Medicine: Mass Lobotomies

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The patients suffered from a variety of mental disorders. Some had anxiety neuroses, others fought against irrational fears, morbid thoughts, hallucinations, a few had drifted into suicidal depression. But for all of them the treatment was the same. Strapped to an operating table, they got three quick jolts of electricity—enough to start violent, involuntary convulsions before they lapsed into anesthetic coma. Next a thin, icepick-like leucotome was inserted under each eyelid, hammered home through the eye socket and into the brain. Carefully manipulating the two icepicks, the doctor severed the connection between thalamus and frontal lobes in the patient's brain. The entire operation took only ten minutes.

By the time he finished his experiments with patients in West Virginia mental hospitals last month, Washington Neurologist Walter Freeman had supervised or performed more than 200 of these transor-bital lobotomies (TIME, May 28, 1951) in two weeks. He already had more than 1 ,000 other lobotomies to his credit. Many doctors still doubt the wisdom of Dr. Freeman's surgery. "Lobotomy,"explained one psychiatrist last week, "is an operation of deduction rather than addition." It does irreparable damage to that part of the brain which is believed to control reason and judgment. It should only be used as a last resort, in desperate cases when all else has failed. But Dr. Freeman, who once said, "I won't touch them unless they are faced with disability or suicide," now believes that "it is safer to operate than to wait." Lobotomy, he insists, "should be considered in a mental patient who fails to improve after six months of conservative therapy."

Many psychiatrists also hesitate before the uncertain results of lobotomy. Completely successful, the operation may relieve a patient's tensions. It can also eliminate fear of pain. Dr. Freeman estimates that within six months, 100 of his West Virginia patients will have improved enough to leave the hospital. And getting people out of mental hospitals is his main objective.

But for the rest of the patients, and even those who are discharged from the hospital, the operation may be too "successful.'" Free from anxiety, they may become, instead, irresponsible, tactless, indolent. They will probably have trouble making up their minds, and may hear voices or echoes. Worse than that, some may regress into placid animals, helpless for the rest of their lives.

By last week Dr. Freeman had these statistics from his West Virginia experiment: of 228 patients, 86 have been discharged from the hospital; five have already returned. There are 36 more ready to go home as soon as their families can take them. Another 29 have shown some improvement but still need hospital care. Of the 77 remaining, 73 have shown no improvement; four have died.