TED Talks · Level C2 Mixing

The history of the lobotomy

In 1935, neurophysiologist John Farquhar Fulton presented some shocking new research. After removing the frontal lobes of two chimps,

Level: C2 · 83 sentences

Transcript

  1. In 1935, neurophysiologist John Farquhar Fulton presented some shocking new research.
  2. After removing the frontal lobes of two chimps,
  3. he found they no longer experienced frustration or anxiety.
  4. As his research associate noted,
  5. it was as if they'd joined a "happiness cult."
  6. Admittedly, the surgery had cost Fulton's chimps some cognitive functions.
  7. But to Portuguese neurologist Egas Moniz,
  8. this was a small sacrifice for what seemed to be eternal happiness.
  9. Moniz believed that replicating this procedure in humans could cure mental illness.
  10. And it was this therapeutic intention
  11. that led to one of the most controversial and destructive medical treatments of the 20th century:
  12. the lobotomy.
  13. Today, we know mental illness comes in many forms
  14. and emerges for many reasons.
  15. But in the early 20th century,
  16. these complex conditions weren't clearly delineated,
  17. and researchers had various theories about their origins.
  18. Moniz believed the symptoms of what we now call depression,
  19. OCD, and bipolar disorder
  20. stemmed from negative ideas getting fixed in the neural fibers
  21. which connect different parts of the brain.
  22. Specifically the thalamus and frontal lobes,
  23. which regulate emotion and sensation.
  24. He proposed that severing these fibers could eliminate the associated conditions,
  25. which led him to invent the prefrontal lobotomy.
  26. In this procedure, a surgeon would drill into the skull
  27. and cut the white matter connecting the prefrontal cortex to the rest of the brain.
  28. Initially, his peers were skeptical.
  29. Moniz's fundamental theory was already controversial.
  30. And psychiatrists advocating for treatments like psychoanalysis
  31. criticized this invasive surgical solution.
  32. But Moniz was undeterred.
  33. He lobotomized 38 individuals
  34. with conditions including anxiety, schizophrenia, and depression.
  35. And his hastily written results reported that two-thirds of these patients
  36. had become tranquil, amicable, and free from distressing hallucinations.
  37. At the time, psychiatrists saw calm behavior as a sign of recovery,
  38. so when Moniz brashly declared the treatment a success,
  39. his peers agreed.
  40. Newspapers celebrated the surgery;
  41. Moniz was awarded the Nobel Prize;
  42. and his procedure became especially popular in the US
  43. thanks to neurologist Walter Freeman and neurosurgeon James Watts.
  44. As a country that had institutionalized nearly half a million people for mental health reasons,
  45. many hoped the new treatment would allow this population to live relatively normal lives.
  46. But from the beginning there were problems.
  47. First, the notion of a "normal life" was determined by this period's restrictive social mores,
  48. which had led huge numbers of people to be institutionalized
  49. simply because they didn't conform.
  50. So, while many people in these facilities did need medical help,
  51. some lobotomy recipients had no mental illness whatsoever.
  52. Second, the details and timeline of the surgeries' results were unpredictable and inconsistent.
  53. In 1941, when future US President John F. Kennedy's sister Rosemary underwent a prefrontal lobotomy,
  54. it permanently impaired her ability to speak and walk.
  55. And even when the surgery did help patients manage overwhelming emotions and hallucinations,
  56. they often experienced significant side effects.
  57. These included apathy, abrupt personality changes,
  58. and cognitive impairment.
  59. Tragically, the stigma around mental illness kept people from discussing their negative experiences,
  60. so the procedure kept happening.
  61. But prefrontal lobotomies required a team of surgeons and specialized equipment,
  62. making them out of reach for most patients.
  63. At least until 1945,
  64. when Freeman began developing a simpler and cheaper alternative.
  65. In his new transorbital lobotomy,
  66. the patient was first rendered unconscious via electroshock therapy.
  67. Then, an ice pick-like instrument was pushed through the thin bone of their eye socket
  68. and manipulated to sever the fibers between the thalamus and frontal lobes.
  69. Transorbital lobotomy was intended to be performed by physicians without surgical training
  70. in under ten minutes.
  71. And Freeman proved his procedure's efficiency during a hospital visit,
  72. where he performed the surgery 228 times in just 12 days.
  73. Transorbital lobotomy was immediately controversial.
  74. Even Freeman's long-time collaborator James Watts
  75. was against making such a consequential surgery quick, dirty, and accessible to amateurs.
  76. But the procedure remained popular throughout the Western world until the 1950s,
  77. when tranquilizers began offering a less permanent and more predictable alternative.
  78. By the mid-60s, lobotomies were most often found in science fiction and horror films,
  79. where they became a potent metaphor for brutally controlling those who don't fit the norm.
  80. Today, lobotomy serves as a chilling reminder
  81. that scientific progress requires transparency and clear ethical standards.
  82. Because without honest reflection,
  83. even efforts to alleviate human suffering can cause serious harm.