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I work for United Healthcare. I'm committed to care. This is Lee Habib, and this is Our American Stories. Up next, a story from Dr. Theodore Schwartz.
Dr. Schwartz is a neurosurgeon as well as a professor of neurosurgery at Wilde 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 brain surgery. Today, Dr. Schwartz tells the story of an antiquated procedure.
The lobotomy. Let's get into the story. I knew nothing about lobotomies. The hand with the fingers extended demonstrates in three dimensions the course of the fibers from the thalamus to the frontal lobe. The battlements are represented by the wristwat.
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. On January 17th, 1946, a psychiatrist named Walter Freeman launched a radical new era in the treatment of mental illness in this country. Train, train, train, train. 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 coming up and how they impact behavior was enticing to me to research.
So I did a lot of research about the frontal lobotomy.
Now that the convulsion has subsided, the nurse holds a toll over the nose and mouth of the patient. The operator lifts the upper eyelid, inserts the lobotom into the conjunctival sac. There were 60,000 frontal lobotomies done in America in the 1950s and 1960s, 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 schizophrenia and 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. They would, you know, submerge them in ice-cold water or shock them or, you know, raise their, give them insulin and lower their glucose.
So they were 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 named Burckhardt did the first one years ago, and then Moniz, who was a neurologist, won the Nobel Prize, believe it or not, for the frontal lobotomy 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 lobotomies in America.
He started out working with a neurosurgeon where they would drill burr holes at the top 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 anesthesiologists. 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 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. We didn't have a refrigerator, we had an ice box. The first ice picks came right out of our kitchen drawer. And it worked like a charm.
And he could do one of these procedures in about 10 minutes. The instrument was put in above the eyeball. and in the plane of the nose. You could feel it hit the roof of the orbit. and then with a tap of a hammer you could knock it through.
Um The whole thing would take three or four minutes. He would charge $25 for it. He would do six or seven in a day. He would do it with no antiseptic, no anesthesia. He would actually give electroshock therapy to the patients to put them under, and then he would do this procedure.
There are reports which he proudly writes down in his diary about fellow professionals fainting. as he proceeds in this all vomiting. 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 4,000 lobotomies, this guy, Walter Freeman. If housewives found their early 1950s existence too depressing for words, why Freeman had a solution that would get them through their day happy as little clams? are if children were misbehaving Conditions we might now see being called hyperactivity disorder, why they might need a lobotomy.
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 evaluate them before and after. And at least a third of the patients really got better from the lobotomies, but two-thirds of them didn't. And some patients were really damaged, severely damaged. And Rosemary Kennedy was one of those. Spurred on by Freeman.
The number of lobotomies performed annually soared from 150 in 1945 To over 5,000 in 1949.
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 was essentially a vegetable. She had regressed dramatically. She was like a little child, and she was institutionalized after that.
But What the lobotomy did do for neurosurgery was it um 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 radiosurgery, the implantation of deep brain electrodes, which we use to treat Parkinson's disease and obsessive-compulsive disorder and epilepsy, and the stereotactic radiation, which we can 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 lobotomy was a horrific moment in time where we rashly adopted a surgery before it was well vetted, but it propelled the field forward fairly dramatically into a lot of what modern neurosurgery is about today. And a terrific job on the production, editing, and storytelling by our own Monty Montgomery and Reagan Habib. And what a story you just heard. This one man, Walter Freeman. just pushing the envelope on lobotomies.
And not all bad, as we learned. One third of the patients did better. Two-thirds didn't. And boy, it really harmed a whole bunch. But it led to the development.
of new techniques and modern brain surgery. The story of the lobotomy. The bad. and the good. Here on Our American Stories.
This is Lee Habib, host of Our American Stories. Every day, we set out to tell the stories of Americans past and present, from small towns to big cities, and from all walks of life, doing extraordinary things that we truly can't do this show without you. Our shows are free to listen to. but they're not free to make. If you love what you hear, go to ouramericanstories.com and make a donation to keep the stories coming.
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Spending time outdoors, then let's talk about skin cancer. Non-melanoma skin cancers, or NMSCs, including basal cell carcinoma and cutaneous squamous cell carcinoma, are the most common cancers in the U.S. and can become harder to treat if left undetected. That's why sun protection and timely detection matter. Our sponsor, Regeneron, is raising awareness about advanced NMSCs.
Learn more and take the pledge to see a dermatologist annually at let's get real about skincancer.com. Liberty has never been just a word to we Americans. It has guided every one of our endeavors for the past 250 years. And now it takes form in a new way. The 2026 Semi-Quincentennial Coin and Metal Program from the United States Mint.
It celebrates the founding ideals that have long shaped our coinage. Available one year only, this historic collection features new coin designs, limited edition releases, and reissues. Shop new official coins at usmint.gov forward slash semi-q. That's usmint.gov/slash S-E-M-I-Q. Your favorite friend group is back.
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