Lobotomy, Version 3.0

Lobotomies endure, as do the accompanying ethical questions

| February 3, 2005

When JFK's sister Rosemary Kennedy died last month, the accompanying obituaries typically re-told the story about Joseph Kennedy's decision to have his unruly, mildly retarded daughter lobotomized. The operation failed and Rosemary's mind was reduced to that of an infant's.

More than 60 years later, cases like Rosemary's shock the collective conscience. It's assumed that the procedure is a relic of medical history, eliminated with the advent of anti-psychotic drugs. For patients who don't respond to drug treatment, however, the lobotomy is sometimes used as a last resort.

In an article published by This Magazine, author Danielle Egan writes that the lobotomy -- also known as psychosurgery -- was introduced in the 1930s, re-emerged in the 1970s, and is once again in vogue. And just as the procedure has reappeared, so has the accompanying controversy.

The serious side-effects -- zombie-like apathy, aggressiveness, depression, fatigue -- remain the same, as do the fault lines that define the medical community's opinion of the procedure. Proponents hold fast to the idea that the source of mental illness is in the organic structure of the brain and can be cut out. Skeptics say mental illness can be traced to psychological trauma in a patient's past and argue that behavioral therapy is superior to surgical solutions, which are both invasive and scientifically suspect.

Egan is a skeptic, but does not dismiss the psychological devastation that drives both doctors and patients to turn to radical measures. What most concerns her is that patients are not fully apprised of the operation's risks and that in some cases doctors are forsaking their Hippocratic Oath in the name of expedience.

All told, though, there are far fewer lobotomies performed today than in Rose Kennedy's day. In Jack El-Hai's new biography, The Lobotomist (whose first chapter you can read online), readers are taken back to the time when Dr. Walter Freeman, who imported the lobotomy from Portugal, might perform up to 25 procedures in a day.

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