The Effects of Cerebral Lobotomy: A Summary

Throughout the history of humanity, disciplines such as medicine, psychology, psychiatry and biology have had dark episodes.

From eugenics, through concentration camp doctors and the defense that racial differences explain differences in intelligence, there are not a few cases in which science was wrong and harmed a group of the society. The principle of “primum non nocere” (“the first thing is to do no harm”) has not always been respected, although there may have been good intentions behind it.

This is the case of lobotomy, a practice which was used with the aim of improving the lives of patients with mental disorders and free them from the bad life they led in the mental hospitals of the mid-century xx. However, this practice proved to be very harmful, giving rise to a set of negative effects that it could not be said with certainty if they implied an improvement or not in the quality of life of those intervened. In this article we are going to do a review of the effects of lobotomy on the lives of operated patients

, in addition to briefly seeing the historical background of this technique.

• Related article: "History of Psychology: authors and main theories"

Brief history of lobotomy

Lobotomy has been a technique that, since its inception, has caused enormous controversy in the field of psychiatry. Its roots go back to the primitive trepanations of ancient cultures. This type of intervention consisted of opening holes in the skull and "expel" the evil spirits that were located in the head. According to his beliefs, these cultures held that these entities were responsible for mental disorders.

However, the lobotomy itself is much more modern, having been developed during the 20th century. The Portuguese António Egas Moniz was the one who laid the foundations of this technique through his first leucotomies, 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 in this way the problematic symptoms would be reduced. He won the Nobel Prize in Medicine in 1949 for being responsible for this technique.

Subsequently, Walter Freeman, a physician with a background in surgery and neurosurgery, modified this technique from his contact with Moniz's leucotomy, and that is how he created the lobotomy. Reformulating the postulates of the Portuguese scientist, Freeman maintained that behind mental disorders was a interaction between the thalamus and the prefrontal cortex, and that it was necessary to destroy the connections between the two structures.

To carry out his technique, Freeman reached a point where he only needed about ten minutes, and an ice pick was enough for his surgical instrument. Here, the word "ice pick" is not a metaphor; Mr. Walter Freeman used tools taken from his own kitchen (according to what was expressed by one of his sons) in order to use them on the brains of his patients.

The intervention was quite simple. First, he took the aforementioned kitchen instrument and introduced it under the upper eyelid to reach the frontal lobe and, with a hammer, tapped to go "chopping" (pun intended) the connections previously mentioned. A peculiarity of this intervention, unthinkable today, is that it was a blind operation. what does this mean? means that Mr. Lobotomist didn't know exactly where he was going.

In short, a lobotomy consisted of sticking an ice pick into the brain of the patients for about ten minutes and trying their luck. During the process, the patient was awake, and questions were asked. When what the patient was saying made no sense, it meant that it was a good time to stop.

It should be said that at that time little was known about the great importance of the frontal lobe, region which is in charge of executive functions: concentration, planning, working memory, reasoning, decision making...

• You may be interested in: "What is the frontal lobe and how does it work?"

Effects of brain lobotomy

Although the objective of this surgical intervention was to improve the condition of the patients and reduce their symptoms, the truth is that both in the short and long term, patients showed signs of worsening. In fact, even the defenders of this technique and lobotomist experts recognized that after the intervention the patients manifested changes in their personality and intelligence.

Walter Freeman himself coined the expression “surgically induced childhood” to refer to the postoperative state manifested by lobotomized patients. In essence, after lobotomy, many patients seemed to behave like children. However, Freeman seemed convinced that this was only going to 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 a matter of time before the lobotomy technique was shown to be a clearly counterproductive surgery and that it meant a clear damage to the health and autonomy of the patients.

The first symptoms manifested by lobotomized people were, normally, stupor, confusional state, and urinary problems such as incontinence, having a clear loss of sphincter control. Along with this, 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 an aspect that was greatly affected. There was less spontaneity, less self-care and a lower degree of self-control. The ability to take the initiative was reduced and there was less inhibition when faced with pleasant stimuli. Inertia was another of the most common effects in people who were lobotomized.

As already mentioned, intervention was performed on the frontal lobe, which is in charge of executive functions. So it was normal to see that capacities such as planning, working memory, attention and others were also diminished. There was also affectation in social cognition, with some being unable to put themselves in the place of others because of it.

The "remedy" calmed the patients, causing their activation to decrease, but not because the disorder had magically disappeared, but rather because they had been turned into zombies. For more inri, many patients began to suffer seizures after being operated on, giving support to the famous saying "the remedy is worse than the disease".

However, the most clearly serious effect was death. According to some sources, one in three patients did not survive this type of interventiondespite its short duration. There were also multiple cases of lobotomized people who ended up committing suicide because of it.