Once upon a time, people with severe mental illness had to undergo surgery to amputate certain joints in the brain. This type of surgery is called 'lobotomy'.
Lobotomy has become one of the most infamous surgeries of the twentieth century, writes Claire Prentice. But Henry Marsh, a neuroscientist who once tried a modified version of the surgery, says it is wrong to divide doctors into heroes and villains.
This may seem unbelievable today, but once upon a time lobotme had a miraculous place. Doctors and the media used to describe the surgery as 'easier than treating a toothache'.
From the early 1940's to the late 1970's, more than 20,000 lobotomy surgeries were performed in the United Kingdom. The surgery was performed especially on patients with dementia, severe depression and obsessive compulsive disorder (OCD). But sometimes the surgery was performed on people who had difficulty learning or who had difficulty controlling aggression.
After lobotomy, a few people's mental symptoms improved, some became dull, they could not communicate, walk or eat on their own. The negative effects of this surgery far outweigh its benefits, as the medical field realized over the years. Related drugs developed in the 1950s were more effective and safer.
While demonstrating lobotomy in 1949, Dr. Walter Freeman
Writers and filmmakers have used darker shades to paint the characters of doctors performing lobotomy surgery. From 'One Flew Over the Cuckoo's Nest', to Netflix's 'Ratched' to 'Suddenly Last Summer', various works of art show such doctors enjoying paraphernalia and sacrificing patients from vulnerable elements and leaving people numb.
But the truth is more complicated. Doctors performing lobotomy were often among the progressive reformers. He wanted to improve the lives of his patients.
There was no effective treatment in the 1940s for people suffering from severe mental illness. Doctors tried insulin shock therapy and electro-convulsive therapy, but with limited success. Psychiatric hospitals began to be filled with patients, including soldiers who had been hit by bombings - with no hope of recovering from their illness or returning home.
It was against this background that the Portuguese neurologist Ekas Moniz developed the surgery lobotomy (or leukotomy as he called it) in 1935. During the surgery, two holes were drilled in the head, and then a sharp instrument was inserted into the brain tissue. Then they cut the connections between the forearm and the rest of the brain.
Agas Moniz was awarded the Nobel Prize.
"The surgery was based on a very crude and simplified approach to the brain. The idea was that the brain system is very simple and some things can be stuck in it. The idea was to stop it, "writes Henry Mash, a neuroscientist and author.
"The real brain is very complex, and we still don't understand the interconnectedness of it."
Moniz claimed a dramatic improvement in his first 20 patients. It had a profound effect on Walter Freeman, a young American neurologist. He performed the first lobotomy surgery in the United States in 1936 with his colleague James Watts. The following year, the New York Times described the surgery as "The New Surgery of the Soul." But basically the process was complicated and time consuming.
While working at St. Elizabeth's Hospital in Washington, D.C., the largest psychiatric hospital in the United States, Freeman was disturbed to see 'wasted manpower' there. He wanted to help patients get out of the hospital. So he set himself the goal of making lobotomy surgery faster and cheaper.
In 1946 he developed the transorbital lobotomy surgery. At the back of the eye sockets are brittle bones, from which the brain was struck by two small steel tools, such as ice-picking tweezers. This greatly reduced the duration of the surgery and eliminated the need to anesthetize the patient - an easy-to-move electro-shock device.
During the long summer vacations, Freeman traveled all over the United States, performing "lobotomy" surgery with the help of ice picks. At times, they even took their own children with them.
At a time when all treatments were exhausting, lobotomy surgery was initially thought to be the last resort for psychiatrists. But Freeman began promoting lobotomy as a treatment for everything from serious mental illnesses to postpartum depression, severe headaches, chronic pain, indigestion, insomnia, and behavioral problems.
Many patients and their families used to express their gratitude to Freeman. They received many thank-you letters and Christmas cards. But in the case of many other patients, the outcome of this surgery was devastating.
The future president of the United States, John F. Kennedy's sister, Rosemary Kennedy, was also one of the patients treated by Freeman. When she underwent lobotomy surgery at the age of 23, she developed incontinence and could not speak clearly.
Freeman performed the surgery on 3,500 patients during his career, including 19 children - the youngest being four years old.
