Case file 029Asylums, Prisons & Human Experiments1900–1945

Ice Pick to The Brain

A doctor who wasn't a surgeon drove across America with his kids and a pair of ice picks, doing thousands of lobotomies. Rosemary Kennedy was one of his patients.

Jul 28, 202341 min
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In this episode

  • Why a nervous stomach or a bad headache could be a reason for brain surgery in 1950s America
  • The gold ring Freeman wore around his neck every day, and where he got it
  • Alice Hood Hammatt, the first patient, and the promise Freeman made her the night before
  • The day Dr. James Watts walked into the office and ended the partnership on the spot
  • A 23-year-old from one of America's most famous families, singing on the operating table, and the moment she stopped

“It is well to remember that no person of creative ability has been restored to normal after lobotomy. All must pay a price for relief from anxiety.”

The story

Father whistled as he drove, a paper map spread across the front seat while the children sang songs and played I Spy in the back. On the floorboard beside him sat a small leather case holding the tools of his trade: a pair of ice picks. Dr. Walter Freeman was crossing America to perform brain surgery, and he had never trained as a surgeon.

In April 1950, Freeman stood before some of the country's top surgeons in Tuskegee, Alabama, and pitched them his method. It took all of 10 minutes, he said, and it was easy to learn. It could free a patient from mental torment if it was done early, before what he called "brain deterioration" set in. Then he passed his instruments around the room for his peers to handle. They were ice picks. The procedure was the lobotomy.

A Nobel for scrambled brains

Freeman didn't invent the lobotomy. That honor, along with the 1949 Nobel Prize in Medicine, went to the Portuguese physician Dr. Antonio Egas Moniz. In 1935 Moniz destroyed the frontal lobes of a 63-year-old woman with pure alcohol. Later he built a needle-like tool with a retractable wire loop that sliced through the brain's white matter as it was swished around inside the skull. He called the procedure a leucotomy. His first patient's anxiety and depression faded, and so did much of her personality and her ability to function.

Cutting into the skull is nothing new. Skeletons as old as 7,000 years show holes drilled by long-dead healers, a practice called trepanation. In a 3,500-year-old tomb in Israel, one of two wealthy brothers was buried with the missing piece of his own skull lying beside him. Even in the ancient world, brain surgery was a last resort. Freeman thought it was underused. In his view, insomnia, postpartum depression, a nervous stomach, headaches, chronic pain and even disruptive behavior could all be fixed with a few taps on an orbitoclast, his surgical ice pick.

The first patient said no

On September 4th, 1936, Freeman and his partner, the neurosurgeon Dr. James Watts, tried their version on Alice Hood Hammatt, a woman diagnosed with agitated depression. The night before, she learned her head would be shaved and refused to go ahead. Freeman promised to leave her hair alone. The next morning she was still resisting, so they sedated her and put her under anyway. They drilled two holes, scooped out white matter at deeper and deeper levels, and nicked a blood vessel along the way. She woke up happy enough not to mind her shaved head. Six days later she was struggling with language, agitated and disoriented. The hospital sent her home, and Freeman declared the operation a success.

He renamed the procedure lobotomy to set it apart from Moniz's work. Over six years the pair performed more than 200 of them. By their own numbers, 14% of patients suffered serious harm or died. The press didn't dwell on that. The Saturday Evening Post ran a rapturous profile, and Freeman played the part of the celebrity doctor with a goatee, a wide-brimmed hat, a walking stick, and a gold ring on a chain around his neck. He had tugged that ring off a young man's penis with forceps, refused to give it back, and had it engraved with his own family crest. A reporter for the Washington Evening Star marveled that "uncontrollable sorrow could be changed into normal resignation with an auger and a knife." One patient's mother wrote, "thank God my daughter is about to be married. I am the happiest mother in the world." Her daughter had gone mute and despairing after getting engaged. Maybe the answer was to call off the wedding.

Ice picks from the kitchen drawer

Freeman wanted the procedure faster still. Borrowing from the Italian psychiatrist Amarro Fiamberti, he started going in through the eye socket, then sweeping the pick sideways through the frontal lobes. His son Franklin later recalled, "The first ice picks came right out of our kitchen drawer and they worked like a charm." Freeman swapped anesthesia for a portable electroshock machine that knocked patients out, and he moved the surgery into an ordinary office. He often skipped washing his hands, dismissing sterile technique as "germ crap."

