Warning: This Post is a Bummer
Rosemary Kennedy, before the lobotomy
The story of Rosemary Kennedy, lobotomized at 23, is one of the saddest from a family history littered with tragedies. I once flipped through The Sins of the Father, a (no doubt sensationalist) biography of Joseph P. Kennedy, at a great used bookstore, and discovered that among the litany of bad decisions Kennedy made in his life, his decision to have a doctor deliberately damage the brain of his young daughter ranks among the worst. Rosemary, a moody girl believed by the family to be “mildly retarded” (and by others to simply have suffered from depression), underwent a secret lobotomy in 1941 and spent the remaining 64 years of her life incapacitated, prone to incontinence, and spending long periods of time staring blankly at walls. When I put down the book and left the store, I walked away wondering how in the world such a barbaric and unnecessary surgery was allowed to take place, especially within one of the richest and most famous families in America. Why wasn’t Joseph Kennedy put in jail? What doctor would advocate deliberately damaging the brain?
Many of my questions have now been answered by the excellent PBS documentary The Lobotimist, which originally aired in the American Experience series, and is free to watch online.
As it turns out, lobotomies were, for a time, quite popular in the United States, thanks almost entirely to one man. Dr. Walter Freeman, the focus of the PBS documentary and the man responsible for maiming Rosemary Kennedy’s brain with what observers described as a “butter knife,” was the inventor and main proponent of the lobotomy. He performed over 3,000 lobotomies on mentally ill patients during his career, and often performed several a day.
Dr. Walter Freeman
Freeman is a fascinating character, seemingly as driven by the allure of fame as by his belief in the procedure he advocated. The sheer audacity of a man willing to drive ice picks and butter knives into the brains of the most vulnerable leads one to wonder whether he was simply a sadist who found his outlet. The word “monster” is used several times in the documentary. It’s difficult to say whether Freeman’s intentions were altruistic (the conditions of asylum inmates at the time could hardly have been worse, and anything to make the experience more tolerable would be seen as humane), or if his drive for fame and fortune prevented him from seeing the errors in his ways. (Among the many horrifying stories in the documentary, the one about a patient who dies on the operating table because Freeman’s ice pick slips while he is posing for a photo—mid-lobotomy—has to be the most shocking.) Perhaps the real monsters of this story are Freeman’s unchecked ambition and a scientific hierarchy that allowed “experts” the unchecked freedom to perform any procedure on a whim.
Jack El-Hai, author of the definitive Freeman biography, puts it thusly: “Walter Freeman was the product of his environment, his impulse to innovate, and personal demons.” The environment El-Hai speaks of is the one in which the medical elite had the power to incarcerate patients or perform dangerous surgeries without patient or family approval, and conditions at mental asylums were bad enough to be compared to concentration camps.
It’s mind-blowing to think the Walter Freeman narrative took place in the middle of the twentieth century, and not in some other, darker age. People could take transatlantic flights but were unable to point out the insanity of a radical brain-damaging operation performed on mental patients without consent? Which is not to say Freeman’s method was without its critics. But Freeman was considered an expert in his field and, as a result, he was able to perform his procedure with impunity for several years. The surgical footage shown in The Lobotomist is horrifying, but it is the before and after photographs of patients that are most haunting. Stern faces become bewildered empty gazes, and confusion, mild fear, and strange placidity the only expressions.
It turns out my questions about how a lobotomy could possibly be performed on a member of an elite American family were off base. It was precisely because Rosemary was a Kennedy that she underwent the surgery, as her father was concerned about the family reputation. She lived the rest of her life hidden from public scrutiny in various institutions.
A young Howard Dully
The story of lobotomy survivor Howard Dully, told late in the documentary, is heartbreaking too. A hyperactive child, Dully underwent the less invasive transorbital (ice pick through the eye socket) version of the procedure at 12 years old. He has since spent his life in different varieties of trouble, from alcoholism to incarceration. Dully is surprisingly articulate, but laments that he has always lacked the ability to make proper life decisions, and blames the involuntary lobotomy his stepmother demanded when he was 12.
As difficult as The Lobotomist is to watch, it contains valuable lessons. Perhaps the most important is that even accepted, ostensibly empirical knowledge is always bound to its time, and therefore ephemeral. Watching this documentary, I began to wonder what contemporary medical practices might someday be viewed as misguided or backwards. Chemotherapy comes to mind, as one hopes doctors will create a method of cancer treatment less damaging to the body. Of course, medicine must work with available information, and these techniques have vastly improved over the last few decades. One wonders, also, how far we’ve come in the treatment of the severely mentally ill. Pharmaceutical advances in the 50s allowed for the phasing out of lobotomies, but is the chemical equivalent any better or more ethical? Will we one day regard the involuntary medication of children and the mentally ill as cruel and unnecessary?
I highly recommend watching The Lobotomist, but be warned that it is an uncomfortably heavy film about an uncomfortably heavy topic.
