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Overview

The word “lobotomy” brings to mind disturbing images, such as zombie-like patients in mental hospitals. The author mentions One Flew Over the Cuckoo’s Nest, a movie that depicts lobotomies and is also about an asylum. However, lobotomy was once a popular treatment for mental illness, which led to many discoveries of what happens when certain parts of the brain are removed.

This passage takes you through the history of lobotomies. It introduces Patient H.M., who was a famous case study for memory loss after a lobotomy, and explains how his brain changed as a result of the procedure. The author also discusses other cases where people had successful results from having their brains operated on with this method, but then he goes into detail about some horrific experiments that were done in an attempt to understand how memories work.

Big Idea #1: There’s a long and storied history of our fascination with the brain.

The brain is really important. It controls everything we do, from walking to talking. Hippocrates (460 BC) was one of the first to realize this and theorize that epilepsy wasn’t a punishment by the gods, but rather an impairment caused by the brain.

The Egyptians were very smart and had a lot of knowledge about the brain. They knew that it was important, so they gave advice on how to protect it.

There are many examples of people trying to tamper with the brain. Some 7,000 years ago, there was evidence that some form of surgery had been performed on a skull in France. In 1888, a Swiss psychiatrist tried to cure a patient’s “madness” by removing 18 grams of her brain matter. This procedure was considered radical at the time because it involved cutting open skulls and slicing up brains. Fifty years later, in 1935, an accomplished neuroanatomist named Egas Moniz picked up where Burckhardt left off and performed the first leucotomy, which is from Greek for white (leucos) and cut (tome), on his patient.

Dr. Moniz was inspired by a physiologist named John Fulton, who had been experimenting on chimpanzees and discovered that the chimps became calmer when their frontal lobes were damaged.

Dr. Moniz performed a surgery on severely depressed patients by drilling holes in their head and cutting out the frontal lobe of their brain tissue. The results were published in 1936, which marked the beginning of modern psychiatry and neurosurgery.

Big Idea #2: Mental asylums were home to experimental therapies, including the lobotomy.

Patients in psychiatric asylums are not known for their calmness. The stereotype of patients as howling, straitjacketed maniacs is simplistic but also contains some truth. In the late 1930’s, physicians were trying to figure out ways to make patients more fit for society. They came up with a variety of ‘therapies’ designed to calm people down. One method was pyretherapy (burning therapy). A patient would lie inside a metal tube and have his body heated above normal levels—up to 106 degrees Fahrenheit, far beyond normal 98.6 temperature. This process could go on regularly for a week if it didn’t produce the desired results and then doctors might move on to insulin coma therapy (insulin shock therapy). It was in this environment that American neurologist Dr Walter Freeman introduced the lobotomy, in 1939. It wasn’t just another treatment; it launched an entire field called psychosurgery.

Lobotomy is derived from the Greek word for “cutting of the lobes.” Dr. Freeman would drill two holes in a patient’s skull and use those openings to cut into their frontal lobes.

Freeman would ask his patients questions during the procedure, and when they were confused and disoriented but not completely incapacitated, he would stop cutting. The lobotomies were supposed to be a cure for many types of patients, including some who suffered from obsessive masturbation disorder. While some patients had obvious dementia issues, others had more subtle “disorders,” such as obsessive masturbation.