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Editorial Reviews
From Publishers Weekly
Set against the backdrop of changing attitudes toward mental illness in the 20th century, El-Hai's scholarly biography of Dr. Walter Freeman is a moving portrait of failed greatness. Born to a distinguished family of physicians, he rose to become one of the most celebrated doctors of his generation. Best known as the doctor responsible for the widespread adoption of lobotomy in America after WWII, he also made signal contributions to the science of medicine through his career-long involvement with George Washington University Medical School and St. Elizabeth's Hospital in Washington, D.C. Yet, despite his achievements, the procedure he helped develop and tirelessly champion would ultimately become his undoing. As physicians sought other, less drastic means to treat mental illness, Freeman's unorthodox methods, which often included an ice pick and carpenter's hammer, came to seem barbaric. When he died in 1972, the sharply negative view of psychosurgery expressed in books like One Flew Over the Cuckoo's Nest (1962) had become commonplace; a mere decade later, movies like Frances (1982) would openly portray lobotomy as institutionalized torture. Although the title of El-Hai's biography might suggest otherwise, he eschews such lurid oversimplifications and portrays Freeman in all his human complexity. To this end, he chronicles Freeman's crusade to help millions of asylum patients who might otherwise remain incarcerated indefinitely; his indefatigable postoperative commitment to his patients; and his flamboyant personality and macabre sense of humor in and out of the operating room. El-Hai's book succeeds as both an empathetic, nuanced portrait of one of America's most complex public figures and as a record of the cultural shifts that have occurred in the treatment of mental illness over the last century.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
From Scientific American
Few words conjure up more gruesome connotations than "lobotomy"—surgically severing the brain’s frontal lobe in an attempt to relieve intractable psychiatric symptoms. And yet these operations—first performed in the U.S. in 1936 by psychiatrist and neurologist Walter Jackson Freeman and neurosurgeon James Winston Watts—continued for more than 40 years. In that time, Freeman, the procedure’s champion, cut the brains of 3,500 people. Biographer Jack El-Hai chronicles lobotomy’s reign through Freeman’s quest to treat mental illness surgically. The tale follows this son and grandson of prominent physicians from his youth in Philadelphia during the early 1900s through his rise and eventual fall in national prominence. Freeman emerges not merely as a maniacal devotee of radical "psychosurgery" but as an earnest advocate of potential treatments for otherwise intractable mental illness. Most of Freeman’s work took place when state psychiatric hospitals overflowed with seemingly untreatable patients, many of whom suffered relentlessly. Effective psychiatric medications were not yet available, and lobotomy became a measure of last resort. El-Hai describes how neurosurgeons experimented to transform the complicated prefrontal lobotomy into the simpler transorbital lobotomy—nearly an outpatient procedure in which a physician entered a patient’s brain through a region above the eye with an ice-pick like tool. A skilled practitioner could perform a transorbital lobotomy in minutes. Surprisingly, many of Freeman’s lobotomies were reported as successful, not only by Freeman but also by some patients and their families, who sent hundreds of letters expressing gratitude. Of course, many surgeries failed; Rosemary Kennedy, the sister of President John F. Kennedy who suffered "agitated depression," was left "inert and unable to speak more than a few words," as El-Hai says, and was ultimately institutionalized. In 1950 Freeman and Watts reported that of 711 lobotomies they had performed, "45 percent yielded good results, 33 percent produced fair results, and 19 percent left the patient unimproved or worse off." Not surprisingly, many patients remained confused, disconnected, listless and plagued by complications such as seizures. With the emergence of effective drugs during the 1970s, physicians halted lobotomies altogether The tale of lobotomy’s rise and fall entails far more than one man’s quest to spearhead a dubious surgical method. It is a story of desperation among thousands of patients, families, clinicians and policymakers struggling to manage a population seemingly crippled by illnesses for which there was no help. It is also a worrisome account of physicians groping for solutions to problems that they could not adequately address. In this sense, El-Hai’s treatment of this medical saga is also poignant and illuminating.
