December 3, 2024 • 7 mins
On this episode of Our American Stories, Dr. Theodore Schwartz, A neurosurgeon as well as a professor of neurosurgery at Weill Cornell Medicine—and the author of Grey Matters, shines some light into the dark history of the lobotomy—and how it led to innovation and modern-day brain surgery.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
This is Lee Habib and this is our American stories.
Up next, a story from doctor Theodore Schwartz. Doctor Schwartz
is a neurosurgeon as well as a professor of neurosurgery
at wild Cornell Medicine in New York City, one of
the busiest and most highly ranked neurosurgery centers in the world.
He's also the author of Gray Matters, a biography of
(00:32):
brain surgery. Today, doctor Schwartz tells the story of an
antiquated procedure, the lobotomy. Let's get into the story.
Speaker 2 (00:42):
I knew nothing about Lobotomi's hand.
Speaker 3 (00:45):
With a thingers extended demonstrates in three dimensions the course
of the viabisi and the attlemus to the frontal lobe.
The atamus is represented by the rest of what.
Speaker 2 (00:53):
When I trained in neurosurgery, we didn't hear anything about
the surgery. Didn't know anything about the history, why it
was done, who it was done on how many were done.
Speaker 1 (01:01):
On January seventeenth, nineteen forty six, a psychiatrist.
Speaker 4 (01:05):
Named Walter Freeman launched a radical new era in the
treatment of mental illness in this country.
Speaker 2 (01:11):
Treat Tree Tree treat I saw it as sort of
a skeleton in our closet that neurosurgeons really didn't talk about.
And you can imagine. My father was a psychoanalyst, So
the concept of repressed memories from childhood, you know, coming
up and how they impact behavior was enticing to meet
your research. So I did a lot of research about
the front of the botomy.
Speaker 3 (01:31):
How about the convution has subside in the nerds role
of towel over the noise and moths of the patient.
The operator left the upper IoLET and starts to love guitar.
I'm end of the content tibal sac.
Speaker 2 (01:41):
There were sixty thousand in front of the botomies done
in America in the nineteen fifties and nineteen sixties, which
is a remarkably high number. You have to understand the context.
At the time. There was no treatment for psychiatric illness,
so people who had severe schizophrenian depression would just sit
in the hallways of mental institutions that were filling with
these patients with no way to treat them. And some
of the treatments were also barbaric. That would, you know,
(02:03):
submerge them in ice cold water, or shock them or
you know, raise their give them insulin and lower their glucose,
so they're essentially torturing these patients. The surgery itself was
developed mostly by neurologists and psychiatrists. I found out it
really was not a surgery developed by neurosurgeons. A guy
(02:24):
named Burkhardt did the first one years ago, and then Mones,
was a neurologist, won the Nobel Prize believe it or not,
for the frontal the botomy that was based on very
little scientific basis. And then there was a gentleman named
Walter Freeman who was also a neurologist, and he started
doing the bottomies in America. He started out working with
a neurosurgeon where they would drill burholes at the top
(02:46):
of the head and put essentially a butter knife down
into the brain and sweep it back and forth on
each side to disconnect the frontal part of the brain
from the back part of the brain. He didn't like
relying on a neurosurgeon. He wanted to be able to
do it on his own. He didn't want to have
to rely on anesthesiology. He was a neurologist, he had
no credentials to perform surgery, so he read about an
Italian neurosurgeon who did a procedure basically taking an ice
(03:08):
pick and lifting the upper lid of the eye and
taking the ice pick, putting it under the eyelid and
cracking through the skull into the frontal lobe and sweeping
it back and forth.
Speaker 3 (03:17):
We didn't have a refrigerator.
Speaker 4 (03:19):
We had an ice box.
Speaker 3 (03:21):
The first ice picks came right out of our kitchen drawer,
and they worked like a charm.
Speaker 2 (03:26):
And he could do one of these procedures in about
ten minutes.
