A Gluttony For Lobotomy
Despite Growing Awareness of Side Effects The Press Positively Covers the Use of Psychosurgery to Treat a Wider Set of Conditions
The first lobotomy in the United States was performed in 1935 and was enthusiastically received by the press. Our study of New York Times coverage of lobotomy suggests that nine years after the first lobotomy, there were two significant developments.
First, there was an eagerness to prescribe lobotomy to treat a greater set of conditions, and secondly, a growing discussion of lobotomy’s side effects. In the first case this included using lobotomies to relieve pain and even to discard criminal tendencies.
This period, which we call Lobotomy in Practice, starts in 1945 and ends in 1954. The introduction of lobotomy and other shock treatments allowed psychiatry to gain a foothold within the realm of medicine and establish the discipline as a “medical specialty” (Pressman). Before, this introduction and even up to the late 1940s few hospitals had psychiatric wards (Pressman).
Fighting For Legitimacy
The development of shock therapies made psychiatrists significant as these new approaches also gave hope that the misery in mental health institutions would finally end.
Across many places, shock treatments were often perceived to be innovative, and Sweden and Spain quickly began to prescribe lobotomies to treat patients (Valenstein, 1977). There were some doctors like Dr Stevenson who denounced that shock treatments were being used “uncritically” (Stevenson, 1947).
Despite his misgivings about the use of shock therapies, he lambasted the conditions inside mental hospitals and scolded the “dreadful mediocrity” of other treatment options. He called overcrowdedness a “universal evil” (Stevenson, 1947). Even those who urged caution had a difficult time suggesting other solutions.
Shock therapies were appealing because the issues of overcrowding and mental disease were seen as significant. Psychosurgery, and more specifically lobotomy, could appeal to both holists (thought there were holistic causes of disease) and localists (mental disease is localized in the brain) who could both interpret why the operation apparently succeeded through different perspectives and thus came to see it as a “valid approach” (Raz, 2013).
For Walter Freeman, it was also a tool to win the debate against Freudians and allegedly demonstrate that mental diseases had biological causes (Pressman, 1986). Freeman saw the success of lobotomy as necessary because otherwise psychiatry and psychiatric solutions would be seen as irrelevant (Pressman). Succeeding would provide psychiatrists and neurologists with the authority to speak across more domains.
These approaches looked scientific at a time when science was enjoying a position of privilege given the perception that nuclear weapons (and by extension science) were fundamental in winning the Second World War. This perception primed Americans trust in science and technology and their roles in overcoming challenges (Pressman, 1986). Shock therapies could be presented as technological solutions.
The Press and The Expansion of Lobotomy
During the Lobotomy in Practice period (1945–1954), The New York Times largely discussed lobotomy in a positive light. Nevertheless, articles in the Times, begin to make references to permanent personality changes which are portrayed as a “positive treatment response” (Diefenbach, 1999).
The increase in lobotomy’s popularity triggered more articles being written. An article titled, Knife Aids Mentally Ill, based on a Joint Committee of State Mental Hospitals study, reported that over 80% of patients benefited from lobotomy (NYT 6, 1947). In another article, Kampffert, a reporter at the Times, wrote that lobotomy “more or less freed” patients “from the disagreeable symptoms” (Kaempffert, 1948).
He claimed that there was “no doubt that the operation has benefitted most of those who have undergone it. Personalities that were once turned inward have been turned outward.” (Kaempffert, 1948).
A lobotomy would turn a “morbidly anxious man into a careless happy drone” (Kaempffert, 1948).
Another article in the Times, reported that Freeman planned to organize an international conference where they would discuss lobotomy’s potential to “correct emotional disorders and obsessions or to relief intractable pains”(WK 2, 1948).
In 1949, Egaz Moniz won the Nobel Prize in physiology. Freeman lobbied for Moniz to win (Harrington, 2019). The Times celebrated Moniz’s win in an article which stated that Moniz invented the lobotomy which was a “sensational operation justified itself”(NYT 13, 1949).
The Associated Press celebrated lobotomy in a two-page report that focused on the economic and medical gains in United States in 1947 (Associated Press 1947). The enthusiasm for lobotomy emboldened doctors to prescribe the operation to treat an increasing number of conditions.
Expanding the Therapeutic Range
The growing popularity of lobotomy coincided with an expansion of its therapeutic range. We introduce the idea of therapeutic range by which we mean that range of conditions that can be treated through a procedure. Diefenbach made no reference to the kinds of uses for which lobotomies were exploited (Diefenbach, 1999).
During this period (1945–1954), lobotomy was used to treat more and more conditions. By 1948, lobotomies were being used to treat, “worries, persecution complexes, suicidal impulses, obsessions, and nervous tensions”(NYT 13, 1949).