Watts objected. Then one day he walked in on a patient lying unconscious with an orbitoclast lodged in his eye socket. Freeman looked up: "oh good you're here. Can you lend me a hand while I take a photograph?" Watts refused, and the partnership ended there.

Freeman took his show on the road, with his children in the car. He liked to draw gasps from a crowd by working with two ice picks at once. When one patient died during a demonstration, Freeman moved on to the next one in line. At a hospital in Virginia, staff reported that the only side effect was bruising that made patients look like they'd been "kicked in the face by a mule." In West Virginia he lobotomized 35 women in one visit, then told their families to offer "lots of loving and just enough punishment to add spice."

The weird part

The doctor who spread the lobotomy across America had never trained as a surgeon. The first ice picks he pushed through patients' eye sockets came out of his own kitchen drawer.

A song cut short

His worst failure had already happened. Rosemary Kennedy, eldest daughter of Joseph and Rose Kennedy, was deprived of oxygen at birth when a nurse forced her head back into the birth canal for two hours while everyone waited on a doctor. She grew up with developmental delays that her image-conscious parents hid, and later with violent outbursts and attempts to run away. In 1941, when she was 23, her father decided a lobotomy might make her more docile. Her diagnosis was intellectual disability, which the procedure had never been used to treat.

She was awake on the table at George Washington University Hospital, singing "All of me, why not take all of me?" as Freeman and Watts swept a metal spatula through her brain. Then she fell silent. She could no longer walk or talk. She spent the rest of her life in institutions and died in 2005. Her siblings weren't told what had happened. Once they knew, they became activists: Eunice founded the Special Olympics, Jack passed disability legislation as president, and Ted helped pass the Americans with Disabilities Act.

All must pay a price

Freeman went on to lobotomize more than 4,000 people, including children, one of them just four years old. He once did 20 in a single day. Between 1949 and 1952, more than 50,000 lobotomies were performed in the U.S. In 1953 he admitted that "no person is emotionally or mentally intact after a lobotomy," and still argued the sooner the better. In 1967 Helen Mortensen died of a brain hemorrhage during her third lobotomy from him, and he was finally banned from doing the procedure.

His own family paid a price too. His wife became an alcoholic, and in 1946 his 11-year-old son was swept over a waterfall at Yosemite. Fourteen years later, Freeman met an 11-year-old named Howard Dully and suggested the two of them go hiking. Then he gave the boy an ice pick lobotomy. "I was different now. I was a freak," Dully said as a grown man. Freeman died in 1972. The ice pick from the family kitchen drawer had also been the one his sons used to punch new holes in their belts.

The transcript

Chapters & full transcript5,450 words
Chapters
  1. 00:01The family road trip
  2. 01:39The first patient said no
  3. 02:49A Nobel for scrambled brains
  4. 20:37The lobotomy road show
  5. 25:00Rosemary Kennedy
  6. 34:02The fall of the lobotomy

This transcript was generated automatically from the episode audio and may contain errors. Times are approximate, since ad breaks can shift them by a minute or two.

00:01

It was a family road trip. Kind of. A working vacation for father. That's why mother stayed behind. But father thought the experience would be good for the children. They'd see some of America, this beautiful country. Father was a very important man. A doctor. As the family wagon bounced along the byways of late 1940s and 50s America, the children sang songs and played games like I Spy. Father whistled to himself as he navigated from a paper map spread out across the front seat. Tucked on the floorboard beside him was a small leather case. In it were the tools of his trade. A pair of ice picks.

01:14

On the evening of April 4th, 1950, some of the top surgeons in the United States gathered in Tuskegee, Alabama for the 28th annual meeting of the John A. Andrew Clinical Society. There was a speaker that night, a very well-known neurologist and consultant to both the VA and Walter Reed Hospital. His name was Dr. Walter Freeman. He was deeply critical of VA's policy that a patient suffering from a mental health disorder had to have been under observation for two years before surgery might be considered as a treatment option.

