A lobotomy (or leucotomy as it was called in Britain) wasn’t necessarily the last resort for patients in the 1940s. Doctors sometimes had other dangerous and bizarre treatments (as well as second or third leucotomies) in store for those who remained in hospital.
At Mapperley hospital in Nottingham, England, Paul Weil experimented with “regressive electroplexy” for the treatment of schizophrenia. Patients were given electroconvulsive treatments at half-hourly or hourly intervals (up to nine a day) on a daily basis until they were “in a state of complete confusion and utter apathy, mute, incontinent and unable to take food without assistance”. It took up to two weeks of treatment for patients to reach this state. Six of the eighteen patients subjected to this experimental treatment had already undergone leucotomy. One twenty-eight year old man who had had a leucotomy died three days after regressive electroplexy treatment. So did one of the patients who hadn’t had a leucotomy.
The surviving patients were described as somewhat more co-operative than before treatment but soon relapsed. Two who were discharged from hospital were readmitted within months. Paul Weil admitted that the results were “unfavourable” and decided not to repeat the experiment.

If you are within reach of Atlanta, Georgia, and are depressed (but not suicidal) and would like to have electrodes implanted in your brain then you could volunteer to be an experimental subject for Helen Mayberg and colleagues at Emory University.

“The purpose of the proposed study is to evaluate the safety, feasibility and efficacy of chronic, high frequency stimulation of the subgenual cingulate white matter (Cg25WM) using the ANS Totally Implantable Deep Brain Stimulation System as an adjunctive treatment for severe treatment-refractory Major Depression in twenty TRD patients, and to investigate potential mechanisms of action of this intervention.”

More details here…

This month’s edition of Scientific American Mind contains an article about Helen Mayberg and her experiments with Deep Brain Stimulation on depressed people. The article is called “Turning off depression” and can be read on the author’s website.

The tone of the article is enthusiastic, both about Professor Mayberg

“Eat dinner with Helen Mayberg, as I happily did, and you are treated not just to a good meal (for she appreciates good food as much as good ideas) but an infectious intellectual excitement. Lively of manner, with big eyes and a ready smile, Mayberg has a knack for stretching a meal while making the time pass quickly. At 50 she combines the enthusiasm of a freshly inspired grad student with the literate veteran’s appreciation of history.”

and about her experiments

“The results were stunning. Some patients felt profound relief as soon as [neurosurgeon] Lozano turned on the electrodes, and two-thirds returned to essentially normal mood and function within months. They saw better, thought better, felt better. They talked of walking amid flowers; of “the noise” stopping; of a horrid weight lifting. Side effects were almost negligible.”

We shall see.

If you happen to be in Leipzig, Germany, this month, why not go along to the Pierogi gallery where a video work by American artist Amy Patton can be seen.

“Amy Patton’s video work A Satisfied Mind leads us on a journey into an obscure narrative landscape. It is the product of work with three small excerpts of unrelated 16mm films found tangled together in a garbage bag in Austin, Texas. The three films, one showing early aviation disasters (c.1929), one discussing amnesia among psychosurgery and electro-shock therapy patients (ca. 1969), and one showing two children who take a ride on a greyhound bus (ca. 1966), were “hijacked”, so to speak, into a narrative framework of the artist’s design.”

In 1951 the Saturday Evening Post published a two-part article about lobotomy by Irving Wallace. The author’s original title of “They cut away his conscience” had been changed to the less controversial “The operation of last resort”.

The article tells the story of Princeton graduate “Larry Cassidy” who had had a breakdown when drafted into the army. Discharged six months later he returned home but continued to suffer from anxiety and depression. Psychoanalysis didn’t help; neither did insulin and electric shock treatment and Larry and his family, encouraged by some psychiatrists and discouraged by others, sought a lobotomy. The operation was carried out in 1947, five years after his original breakdown, by private doctors in Boston (who didn’t want to be named in the article).

Wallace describes the effect of the operation on Larry. At first it seemed successful - Larry appeared to have become more cheerful and even-tempered but it soon became apparent that he had no interest in anything and no concept of socially appropriate behaviour. His wife left him and his brother had him committed to a mental hospital. His brother Jack reflects: “Now he is dulled, no longer the person that they once knew. On the other hand, some of him is still that same person. And the rest of him is happier, and enjoys certain pleasures, and does not mind what he has become. Perhaps that is better than nothing”.

Wallace summarizes the controversy surrounding lobotomy:

“Thus, in the years since its inception, prefrontal lobotomy has been the center of a heated, worldwide controversy. The neuropsychiatrists who favor the operation can back up their stand with the fact that pre-frontal lobotomy prevents insanity and suicide and alleviates pain by reducing anxiety and removing worry….On the other hand, there is the school of thought that can prove, also from factual evidence, that prefrontal lobotomy converts patients into docile, inert, often useless drones, stripping them of their old powers, giving them convulsive seizures, making them indifferent to social amenities, filling them with aggressive misbehaviour, and impairing their foresight and insight. Then, there are those who feel the operation tampers with the God substance, who feel that if it cuts out a man’s cares, it also cuts out his soul and his conscience….Neither side in the disagreement is able to marshal adequately decisive statistics as evidence - although, currently, the Veterans Administration Psychiatric Division, which has performed 1,200 of these lobotomies, is in the process ofmaking a survey of the results. Their findings may, one day, help evaluate the operation’s merits and settle the controversy. But, while surveys may seem to show whether or not the results justify the attendant changes in personality, it is doubtful if statistics will ever actually be able to solve the human equation involved. For, in trying to determine, if an operation has been good or bad, what absolute measuring stick or standard can be used to judge? And from whose point of view can judgment be made? From the point of view of the patient? Or from the point of view of those around him? Or from the point of view of the doctor in the case?”

The story, under its original title “They cut away his conscience”, was included in Wallace’s 1966 collection “The Sunday Gentleman”. In a postcript to Wallace describes the response when the Saturday Evening Post published the article:

“Whereas an average article or essay might bring me a half-dozen letters from appreciative or critical readers, the travail of Larry Cassidy inspired a small mountain of mail. Much of the mail was congratulatory; readers were deeply moved. Some of the letters, from physicians and clergymen, questioned or discussed the wisdom of Larry’s psychosurgery. Other letters came from parents or relatives of mentally ailing persons, tragic, heartrending letters, asking for more factual information, inquiring for the real names and addresses of Dr Leon Goldsmith and Dr Raymond Rogers. The editors of the Saturday Evening advised me that the double-length feature had drawn a record amount of mail, and was, in this respect, among the two or three most provocative stories they had published in a decade.”

And there is an update on what had happened to Larry in the intervening years. He had discharged himself from hospital and returned to New York where a his old college room-mate found him a small apartment. A series of unskilled jobs never lasted more than a few days due to his eccentric behaviour and inability to concentrate. Larry eventually married again and survived on a his veteran’s pension, spending his days reading, watching TV and fruitlessly looking for a job.