Cutting Edge

Jacqueline Doyle


In a lobotomy, neural fiber connections in the prefrontal cortex of the brain are severed. The irreversible surgical procedure was widely used in the late 1930s, 1940s, and early 1950s for patients with schizophrenia, bipolar mood disorder, and an array of other mental problems, including depression, migraines, alcoholism, insomnia, anxiety, hysterical paralysis, and 鈥渘ymphomania.鈥

Where did they go? The rosy-cheeked girls we once were. The bright-eyed women with quick wits and careless laughs. The mothers and grandmothers who hugged their sadness to themselves.

Psychosurgery, later called the leucotomy, then the lobotomy, was developed by the Portuguese neurologist Ant贸nio Egas Moniz, who built on similar work that had been done at Yale University on chimpanzees. The first psychosurgery was performed in 1935 in Portugal on a 63-year-old woman suffering from depression and anxiety. Early surgeries involved drilling two holes in the patient鈥檚 forehead and injecting absolute alcohol into the prefrontal lobe to destroy it. Later Moniz devised a retractable wire loop called a leucotome that was rotated to surgically separate the prefrontal lobe from the rest of the brain. 

Sixty-three, long past my childbearing years. Does anyone need me any more? My family is tired of me. I am tired of me. Will I ever get better? They say I鈥檓 cured but they won鈥檛 let me go home. 

The first prefrontal lobotomy in the United States was performed in 1936 on Alice Hood Hammatt, a 63-year old Kansas housewife who suffered from agitated depression and insomnia. The physician Walter J. Freeman II and neurosurgeon James W. Watts drilled six holes in her skull and repeatedly inserted a leucotome, rotating it to cut away brain tissue. The hour-long operation was deemed a success.

My insomnia is gone. I鈥檓 calmer. I don鈥檛 feel much of anything. I sleep and sleep. Is this what they mean by well? Some days I can barely get out of bed, but I drag myself into the kitchen to clear the table, sweep the floor, and wash my husband鈥檚 breakfast dishes. The sunlight slants through the window over the sink, warm on my face, and I close my eyes. It鈥檚 not much, but it鈥檚 something. My grown children say they barely know me any more.

In 1939 Moniz was shot by a schizophrenic patient and left partially paralyzed. He spent the rest of his life in a wheelchair. Freeman later claimed that the 鈥渞isk of assassination by patients鈥 was an 鈥渙ccupational hazard.鈥 

It wasn鈥檛 the first time I鈥檇 shot a gun, but it was the first time I鈥檇 shot a man. I shot him five times and he half stood up, a look of shock on his face. Two more times and he fell from his chair, blood sprayed all over the papers on his desk. I thought he was dead. He deserved it. I hope he thinks of me every day, as I think of him.

Lobotomies were touted as miracle cures. Patients reportedly became more docile and easier to handle after the procedure. Many, however, became apathetic and lethargic, and suffered from seizures, obesity, personality changes, and severe intellectual and emotional impairment. Some were left in a permanent vegetative state. Some died as a result of the procedure. Beulah Johnson鈥檚 granddaughter described the results of her grandmother鈥檚 lobotomy: 鈥She was strange because she would do things like rock in place. She didn鈥檛 make a lot of sense when she talked. And she didn鈥檛 talk about the same things that other adults talked about. She was鈥攃hildlike is probably the best description.鈥  

I play with the little ones. Pat-a-cake, pat-a-cake, baker鈥檚 man. Bake me a cake as fast as you can. Ring around the rosie, A pocket full of posies, Ashes! Ashes! We all fall down. I鈥檝e fallen down. Who am I now? 

In 1941, Freeman operated on John F. Kennedy鈥檚 lively, learning-disabled, 23-year-old sister Rosemary, who was left incontinent and unable to speak or walk after the procedure, and never regained her previous level of intelligence. She spent the remaining sixty-four years of her life in institutions. It was twenty years before her mother saw Rosemary again. The Kennedy family kept Rosemary鈥檚 existence a secret until after John was elected president, when she was described as mentally retarded. Her father, Joseph F. Kennedy, who鈥檇 arranged for the prefrontal lobotomy without consulting other family members, never visited his daughter again after the failed operation. 