01:53

Dr. Freeman believed passionately that there was a simple surgical procedure that could be performed in the early stages of a mental health crisis before what he called brain deterioration set in. A procedure that had the potential to free the patient forever from their mental torment. Not everyone at that meeting agreed with Dr. Freeman. There were some vocal skeptics in the room, which didn't stop Freeman from talking with great enthusiasm about his method of psychosurgery. He described the procedure as something easily learned that might take all of 10 minutes to perform. Then he passed around a pair of his surgical tools for his peers to handle and examine. The tools were ice picks and Freeman's psychosurgery had another name, lobotomy. Dr. Walter Freeman didn't invent the lobotomy. That distinction and the Nobel Prize belongs to Portuguese physician, Dr. Antonio Igas Moniz. Moniz performed the first lobotomy in 1935. The patient was a 63-year-old woman suffering from anxiety, depression, insomnia, paranoia, and hallucinations. Moniz didn't use an ice pick. That was Freeman's innovation. Moniz began by using absolute alcohol, which is also known as ethanol, to destroy the frontal lobes. Eventually though, he created a needle-like tool with a retractable wire loop that sliced through the white matter fibers of the brain as it was swished around inside the patient's head. If you're thinking, what? What did I just hear? That is so crude and chaotic. Ding, ding, ding. You are absolutely correct. Dr. Moniz called the procedure a leucotomy. His first patient got the ethanol treatment, which is no less crude or chaotic when you think about it. I mean, after all, you'd probably rather we didn't drill a hole in your skull and drizzle in some ethanol. Now, to be fair, this Frankenstein-sounding treatment did appear to cause much of the patient's anxiety and depression to decline, though at the cost of her personality and ability to function.

04:17

Still, what's the old saying? You can't make an omelet without breaking some eggs. Guess you couldn't win the 1949 Nobel Prize in Medicine without scrambling some brains. As barbaric as it sounds, it was actually, well, it was barbaric. That is the right word. Freeman recommended a frontal lobotomy in order to change my behavior.

04:49

I was 12 years old. That's Howard Dully speaking in the documentary Howard's Story. He was one of Freeman's youngest patients at age 12, and he's one of the last survivors of the transorbital lobotomy. His adult life has been marked by struggle, poverty, depression, criminality. I remember arriving there and being checked in just normally in the bed. I did not know that Freeman had written instructions that I was not to be told what I was really there for.

05:23

I do remember that they gave me electroshock. Freeman stated that he probably gave me one more than I need. The memory comes back that I think I was horrified when I was getting the shocks because they were intense and I didn't understand them. And I just wanted them to stop. And then they did the I-spec procedure in 10, less than 10 minutes. I did not know even after the lobotomy that I had a lobotomy. I think the anger, if there's any anger involved, is that they would have the nerve to play with someone's life like that.

06:08

Psychologically, it definitely damages the person in their own mind because you are always different. You're always strange. You're not normal in your mind. I was different now. I was a freak. The human brain has always been a mystery to us. Even now, with all the extraordinary imaging technology at our disposal, we can map the brain, but there's so many unknowns. Setting aside the whole mystery of human consciousness, we really don't know how any of that works. The physical brain itself holds secrets we've yet to unlock. Even the ancients believed, or at least sensed, that the very essence of a person appeared to reside in the relatively cramped confines of the human skull.

06:58

We know this because we found archaeological evidence of primitive brain surgery dating back thousands of years, about 7,000 years in at least one case. Ancient human skeletal remains have been unearthed with the skull showing clear signs of cuts on the bone, as well as holes drilled by some long-deceased surgical pioneer. The procedure is called trepanation, and whether it was a desperate last-ditch attempt to relieve pain or treat an injury, or perhaps release what was feared to be a demon, trepanation means drilling or cutting away a portion of bone from the skull. Here's an example. The bodies of two brothers were found in a 3,500-year-old tomb in Israel. Their skeletons showed significant developmental anomalies, as well as lesions on the bones that suggest leprosy. One of the brothers' skulls had clearly not fused together properly after infancy, and also featured a missing section of frontal bone.

