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The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness

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Walter Freeman almost singl-handedly created the craze for psychosurgery that was in vogue from the late 1930s until the
mid 1960s. This was a time when "psychosurgery" meant "lobotomy". While lobotomies were invented by Egas Moniz it was Freeman who advanced the research and tirelessly publicised it as the solution to almost all psychological ills.
It would be all too easy for an author to write Freeman off as an uncaring villain of the first order, a Josef Mengele like figure who mutilated the brains of his victims/patients in an attempt to make them conform to societal norms by amputating their personalities. However Jack El Hai presents Freeman as a man desperate to improve the lives of his patients, a self-promoting man, but nonetheless someone who cared. It is this portrayal by El Hai that makes Freeman an even more horrible character. When El Hai describes how Freeman almost obsessively kept in touch with his patients you have to contrast this caring image with that of Freeman performing lobotomies in his office with an ice-pick and then sending the patients home in a taxi. Freeman doesn't come off as a two-dimensional monster, instead he is revealed to be an all to real three-dimensional, deeply and desperately flawed man.
El Hai avoids scrutinizing larger questions such as to what degree lobotomy was used as an instrument of societal control of troublesome individuals, but others have speeculated on that question, instead he provides new englightenment on that issue by examining Walter Freeman and his times.

Jack El-Hai takes us into the mind of one of America's most complex medical personalities. The Lobotomist explores the life and work of Dr. Walter Freeman who performed thousands of "ice-pick lobotomies" during the 40s and 50s as a way to treat mental illness. Some saw Freeman as a savior with a miracle cure, others saw him as a cold-blooded egomaniac... Jack El-Hai presents him as a tragic and complex soul by giving us an intimate look into his life and career. A brilliant read...especially because it provides such a vivid snapshot of a terrible chapter in medical history!

I'm not usually a fan of biographies, but I was persuaded to read this one because a friend who's well aware of my preference for fiction recommended it as "just a great story." And that it is. Dr. Walter Freeman, the godfather of the lobotomy, is as intriguing a character as any of the noble but flawed doctor/scientist heroes of classical literature. Driven by ambition and a desire to accomplish great things for humanity, as well as for himself, he scaled the heights of his profession only to be brought low by arrogance and pride.

Jack El-Hai tells Freeman's story with fairness, grace and a novelist's understanding of character and human frailty. I recommend this fine book not only to readers interested in the subject but to anyone who enjoys, as my friend suggested, "a great story."

As a public health researcher and historian, I found Dr. Freeman's story to be fascinating and horrifying. The book is a fascinating history of psychiatric surgery and of many of the controversies in the development of the science of the mind.

From a researcher's standpoint, it is astounding to read about the highly suspect levels of evidence that Dr. Freeman was willing to accept and pass on to argue for the widespread use of lobotomy. It would be comforting to think that research standards are much more rigorous today, but recent disclosures into the problems with highly marketed pharmaceuticals put the lie to that idea. In fact, in some ways, Dr. Freeman acted more ethically than today's pharmaceutical companies in the sense that, whatever his motives, he was not driven by financial greed. His devotion to his patients, his long road trips to visit them, and his enormous efforts to keep tabs on them are amazing, especially considering that his patient database was boxes of index cards and charts.

Still, Dr. Freeman's arrogance is breathtaking. His willingness to carve up sections of healthy brains is astonishing. And it is clear that he, who was a physician but not a licensed surgeon, took terrible liberties in performing the "ice pick" procedure on his own on the grounds that no general anesthesia was needed.

My only (minor) complaint about the book itself is that the last third seemed overly long. All in all an excellent read.

