What a Homemade Lobotomy Kit Can Teach Us

When I was in grade school…maybe eight or nine years old…I made myself a Homemade Lobotomy Kit. While I no longer have it to show you what it looked like, I’ve drawn a picture.

Yes, I colored the knife and gloves with red marker. And, yes, I remember being so proud of myself, although my parents were a little dismayed at my sudden creation.

In September, it came to my attention that Rosemary Kennedy–of the Kennedys–had a lobotomy in the late 40s. I was shocked. But it also brought back to me my own homemade lobotomy kit, and the realization that while I made fun of the act as a child, I actually knew very little about the procedure itself.

And so I set about to do a little research.

Lobotomies, for those who don’t know, are a surgical procedure in which a surgical instrument is inserted into a patient’s brain and a part (or parts) of the brain are severed or “scrambled.”

While lobotomies didn’t gain traction until the 1930s, a form of lobotomy has actually been around for millennia in the form of trepanning. Trepanning is the act of drilling a hole in the skull in an attempt to release evil spirits. There’s evidence of trepanning even in prehistoric man, and the National Center for Biotechnology Information states, “Trephination (or trepanation) of the human skull is the oldest documented surgical procedure performed by man.”

In 1890, a German scientist named Friederich Golz reported that when he severed the temporal lobe of some dogs, they became tame and calmer than before.

Lobotomies soon became the cutting edge of psychological science. And while I included a knife with my kit, actual lobotomies were performed using nothing more sophisticated than an ice pick or an ice-pick-like instrument, and sometimes a medical spatula.

The first person to perform a lobotomy on a human was Egas Moniz, a Portuguese neurologist. He believed that patients with certain mental illnesses were suffering from “fixed circuits in the brain.” By drilling a hole in the patient’s head and quite literally stirring around its contents, Moniz believed the patient would be cured of these recurring thought patterns.

American neurologist Walter Freeman liked Moniz’s results so much that in 1936, he brought the lobotomy to the United States. At this point, the state of mental health in America was abominable. Patients were locked up in asylums where they were neglected, beaten, sexually abused, restrained, and tortured. Lobotomies, even those that left the patient a vegetable, were seen as a humane alternative to life in an asylum.

Walter Freeman

Freeman toured the United States, teaching and performing thousands of lobotomies. In fact, he developed a new, quicker way to access the brain, called the “ice pick lobotomy,” in which he’d literally stick an ice pick against the patient’s temple and hit it with a hammer, slowly breaking through into the brain. With this technique, Freeman could perform more lobotomies in less time, and the patient would require no more than a local anaesthetic for the procedure. Once inside the brain, Freeman would sweep the pick from side to side, severing the frontal lobe from the rest of the brain.

Now, before we label Freeman a monster, keep in mind that while he may have been rather forward in pushing his “cure” onto the nation, he truly felt he was doing something good. He was searching for a solution to mental illness, and who’s to say what aggressive therapy we use today won’t be looked back on as barbaric and ineffective.

Remember that this was a time in which drug therapy–especially for mental illness–was not available. Physicians charged with taking care of the increasing number of mentally ill were asked to come up with a solution where none was easily found.

Lobotomies became so popular that between 1939 and 1951, more than 18,000 had been performed in the United States alone, and in 1949, Egas Moniz won the Nobel Prize.

In 1941, Rosemary Kennedy, sister to the soon-to-be President John F Kennedy, was forced into a lobotomy by her politically-motivated father.

Rosemary Kennedy

The true reasons behind Joe Kennedy’s decision to lobotomize his mentally disabled daughter can only be speculated, but they were no doubt motivated by Rosemary’s increasingly good looks and independent behavior. Shortly before World War II, the Kennedys moved to Britain for Joe’s career. While there, Rosemary attended a small Catholic school where she flourished.  When the Germans marched on Paris, however, the Kennedys returned to the United States. Taken from her happy life in England, Rosemary began to lash out. At one point, she left the convent where she was staying and was found wandering the streets in the dark. Fearing for her honor, and his sons’ chances at political office, Joe Kennedy made the decision to take his eldest daughter in for a lobotomy.

During the procedure, however, something went wrong. Rosemary lost consciousness. When she woke, she could no longer speak, read, write, or walk. She was secreted away to an institution where she spent months in rehab. The other Kennedys, including Rosemary’s mother, claimed to have been kept in the dark not only about the lobotomy but also its severe consequences.

After Joe Kennedy’s stroke in 1961, their sister’s true fate was revealed to the family, and from that point on, the Kennedys took up the cause of the physically and mentally disabled. As President, JFK signed what would become the precursor to the Americans With Disabilities Act, and Rosemary’s younger sister Eunice helped found the Special Olympics.

By the mid 1950s, lobotomies rapidly fell out of favor, partly because of poor results and partly because of the introduction of the first wave of effective psychiatric drugs. But for the victims of the lobotomy, the scars remain.

Image from Journey to Optimal Health

Besides the utter weirdness of my homemade lobotomy kit, why is it important to remember the horrific (and horribly misguided) history of the lobotomy?

Following the horror of lobotomies, many ethical standards were put in place, including the need to consider less invasive measures first, a patient’s ability to provide full consent, the procedures safety and efficacy, and the risk of adverse changes to a patient’s personality post procedure. In addition, further guidelines have encouraged multidisciplinary collaboration in treatment, post operative support, and the awareness of potential conflicts of interest among those involved in care.

Like it or not, Walter Freeman helped found the field of psychosurgery. His legacy remains not only the ethical quandaries raised by his actions, but also what we learned, and have subsequently developed, in response to those quandaries.

Do you believe Freeman was a monster? Comment below!

Resources used for this post:

BBC Magazine, Cerebromente, NCBI, All That’s Interesting, The JNS

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