08:04

That missing piece was found in the tomb alongside the body. The tomb was also filled with the kinds of artifacts that tell us that these two brothers came from a family of means, which probably explains why they received so much medical intervention and lived as long as they did. The rich having access to better medical care is clearly not a modern phenomenon. One more thing before we climb out of this dusty old tomb and return to our own time. Trepanation is still a valid medical procedure today. Removing a section of bone or drilling a small hole or two in the skull of a patient who has suffered a head injury is done now to help alleviate swelling or to drain a hematoma. Now, of course, today we do that to people in sterile operating rooms with the help of some sort of anesthesia. We have no idea what trepanation was like for the ancients. Were they awake? Were they tied down? Were they offered some kind of plant-derived sedative? And more importantly, how many managed to even survive the operation? Never mind the risk of infection or inflicting permanent damage. Your first challenge was dodging the very real risk of bleeding out, which is why even in the ancient world, brain surgery was not a first option but a last resort. And it was still considered a last resort for psychiatric patients in the 20th century. Something to turn to only after all other treatments had failed. But Dr. Walter Freeman thought that lobotomy was not only misunderstood but very much underutilized. Freeman saw lobotomy as a potential cure for not just mental illness but for a whole list of other ailments too. Insomnia, postpartum depression, a nervous stomach, headaches, chronic pain, even disruptive behavior could all be addressed with a minimally invasive tap, tap, tap of an ice pick hammered into an eye socket. Okay, okay, that was disrespectful. Please let me correct myself and use the proper medical terminology. Transorbital instead of eye socket. Orbitoclast instead of ice pick. Surgical mallet instead of hammer. But I the whole minimally invasive part because Dr. Freeman's technique didn't require fancy things like operating rooms or anesthesiologists or even formal surgical training. Freeman himself hadn't trained as a surgeon. See, that was the beauty of it, according to Freeman, that so much suffering could be alleviated through such simple means. In the early days of his enthusiasm for fast brain surgery as an easy and life-altering treatment option, Dr. Freeman enlisted the expertise of a neurosurgeon named Dr. James Watts. The pair developed the Freeman-Watts standard lobotomy.

11:12

It involved inserting a spatula-like tool and manipulating it to sever the nerve pathways in one lobe or lobes of the brain from those in other parts of the brain. Now, can we just pause here and marvel that anyone, anywhere, at any point in human history heard that and thought, yeah, yeah, that sounds like a very reasonable and very good idea. Sign me up. I mean, you do have to wonder how humanity has even made it this far. Anywho, on September 4th, 1936, Freeman and Watts gave their procedure its first real-world tryout. The patient was a woman named Alice Hood Hammatt.

11:55

She'd been diagnosed with agitated depression, but the operation almost didn't happen. Upon learning the night before that her head was to be shaved, Alice Hammatt was like, that's a hard no. But Freeman persuaded her to go forward, promising to leave her hair intact. Still, the next morning, Alice continued to resist and was ultimately sedated and placed under general anesthesia.

12:23

Today, that would mean a giant lawsuit. But back then, I guess it was, you know, just a typical Friday in 1936. Here's how that surgery went down. Two holes were drilled in Alice's skull, one on either side of the frontal lobes. They used a tool like the one invented by Dr. Moniz, a metal cylinder that extracted cores of white matter between the prefrontal cortex and the rotating the wire loop at the end of the tool. They scooped out more white matter, starting at a depth of two centimeters, then three centimeters, then four centimeters.

13:06

There was one oopsie when they accidentally sliced through a blood vessel, but the patient's vital signs remained steady, and so they flushed out the surgical site with saline and stitched her back up. When Alice Hammatt woke up in post-op recovery, she described herself as feeling happy, so much so that she reportedly announced that she didn't even mind that Freeman had broken his promise and shaved her head. Six days later, though, Alice Hammatt began experiencing difficulties with language. She was agitated and disoriented, but the hospital sent her home anyway, and Freeman declared the operation a success. He also abandoned Dr. Moniz's term for the procedure, leucotomy, and instead dubbed it lobotomy. That accomplished two things. One, it set what Freeman and Watts were doing apart from the work of the Nobel winner, and two, it made it very clear that their process focused on the frontal lobes and involved both white and gray matter.

14:18

Over the next six years, the pair performed more than 200 frontal lobotomies. The data they shared indicated that 63% of patients showed improvement, 23% showed no change whatsoever, and 14% experienced significant negative outcomes post-op and or death. 14% seems like a lot when we're talking about catastrophic damage to the brain and or death, but Dr. Freeman had an extremely powerful ally when it came to glossing over the bad news and highlighting the good, the media.

