Lobotomy 1946 – Intervening in Brain Connections

Scientists had known since the mid-1800s that particular regions of the brain specialise in different functions. The possibility of using brain surgery to control mental illness had therefore long been considered. However, the lobotomies performed in the 1900s, in which connections to and from the prefrontal cortex were cut, appear very primitive today.

The prefrontal cortex controls personality expression, decision-making, social inhibition and many other functions. Prefrontal leucotomy, or lobotomy, involves making holes in the skull and then using wire loops or blades to cut the brain. 

Because the aim in lobotomy was to reach the brain and frontal lobe areas, the instruments used to get there had breaking and cutting properties. For example, Freeman used an ice pick for lobotomy.

Medical historian Ole Enersen writes that Freeman performed lobotomies "with a carelessness bordering on insanity, travelling around the country like an itinerant preacher". According to Enersen, "Between 1948 and 1957, he alone performed lobotomies on 2400 patients. In most cases, the procedure was nothing more than a crude mutilation without any justification." 

Lobotomies were performed for various conditions, ranging from obsessive-compulsive disorder to schizophrenia and depression, with the aim of "treating" . However, the results were often reduced emotional responsiveness and loss of the ability to plan. In the 1940s and 1950s, approximately 40,000 people in the US underwent lobotomy. Its use declined after the invention of antipsychotic drugs such as chlorpromazine.

President John F. Kennedy's sister Rosemary Kennedy is one of the best-known examples of failed lobotomy surgery. At the age of 23, her father ordered a lobotomy because of her moody and rebellious behaviour, leaving her paralysed, unable to communicate intelligibly and condemned to spend the rest of her life in care.

Description of the article image: Before lobotomies, Phineas Gage (1823-1860) survived an iron bar accidentally passing through his head and destroying a large part of his left frontal lobe. Gage, shown posing with the iron bar that passed through his head, experienced some personality changes but survived. 

Historical figures mentioned in the article: Egas Moniz (1874 – 1955), Walter Jackson Freeman II (1895 – 1972), James Winston Watts (1904 – 1994), Rosemary Kennedy (1918 – 2005)

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