John Sutherland writing in the British newspaper The Independent last month:

“We should be humble in assuming that our therapies, whatever stage scientific knowledge may have reached, can do what we think they can do. It is to me strange, for example, that Stockholm has never seen fit to withdraw, retroactively, the Nobel Prize it awarded Egas Moniz, in 1949. Moniz invented prefrontal lobotomy. He was, the committee said, “a wonderful man”. Many, then, might have agreed. Now, few would.
The operation, which involved scooping lumps out of the brain, as if it were ice-cream, was subsequently popularised in the US by Walter Freeman who trundled round in his “lobotomobile”, demonstrating his “ice pick and hammer technique” to any hospital that would let him in, and knocking off 10 ops a day in hotel rooms. Nothing could stop his campaign to make America mentally “healthier”.
It would be a commendable act of humility, and an admission that mental health is difficult to define and fiendishly difficult to manufacture, were Stockholm to respectfully rescind that award to Moniz.” (more…)

In an article about Egas Moniz, author João Sodré criticised Portuguese psychiatrists who try to justify leucotomy with claims that it is more humane than ECT. They are not the only ones. British neurosurgeon Harvey Jackson describes in 1954 how he overcame his doubts about leucotomies:

“When originally I undertook to perform leucotomy it was not without a feeling rather of reproach, for mutilation no doubt it must be. However I first of all went to watch my psychiatrist colleagues applying chemical or electric convulsive therapy - so disturbing was the exhibition at the time that thereupon I decided that the surgical approach was probably a less traumatic measure.”

And American neurosurgeon William Beecher Scoville felt that psychosurgery “is preferred to shock treatment in those depressions requiring more than short courses of shock treatment because of less emotional blunting, memory loss and relapses.”

The Portuguese radio and TV station, RTP, is running a poll to find the greatest ever Portuguese. In January there will be a programme featuring the ninety people who collected the most votes and the ten finalists will be announced - each will have their own documentary. Egas Moniz is of course amongst those nominated. A Portuguese doctor defends Moniz’s Nobel Prize on the RTP website; whilst acknowledging that leucotomy could be damaging he points out that Nobel Prizes are awarded not for therapeutics but for the advancement of knowledge. Nobel Prizes for medicine and physiology are indeed usually won in the laboratory - neither of this year’s winners (Andrew Z Fire and Craig C Mello) are doctors of medicine. They are awarded for discoveries and Moniz’s prize was awarded for “the discovery of the therapeutic value of leucotomy” and so the therapeutic value, or lack of it, is relevant. And how exactly, in any case, was leucotomy supposed to have advanced our knowledge of either the frontal lobes or mental illness?
Another Portuguese website, Portuguese lives, has an interesting biography of Egas Moniz with quite a few illustrations. The author, João Sodré, says that Egas Moniz is not held in high regard by the people of Portugal; the friends, taxi drivers, bartenders, coffee-drinkers and passers-by he spoke to all expressed a negative opinion of the Nobel Prize winner (let’s hope they have been voting). Sodré criticises Portuguese psychiatrists for defending leucotomy as a more humane treatment than ECT and wonders how far leucotomy would have got if its inventor had followed Bazett-Haldane principles of not subjecting others to medical experimentation that you wouldn’t want to be subjected to yourself. Finally he tackles a popular myth about Egas Moniz - that he was murdered by a patient. He was injured but survived. It was another well-known Portuguese psychiatrist, Miguel Bombarda, who was killed by a patient.