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Walter Jackson Freeman.

Freeman performed nearly 2500 lobotomies in 23 states[3], mostly based on scanty and flimsy evidence for its scientific basis[4][5], but more significantly he popularized the lobotomy. A neurologist without surgical training, he initially worked with several surgeons, including James W. Watts. In 1936, he and Watts became the first American doctors to perform prefrontal lobotomy (by craniotomy in an operating room).

Seeking a faster and less invasive way to perform the procedure, Freeman adopted Amarro Fiamberti's transorbital lobotomy and began to perfect it, initially by using ice picks hammered into each frontal lobe through the back of each eye socket ("ice pick lobotomy"). Freeman was able to perform these very quickly, outside of an operating room, and without a surgeon. For his first transorbital lobotomies, Freeman used an actual icepick from his kitchen. Later, he utilized an instrument created specifically for the operation called a leucotome. In 1948 Freeman developed a new technique which involved wrenching the leucotome in an upstroke after the initial insertion. This procedure placed great strain on the instrument and in one case resulted in the leucotome breaking off in the patient's skull. As a result, Freeman designed a new, stronger instrument, the orbitoclast.

Freeman embarked on a national campaign in his van which he called his "lobotomobile" to demonstrate the procedure to doctors working at state-run institutions; Freeman would show off by icepicking both of a patient's eyesockets at one time - one with each hand.[5] According to some, institutional care was hampered by lack of effective treatments and extreme overcrowding, and Freeman saw the transorbital lobotomy as an expedient tool to get large populations out of treatment and back into private life.

The "ice pick lobotomy" was, according to Ole Enersen, performed by Freeman "with a recklessness bordering on lunacy, touring the country like a travelling evangelist. In most cases," Enersen continued, "this procedure was nothing more than a gross and unwarranted mutilation carried out by a self righteous zealot."[6]

Freeman's most notorious operation was on the ill-fated Rosemary Kennedy, who was permanently incapacitated by a lobotomy at age 23. Another of his patients, Howard Dully, has now written a book called My Lobotomy about his experiences with Freeman and his long recovery after the surgery he underwent at 12 years old.[7]

Who's bonkers now? But then:

Anti-psychiatry.

Laing, Cooper, Theodore Lidz, Silvano Arieti and others went on to argue that schizophrenia could be understood as an injury to the inner self inflicted by psychologically invasive "schizophrenogenic" parents, or as a healthy attempt to cope with a sick society. Psychiatrist Thomas Szasz argues that "mental illness" is an inherently incoherent combination of a medical and a psychological concept, but popular because it legitimizes the use of psychiatric force to control and limit deviance from societal norms.

Adherents of this view referred to "the myth of mental illness" after Szasz's controversial book of that name. (Even though the movement originally described as anti-psychiatry became associated with the general counter-culture movement of the 1960s, Szasz, Lidz and Arieti never became involved in that movement.) Michel Foucault, Erving Goffman, Deleuze and Guattari, and others criticized the power and role of psychiatry in society, including the use of "total institutions", "labeling" and stigmatizing.[25]

I think it's a little glib to say that all mental illness is social. But it's equally simplistic to pretend that you can take individuals out of their personal contexts, and assume that any "distress" is remote from their circumstances.

I'll just repeat what I said earlier - we have a psychiatry of the individual, and we have the beginnings of a much less developed psychiatry of the family. But we don't have a psychiatry of corporations, of social institutions, of belief systems, or of policy.

by ThatBritGuy (thatbritguy (at) googlemail.com) on Thu Jan 27th, 2011 at 12:25:50 PM EST
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