Speaker 4 (03:29):
The instrument was put in above the eyeball and in
the plane.
Speaker 3 (03:34):
Of the nose.
Speaker 4 (03:36):
You could feel it hit the roof of the orbit,
and then with a tap of a hammer you could
knock it through. The whole thing would take three or
four minutes.
Speaker 2 (03:48):
He would charge twenty five dollars for it. He would
do six or seven in a day. He would do
it with no antiseptic, no anesthesia. He would actually give
electra shock therapy to the patients to put them under
and then would do this procedure.
Speaker 5 (04:01):
There are reports which he proudly writes down in his
diary about fellow professionals fainting as he proceeds in this
old vomiting.
Speaker 2 (04:12):
And he would have people around him, and he publicized it,
and he traveled all around the country doing I think
he personally did about four thousand lobotomies. This guy, Walter Freeman.
Speaker 5 (04:20):
If housewives found their early nineteen fifties existence too depressing
for woods, why Freeman had a solution that would get
them through their day happy as little clams. If children
were misbehaving conditions we might now see being called hyperactivity disorder,
(04:40):
why they might need a lobotomy.
Speaker 2 (04:42):
And the truth is, there were some people who got better,
and there were a few neurosurgeons who studied the lobotomy
who sort of scientifically said, all right, we're going to
do this right, we're going to do it cleanly, we're
going to do a real operation here, and we're going
to have psychiatrists to evaluate them before and after. And
at least a third of the patients really got better
from the lobotomies, but of them didn't, and some patients
were really damaged, severely damaged, and Rosemary Kennedy was one
(05:04):
of those.
Speaker 4 (05:05):
Spurred on by Freeman, the number of lobotomies performed annually
soared from one hundred and fifty in nineteen forty five
to over five thousand in nineteen forty nine.
Speaker 2 (05:16):
So Walter Freeman did her lobotomy. Many people didn't know
she had a lobotomy. Her brothers and sisters didn't really know.
It's unclear if her mom knew that she had a lobotomy.
Joe Kennedy basically just took her to have this done.
They were hiding her mental illness at the time. It
was very shameful that she had mental illness at the time.
And when she emerged from the lobotomy, you know, she
(05:36):
was essentially a vegetable. She had regressed dramatically. She was
like a little child, and she was institutionalized after that.
Speaker 4 (05:46):
But what the.
Speaker 2 (05:46):
Lobotomy did dude for neurosurgery was it promoted the development
of a lot of new techniques. So a lot of
the things we do now, the focal delivery of radiation
called stereotactic radio surgery, the implantation of brain electrodes, which
we used to treat Parkinson's disease and an obsessive compulsive
disorder and epilepsy, and the stereotactic radiation which we can
(06:08):
use to treat tumors and facial pain. All of those
things those were developed by surgeons trying to improve on
the frontal lobotomy because they realized it was a sort
of grotesque, imprecise operation and they wanted to figure out
a better way to do it. So they developed all
these new techniques and then realized they could use all
these techniques to treat other neurologic diseases. And we still
use those techniques today. So the frontal abiotomy, that was
(06:29):
a horrific moment in time where we rashly adopted a
surgery before it was well vetted. But it propelled the
feel forward fairly dramatically into a lot of what modern
neurosurgery is about today.
Speaker 1 (06:47):
And a terrific job on the production, editing and storytelling
by our own Monty Montgomery and Reagan Habibe. And what
a story you just heard this one man Walter Freeman,
just pushing the envelope on lobotomies and not all bad.
As we learn, one third of the patients did better,
two thirds didn't, and boy, it really harmed a whole bunch,
(07:09):
but it led to the development of new techniques and
modern brain surgery. The story of the lobotomi, the bad
and the good. Here on our American stories. This is
(07:31):
Lee Habib, host of Our American Stories, the show where
America is the star and the American people, and we
do it all from the heart of the South Oxford, Mississippi.
