I’d fully intended to move away from the subject of insane asylums and talk about a cowgirl from Oklahoma by the name of Lucille Mulhall. But I cannot in good conscience leave the subject without telling what I’ve learned about the barbaric brain surgeon responsible for Rosemary Kennedy’s lobotomy, the operation that permanently incapacitated her at the young age of 23. Rosemary had been acting in an agitated behavior, according to her father, Joseph P. Kennedy, throwing fits and showing interest in boys, and he sought an operation to settle her down. Two doctors were in the operating room that day in 1941: Dr. Walter Freeman, the director of the laboratories at St. Elizabeth’s Hospital in Washington, D.C., together with his partner, James W. Watts, MD, from the University of Virginia.
Dr. Freeman was obsessed with finding a cure for mental illness. In the day before psychiatric drugs, mentally ill patients were shuttered away in institutions like St. Elizabeth’s. Shock therapy, pioneered in the thirties, though not completely successful, had effectively reduced some psychiatric symptoms in agitated patients, rendering them calmer for a time following treatment. Psychiatrists like Dr. Freeman wanted to find the locus of mental illness of the brain. They understood that there were regions of the brain and were looking for surgical answers instead of just locking people up for life. Freeman, however, was not a surgeon but a neurologist. He was wildly ambitious and longed to achieve the lasting fame of his grandfather, a pioneer brain surgeon, once the president of the American Medical Association. Freeman was determined to find a procedure that would root out the defect in the brain that he believed responsible for mental illness.
Freeman discovered the work of a Portuguese neurologist named Egas Moniz who had performed a radical new operation on a group of 20 mental patients. By taking small corings of their brains, Moniz asserted, it had been possible to rid a third of these patients of their symptoms. Moniz didn’t explain why this worked. He had a crude notion that people “who are mentally ill are sort of obsessed, he called them fixed ideas. And that these fixed ideas probably resided in some way in the frontal lobes.”
Along with Dr. Watts, Freeman began to perform lobotomies, or surgeries on the frontal lobes. After several operations, Dr. Freeman called his operation a success. According to Edward Shorter, Medical Historian, “Freeman’s definition of success is that the patients are no longer agitated. That doesn’t mean that you’re cured, that means they could be discharged from the asylum, but they were incapable of carrying on normal social life. They were usually demobilized and lacking in energy. And they were that on a permanent basis.” Many had to be retaught how to use the toilet. They were definitely not the same persons they were before the operation.
Why didn’t the medical establishment stop Drs. Freeman and Watts from performing this radical and untested procedure? This was back in the day when it was considered unethical for doctors to criticize their peers – plus, Dr. Freeman manipulated the press in his favor. He proclaimed he’d found a cure for mental illness. Soon he was receiving glowing reviews. The Washington Star called prefrontal lobotomy “One of the greatest surgical innovations of this generation.” The New York Times called it “surgery of the soul,” and declared it “history making.”
It gets worse. Freeman decided that there was a simpler way to get into the brain than through the top of the skull, as he had done with Rosemary Kennedy. He decided that the skull was thinner behind the eye and that he could make an incision there with an ice pick. Freeman “would hammer the ice pick into the skull just above the tear duct and wiggle it around.”
He began to travel around the nation in his own personal van, which he called his “lobotomobile”, hawking this new procedure which he performed with a gold ice pick, and training other doctors in his methods. He even performed a few lobotomies in hotel rooms. Before he was stopped and the lobotomy discredited, Walter Freeman had performed over 3,500 lobotomies. His medical license was revoked when one of his patients died during a lobotomy. Nevertheless, he continued to tour the country in his lobotomobile, visiting his former patients, until his death from cancer in 1972.