The Lobotomy Craze

by | Feb 6, 2019

Dr. Walter Freeman performing a lobotomy with an Ice Pick

In 1936, the Portuguese neurologist Egas Moniz introduced a surgical operation, now known as a lobotomy, which consisted of drilling holes in the patient’s skull and then making incisions that destroyed connections between the prefrontal region and other parts of the brain. Lobotomies were mainly used in the treatment of schizophrenia.

Lobotomies were life-altering procedures and the patient was left forever changed. According to Dr. Steven Holtz of UCLA, “The frontal lobe is the pilot of your brain. It controls your executive function, which directs everything. The theory behind it is essentially preventing the direction of impulses that were adherent. When one emerges from a lobotomy, one becomes docile, placid, apathetic, and devoid of affect.”

According to Discover Magazine, “Patients often suffered major personality changes and became apathetic, prone to inappropriate social behavior, and infatuated with their own toilet habits. They told pointless jokes and exhibited poor hygiene.” The popularity of lobotomies declined in the 1950s and there have been no lobotomies performed since 1967.

For decades (until the invention of anti-psychotic drugs in the 1950s) there was no effective treatment for schizophrenia and many other mental illnesses other than a lobotomy. According to Jennifer Wright in her book Get Well Soon: “Asylums, prior to the rise of medications that could help or at least subdue patients, often acted as little more than holding pens where ill and sometimes violent people were kept.” Thus, people and their families typically turned to lobotomy out of desperation.

In the 1940s, Walter Freeman, an American doctor who was not a neurosurgeon (or any type of surgeon), developed and popularized a modified technique which avoided the need of drilling holes in the patient’s head. According to Discover Magazine “in Freeman’s modification of the procedure, the lobotomist inserted an ice pick (yes, an ice pick) under the upper eyelid and drove it upward into the frontal lobe with a few sharp raps of a mallet. The pick was then twisted and jiggled about, thus scrambling the anterior frontal lobes. The ice-pick lobotomy could be done by anyone with a strong stomach, and, even better, it could be done anywhere. Freeman carried his ice pick in his pocket, using it on one occasion to perform a lobotomy in a motel room. A cheap outpatient procedure, the ice-pick lobotomy became a common psychosurgical choice in state hospitals across the country.” Before performing a lobotomy, the patient was often subdued with electroshock therapy.

Lobotomies became quite popular led by Dr. Freeman: in the U.S. from 1949 until 1956 about 50,000 patients were lobotomized (they became so popular that they began to be used for a host of problems other than schizophrenia such as being “difficult” or “moody”).

In retrospect, it is somewhat shocking that in 1949 Dr. Moniz received the Nobel Prize in Medicine for developing the lobotomy.


  1. Rose Mary Kennedy (John F Kennedy’s oldest sister) received a lobotomy in her early 20’s. It is an interesting, sad and disturbing story behind the Kennedy family and lobotomies in general.
    It’s worth looking up.
    My wife read (and recommends) the book. “Rosemary the hidden Kennedy daughter”

  2. Yikes. Thought perhaps I was reading a story from The Onion. I guess the glass-half-full perspective is we’ve progressed from this primitive approach.

  3. Yes lobotomies was a crude approach to treatment of mental illness. At that time the alternates were limited. During this period the lobotomies preformed at the state hospitals and medical centers were done by a neurosurgeon in an appropriate medical setting in Kansas.

    I am old enough to see the advances in pharmacological treatment of severe mental illness. We had four serious injuries to medical personnel/ security officers during my two months of psychiatric rotation as a medical student. A patient in an uncontrolled maniac episode or decompensated paranoid schizophrenic can be very dangerous. They can be dangerous to themselves, their families , the community and medical personnel.

    We should be thankful for our current methods to treat mental illness and not be quick to judge the past. They were few alternatives to deal with a very difficult Medical condition.

    • Great comment. Thanks Doug.

  4. Thanks John for the article.
    What a shocking part of Medicine. Its shocking that medical professionals could abide with brutal and barbaric techniques, and this wasn’t that long ago.
    Glad we don’t do things like that today…


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