But we truly can't do this show without you. If
you love what you hear, consider making a tax deductible
donation to Our American Stories. Go to our American Stories
dot com. Give a little, give a lot. That's Our
(07:54):
American Stories dot com.
This is Lee Habib and this is our American stories.
Up next, a story from doctor Theodore Schwartz. Doctor Schwartz
is a neurosurgeon as well as a professor of neurosurgery
at wild Cornell Medicine in New York City, one of
the busiest and most highly ranked neurosurgery centers in the world.
He's also the author of Gray Matters, a biography of
(00:32):
brain surgery. Today, doctor Schwartz tells the story of an
antiquated procedure, the lobotomy. Let's get into the story.
Speaker 2 (00:42):
I knew nothing about Lobotomi's hand.
Speaker 3 (00:45):
With a thingers extended demonstrates in three dimensions the course
of the viabisi and the attlemus to the frontal lobe.
The atamus is represented by the rest of what.
Speaker 2 (00:53):
When I trained in neurosurgery, we didn't hear anything about
the surgery. Didn't know anything about the history, why it
was done, who it was done on how many were done.
Speaker 1 (01:01):
On January seventeenth, nineteen forty six, a psychiatrist.
Speaker 4 (01:05):
Named Walter Freeman launched a radical new era in the
treatment of mental illness in this country.
Speaker 2 (01:11):
Treat Tree Tree treat I saw it as sort of
a skeleton in our closet that neurosurgeons really didn't talk about.
And you can imagine. My father was a psychoanalyst, So
the concept of repressed memories from childhood, you know, coming
up and how they impact behavior was enticing to meet
your research. So I did a lot of research about
the front of the botomy.
Speaker 3 (01:31):
How about the convution has subside in the nerds role
of towel over the noise and moths of the patient.
The operator left the upper IoLET and starts to love guitar.
I'm end of the content tibal sac.
Speaker 2 (01:41):
There were sixty thousand in front of the botomies done
in America in the nineteen fifties and nineteen sixties, which
is a remarkably high number. You have to understand the context.
At the time. There was no treatment for psychiatric illness,
so people who had severe schizophrenian depression would just sit
in the hallways of mental institutions that were filling with
these patients with no way to treat them. And some
of the treatments were also barbaric. That would, you know,
(02:03):
submerge them in ice cold water, or shock them or
you know, raise their give them insulin and lower their glucose,
so they're essentially torturing these patients. The surgery itself was
developed mostly by neurologists and psychiatrists. I found out it
really was not a surgery developed by neurosurgeons. A guy
(02:24):
named Burkhardt did the first one years ago, and then Mones,
was a neurologist, won the Nobel Prize believe it or not,
for the frontal the botomy that was based on very
little scientific basis. And then there was a gentleman named
Walter Freeman who was also a neurologist, and he started
doing the bottomies in America. He started out working with
a neurosurgeon where they would drill burholes at the top
(02:46):
of the head and put essentially a butter knife down
into the brain and sweep it back and forth on
each side to disconnect the frontal part of the brain
from the back part of the brain. He didn't like
relying on a neurosurgeon. He wanted to be able to
do it on his own. He didn't want to have
to rely on anesthesiology. He was a neurologist, he had
no credentials to perform surgery, so he read about an
Italian neurosurgeon who did a procedure basically taking an ice
(03:08):
pick and lifting the upper lid of the eye and
taking the ice pick, putting it under the eyelid and
cracking through the skull into the frontal lobe and sweeping
it back and forth.
Speaker 3 (03:17):
We didn't have a refrigerator.
Speaker 4 (03:19):
We had an ice box.
Speaker 3 (03:21):
The first ice picks came right out of our kitchen drawer,
and they worked like a charm.
Speaker 2 (03:26):
And he could do one of these procedures in about
ten minutes.
Speaker 4 (03:29):
The instrument was put in above the eyeball and in
the plane.
Speaker 3 (03:34):
Of the nose.
