Walter FREEMAN was a hard man to like. Most of his contemporaries found him abrasive, arrogant and egotistical, and so he was. Subsequent generations have identified him as the premier lobotomist of the 20th century, and so he was.
He did not invent this supposed cure for psychosis. As Jack El-Hai points out in "The Lobotomist," his powerful biography of Freeman, that dubious honor belongs to the Portuguese neurologist Egas Moniz, who pioneered the operation in the mid-1930s and received the Nobel Prize in physiology or medicine in 1949 as a reward for his accomplishment. But it was Freeman, in collaboration with the comparatively shy and retiring neurosurgeon James Watts, who fostered the operation in the United States.
And it was Freeman who popularized an alternative way of performing the surgery -- the transorbital lobotomy, which involved inserting ice picks under the eyelids and pushing them through the orbital plate into the brain's frontal lobes -- and announced that the procedure was so simple that with a little practice it could be performed by the most witless of state hospital psychiatrists. He also announced, and repeatedly demonstrated, that it could be done on an outpatient basis, using two or three electroshocks to the brain as anesthetic. He insisted that the newly lobotomized patient could return home within hours of the surgery, taking only the simple precaution of wearing sunglasses to cover the black eyes that were evidence of the slicing and dicing of her brain. (It was usually "her" brain.) Freeman, moreover, was willing (indeed, eager) to lobotomize children as young as 4 years old and adults whose neuroses were of recent origin. He warned that unless such patients were treated promptly, their personalities would deteriorate and they would spend the rest of their lives as chronic lunatics on the back wards of state hospitals, a fate surely worse than death.
Children's brains, he pointed out, were more resilient than those of adults. Just as well, because he also insisted that in pediatric cases, "maximal operation" -- a particularly extensive standard lobotomy -- "is the only effective procedure and necessarily leads to a rather vegetative condition." For adults he preferred the transorbital operation, because it was so much simpler and quicker. Whereas a standard lobotomy might take several hours, the operation via the eye sockets took less than six minutes, including time out to photograph the ice picks in place. El-Hai notes that Freeman delighted in demonstrating his prowess before an audience. Wearing no gown, mask or gloves, he treated the occasion almost as a circus act, spearing the brain and twisting his hands back and forth to make identical cuts behind each eye. He once managed to perform 228 of these procedures in the space of only 12 days, courtesy of the superintendents of the West Virginia state hospitals, who gave him unlimited access to their charges.
