A pioneering lobotomist’s mixed legacy

When he began his biography of Walter J. Freeman, M.D., a Yale College graduate who pioneered lobotomy in the United States, journalist Jack El-Hai expected he would be writing about “a monster.”

The truth was more complicated, said El-Hai, author of The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness, speaking at a master’s tea at Yale in November. Psychiatrists embraced the crude surgery that severed neural pathways between the frontal lobes and the thalamus, El-Hai argued, because until the advent of Thorazine in 1954 they had few effective treatments for psychiatric illnesses. “They were willing to try something experimental, something desperate. ... because at least it held out some hope,” said El-Hai.

From 1936 to 1967 roughly 40,000 patients underwent lobotomies nationwide, for conditions ranging from depression to schizophrenia. Freeman did 3,400 of them, including one on a sister of John F. Kennedy. Some patients felt better, some became disabled and 2 percent died.

Freeman, El-Hai noted, “was one of the few advocates of a biological orientation for psychiatry. That is his most positive legacy today, if you can find one.”