Matthew Collings' father

British art critic and broadcaster Matthew Collings has written about his father who underwent a leucotomy and committed suicide.

In an article in the Independent Newspaper, "Sculpted time", (3 April 2006, page 39) Collings writes:

"Among his crowd in Chelsea he was seen as a romantic figure, good-looking like a film star, moody, fascinated by art. He fulfilled a stereotype. It was partly the culture of the time, which was literary existentialism inherited from Paris. Partly it came from what was going on is society generally: the aftermath of the Second World War, all the tragedy, death, bravery, etc. I suppose it was a way of positively mythologizing a horror to which there really couldn't be any answer. In any case, my father was a romantic bohemian type but he was also ill - he'd had an unsuccessful brain operation and he'd received a head injury in the war. Plus, unknown to anyone, a part of his brain that hadn't been attended to during his operation was being attacked. After his death an autopsy revealed a tumour. It could have been removed by surgery if it had ever been diagnosed while he was alive. It may have been the cause of his symptoms.

The brain operation was a leucotomy, performed immediately after the war. He came back depressed from a POW camp. It was in East Germany - the Russian army liberated him. I think he signed up for the RAF partly because he had some emotional disturbance in his life. Perhaps he was already suicidal. He had an alcoholic father and a domineering mother - the father walked out and never returned. When war broke out Arthur was in a reserved occupation, working as a draughtsman for the Admiralty. However, he joined the Pathfinders as a navigator. The Pathfinders was known to be a particularly dangerous section of the RAF. They flew ahead of bombers laying down flares to light the target. He was shot down, his parachute failed to open correctly and his head was injured.

He was in the camp for two years. He suffered a breakdown. He thought he was Jesus. He gave away his blankets. In Britain a psychiatrist examined him - he was free now so why wouldn't he pull himself together? He was accused a malingering. He punched a psychiatrist in the face. Later the leucotomy was done...

Arthur's depression didn't clear up. He had girlfriends, he socialised and he was good company, interested in ideas and culture and history, and in psychology and what made everything tick. But he had dark moods, terrible headaches, he couldn't concentrate, he couldn't work with any ambition or intensity. His inability to keep an even keel gradually caused him to be self-pitying and cruel. He caused scenes. He disappeared for days on drink binges...."

After a broken engagement with the sculptor Elisabeth Frink who made a portrait bust of him, Arthur met and married Matthew's mother, a nurse. Collings continues:

"When my father died my mother was seven months pregnant. He just went out one day and never returned. The the police called and said he was dead on one of the Channel Islands. He'd been secretly saving up the sleeping pills my mother served him each night, one by one, in a Swan Vesta matchbox. He took them all..."

Psychosurgery in France

France, along with Germany, Spain, Scotland, Wales, Belgium, the Netherlands, Finland, Sweden and Italy (that I know of, there may be others) is one of the Western European countries that still practises psychosurgery. Along with, for example, Spain and Italy it is one of the few where agressive behaviour in psychiatric patients is still considered an indication for surgery.

In 2002 the National Committee for Medical Ethics (CCNE) produced a report on psychosurgery, Opinion no 71. The report was prompted by two different requests for guidance on the ethical implications of psychosurgery. One concerned the following case:

"a 20 year old patient, suffering from severe psychiatric disorders (agitation, hetero-aggressivity, threatened self-mutilation) for which he had been hospitalised almost continuously since 1995. Since his condition is proving refractory to the usual psychiatric medication, surgical procedures are being considered so as to try and reduce his potential for violence and make him less dangerous to others. The health caring team hopes in this way to be able to provide more humane treatment than the almost prison-like incarceration which is his present lot."

The other request came from neurosurgeons in Grenoble who use Deep Brain Stimulation to treat people with Parkinson's disorder and want to expand into psychiatric disorders.

Opinion no 71 was largely favourable to psychosurgery, with the usual caveats about consent, committees and follow-ups, although they stopped short of recommending its use for agressive behaviour.

