Throughout human history, disciplines such as medicine, psychology, psychiatry and biology have had dark episodes.
From eugenics, through concentration camp doctors and the defense that racial differences explain differences in intelligence, there are many cases in which science was wrong and harmed a group 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 proved to be very harmful, giving rise to a set of negative effects that could not be said with certainty whether or not they represented an improvement in the quality of life of those operated on. In this article we are going to do a review of the effects of lobotomy on the lives of patients undergoing surgery in addition to briefly seeing the historical background of this technique.
Lobotomy has been a technique that, from its beginnings, caused enormous controversy in the field of psychiatry. Its roots go back to the primitive trepanation of ancient cultures This type of intervention consisted of opening holes in the skull and “expelling” the bad spirits that were located in the head. According to their beliefs, these cultures maintained that these entities were responsible for mental disorders.
However, 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 of this technique through his first leucotomies, 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, maintaining that in this way problematic symptoms would be reduced. He won the Nobel Prize in medicine in 1949 for being responsible for this technique.
Subsequently, Walter Freeman, a doctor with knowledge of surgery and neurosurgery, modified this technique from his contact with the Moniz leucotomy, and that is how he created the lobotomy. Reformulating the postulates of the Portuguese scientist, Freeman maintained 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 an ice pick was enough as a surgical instrument. 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 children) in order to use them on the brains of his patients.
The intervention was quite simple. First, she took the aforementioned kitchen instrument and introduced it under the upper eyelid to reach the frontal lobe and, with a hammer, she tapped to “poke” (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 did not know exactly where he was going
In short, a lobotomy consisted of sticking an ice pick into a patient’s brain for about ten minutes and trying your luck. During the process, the person being operated on was awake, and questions were asked. When what the patient was saying made no sense, that 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 region which is responsible for executive functions: concentration, planning, working memory, reasoning, decision making…
Although the objective of this surgical intervention was to improve the patients’ condition and reduce their symptoms, the truth is that In both the short and long term, patients showed signs of worsening In fact, even the defenders of this technique and lobotomist experts recognized that after the intervention patients showed changes in their personality and intelligence.
Walter Freeman himself coined the expression “surgically induced childhood” to refer to the postoperative state manifested by lobotomized patients. In essence, After lobotomy, many patients seemed to behave like children However, Freeman seemed convinced that this was only going to be 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 was shown to be a clearly counterproductive surgery that posed clear harm to the health and autonomy of patients.
The first symptoms that lobotomized people manifested 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 a point 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 when faced with pleasurable 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 impact on social cognition, with some being unable to put themselves in the shoes of others because of it.
The “remedy” calmed the patients, causing their activation to decrease, but not because the disorder had magically disappeared, but rather because they had become zombies. To make matters worse, many patients began to suffer seizures after undergoing surgery giving support to the famous saying “the cure 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.
