A description of the most common effects lobotomy produced in patients.
Throughout human history, disciplines such as medicine, psychology, psychiatry, and biology have had dark episodes.
From eugenics, to concentration camp doctors and the defense that racial differences explain differences in intelligence, there are not few cases in which science was wrong and harmed a whole of society. The principle of “primum non nocere” (“the first thing is to do no harm”) has not always been respected, although there may have been good intentions behind it.
This is the case of lobotomy, a practice which was used with the aim of improving the lives of patients with mental disorders and freeing them from the bad life they led in the asylums of the mid-20th century. However, this practice was very harmful, giving rise to a set of negative effects that could not be said with certainty if they meant an improvement or not in the quality of life of those operated. In this article we are going to review the effects of lobotomy on the lives of operated patients, in addition to briefly looking at the historical background of this technique.
Brief history of lobotomy
The lobotomy has been a technique that, since its inception, was a huge controversy in the field of psychiatry. Its roots go back to the primitive trepanations of ancestral cultures. This type of intervention consisted of opening holes in the skull and “expelling” the evil spirits that were located in the head. According to their beliefs, these cultures held that these entities were responsible for mental disorders.
However, the lobotomy itself is much more modern, and was developed during the 20th century. The Portuguese António Egas Moniz was the one who laid the foundations for this technique through his first leukotomies, with the aim of treating and curing psychotic disorders. This intervention consisted of cutting the connections of the frontal lobe with the rest of the brain, arguing that in this way the problematic symptoms would be reduced. He won the Nobel Prize in Medicine in 1949 for being responsible for this technique.
Later, Walter Freeman, a doctor with notions of surgery and neurosurgery, modified this technique from his first contact with the Moniz leucotomy, and that is how he created the lobotomy. Reformulating the postulates of the Portuguese scientist, Freeman argued that behind mental disorders was an interaction between the thalamus and the prefrontal cortex, and that the destruction of the connections between both structures was necessary.
To carry out his technique, Freeman reached a point where he only needed about ten minutes, and as a surgical instrument an ice pick was enough. Here, the word “ice pick” is not a metaphor; Mr. Walter Freeman used tools taken from his own kitchen (according to what was expressed by one of his sons) in order to use them on the brain of his patients.
The intervention was quite simple. First, he took the aforementioned kitchen instrument and inserted it under the upper eyelid to reach the frontal lobe and, with a hammer, he tapped to “chop” (pun intended) the aforementioned connections. A peculiarity of this intervention, unthinkable today, is that it was a blind operation. what does this mean? It means that Mr. Lobotomist didn’t know exactly where he was going.
In short, a lobotomy consisted of sticking an ice pick into the brain of patients for about ten minutes and trying their luck. During the process, the intervened person was awake, and questions were being asked. When what the patient was saying was nonsense, it meant it was a good time to stop.
It should be said that at that time, little was known about the great importance of the frontal lobe, a region which is responsible for executive functions: concentration, planning, working memory, reasoning, decision-making …
Effects of brain lobotomy
Although the objective of this surgical intervention was to improve the patients’ condition and reduce their symptoms, the truth is that both in the short and long term the patients showed signs of worsening. In fact, even the defenders of this technique and lobotomist experts recognized that after the intervention the patients showed changes in their personality and intelligence.
Walter Freeman himself coined the term “surgically induced childhood” to refer to the postoperative state of lobotomized patients. In essence, after the lobotomy, many patients appeared to behave like children. However, Freeman seemed convinced that this was going to be just a temporary phase. According to this doctor, after a period of “maturation” the patients would behave like adults without disorder or with some improvement.
But in practice this did not happen. It was a matter of time before the lobotomy technique turned out to be a clearly counterproductive surgery, which was clearly detrimental to the health and autonomy of patients.
The first symptoms manifested by lobotomized people were, normally, stupor, confusional state and urinary problems such as incontinence, with a clear loss of sphincter control. Along with this, there were alterations in eating behavior, manifesting an increase in appetite to such an extent that a lot of weight was gained after the operation.
Personality was an aspect that was greatly affected. There was less spontaneity, less self-care, and a lower degree of self-control. The ability to take the initiative was reduced and there was less inhibition in the face of pleasant stimuli. Inertia was another of the most common effects in people who were lobotomized.
As already mentioned, the frontal lobe was intervened, which is in charge of executive functions. So it was normal to see that abilities such as planning, working memory, attention and others were also diminished. There was also an impairment in social cognition, with some being unable to put themselves in the place of others due to this.
The “remedy” calmed the patients, causing their activation to decrease, but not because the disorder had magically disappeared, but rather because they had turned into zombies. To make matters worse, many patients began to suffer seizures after being operated on, supporting the famous saying “the remedy is worse than the disease.”
However, the most clearly serious effect was death. According to some sources, one in three patients did not survive this type of intervention, despite its short duration. There were also multiple cases of lobotomized people who ended up committing suicide because of it.
- Cosgrove, G. Rees; Rauch, Scott L. (1995). “Psychosurgery”. Neurosurgery Clinics of North America.
- Cooper, Rachel (2014). On deciding to have a lobotomy: either lobotomies were justified or decisions under risk should not always seek to maximize expected utility. Medicine, Health Care and Philosophy. 17 (1): 143-154.