Last Resort: Psychosurgery and the Limits of Medicine (Cambridge Studies in the History of Medicine) [Hardcover]

Jack D. Pressman (Author)

Book Description

Publication Date: February 13, 1998 | Series: Cambridge Studies in the History of Medicine

During the 1940s and 1950s, tens of thousands of Americans underwent some form of psychosurgery; that is, their brains were operated upon for the putative purpose of treating mental illness. From today's perspective, such medical practices appear foolhardy at best, perhaps even barbaric; most commentators thus have seen in the story of lobotomy an important warning about the kinds of hazards that society will face whenever incompetent or malicious physicians are allowed to overstep the boundaries of valid medical science. Last Resort challenges the previously accepted psychosurgery story and raises new questions about what we should consider its important lessons.

Editorial Reviews

From The New England Journal of Medicine

Last Resort is medical history at its best. No exercise in antiquarianism, it illuminates the meaning of a misguided therapeutic innovation so as to shed light on the dilemmas medicine continues to face in assessing therapeutic options. Pressman has conducted a close, careful, and thoroughly documented examination of original sources. Notes occupy 78 pages at the end of the book; they need not weigh down readers persuaded by the logic of the author's analysis, but they will be invaluable for the scholar who wants to review the evidence. This book is much more than an important contribution to medical history (as if that were not enough). Every student and practitioner in psychiatry, psychology, and social work -- in short, any student who wants to understand contemporary psychiatry and medicine -- will find Last Resort extremely rewarding. It should become required reading for all psychiatric house officers. Last Resort exemplifies the uses Joseph Needham ascribed to medical history in his History of Embryology (2nd ed. New York: Abelard-Schuman, 1959):

Reviewed by Leon Eisenberg, M.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review

"The physician's maxim to 'do no harm' never clashes more with the desperate need to 'do something' then in the case of psychosurgery. Jack Pressman's thorough analysis in Last Resort has deep implications for the decisions that doctors make every day." Dr. Michael Brown, Nobel Laureate, University of Texas Southwestern Medical Center at Dallas

"To cut into a person's brain on rather dubious scientific grounds seems like the ultimate in medical imperialism. But as the late Jack Pressman shows in this impressive but flawed work, the story is much more complex...Pressman's main point is that much of the condemnation of leuctotomy has taken no account of its history, in that it ignores the clinical and administrative problems faced by those who used it and has an unreal view of the actual process of mediccal advance...Regrettably, Pressman died shortly after finishing this work. Had he lived, he would undoubtedly have made further important contributions to medical history." Hugh Freeman, Nature

"...first-rate...." Donald W. Goodwin MD, JAMA

"Last Resort is medical history at its best....it illuminates the meaning of a misguided therapeutic innovation so as to shed light on the dilemmas medicine continues to face in assessing therapeutic options. Pressman has conducted a close, careful, and thoroughly documented examination of original sources. This book is much more than an important contribution to medical history....Every student and practitioner in psychiatry, psychology, and social work--in short, any student who wants to understand contemporary psychiatry and medicine--will find Last Resort extremely rewarding. It should become required reading for all psychiatric house officers. We owe Jack Pressman an enormous debt for Last Resort." Leon Eisenberg, MD; The New England Journal of Medicine

"Jack Pressman has written a truly important book that addresses fundamental questions about the nature of medical progress and therapeutic effectiveness. This book is all the more remarkable for exploring these questions by way of one of the most discredited medical interventions of the twentieth century, namely, lobotomy." Joel Braslow, Journal of the History of the Behavioral Sciences

"Pressman's project is so vast that any single chapter could stand on its own as an independent, well-written monograph. The originality of Pressman's topic, his staggering amount of research, and the cogency of his theme are impressive, but it is the depth of his analysis and the subtlety of his synthesis that set his work apart. Historians of medicine and neuroscience in particular will welcome this book, but any historian will read it profitably." Thomas P. Gariepy, Isis

"...a well-written, thorough understanding of psychosurgery and the surrounding feelings, pro and con, at the height of its popularity." George B. Murray, Journal of Interdisciplinary History

"...long, detailed, and engaging book..." Elizabeth Lunbeck, Journal of the History of Medicine

"...well-documented, definitive study of the rise and fall of psychosurgery...hist owrk inspires friends and admirers to write their own social histories of American medicine and psychology." Westwick

See all Editorial Reviews

Product Details

• Hardcover: 574 pages
• Publisher: Cambridge University Press; 1 edition (February 13, 1998)
• Language: English
• ISBN-10: 0521353718
• ISBN-13: 978-0521353717
• Product Dimensions: 9.3 x 6.3 x 1.3 inches
• Shipping Weight: 2 pounds (View shipping rates and policies)
• Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
• Amazon Best Sellers Rank: #1,362,984 in Books (See Top 100 in Books)
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Most Helpful Customer Reviews

9 of 11 people found the following review helpful:

5.0 out of 5 stars Brilliant, gifted inquiry into the 'why' of psychosurgery., March 2, 2001

By 

K. L Sadler "Dr. Karen L. Sadler" (Freedom, Pa. USA) - See all my reviews
(VINE VOICE)    (REAL NAME)   

This review is from: Last Resort: Psychosurgery and the Limits of Medicine (Cambridge Studies in the History of Medicine) (Hardcover)

This is not a lightly undertaken book to read. It is an exemplary work on the social, political and medical trends which led to neuro/psychiatric surgery being tried, accepted, and then discarded after research found it to be severely lacking in moral and therapeutic worth. Pressman did an outstanding job of research into the advancement of lobotomies in psychiatry as a means to control patients, who up til that time, had no resort or cure with which to treat these patients. The drugs which are used today to control schizophrenics and manic-depressives were not available in the early twentieth century, yet the advancement of regular medical science in both areas of surgery and pharmaceuticals raised the expectations of U.S. society towards those of psychiatric persuasion to find like means of treating the immense numbers of patients in state hospitals with mental illness.

Like many who went through medical school and biology/neuroscience, I was appalled to read about the use of lobotomies. This book endeavors with great fairness and accuracy to put the pressures of both society and science on psychiatrists into the picture, in order to create understanding as to why this means of treatment was pushed so hard, and why so many underwent a questionable method before it could be proven totally effective. Not only did Pressman write well and intensely about this, but his ability to put the topic into historical perspective and his impartiality towards both the method and the doctors involved made me rethink my prior prejudices towards these men.

This is a wonderful book, and not only should it be in medical libraries, but it should be part of the required readings for all medical students and ethicists. It is our great loss that Pressman died after this book was finished and too young, because his ability to write medical history and ethics could have been much used at this point. Karen Sadler, Science Education, University of Pittsburgh