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The lobotomy is a term we've all encountered in popular culture. In modern times, it’s often seen as a bizarre and outdated solution for mental health issues. Sometimes it's used humorously, while other times, it describes someone who appears mentally numb or incapable of self-care.
Yet, despite its complete discrediting today, lobotomy wasn’t that far in the past. In fact, it was performed on thousands of individuals suffering from issues like depression or behavioral problems just a few decades ago. Many of these individuals are still alive and dealing with the irreversible consequences of botched surgeries that severed critical brain connections. The history of lobotomy is painful, and its scars are still visible.
10. The Procedure Received a Nobel Prize
Today, the lobotomy is viewed as a disastrous mistake in modern psychiatry, but during its peak, it was considered a highly respected medical procedure. It was first pioneered by Egas Moniz, a Portuguese doctor who initially created a method called prefrontal leucotomy. Moniz used it to treat schizophrenia, and he found that patients became more manageable. Over time, Walter Freeman, another doctor, refined it into the rapid, behind-the-eye technique known today as the transorbital lobotomy. In 1949, Moniz was awarded a Nobel Prize for his innovation, which lent significant credibility to a procedure that had barely been tested. Soon, lobotomies were being performed worldwide.
The families of some of the lobotomy victims are advocating for the Nobel committee to revoke the award given to Moniz due to the immense harm caused by the procedure. Unfortunately, the Nobel committee has firmly rejected this request, publishing a thorough defense of their original decision. They argue that at the time, it was seen as a better alternative to other treatments for schizophrenia, and they maintain that Moniz’s work was groundbreaking for his era. It's important to understand that revoking a Nobel Prize is highly unprecedented; the committee has never rescinded an award, and their policies make it unlikely they ever will. As such, Moniz's Nobel Prize is likely to stand in perpetuity.
9. Some Believed It Was the Best Available Option
Some may wonder how a procedure involving the insertion of an ice pick behind someone's eye and damaging their brain connections could have gained such widespread acceptance. While it eventually became a fad, initially the purpose was to help individuals suffering from schizophrenia or other severe mental disorders. The doctors who performed lobotomies were unaware of all the potential risks, and they conducted brain surgery without being able to directly observe the brain. Despite this, many believed they were doing the right thing, convinced that mental hospitals of the time were so horrific that the procedure might offer patients a chance at a more normal life.
The major issue at the time was the lack of medications that could calm patients who were out of control. Keeping violent and mentally unstable individuals from harming themselves or others was an overwhelming challenge. Patients often had to be confined in straitjackets and locked away in padded rooms. Without the benefit of drugs, the only solution was physical restraint, which frequently led to violence. Treatments were harsh, and with no real way to cure or manage schizophrenia, many patients had no hope of ever escaping their situation. For both doctors and patients, it seemed like an escape from a terrible predicament, but it was far from the right answer.
8. Follow-Up Care for Patients
Moniz, the originator of the lobotomy, and Freeman, who quickly popularized it in the US, had frequent disagreements. Moniz believed that Freeman's ice-pick method was not the most responsible way to perform brain surgery. Eventually, Moniz distanced himself from Freeman. However, despite Freeman’s overly enthusiastic approach to poking into people's brains, Moniz was not without fault when it came to patient care.
Moniz was not particularly known for thorough follow-up, which is concerning given the untested nature of the brain surgery he was performing. He typically followed up with patients only for a few days after permanently severing their brain connections, and many critics felt his criteria for assessing patient improvement were biased, influenced by his desire to see positive results. In essence, Moniz saw positive progress in most cases simply because he expected to see it. On the other hand, Freeman, despite his more barbaric approach to the procedure, believed in the importance of consistent follow-up care and continued to monitor his patients until his death.
