First lobotomy: Nov. 12, 1935

Believing that some forms of mental illness are caused by neural connections in the brain getting stuck, Portuguese neurologist Antonio Moniz tries a new procedure.

He drills two small holes into the skull of a woman patient with symptoms of paranoia, then shoots alcohol directly into her frontal cortex. The procedure appears to be a success—the woman is less agitated. But she also seems more apathetic.

Moniz wasn't deterred. He refined this new surgery and instead of pumping alcohol into the brain, he tried sucking out brain tissue with a needle or severing neural connections with a wire. All of the procedures were done blind—he didn't open up a patient's skull to see where he was cutting.

Moniz called the procedure a "leucotomy" and wrote enthusiastically of the positive results of disconnecting the frontal cortex from the rest of the brain.  An American doctor named Walter Freeman embraced the approach with a fervor.  Within a year of reading about Moniz' technique, he had performed 20 of the surgeries, which he renamed "lobotomies."

But Freeman developed his own technique. He began experimenting with a procedure where he would drive an instrument that looked very much like an ice pick into a patient's brain near the top of his or her eye sockets. Once the tool was inside the brain, Freeman would wiggle it around, with the purpose of cutting nerve connections. He got so good at it that he started doing lobotomies on an outpatient basis, sometimes taking only 10 minutes to finish. Often, he didn't use any anesthesia, although he did use shock treatments on his patients so they weren't aware of what was happening.

Freeman wrote about how effective his lobotomies were in erasing confusion, phobias and delusions in his patients, although he also acknowledged that "every patient probably loses something by this operation, some spontaneity, some sparkle, some flavor of the personality."

He also was quite the showman, frequently performing the procedure in front of journalists, and doing the surgery as often as 25 times a day. During one two-week period in 1952, Freeman performed 228 lobotomies in West Virginia, a project dubbed "Operation Ice Pick" by the local newspapers.  The publicity helped make lobotomies a particularly popular treatment for mental illness in the U.S. The number of people who had the procedure jumped from 100 in 1946 to 5,000 in 1949. Between 40,000 and 50,000 Americans ultimately received lobotomies, most of them between 1949 and 1952.

In fact, lobotomies were held in such high regard that Moniz was awarded the Nobel Prize in 1949. But there were more and more reports about the side effects of the surgery—that many patients were left in a catatonic state, such as Rosemary Kennedy, the sister of President John F. Kennedy (Freeman had performed her lobotomy in 1941.). Some countries, including Japan, Germany and the Soviet Union, banned lobotomies in the 1950s. And in the U.S., doctors began choosing to instead treat mental health patients with new drugs, such as Thorazine.

But Freeman kept at it. In 1960, he actually lobotomized a 12-year-old  boy whose stepmother felt he was too defiant. In 1967, he performed a third lobotomy on a longtime patient of his. It would be his last. After she died of a brain hemorrhage, Freeman was banned from ever operating again.

By the early 1970s, lobotomies had largely disappeared as a treatment.

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