the startling story of lobotomies in the 20th century

E2995772-d281-11e6-962c-fe439ed038d1 Andrew Scull at the Times Literary Supplement:

On November 19, 1948, the two most enthusiastic and prolific lobotomists in the Western world faced off against each other in the operating theatre at the Institute of Living in Hartford, Connecticut. They performed before an audience of more than two dozen neurosurgeons, neurologists and psychiatrists. Each had developed a different technique for mutilating the brains of the patients they operated on, and each man had his turn on the stage.

William Beecher Scoville, Professor of Neurosurgery at Yale, went first. His patient was conscious. The administration of a local anaesthetic allowed the surgeon to slice through the scalp and peel down the skin from the patient’s forehead, exposing her skull. Quick work with a drill opened two holes, one over each eye. Now Scoville could see her frontal lobes. He levered each side up with a flat blade so that he could perform what he called “orbital undercutting”. What followed was not quite cutting: instead Scoville inserted a suction catheter – a small electrical vacuum cleaner – and sucked out a portion of the patient’s frontal lobes.

The patient was wheeled out and a replacement was secured to the operating table. Walter Freeman was next, a Professor of Neurology from George Washington University. He had no surgical training and no Connecticut medical licence, so he was operating illegally – not that this seemed to bother anyone present. Freeman sought an assembly-line approach so that lobotomy could be performed quickly and easily. His technique allowed him on occasion to perform twenty and more operations in a single day. He proceeded to use shocks from an Electro-Convulsive Therapy machine to render his female patient unconscious, and then inserted an ice pick beneath the eyelid until the point rested on the thin bony structure in the orbit.