ICE PICKS TO THE BRAIN The History of Psychosurgery

The following is a brief history of this destructive procedure:

1848: Modern psychosurgery can be traced to an incident when an explosion drove an iron rod through the cheek and out the top of the head of railway worker Phineas Gage. Before the accident, Gage had been a capable foreman, a religious man with a well-balanced mind and shrewd business sense. After the accident, Gage recovered, but he became fitful, irreverent, grossly profane, impatient and obstinate. Psychiatrists continued to be intrigued by the sudden mood change and began testing the use of psychosurgery to alter the behavior of their patients.

1882: Swiss asylum superintendent Gottlieb Burckhardt was the first known psychosurgeon. He removed cerebral tissue from six patients, hoping “the patients might be transformed from a disturbed to a quiet [lunatic].” Although one died and others developed epilepsy, paralysis and aphasia (loss of ability to use or understand words), Burckhardt was pleased with quiet patients.

1935: Egas Moniz, a professor of neurology in Lisbon, Portugal, performed the first lobotomy, inspired by an experiment in which the frontal lobes of two chimpanzees were removed. Moniz conducted the same operation on humans, theorizing that the source of mental disorders was located in this part of the brain. “In accordance with the theory we have just developed,” he said, “one conclusion is derived: to cure these patients we must destroy the more or less fixed arrangements of cellular connections that exist in the brain.” A 12-year follow-up study observed that Moniz’s patients suffered relapses, seizures and death. Moniz was awarded the Nobel prize for psychosurgery. Ironically, he was paralyzed in 1944 by five gunshots in the back from a disgruntled patient. Sixteen years later, he was shot and killed by another dissatisfied patient.

1946: American psychiatrist Walter J. Freeman performed his first lobotomy. In 1967 Freeman lost his license to practice after killing a female patient with his brutal procedure. Postoperative death and suicide mortality rates resulting from his operations were as high as 10%.

Late 1940s: Psychosurgery was “refined” to burning the brain tissue with a fine probe. The result, however, was as destructive as ever.

Today: Despite killing thousands of people internationally and ushering in an era that American Psychiatric Association President Alan Stone called “a tragic and unfortunate chapter of psychiatry,” psychiatrists around the world still practice psychosurgery.

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