Neurophilosophy

The rise & fall of the prefrontal lobotomy

lobotomy.jpg

LOBOTOMY (from the Greek lobos, meaning lobes of the brain, and tomos, meaning cut) is a psychosurgical procedure in which the connections the prefrontal cortex and underlying structures are severed, or the frontal cortical tissue is destroyed, the theory being that this leads to the uncoupling of the brain’s emotional centres and the seat of intellect (in the subcortical structures and the frontal cortex, respectively).

The lobotomy was first performed on humans in the 1890s. About half a century later, it was being touted by some as a miracle cure for mental illness, and its use became widespread; during its heyday in the 1940s and ’50s, the lobotomy was performed on some 40,000 patients in the United States, and on around 10,000 in Western Europe. The procedure became popular because there was no alternative, and because it was seen to alleviate several social crises: overcrowding in psychiatric institutions, and the increasing cost of caring for mentally ill patients.

Although psychosurgery has been performed since the dawn of civilization, the origins of the modern lobotomy are found in animal experiments carried out towards the end of the nineteenth century. The German physiologist Friedrich Goltz (1834-1902) performed ablations of the neocortex in dogs, and observed the changes in behaviour that occurred as a result:

I have mentioned that dogs with a large lesion in the anterior part of the brain generally show a change in character in the sense that they become excited and quite apt to become irate. Dogs with large lesions of the occipital lobe on the other hand become sweet and harmless, even when they were quite nasty before.

These findings inspired the physician Gottlieb Burkhardt (1836- ?), the director of a small asylum in Prefargier, Switzerland, to use ablations of the cortex to try and cure his mentally ill patients. In 1890, Burkhardt removed parts of the frontal cortex from 6 of his schizophrenic patients. One of these patients later committed suicide, and another died within one week of his surgery. Thus, although Burkhardt believed that his method had been somewhat successful, he faced strong opposition, and stopped  experimenting with brain surgery.

It was not until the 1930s that lobotomy was again performed on humans. The modern procedure was pioneered at that time by the Portugese neuropsychiatrist Antonio Egas Moniz, a professor at the University of Lisbon Medical School. While attending a frontal lobe symposium in London, Moniz learned of the work of Carlyle Jacobsen and John Fulton, both of whom were experimental neurologists at Yale University.

Jacobsen and Fulton reported that frontal and prefrontal cortical damage in chimpanzees led to a massive reduction in aggression, while complete removal of the frontal cortex led to the inability to induce experimental neuroses in the chimps. Here, they describe the post-operational behaviour of a chimp named “Becky”, who had previously got extremely distressed after making mistakes during the task she had learnt:

The chimpanzee…went to the experimental cage. The usual procedure of baiting the cup and lowering the opaque screen was followed…If the animal made a mistake, it showed no evidence of emotional disturbance but quietly awaited the loading of the cups for the next trial. It was as if the animal had joined the “happiness cult of the Elder Micheaux,” and had placed its burdens on the Lord!

On hearing the presentation by Jacobsen and Fulton, Moniz asked if the surgical procedure would be beneficial for people with otherwise untreatable psychoses. Although the Yale researchers were shocked by the question, Moniz, together with his colleague Almeida Lima, operated on his first patient some three months later.

On November, 12th, 1935, Moniz and Lima performed for the first time what they called a prefrontal leucotomy (“white matter cutting”). The operation was carried out on a female manic depressive patient, and lasted about 30 minutes. The patient was first anaesthetized, and her skull was trepanned on both sides (that is, holes were drilled through the bone). Then, absolute alcohol was injected through the holes in the skull, into the white matter beneath the prefrontal area.  

In this way, two of the bundles of nerve fibres connecting the frontal cortex and the thalamus were severed. (The thalamus is a subcortical structure that relays sensory information to the neocortex, and the thalamo-cortical projections are called the corona radiata.) Moniz reported that the patient seemed less anxious and paranoid afterwards, and pronounced the operation a success. Subsequently, he and Lima used a knife, which, when inserted through the holes in skull and moved back and forth within the brain substance would sever the thalamo-cortical connections. They later developed a special wire knife called a leucotome, which had an open steel loop at its end; when closed, the loop severed the nerve tracts within it.

These procedures were “blind” – the exact path of the leucotome could not be determined, so the operations produced mixed results. In some cases, there were improvements in behaviour; in others, there was no noticable difference; and in yet others, the symptoms being treated became markedly worse. In all, Moniz and Lima operated on approximately 50 patients. The best results were obtained in patients with mood disorders, while the treatment was least effective in schizophrenics.

In 1936, Moniz published his findings in medical journals, and travelled to London, where he presented his work to others in the medical community. In 1949, he was shot four times by one of his patients (not one who had been lobotomized); one of the bullets entered his spine and remained lodged there until his death some years later. In the same year as the shooting, Moniz was awarded the Nobel Prize for Medicine, for his innovations in neurosurgery.

The American clinical neurologist Walter Freeman (1895-1972) had been following the work of Moniz closely, and had also attended the symposium on the frontal lobe. It was Freeman who introduced the lobotomoy to the United States, and who would later become the biggest advocate of the technique. With neurosurgeon James Watts, Freeman refined the technique developed by Moniz. They changed the name of the technique to “lobotomy”, to emphasize that it was white and grey matter that was being destroyed.

leucot1.gif

The Freeman-Watts Standard Procedure was used for the first time in September 1936. Also known as “the precision method”, this involved inserting a blunt spatula through holes in both sides of the skull; the instrument was moved up and down to sever the thalamo-cortical fibers (above). However, Freeman was unhappy with the new procedure. He considered it to be both time-consuming and messy, and so developed a quicker method, the so-called “ice-pick”lobotomy, which he performed for the first time on January 17th, 1945.

With the patient rendered unconscious by electroshock, an instrument was inserted above the eyeball through the orbit using a hammer. Once inside the brain, the instrument was moved back and forth; this was then repeated on the other side. (The ice-pick lobotomy, named as such because the instrument used resembled the tool with which ice is broken, is therefore also known as the transorbital lobotomy. The photograph at the top shows Freeman performing the procedure on an unidentified patient.)

Freeman’s new technique could be performed in about 10 minutes. Because it did not require anaesthesia, it could be performed outside of the clinical setting, and lobotomized patients did not need hospital internment afterwards. Thus, Freeman often performed lobotomies in his Washington D.C. office, much to the horror of Watts, who would later dissociate himself from his former colleague and the procedure.

Freeman happily performed ice-pick lobotomies on anyone who was referred to him. During his career, he would perform almost 3,500 operations. Like the leucotomies performed by Moniz and Lima, those performed by Freeman were blind, and also gave mixed results. Some of his patients could return to work, while others were left in something like a vegetative state.

Most famously, Freeman lobotomized President John F. Kennedy’s sister Rosemary, who was incapacitated by the operation, which was performed on her when she was 23 years of age. And, on December 16th, 1960, Freeman notoriosly performed an ice-pick lobotomy on a 12-year-old boy named Howard Dully, at the behest of Dully’s stepmother, who had grown tired of his defiant behaviour. 

My stepmother hated me. I never understood why, but it was clear she’d do anything to get rid of me…If you saw me you’d never know I’d had a lobotomy.

The only thing you’d notice is that I’m very tall and weigh about 350 pounds. But I’ve always felt different – wondered if something’s missing from my soul. I have no memory of the operation, and never had the courage to ask my family about it.

So [recently] I set out on a journey to learn everything I could about my lobotomy…It took me years to get my life together. Through it all I’ve been haunted by questions: ‘Did I do something to deserve this?, Can I ever be normal?’, and, most of all, ‘Why did my dad let this happen?’

dully_icepick450.jpg

Howard Dully during his ice-pick lobotomy, Dec. 16th, 1960.

(George Washington University Gelman Library)

Dully’s mother had died when he was 5 years old, and his father subsequently remarried a woman named Lou. Freeman’s notes later revealed that Lou Dully feared her stepson, and described him as “defiant and savage-looking”. According to the notes:

He doesn’t react to either love or punishment. He objects to going to to bed but then sleeps well. He does a good deal of daydreaming and when asked about it says ‘I don’t know.’ He turns the room’s lights on when there is broad daylight outside.

Freeman recorded the events leading up to Dully’s lobotomy:

[Nov. 30, 1960] Mrs. Dully came in for a talk about Howard. Things have gotten much worse and she can barely endure it. I explained to Mrs. Dully that the family should consider the possibility of changing Howard’s personality by means of transorbital lobotomy. Mrs. Dully said it was up to her husband, that I would have to talk with him and make it stick.

[Dec. 3, 1960] Mr. and Mrs. Dully have apparently decided to have Howard operated on. I suggested [they] not tell Howard anything about it.

Following the operation, the notebook reads:

I told Howard what I’d done to him…and he took it without a quiver. He sits quietly, grinning most of the time and offering nothing.

Now in his late fifties, Dully works as a bus driver in California. About 40 years after his lobotomy, he discussed the operation with his father for the first time. He discovered that it was his stepmother who had found Dr. Freeman, after being told by other doctors that there was nothing wrong, and that his father had been manipulated by his second wife and Freeman into allowing the operation to be performed.

It was largely because of Freeman that the lobotomy became so popular during the 1940s and ’50s. He travelled across the U. S., teaching his technique to groups of psychiatrists who were not qualified to perform surgery. Freeman was very much a showman; he often deliberately tried to shock observers by performing two-handed lobotomies, or by performing the operation in a production line manner. (He once lobotomized 25 women in a single day.) Journalists were often present on his “tours” of hospitals, so that his appearance would end up on the front page of the local newspaper; he was also featured in highly popular publications such as Time and Life. Often, these news stories exaggerated the success of lobotomy in alleviating the symptoms of mental illness.