If I could tell my story, I鈥檇 tell you I was beautiful once, I remember that. I visited the White House when Roosevelt was president. I was presented at court in England when my father was ambassador. I went to dances. It鈥檚 true, I needed home schooling. I had seizures. It鈥檚 true, I used to sneak out at night to see boys when I was in the convent boarding school. I know my father was angry. They gave me a tranquilizer and kept me awake during the lobotomy. They asked me questions while they operated. When I could no longer sing 鈥淕od Bless America,鈥 they stopped. Then, nothing. 

In 1943, a bilateral prefrontal lobotomy authorized by her mother was performed on Tennessee Williams鈥 24-year-old sister Rose, who had been diagnosed with paranoid schizophrenia. She was institutionalized for the remainder of her life. Tennessee paid for her expensive private care, and left provisions in his will for her upkeep, including fresh flowers in her rooms every week. She outlived her brother by thirteen years. Writing to his agent about yet another character in one of his plays based on Rose, he said, 鈥淭he great psychological trauma of my life was my sister鈥檚 tragedy, who had the same precarious balance of nerves that I have to live with, and who found it too much and escaped.鈥 

I was popular in high school, but nervous around boys, I chattered and smiled and smiled鈥攂efore I became so wound up and anxious, before I dropped out of school, before I fell in love with someone who did not love me back. My stomach hurt all the time. I knew I was being poisoned, but my mother thought I just needed the right gentleman caller. My psychiatrist thought I couldn鈥檛 keep a job because I was afraid of sex. They sent me to doctor after doctor, hospital after hospital, then St. Vincent鈥檚 Catholic Sanitarium in St. Louis for the mad, then the state hospital at Farmington. Six fruitless years of Metrazol and insulin shock therapy. Since the operation, I can鈥檛 think any more, I can鈥檛 seem to feel anything. They鈥檙e good to me, my brother, my mother (her fault, her fault). Everyone meant well. I smile and smile. I love Christmas. I like to watch 鈥淕eneral Hospital鈥 on TV. I like the grilled cheese sandwiches at the Highland Diner. I like to sing in church.

In 1945 Freeman developed a new, cutting edge, 10-minute procedure to replace Moniz鈥檚 leucotomy. Freeman performed the first transorbital lobotomy on Sallie Ellen Ionesco, a 29-year-old housewife who was depressed and suicidal. After rendering her unconscious using electroshock, he hammered an instrument like an ice pick through her eye socket into her brain to cut into her frontal lobe. Although she couldn鈥檛 walk without assistance, he sent her home in a taxicab. A week later he repeated the procedure in her other eye socket. According to her family, Sallie suffered some memory loss, but was able to resume a normal life.

Once I wanted to kill myself at the prospect of living like this. Now I can hardly remember feeling that way. When my husband leaves for work, I make the beds. I make breakfast for the children, pack their lunches, send them off to school, sit and wait in our empty house, pick them up from school. When my husband comes home at night, I make martinis. I make conversation. I make casseroles. My family praises them. I trade recipes with the neighbors. It鈥檚 what you鈥檇 call a normal life. Lots of people would consider me lucky.

Watts, who was trained as a surgeon, and Freeman, who was not, had a falling out over the radically simplified operation. Freeman traveled across the country to demonstrate his new procedure in theatrical public displays at mental hospitals, performing 228 transorbital lobotomies in just two weeks in West Virginia. A P.T. Barnum-style showman who reveled in media attention, he liked to insert picks in both eye sockets of the patient at the same time. A student nurse who observed his demonstration at the University of Virginia recalled: 鈥淗e looked up at us, smiling. I thought I was seeing a circus act.鈥 Once, when an instrument slipped and the patient died, he moved onto the next without dropping a beat. He called his tour 鈥淥peration Icepick.鈥 

Step right up folks, step right up. You鈥檒l be amazed. You鈥檒l be astounded. You鈥檝e seen a woman sawed in half. Now you鈥檒l see a woman with ice picks in her brain! Yes! Her brain!

The lights are so bright. The people in the crowd are on the edge of their seats. They leer and jeer. Dear God, help me. 

