I Can Just Imagine Saying “lobotomies Are Bad” In Like 1949 And Having Someone Say “you’re Wrong,

I can just imagine saying “lobotomies are bad” in like 1949 and having someone say “you’re wrong, the science is settled, lobotomies are the best way to treat mental illness” and guess what? In 1949 I might be the unpopular and socially wrong one. The person with the backwards, conservative thinking. That is the year that António Egas Moniz won the Nobel Prize for lobotomies.

Lobotomies are still bad, but a lot of people have now understood that it’s a deeply harmful and anti-human practice. It was often performed on women (60% of cases were women in the US, a study in Ontario put women patients at 72%) and on gay men. Societal mores have changed on what is psychiatrically appropriate—many of these women were depressed and repressed housewives, or were not naturally submissive to their husbands and considered “combative”.

Many lobotomies were called “ice pick lobotomies” because they involved inserting an ice pick through the eye to sever the part of your brain that feels emotions. There were different techniques, largely dependent on which surgeon you saw. Norbert Wiener said in 1948, "Prefrontal lobotomy... has recently been having a certain vogue, probably not unconnected with the fact that it makes the custodial care of many patients easier. Let me remark in passing that killing them makes their custodial care still easier."

In 1944, the Journal of Nervous and Mental Disease ran an article saying, “The history of prefrontal lobotomy has been brief and stormy. Its course has been dotted with both violent opposition and with slavish, unquestioning acceptance."

Walter Freeman called the practice “surgically induced childhood”—he specialized in lobotomies and performed them until 1967, so he found this to be a good outcome. In fact, he worked on an “assembly line” process where he could lobotomies 20 people a day, and even did a surgical procedure face-off with another doctor in 1948 to compete in an operating theatre to show an audience of doctors that his technique was superior. The other professor was a professor at Yale, William Beecher Scoville, another famous lobotomist known for proliferating the procedure. They called it a miracle cure, and the gold standard for psychiatric treatment.

Scoville’s most famous patient, Henry Molaison, was a 7-year old boy with epilepsy after a fall from his bike. Scoville couldn’t find the problem, so he just destroyed all three regions of Henry’s temporal lobes. Afterwards, the surgeon noted memory loss “so severe as to prevent the patient from remembering the location of the rooms in which he lives, the names of his close associates, or even the way to the toilet or the urinal.”

Scoville’s wife sought psychiatric care after her husband cheated on her and she had a breakdown. Her husband lobotomized her himself.

In the 1960s, when schizophrenia became a radicalized charged diagnosis that was often used against Black people, especially those involved in the civil rights struggle. Walter Freeman did several pushes to lobotomize Black people, including as young as five, for “hyperactive and aggressive behavior”.

The practice continued in some places until the 1980s. It was used to treat schizophrenia, affective disturbance (mood disorders and people reacting in non-mainstream ways like being an opinionated woman or gay), and OCD, chronic neurosis (anxiety), psychopathic disorders, and depression, among other things. You may notice the old names for these things—things that we might not consider the same way now. Being gay was a mental disorder. Women who wanted independence or respect were often diagnosed. Not fulfilling your traditional societal role was a good way to end up institutionalized.

It was considered, at time of invention, to be an humane alternative to insulin comas and shock therapy (ECT). Many people considered it lifesaving and gold standard treatment for mental illness. Some reports believe that about a third of patients found the procedure beneficial. Others faced dementia, death, incontinence, inability to speak, paralysis, and other effects. Many people were unable to ever leave care again afterwards, though they were more complacent.

I don’t think any scientist who tells you that science is settled is a good scientist. I think that treatments that target people who don’t fit the mold of society, people who are countercultural, and people from marginalized groups should be especially criticized. Psychiatry is a very new field. Part of the phasing out of lobotomies had to do with the development of the first medications for psychiatric use—which in turn have had their own social, political, and ethical conundrums and misuse. Many could consider Valium (“mother’s little helper”) the spiritual successor to the lobotomy.

But in 1949, if I said lobotomies are bad—I might have been met with “Do you hate mentally ill people?” “It works great for most people!” “Without it, she will just be depressed and kill herself” or “My friend did it and all her problems seem better now”.

Lobotomies were bad the whole time.