Consequently, the use of lobotomies became widespread. As well as being used to treat the criminally insane, lobotomies were also used to “cure” political dissidents. It was alleged that the procedure was used routinely on prisoners against their will, and the use of lobotomies was strongly criticised on the grounds that it infringed the civil liberties of the patients.

An excellent account of the effects of lobotomy, and of the ethical implications of the use of the procedure, can be found in Ken Kesey’s book One Flew Over the Cuckoo’s Nest. (This was made into a film in 1975, by Milos Forman, who received the Academy Award for Best Director. Jack Nicholson won the award for Best Actor in a Lead Role.)

The use of lobotomies began to decline in the mid- to late-1950s, for several reasons. Firstly, although there had always been critics of the technique, opposition to its use became very fierce. Secondly, and most importantly, phenothiazine-based neuroleptic (anti-psychotic) drugs, such as chlorpromazine, became widely available. These had much the same effect as psychosurgery gone wrong; thus, the surgical method was quickly superseded by the chemical lobotomy.  

Comments

  1. #1 gerald spezio
    July 24, 2007

    Terrific post, Mo. What a lesson.

  2. #2 josh
    July 24, 2007

    I find it amazing that blindly damaging an area of the brain was done so freely. I would like to see what percentage of lobotomy patients ended up like Rosemary Kennedy, and an in depth before-and-after of a successful lobotomy patient’s personality and cognitive abilities.

  3. #3 Shelley
    July 25, 2007

    Its not quite fair to present Freeman as such a crazed maverick. While at the beginning he faced some friction as to his ideas, he largely won over the most respected neurologists of the day. Quite a few doctors adopted his techniques (much to the detriment of patients).

    What I mean is, yes, now we can say frontal lobotomies are mutilating, debilitating, dehumanizing. But hindsight is 20-20, so to speak. Surgeries to reduce cranial swelling or bleeding, or tumor removal, etc might well have been termed barbaric with the methodology employed today. Freeman’s true mistake was to be so reluctant to give up the lobotomy technique after modern anti-psychotics came about.

  4. #4 tinyfrog
    July 25, 2007

    I didn’t realize you had included a link to the NPR story until I managed to track it down with google. You might want to make that link a little more obvious. It’s interesting to hear Howard Dully talk about things in his own words. (You can listen to the story by clicking on the MP3 after the link.)
    http://www.npr.org/templates/story/story.php?storyId=5014080

  5. #5 Francesco
    July 25, 2007

    Secondly, and most importantly, phenothiazine-based neuroleptic (anti-psychotic) drugs, such as chlorpromazine, became widely available. These had much the same effect as psychosurgery gone wrong; thus, the surgical method was quickly superseded by the chemical lobotomy.

    Fascinating. In most of the standard histories that you hear about these things (well, those I have read anyway), the introduction of Thorazine and the other drugs is depicted as a kind of miracle cure!! Could you go into this a bit more? What was so bad about Thorazine?? And what about many of today’s psychiatric drugs? For example, my brother—who is manic depressive and generally takes his meds very assidiously and sucessfully–often talks about Haldol as a “chemical lobotomy” or “zombie” drug that he would never take. Personally, I have serious doubts about the whole “business” (pun intended).

  6. #6 Sheldon
    July 25, 2007

    “He doesn’t react to either love or punishment. He objects to going to to bed but then sleeps well. He does a good deal of daydreaming and when asked about it says ‘I don’t know.’ He turns the room’s lights on when there is broad daylight outside.”

    As for this bedtime behaviour, this is typical of my three year old, but I think we will pass on the lobotomy. The rest is pretty typical teenage behaviour. Tragic indeed.

  7. #7 Moses
    July 25, 2007

    One day I was reading about the supporters of the Nazi’s sorted by a “professional class” domain in pre-WWII Germany. Lawyers were the least likely to support the Nazi’s, about 20% if memory serves me correctly. Doctors, OTOH, were the MOST LIKELY to support the Nazis, at about 80%. I actually found that shocking because, on my own, I would have gone the other way.

    The article went on to discuss some of the underlying reasons this may be so. And these underlying reasons made a lot of sense.

    So, while I’m not going to get into it; mostly because I don’t have the citations and I’m not really that interested in arguing the point, I will say that when I read that these things happen, and that the other doctors just followed right in line (allowing this to be “acceptable medical practice” without saying a damn thing… I’m not surprised.

    Not in the slightest.

    (And no, I’m not saying Dr.’s are Nazis. Rather that certain factors that attract people to medicine and the way medical training is conducted tend to select for authoritarian/compliant persons, versus law, which tends to attracts non-authoritarian/non-compliant persons.)

  8. #8 stewart
    July 25, 2007

    The best book on this, to my mind, is Great and Desperate Cures, by Elliot Valenstein, the neuropsychologist. Freeman was a neuropsychiatrist and neuropathologist, and his commitment to psychosurgery left him isolated once treatments changed.
    I’ve seen a few patients, many years post-lobotomy/leucotomy. They have been passive, docile, with little initiation, just as you’d expect from someone with marked frontal lobe injury. As usual in these cases of isolated frontal injuries, reasoning is fine, memory is grossly normal, it’s initiation, intention, and conation that’s affected.

  9. #9 Caledonian
    July 25, 2007

    What I mean is, yes, now we can say frontal lobotomies are mutilating, debilitating, dehumanizing. But hindsight is 20-20, so to speak.

    The data indicating how damaging the procedure was were available for decades before it became popular. Just how obvious does it have to have been before we can consider holding those who performed it responsible?

  10. #10 shyster
    July 25, 2007

    After reading this post all I can say is: I’d rather have a full bottle in front of me than a prefrontal lobotomy.

  11. #11 llewelly
    July 25, 2007

    I find these last few sentences puzzling:

    Secondly, and most importantly, phenothiazine-based neuroleptic (anti-psychotic) drugs, such as chlorpromazine, became widely available. These had much the same effect as psychosurgery gone wrong; thus, the surgical method was quickly superseded by the chemical lobotomy.

    Specifically, you say chlorpromazine and other early anti-psychotics ‘had much the same effect as psychosurgery gone wrong’ , but it had previously been my impression that the effects of early anti-psychotics were comparable (in the perception of psychiatrists of the time) to the best outcomes of lobotomies. Could you clarify?
    Separately, despite Shelley’s words, this account of Freeman’s work, like others that I have read, makes Freeman seem akin to an enthusiastic practitioner of alternative medicine; the focus on showmanship, and volume of patients, the belief that a treatment worked despite mixed results and lack of any clear theory as to why it should work, and most importantly, continuing to advocate a treatment long after the communities’ consensus was that it should be replaced.

  12. #12 HPLC_Sean
    July 25, 2007

    I wonder what medical techniques are currently done that will seem barbaric in 100 years time? Perhaps advanced drug eluting stents will replace bypass surgery. We are already seeing that laproscopy is replacing traditional surgical methods.

  13. #13 gerald spezio
    July 25, 2007

    Shelly, if 20-20 hindsight has its weaknesses (What is good history trying to do); there is much worse – no hindsight.
    Are modern anti-psychotics, Zyprexa, Stelazine, etc., significantly similar to an attack with ice picks in a medical setting, especially in terms of her does the administering? “True mistakes” is a new term for me, and it is pregnant with triplets.

  14. #14 mirror
    July 25, 2007

    I’m sorry Shelley. It is clear from the accounts that Freeman was one very sick motherfucker. Being part of a trend doesn’t make it non-evil.

    Vigorously resisting going to bed, spacing out, and turning on lots of lights in the house in the middle of the day, despite ongoing contrary efforts on our part, is a regular feature with my 11 yo.

    Sick bastard Freeman just wanted to experiment to see if he could use his miracle technique to “cure” a routine case of preadolescent (lively) boyness.

    Lots more could be said about the disconnect between self-agrandizement and concern for individual well-being of the patient among those treating percieved mental illness…

  15. #15 jeff
    July 25, 2007

    I shudder to think there are still people like Shelley around. I pray she is not in a position of power. Maybe I’ll renew my ACLU donation.

  16. #16 Ed Darrell
    July 25, 2007

    There is some evidence that people volunteered for the operation, too — “lined up around the block for it” as a friend of mine put it after a year of research. Among other things, these studies show the dangers of popular opinion.

    “Here, cue up for smack in the head with a 2-by-4!”
    “Sure! I can barely wait!”

    Listen to the entire radio program Mr. Dully put together. It’ll rattle you, if you’re sane.

    Now ask: What’s the 21st century equivalent of the transorbital lobotomy? How would we know?

  17. #17 Shelley
    July 25, 2007

    Oh good grief, I wasn’t defending his methodology, so just relax. I suppose my comment comes from the fact that I’m reading Freeman’s biography right now (“The Lobotomist”) and the author presents Freeman in a more humanizing light.

  18. #18 Mo
    July 25, 2007

    Shelley – it wasn’t my intention to portray Freeman as crazy. But he was a maverick, and he was very enthusiastic about the lobotomy. Actually, he was way too over-enthusiastic. Unlike Moniz and Lima, Freeman did not exercize caution. He performed 3,500 lobotomies; that is just reckless.