14:58

In May 1941, the Saturday Evening Post published a rapturous profile of Freeman and Watts, and Freeman was a natural when it came to the media. He had a big theatrical personality. He adopted a kind of eccentric costume, a long goatee, round-rimmed spectacles, a dramatic wide-brimmed hat, a fancy walking stick, and around his neck, always an engraved gold ring threaded onto a chain. Fun story about that ring. Early in his medical career, Freeman treated a young male patient who'd managed to get a metal ring stuck on his penis. Surprise! In case you thought dudes getting their junk trapped in whatever happens to be handy is some kind of new behavior. Anyway, Freeman managed to tug the ring off using a pair of forceps. When the patient asked for the ring back, Freeman lied and said that it was a medical artifact now and could not be returned. Freeman then had the ring repaired by a jeweler, engraved with his own family crest, and strung it on a chain, which he then wore pretty much every day. Weird, weird, weird. But then, Freeman was known to keep a little souvenir from each of his lobotomy patients. The media was Freeman's accomplice in spreading that good news about this near miraculous way of restoring peace and productivity to the troubled mind. The Saturday Evening Post hailed what Freeman and Watts were doing as nothing short of transforming a world full of hatred into one radiant with sunshine and kindness. A science reporter for the Washington Evening Star named Tom Henry wrote, quote, it seems unbelievable that uncontrollable sorrow could be changed into normal resignation with an auger and a knife. In May 1946, a newspaper in Pittsburgh reported that Freeman and Watts had discovered a way to painlessly cure insanity. The story described one patient as a timid bookkeeper who, post-lobotomy, went on to become a successful gregarious salesman and ultimately the president of his company. An article in the San Francisco Examiner in September 1948 told of a young woman who suddenly began experiencing bouts of muteness and despair. These episodes began when the woman became engaged to be married. Therapy had been ineffective. Electroshock treatment failed to deliver results. A 10-minute lobotomy? That did the trick. The woman's mother wrote her thanks to the surgeon saying, quote, thank God my daughter is about to be married. I am the happiest mother in the world. End quote. I'm just going to pop in here and say that, listen, if you are engaged and having doubts so extreme as to cause despair and muteness, perhaps what you need is not a lobotomy but to call off the wedding. Sweet baby Jesus with an ice pick. What were people thinking back then? So the media loved Dr. Freeman. Dr. Freeman loved the media. In fact, historians credit Freeman's media savvy for taking the lobotomy from an experimental option to something you might consider a quick and easy standard fix. Freeman arranged to have his lobotomy procedures photographed. He purchased the length of green felt, you know, like the kind you see on pool tables for use as a photographic backdrop. When you see those images all in stark black and white, the light from the camera's flash creating foreboding shadows. It's some mad scientist looking stuff for real. But Freeman wasn't content with his first successes. He wanted to make the lobotomy procedure even more streamlined. Inspired by the work of Italian psychiatrist Amaro Fiamberte, who performed the very first transorbital lobotomy in 1937, Freeman began developing his own techniques and his own tools. This is his son Franklin

19:12

appearing in a 2013 PBS documentary called Lobotomy. We didn't have a refrigerator, we had an ice box. The first ice picks came right out of our kitchen drawer and they worked like a charm. I guess we can be thankful he didn't reach for a whisk too. Freeman's method, which called for penetrating the frontal lobes via the eye socket followed by a lateral sweeping motion, essentially obliterated the frontal lobes of the brain.

19:42

Freeman also dispensed with surgical anesthesia using a portable electroshock machine instead. Gone too was any need for a surgical operating suite as Freeman could now perform transorbital as an outpatient procedure in an office setting. His partner neurosurgeon Dr. James Watts strongly objected to all of this. He was troubled by Freeman's disregard for the established standards of sterile medical protocols. Freeman often didn't even wash his hands before performing a lobotomy, rolling his eyes at all that germ crap as he called it. Watts also acknowledged that the hospital at George Washington University had reprimanded Freeman for, you know, performing surgery without being an actual surgeon. Even back then hospitals were picky about that sort of thing.

