"The Lobotomist" Reviews
Yes, I'm going to post my review in the next couple of days, but in the meantime here are a few articles on and reviews of Jack El-Hai's "The Lobotomist":
New book reconsiders 'icepick lobotomist' who did some surgeries in Athens hospital
TRANSORBITAL LOBOTOMY
Book portrays lobotomy pioneer, local hospital co-founder
"The Lobotomist" examines an infamous doctor
The man behind the lobotomy
To aid tortured minds, he cut the brain
New book reconsiders 'icepick lobotomist' who did some surgeries in Athens hospital
TRANSORBITAL LOBOTOMY
Book portrays lobotomy pioneer, local hospital co-founder
"The Lobotomist" examines an infamous doctor
The man behind the lobotomy
To aid tortured minds, he cut the brain
3 Comments:
The Hopeless Remnant
I haven’t read Jack El-Hai’s book yet, but it seems that there is a word that is used in almost every review - “hopeless”. The reviewers of course are not referring to the book, but to the plight of mental patients at the time, as in:
“But El-Hai described the mental institutions of Freeman’s time as overcrowded, hopeless places where patients, family and staff possessed an overwhelming sense of despair because of the few available treatments” (The Cardinal Inquirer)
“many within the medical establishment supported the surgery as a possible beacon in what seemingly had become a hopeless battle against a mental-illness epidemic.” (The Seattle Times)
“He has assembled in The Lobotomist a portrait that is much different from Freeman's image today as a monstrous and even criminal physician-that of a brilliant doctor, determined to develop a treatment for seemingly hopeless mental patients.” (Townsend Letter for Doctors and Patients)
Hopeless institutions; a hopeless battle against mental illness; hopeless patients… it reminds me of a phrase used by Professor of medical ethics Grant Gillet when reviewing a previous attempt to rehabilitate Walter Freeman, Jack Pressman’s book The Last Resort, - “a hopeless remnant of patients”.
But were things really so hopeless, and is it fair to call the people operated on a hopeless remnant?
In Britain, far from sitting around waiting for the invention of psychosurgery or tranquillisers, psychiatrists in the 1920s were confident of being able treat mental illness successfully and they were campaigning for a change in the law to make it easier to admit people to mental institutions; the idea being that if you got them earlier even more people could be cured. Even as it was in the 1920s, when you had to be “certifiably insane” to be admitted to an asylum, about 10,000 people were discharged every year (compared to about 22,000 admissions).
Psychiatrists got their way with the Mental Treatment Act 1930. The asylums were renamed mental hospitals; outpatient departments were opened; voluntary patients were admitted for the first time; and it became easier to detain patients. Of course, there were still some long-stay patients but psychosurgery was not given exclusively to these patients and when they were operated on it was often in the hope of making them better behaved and easier to look after, rather than of giving them a chance of cure and a return to life outside the hospital. Many psychosurgery patients had only been in hospital a short time, sometimes only a matter of days, before being operated on and, if they had a hopeless prognosis, it was only because psychiatrists had given them one (and what a convenient way to cover yourself if you are going to do something dangerous to someone).
So, here are a few examples of what has been called the “hopeless remnant of patients”.
Barbara was 37, had a first-class honours degree, a husband and three children (including a stepson from her husband’s first marriage) and a neurosis, which led to her admission to St George’s Hospital, London, and a leucotomy. After her operation, which was performed by Wylie McKissock, she had lost her grasp of the English language and gave up a teaching job after a term. But her husband was impressed as she ate “like a horse”, no longer quarrelled with him, was more affectionate towards her stepson and generally easier to live with. Barbara and another 41 neurotic patients (mostly women) from St George’s Hospital were selected for investigation because, in the words of Asenath Petrie in “Personality and the Frontal Lobes”, they were “as near the normal as any likely to be operated on”.
