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Health Lover

Documentary Shows Damage Done When Medicine Goes Awry
   
Walter J. Freeman performs a lobotomy in 1949. The surgery aimed to
cure mental illness.
http://www.washingtonpost.com/wp-dyn/content/article/2008/01/14/AR2008011401484.html
By Sandra G. Boodman
Washington Post Staff Writer
Tuesday, January 15, 2008; Page HE01

One of the most horrifying medical treatments of the 20th century was
carried out not clandestinely, but with the approval of the medical
establishment, the media and the public. Known as the transorbital or
"ice pick" lobotomy, the crude and destructive brain-scrambling
operation performed on thousands of psychiatric patients between the
1930s and 1960s was touted as a cure for mental illness.

Its prosaic name comes from the instrument initially used to perform
it: an ice pick plucked from the kitchen drawer of the procedure's
tireless proselytizer, Walter J. Freeman, who pioneered the operation
in 1936 while at George Washington University Hospital.

The story of how Freeman sold his procedure to credulous colleagues,
assiduously courted the press and convinced desperate families that
sticking an ice pick through a patient's upper eye sockets and
twirling it like a swizzle stick through brain matter would cure
psychosis, depression or troublesome behavior is the ultimate in
cautionary medical tales.

As the riveting hour-long "American Experience" documentary "The
Lobotomist" (scheduled to air Jan. 21 at 9 p.m. on WETA and other PBS
stations) makes clear, Freeman's operation reflected the neurologist's
peculiar combination of zealotry, talent, hubris and, as one of his
trainees noted, craziness. Sometimes Freeman, who relished putting on
a show, used a carpenter's mallet instead of a surgical hammer during
demonstrations of his operation. At other times, he would operate
left-handed rather than right-handed.

Based in part on the much-praised 2005 biography "The Lobotomist" by
medical writer Jack El-Hai, who appears in the film and served as a
consultant, the film by Barak Goodman and John Maggio features
chilling black-and-white home movies as well as haunting photographs
of patients before and sometimes after their lobotomies. Many of the
movies are narrated by a gravel-voiced Freeman demonstrating the
procedure he performed on more than 2,900 people, the youngest of whom
was 4.

As the filmmakers note, lobotomy flourished in a therapeutic vacuum:
Until the mid-1950s when the groundbreaking tranquilizer Thorazine
swept through mental hospitals, ushering in the era of
psychopharmacology, medicine had virtually nothing to offer
psychiatric patients.

State hospitals were teeming, squalid warehouses that had become
permanent homes to thousands who had little hope of ever leaving. One
of the most notorious was Washington's St. Elizabeths Hospital, where
Freeman began his career in the 1920s and was struck by the sight of
5,000 patients "whose lives were going nowhere, would go nowhere," in
the words of El-Hai.

The solution, Freeman believed, lay in a radical experimental
procedure invented by a Portuguese neurologist who in 1949 would win
the Nobel Prize in medicine. He claimed the drastic brain operation
had cured a substantial number of people with mental illness.

The scion of a distinguished Philadelphia medical family who had a
burning desire for fame, Freeman began experimenting and developed the
ice pick procedure. His operation severed the frontal lobe from the
thalamus, the repository of emotions and the site where Freeman
believed mental illness originated.

A few patients and their families claimed lobotomy was beneficial,
especially in reducing agitation, which was Freeman's measure of
success. But others died on the table or were left irreparably
damaged: childlike, docile, vacant and incontinent. Among them was
Rosemary Kennedy, the 23-year-old mildly retarded sister of John F.
Kennedy, who spent 56 years of her life in an institution after
Freeman operated on her in 1941.

Undaunted by his failures, Freeman's pitch that lobotomy cured mental
illness was seized on by the press -- the Washington Star called it
among "the greatest innovations of this generation," and the New York
Times pronounced it "history-making." Many doctors embraced it as a
10-minute operation that promised to empty mental hospitals and return
patients to their families. Opponents, mostly psychiatrists who
practiced Freudian talk therapy, didn't matter much: In those days
public criticism of a doctor by his peers was regarded as unethical.

By the early 1960s lobotomy had fallen out of favor, in part because
of its low success rate and the disastrous harm it inflicted on many
patients.

Freeman, who died in 1972, performed his last lobotomy in 1967; his
privileges at Herrick Hospital in Berkeley, Calif., were revoked after
the patient died.

While several of his relatives appear on camera, one of the most
affecting interviews is with Berkeley bus driver Howard Dully, who was
lobotomized by Freeman at age 12 after his stepmother complained he
was difficult.

The issue at the heart of this powerful and unsettling film is not, as
one writer puts it, "how a man could go off the rails, but how science
could go off the rails."

It's a question well worth pondering. ¿