    Stewart – unfortunately, I think Valenstein’s biography is now out of print (but here’s an interview he gave). The book mentioned by Shelley in the previous comment is by Jack Le-Hai.

    llewelly – neuroleptics are VERY HEAVY drugs which basically zombify people. I have a first-hand account of their effects from a very good friend who was prescribed chlorpromazine after a single schizophrenic episode some years ago. He took one and threw them away because he didn’t like what they did to him. Fortunately, he hasn’t had another episode since. The neuroleptics have also been described as a “chemical straight-jacket”.

    mirror – watch your language!

  19. #19 apy
    July 25, 2007

    “In 1949, he was shot dead by one of his patients (not one who had been lobotomized). “

    Are you sure about this?

    http://en.wikipedia.org/wiki/Egas_Moniz

    “Dr. Moniz was shot in 1939 by a psychiatric patient. He survived and recovered completely[citation needed]. The patient gave vague reasons for the shooting saying he was unsatisfied with the dose of a drug Dr. Moniz had prescribed. Dr. Moniz died in 1955, in Lisbon, Portugal, of natural causes[citation needed].”

  20. #20 Mo
    July 25, 2007

    Sorry…my mistake.

  21. #21 Ktesibios
    July 25, 2007

    I can’t help being reminded of a comment made by a psychologist whom I saw for several years when I lived back East: “There are a lot of sadists in this field”.

    She was right. The “mental health” industry has historically had a truly ugly tendency to authoritarianism and a love of force and coercion, as well as being full of what the Germans call a “bicyclist”- people who, in the physical manner of a cyclist, nod deferentially at their “superiors” while treading on those below them in the social hierarchy.

    Freeman is just another example of how poorly the psychiatric industry does at weeding out the jeebers who aren’t fit to hold the position of chief dogcatcher, let alone wield physical power over others.

  22. #22 DuWayne
    July 25, 2007

    I heard a segment on NPR about Freeman, several months ago. When they brought Duffy on, to tell his story, it was mindboggling. I actually wept when they had him talk to his dad for the first time, about the lobotomy. I am really looking forward to reading his book.

  23. #23 moonenite
    July 26, 2007

    >With the patient rendered unconscious by electroshock, an >instrument was inserted above the eyeball through the orbit >using a hammer.

    Electroshock can be used to induce unconsciouness? I thought it’s only application was as treatment for mood dysfunction.

  24. #24 Kevin Z
    July 26, 2007

    Mo,

    Do you know if anyone has studied the historical relationship between phrenology and lobotomy? Was the practice of lobotomy derived from the study of phrenology in say the victorian era?

    Fantastic post. This should have been in a science history journal or popular science magazine instead!

  25. #25 Mo
    July 26, 2007

    I haven’t found anything to suggest any relation between the lobotomy and phrenology. But then, that’s not what I was looking for.

    As far as I can tell, the lobomoty is based on sound neurobiology. The thalamus is like a relay station for information going from structures in the limbic system (which are involved in emotion) to the frontal lobes.

    So, in theory at least, severing the thalamo-cortical projections would separate the emotions from intelligence.

  26. #26 Caledonian
    July 26, 2007

    So, in theory at least, severing the thalamo-cortical projections would separate the emotions from intelligence.

    And that’s precisely what happens – motivation, reaction, and the ability to construct complex behaviors to answer basic desires and needs are all crippled. Everything needed for higher thought, in fact.

  27. #27 Kevin Z
    July 27, 2007

    But it seems like the the next step in the study of phrenology in the 1700s and 1800s might have been to experiment with the bumps on people heads to see if one could manipulate personality (as theorized by phrenologists) and correct for certain personality “disorders” as defined by victorians. I guess I can sort of see a natural evolution, in that respect, towards performing lobotomies.

  28. #28 gerald spezio
    July 27, 2007

    The famous post war (WW2) actress, Frances Farmer, was brought “under control” in the fifties by severing her fore-brain from the rest of her brain. She was robbed of part of her “mind.”
    Jessica Lange’s magnificent performance in the film, Frances, will give you the heebie jeebies about psycho surgery in modern times as well as psycho anything. Could the masterful psycho surgeon, Freeman, have done the dirty deed on Frances’s brain meat?

  29. #29 Mo
    July 27, 2007

    According to this, it was Freeman who operated on Farmer. But the Wikipedia entry states that this was just a rumour that has now been been proven as false.

  30. #30 llewelly
    July 27, 2007

    llewelly – neuroleptics are VERY HEAVY drugs which basically zombify people. I have a first-hand account of their effects from a very good friend who was prescribed chlorpromazine after a single schizophrenic episode some years ago. He took one and threw them away because he didn’t like what they did to him. Fortunately, he hasn’t had another episode since. The neuroleptics have also been described as a “chemical straight-jacket”.

    I had thought that psychiatrists at the time thought lobotomies were at best comparable to this (often much worse), except that most (all?) of the effects of neuroleptics wear off after one stops taking them (an advantage lobotomy does not have.) That is to say, if you think chlorpromazine is psychosurgery gone wrong, I don’t disagree with you; instead I had thought that neuroleptics superseded lobotomies because psychiatrists in those bygone days saw them as comparable to the best that the psychosurgery extant at that time could do. You and I see chlorpromazine and so forth as ‘psychosurgery gone wrong’, but psychiatrists of those days I suspect did not, and in fact, many today would see chlorpromazine and other neuroleptics as less awful than lobotomy.

  31. #31 gerald spezio
    July 28, 2007

    Mo, you are one thorough and precise fellow. Give us more.

    I remember so clearly viewing the “This is your life” fiasco with fawning Ralph Whoever. As best I can recall, it was sometime about 1954, and I was in the ninth grade. Remembering it now makes me consider my own brain damage from fifties television. I never even considered that Frances DIDN’T have the alleged lobotomy until today. Much of what we are taught, learn, and come to believe as gospel is, indeed, pure nonsense and falsehood. Sad but true. Grazi.

  32. #32 gerald spezio
    July 28, 2007

    I just squandered more brain cells trying to decipher the actual date of my youthful dose of fifties tv flap and foo-foo. It appears that I must have viewed the Frances episode on the “This is your life” schmaltz show in 1958. Frances supposedly knew of her appearance on the tv show beforehand, and like most else, it was an engineered peeyar stunt to re-invigorate her career. Ralph Smooth and Saccharine, the host, was more foul than smooth. It is very powerful to recall my experiences here, because of all the flap and falsehood.

  33. #33 Alan
    July 30, 2007

    Frances Farmer was *not* lobotomized

    http://www.historylink.org/essays/output.cfm?file_id=5059

  34. #34 Travis
    July 31, 2007

    It is quite frightening to read about how blindly these types of things were both done and accepted by the world.

    Chemical treatments might be a step up from poking around at the frontal lobe of your brain, however, having a relative that’s undergone a lot of chemical treatments in order to fix his mental state, I know that even that can be just as blind and dangerous as physically cutting into the brain itself.

  35. #35 SK
    July 31, 2007

    “he often deliberately tried to shock observers by performing two-handed lobotomies, or by performing the operation in a production line manner. (He once lobotomized 25 women in a single day.)”

    I wonder what percentage of his patients overall were female? This is just so frightening to contemplate. If you were an outspoken, independent woman who was recovering from abuse and had depressive symptoms someone could simply neuter your personality for you? Yech. I wonder how many “uppity” women he rendered docile and obedient. Sickening.

  36. #36 TJ
    July 31, 2007

    The “nice” thing about lobotomy and electroshock is that they left no tell-tale marks. Somehow it became okay to murder a mind, so long as the basic functions remained. Eventually both were used to punish “incorrect” social behavior.

    Such attitudes towards the welfare of *others* — the good doctors never needing this kind of treatment — made possible experiments like Mengeles, the atomic veterans, the irradation of patients, giving syphilis to patients, etc. Even the gassing of millions became thinkable.

    Hard to fathom now. But that wasn’t so long ago. Hopefully we can keep those tides of fashion from rising again.

  37. #37 luke
    July 31, 2007

    I’m a little disturbed by the anti-psychiatry misinformation that’s being allowed to sit unchallenged on this page. Lobotomy is certainly barbaric by today’s standards, but the incentive to perform the operation is understandable to anyone who’s actually seen a few severely psychotic patients. How many of you have actually seen them? Most likely very few, if any, of you because society makes significant efforts to shield laypeople from it. The psychiatrists of Freeman’s era did what they could with the crude tools at their disposal, and it wasn’t very much.

    The statements made by several of you that neuroleptic drugs are “chemical straitjackets”, “zombify” people, or are equivalent to lobotomy are simply factually incorrect. Mo–your friend’s experience is hardly fair, since taking the first few doses of antipsychotics (especially the older ones, like chlorpromazine) is associated with nasty side effects, but those largely go away after a few doses. If we’re getting into anecdotes here, I have a friend who went psychotic during graduate school and was locked up for her own protection at an inpatient psych unit. She was put on antipsychotics, and now she’s finishing her second doctorate from an ivy league institution. The same thing happened to another friend of mine, and she was also put on antipsychotics (with some nasty side effects), and now she’s finished her masters and has a high-paying job in industry.

    A good analogy is cancer chemotherapy. Chemo is brutal, but most sensible people understand that it’s necessary because of how serious a disease cancer is. Well, serious psychotic illness (which most of you have never seen up close, and likely never will) is every bit as bad, and it’s much more common than most people think. Antipsychotic drugs are far from perfect, but they are absolutely necessary, and they make a huge difference in people’s lives.