Shortly thereafter, there were attempts to use lobotomy for other purposes, such as behavior modification. Ruch, a reporter, said that a lobotomy had been used in “the hope turning a morally degenerate woman into a useful member of society”(Ruch, 1946). Ruch claimed the operation worked and that the woman became more relaxed, more composed emotionally, and friendly and sociable(Ruch, 1946).
Lobotomies offered a return to normalcy for those with mental diseases, it was claimed it would allow them to be productive members of society. Further, the promise of eliminating criminal impulses through psychosurgery captivated the imagination of doctors and even some criminals themselves.
Cutting Brains, Cutting Crime Rates
Frank Di Cicco, a convicted prisoner, requested and obtained a lobotomy to “to rid himself of criminal traits”(NYT 16, 1952). The fact that a prisoner made this request, a doctor performed this operation, and that they applied for parole even if it was rejected by the State, demonstrated that the idea that lobotomies could curtail criminal behavior was plausible.
Cicco’s physician advocated for him to get parole but the request was denied(NYT 16, 1952). We will cover Cicco’s story in a future post as he eventually was lobotomized.
In the same year, the Times reported yet another criminal who had a lobotomy. The paper reported that Millard Wright, “risked his life” to “cure an uncontrollable urge to steal” and the operation seemed to work as “Wright became a model prisoner” (NYT 17, 1952; NYT 18, 1952). Wright was lobotomized in 1947.
After three years on the outside, Wright was caught committing a crime and sent back to prison where he used broken glass from his spectacles to commit suicide (NYT 18, 1952). We will also be covering Wright’s story in the future.
These articles mention lobotomy and imply that it could perhaps effectively cut criminal tendencies. Even the articles about Wright emphasize he became a model prisoner and went “straight for three years” (NYT 17, 1952). Another article mentioned the murder of a Yale professor by Trent-Lyon, who had been recently lobotomized (NYT 15, 1950).
The manner in which the press covered these cases suggested that, even if not very successful, it was within the plausible that lobotomy could be used to curb future crime. Some staunch advocates of lobotomy claimed it would not fully eliminate such tendencies, but it would make incorrigible criminals less effective (Pressman, 1986).
Moreover, there were reports that the Soviet secret police had used a modified lobotomy to extract confessions from prisoners (NYT 14, 1950). The range of conditions for which lobotomies would be seen as useful would continue to expand and include pain management.
Doctors supposedly found that lobotomies could be used to reduce pain and the press celebrated it. This use of lobotomy was said to have “no undesirable after-effects on the mentality, intellectual capacity, or personality” and it even eliminated the need for narcotics (NYT 10, 1948).
The Issues With Lobotomy: Happy Productive Drones
The media’s coverage of both pain and crime started to pay attention to lobotomy’s side effects. However, newspaper articles overwhelmingly stress that lobotomies are still useful. W. L. Laurence, cited Dr White in his article which sought to establish lobotomy as the “best procedure known for relief of the mental as well as physical suffering that occurs certain cancers”(Laurence, 1950).
Laurence recognized that the surgery has side effects and that at “best, these individuals become childish, dull, apathetic, with little capacity for any emotional experience, pleasurable or otherwise”(Laurence, 1950). Despite these, Dr White insisted that the surgery was “justified in hopeless cases”(Laurence, 1950).
Another article which explored concerns about lobotomy provided counterarguments. This article discussed concerns that Swedish doctors have about the effects of lobotomy on IQ, but stated these were rejected by Freeman (NYT 7, 1947).
Some specialists were aware that mental deficit could occur yet these were preferred to constant pain (Lerner, 2011). Patients often said that they stopped suffering or that pain ceased to bother them(Lerner, 2011). The Times reported on attempts to develop better ways to assess the effects on those lobotomized through the use of finger painting(NYT 11, 1948).
Another article said that lobotomized patients may lose the power of abstraction (Kaempffert, 1948). Kaempffert cited Dr Goldstein who advocated for determining whether lobotomy does more harm than good. Yet, despite his apprehension, Dr. Goldstein stated that “In daily life the loss of the power of abstraction is easily overlooked…the family..is delighted”(Kaempffert, 1948).
Other doctors like Dr LH Smith acknowledged the need for cures for the masses; however, he thought lobotomies destroyed the faculties that separate man from the animals and therefore their use should “not be lightly assumed” (NYT 4, 1948). Within a year, Laurence would write another article, Big Advance Seen in Brain Surgery, where he would argue that a modified lobotomy results in the relief of pain without “impairment of the patients intellectual faculties”(Laurence, 1951).
Another critique covered by the Times was patient selection. Again, these articles questioned who was lobotomized rather than whether lobotomy was good. Some of the articles discussed modified lobotomy procedures like topectomies which were claimed to have no effect on personality, and make hopeless patients fit for discharge (NYT 8, 1948; NYT 9, 1948).