Set against the backdrop of changing attitudes toward mental illness in the 20th century, El-Hai's scholarly biography of Dr. Walter Freeman is a moving portrait of failed greatness. Born to a distinguished family of physicians, he rose to become one of the most celebrated doctors of his generation. Best known as the doctor responsible for the widespread adoption of lobotomy in America after WWII, he also made signal contributions to the science of medicine through his career-long involvement with George Washington University Medical School and St. Elizabeth's Hospital in Washington, D.C. Yet, despite his achievements, the procedure he helped develop and tirelessly champion would ultimately become his undoing. As physicians sought other, less drastic means to treat mental illness, Freeman's unorthodox methods, which often included an ice pick and carpenter's hammer, came to seem barbaric. When he died in 1972, the sharply negative view of psychosurgery expressed in books like One Flew Over the Cuckoo's Nest (1962) had become commonplace; a mere decade later, movies like Frances (1982) would openly portray lobotomy as institutionalized torture. Although the title of El-Hai's biography might suggest otherwise, he eschews such lurid oversimplifications and portrays Freeman in all his human complexity. To this end, he chronicles Freeman's crusade to help millions of asylum patients who might otherwise remain incarcerated indefinitely; his indefatigable postoperative commitment to his patients; and his flamboyant personality and macabre sense of humor in and out of the operating room. El-Hai's book succeeds as both an empathetic, nuanced portrait of one of America's most complex public figures and as a record of the cultural shifts that have occurred in the treatment of mental illness over the last century.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
From Scientific American
Few words conjure up more gruesome connotations than "lobotomy"—surgically severing the brain’s frontal lobe in an attempt to relieve intractable psychiatric symptoms. And yet these operations—first performed in the U.S. in 1936 by psychiatrist and neurologist Walter Jackson Freeman and neurosurgeon James Winston Watts—continued for more than 40 years. In that time, Freeman, the procedure’s champion, cut the brains of 3,500 people. Biographer Jack El-Hai chronicles lobotomy’s reign through Freeman’s quest to treat mental illness surgically. The tale follows this son and grandson of prominent physicians from his youth in Philadelphia during the early 1900s through his rise and eventual fall in national prominence. Freeman emerges not merely as a maniacal devotee of radical "psychosurgery" but as an earnest advocate of potential treatments for otherwise intractable mental illness. Most of Freeman’s work took place when state psychiatric hospitals overflowed with seemingly untreatable patients, many of whom suffered relentlessly. Effective psychiatric medications were not yet available, and lobotomy became a measure of last resort. El-Hai describes how neurosurgeons experimented to transform the complicated prefrontal lobotomy into the simpler transorbital lobotomy—nearly an outpatient procedure in which a physician entered a patient’s brain through a region above the eye with an ice-pick like tool. A skilled practitioner could perform a transorbital lobotomy in minutes. Surprisingly, many of Freeman’s lobotomies were reported as successful, not only by Freeman but also by some patients and their families, who sent hundreds of letters expressing gratitude. Of course, many surgeries failed; Rosemary Kennedy, the sister of President John F. Kennedy who suffered "agitated depression," was left "inert and unable to speak more than a few words," as El-Hai says, and was ultimately institutionalized. In 1950 Freeman and Watts reported that of 711 lobotomies they had performed, "45 percent yielded good results, 33 percent produced fair results, and 19 percent left the patient unimproved or worse off." Not surprisingly, many patients remained confused, disconnected, listless and plagued by complications such as seizures. With the emergence of effective drugs during the 1970s, physicians halted lobotomies altogether The tale of lobotomy’s rise and fall entails far more than one man’s quest to spearhead a dubious surgical method. It is a story of desperation among thousands of patients, families, clinicians and policymakers struggling to manage a population seemingly crippled by illnesses for which there was no help. It is also a worrisome account of physicians groping for solutions to problems that they could not adequately address. In this sense, El-Hai’s treatment of this medical saga is also poignant and illuminating.
Richard Lipkin
See all Editorial Reviews
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