Warning: this post contains potentially disturbing material.
In 1949, the Nobel Prize for medicine to two neurologists: Walter Rudolf Hess and Antonio Caetano de Abreu Freire Egas Moniz. Hess had discovered that different parts of the brain controlled different functions. Moniz was to find a deeply unfortunate application for this discovery. The official presentation speech included the following:
It occurred to Moniz that psychic morbid states accompanied by affective tension might be relieved by destroying the frontal lobes or their connections to other parts of the brain. On the basis of this idea Moniz gradually worked out an operative method whose purpose was to interrupt the lines of communication of the frontal lobes to the rest of the brain. Since these lines of communication run through the white matter, this operation was called frontal or prefrontal leucotomy. It was soon found that morbid conditions in which emotional tension was a dominating part of the pathological picture reacted very favorably to such operations. To this group of diseases belong, primarily, states of depression accompanied by fear and anxiety, obsessive neuroses, certain forms of persecution mania, and a considerable part of the most important and common of all mental diseases, schizophrenia: those cases, namely, in which the schizophrenic pattern of behaviour and the emotional condition is affectively charged to a high degree, as for instance in states of anguish or anxiety, refusal to take food, aggressiveness, and the like. Great subjective suffering and invalidism are characteristic of this group of diseases. Many of the diseased, especially within the schizophrenic group, are very difficult patients and are often dangerous to the people around them. When it is remembered that other methods of treatment have failed or have been followed by recurrence of the disease, it is easy to understand the immense importance of Moniz’ discovery for the problems of psychiatric treatment. As was expected, the results are best for the non-schizophrenic groups, that is to say, among those suffering from depression, obsessive neurosis, and the like, where the great majority of patients operated upon have recovered and become capable of working. Within the schizophrenic group, where the disintegration of the personality has often advanced very far, the prospects are less favourable, but even in this group quite a few cases can be released from the mental hospitals, some of them after having fully regained the capacity for work. In other less favourable cases, the nursing problem will be much simplified by the fact that the patient, after operation, can be kept in a «quiet» ward.
The results would be horrifying. The procedure was essentially jamming an ice pick through someone’s eye socket and into their brain. Unsurprisingly that produced disturbing results:
The lobotomy in many cases either turned them into a vegetable or simply made them more docile, passive, and easy to control—often much less intelligent as well. Many of the doctors took this as being “good progress” because they didn’t know how else to treat severely mentally ill patients. During the days of the lobotomy, unless it killed someone they considered all of the permanent brain damage be a negative side effect of the treatment. Many of the people who have asked for the Nobel Prize awarded to Moniz to be rescinded have complained that they or their family members not only weren’t cured but suffered permanent damage that changed who they were and, in some cases, made it impossible for the individual to live a normal life. In one case, a pregnant woman was given the procedure simply for headaches, and afterward she was never the same again. It was more than just being like a child; she could not feed or take care of herself at all—it took her years just to relearn basic tasks. In another case, a boy named Howard Dully was lobotomized by a stepmother who didn’t like him, simply for being a difficult child. Freeman seriously recommended it as a way to change the child’s personality, and Dully spent most of his life feeling like a part of himself was missing.
There’s a whole article on Dully’s case from the Guardian. The extra details are as horrifying as you would expect. Worst of all is the scale of all this. Tens of thousands of these procedures were performed. On one occasion Freeman performed 25 lobotomies in a single day. This becomes all the more disturbing when you realise that 14% of those he lobotomised died as a direct result of the operation.
That along with his reckless evangelism must make Freeman the principal villain of this story. Nonetheless, Moniz is not necessarily innocent here. He has been criticised for not properly following up the patients he operated on. There’ve also been calls for his Nobel prize to be rescinded.