Cutting Edge
Jacqueline Doyle
In a lobotomy, neural fiber connections in the prefrontal cortex of the brain are severed. The irreversible surgical procedure was widely used in the late 1930s, 1940s, and early 1950s for patients with schizophrenia, bipolar mood disorder, and an array of other mental problems, including depression, migraines, alcoholism, insomnia, anxiety, hysterical paralysis, and “nymphomania.”
Where did they go? The rosy-cheeked girls we once were. The bright-eyed women with quick wits and careless laughs. The mothers and grandmothers who hugged their sadness to themselves.
Psychosurgery, later called the leucotomy, then the lobotomy, was developed by the Portuguese neurologist António Egas Moniz, who built on similar work that had been done at Yale University on chimpanzees. The first psychosurgery was performed in 1935 in Portugal on a 63-year-old woman suffering from depression and anxiety. Early surgeries involved drilling two holes in the patient’s forehead and injecting absolute alcohol into the prefrontal lobe to destroy it. Later Moniz devised a retractable wire loop called a leucotome that was rotated to surgically separate the prefrontal lobe from the rest of the brain.
Sixty-three, long past my childbearing years. Does anyone need me any more? My family is tired of me. I am tired of me. Will I ever get better? They say I’m cured but they won’t let me go home.
The first prefrontal lobotomy in the United States was performed in 1936 on Alice Hood Hammatt, a 63-year old Kansas housewife who suffered from agitated depression and insomnia. The physician Walter J. Freeman II and neurosurgeon James W. Watts drilled six holes in her skull and repeatedly inserted a leucotome, rotating it to cut away brain tissue. The hour-long operation was deemed a success.
My insomnia is gone. I’m calmer. I don’t feel much of anything. I sleep and sleep. Is this what they mean by well? Some days I can barely get out of bed, but I drag myself into the kitchen to clear the table, sweep the floor, and wash my husband’s breakfast dishes. The sunlight slants through the window over the sink, warm on my face, and I close my eyes. It’s not much, but it’s something. My grown children say they barely know me any more.
In 1939 Moniz was shot by a schizophrenic patient and left partially paralyzed. He spent the rest of his life in a wheelchair. Freeman later claimed that the “risk of assassination by patients” was an “occupational hazard.”
It wasn’t the first time I’d shot a gun, but it was the first time I’d shot a man. I shot him five times and he half stood up, a look of shock on his face. Two more times and he fell from his chair, blood sprayed all over the papers on his desk. I thought he was dead. He deserved it. I hope he thinks of me every day, as I think of him.
Lobotomies were touted as miracle cures. Patients reportedly became more docile and easier to handle after the procedure. Many, however, became apathetic and lethargic, and suffered from seizures, obesity, personality changes, and severe intellectual and emotional impairment. Some were left in a permanent vegetative state. Some died as a result of the procedure. Beulah Johnson’s granddaughter described the results of her grandmother’s lobotomy: “She was strange because she would do things like rock in place. She didn’t make a lot of sense when she talked. And she didn’t talk about the same things that other adults talked about. She was—childlike is probably the best description.”
I play with the little ones. Pat-a-cake, pat-a-cake, baker’s man. Bake me a cake as fast as you can. Ring around the rosie, A pocket full of posies, Ashes! Ashes! We all fall down. I’ve fallen down. Who am I now?
In 1941, Freeman operated on John F. Kennedy’s lively, learning-disabled, 23-year-old sister Rosemary, who was left incontinent and unable to speak or walk after the procedure, and never regained her previous level of intelligence. She spent the remaining sixty-four years of her life in institutions. It was twenty years before her mother saw Rosemary again. The Kennedy family kept Rosemary’s existence a secret until after John was elected president, when she was described as mentally retarded. Her father, Joseph F. Kennedy, who’d arranged for the prefrontal lobotomy without consulting other family members, never visited his daughter again after the failed operation.
If I could tell my story, I’d tell you I was beautiful once, I remember that. I visited the White House when Roosevelt was president. I was presented at court in England when my father was ambassador. I went to dances. It’s true, I needed home schooling. I had seizures. It’s true, I used to sneak out at night to see boys when I was in the convent boarding school. I know my father was angry. They gave me a tranquilizer and kept me awake during the lobotomy. They asked me questions while they operated. When I could no longer sing “God Bless America,” they stopped. Then, nothing.
In 1943, a bilateral prefrontal lobotomy authorized by her mother was performed on Tennessee Williams’ 24-year-old sister Rose, who had been diagnosed with paranoid schizophrenia. She was institutionalized for the remainder of her life. Tennessee paid for her expensive private care, and left provisions in his will for her upkeep, including fresh flowers in her rooms every week. She outlived her brother by thirteen years. Writing to his agent about yet another character in one of his plays based on Rose, he said, “The great psychological trauma of my life was my sister’s tragedy, who had the same precarious balance of nerves that I have to live with, and who found it too much and escaped.”
I was popular in high school, but nervous around boys, I chattered and smiled and smiled—before I became so wound up and anxious, before I dropped out of school, before I fell in love with someone who did not love me back. My stomach hurt all the time. I knew I was being poisoned, but my mother thought I just needed the right gentleman caller. My psychiatrist thought I couldn’t keep a job because I was afraid of sex. They sent me to doctor after doctor, hospital after hospital, then St. Vincent’s Catholic Sanitarium in St. Louis for the mad, then the state hospital at Farmington. Six fruitless years of Metrazol and insulin shock therapy. Since the operation, I can’t think any more, I can’t seem to feel anything. They’re good to me, my brother, my mother (her fault, her fault). Everyone meant well. I smile and smile. I love Christmas. I like to watch “General Hospital” on TV. I like the grilled cheese sandwiches at the Highland Diner. I like to sing in church.
