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 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.
