ABSTRACT
While applying what we had previously learned from cases of neurotrauma, medicine received a major step forward when Dr. Egas Moniz of Portugal developed the carefully controlled procedure of the prefrontal lobotomy. Though heavily criticized by those who argued minimal surgical interventions, patients undergoing the careful transection of frontal lobe tissues reported alleviations of many mental health symptoms, and the procedure’s popularity and use in medical practice expanded. However, the procedure was time-consuming and expensive, limiting its application to many who could potentially benefit from it, and so an American physician, Walter Freeman, sought out an easier and more affordable method. Sterilizing an ice pick from his wife’s freezer, Freeman applied electroshock as a short-term anesthetic, and punctured the skull through each orbital socket, rocking the instrument to sever connections in the prefrontal cortex in a procedure that now took only 15–30 minutes to complete. The transorbital lobotomy became so widely used that among its most famous patients are Rosemary Kennedy, Howard Dully (who was only 12 years old), and Rose Williams, sister of playwright Tennessee Williams. Though many reported relief of symptoms, Freeman was somewhat reckless with overuse of his new method, and the procedure was banned after a patient died due to cerebral hemorrhage during her third lobotomy. Now considered by many to have been a barbaric approach to treating mental illness, we have developed a number of techniques based on Moniz’s original idea, including the commissurotomy, or ‘split-brain procedure’, to treat severe epilepsy, localized transections and ablations to treat emotional disorders, and experimental lesions to study axonal regeneration.
