It is with welcome relief that science has advanced in leaps and bounds since “the good old days.” No longer do people smear mercury on their skin, eat ground-up mummy parts to cure epilepsy, or rely on leeches to stop infections. Yet, even well into the 20th century, horrific medical procedures persisted — one of the darkest being the lobotomy.
Introduction
Lobotomies in their modern form gained traction as late as the 1930s. Earlier still, in 1888, Swiss doctor Gotlieb Burckhardt faced heavy criticism for his lack of morality after one of the first documented attempts.
Portuguese neurologist Egas Moniz pushed the practice into the medical mainstream. His leucotomy procedure involved removing or damaging part of the frontal lobe of the brain. Despite the devastating consequences, Moniz received the 1949 Nobel Prize in Physiology or Medicine for discovering the “therapeutic value of leucotomy in certain psychoses.”
Inspired by a Yale experiment on chimpanzees that showed drastic behavioural change after frontal lobe removal, Moniz applied the same principle to humans. Using a sharp instrument called a leucotome, he would sever the fibres connecting the frontal cortex to the rest of the brain.
Exploitation Under Walter Freeman
The word “lobotomy” was popularised by American physician Walter Freeman, who performed the surgery despite not being a trained neurosurgeon.
Freeman introduced the brutal transorbital lobotomy — an “ice pick” operation that involved driving a metal instrument through the eye socket, severing the connection between the frontal lobes and the thalamus (which he believed controlled emotions).
Sterilisation was not routine; Freeman often operated without gloves or a mask. The orbitoclast was hammered two inches into the skull with a mallet, rotated, then driven deeper before repeating the process on the other eye.
This showman-like figure performed more than 4,000 lobotomies across 23 U.S. states between the 1930s and 1967. Charging just $25, he operated on patients as young as four years old, sometimes working on both eye sockets simultaneously with instruments in each hand.
The results were devastating. Around 5% of patients died immediately. Survivors often regressed mentally, suffered seizures, or were left in a zombified state. Many were institutionalised permanently.
The grim reality: lobotomies were embraced because they made “managing” mentally ill patients easier, leaving them docile and subdued.
The Sad Case of Rosemary Kennedy
Women were disproportionately subjected to lobotomies, reflecting the gender and social attitudes of the era.
One of the most infamous cases was Rosemary Kennedy, sister of future U.S. President John F. Kennedy. Suffering from mood swings, seizures, and violent rages, her father Joseph P. Kennedy arranged the procedure in 1941 without informing his wife.
Performed by Walter Freeman and James W. Watts, the operation left Rosemary permanently disabled. As Watts recalled in Ronald Kessler’s Sins of the Father, Rosemary was only mildly sedated:
“We went through the top of the head. She was awake. I made a surgical incision in the brain through the skull, near the front, on both sides. The instrument looked like a butter knife. I swung it up and down to cut brain tissue.”
The result was catastrophic. Rosemary was left with the mental capacity of a toddler. She had to relearn how to walk and talk, suffered incontinence, and developed Erb’s Palsy in her arm. Her father never visited her again.
Rosemary lived to 86 but spent most of her life in care. Her story is often seen as having influenced JFK’s later advocacy for mental health reform, including the Mental Health Work Bill of 1963, the last bill he signed before his assassination.
Other famous figures subjected to lobotomy included Eva Perón and playwright Tennessee Williams’s sister.
Impact
(Photo courtesy of Gillies and Judd Family History)
Lobotomies were shockingly widespread.
- In 1949 alone, 5,000 lobotomies were performed in the U.S., up from 700 between 1940–1944.
- By 1951, 20,000 Americans had undergone the procedure, with the national total eventually reaching around 40,000.
- The UK carried out approximately 17,000 lobotomies.
- Worldwide, the figure is estimated at over 100,000, with Scandinavia recording the highest number per capita.
One of the first countries to ban the practice was the Soviet Union, in 1950. Over the following decades, lobotomies gradually fell out of favour as psychiatry and medicine advanced.
Epilogue
An inhumane, appalling medical procedure, the lobotomy feels like it belongs to the Middle Ages — yet it persisted well into the 20th century. Patients displaying symptoms of mental illness were subjected to a surgery that destroyed lives in the name of making them “manageable.”
What is most horrifying is how widely the practice was accepted and even celebrated. Lives and families were ruined by an operation that medical science eventually rejected as barbaric.
Thankfully, modern mental health care has moved far beyond such practices. While medicine is still imperfect, it is unlikely that the civilised world will ever again see something as destructive and dehumanising as the lobotomy.