20:37

The conflict between Freeman and Watts came to a head in one utterly ghastly moment. Watts had informed Freeman that he would quit and Freeman did not cease performing lobotomy procedures in the office of their shared practice. And then came the day when Watts walked into the room to see a patient lying on the table unconscious with an orbitoclast lodged in his eye socket. Freeman glanced up and said, oh good you're here. Can you lend me a hand while I take a photograph? That was it for Dr. Watts. He flatly refused. He told Freeman that he would lobby the hospital to block transorbital lobotomies from being performed and would not even entertain the idea of psychiatrists being trained to deliver the procedure. The partnership between the two men was over. And Freeman was now free to take his one-man portable lobotomy show on the road and he did. The road trip that kicked off this episode? Just one of many summers he spent traveling America, his children in tow, tools and electroshock machine packed and ready. And Freeman wasn't just delivering the procedure to patients, he was often doing it for an audience. He enjoyed the attention, was described as a natural showman. He apparently liked to elicit a shocked gasp or two from his audience by inserting two ice picks into each socket at a time. One report states that a patient died during one of these demonstrations when a sharp instrument slipped into the brain. Freeman's reaction? Indifference mostly. He immediately moved on to the next patient in line. The Minneapolis Star-Tribune reported that Dr. Freeman did two lobotomies there in March 1949, witnessed by a group of Twin Cities psychiatrists and neurosurgeons. In 1951, he performed five lobotomies as a training session for staff at Patton State Hospital in California. In January 1952, he demonstrated the procedure on 20 patients at Eastern State Hospital in Virginia. The clinical director of that institution, Dr. Eleanor Beamer Maxwell, reported that the only negative effects her team had observed were blackened and bruised areas around the eyes, which they described as looking like the patient had been kicked in the face by a mule. She boasted that of the 26 transorbital lobotomy patients under her care, 20 showed improvement and eight had been able to go home. By this point, Freeman was advising lobotomy for anxiety, depression, grief, phobias, and even the pain of cancer.

23:31

August 1952 brought a mass operation. Freeman performed lobotomies on 35 female patients at Spencer State Hospital in West Virginia. Newspaper The Spokesman Review reported that Freeman invited 150 relatives of patients there to attend a meeting on how to care for lobotomy patients once they were discharged and sent home. Freeman warned that the readjustment period post-lobotomy could last as long as a year and that side effects might include overindulging in food, alcohol, sex, and spending. He advised families to offer lots of loving and just enough punishment to add spice. Let's just sit here for a second and take that in. By that point, Dr. Freeman had performed more than 1,100 transorbital lobotomies, many done under circumstances he called a demonstration project. Shockingly, his biggest failure, the one that history would remember best, didn't await him in the future. It was in his past, in the early days of Freeman's evangelizing for the lobotomy procedure. And had that early failure been as notorious when it happened as it later became, hundreds of people may have been spared the tragic outcomes of Freeman's quick and easy outpatient brain surgery. Her name was Rosemary Kennedy. She was born in 1918, the eldest daughter of Rose and Joseph Kennedy, sister to John, Robert, and Edward Kennedy, as in the Kennedy family. Rose Kennedy went into labor at home, and though her doctor was summoned, he was delayed. An outbreak of the Spanish flu epidemic at the time was straining medical resources to the breaking point. A nurse instructed Rose to keep her legs tightly together until the doctor could arrive. And apparently, the nurse also took the extreme step of forcing the baby's emerging head back up into the birth canal for two hours. When the doctor finally arrived, he pronounced the infant healthy, but those two hours of oxygen deprivation had taken a toll. Rosemary failed to hit developmental milestones, walking, grasping objects. As time went on, there were clear educational delays. The Kennedy parents, fixated on appearances, tried to conceal Rosemary's condition from family, friends, the public, and even Rosemary herself. They tried boarding school and a convent school, but as Rosemary matured, she became prone to aggression and violent outbursts. Were these episodes fits? Seizures? It's unclear, though you should know that Rosemary's letters, written with a childish, slanting penmanship, reveal a young girl trying desperately to fit in, to be good, to win the approval of her mother and father. Heartbreaking stuff. Yet in photographs taken in 1940, you can also see a radiant and beautiful Rosemary Kennedy standing with her siblings, Jean and John, laughing and carefree. In 1941, when Rosemary was 23 years old, her father, Joseph Kennedy, was weary of the outbursts, weary of Rosemary's repeated attempts to run away. He decided that this new lobotomy procedure might be just the thing to make his daughter more docile and manageable. The surgery, at that point in time, was considered a legitimate option in cases of mental illness, but Rosemary Kennedy's diagnosis was mental retardation, something lobotomy had not been used to treat. Still, the family proceeded. Whether or not Rosemary consented or even knew what was about to happen to her is a matter of debate. And so, in the autumn

27:41

of 1941, at George Washington University Hospital, Dr. Freeman and his then-partner, Dr. James Watts, performed a prefrontal lobotomy on young Rosemary Kennedy. She was strapped to the operating table. She was wide awake. An anesthetic was used only in the areas where Freeman and Watts planned to fill two small holes in her skull. As the team worked, Rosemary recited poems and sang.