Sir Wylie McKissock, a neuroscientist in the United Kingdom, performed different lobotomy surgeries on about 3,000 patients.
"This surgery is not time consuming. A team from a well-organized psychiatric hospital can perform four such surgeries in two to two and a half hours," he boasted. "If there are properly trained neuroscientists, bilateral anterior leukotomy surgery can be performed in six minutes, rarely more than ten minutes."
McKissock has led more per capita lobotomy surgeries in the United Kingdom than in the United States.
Henry Marsh, a medical student in the 1970s, accepted a job at a psychiatric nursing home. ‘It was a ward for the very last stage patients. The dying were being brought there. ' There he saw for himself the devastating effects of lobotomy. "The health of these patients was not properly monitored, and I clearly noticed the distressing situation there," he says. "Patients who underwent lobotomy surgery would have gone to the worst, worst and worst."
All of them were operated on by McKissock and his colleagues.
Marsh later earned a degree as a neurosurgeon, during which he underwent a modified form of lobotomy called lymphatic leukotomy. "A more microscopic, more refined version of the type of lobotomy surgery that people used to perform many years ago was used by leukotomy," says Marsh.
He himself had performed such surgery on dozens of patients with severe OCD. He had done this treatment till 1990.
"All of those patients were on the verge of death, all the other treatments had failed, so it doesn't hurt as much at such times, but I didn't do those surgeries as a priority," he says.
"I never saw those patients again, just worked like a technician. The concerned psychiatrists told me that the surgery was a success."
I asked Marsh how he felt about the surgery. He said, "I did not like to have this surgery. I left the practice relatively soon and started working as a consultant."
About 500 lobotomy surgeries were performed annually in the United Kingdom in the 1960s. A maximum of 1500 surgeries were performed in one year. In the 1970s, that number dropped to about 100-150 a year. Moreover, most of the time, even the thinnest parts were cut off and disconnected at the exact target.
With the enactment of the Mental Health Act in 1983, more control and monitoring mechanisms were established. Today, surgeries for mental illness are rarely performed.
Howard Dooley was 12 years old when he was operated on by Walter Freeman. "I try to avoid the thought that if it hadn't been for the surgery, my life would have been different, because I'm afraid I'm going to be upset," says Dully.
"I've been trying to slowly unify my life. It took a long time," he says. "As a young man, I had to deal with a lot of problems - drugs, alcohol, crime, money laundering. It was hard to get out of it."
Dooley underwent the surgery because he did not get along with his stepmother, and he feels that his dark shadow is on every side of his life.
"I don't tell people on my own that I've had lobotomy surgery, because if I did, they wouldn't even come around me," he says.
Sixty years have passed since he underwent surgery, but he remembers every detail of that time.
"They lifted part of the eye, slammed it to the side of the corner, and turned it around with the same tool they use to break eggs," he says.
"I think it's incomprehensible. What's the point of doing this without any precision in the case of the brain?"
There were people who criticized lobotomy from the beginning, and as it became more and more clear that the consequences were worse, the tone of opposition grew.
Walter Freeman, who initially said the success rate was 85 percent, also found that 15 percent of the patients he operated on died. When doctors examined the long-term effects on their patients, they found that one-third of the patients had some improvement, while one-third had significantly reduced their condition.
A former proponent of lobotomy in the United States says: "The risk of being shot in the head was the same as lobotomy."
Agas Moniz was awarded the Nobel Prize in 1949 for his work on lobotomy surgery. Some doctors, LobotMedit and his family had launched a campaign 15 years ago to get the award back. However, he did not accept the request, as the Nobel Foundation's charter stated that the prize should not be withdrawn.
One of Freeman's colleagues, Dr. James Shacklin while preparing a patient for a transaminital lobotomy.
How do we look back at the people who underwent this most controversial medical procedure?
"It's wrong to divide doctors into heroes and villains. We're all mixed up. We're the product of our time, our culture and our training," says Henry Marsh.
"The generation of surgeons I taught had tremendous authority, even if not God-like, no one questioned or questioned them, and some of the people who taught me were basically good at it, but this authority made it worse and somewhat demonic."
No comments:
Post a Comment