  38. #38 Chuck
    August 1, 2007

    I’d heard (as an undergrad, from my physiological psychology professor) that Freeman would carry the icepick instruments in a leather doctor’s bag. And he drove a station wagon, nicknamed the “Loboto-Mobile.”

  39. #39 Mo
    August 1, 2007

    Yeah…I read about Freeman’s loboto-mobile the other day.

    “Step right up…it’s the lobotomy road show!”

  40. #40 Howard Dully
    September 1, 2007

    Thanks for listening, BTW my book “My Lobotomy” will be out September 4th 2007 and it goes a lot deeper than the 22 minutes that was allowed for the radio documentary.

  41. #41 Michelle
    September 10, 2007

    I was researching lobotomies for a project I am working on and came across this interesting article. My grandmother received a frontal lobotomy in about the mid-1950’s in England. She would have been in her 50’s at the time. She had been suffering from anxiety and some depression (her husband had been killed by a drunk driver a couple of years prior). Lobotomies were already quite controversial by that time, and my mother and her sister (who were only in their early 20s at the time) were under considerable pressure to authorize the procedure, which they did. After the lobotomy my grandmother’s anxiety had subsided but her personality had flat-lined. Apparently she had no emotional reactions at all, she had no interest in anything, and she spoke in an extremely monotone voice. Her attention span was also very short after the procedure. I don’t know if that’s typical. She died a few years after the lobotomy, from another cause. I know my mother felt tremendous guilt later about the decision she had made; I’m not sure if she ever came to terms with it.

  42. #43 Karl
    June 3, 2008

    luke: “The psychiatrists of Freeman’s era did what they could with the crude tools at their disposal, and it wasn’t very much.”

    It was not that Freeman did “the best that was possible at that time” to help these people. He “cured” children for their bad behaviour, people with simple headaches, communists for their ideas, etc. That man was obsessed with what he did.
    He was obsessed of creating mindless machines, of destroying people’s will and personality, and nobody stopped him. He was not an inch better than Mengele.
    Anything less than a war crimes tribunal for that sicko would have been intolerable. People get the chair for far less, he instead had a licence to kill off thousands of people!
    Which doctor would inflict physical damage on his patient?
    Without consent, without a court order, without anything?
    Didn’t they swar the hippocratic oath, “To practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them.”, and “ever to do deliberate harm to anyone for anyone else’s interest” to name just a few parts?

    It is unbelievable there are still some who defend him “oh, but he just wanted to help, and it was the best method of his time”. This is just sick. Everyone who conducted this type of “operation” still alive today should be brought to court.

  43. #44 Charles Yanofsky
    November 14, 2008

    I’m disturbed by unanimous condemnation of prefrontal lobotomy. I don’t think it’s fair. I’d guess that nearly everyone who has written in has never dealt with wildly psychotic manic or delirious persons. In the days that psychosurgery was performed there were no effective alternative treatments, no means of controlling dangerous injurious behaviors except restraints and torture such as immersion and these worked only temporarily and required prolonged hospital confinement. Many lobotomized persons were able to be discharged home. “Desperate Cures” is an apt description and Moniz and Freeman were not Joseph Mengeles. Freeman was certainly guilty of self aggrandizement and performing his procedures sloppily and too widely. The American media helped to popularize a procedure that reduced most to a state of docility and inertia. Lobotomies may have had limited efficacy at one time but are now simply outmoded. Medicine marches on.

  44. #45 Neuroskeptic
    November 15, 2008

    Two great books about lobotomy are Last Resort: Psychosurgery and the Limits of Medicine (academic) and The Lobotomist (shorter and an easier read.)

    One interesting thing I remember from these books is that the story about Moniz hearing Jacobson & Fulton’s lecture and then getting the idea of lobotomy, is probably a myth…

  45. #46 chrisT
    December 2, 2008

    truly fascinating ^_^ i love a good rally show of clinical work! my goodness what great informalities you have given me! i find it so very lovely! <3

  46. #47 meherna
    December 8, 2008

    I don’t know this just seems unreal. I feel so sorry for the patients. No one should ever stick a knife in the brain without knowing exactly what things are, where they are, and what they do. I wonder what the patients thought of this procedure. Freeman should have never been awarded.

  47. #48 Neuroskeptic
    December 13, 2008

    I write about a case of a possible, unintentional self-lobotomy here

    There’s another one on record involving a crossbow…

  48. #49 marc
    December 13, 2008

    Well done. I realy enjoyed to read this article.
    Greetings from Germany,
    Marc

  49. #50 StrangeAngel
    January 2, 2009

    He doesn’t react to either love or punishment. He objects to going to bed but then sleeps well. He does a good deal of daydreaming and when asked about it says ‘I don’t know.’

    It actually sounds like the boy may have been autistic, possibly Asperger’s. Of course at the time there’s no way he would have been diagnosed as such, as although it had been named, autism was not commonly diagnosed, and Asperger’s was definitely not a diagnosis to be considered at the time.

  50. #51 Iain
    January 14, 2009

    The modern practice that springs to mind is the treatment of children who are said to have ADHD. I have heard the supposed symptoms of ADHD described as “childhood”. There may be medical condition for some of them, but I’d bet that there are a whole lot for whom it is just convenient to the adults to keep them drugged.

  51. #52 amy30
    January 14, 2009

    Well I think that lobotomy were terrible . But to say that anti-depesent and neuroleptic drugs are just as bad is wrong . There are people out there that need them to function , I am one of them. I was just in the hospital becuase of sever axaity (sorry about spelling) and oppsesive,compulsive,disorder also bi polar . If it was not for my meds I would still be there they have helped me greatly . They do have side effect I do not like . But it better then how I was feeling .And I tell my doctor what I do not like and we are slowly getting me on the right drugs that will help me with the least side effects .
    What I do not like about these meds is how people treat you once they find out you are on them and how they think you do not have to be on them that theres nothing really wrong with you . Anyways I am glad I am in today day and age becuase if I was back then they would have locked me away and gave me a lobotomy . O by the way they still do eltro shock treatment on people that have really bad mental disorders some of the people I take to while I was in the hospital told me they had it . But now they hook a think up to your toe and shock you that way . But they still loose some of ther memories which I think is sad

  52. #53 Tony P
    February 5, 2009

    I’d see the equivalent 21st Century barbaric practice as that of conversion therapy, you know, changing gay to straight.

    I’ve seen a number of people come out of that process as more fucked up messes than they were when they went in. And yes, they were still gay.

  53. #54 santo agostinho
    March 2, 2009

    It’s a wonderful post, a great history. Congratulations!!

  54. #55 digger
    March 11, 2009

    Do you see that set of keys on Freeman’s belt as he operates? What’s up with that? Did he have a job as a janitor? The guy was an enthusiastic monster, destroying lives with manic abandon. Frankly, he was mad, and should have been lobotomized. If merely imprisoned, he would certainly have operated on fellow inmates. Unfortunately, the history of psychiatry is rife with pseudo-scientific figures who seemed attracted to the field mainly for the power over others, a deep desire to control and destroy lives, the ego gratification of having their ridiculous theories taken seriously, and of course, the governmnent checks.

  55. #56 nayara alves
    March 27, 2009

    That was an amazing post, bringing up a very controversial and important subject in our History.

  56. #57 Moss Bliss
    April 5, 2009

    Anyone wanting to know of the MANY damaged people, from lobotomies, use of “anti-psychotics”, and other forms of mental health “treatment”, should read Robert Whitaker’s excellent book, “Mad In America”. There is also news that he is working on a new book on the subject.

    People diagnosed as “mentally ill” are ROUTINELY treated as though they are no longer people. If you don’t take your drugs, you can be confined and forced to take them, regardless of whatever provable damage the drugs are doing to you. Ditto for electric shock, euphemistically called “electro-convulsive therapy”. Ask Ray Sandford what he thinks of ECT, the State of Minnesota has forced him to have ECT every couple of months for several years, and his doctors will not even state how long this must continue.

  57. #58 Nilmadhab
    April 9, 2009

    Superb.

    I thoroughly enjoyed the post.

  58. #59 Anu Beginning
    May 10, 2009

    Racism is racism no matter how much you try and white wash it, sugar coat it, or talk about it in agreement behind the safety of your white picket fence. The bottom line is white supremacists then and today have and continue to hide the fact they went to Kemet (africa) to get the ancient scriptures and text on the study of the soul and body. White being unable to grasp the complexity of such sacred information have chosen instead to use it as a tool against the beings they still psychologically/spiritually terrorize. The white supremacist is always at war not just with others whom are different from him but with him self and fear of letting other’s see his true savage non-noble self.
    If this was even a little true than your forefathers would not have written their names on Moorish Sciences/Music. Mozart did. He couldn’t hear a damn thing a black/Kemetian wrote the songs. Shakespeare was also a Moor! You guys have nothing, and this is proven fact today, have not created new anything it all has come from Kemet and this includes the bible. Romans and Greeks were too busy having sex with other whites they thought were another species. Ergo the Women/Venus, Men/Mars garbage. You guys will not be allowed to kill us all to hide the awareness continuing to rise. You had to start demonizing us from the inside out in order for your pseudo-science to take hold. You finished it off with your mason demon god for extra measure.
    None of this however is true. You really need to ask for the real documents and canons about Kemetian peoples that have been collected by secret scientists in order for you to get the point. This crap here was a stepping stone and since white supremacist can’t stand being wrong day after day, year after year, they’ve had to dig a little deeper. What they’re coming to is that black is in no way inferior and that whites however are. Brain size has never had anything to do with this but, it’s been a great way for whites consciousness to be cleared whenever they’re called out on their thoughts, actions, words, etc.

