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In 1935, neurophysiologist
John Farquhar Fulton
presented some shocking new research.
After removing the frontal lobes
of two chimps,
he found they no longer experienced
frustration or anxiety.
As his research associate noted, it was
as if they’d joined a “happiness cult.”
Admittedly, the surgery had cost Fulton’s
chimps some cognitive functions.
But to Portuguese neurologist Egas Moniz,
this was a small sacrifice for what
seemed to be eternal happiness.
Moniz believed that replicating this
procedure in humans
could cure mental illness.
And it was this therapeutic intention
that led to one of the most
controversial and destructive
medical treatments of the 20th century:
the lobotomy.
Today, we know mental illness comes in
many forms and emerges for many reasons.
But in the early 20th century,
these complex conditions weren't
clearly delineated,
and researchers had various theories
about their origins.
Moniz believed the symptoms of what we now
call depression, OCD, and bipolar disorder
stemmed from negative ideas
getting fixed in the neural fibers
which connect different parts
of the brain.
Specifically the thalamus
and frontal lobes,
which regulate emotion and sensation.
He proposed that severing these fibers
could eliminate the associated conditions,
which led him to invent
the prefrontal lobotomy.
In this procedure, a surgeon would drill
into the skull and cut the white matter
connecting the prefrontal cortex
to the rest of the brain.
Initially, his peers were skeptical.
Moniz’s fundamental theory
was already controversial.
And psychiatrists advocating
for treatments like psychoanalysis
criticized this invasive
surgical solution.
But Moniz was undeterred.
He lobotomized 38 individuals
with conditions including anxiety,
schizophrenia, and depression.
And his hastily written results reported
that two-thirds of these patients
had become tranquil, amicable, and
free from distressing hallucinations.
At the time, psychiatrists saw calm
behavior as a sign of recovery,
so when Moniz brashly declared the
treatment a success,
his peers agreed.
Newspapers celebrated the surgery;
Moniz was awarded the Nobel Prize;
and his procedure became
especially popular in the US
thanks to neurologist Walter Freeman
and neurosurgeon James Watts.
As a country that had institutionalized
nearly half a million people
for mental health reasons,
many hoped the new treatment would allow
this population
to live relatively normal lives.
But from the beginning
there were problems.
First, the notion of a “normal life”
was determined by this period’s
restrictive social mores,
which had led huge numbers
of people to be institutionalized
simply because they didn’t conform.
So, while many people in these facilities
did need medical help,
some lobotomy recipients had
no mental illness whatsoever.
Second, the details and timeline
of the surgeries’ results
were unpredictable and inconsistent.
In 1941, when future US President
John F. Kennedy’s sister Rosemary
underwent a prefrontal lobotomy,
it permanently impaired her ability
to speak and walk.
And even when the surgery did help
patients manage
overwhelming emotions and hallucinations,
they often experienced
significant side effects.
These included apathy, abrupt personality
changes, and cognitive impairment.
Tragically, the stigma around mental
illness kept people from discussing
their negative experiences,
so the procedure kept happening.
But prefrontal lobotomies required a team
of surgeons and specialized equipment,
making them out of reach
for most patients.
At least until 1945,
when Freeman began developing
a simpler and cheaper alternative.
In his new transorbital lobotomy,
the patient was first rendered unconscious
via electroshock therapy.
Then, an ice pick-like instrument
was pushed through the thin bone
of their eye socket
and manipulated to sever the fibers
between the thalamus
and frontal lobes.
Transorbital lobotomy was intended to be
performed by physicians
without surgical training
in under ten minutes.
And Freeman proved his procedure’s
efficiency during a hospital visit,
where he performed the surgery
228 times in just 12 days.
Transorbital lobotomy was
immediately controversial.
Even Freeman’s long-time collaborator
James Watts
was against making such
a consequential surgery
quick, dirty, and accessible to amateurs.
But the procedure remained popular
throughout the Western world
until the 1950s,
when tranquilizers began offering
a less permanent
and more predictable alternative.
By the mid-60s, lobotomies were most often
found in science fiction and horror films,
where they became a potent metaphor
for brutally controlling those
who don't fit the norm.
Today, lobotomy serves as a chilling
reminder that scientific progress
requires transparency
and clear ethical standards.
Because without honest reflection,
even efforts to alleviate human suffering
can cause serious harm.
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