Walter Jackson Freeman II, father of lobotomies

Many of the words 'lobotomy' in thought call an image of surgery that is performed by primitive instruments and transforms the patient into a slimy plant. You may have heard stories about a crazy doctor traveling to America and offering a procedure from his four-wheeled "Lobot". This story is, of course, a blend of truth and fiction – a story that corresponds to the eccentric creator of the procedure, Walter Jackson Freemann II

Despite the dark inheritance, Freeman comes from a family who was respected for his work in the healing profession. His father was known as an otorhinolaryngologist, and his grandfather on his mother's side was an American Civil War surgeon who treated six US presidents, including then the then president Franklin Roosevelt in the early years of his paralysis caused by poliomyelitis (child paralysis).

Freeman's academic career was also promising. He received a graduate degree at Yale in 1916 and applied for medical studies at the University of Pennsylvania, and graduated and interns before leaving for Europe to study neurology. Upon return he received the position of the Laboratory Director at St. Elizabeth, a prominent psychiatric institution in Washington.

Freeman was under great influence of the troubled conditions he testified in St. Paul's Hospital. Elizabeth. Prior to the release of Thorazine and other effective psychiatric drugs in the mid-1950s, mental health centers were regularly overcrowded, and many patients were kept there for decades. In Freeman's native Philadelphia, for example, the state hospital has placed about 75 percent more patients than its approved capacity. In 1948 Albert Albert described a visit to the hospital that reminded him of "pictures of Nazi concentration camps," describing the rooms as "catching the naked people in the bloodstream as cattle that they pay less and worries than the livestock."

While in St. Paul's Hospital, Elizabeth, Freeman rejected the ruling psychoanalytic approach – in which mental illness was seen as an unconscious product – particularly useless in institutional terms. He believed mental disorders had a well-defined physical cause, and the idea of ​​psychosurgery (cerebral surgery as a form of psychological treatment) is becoming increasingly common. His research in this field led him to the work of the Portuguese neurologist Egad Monis, who in 1935 achieved some success in alleviating mental illnesses with leukotomy, a process where interconnected neuronal links were pulled out of the prefrontal cortex. Freeman was so impressed by the fact that in 1944 he named Monica for the Nobel Prize, which the Portuguese neurosurgeon received five years later.

Because Freeman's background was more of a neurologist than a surgeon, he asked for help from neurosurgeon James Watts to modify Moniz's technique, which he renamed "lobotomy". (To what extent Freeman modified the Moniz process – which he continued to refine – in the face of adoption it is the subject of an entire debate.)

Freeman and Watts performed their first lobotomy in September 1936 at a housewife from Kansas called Alice Hood Hammatt. The results were encouraging: although "agitated depression" was previously diagnosed and was prone to hysterical laughter and crying, the operation woke up with a "silent expression," as its doctors said, and soon could no longer remember what was it so much disturbed. Hammatt's husband, who later wrote to Freemann to thank him, called his wife's post-operative years "the happiest years of her life."

By 1942, Freeman and Watts performed the operation in more than two hundred patients (63% reported improvement in condition) and other surgeons took over. Freeman alleged that lobotomy was "just a little more dangerous than the operation of removing the infected tooth". But he was still hoping to develop a procedure that would be available to thousands of patients in mental hospitals – a process that would be faster, more effective, and require less resources and specialized tools

After hearing about an Italian doctor who had accessed the brain through the eyebrow, Freeman developed a transorbital lobotomy. This "enhanced" technique was performed by an instrument that duly cut between the occiput and the bone orbiting in the skull. The nib spurred through the bone and migrated to the intersection of nerve fibers that connect the frontal lobe and thalamus. The process would be repeated in the other eye. Sometimes called lobotomy with "ice breaker" ice pick lobotomy ), early surgeons used the actual ice-breaker tool from Freeman's kitchen

Photo: The few instruments Watts and Freeman used during lobotomy. Wellcome Images, CC BY 4.0

While lobotomy required more than an hour of surgeries, this new procedure could be completed in 10 minutes. There was no need to drill the skull, nor close the postoperative wounds. Freeman hoped that psychiatrists who did not undergo surgery would one day be able to carry out the procedure.

Like prefrontal lobotomy, early surgery seemed conscientious. The operation was first performed in 1946 on housewife Sallie Ellen Ionesco. Angelene Forester, her daughter, remembers her mother as an "absolutely violent suicide" before her surgery. After Freeman's dunk and probe, "The instant stopped. It was just peace. "

Under the slogan "Lobotomy is coming home", Freeman began to explore the country by promoting his astonishing new ideas. During his visit he was aided by the ferocious personality that represented him more than life. Watts later recalled that during the lecture Freeman was "almost like a net-rated actor", so fun that "people brought their better half to the clinic to listen to his lectures." Freeman's fanatically bulging lobotomy, however, over time became too much for Watts, which led to the separation of the 1950s. "Any procedure involving brain tissue cutting is a major surgery and should remain in the hands of a neurologist," wrote Watts later. He explained to The Post : "I just did not think someone could spend a week with us and go home and perform lobotomy."

Everything Freeman did was focused on economy, speed, and publicity. In 1952, he performed 228 lobotomies in two weeks for the state hospital of West Virginia; he only paid $ 25 per operation, and worked without a surgical mask and glove. During the marathon operation, he often talked with the journalists he invited to promote his visit, occasionally praising the "dudes" technique, striking the pins in both eyeballs at the same time. One patient in the hospital in Iowa died in 1951 during the process when Freeman allowed himself to be interrupted by painting for newspapers.

Freeman advocated transorbital lobotomy for a wide spectrum of patients, including seven-year-olds. But with the reduction of unwanted symptoms, tragic death of all emotions can come. The shocking number of those who passed the procedure are left completely weakened and unable to take care of themselves. This was true for prefrontal lobotomy: Rosemary Kennedy, the sister of the former president, and Rose Williams, the sister of the dramatic author Tennessee Williams, are the most vulnerable patients.

Of the approximately 3,500 lobotomies Freeman did, 490 ended up dead.

After a 1967 patient suffering from cerebral bleeding during surgery, Freeman decided to stop performing lobotomy. But he did not give up on his advocacy and traveled to a camper (later called "Lobotomobil") and visited the former patients and noted their success. (Although the popular myth claims that Freeman had performed in a camper operation, it never happened.)

By then, the medical community had little benefit from Freeman's triumphalism. In the mid-1950s, a new generation of more effective psychiatric remedies emerged and the memory of the psychiatry itself was marked by an increasing stigma. By 1950, lobotomy was forbidden in the Soviet Union, and soon followed by Germany and Japan. In the United States, the procedure no longer exists in the same form, even if it is not technically unlawful. However, some scholars have noted that Freeman's work has paved the way for neurosurgeon forms that are still in use in cases of serious psychiatric illness, as well as procedures such as deep brain stimulation, used in the treatment of neurological conditions such as Parkinson's disease.

Walter Freeman died of cancer in 1972 at age 76. Despite the dark associations surrounding the operation in which he was a pioneer, he considered himself a humanitarian pioneer to the very end.

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