Just what you need: a hole in the head

If you’ve ever read Ken Kesey’s novel One Flew Over the Cuckoo’s Nest, or seen the movie, you probably have a very dim view of lobotomies. Even if you’ve never heard of the book or film, the word “lobotomy” is unlikely to conjure up any sunshiny thoughts. It’s a scary word of pain, humiliation, and powerlessness. Surely no one would ever willingly submit to having his or her brains whisked about like a chef getting rid of stubborn lumps in a white sauce?

And yet history is full of people who did just that, who volunteered for violent, ill-researched brain surgery. Lobotomies came in two flavours: the prefrontal lobotomy pioneered by neurologist, Egas Moniz (who won a Nobel Prize for his contribution to medicine), and the transorbital lobotomy. Transorbital lobotomies were the brain child of psychiatrist Walter Freeman and touted as an easier, more successful alternative to prefrontal lobotomies.

While Moniz’s technique involved drilling holes into the skull to get at the frontal lobes of the brain, Freeman’s was relatively bloodless, as the brain was accessed through the eyes. Using Freeman’s technique the patient’s upper eyelid was lifted and a thin ice-pick like instrument inserted underneath, against the top of the eye socket. A mallet was then used to hammer the instrument, called a leucotome, through the bone and into the delicate brain tissue. The leucotome was then moved about in a scientific manner to cut the nerve fibres that connect the frontal lobes to the thalamus.

The intention was to still overactive emotions, effectively cutting off the brain’s ability to process them and react accordingly. The whole procedure took 10 minutes, from rendering the patient unconscious with an electric shock to the patient waking up with two black eyes (both sides of the face had to be done for the sake of balance).

Freeman’s first lobotomy, on suicidal housewife Ellen Ionesco, was deemed a great success by all, including Ellen herself, and Ellen’s daughter, who witnessed the procedure. Other results were not that successful, with some very unpleasant results and some very tragic ones, at least according to Dr. Elliot Valenstein, who wrote a book on the history of lobotomies called Great and Desperate Cures. Vegetative states and death were not uncommon.

Despite this, over 50,000 lobotomies were performed in the US between 1949 and 1952. Valenstein says that the reason was because there simply weren’t any other alternatives. Psychiatric drugs were only introduced in the mid-50s and until then desperate times and desperate measures went hand in hand.

One would think that with the advancements in medicine, particularly psychiatry, lobotomies would have fallen completely out of favour, with doctors preferring less invasive treatment measures. This is not entirely the case. According to a poll taken in 1999, 74% of American Psychiatric Association members would consider neurosurgery for their patients. 74%! This, despite the fact that it’s still not certain how the four major psychiatric neurosurgeries work. Makes you want to choose your psychiatrist very carefully indeed.

Lobotomy procedures have obviously come a long way since the ice-pick-in-the-eye days. But despite all of the phenomenal advancements since the 50s, there is still so much about the brain that we don’t know. Fiddling about in sensitive grey matter should be an absolute last resort and not touted as a quick and efficient cure for anything.

Recommended sites:

http://www.npr.org/templates/story/story.php?storyId=5014080

http://www.npr.org/templates/story/story.php?storyId=5014565

http://www.thismagazine.ca/issues/2005/01/magicalmystery.php

http://en.wikipedia.org/wiki/Lobotomy

Sandra wrote this article for the online marketers MediClinic modern, private medical service provider a modern private medical centre offering a range of services from health screens to psychiatric services to cosmetic procedures.