    But in everything you say we don’t have you quickly scope up from us. This cultural poaching started back in the 1600’s from the busts of white supremacist whores to the music. White supremacists learned how to be civil and deal with their social, political, sexual problems from not just Kemetians but First People’s also. LMAO.
    You ain’t come that far unfortunately. Just a bunch of racist neanderthals with on bullet in six shooter.

  59. #60 Manuel Correia
    May 21, 2009

    It is a minor correction: Moniz was shot in 1939 (ten years before he got the Nobel Prize).

  60. #61 lamprey
    June 14, 2009

    Earlier today I was chatting with an anesthesiologist acquaintance of mine about his son, and a mentee of mine, who will be starting medical school together this Fall. I mused externally that perhaps I should have gotten an M.D. to compliment my Ph.D. and neuroscientific training. The thought continued to hang heavy on my mildly regretful mind throughout the day. “I am a creative fellow,” I complimented myself. “Perhaps I could have come up with some clever surgical techniques!” Powerful, indeed, is the temptation to intervene in very direct ways, especially to stop human suffering or to affect the human condition. Ah, but after reading this blog by Mo, some peace has been granted. By a career choice, my tendencies toward putting exploration into practice were checked and the great Hippocratic injunction to do no harm was decisively satisfied.
    (As a minor note, I found the comment in support of the ACLU in Post #15 to be bizarre, to say the least. Personally, I’d throw my hopes in with the conservatives and their legal organizations. I trust more their capacites to apprehend and defend human dignity and freedom.)

  61. #62 mikele
    August 12, 2009

    Great. I was inspired by this post, so I made version for my blog too. I like your retrospective posts.

  62. #63 Peter
    October 20, 2009

    Thanks for a great summary. Beside US, lobotomy has been common treatment in scandinavia. Sweden has a lobotomy frequence 2.5 times the US. Interresting to note, the same pattern occur ; a strong, charismatic person is advcating the treatment, himself preforming and evaluating (not always correct i might add) thus building a carieer.
    The lobotomy will always remain in a gray zone of history – partly because ambition, presige and poor jugement of singular individuals as much as the treatment itself.

  63. #64 Sandra Lozes
    October 29, 2009

    Wow, glad I found your blog. I am no scientist, but I have been fascinated by the brain since as far back as I can remember. I read the autobiography by Howard Dully, “My Lobotomy” along with what I consider a great companion read on Freeman, “The Lobotomist.” From what I read, Freeman was definitely a maverick, and his ambitions to promote his methods were very misleading. He used a chimp during a medical symposium to show how well the leucotomy worked. What he did not disclose however, was that the chimp died soon after.
    Initially perhaps Freeman wanted to help the very mentally ill, and others were treated for chronic pain that left them unable to function. However, like many ambitious and ego driven people, he became less selective on who he chose for the procedure. Howard Dully was such a case, and at the tender age of 13 it is unimaginable. “The Lobotomist” was written in a fairly objective manner in my opinion. I believe an earlier post said he was seen in a positive light- unless compared to another book, I disagree with that opinion. It was all very disturbing to me, and I am not in any way an adversary to psychiatric medicine and practice. Freeman did carry around a custom made “ice pick” leucotome with an inscription…perhaps his name or initials, I can’t remember exactly. He also was not well taken by the psychiatric community, ie the surgical community. He was not a surgeon, and had no business performing surgeries. He was also all about quantity, and not keen on sterilization—note the above photo—no gloves, no scrubs, mask, etc. It is unbelievable!
    Howard Dully, you are brave to tell your story. I have tons of respect for you, and I thoroughly enjoyed your book. I am sorry your father allowed himself to be manipulated by Lou. It sounded like you did have family who were fighting for you, and I hope you have found some happiness in finding the truth you longed for. Again, you have done a great justice in sharing your experiences, and shedding light on a little known dirty secret many never knew about. Bravo and thank you!
    In regards to the followers of this experiment, I believe Milgram did a fine job on showing how easily humans are persuaded into doing what they are told because an authority says it is okay. Social group think. Thanks for the great history!

  64. #65 Jon
    November 22, 2009

    I would like to relate several experiences I have had with doctors regarding treatment for mild psychological disorders.
    1) I was prescribed Chlorpromazine by a general practitioner for anxiety. It felt like wet concrete had been poured into my brain and then solidified, leaving me unable to think.
    2) I was hospitalised for schizophrenia, based on lies told by a neighbour of mine, though I had earlier seen a psychiatrist about hearing voices. I found the psychiatrists to be a bunch of authoritarian assholes who used hospitalisation as a form of punishment / social control.
    3) I have been on 3 different drugs for voices, all quite new and based on current theory and practice – none of them work. After I decided to go off the drugs the female voice I used to speak to (quite happily) told me she was bored with me and has since refused to talk.
    4) They also tried a fourth drug but I refuded to take it because it made me feel retarded and gave me a voracious appetite. I was a voluntary patient at that stage so they didn’t mind my refusal, but had I been in hospital it would have been mandatory.
    5) The vast majority of people I met in hospital had little if any psychiatric disability, but doctors in my country (Australia) repeatedly write into newspapers claiming a chronic shortage of beds to treat the seriously mentally ill. Psychiatry, from my experience, is an industry. As in many industries its practitioners are mainly interested in maximising their income by exaggerating the prevalence and seriousness of “mental illness”. They are also mainly authoritarian bastards who routinely invent symptoms (in my case, a supposed “lack of affect”), chronically overestimate the seriousness of “illness” in the patients, and are more than happy to step all over their human rights.

  65. #66 Crazy Mermaid
    December 12, 2009

    Your article, as usual, is well-written, though I have one small objection. Calling medication a form of lobotomy is counterproductive and frankly just wrong. I’ve experienced life without medications and with it, and life substantially improved with the meds. I wouldn’t call medication a lobotomy any more than I would call some other medication that treats an illness like diabetes a “lobotomy”. If the symptoms are bad enough, the medication is a good thing. I would even hedge a bet that Jon, your poster of 11-22-09, has not yet found a sufficient combo to work for him. He implies that hearing voices isn’t a bad thing, and that he shouldn’t be medicated because of them. But his escalating crossover into the world of delusions will eventually cause himself and/or others harm. That’s why he needs meds.

  66. #67 Name
    January 8, 2010

    Science is in the wrong hands. Other methods have emerged since. many all in the name of mind control and torture not just inside the lab but in torture centers disclosed or undisclosed and more horrific attack taking place in the privacy of once home. microwave attacks and various form of electroshock.
    In third world countries and respectable so called democracy. The cases will surface gradually. The politics of fear is a powerful forms of repression and oppression, for now. if they can kill a million they can kill one. Adam

  67. #68 Elfie
    January 24, 2010

    Interesting article, but as many have noted – the author doesn’t know what the fuck he’s talking about with regards to anti-psychotics. Nobody who claims to be a scientist should ever make judgments on medical treatments through *anecdote*, period.

  68. #69 Elfie
    January 24, 2010

    Article is interesting, but author doesn’t know what he/she is talking about with regards to anti-psychotics.

    Any scientist worth his/her salt doesn’t make judgments off anecdotes. This is how anti-vaccine woo gets started.

  69. #70 Cat
    February 11, 2010

    A very interesting article.

    I would like to point out to the other commenters that the Citizens Commission on Human Rights is a known affiliate of the Church of Scientology and as such, should not be considered a reliable source.

  70. #71 Ben
    May 12, 2010

    “He doesn’t react to either love or punishment. He objects to going to to bed but then sleeps well. He does a good deal of daydreaming and when asked about it says ‘I don’t know.’ He turns the room’s lights on when there is broad daylight outside.”

    That only describes what, about 50% of teenage males? Talk about an evil stepmother…

  71. #72 sickened by this
    May 19, 2010

    I think the SSRIs and related drugs are the lobotomies of our recent era.

    I think we’ve got a lot of sick f*cker scientists out there. Think about all of them who perform experiments on animals to test drugs, surgical procedures, and the effects of trauma, like they’re Jeffrey Dahmers with advanced degrees. I’ve read accounts of experiments on PubMed that brought tears to my eyes. I cannot imagine what kind of person could incluft such torture on animals. Likewise, what sick person would poke around in someone’s brain with crude instruments and a lack of precision? (shudder)

  72. #73 Todd I. Stark
    July 16, 2010

    Great perspective piece, Mo.

    I’ve always found psychiatry to be an easy target. It’s a profession based on the assumption that we can solve problems where we don’t even understand the illness, and sometimes don’t even recognize it as an illness. More than a little challenging. Easy to attack the desperate measures taken historically to address dark shadows on the mind.

    Many of us who have worked in psychiatric hospitals directly with the profoundly psychotic and disturbed and suffered along with them tend to be slightly more sympathetic toward the attempts to find and promote humane treatments even though it is a bittersweet course.

    Yes there are plenty of abuses of the mentally ill to be found, no argument, but these did not begin or end with psychiatric medical treatments. Pinning the focus of anger and blame on the psychiatrists who were trying to help makes me very sad and frustrated.

    Most people didn’t even want to know schizophrenia existed outside of lunatics in the movies and wanted to believe depression was a trivial matter of sadness when a few folks were actually looking for ways to help these people hidden away in awful places. Freeman came out of that motivation although he overshot it by quite a bit by trivializing the significance of cutting into the brain.

    I found Freeman’s showmanship and extremism and lack of restraint extremely offensive, but the people who think he was just a “sick bastard” are also way off the mark. He was more like the overenthusiastic evangelist for a movement toward doing something better than just warehousing florid psychotics in restraints and cages.

