Medical Horror

I can't imagine much that could be worse than to have you mind taken away from you.

The Freeman-Watts Standard Procedure was used for the first time in September 1936. Also known as "the precision method", this involved inserting a blunt spatula through holes in both sides of the skull; the instrument was moved up and down to sever the thalamo-cortical fibers (above). However, Freeman was unhappy with the new procedure. He considered it to be both time-consuming and messy, and so developed a quicker method, the so-called "ice-pick"lobotomy, which he performed for the first time on January 17th, 1945.

With the patient rendered unconscious by electroshock, an instrument was inserted above the eyeball through the orbit using a hammer. Once inside the brain, the instrument was moved back and forth; this was then repeated on the other side. (The ice-pick lobotomy, named as such because the instrument used resembled the tool with which ice is broken, is therefore also known as the transorbital lobotomy. The photograph at the top shows Freeman performing the procedure on an unidentified patient.)

Freeman's new technique could be performed in about 10 minutes. Because it did not require anaesthesia, it could be performed outside of the clinical setting, and lobotomized patients did not need hospital internment afterwards. Thus, Freeman often performed lobotomies in his Washington D.C. office, much to the horror of Watts, who would later dissociate himself from his former colleague and the procedure.

Freeman happily performed ice-pick lobotomies on anyone who was referred to him. During his career, he would perform almost 3,500 operations. Like the leucotomies performed by Moniz and Lima, those performed by Freeman were blind, and also gave mixed results. Some of his patients could return to work, while others were left in something like a vegetative state.

Thankfully it is a thing of the past.

The use of lobotomies began to decline in the mid- to late-1950s, for several reasons. Firstly, although there had always been critics of the technique, opposition to its use became very fierce. Secondly, and most importantly, phenothiazine-based neuroleptic (anti-psychotic) drugs, such as chlorpromazine, became widely available. These had much the same effect as psychosurgery gone wrong; thus, the surgical method was quickly superseded by the chemical lobotomy.