Subject 28, like Barbara, was chosen as a research subject (this time for Peter Macdonald Tow’s book “Personality Changes following Frontal Leucotomy”) because she was essentially normal before operation. Again like Barbara, Subject 28 was a well-educated woman who was unhappily married and was diagnosed as neurotic. She was 27 when she was operated on. As part of his investigations, Peter Macdonald Tow asked his research subjects to write brief autobiographies before and after operation. Before operation, Subject 28 wrote a fascinating and literary account of her wartime experiences in Shropshire, London and Africa. After operation, she wrote a brief and ungrammatical account of despair, fatigue and incontinence. But she was better off than several of her fellow research subjects who were killed by the operation.
The 36 year old D-day veteran described in William Sargant’s article in the 1947 British Medical Journal “Chronic battle neurosis treated with leucotomy” had been in heavy tank fighting in France, Belgium and Holland before being wounded in Germany. After his physical wounds healed he was diagnosed with battle neurosis. Barbiturates, insulin treatment and ECT made him worse. Psychiatrist Louis Minski, asked for his opinion, described him as a self-centred and shallow hysteric with a compensation neurosis. William Sargant decided on leucotomy, which was performed by Wylie MacKissock. A few months after surgery he was reported to be working satisfactorily as a printer although lacking in energy. Over fifty years later Ben Shephard takes up his story in his book “A War of Nerves: soldiers and psychiatrists in the twentieth century”. He notes that Harold Smith, as he calls him, mysteriously disappeared from William Sargant’s papers and says: “Perhaps Harold Smith was lucky. Perhaps his was one of those dramatic cases which for so long blinded doctors to the dreadful after-effects of leucotomy. Perhaps he never needed to see the doctor again and was able to lead a happy and contented life”.
Case 3, the third person to be operated on (by Wilfred Willway using a paperknife) at the Burden Neurological Institute in Bristol, was a 42 year old veteran of the First World War. In spite of suffering from anxiety and nightmares since then, he had managed to work as a labourer and raised a family. The heavy bombing of Bristol by the Luftwaffe in late 1940 and early 1941, and in particular one raid when he had to clear up a bomb shelter that had taken a direct hit, made his anxiety worse and he was admitted to hospital. After just four days he was operated on. The operation was considered a success because afterwards he was indifferent to air raids.
All the above, like the majority of those operated on, were in their twenties, thirties or early forties. But a few people were even younger.
Case 293, described by Maurice Partridge in his book “Pre-frontal Leucotomy: a survey of 300 cases personally followed over one and a half to three years”, was just 16 years old when she was operated on by Wylie MacKissock. She had spent part of her childhood in care, part of it with her deaf mother and stepfather who used sign language, and was working in factories by the age of 13 (although at the time the minimum school-leaving age was 14). At that age she was certified and diagnosed as an aggressive psychopath as she had thrown a teapot at a social worker and smashed things when she was angry. After surgery she became dishevelled, had hallucinations and delusions and a total lack of insight. She was given a new diagnosis of schizophrenia. Maurice Partridge’s conclusion: “From the standpoint of the nursing problem there is a slight gain”.
Excellent post, Sue. I think you are right on target with these comments. In the lecture I gave at the library the general consensus was that the only people who were lobotomized were the "worst, sickest, and most violent" patients. Though I tried to explain otherwise, it was a struggle to get them to truly understand.
Readers should know that Sue and I are email correspondents. She has been invaluable in pointing out excellent responses to the arguments of psychosurgery apologists, particularly the Nobel Committee. Thank you Sue!
Wylie McKissock seems to have been the nearest Britain came to a Walter Freeman. Based in London, he travelled round the South of England and Wales performing leucotomies. By 1951 he had done more than 1800.
Wylie McKissock was a respected neurosurgeon. He set up the world-famous neurosurgical unit at Atkinson Morley's hospital and was President of the Society of British Neurological surgeons. On his retirement he was awarded a knighthood.
When he died in 1994 a long obituary in The Independent made no mention of his psychosurgical operations. As a young neurosurgeon he had worked with the Swedish neurosurgeon Herbert Olivecrona who was later to recommend the award of the Nobel Prize to Egas Moniz.
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