73 Years Ago Today: First “Modern” Lobotomy. Would Your Ethics Board Approve?
The lobotomy is about as controversial as surgical interventions get. Nothing else stirs the popular imagination — a bit of fascination, a bit of horror — in just the same way. It is also a controversial procedure, in part because it does precisely what it promises to do: change behaviour. It is surely a procedure that has its victims; and just as surely, there are people it helped.
It is a truism that for every medical procedure, there is a first time. Today, as it happens, is the 73rd anniversary of one such innovation. From Wired.com: Nov. 12, 1935: You Should (Not) Have a Lobotomy
Nov. 12, 1935: The world’s first modern frontal leukotomy is performed in a Lisbon hospital by Portuguese neurologist Antonio Egas Moniz.
Moniz’s leukotomy (or leucotomy, from the Greek for “cutting white,” in this case the brain’s white matter) soon became popularly known as the lobotomy. It was not, however, the surgical procedure now generally associated with lobotomies. Rather, Moniz drilled two holes in the patient’s skull and injected pure alcohol into the frontal lobes of the brain to destroy the tissue, in an effort to alter the patient’s behavior.
Within a year of Moniz’s procedure at Lisbon’s Santa Marta Hospital, American neurosurgeons Walter Freeman and James Watts had performed the first prefrontal lobotomy in the United States. Their approach, which they would continue refining in subsequent surgeries, also involved drilling holes, but instead of using alcohol they surgically severed the nerves connecting the prefrontal cortex to the thalamus.
With various refinements, this became standard operating procedure for the prefrontal lobotomy.
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Two books providing very different perspectives on the practice, as popularized by Freeman:
My Lobotomy by Howard Dully and Charles Fleming
The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness, by Jack El-Hai
Research Ethics Blog 