As far back as 1948, the Times covered Dr. Knight, “leading psychiatrist” attack on the “prostituted” methods of psychiatry which seek to have madness “beaten out” of patients(Freeman L4, 1948). The New Your State Medical Society echoed these criticisms and urged greater care in the selection of patients (Freeman L4, 1948). Knight opposed the overuse of these methods, rather than the methods themselves, which he claimed have their “place and purpose”(Freeman L4, 1948).
That same year, 1948, another article on the Times claimed that electroconvulsive shocks and lobotomies had cured patients with schizophrenia(NYT 12, 1949). The Times started to publish articles where doctors advocated for psychosurgery to be used as a last resort. One of their articles cited Dr Stecker who described psychosurgery as one of the “most controversial issues” (Freeman L5b, 1949).
Despite these apprehensions, Freeman would continue to draw attention to whether patients could return to work, which continued to be the main criterion for “internal standards of professional psychiatry” (Pressman, 1986). Lobotomy could help people be useful and restoring this ability, Freeman thought, was the most important measurement and the reason why they could claim legitimacy (Raz, 2013; Ilson, 1953). This probably resonated as it was congruent with “the belief in the values of productivity, industry and personal responsibility, were contributing factors to its success” (Raz, 2013).
Notably, the NYT did publish one article that reported that the Soviets were hugely critical of the practise of lobotomy. The article by Laurence described a speech given by Professor Oserezki, a Soviet scientist, in an International conference in Stockholm where he announced that the Soviet Union had banned lobotomies because it “does much harm and no good” (Laurence, 1953).
There is some evidence that psychosurgeries were perfumed at Moscow Medical Institute up to 1950 (Valenstein, 1977). The article about the Soviets has been described as largely critical of lobotomy; however, it is important to keep in mind that it highlights the views of Soviet scientists (Diefenbach, 1999). The Soviets argued that they saw lobotomy as “inhumane” (Laurence, 1953).
Laurence does discuss whether this is the correct view but does mention that the scientist is a Soviet. The Soviets were the bitter enemy in the Cold War. The article does mention that some European experts agreed with the ban but readers were probably more skeptical of a Soviet specialist than they would have been of an American one. Thus, while this article is rather critical, it is important to consider how it would have been read.
Efforts to Understand Lobotomy and its Effects
The following year, at the APA, Freeman announced that his ice-pick method eliminated a lot of the risks previously associated with lobotomy (Freeman L6, 1950).
Freeman would embark on Operation Icepick, in the early 1950s, to showcase and train others in this transorbital lobotomy (Harrington, 2019). The ice-pick method allowed doctors to lobotomize a patient through the eye socket rather than requiring the skull to be opened. Thus, lobotomies could be done as out-patient procedures. For example, Freeman lobotomized a patient at their hotel room.
By 1949, the apparent loss that many lobotomies caused was somewhat undeniable, yet the Times continued to platform voices which supported lobotomies. Scientific and media’s interest in lobotomies would continue. Attempts at developing a better understanding about the use of lobotomy were reflected in the media; for example, the Times published an article reviewing a study of two hundred patients (Bracker, 1953).
Another article mentioned how West Virginia authorities embarked on a “large scale test of mass surgery in an effort to help the insane” (NYT 19, 1952). The fact that WV embarked on this project and that it implied that it could help, demonstrates that both medical experts and the media had hope in lobotomy. These approaches helped psychiatry learn about experimental design (Pressman, 1986).
Taking a cue from the concerns expressed by Goldstein, the Times reported on a meeting of the APA in 1953 in which they highlighted discussions about the effects of lobotomy. This time, they drew a contrast between the views of Dr. McIntyre who argued that those who are lobotomized, pay too high price by surrendering “the emotional charges necessary for the ability to experience exultation and other joys of living” whereas Freeman presented data to suggest that two thirds of patents who were treated during the first six months of their illness, returned to “effective social living” (Ilson, 1953). The Times continued to favorably report on distinct variations of psychosurgery including ones based on sound waves (Laurence, 1953).
Conclusions
In short, between 1945 and 1954, the use and popularity of lobotomy spread even if medical professions and the press became “increasingly uneasy” about it. In spite of their frequent failures, Freeman argued that doctors had a moral responsibility to help, regardless of little hope of succeeding.
This was, in part motivated by his experience in France, where he thought doctors waited until it was too late to operate on patients. During this period, the Times started to mention the devastating side effects that lobotomies had. Nevertheless, they continued to highlight that the operation often made patients manageable and enabled them once again to be productive.
Secondly, this period is characterized by the hope that lobotomies could address an even wider set of conditions. Both the attempts to ameliorate pain and vanquish criminality and how these were covered, suggest that psychiatric, neurologists, criminals, and reporters found this therapeutic use plausible.
Authors: Christian Orlic and Lucas Heili
This week’s article has been adapted from a term projected completed by Christian for a class on Narratives about Mental illnesses at HES. In some ways this article is a continuation of “Cutting Through the Problem”
