Want to Know How to Perform a Prefrontal Lobotomy?

     Psychosurgeon Walter Freeman enlisted the surgical expertise of James Watt in 1936 to help him perform the first prefrontal lobotomy in America. Freeman had become enamored with the work of Portuguese psychosurgeon Egas Moniz who had recently performed the first of these brutal brain surgeries. Muniz would later be awarded a Nobel Prize for it, but he was unfortunately shot thereafter by one of the schizophrenic patients whose brain he had removed part of.

     Freeman and Watts went to work on perfecting prefrontal lobotomies as well as broadly publicizing the barbaric procedure’s merits. However, one of their joint early lobotomies was on 23 year old Rosemary Kennedy. Their botched surgery left her permanently incapacitated and unable to speak coherently again.

     In 1942 Freeman and Watts directed the filming of a George Washington University instruction film showing exactly to how to perform their prefrontal lobotomy. It was published on YouTube nine years ago and has been viewed 1.3 million times and has accrued over 4000 viewer comments, virtually all expressing their horror at the procedure.

     The film shows that the lobotomy is done while the patient is awake with only a local anesthetic applied to the surface area of the incision into the skull. A patient can be made unconscious, however, if he or she is deemed too “uncooperative” beforehand. The film’s narrator comments dispassionately that the only moment when the fully conscious patient becomes “disoriented” is when the final nerve fibers in the brain are severed.

     Freeman used standard anesthesia for those “uncooperative” patients, but he also gave them an electroshock session so the voltage and grand mal seizure would make them unconscious for the lobotomy.

     The 1942 film shows how a chisel and hammer are used to mark the spot on the skull where the bore hole is to be made after the skin above is cut open. Then a series of larger and larger, hand-cranked boring tools are used to drill the hole itself through the patient’s skull bone. A pliers-like device is then used to pull away the bone and enlarge the hole. A second hole is then made across and up on the skull so that a neurologist can help the surgeon guide his nerve severing tool to the right spot of the prefrontal lobe.

     It was at this moment during the surgery, when the final nerves were cutt, that the patient became disoriented as the surgery “deletes you from your own memory,” as one YouTube commenter aptly put it.

     During this time Freeman was also developing his own transorbital lobotomy technique in which he passed an ice pick tool up under the eyelid and into the prefrontal lobe and then “swished” it around to sever the offending nerve issue. When Watt found out about Freeman’s new procedure, he told him it was too dangerous to be performed alone and insisted Freeman cease his new practice. Freeman refused and Watts ended their partnership.

     Freeman went on to deliver more than two thousand of his transorbital lobotomies himself while touring psychiatric hospitals cross country in his “lobotomobile” demonstrating his technique and teaching doctors its use. Freeman reported in 1953 that over 25,000 lobotomies had been performed.

     In the nineteen-fifties heavy antipsychotic medications like Thorazine were developed and approved by the FDA and they could be used to chemically lobotomize a patient without the surgical butchery involved in a lobotomy.

     Thank God for that little improvement in psychiatric torture.