7. Surgically Induced Childhood
Freeman, who collaborated with Moniz to develop the lobotomy and played a key role in its spread throughout the United States, coined the term 'surgically induced childhood' for patients who underwent the procedure. He believed that the loss of normal mental functions, confusion, and other impairments were signs of patients regressing to a younger mental state. However, Freeman didn't see this as permanent personality damage; rather, he thought that the patients would eventually begin to mature again. He believed that once this maturation process began, it would happen quickly and lead to a full recovery. In the meantime, Freeman suggested treating these patients, even if they were adults, as if they were children if they misbehaved.
Freeman even recommended that if an adult daughter, who had undergone the lobotomy, misbehaved, her parents should physically restrain her and spank her, followed by comforting her with ice cream and kisses. However, the regressive behaviors that many lobotomy patients exhibited rarely faded with time. Instead, they often left individuals mentally and emotionally crippled for the rest of their lives.
In many cases, lobotomy patients developed issues like incontinence or exhibited other childlike behaviors, such as becoming easily excited by various stimuli, struggling with attention, and having frequent emotional outbursts. Some might argue that this was still an improvement over untreated schizophrenia, given the lack of viable treatments at the time. However, it raises the question of whether anyone would want to live with such a fundamentally altered personality.
6. Informed Consent
Today, before undergoing any significant medical or psychiatric procedures, patients are required to be thoroughly informed about the process, including the risks and potential complications. They must demonstrate that they have full mental capacity to make decisions and sign numerous consent forms. However, during the lobotomy's peak, informed consent was virtually nonexistent. Surgeons often proceeded as they saw fit, with little regard for the patient's autonomy or awareness of the procedure.
Freeman acknowledged that a patient who was too mentally impaired to understand the procedure shouldn't be expected to give consent. Yet, this didn't stop him from performing lobotomies. If the patient refused, Freeman would seek approval from the patient's relatives, hoping one would consent. Even worse, if a patient had previously agreed but changed their mind, Freeman would go so far as to have the patient sedated to ensure the operation proceeded. In many cases, individuals were coerced into the procedure, sometimes by well-meaning but utterly irresponsible family members and doctors.
5. It Destroyed People’s Lives
At the time, doctors proudly boasted about the lobotomy’s high success rates and minimal long-term damage to patients' brains. However, the reality was that many of the individuals who underwent the procedure were already suffering from severe mental illnesses.
In many instances, the lobotomy either left patients in a vegetative state or turned them into passive, docile individuals—often with a significant loss of cognitive abilities. Many doctors mistakenly saw this as positive progress, as they had no alternative treatments for these patients. During the era of lobotomies, unless the procedure resulted in death, any lasting brain damage was often viewed as an unfortunate yet acceptable side effect of the treatment.
Numerous people who have petitioned for the revocation of Moniz’s Nobel Prize argue that not only did they or their loved ones fail to find relief, but the lobotomy caused permanent damage that irreversibly altered their identities, making it impossible for them to live a normal life. One particularly tragic case involved a pregnant woman who underwent the procedure for a simple headache and never regained her former self. She became incapable of performing basic tasks and it took her years to relearn them.
In another heartbreaking instance, a boy named Howard Dully was subjected to a lobotomy by his stepmother, who found him to be difficult. Freeman strongly endorsed the procedure as a means to change the child’s behavior. Dully spent much of his life feeling incomplete, as though a part of him had been taken away.
4. Surgery Theater
Some of the critics who called for the revocation of Moniz's Nobel Prize also felt Freeman had a troubling enthusiasm for performing lobotomies whenever possible. The issue wasn’t just his failure to properly inform his patients, but also his tendency to treat the procedure like a spectacle for eager onlookers. Freeman often completed the operation in just 10 minutes, which seems like an incredibly rushed approach for something as delicate as brain surgery, even if it had been the most effective treatment available. Unfortunately, Freeman disagreed.
On one occasion, Freeman managed to perform an astounding 25 lobotomies in a single day. To prepare the patients, he would first use electroshock therapy to render them mostly unconscious, but that was the extent of his ethical concerns. Afterward, he would take his ice picks and begin severing brain connections. To make things worse, Freeman sometimes performed the lobotomies on both sides of the brain simultaneously, seemingly to impress his audience. While it's impossible to know how many patients suffered due to Freeman’s rushed methods, it’s clear that many did not fare well after the procedure, considering the careless manner in which it was performed.