In 1945 Freeman developed a new, cutting edge, 10-minute procedure to replace Moniz’s leucotomy. Freeman performed the first transorbital lobotomy on Sallie Ellen Ionesco, a 29-year-old housewife who was depressed and suicidal. After rendering her unconscious using electroshock, he hammered an instrument like an ice pick through her eye socket into her brain to cut into her frontal lobe. Although she couldn’t walk without assistance, he sent her home in a taxicab. A week later he repeated the procedure in her other eye socket. According to her family, Sallie suffered some memory loss, but was able to resume a normal life.
Once I wanted to kill myself at the prospect of living like this. Now I can hardly remember feeling that way. When my husband leaves for work, I make the beds. I make breakfast for the children, pack their lunches, send them off to school, sit and wait in our empty house, pick them up from school. When my husband comes home at night, I make martinis. I make conversation. I make casseroles. My family praises them. I trade recipes with the neighbors. It’s what you’d call a normal life. Lots of people would consider me lucky.
Watts, who was trained as a surgeon, and Freeman, who was not, had a falling out over the radically simplified operation. Freeman traveled across the country to demonstrate his new procedure in theatrical public displays at mental hospitals, performing 228 transorbital lobotomies in just two weeks in West Virginia. A P.T. Barnum-style showman who reveled in media attention, he liked to insert picks in both eye sockets of the patient at the same time. A student nurse who observed his demonstration at the University of Virginia recalled: “He looked up at us, smiling. I thought I was seeing a circus act.” Once, when an instrument slipped and the patient died, he moved onto the next without dropping a beat. He called his tour “Operation Icepick.”
Step right up folks, step right up. You’ll be amazed. You’ll be astounded. You’ve seen a woman sawed in half. Now you’ll see a woman with ice picks in her brain! Yes! Her brain!
The lights are so bright. The people in the crowd are on the edge of their seats. They leer and jeer. Dear God, help me.
Allen Ginsberg’s mother Naomi, who suffered from paranoid delusions and was diagnosed as schizophrenic, was in and out of mental institutions for thirty years, spending years at a time at Greystone Mental Hospital in New Jersey, where she underwent electroshock treatments, Metrazol shock treatments (drug-induced convulsions so severe that some patients’ spines broke), and insulin coma therapy (weeks of drug-induced daily comas). In 1947 she was lobotomized at Pilgrim State Psychiatric Center on Long Island. Ginsberg memorialized his mother in “Kaddish”—“sweating, bulge-eyed, fat” from the Metrazol, later broken by her lobotomy and a stroke. He described visiting her in Pilgrim: “I went in—smelt funny—the halls again—up elevator—to a glass door on a Women’s Ward—to Naomi—Two nurses buxom white—They led her out, Naomi stared—and I gaspt … / Too thin, shrunk on her bones … / … lame now—wrinkles—a scar on her head, the lobotomy—ruin, the hand dipping downwards to death—“ Naomi was incarcerated at Pilgrim when she died of a brain hemorrhage in 1956.
America, America. What justice is here for the tired, the poor? I was ten years old in 1905, when my family arrived in New York from the small village of Nevel in Russia. My first language was Yiddish. We fled the anti-Jewish pogroms and the Czar’s political oppression, the massacres of workers and peasants and Jews. I continued to battle political oppression in the U.S. I marched. I took my sons to demonstrations and meetings. I joined the Communists, hoping for a better world. Instead I cowered in our dark apartment, afraid of the light that hurt my eyes, of my mother-in-law, of my husband, of the government. The doctors called it paranoia but my son Allen understood. They were after me. They’re still after me. Don’t you know there are spies everywhere? They have the power. Electricity. Knives. Poison. Why will no one believe me? We’re all in danger.
Two thousand lobotomies were performed at Pilgrim State Psychiatric Center alone. Records survive for many of them. A Pilgrim patient who was described as “assaultive and noisy” before her lobotomy became “obese, quiet, smiling, friendly” after the procedure. According to the doctors, her hygiene improved. “There is massive regression and chronic hallucinations, but she is clean.” Among other cases at Pilgrim was a 26-year-old woman suffering from “tension neurosis.” After her lobotomy in 1948, doctors reported, she complained that the operation “should not have been done, but she is keeping house again for her husband.”
I want to go home. If I do what they ask me to, will they let me go home? If I do what they ask me to at home, will they let me stay there?
In 1949, Moniz was awarded a Nobel Prize in Physiology or Medicine “for his discovery of the therapeutic value of leucotomy in certain psychoses.” As problems with the procedure began to surface, attempts were made by family members of lobotomy patients to rescind the award, but they proved unsuccessful. Moniz continued to practice until 1955.
Who will remember? Will our children, our grandchildren speak for us? Will anyone hear what they say?
It was not until the FDA approved the sedating antipsychotic medication Thorazine in 1954 that lobotomies waned in popularity. Fifty million prescriptions for Thorazine were filled during its first ten years on the market.
Ghostly figures began to crowd the halls of the mental wards, afflicted by tardive dyskinesia from the new antipsychotic meds, doing the Thorazine shuffle.
Fifty thousand lobotomies had been performed in the United States by the 1960s. More were performed on women than on men. Freeman himself performed or oversaw more than 3,500. He continued to perform lobotomies until 1967, when his patient Helen Mortensen died during a botched lobotomy—her third—and his surgical privileges were revoked.
Too late. Too late.
Jacqueline Doyle is the author of the award-winning flash chapbook The Missing Girl (Black Lawrence Press). She has published creative nonfiction in The Gettysburg Review, New Ohio Review, Passages North, The Collagist, and Fourth Genre. Her work has earned seven Notable Essay citations in Best American Essays. Find her online at and on Twitter @doylejacq.