28:10

All of me, why not take all of me? Can't you see I'm no good without you? Remember, these were the early days for Freeman and Watts, the days before ice picks and eye sockets. They inserted a small metal spatula into the holes drilled in Rosemary's skull and began sweeping and slicing the connections between her prefrontal cortex and the rest of her skull. Take my arms, I'll never use them. And then, abruptly, Rosemary fell silent.

29:19

Freeman and Watts realized they had gone too far. Whatever Joseph Kennedy's hopes had been for the procedure, the reality was devastating. Rosemary was no longer able to sing. She was no longer able to talk or walk. It took months of therapy before she could move on her own volition at all. One of her legs was permanently turned inward.

29:46

She had only partial use of one arm. Her speech, when it finally returned, was garbled and incoherent. Her father had her moved to a psychiatric care clinic and then to a residential facility in Jefferson, Wisconsin, where she remained until her death in 2005. Your goodbye I left me with eyes that cry. How can I go on, dear, without you?

30:27

Even Rosemary's siblings were kept in the dark about their sister's condition and her whereabouts. Though, decades later, her fate inspired their activism. Rosemary Kennedy's biographer, Kate Clifford Larson, said this in a 2015 interview with Boston's GBH News. Her siblings were deeply shaken by her disappearance from the family. They were not told what happened to her. And once they became cognizant of what did happen to her, they became activists to make the world a better place for people with disabilities.

31:01

Eunice went on to start the Special Olympics. Her brother Jack, as president, passed legislation that was important for people with disabilities and to get research and funding for that. And Senator Ted Kennedy, of course, was instrumental in getting the Americans with Disabilities Act passed. So the family carried on that legacy because of her. And the rest, as they say, is history. You know now that as Freeman turned away from Rosemary Kennedy and exited that room, he went on to perform lobotomies on more than 4,000 patients. Some were children, at least one as young as four years old. You also know that Freeman made a show of it.

31:40

On one particularly busy day, he single-handedly completed 20 lobotomies. His influence on psychiatry and on the doctors he trained in the procedure led to a dramatic increase in the use of lobotomy. Thanks in large part to Freeman's traveling brain surgery shows and his tireless courting of the media, more than 50,000 lobotomies were performed in the U.S. between 1949 and 1952. This despite a 14 percent mortality rate and very mixed results in terms of patient outcomes. In 1953, Freeman presented his findings at the 109th Annual Meeting of the American Psychiatric Association held that year in Los Angeles. Freeman declared that in cases of patients who'd been in a mental health institution for less than six months, lobotomy returned two out of three of them to a effective life. After six months of institutionalization, the odds were 50-50 that lobotomy would prove effective. After more than a year, positive outcomes declined, though Freeman argued that it was really never too late for a lobotomy and in fact the sooner the better. Then he got even more specific and declared that 30 percent of lobotomy patients were able to hold down a job. 30 percent were able to be cared for at home and only 20 percent could be characterized as, to use his words, flat failures. Reading from his own prepared paper, Freeman stated, it is undoubtedly true that no person is emotionally or mentally intact after a lobotomy. When one gives up anxiety and depression, one also relinquishes in some measure the emotional charges necessary for the ability to experience exultation and other joys of living.

33:37

You took the part that once was my heart. It is well to remember that no person of creative ability has been restored to normal after lobotomy. All must pay a price for relief from anxiety. Why not take all of me? Lobotomy was increasingly falling out of favor as the 1950s and 1960s progressed. One state hospital in Virginia stopped allowing the procedure in 1955 and discontinued it altogether in 1962. Not on the grounds that it was barbaric or inhumane, but because it just hadn't proved all that effective. Dr. Freeman performed his last transorbital lobotomy in 1967.

34:30

The patient was a woman named Helen Mortensen and this was to be her third lobotomy from Freeman. She died of a cerebral hemorrhage, joining at least 100 of Freeman's other patients in that fate. After Mortensen's death, Freeman was banned from ever doing the procedure again. No one associated with this grim and terrible chapter in medicine escaped unscathed.

