The culprit in this whole story is the American railroad worker Phineas Gage, who in 1848 received a steel bar in the head in an accident. The rod entered the cheek, unbolted the medulla, and exited in front of the skull. Gage, surprisingly, survived and became the object of close scrutiny by American psychiatrists.
Scientists were interested not in the fact that the railroad worker survived, but in what changes happened to the unfortunate man. Before his injury, Phineas was an exemplary God-fearing person who did not violate social norms. After a rod with a diameter of 3, 2 cm destroyed part of his frontal lobes of the brain, Gage became aggressive, blasphemous and intemperate in sex life. It was during this time that psychiatrists around the world realized that brain surgery could significantly change a patient's mental health.
40 years later, Gottlieb Burckhardt from Switzerland removed parts of the cerebral cortex from six seriously ill patients in a psychiatric hospital in the hope of alleviating their suffering. After the procedures, one patient died five days later in epileptic seizures, the second later committed suicide, the operation had no effect on the two violent patients, but the remaining two really became calmer and caused less trouble to others. Burckhardt's contemporaries say that the psychiatrist was pleased with the results of his experiment.
The idea of psychosurgery was revived in 1935 with encouraging results in the treatment of violent chimpanzees with excision and removal of the frontal lobes of the brain. In the primate neurophysiology laboratory of John Fulton and Carlisle Jacobson, operations were performed on the cortex of the frontal lobes of the brain. The animals became calmer, but lost all learning abilities.
The Portuguese neuropsychiatrist Egas Moniz (Egas Moniz), impressed by such results from overseas colleagues in 1936, decided to test leukotomy (the predecessor of lobotomy) on hopelessly ill violent patients. According to one of the versions, the operations themselves to destroy the white matter, which connects the frontal lobes with other areas of the brain, were carried out by Monica's colleague Almeida Lima. Himself 62-year-old Egash could not do this because of gout. And leucotomy was effective: most of the patients became calm and manageable. Of the first twenty patients, fourteen showed improvement, while the rest remained the same.
What was such a miraculous procedure like? Everything was very simple: the doctors drilled a hole in the skull with a brace and introduced a loop that dissected the white matter. In one of these procedures, Egash Monitz was seriously injured - after dissecting the frontal lobe of the brain, the patient became furious, grabbed a pistol and shot at the doctor. The bullet hit the spine and caused partial unilateral paralysis of the body. That, however, did not prevent the scientist from launching a wide advertising campaign for a new method of surgical intervention in the brain.
At first glance, everything was excellent: calm and manageable patients were discharged from the hospital, whose condition was hardly monitored in the future. This was a fatal mistake.
But Monica later turned out to be very positive - in 1949, the 74-year-old Portuguese received the Nobel Prize in Physiology or Medicine "for the discovery of the therapeutic effects of leukotomy in certain mental illnesses." The psychiatrist shared half of the prize with the Swiss Walter Rudolf Hess, who conducted similar studies on cats. This award is still considered one of the most shameful in scientific history.
Ice pick
The advertisement for the new method of psychosurgery especially influenced two American doctors, Walter Freeman and James Watt Watts, who in 1936 lobotomized housewife Alice Hemmett as an experiment. Among the high-ranking patients was Rosemary Kennedy, the sister of John F. Kennedy, who was lobotomized in 1941 at the request of her father. Before the operation, the unhappy woman suffered from mood swings - sometimes excessive joy, then anger, then depression, and then turned into a disabled person, unable even to take care of herself. It is noteworthy that most of the patients were women, whom fathers of families, husbands or other close relatives sent to psychiatric institutions for treatment of violent temper. Most often, there were no special indications even for treatment, let alone surgical intervention. But on the way out, caring relatives received a controlled and compliant woman, of course, if she survived after the procedure.
By the early 1940s, Freeman had perfected his lobotomy, which separates the frontal lobes of the brain, so much that he got used to doing without drilling the skull. To do this, he introduced a thin steel instrument into the prefrontal lobes of the brain through a hole, which he had previously punched above the eye. The doctor had only to "rummage" a little with the instrument in the patient's brain, destroy the frontal lobes, remove the bloody steel, wipe it off with a napkin and start a new lobotomy. With the outbreak of the war, thousands of mentally broken veterans of military operations were drawn in the United States, who had nothing to heal. Classical psychoanalysis has not been particularly helpful, and chemical treatments have not yet emerged. It was much more economical to lobotomize most of the front-line soldiers, turning them into obedient and meek citizens. Freeman himself admitted that lobotomy "was ideal in overcrowded mental hospitals, where there was a shortage of everything except patients." The Department of Veterans Affairs even launched a program to train lobotomists, which had a very negative impact on further psychiatric practice. Freeman also unexpectedly adapted an ice pick ("ice pick") for a lobotomy tool - this greatly simplified the barbaric operation. Now it was possible to destroy the frontal lobes of the human brain almost in a shed, and Freeman himself adapted a small van for this purpose, called a lobotomobile.
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Doctors often performed up to 50 lobotomies a day, which significantly relieved the burden of psychiatric hospitals in the United States. Former patients were simply transferred to a silent, calm, humble state and released home. In the overwhelming majority of cases, no one monitored people after operations - there were too many of them. In the United States alone, more than 40 thousand frontal lobotomy surgeries were performed, a tenth of which were carried out personally by Freeman. However, one should pay tribute to the doctor, he monitored some of his patients.
Catastrophic consequences
On average, 30 out of 100 lobotomized patients had epilepsy to some extent. Moreover, in some people the disease manifested itself immediately after the destruction of the frontal lobe of the brain, and in some after several years. Up to 3% of patients died during a lobotomy from a cerebral hemorrhage … Freeman called the consequences of such an operation the syndrome of frontal lobotomy, the manifestations of which were often polar. Many became unrestrained in food and became severely obese. Irritability, cynicism, rudeness, promiscuity in sexual and social relations became almost the hallmark of the "cured" patient. The person lost all ability for creativity and critical thinking.
Freeman wrote in his writings on this matter:
“A patient who has undergone extensive psychosurgery at first reacts to the outside world in an infantile manner, dresses carelessly, performs hasty and sometimes tactless actions, does not know the sense of proportion in food, in drinking alcoholic beverages, in love delights, in entertainment; wastes money without thinking about the convenience or well-being of others; loses the ability to perceive criticism; may suddenly become angry with someone, but this anger quickly passes. The task of his relatives is to help him overcome this infantilism caused by surgery as soon as possible”. …
The advertisement of the founding father of lobotomy Egas Moniz and his follower Freeman, as well as the subsequent Nobel Prize, made such a crude and barbaric intervention in the human brain almost a panacea for all mental illnesses. But by the beginning of the 50s, a huge amount of data began to accumulate, exposing the vicious nature of lobotomy. The fashion for such psychosurgery quickly passed, the doctors unanimously repented of their sins, but almost 100 thousand lobotomized unfortunates were left alone with their acquired ailments.
A paradoxical situation has developed in the Soviet Union. The monopoly of the teachings of Ivan Pavlov, which developed in physiology and psychiatry in the 40-50s, largely limited the development of medical sciences, but here the effect turned out to be the opposite. After 400 lobotomies, the medical community abandoned the fashionable technique with the formulation "refrain from using prefrontal leukotomy for neuropsychiatric diseases as a method that contradicts the basic principles of Pavlov's surgical treatment."