Allen Ginsberg鈥檚 mother Naomi, who suffered from paranoid delusions and was diagnosed as schizophrenic, was in and out of mental institutions for thirty years, spending years at a time at Greystone Mental Hospital in New Jersey, where she underwent electroshock treatments, Metrazol shock treatments (drug-induced convulsions so severe that some patients鈥 spines broke), and insulin coma therapy (weeks of drug-induced daily comas). In 1947 she was lobotomized at Pilgrim State Psychiatric Center on Long Island. Ginsberg memorialized his mother in 鈥淜addish鈥濃斺渟weating, bulge-eyed, fat鈥 from the Metrazol, later broken by her lobotomy and a stroke. He described visiting her in Pilgrim: 鈥淚 went in鈥攕melt funny鈥攖he halls again鈥攗p elevator鈥攖o a glass door on a Women鈥檚 Ward鈥攖o Naomi鈥擳wo nurses buxom white鈥擳hey led her out, Naomi stared鈥攁nd I gaspt 鈥 / Too thin, shrunk on her bones 鈥 / 鈥 lame now鈥攚rinkles鈥攁 scar on her head, the lobotomy鈥攔uin, the hand dipping downwards to death鈥斺 Naomi was incarcerated at Pilgrim when she died of a brain hemorrhage in 1956.

America, America. What justice is here for the tired, the poor? I was ten years old in 1905, when my family arrived in New York from the small village of Nevel in Russia. My first language was Yiddish. We fled the anti-Jewish pogroms and the Czar鈥檚 political oppression, the massacres of workers and peasants and Jews. I continued to battle political oppression in the U.S. I marched. I took my sons to demonstrations and meetings. I joined the Communists, hoping for a better world. Instead I cowered in our dark apartment, afraid of the light that hurt my eyes, of my mother-in-law, of my husband, of the government. The doctors called it paranoia but my son Allen understood. They were after me. They鈥檙e still after me. Don鈥檛 you know there are spies everywhere? They have the power. Electricity. Knives. Poison. Why will no one believe me? We鈥檙e all in danger. 

Two thousand lobotomies were performed at Pilgrim State Psychiatric Center alone. Records survive for many of them. A Pilgrim patient who was described as 鈥渁ssaultive and noisy鈥 before her lobotomy became 鈥渙bese, quiet, smiling, friendly鈥 after the procedure. According to the doctors, her hygiene improved. 鈥淭here is massive regression and chronic hallucinations, but she is clean.鈥 Among other cases at Pilgrim was a 26-year-old woman suffering from 鈥渢ension neurosis.鈥 After her lobotomy in 1948, doctors reported, she complained that the operation 鈥渟hould not have been done, but she is keeping house again for her husband.鈥 

I want to go home. If I do what they ask me to, will they let me go home? If I do what they ask me to at home, will they let me stay there? 

In 1949, Moniz was awarded a Nobel Prize in Physiology or Medicine 鈥渇or his discovery of the therapeutic value of leucotomy in certain psychoses.鈥 As problems with the procedure began to surface, attempts were made by family members of lobotomy patients to rescind the award, but they proved unsuccessful. Moniz continued to practice until 1955.

Who will remember? Will our children, our grandchildren speak for us? Will anyone hear what they say?

It was not until the FDA approved the sedating antipsychotic medication Thorazine in 1954 that lobotomies waned in popularity. Fifty million prescriptions for Thorazine were filled during its first ten years on the market.

Ghostly figures began to crowd the halls of the mental wards, afflicted by tardive dyskinesia from the new antipsychotic meds, doing the Thorazine shuffle.  

Fifty thousand lobotomies had been performed in the United States by the 1960s. More were performed on women than on men. Freeman himself performed or oversaw more than 3,500. He continued to perform lobotomies until 1967, when his patient Helen Mortensen died during a botched lobotomy鈥攈er third鈥攁nd his surgical privileges were revoked.

Too late. Too late.


About the Author

Jacqueline Doyle is the author of the award-winning flash chapbook The Missing Girl (Black Lawrence Press). She has published creative nonfiction in The Gettysburg Review, New Ohio Review, Passages North, The Collagist, and Fourth Genre. Her work has earned seven Notable Essay citations in Best American Essays. Find her online at  and on Twitter @doylejacq.