The effects of lobotomy: a summary

Throughout human history, disciplines such as medicine, psychology, psychiatry, and biology have experienced dark episodes.

From eugenics to concentration camp doctors and the defense that racial differences explain differences in intelligence, there are many cases in which science has gone wrong and has harmed society as a whole. The principle of “primum non nocere” (“the first is not to hurt”) has not always been respected, although there may have been good intentions behind it.

This is the case with lobotomy, a practice that was used with the aim of improving the lives of patients with mental disorders and freeing them from the bad life they led in mental hospitals in the mid-20th century. . However, this practice was very harmful, leading to a set of negative effects which one could not say with certainty whether or not they led to an improvement in the quality of life of those involved. In this article we will a review of the effects of lobotomy on the life of operated patients, In addition to briefly seeing the historical background of this technique.

    Brief history of lobotomy

    Lobotomy is a technique that since its inception has been a huge controversy in the field of psychiatry. Its roots go back to the primitive trepanations of ancestral cultures. These types of interventions consisted of opening holes in the skull and “expelling” the evil spirits that were in the head. According to their beliefs, these cultures considered these entities to be responsible for mental disorders.

    However, the lobotomy itself is much more modern and was developed during the 20th century. The Portuguese António Egas Moniz is the one who established the bases of this technique by means of his first leukotomies, With the aim of treating and curing psychotic disorders. This intervention consisted of cutting the connections of the frontal lobe with the rest of the brain, arguing that this would reduce the problematic symptoms. He won the Nobel Prize in Medicine in 1949 for being responsible for this technique.

    later, Walter Freeman, a doctor with notions of surgery and neurosurgery, modified this technique of his contact with Moniz’s leukotomy, and was how he created the lobotomy. Rephrasing the Portuguese scientist’s postulates, Freeman argued that behind mental disorders was an interaction between the thalamus and the prefrontal cortex, and that the destruction of the connections between the two structures was necessary.

    To perform his technique, Freeman reached a point where he needed barely ten minutes, and as a surgical instrument he needed an ice pick. Here, the word “icebreaker” is not a metaphor; Mr. Walter Freeman used tools taken from his own kitchen (according to what he expresses for one of his children) in order to use them on the brains of his patients.

    The intervention was quite simple. First, he took the aforementioned kitchen instrument and inserted it under the upper eyelid to reach the frontal lobe and, with a hammer, tapped to go “chop” (never better said) the aforementioned connections. A peculiarity of this intervention, unthinkable today, is that it was a blind operation. What does it mean? It means that Mr. Lobotomist didn’t know exactly where he was going.

    In short, a lobotomy consisted of putting an ice pick in the brain of patients for ten minutes and trying their luck. During the process, the respondent was awake and asked questions. When what the patient was saying didn’t make sense, it meant it was a good time to stop.

    It goes without saying at that time, little was known about the great importance of the frontal lobe, Region in charge of executive functions: concentration, planning, working memory, reasoning, decision-making …

      Effects of lobotomy

      Although the aim of this surgery was to improve patients’ condition and reduce their symptoms, the truth is that in both short and long-term patients showed signs of worsening. In fact, even proponents of this technique themselves and lobotomism experts have recognized that after the procedure, patients manifested changes in their personality and intelligence.

      Walter Freeman himself coined the term “surgically induced childhood” to refer to the postoperative condition manifested by lobotomized patients. Essentially, after the lobotomy, many patients seemed to behave like children. However, Freeman seemed convinced it would only be a temporary phase. According to this doctor, after a period of “maturation”, the patients would behave like adults without disorder or with some improvement.

      But in practice, this did not happen. It was only a matter of time before the lobotomy technique turned out to be a clearly counterproductive surgery and a clear detriment to the health and independence of patients.

      The first symptoms of people with lobotomies were usually stupor, confusion, and urinary problems such as incontinence, Have a marked loss of sphincter control. At the same time, there were alterations in eating behavior, manifesting an increase in appetite to such an extent that a lot of weight was gained after the operation.

      Personality was a very affected aspect. There was less spontaneity, less self-care, and a lower degree of self-control. The ability to take initiative was reduced and less inhibition was given to pleasant stimuli. Inertia was another of the most common effects in people with lobotomies.

      As already mentioned, the intervention was performed on the frontal lobe, which is responsible for executive functions. So it was normal to see that skills such as planning, working memory, attention and others were also diminished. There was also an impairment in social cognition, some being unable to put themselves in other people’s shoes because of it.

      The “cure” calmed the patients, causing their activation to slow down, not because the disorder magically disappeared, but rather because they had become zombies. For more inri, many patients have started to have seizures after surgery, Supporting the famous saying “the cure is worse than the disease”.

      However, the most serious effect was death. According to some sources, one in three patients did not survive this type of intervention, Despite its short duration. There have also been several cases of people suffering from lobotomies who ended up committing suicide because of it.

      Bibliographical references:

      • Cosgrove, G. Rees; Rauch, Scott L. (1995). “Psychosurgery”. Neurosurgery clinics in North America.
      • Cooper, Rachel (2014). When deciding to do a lobotomy: Lobotomies were justified or risky decisions should not always seek the maximum expected utility. Medicine, health care and philosophy. 17 (1): 143-154.

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