    It’s a nightmare when your own mind betrays you, and we still don’t have any easy answers to some of the worst problems. In some cases even an extreme medical treatment is considerably more humane than the alternative, leaving people alone to live with the nightmare of a deteriorating mind and often an acute awareness that their capacities are deteriorating. People better recognize how sad Alzheimer’s is, but we often still think of psychosis as some sort of joke and criticize the albeit crude attempts to treat it or revert to ridiculously prejudiced sources like the offshoots of the CoS rather than contributing to better medical understanding of the seriousness and often intractability of the problem.

  73. #74 Todd I. Stark
    July 16, 2010

    A note on anti-psychotics: yes they are a big hammer. Yes it makes a certain sort of sense to say that chlorpromazine for example has (temporary) affects reminiscent of radical prefrontal leucotomy (they were once referred to as “major tranquilizers” for a reason, “antipsychotic” isn’t really accurate for Thorazine). They usually don’t get rid of the voices and they generally don’t help the distorted cognition, and the low compliance on most of them shows that people find them unpleasant rather than helpful. They do have a therapeutic role other than “zombification” however when psychosis is extremely debilitating.

  74. #75 Ashli
    July 19, 2010

    I suspect Dully had Asperger. I say this because I have an 11-year-old with the condition, and some of the things the horrible stepmother mentioned are textbook Asperger, like seeming to be oblivious to the weather (wearing long sleeved shirts in summer and short sleeved t-shirts in winter), not wanting to work with his hands, odd gait, “flailing” arms, defiance, meltdowns (not wanting to go to bed), not having a particular reaction to pain, etc. Lou was NUTZ. Living with a child with Asperger can be harder than hard, but I have no sympathy for Lou (who instructed one of the sons to attempt to kill the dad with a hammer by the way). I have no sympathy for Howard’s dad who was ultimately totally into himself and didn’t protect his child from what he KNEW wasn’t right (he never thought there was anything wrong with Howard, but he let people mutilate his adolescent child’s brain). I have no sympathy for Freeman who complained that he was being treated as an undesirable, lumped in with the likes of abortionists by hospitals that wanted no association with him. But he WAS akin to the abortionist, tearing into children’s precious brains and destroying them because their parents gave consent. I am heartbroken for Howard and how, as a victim, he still sought approval and love from his victimizers, because they were his parents, and children are wired for love. I am disgusted and hurt by his dad’s reaction to Howard’s searching for answers (and love) as an adult. I am deeply angry that Howard’s dad finally left Lou in order to protect his dog and that he even “protected” Lou’s corpse from Howard’s benign presence at her funeral. He didn’t protect his little boy from lobotomy nor did he give much of anything of himself or his comfort to help heal the hurting heart of the man his son had become after lobotomy. Somehow Howard overcame all of this and has an extraordinary attitude that serves him and others well. God bless you, Howard. God bless you and keep you forever. You are much loved by the Lord, your true Father in heaven. For His good purpose He hid you in the shadow of His wing, and the leucotomes were not permitted to rob you of your sanity or your soul.

  75. #76 mark
    August 20, 2010

    Good God, a lobotomy on a 12 year old for day dreaming. And to think some of the comments seem to justify this with an, oh well live and learn attitude, sickening. As a person who has struggled with depression, anxiety, and suicidal thoughts my entire life, I am thankful I was born in 1963 and not in 1953. I have been on different medications and for years on none at all, however if one medication doesn’t seem to be working my doctors try a different or newer one until the desired results are achieved. MEDICATIONS CAN BE ADJUSTED OR STOPPED, A LOBOTOMY IS FOREVER.

  76. #77 Nowhere Girl
    August 31, 2010

    Lobotomy of the 21st century? For me it’s clearly “treatment” of intersex children. What’s common to psychiatry and to medicine in service of gender order is the risky involvement with extremely oppressive social control (some degree of social control in neccessary, but when it aims to eliminate psychological and gender “freakness”, it’s clearly authoritarian). In extreme cases the patients have no rights, everything about them may be used to their detriment.
    Just think of what is being done to children who are intersex or just a bit sexually ambigous. Everyone is mad about so-called “female circumcision” in some African countries, but what about something similar being done in America? Surgery on “oversized” clitorises because they look “unfeminine”. Some of these girls were left with complete, biologically grounded anorgasmia. So now a “good doctor” is trying to operate on clitorises without damaging the nerves – later he examines girls to see if everything went right, touching their extremely intimate parts with something most people would just call a dildo. And he’s expecting parents to allow him further follow-up. Poor girls – raped with their parents’ consent! And they have nothing to say because they are children, they have no right to intimacy unless their parents are able to resist pressure from the doctor.
    Another example: boys with “micropenis”. Not so rarely they are changed into girls because the doctors presume a man won’t be able to function without a porn-movie-like rod. Compare this to procedures in cases of sex reassignment: they are very strict and it’s not bad because it’s meant to ensure only truly determined transsexual people are able to pass them – so they don’t regret after something irreversible has been done. In some cases it goes very far: here in Poland doctors and courts quite routinely dismiss nonheterosexual transgender persons (male to lesbian woman or female to gay man), they believe one can’t be homo- or bisexual and transgender at the same time. A person I know has heard something like: “I don’t believe you [that you feel a woman] because you are wearing male socks”. At the same time tens of little boys are being changed into girls with no regard if they will ever accept their new gender (just think of the case of Bruce/Brenda/David).
    Our thinking-feeling (I will never regard the “intellectual” and “emotional” as something separate) and our gender identity – and everything so deeply within us – are so personal, so intimate, so fragile that they should to a highest degree possible be left to personal discretion. A person who is deemed “mentally ill” but doesn’t pose any danger to others should be left in peace if he or she wishes so. Some diseases are in my opinion no diseases at all – “ADHD” is definitely overdiagnosed and many say it’s just childhood behavior, depression is sometimes a completely normal reaction to something touching the fringes of human endurance. We should treat causes and not effects. But it’s easier, it takes less time to solve the problem with an ice-pick or a “magic pill”.
    Conflict-of-interest statement: yes, I deeply distrust psychiatry, I’m less than 100% “normal” myself, I’m a feminist, I have gay and transgender friends, I chose to live an asexual life, I’m deeply, though so far theoretically, fascinated with psychedelics. But I believe my point of view is valid as well. There is no “objectivity”, everyone is subjective and there’s no reason to automatically put scientific subjectivity over personal subjectivity. Everyone has something to say and we better listen instead of dismissing personal perspectives as “unobjective”.

  77. #78 D Chambers
    August 31, 2010

    “I wonder what medical techniques are currently done that will seem barbaric in 100 years time? Perhaps advanced drug eluting stents will replace bypass surgery. We are already seeing that laproscopy is replacing traditional surgical methods.”

    In my eyes, Chemotherapy is an extremely barbaric practice. Unfortunately/fortunately, it is the most effective treatment. I do believe 100 years from now people will be looking back on its usage in a similar way we look at lobotomies now, though certainly not to the same extent as there were other options for mentally ill patients and aren’t many for cancer patients.

  78. #79 L. Corvid
    October 12, 2010

    This article was a very interesting read. My grandmother recently died. In the 1940s and 1950s she underwent three or four separate lobotomy procedures, each one cutting away a little more tissue. Why anyone would lobotomize someone ONCE is a good question. Four times is outside my comprehension. In my lifetime (I was born in 1970), my grandmother was a barely functional person. She could perform basic daily tasks, but there was no one home upstairs. She had no personality, no affect, nothing. All I remember of her is random inappropriate giggling and her awkward, empty smile.

    The family says that she was diagnosed as mentally ill (what kind of mental illness, no one knows) after the birth of her first child (my father) in the early 1940s. She apparently had some seizures, and some kind of “fit” involving violent behavior. She was given her first lobotomy between her first and second child. Her family was extremely poor and uneducated, putting her in a terribly vulnerable position. What I cannot understand is, if the first lobotomy did not fix the problem, why would her doctors do it AGAIN? (and again?) My mother, who is a nurse, believes that my grandmother was used as a kind of test subjest- an easy thing to do with a woman of limited education and no resources.

    I always wondered what my grandmother would have been like if she had been whole. Her story makes me sad, but I must say, Howard Dully’s story is an entirely different level of tragic.

  79. #80 Evelyn
    October 12, 2010

    Late coming to this article but in my work in the 1980s in a large institution for the developmentally disabled I came across several folks who had lobotomies, or that I suspected had had them, as they were not listed in the records. Several of them were physically disabled, from what cause was unknown. Many of them were violent and difficult to manage even with the rather incredible amounts of neuroleptic drugs that were administered to them. So much for “calming folks down”, eh? Thank all that’s holy, the institution has since closed.

    I can’t imagine a less scientific treatment or a crueler joke than to do more damage to an already dysfunctional brain. These operations were performed without permission on children and young people whose parents had been counseled by the “authorities” to give up their children and forget they had ever been born. Most of these folks were middle-aged or elderly when I helped to care for them, and were victims of a system that exploited them from a young age. Some were taught to box as amusement for the caregivers in the earlier parts of the last century. Some did farm work to help supply food for the system — which was an improvement over what they did at the institution, in my opinion. All had been abused in some way.

    It was hurtful to read the records of these folks when I was 22, and it still stings to think of them now, 30 years later. Many of them have passed away. I hope they have peace.