Speaker 4 (03:36):
You could feel it hit the roof of the orbit,
and then with a tap of a hammer you could
knock it through. The whole thing would take three or
four minutes.
Speaker 2 (03:48):
He would charge twenty five dollars for it. He would
do six or seven in a day. He would do
it with no antiseptic, no anesthesia. He would actually give
electra shock therapy to the patients to put them under
and then would do this procedure.
Speaker 5 (04:01):
There are reports which he proudly writes down in his
diary about fellow professionals fainting as he proceeds in this
old vomiting.
Speaker 2 (04:12):
And he would have people around him, and he publicized it,
and he traveled all around the country doing I think
he personally did about four thousand lobotomies. This guy, Walter Freeman.
Speaker 5 (04:20):
If housewives found their early nineteen fifties existence too depressing
for woods, why Freeman had a solution that would get
them through their day happy as little clams. If children
were misbehaving conditions we might now see being called hyperactivity disorder,
(04:40):
why they might need a lobotomy.
Speaker 2 (04:42):
And the truth is, there were some people who got better,
and there were a few neurosurgeons who studied the lobotomy
who sort of scientifically said, all right, we're going to
do this right, we're going to do it cleanly, we're
going to do a real operation here, and we're going
to have psychiatrists to evaluate them before and after. And
at least a third of the patients really got better
from the lobotomies, but of them didn't, and some patients
were really damaged, severely damaged, and Rosemary Kennedy was one
(05:04):
of those.
Speaker 4 (05:05):
Spurred on by Freeman, the number of lobotomies performed annually
soared from one hundred and fifty in nineteen forty five
to over five thousand in nineteen forty nine.
Speaker 2 (05:16):
So Walter Freeman did her lobotomy. Many people didn't know
she had a lobotomy. Her brothers and sisters didn't really know.
It's unclear if her mom knew that she had a lobotomy.
Joe Kennedy basically just took her to have this done.
They were hiding her mental illness at the time. It
was very shameful that she had mental illness at the time.
And when she emerged from the lobotomy, you know, she
(05:36):
was essentially a vegetable. She had regressed dramatically. She was
like a little child, and she was institutionalized after that.
Speaker 4 (05:46):
But what the.
Speaker 2 (05:46):
Lobotomy did dude for neurosurgery was it promoted the development
of a lot of new techniques. So a lot of
the things we do now, the focal delivery of radiation
called stereotactic radio surgery, the implantation of brain electrodes, which
we used to treat Parkinson's disease and an obsessive compulsive
disorder and epilepsy, and the stereotactic radiation which we can
(06:08):
use to treat tumors and facial pain. All of those
things those were developed by surgeons trying to improve on
the frontal lobotomy because they realized it was a sort
of grotesque, imprecise operation and they wanted to figure out
a better way to do it. So they developed all
these new techniques and then realized they could use all
these techniques to treat other neurologic diseases. And we still
use those techniques today. So the frontal abiotomy, that was
(06:29):
a horrific moment in time where we rashly adopted a
surgery before it was well vetted. But it propelled the
feel forward fairly dramatically into a lot of what modern
neurosurgery is about today.
Speaker 1 (06:47):
And a terrific job on the production, editing and storytelling
by our own Monty Montgomery and Reagan Habibe. And what
a story you just heard this one man Walter Freeman,
just pushing the envelope on lobotomies and not all bad.
As we learn, one third of the patients did better,
two thirds didn't, and boy, it really harmed a whole bunch,
(07:09):
but it led to the development of new techniques and
modern brain surgery. The story of the lobotomi, the bad
and the good. Here on our American stories. This is
(07:31):
Lee Habib, host of Our American Stories, the show where
America is the star and the American people, and we
do it all from the heart of the South Oxford, Mississippi.
But we truly can't do this show without you. If
you love what you hear, consider making a tax deductible
donation to Our American Stories. Go to our American Stories
dot com. Give a little, give a lot. That's Our
(07:54):
American Stories dot com.
Host
Lee Habeeb
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