35:00

Dr. Moniz may have won the Nobel Prize for his experimental brain procedure, but that award is considered by many to be a stain on the legacy of the Nobel. Moniz himself suffered a tragic fate when in 1949, a patient in the grip of a psychotic episode managed to lay hands on a gun. He fired four shots into Moniz, leaving him in a wheelchair until his death in 1955. He was 81. Freeman, ever on the road as a traveling lobotomist, knew his own share of tragedy. His wife Marjorie became an alcoholic. Freeman was not only an absent husband, he was also a prolific adulterer. Then in 1946, unthinkable tragedy struck when Freeman's 11-year-old son lost his footing and was swept over a waterfall at Yosemite National Park.

35:56

Devastating as that loss must surely have been, Freeman seldom acknowledged it publicly. But 14 years later, when he first met then 11-year-old Howard Dully, the now grown-up lobotomy patient we heard from earlier in this episode, Freeman suggested to the boy that the two of them go hiking. Freeman died in 1972 of complications from cancer. His surviving children became fierce defenders of their father's legacy. Two, Paul and Walter Jr., followed in his footsteps and chose careers in psychiatry and neurobiology. The third, Frank, retired from a career as a He confirmed that the original ice pick Freeman used came from the kitchen drawer of his childhood home. The same ice pick they'd use to punch new holes in their leather belts as they grew.

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This is exactly the kind of random detail that sticks with a person long after other more important things are forgotten. With the luxury of hindsight, we can see how reckless and irresponsible so many of Freeman's decisions were. It seems impossible to us now that anyone ever thought that blindly and crudely poking around in the brain of a human being might yield anything but disaster. We can be appalled by Freeman himself, by his colleagues, by the casual indifference shown to so many of his patients. We can look at Joseph and Rose Kennedy and judge them harshly. They viewed their daughter, Rosemary, as defective, as a reason for shame, and in their devout Catholic belief system, perhaps even a judgment laid upon them by God. How might history be different if, after Freeman and Watts left 23-year-old Rosemary Kennedy in a vegetative state, the Kennedy parents had protested, made a fuss, you know, blown the whistle on what Freeman and Watts were doing?

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Would hundreds, possibly thousands of other patients, have been spared the consequences of Freeman's quick and easy outpatient brain surgery? But of course, that kind of thinking doesn't take you anywhere. There's no rewriting the past, no unscrambling the eggs, or in this case, the brains. You just have to hope and believe that the lessons we learn from the stakes of this gravity lead to better, safer, more ethical practices going forward. That's why we have to tell this story, why we can't let it slip into the past as though it were some freakish anomaly in the history of medicine, because it isn't. Without transparency and accountability, Freeman's patients suffered the loss of themselves for nothing. We owe them more and better than that, more and better than a game of woulda, you took the best, or coulda, so why not take the rest, or even shoulda, baby, take all of me.

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Next time on True Weird Stuff, Brian Koberger, he stands accused of brutally murdering four college students at Idaho State University. The trial will be next year, but right now, Koberger is at the center of two baffling cultural phenomenon, women in love with murderers, and the incel. Next time on True Weird Stuff. And if you listen to us on Apple Podcasts, hit the plus button in the top right corner, and now it helps an independent podcast like ours to get discovered. And we really appreciate it if you subscribe, rate, and review True Weird Stuff. Hit our website, trueweirdstuff.com for show notes, and photos, and videos when we have it, and bonus content. Everything true weird is waiting for you at trueweirdstuff.com. And follow True Weird Stuff on Instagram and Twitter. True Weird Stuff is a Now! Media production. Our along with my deeply weird director, Max Sweeten. Our equally odd producer is Kary Bowser.

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Additional production by the mysterious Stephen Karl. Our digital witch and social media cult leader is Heather Furr. Original graphics by Kevin Nash. Original artworks by Olivia Axelman. True weird original music composed and performed by Jack Griffin and Zane Nash. Copyright 2023 Now! Media. All rights reserved. All wrongs remembered. Special thanks going out to Elizabeth Jordan for singing on this episode. That song, All of Me, was a big hit for Billie Holiday at around the time Rosemary Kennedy received that doomed and terrible lobotomy. Thank you, Elizabeth.

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