  80. #81 PraeToriaN
    January 17, 2011

    The INEVITABLE RESULT of a DELUSIONAL and INSANE MANKIND

    As one that has been subjected as a minor to a “modern” psychiatric institution, and “chemically” lobotomized in proportionate fashion in a “top-three city” in the US, I agree wholeheartedly with this article.
    As a sane individual, en-caged and forcibly subservient to the insane “doctors”, “leaders” and controllers of the time, indoctrinated on how to be a willingly conforming individual in their supposedly “civilized” society, yet living with other “normal” yet rejected and/or abused individuals subjected to this exploitative, engineered, centrally-planned cult-ure for a “portion of time”.
    I can say I know that the modern psychiatric-pharmaceutical drug industry era will be looked at in similar fashion at some point in the future (as some elements on the fringe of society already know), but of course, that requires the intellect of the cult-ure to increase exponentially as it thought it did during the transition from physical to chemical lobotomies and medicines to drugs.
    The problem herein relies upon experimentally “treating” humans in similar fashion as they have with animals, with an unproven belief they are one and the same, a fore-bearer of, or a “coal-mine canary” of the human race, in the hopes of achieving the same or similar results, thus requiring a prerequisite of a culture of so-called “science” based on unproven theories and the current paradigm and exploitation of Darwins’ ill-founded yet “modern” theory of evolution as their core doctrine and not on deciphering the infinitesimal amount of code contained in human DNA which is a monumental task, if indeed even possible, and yet they maintain the audacity and deceit to continually label it “medicine” as if it were the same medicine humans thought of and used for millennia.
    (see: misdirection, propaganda, perception management & information warfare)
    Therefore they no longer follow scientific principles, but a perspective and intent of manipulation of the human being and mind, with the goal of achieving a contrived and a desired result, an exertion of dominance, manipulation and control, not in which to help or aid, but to conform, mold, re-create, sublimate the human being and to further the future advancement of this innovation, technology, ability, experimentation and manipulation either ignorantly or arrogantly.
    This religious-like infusion of certain specified ideologies has an extremely disturbing contextual relationship to what the Nazi’s were trying to accomplish in their pursuit of acquiring and implementing the Aryan/Alien/God race of beings through their then-current “modern” eugenics programs and “experimentation’s” on “lesser” races and forcible control of population groups (as opposed or in contrast to other governments and/or dictators simply eliminating or terminating such ‘undesirables’ during the twentieth century).
    This paradigm is perceived to be science, scientific, or even fact, by a majority of uneducated or naive individuals in society, but when actually examined, most of its qualities are entrenched with theories, ideologies, superstition and doctrine, more akin to folklore, fairy tales and bed-time stories than with respectable, civilized, institutions working for the betterment of individuals, society and the human race as a whole.
    Yet, how often have we heard of civilization, being civil, bringing “civilization” to the “uncivilized” at the tip of a spear, end of a gun or bottom of a bomb in the thousands of years of known human existence on this planet?
    This “modern” ages practices, delusions, exploitations, illusions, manipulations and deceit, et cetera – ad nauseum infinitum, is utterly appalling, disgusting and abusive, etc, on so many levels, yet remains unseen, unnoticed and unchanged due to lack of critical thinking, level of education, perception, or psychological blockage, cognitive dissonance, complacence, insensitivity, etc, by society and heralded, promoted, funded and furthered by governments, military’s, medical establishments and institutions, etc, and on top of it all, is claimed to be an advancement of human civilization, which is a pure representation of the complete and utter failure and destruction that human beings are capable of, constantly repeat, and continually implement in their societies around the world for thousands of years.

    “Speaking the Truth in times of universal deceit is a revolutionary act.”

    “Que es Veritas?”

    Its pretty obvious what needs fixing…
    Yet how will it be changed, when the blind lead the blind?
    When the people continually believe that which they have been led to believe?
    When those who lead are the most corrupt of all, servicing their own endeavors, by any means willing, to any end thought worthy, by relativising ethics and morality to suit their fancy or any pursuit they see fit.
    This is the error of mankind, the hindrance of humanity: the contempt and devaluation of life, which they cannot even create but only can manipulate, terminate and reproduce.

    Maybe this is their envy, and the cause for their actions.
    The consequences which untold numbers have endured and suffered.

    It should be apparent that man cannot save mankind.
    So I ask, Who will save us from ourselves?
    That subject matter has been and is addressed elsewhere.
    Seek and you may find, if you so choose.

    My intentions from my experience and perspective are to make known this information of human depravity in reality, which can be incorporated into knowledge, and eventually be applied through wisdom, in the hopes for a “should be” humanity and not a “we are” civilization – often found comparing to more degraded situations and circumstances for comfort and complacency, instead of what we should be, and what we should be aspiring to.

    LIGHT UP the darkness…
    I bear my candle;
    for those who choose to see,
    or seek to find.

    Relativity s&g, quantum mechanics, universe location, zero point energy, gravity, thermodynamics, electromagnetic spectrum, time, string/dimensional theory, planck length, energy, Pi, DNA, etc, (ad nauseum infinitum again) all uniquely explained through math(the language of the universe) that most humans do not know anything about reality, and the mere .0001% of the portion of reality they can interact with, measure, sense, etc, they arrogantly, albeit ignorantly, declare, think and act as if it is the “be all, end all” and they are masters of the universe, creators of their own domain, and gods in their own right, all knowing and yet ever advancing, when in fact it is their own illusion, fueled by their delusions of grandeur, and spread as a disease amongst, over and atop their brothers and sisters of this rock they call earth, all the while not seeing, contemplating, learning, understanding, comprehending, etc, or just ignoring their place in this space, and the immeasurable amount of information directly in their face, in this time. HERE, NOW.

    I can go on and on about this “subject” but the average attention span of a being has been degraded and diminished to that of five seconds a canine or an infant has.
    See the ball? but as the ball is put behind the “adults” back the ball has seemingly, mysteriously disappeared, and the focus is put on another toy or object – ingrained materialism…

    My perspective has been forever altered since that “moment” in time, a fork in the road, if you will, and I can no longer go back or retrieve it ever again. For the better I suppose, but now that i have gone far enough past that experience, I am thankful I went through it, that another might not have, and now i can see what others cannot, will not, or refuse to, never the less I must infect this cult-ure with my perspective, condemn their cause in it, in the hope and direction for a better world, yet i am ignored, shunned, reprimanded and outcasted for it. For being a product of society, and not willing to be a part of it, of this, yet I am better than this, and so are we all.

    Is it any wonder people act like animals, when they have been taught from their youth that they are animals?
    (animals x humans = far worse than both)

    Be the change, whatever the amount, for a better standard, other than the lowest common denominator.

    Do unto others, not as you want that they should do unto you, but as YOU SHOULD DO UNTO OTHERS.
    (Another thousands of years discussion)

    INFECT this world with TRUTH, LIGHT, PEACE, LOVE

    BOOK OF JAMES

  81. #82 Peppino
    January 19, 2011

    Those weren’t doctors. They were animals for doing that to oher human beings. They should have lobotomies done on them first to see how they liked it, damn barbarians.

  82. #83 adsense hack
    February 5, 2011

    The article went on to discuss some of the underlying reasons this may be so. And these underlying reasons made a lot of sense.

  83. #84 Kens G
    April 5, 2011

    First and foremost, I think the doctors performing these “Operations” Where more than monsters, they where sick and should have performed these blind surgeries into the brain on themselves. Individuals drunk with the “Need to know” theory. How the brain works, what happenes if we snip this and cut this and do this. Emotions are not meant to be “cut out” That makes absolutely no sense. As far as the animals, they were most likely less agressive because of the fact that they had no brains left to even remember that they where dogs. Human beings have been doing things of this nature since the begining of time im sure. Making up the “big bang” theory and etc, trying to find out where we came from, how we got here, how our brains work. Using science as a clutch of some sort to make whatever you are doing even if it is horribly wrong a fact. When the fact is it isnt fact, bottom line. To take a child and ruin his/her life because you are tired of them or that their behaviour does not suit you is evil and it is wrong. Using this “science” to justify puncturing their brain through the eyeball is cruel and unusual and sick. Back in the 1900s lots of things where wrong, Castration because a boy is too wild or aggressive, this labotomy bull. I highly doubt that everyone that stepped foot in a hospital and had emotional issues where mentally ill. 50,000 individuals where offered up to a mad scientist who was blood thirsty for knowledge. Probably even possessed by satan himself. Who knows, thats probably why one of them ended up getting shot four times. The world can be so cruel and so blind. I wonder why noone thought about the operation thoroughly back then. Why it became ok to hammer blindly into someones brain cutting away at God knows what. Putting people in vegetative states or worse even death if that is worse than being a vegetable even. Someone should have stopped them. And we did nothing.

  84. #85 Steve
    April 6, 2011

    Actually, the root cause is simply because early psychiatrists were just dumb, seriously dumb. Going to medical school back then wasn’t a matter of competitive educational talent as it is now. One just went because of their family status. Law school was always distasteful for the lazy since it involves stationary research of books for hours on end. The true intellectuals went to study the hard sciences, such as chemistry, bio, math and applied or theoretical physics.

    The dumbest of the dumb elite family students went to medical school but had no talent to do surgical or true medical research at a collegiate level. Therefore, they had no where else to go in private practice except psychiatry where one could instantly be a “surgeon” with a one day training session.

    Remember, back then the social norms required a male to “hold” a professional title no matter what their limitations were. Nowadays, the same trust fund inheritors with no intellectual capability just party all day long, boozing till sunrise, drive home in their paid-for 7-series BMWs and sleep in all day. Yea, I’m sure you’ve seen them around typical upscale spots. Just imagine one of them masquerading around as a “doctor” with an icepick in their hand. Frightening.

