The Medical World After 1941: Lobotomy’s Rise and Fall
The procedure performed on Rosemary Kennedy in November 1941 did not remain a fringe experiment. In the years immediately following, lobotomy’s use expanded rapidly in the United States.
Walter Freeman became its most energetic promoter. He toured the country, visiting state psychiatric hospitals and demonstrating the procedure to staff and administrators who were desperate for anything that might relieve the overcrowding and misery of institutions stuffed with patients for whom no effective treatments existed. He developed the transorbital technique — the “ice pick” method — in the mid-1940s, in which a modified surgical instrument was inserted through the thin bone above the eye socket to access the frontal lobes. This approach required no drilling, no operating room, no anesthesia in the traditional sense — Freeman used electroconvulsive shock to induce unconsciousness — and no surgical license. He could perform it in a physician’s office.
In 1949, António Egas Moniz was awarded the Nobel Prize in Physiology or Medicine for the development of the lobotomy. This is one of the most contested decisions in Nobel history; critics would later argue that the prize was awarded on the basis of misrepresented or inadequate evidence, and that it gave unwarranted scientific legitimacy to a procedure whose dangers were becoming increasingly clear.
By the early 1950s, tens of thousands of lobotomies had been performed in the United States. Freeman alone eventually performed an estimated three to four thousand procedures over his career. His patients included children. At least one hundred patients died of cerebral hemorrhage.