The report provoked a critical response from one French psychiatrist, Alain Bottero, who wrote a spirited twenty-page article, L'ethique au secours de la psychochirurgie? (When medical ethics come to the aid of psychosurgery), in the French psychiatric journal L'evolution Psychiatrique, vol 70, 2005. Bottero expresses his disappointment at his fellow psychiatrists' silence in the face of the report - apparently psychiatrists in France have traditionally been less enthusiatic than neurosurgeons about psychosurgery.

Bottero begins his article with a scathing attack on the National Committee for Medical Ethics (CCNE) for having produced a report that is rambling, repetitive, error-ridden and at times incoherent. Was there, he asks, so much pressure from neurosurgeons who were waiting for the go-ahead to operate on psychiatric patients that there was no time to proofread the document? If, he points out, Boileau was right in saying "Whatever we well understand we express clearly", then there are certainly some doubts about the Committee's understanding of psychosurgery.

The author criticises the report for claiming that new functional neurosurgery treats symptoms whilst leaving the personality intact, unlike old lobotomies. New techniques are just less mutilating, and they are not even new, he says.

Bottero takes the Committee to task for its failure to address the concerns of psychiatrists, in particular the lack of a scientific rationale for psychosurgery (and here he points out that the hypotheses of the neurosurgeons haven't advanced much since the 1940s)and the lack of evidence for both the efficacy and safety of psychosurgery.

Finally, Bottero takes issue with the concept of "treatment-resistant" disorders. Psychosurgery is usually justified - and Opinion no 71 is no exception to this - by stressing the intolerable suffering of the patients and their failure to respond to other treatments. But Bottero argues that neurosurgeons are ill-equipped to understand the fluctuating course of mental disorders and their responsiveness to environmental influences. The best response to treatment failures, he says, is not necessarily ever more drastic treatment until the treatment of "last resort" is reached; a completely different approach may be called for in order to build up a therapeutic relationship which will give the patient hope.

In conclusion:

"The CCNE has been too hasty in taking up its position on neurosurgery for mental disorder. It is up to psychiatrists to make it clear that such interventions remain ethically dubious for at least three reasons that can no longer be ignored. Their efficacy remains unproven; they are dangerous and have serious irreversible side-effects; there are other therapeutic options available which, even if proof of their efficacy is lacking, should nevertheless be actively explored and encouraged because they are a lot less dangerous.... Consent and protocols won't change anything when it comes to a question that still has no satifactory response: the lack of scientific validity for interventions that carry with them the risk of breaching the integrity of the personality."(Bottéro A. L'éthique au secours de la psychochirurgie ? Evol. psychiatr. 2005 ; 70)

Oregon State Hospital

Oregon State Hospital, Salem, was the setting for Ken Kesey's book "One flew over the cuckoo's nest" and the film was shot on location at the hospital.

In an article in the New York Times, Richard Levine described being given a conducted tour of the hospital whilst filming was taking place in 1975:

Dr. Brooks [the hospital director], however, felt that the therapeutic and financial advantages for those patients who got to work on the movie - as actors, technicians or maintenance people - far outweighed any disadvantages, although he insisted that the film be set in 1963 instead of the present and that a disclaimer be included saying that it is not a factual representation of life in a mental ward. ''I just hope people realize that this is an allegory about how a man can be caught up in the System and allowed to undergo electroshock and a lobotomy,'' Dr. Brooks said. ''Why, except for the one that was done two years ago, we haven't had a lobotomy in this hospital since 1958.''

One of the people who underwent a lobotomy at Oregon State Hospital was the train robber and killer Roy DeAutremont. According to one source, the operation left him easier to control but severely damaged. He died in Oregon State Hospital in 1983. Salem newspaper The Stateman Journal marked the eightieth anniversary of the robbery with an article:

Ray, Roy and Hugh DeAutremont held up a Southern Pacific mail and passenger train near Ashland on Oct. 11, 1923. After dynamiting the mail car and killing four men, they fled empty-handed and remained at large for four years.
The brothers eventually were arrested and sentenced to life in the Oregon State Penitentiary. All three were released before their deaths....
Ray worked in the prison flax mill. He learned several languages and taught French, Spanish and Latin in the prison school. He also learned to paint, and several of his landscapes won awards in local exhibits.
Hugh founded a monthly magazine called “Shadows,” which twice won national honors for best prison publication.
Roy worked as a barber and contributed to his brother’s magazine. He later was diagnosed with schizophrenia and was transferred to the Oregon State Hospital, where he had a lobotomy.(Capi Lynn, 1923 botched train holdup nears anniversary, Statesman Journal, October 7, 2003)