  85. #86 Arthur
    April 21, 2011

    It’s quite easy to compare Freeman to Hitler in the sense that he was trying to “cure” something that wasn’t an illness. they share views in the sense that “there’s one way to be a human, and i say what way that is”.

    I’ve never really been interested in lobotomy or the brain particularity. I’m just a regular guy, likes his music, friends, works in construction, has an opinion.

    There is so much i want to convey about this article it most likely will come out garbled, but I’ll give it a shot.

    first and foremost, freeman was a monster. but he also wasn’t solely responsible for it. everyone who honored him for his treatments helped in creating such a beast. they gave him confidence. freeman may have come up with the procedure, but the world backed him.

    and yes, the lure of scientific curiosity and the chance to help others deeply is hard to resist sometimes. and to be perfectly honest, maybe at sometimes good. hear me out on this, if we never took any risks, how would be know what NOT to do? or better yet, what TO do. of course, i am far from justifying any of freeman’s work, he obviously overstepped the boundaries of right and wrong. i just want you to ask questions about it. how far is too far?

    i really like the question about what our future generations will think of our medical practices. albeit, all human technology of today. will we be frowned upon for our obvious overuse of fossil fuels? of course. will it be considered a serious low point in our medical history the overuse of medication used to treat “diseases” or “illnesses” that aren’t properly diagnosed (ADHD,depression)? probably. chemotherapy is another example. flushing patience with radiation that can mutilate or kill them because we have no better means. right now we consider this to be completely reasonable because we have no better means to help. but in 100 years, how will they portray how we used this treatment. will we be monsters or just people trying to do the best with what we had? humanity knows that we use it with all the best intentions and results RIGHT NOW, but over time stories and opinions can be changed. if different procedures in the future are so far better than chemo, then chemo IS the monstrous treatment. i’m just saying that monstrosity (like many other human characteristics) is only quantifiable by comparison. odd thing to think about.

    and yes, i find it deplorable that the industry is based upon monetary income. not to mention the “authoritarianism and a love of force and coercion” that seems to come hand in hand with such psychiatric procedures.
    (“___”quoted from earlier post)

    that being said, without trying these procedures, maybe we wouldn’t make the strides to better medication in the future. it’s a touchy subject, and i don’t know the answer.

    **earlier post**

    “I wonder what percentage of his patients overall were female? This is just so frightening to contemplate. If you were an outspoken, independent woman who was recovering from abuse and had depressive symptoms someone could simply neuter your personality for you? Yech. I wonder how many “uppity” women he rendered docile and obedient. Sickening.”

    Posted by: SK | July 31, 2007 2:02 AM

    I think this statement is ridiculous. yes, it’s a little odd that he would be preforming 25 lobotomies on only women, but there is NO documentation anywhere (that i could find) stating that freeman preformed lobotomies on women more then men. the Wikipedia page on lobotomy states that Denmark was the only notable place they lobotomized young women mostly, and freeman worked in the U.S.

    don’t get me wrong, i’m all for equal rights, i just think it’s ridiculous to bring in feminist rights on a blog about lobotomy. the men freeman lobotomized suffered just the same, and i feel this is a stretch to get sympathy for women’s rights.

    i wonder what the “success” to “vegetative state or death” ratio was for freeman’s lobotomies. how many actually came out “cured”? how many were volunteers?

  86. #87 Nicole
    April 28, 2011

    Fascinating and well written article, thank you!

    After reading all the comments I wanted to interject my opinion on a few points that seem to constantly be brought up…

    A) Feeling as though Freeman was a monster does not translate into thinking that Psychiatry as a whole is on the same level. Doctors of any profession are viewed by the general public to “Protect” and “Heal”, the mental health profession certainly falls into that category. Freeman and others like him do not, not because of what they do but because of HOW they do it; without regard for “protection” and “healing” of their patients. Lobotomizing those that suffer from defiance or depression is a gross over use of power regardless of what tools are used or what location it is done in. For those that state the critics aren’t justified in their criticism because we haven’t spent time with truly mentally ill patients, that is an overly sensitive response, because we aren’t talking about the truly mentally ill patients Freeman worked on, we are talking about defiant children and depressed housewives. The public outrage would not be the same if the patient population Freeman worked on were strictly mentally ill patients that were proven to regularly be a danger to themselves and others.

    B) It is true that many procedures done in the past seem barbaric today and many procedures today will seem barbaric in the future. The surgeries Egyptians did are an excellent example. The difference lies in WHY and HOW. When you compare lobotomies to chemo you are comparing apples to oranges. Lobotomies could be obtained at the request of a family member regardless of the patients age or by a court order regardless of the infraction. Patients who did not agree were not given the choice and while it was intended to treat sever mental illness it was grossly misused to treat any behavioral, emotional or mental issue perceived by others. In the case of Freeman’s favorite delivery, the “Ice Pick Lobotomy”, they were preformed in an unsterile environment often after torture (being rendered unconscious by electroshock therapy means you have to be shocked with such intensity you pass out long enough for your eye socket to be penetrated with an ice pick guided in by a hammer. And in other methods you were passed out long enough for your skin to be cut open with out you waking up….even in office removal of warts warrants a local anesthetic today and no doctor would cut into your scalp and drill your bone out without anesthetic before and pain medications afterwards. while patients may have no memory of it that doesn’t mean it was because electroshock was safe and pain free, it’s because their brain was so fried by the electricity they lost that part of it…bet that hurts up until you pass out). On the flip side no one is FORCED to receive chemo which is only administered in the case of illness so severe you could die in a painful and degrading manner without it. When my teenager acts in a way I find unsuitable chemo is not an option to deal with her behavior. Those receiving chemo are also given every option to make the treatment more comfortable (chemo is very painful and induces illness regardless of what methods are used but at least doctors TRY to make you as comfortable as they possibly can). Barbaric in nature, such as having limited tools, knowledge or technology, is not the same as barbaric in meaning. Freeman’s complete disregard for who, why and how he was operating on is barbaric in a way that using primitive methods with primitive knowledge can never be. We as a society do not fault the Egyptians for their early surgery techniques, because while barbaric in nature, their use of and reasons for were not barbaric but rather protective and healing. The same will hold true for legitimate medical practices of today. Chemo may be deemed barbaric in nature but only because of the limited technology, not because it was used to control or deal with those you find offensive or unruly. Freeman’s scruples were what was barbaric and what enrages the public. Comparing chemo to lobotomies is like comparing vigilantism to law enforcement. Both may be medical practices but they are not even close to the same thing.

    C) I can’t begin to comment on what type of person Freeman was and what his intentions were because I didn’t know him and while his biography may shed a different light I don’t know what the relationship of the author to his subject was. If the author felt an attachment to Freeman he could paint his actions in a very different light than if he had disdain for Freeman. What I can say is that Freeman may have felt what he did was for the greater good and in the spirit of “healing” but that doesn’t mean it was. Hitler was an example I saw several times in the comments and I can see why. Hitler truly believed that his action were for the greater good and because of that they were justified, but obviously thinking it doesn’t make it so. It is possible that Freeman didn’t do it for “evil” reasons as someone said but the outcome was still “evil”.

  87. #88 Sosh
    June 21, 2011

    I’D RATHER HAVE A BOTTLE IN FRONT OF ME
    THAN A FRONTAL LOBOTOMY!!

  88. #89 Thomas
    July 17, 2011

    I think it is the same with every medical treatment you review: it always looks different in hinsight. But… More importantly, there is another topic that nobody touches on, and IS the main topic. Whether you discuss lobotomy, treating an ingrown toenail, or euthanasia. What about the “right of a human/ patient to determine his/ her own actions, destiny, or in this case, treatment”? Oh, they don’t know what they want? no idea what they are talking about? Sure… But THAT is why consent was invented. So you are not lobotomised because your mum thinks you are a nuisance. That is why you are not castrated chemically anymore if you are gay. And sometimes can seek help if YOU want to limit the suffering you seemingly have to go through. Because as we know (and I can say this because I am one) physicians can always do the trick if somebody let’s them. It is the ethics that can be a challenge for some. So, if a patient can not make up his or mind, maybe you did not explain well enough?

  89. #90 Connie
    July 25, 2011

    I can’t believe how doctors did not find the thought of invading the human brain blindly horrifying. Even though at that time, they did know enough about not messing with the brain, if you allow me that phrase.
    Tragic at the least.

  90. #91 niyaxp
    July 31, 2011

    @nicole, i myself had 2 take chemo. I dont recall it ever being painful, tho it did make me nauseated. basically u get medication(chemical) pumped in u thru an iv. now mayb it depends on the type of chemo ur getting but my mom had it also & never complained of pain. chemo is nowhere near a lobotomy. although it has nasty side effects, it has saved many lives unlike a lobotomy. in fact it has destroyed more lives then saved! i cant imagine what would make a person think that sticking a pick in ur socket & banging it with a hammer would fix anythng. now in their defense, we were less advance in those days then we r now & in the future u can b sure that it will b even more advanced. some of the practices we do now will b done away with & called stupid!

  91. #92 Romain
    August 6, 2011

    Reading this story made me sick!
    Freeman was a fucking monster, I would have put him on a firing squad.
    i read about lobotomy after seeing the movie “sucker punch”. I would never think it was really real!!
    it’s so crazy to do something like that irreversible to the brain, terrific. It shows the worst part of humanity.

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