3. The Chemical Lobotomy Drug
The lobotomy is now seen as a barbaric and nonsensical procedure from a time when medical knowledge was limited. What’s startling is how recent its use was. Many would like to think that the lobotomy vanished due to a collective moment of clarity, but in reality, it was simply replaced by a more effective treatment. Despite the fervor of people like Freeman, who championed it as a life’s work, most doctors were uneasy with the procedure, resorting to it only when they saw no better alternatives. As psychotropic medications began to emerge, the lobotomy's popularity quickly began to wane.
A new medication called Thorazine began to gain traction and was initially dubbed a 'chemical lobotomy.' The lobotomy had primarily been used to treat severe psychotic symptoms, which Thorazine proved to be much more effective at managing. While the lobotomy had other applications, it was no longer widely used for schizophrenia and simply couldn’t maintain its place in mental health treatments. The focus shifted to using medications to manage psychiatric conditions.
Some were concerned that Thorazine might still alter someone’s personality, but it offered the advantage of not reducing patients to a state of confusion where they were unable to care for even their most basic bodily needs. Over time, the lobotomy quickly lost favor, and today it’s often regarded as a grim joke—though for those who underwent the procedure, it was no laughing matter.
2. The 2,000 Lobotomized War Veterans
In the United States, soldiers are often thanked for their service, and there is even a federal holiday dedicated to honoring war veterans. Yet, many veterans struggle with mental health issues and face homelessness. Despite the widespread pride many citizens feel for those in military service, the unfortunate reality is that many veterans are not adequately cared for. After World War II, a large number of soldiers returned home carrying the scars of traumatic experiences, but with very few resources for mental health care.
Rather than taking the time to provide proper treatment and rehabilitation, the Wall Street Journal uncovered that approximately 2,000 soldiers were subjected to lobotomies—many of which were performed without their consent. Much like civilians who endured the procedure, these veterans underwent lobotomies for reasons as trivial as depression or symptoms more likely linked to post-traumatic stress disorder (PTSD), and occasionally even homosexuality.
Many of these soldiers returned home with a deeply unsettling pamphlet explaining how their families could care for their now permanently brain-damaged relative. The pamphlet was extensive, outlining various scenarios and offering advice. It explained that the lobotomized individual would lose interest in activities, stare vacantly, speak inappropriately, display childlike behavior, and become listless and hard to manage. Despite the obvious trauma they had endured—having just fought in a war and undergone brain surgery—the pamphlet emphasized that the person should never be allowed to rest or sleep in, and would require constant attention for the rest of their life.
1. It Wasn’t Just Used For Severe Mental Problems
As we mentioned earlier, lobotomies were initially performed to treat behavioral issues and were even attempted as a remedy for chronic headaches, but the list of conditions it was applied to extended far beyond that. Originally conceived as a last-resort treatment for severe schizophrenia in a time when few alternatives existed, Freeman and Moniz's fervor quickly turned the lobotomy into a widespread medical trend. People began bringing in their loved ones—or themselves—to undergo lobotomies for a wide range of issues. At one point, it was even considered a possible cure for homosexuality.
While Moniz preferred to carry out the procedure in a more clinical fashion and was somewhat cautious in his approach, Freeman, on the other hand, seemed eager to perform lobotomies on anyone who was willing. He would offer the procedure to people with conditions ranging from migraines and depression to postpartum depression, behavioral issues, mild developmental delays, or really anything he thought could benefit from his infamous ice pick method.
Freeman wasn’t malicious—he was simply fervently convinced that his operation was the solution for nearly everyone. Some reports even suggest that he performed lobotomies on children under five, suspecting them to be schizophrenic. However, it is crucial to note that schizophrenia typically does not manifest at such an early age, making such diagnoses highly questionable and irresponsible.