Alys Robi

The Canadian 1940s singer Alys Robi underwent a lobotomy at the age of 29 in 1952. She had become depressed after she was injured in a car crash, and spent five years in a Quebec mental hospital. She described the experience in her book "Long Cri dans la nuit: Cinq Années à l'Asile" (Montreal 1990). Although she was terrified at the prospect of a lobotomy, she credited it with giving her a chance of recovery: "Je me réveillai guérie et j'ai compris plus tard que j'avais été un des rares cas réussis de lobotomie" (I woke up better and later understood that I was one of the rare success stories). She returned to singing, but not quite as successfully as before; the Canadian Encyclopaedia refers to her attempting "several comebacks 1952-74".

A film was recently made about Alys Robi's life.

BITTERSWEET MEMORIES
Directed by Denise Filiatrault, Starring Pascale Bussières, Michel Barrette, Serge Postigo.
Is it officially a genre now, biopics about gifted, glamorous women who go mad? If it isn’t, it should be. To the true stories of Marilyn, Billie Holiday, Frances Farmer and Piaf, add Quebecoise chanteuse Alys Robi. Like those other beautiful ruins, Alys Robi came from humble roots, was too strong and too talented to stay home, but not strong enough to survive in the world she went into.

The movie opens with Alys (Pascale Bussières) in a Quebec hospital, about to have a lobotomy to "cure" her manic depression, then flashes back to her childhood in the 1920s, following her rise from small-town singing sensation to international star. She was only 13 when she left home to go to Montreal to pursue her singing career. There, she changed her name from Alice Robitaille to Alys Robi, joined the National Theater, and was mentored by musical comedy star Rose Ouellette. It was in Montreal that she later became involved with comedian Olivier Guimond (Serge Postigo), her first love and a married man, whom she later derided for his lack of ambition. Her ambition led her to leave him for Toronto and the orchestra leader Lucio Agostino (Denis Bernard)–another married man with children back in Montreal. A pregnancy resulted, leading to an abortion that was very traumatic for Robi and forcefully brought to the surface the crippling religious guilt drummed into her in Catholic Quebec.

Professionally, the collaboration with Agostino was a fruitful one. She became the toast of Montreal, Toronto, London and Hollywood. As Robi’s star was rising, her family back in Quebec was struggling. Her beloved brother became ill with a crippling spinal disease that put him in a wheelchair and ultimately killed him, despite Alys’ efforts and expenditures to save him. This sent Robi into a tailspin. Already temperamental and prone to stage fright, she began to have irrational, diva-like fits of temper, and to make mistakes on stage. She felt hunted by paparazzi and gossip. Then the affair with Agostino imploded, and so did Robi, leading her father to have her committed to a mental institution for a lobotomy, against her will.

The story follows the genre’s formula pretty closely, and while he movie doesn’t go deep enough into her mental illness, its compelling storytelling provides a tantalizing look at Robi’s talent, exposing it to a whole new audience.

Pascale Bussières does a good job as Robi, and evidently does her own singing for the movie. She has a wonderful voice: I would have liked to have heard even more of it. And is it my imagination, or is Quebec producing some exceptional cinematographers and production designers these days? This is a richly beautiful film, a real treat for the eyes. From the hardscrabble hometown with its small comforts to the dazzling color of Robi’s big city life, every detail is right.

Alys Robi: Bittersweet Memories, has a much better title in French. Translated, it is My Life in Cinemascope, an apt metaphor for the wide-screen, larger than life Alys Robi. Too sensitive for the slings and arrows of stardom, yet too sensitive for the rigors and common tragedies of her family life back in Quebec, Robi seemed to have nowhere to go but mad.

SPARKLE HAYTER (SEE magazine, July 21 2005)