The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness

“Doctors say that worry can be cut out of the brain with a knife. There is a better way. GO TO CHURCH.” So read one newspaper reaction to Dr. Walter Freeman’s lobotomy exhibit at a medical convention in 1937. It wasn’t good publicity, but Freeman appreciated it nonetheless, seeing it as an acknowledgement that the popularity of lobotomy as a treatment option was growing. In The Lobotomist, Jack El-Hai tells the tale of the eccentric doctor who championed lobotomy as a remedy for mental illness.

Walter Freeman was an unusual doctor in many respects. Trained in neuropathology, he had no use for psychoanalysis. Refusing to classify lobotomy as a surgery, he operated in his suit, unmasked and ungowned, and insisted that any psychiatrist could learn to perform this simple ten-minute procedure. His P.T. Barnum-like style of turning a demonstration operation into a public performance could be off-putting to some: taking a cue from a former professor who held students’ attention with his two-handed chalkboard drawings, Freeman once operated with both hands simultaneously, turning to smile at his audience mid-cut. He kept copious notes on former patients, and made every effort to keep in touch with them decades after their operations: “He craved evidence that he had helped restore patients to usefulness in society.”

The procedure itself involved cutting nerve fibers in the frontal lobes of the brain to sever connections that Freeman and others believed were involved in emotional response. Because it involved cutting into healthy tissue, many in the medical community found lobotomy anathema to the ethical practice of medicine. But Walter Freeman was concerned with results, not ideology, and forged ahead when he saw patients formerly incapacitated by crippling anxiety or depression now able to care for themselves, interact with family, and hold a job. “To think more constructively with less brain,” said Freeman, was worth the sacrifice of a few severed nerve fibers.

Much of the cultural baggage associated with lobotomy is undeserved, as El-Hai notes, especially in relation to Freeman, who used the procedure solely to provide relief from debilitating illness. Only in the waning years of its popularity was lobotomy rumored (incorrectly, as it turned out) to be used for suppression of political dissent in communist countries. Freeman was also against the idea of using lobotomy on criminals, and took issue with doctors who claimed the procedure could inhibit the impulse to commit crimes. Mainly, Freeman’s goal was to get people well enough to function, to get them out of psychiatric institutions and back into society.

Treatment for severe mental illness in Freeman’s time was very limited: electroconvulsive shock therapy was one option, near-lethal poisoning (with cyanide or insulin) was the other. Most patients weren’t treated at all—they were simply warehoused in overcrowded, understaffed hospitals. Considering the alternatives, it’s hard to dismiss Walter Freeman’s passion for lobotomy as barbaric. The Lobotomist paints a complex, detailed portrait of both Freeman and the practice of lobotomy, making it a deeply engaging read for anyone interested in the troubled history of mental illness.

Author’s Note: The Lobotomist recently won the 2006 Minnesota Book Award in the History and Biography category. Not long after I wrote this review for Rain Taxi, I heard an amazing story on NPR, told by one Howard Dully, a patient of Dr. Walter Freeman’s in 1960. Dully’s personal investigation of his own case, along with interviews of family members of other lobotomy patients, can be read and/or listened to at www.soundportraits.org/on-air/my_lobotomy

Carrie Mercer is a freelance writer and artist living in Minneapolis. She has an MFA from Hamline University and is currently learning to ice skate. Read her blog at www.findingjimmy.blogspot.com or reach her by email at cmercer@mn.rr.com.