The story of Dr. Walter Freeman, a psychiatrist - is as convoluted as the human brain. After learning about this maverick medical pioneer, I come to believe that Dr. Freeman was a man consumed with finding the ultimate cure for those stricken with debilitating mental illnessess. He witnessed the mental asylums of the 1930's - and these houses were wretched prisons where the truly lost souls of our planet were housed.
Freeman could not bear to leave those patients with no hope / no chance of a treatment or way of getting better. Persons who were insande in the 30's, 40's and 50's were left with no treatment whatsoever. God help those who were schizophrenic, or obsessive-compulsive or agitatedly depressed or suicidal. In those early days, there was nothing other than confinement to treat the mentally ill.
A lifetime of confinement...loneliness...despair.
Dr. Freeman developed psychosurgery in the form of the frontal lobe, bilateral lobotomy procedure...he practiced on hundreds of patients along with his esteemed collegue, Dr. James Watts; a neurosurgeon. Together, they attacked severe mental incapacity with their frontal lobe-disconnecting surgeries....which was first performed with a leucotome inserted through the sides of the frontal lobes in the surgical suite....which then evolved into the use of a simple ice pick, which was inserted straight into the frontal lobes via the superior medial aspects of the orbits of the eyes!
This approach sickened and repulsed all nurses assisting in the procedure, no matter how experienced they were.
The method of anesthesia was delivering several jolts of electroshock therapy....which wasn't actually anesthetizing, it more promotoed amnesia and unconsciousness than actual sedation, but the manuver worked.
Thus, this rather barbaric approach to lobotomies is what Dr. Freeman stuck to for the remainder of his less-than-illustrious medical career. This outraged many of the medical community; eventually even Dr. James Watts distanced himself from the practice, preferring the use of the sterile surgical environment.
Other shock treatments that are explained in this novel are Metrazol, Insulin, and electro-shock treaments that helped to erradicate certain psychiatric diagnosies. All with very limited success.
As outrageous as it may seem, the lobotomy was actually researched and found to be theraputic in about 33% of all cases.
19% of the time, it was a miserable failure and the remainder of the time, the patient simply traded one set of psychiatric problems for another set of equally disturbing problems.
Amazingly, 33 % of patients were discharged from state hosptials and could function independently at home.
Dr. Freeman understood the seriousness of the despondency that hung in the wards like a dark cloud in state institutions.
He wanted to do something about it, and he also didn't mind if he were to become famous for discovering a cure.
The life & career of Dr. Walter Freeman is a lesson in the human condition and a wise man once said, "Psychiatry is the management of despair." Lobotomy was basically outlawed by the 1950's and not done hardly at all in the 1960's.
What will shock you most is that now, psychosurgery is experiencing a renaissance. The use of surgery to correct intractable psychiatric problems is once again being used to treat numbers of resistant obsessive-compulsive patients and severly depressed patients. Today neurosurgeons employ more precise tools, such as lasers or radiation to produce tiny lesions in narrowly targeted regions of the brain. So, the term lobotomy is shunned currently. The ghost of Dr. Freeman still hovers over the science of modern neurosurgery for mental disorders and perhaps someday, he will recieved the recognition and praise that evaded him during his lifetime.
This book is an excellent intellectual adventure into the brilliant minds of those who seek cures for those who have not found their cure. Read it!

Author Jack El-Hai makes it clear in the prologue that he does not wish to demonize Walter Freeman. That wish is admirable, but the author puts so much effort into humanizing Freeman he glosses over the incalculable suffering he caused.

The author's attempt to humanize Dr. Walter Freeman does not jibe with the facts he presents. If Freeman truly believed in his heart that lobotomy was justifiable for the wide range of ailments he claimed (including alcoholism, depression) why then did he not seek this miraculous cure for his own wife, who apparently suffered from both as a result of his chronic infidelity?

Equally repellent are Freeman's colleagues in the medical establishment who kept their criticisms to themselves while the carnage continued for decades. Can you imagine (as in the case of Freeman's cohort Dr. Watts) seeing your colleague (who is not even a licensed surgeon) sticking an ice pick into the head of a patient in an office setting and doing no more than ending your partnership? This sounds more like organized crime than medicine.

The author makes much of Freeman's bizarre and obsessive followup of his patients as if it evidenced caring rather than a guilty conscience and a pathological need to be liked by his victims.

It takes an enormous leap of faith to believe Freeman's primary motivation was the good of his patients. Handing a camera to a colleague so he could record Freeman's ability to bore holes into the brains of his patients with both hands is not the mark of devoted physician.

Unfortunately, neither Freeman nor his accomplices were ever called to account in their lifetime. On the contrary, they were honored as distinguished gentleman of the medical profession. The medical establishment as a whole owes a belated apology to the thousands of victims and their families.

Jack El Hai has produced a masterful,gripping account of the
crude but well-intentioned efforts of a medical genius to find a cure for mental illness. By so doing, he describes the bias and barriers confronting Walter Freeman's somewhat bizarre forays into an uncharted medical area and the man himself, a
talented, egotistical individual who braved the calumny of the
medical profession.
A must read

It would be easy to see Walter Freeman as a one of the greatest monsters who ever practiced medicine. Jack El-Hai has avoided thais trap and has written a deeply intelligent and fascinating biography. The Lobotomist richly portrays the desperation of those who suffered from psychiatric disorders and their families before the advent of psychotherapeutic drugs. Freeman attempted to improve the lives of hundreds of thousands of mentally ill patients who were sentenced to confinement within horrible facilities during those times. Perhaps Freeman's greatest failing was his inability to divorce himself from the outcomes of his procedures and design rigorously controlled scientific studies. This book is remarkably engaging. I found myself hoping that Freeman wouldn't make each new mistake, even though I already knew he would. In that way, this book has the elements of many of the great tragedies.

This book is superbly well written, and it is able to capture the interest of any reader regardless of any previous exposure to psychiatry or surgery. It has all of the elements of a captivating biographical work: anecdotes, in-depth analysis, intrigue, speculation... and it's capable of making the reader cringe with the somewhat explicit descriptions of a most scorned medical procedure.

Through the pages, it is possible to reflect on how medical science in general has evolved, and how primitive is (and little we know of) mental health. When Walter Freeman (the lobotomist) is placed in his time and societal context, it is hard not to admire his dedication and courage to explore and pursue the cure to the pain of people... Lobotomy is possibly one evidence we have to suggest that behaviour and biology are linked.

I recommend this book wholeheartedly to anyone with an interest in the history of science and indeed to any lover of biographical studies.