Lobotomies inc.

>50k victims of institutional violence in America.

The other day I read the latest article from Radically Genuine, one of my favourite substack authors:

The Corruption of "Science" for Manipulation & Control

In that article, the following reference to a “lobotomile” piqued my interest:

Like many people, I was generally aware that lobotomies were at one time lauded as the “next big idea” for treating mental illness (the Portuguese inventor of the procedure, Egas Moniz, even being awarded a nobel prize), before being abandoned when the medical community changed its mind.

However, I wasn’t aware of the timeline involved in the story.

The article in “Medium” referenced in the Radically Genuine post (here) is actually paywalled, but there is plenty of other material available by which the story of the rise and fall of the lobotomy - including the specific role of Walter Freeman - can be scrutinised.

Here are some examples:

• In this article you can read some fascinating testimony from people involved; including sveral people who were actually subjected to the procedure, a nurse who assisted Freeman, and a doctor who witnessed it.

• This Guardian article features one of those interviewed in the above - Howard Dully.

• Here you can listen to a short podcast describing a tragic incident in which Walter Freeman’s son dies, which is said to have radicalised him in his mission to lobotomise as many metally ill as possibe.

• This 1942 Time Magazine article lauds the procedure.

• This piece describes a 2019 National Library of Medicine lecture on the history of the procedure (viewable here).

• Finally, this Britannica article gives a brief history of the procedure.

Before delving into this topic further, I had assumed that lobotomies were performed throughout the 1940s with mainstream medical support, the nobel prize then came on the back of a groundswell of enthusiasm for the procedure, and it was only later that sentiment turned against it.

However, when one looks at the timeline, things look quite different.

The below is generated by Gemini AI using a number of articles I “fed” it, and to me it is a fair representation of events as reported:

The above suggests that throughout the history of the lobotomy in the USA - and certainly covering the period when most of the 50,000 or more such procedures were actually carried out - the lobotomists were certainly not carrying out sanctioned “standard of care”, but were actually acting as mavericks, performing operations for which there a distinct lack of evidence in their favour¹.

The numbers of procedures carried out was allowed to climb past 50,000 cases in the United States, despite these practitioners being viewed with deep scepticism by their peers; this relentless march went unchecked for well over two decades.

Concerns about consent and legality were even raised outside the medical profession, as evidenced by an anonymous 1949 article in the Stanford Law Review “Lobotomy: Surgery for the Insane”, which can be found here (though paywalled). To quote:

...There are some cases where the doctor’s scalpel so far alters a patient’s personality as to leave a mere “human vegetable.” The thought-provoking aspect is that the operation is still experimental in theory and technique, and the experimentation must be done on human beings. Thus, a suggestion for some sort of legislation providing for a board of medical and legal experts to review the necessity and the results of the operations seems to have much merit.

How and why the unchecked growth in the use of the lobotomy was allowed to happen is worthy of further investigation, so I went in search of some articles which addressed the matter, and came across this 2018 paper:

You can download a PDF here:

Marchr Lobotomiesus

506KB ∙ PDF file

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The abstract provides a high-level hint as to the reasons why lobotomies were carried in such high volumes for so long: basically, money and control.

This (from page 6) is key:

The above picture is one of institutional overreach responding to perverse incentives. We have state funded institutions - funded on a per-capita basis - prioritising the reducing of occupancy - and making patients “easier” to look after - over the needs of individuals. Physicians are acting as administrators, bypassing any notions of informed consent. “Institutional efficiency” has - in essence - becomes a euphemism for sanctioned administrative violence.

By way of an illustration as to precisely how utilitarian the approach was, a further quote from the above paper is notable. Below are the words of the physician Mesrop Tarumianz, who acted as superintendent of Delaware State Hospital, during a 1941 panel discussion at the American Medical Association:

From an Economic point of view, I should like to give some figures as to what this may mean to the public. We have the following conclusions with regard to our own cases: In our hospital, there are 1,250 cases and of these about 18 could be operated on for $250 per case.

That will constitute a sum of $45,000 for 180 patients. Of these, we will consider that 10 percent, or 18, will die, and a minimum of 50 percent of the remaining, or 81 patients will become well enough to go home or be discharged.

The remaining 81 will be much better and more easily cared for the in hospital. Thus the hospital will be relieved of the care of 99 patients. That will mean a savings $351,000 in a period of ten years.”

Note the casual acceptance of the idea that 10% of these people will die, and the lack of interest in or reporting of what happens to the 45% of patients who don’t become “well enough to go home”².

Concluding remarks.

In the above, I have identified the following key features of the story of the unchecked growth in the use of the lobotomy:

• Perverse financial incentives.

• The forcing of an experimental procedure on individuals with lack of proper informed consent, usually behind closed doors.

• Enthusastic adoption with no regard to long-term outcomes.

• Justification by means of over-simplified and rudimentary understanding of complex biology.

• The prioritising of institutional needs over those of the individual.

It is naive to think we are any more “advanced” these days - we saw all of the above during the so-called “covid pandemic”.

I believe that the common thread we see running through these atrocities is the involvement of the state in science and medicine.

1. I make no admissions here as to truly how “evidence-based” the standard of care - when “sanctioned” - might have been. Today, it is anything but…

2. I have placed that in quote marks to reflect the fact that the personalities of the victims were - in most cases - permanently damaged.