
by davidthewatson on 9/30/23, 9:59 AM
by fuzzfactor on 9/30/23, 11:03 PM
It's not only the alcoholics that used to say "I'd rather have a bottle in front of me than a frontal lobotomy".
by quickthrower2 on 9/30/23, 10:14 AM
Lobotomy, or attempted murder by a stepmother? Hard to guess.
by boringuser2 on 9/30/23, 3:07 PM
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.
by Borrible on 9/30/23, 10:56 AM
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
by tetris11 on 9/30/23, 8:38 AM
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.