The Lobotomist
Jack El-Hai
(Reviewer - Dr. Alma Bond)
2005 John Wiley & Sons
ISBN: 0471232920

A maverick medical genius & his tragic quest to rid the world of mental illness.

Today the word “lobotomy” evokes images of medical savagery: innocent lives wrecked by experimental procedures & misguided psychiatrists using the insane as guinea pigs. The man behind this controversial surgical procedure, whose tireless advocacy led to 50,000 lobotomies performed in the United states. This biography by Jack El-Hai offers us a picture of the man behind the icepick, Dr. Walter Freeman.

Sr. Associate Reviewer Dr. Alma H. Bond writes:

Walter J. Freeman was the physician who refined & promoted the operation which cut the frontal lobes of the brain in the attempt to relieve psychiatric disorders. In his fifty-year long career, he performed nearly thirty-five hundred lobotomies, including the first of such surgeries in the United States.

Walter Freeman is not a particularly appealing character, at least as El-Hai presents him. The only time I really liked him or felt much for him was when he took his sons on camping trips, & when his son Keen died. I don't envy El-Hai his task. He probably presents Freeman in this unempathetic manner because he was a remote, detached person who displayed a minimum of emotion about anything except psychosurgery.

Nor is his wife Marjorie fleshed out. El-Hai tells us that the marriage is deteriorating, but does not show what is wrong, besides stating that Freeman carried on extramarital affairs. The author never informs us what was amiss in the union that necessitated the affairs. How did Freeman treat his wife? Was he loving, gentle, generous? Abusive, sadistic, disinterested? Did he love her, or she him? From El-Hai's reports, the marriage, like Freemans' personality, seems estranged & without affect. We are not told what Marjorie was like as a person, what she saw in Freeman, why she married & stayed with him for decades, & what comfort or companionship, if any, he found in her.

In fact, we are given little insight into the depths of his nature. Most important in a book entitled The Lobotomist, as a psychoanalyst I can only speculate as to why he was so besotted with psychosurgery. El-Hai tells a good story & has done excellent research, but his psychological understanding of Freeman would have been deepened by the very psychoanalytic approach Freeman hated.

Not incidentally, why did he hate psychoanalysis so much? Was he afraid he would discover it was the force of his unconscious sadism that led to his obsession with psychosurgery? One gets a sinking feeling on reading about the operations Freeman conducted utilizing an icepick from the kitchen. The following report by Freeman after he performed a lobotomy on a huge, aggressive woman suggests that if not sadistic, his behavior was boorish & unprofessional. “He could teasingly grasp her around the throat, twist her arm, tickle her in the ribs and slap her behind without eliciting anything more than a wide grin or a hoarse chuckle.” (p. 150). In discussing his lifelong lack of enthusiasm for psychoanalysis, Freeman wrote, “Insight is a terrible weapon, and few know how to use it constructively. When we really get to know what stinkers we are, it takes only a little depression to tip the scales in favor of suicide.”(pp. 127-128) Perhaps this statement tells more about Freeman than it does psychoanalysis.

Freeman was a solitary, uninteresting child, adolescent, & man, except for his fascination with the brain, which began as early as his first year of medical school. A neighbor called him, “indifferent, aloof, conceited, peculiar and eccentric” (p. 152). “Medicine held my interest to the point where I excluded many other things,” Freeman said “In fact I was barely unaware of my family” (p. 43). Even when Freeman's father was dying of cancer, he spent little time with him. Freeman was equally uninvolved with his mother. He admired her energy, but felt little affection for her. “My eyes were moist when I saw her fighting the oxygen tent, but dry when she died,” he reported (p. 82).

Surgery in general bored him & he said he liked the preliminary neurological work-up in the laboratory too much to become a surgeon. Freeman was a prolific writer, leading to the publication of numerous articles & books. His first, Psychosurgery (now out of print), written with his most important collaborator, James Watts, was approved of by the press, which uncritically accepted their theories. Nevertheless, many of his medical colleagues disapproved of Freeman's willingness to promote lobotomy in the popular press, along with his entire career. More books by Walter J. Freeman still in print are: How Brains Make Up Their Minds; Societies of Brains: A Study in the Neuroscience of Love and Hate, & Neurodynamics: An Exploration in Mesoscopic Brain Dynamics.

Whatever his shortcomings, Freeman was a talented writer. I like his description of why he kept a beard for most of his life, which makes him sound almost human. Both his grandfathers & his father had worn them. “Those who have never grown beards cannot appreciate the delicious feeling of a breeze blowing through it on a warm summer day as the car covers the miles,” Freeman wrote in a personal manuscript. “There is the softest titillation, like the caress of a beautiful woman.” (p. 49) Too bad he didn't apply this sensitivity to his personal relationships.

As the savant promoting the widespread use of psychosurgery, the solitary Freeman at last had found a role which took him back to people. Mental hospitals around the country invited him to operate on their patients. He enjoyed displaying his skills, passing on his knowledge to others, & salvaging people trapped in the worst & most hopeless medical facilities in the United States. He liked the role so much that once he even refused to let a broken arm keep him from demonstrating transorbital lobotomy.

Yet nothing lasts forever. After a half century of fame & fortune, Freeman's raison d'etre came to an end. The introduction of psychotropic drugs, the gradual emptying of psychiatric hospital beds, & the ascent of psychoanalysis heralded the retreat of lobotomy as an important method for “curing” mental illness. Freeman, however, never accepted the possibilities of the new medications, but persisted in believing that psychosurgery would again take its place in the treatment of the mentally ill. He proved wrong. Psychosurgery never again returned to center stage in the treatment of psychiatric illness, & Freeman slipped into a new chapter of his life in which everything he believed in was lost to him; his accomplishments, his convictions, & his marriage. He spent the last years of his life traveling alone about the country wracking up research on patients upon whom he had performed lobotomies. He died of colon cancer at the age of 76.

The Lobotomist is recommended for people interested in the history of psychiatry, who want to learn about the meticulous research concerning the development & waning of psychosurgery, & to know something about a man famous in his time who otherwise might be lost to history. El-Hai tells a good story, which holds the interest of the reader. For those who seek an in-depth portrait of Dr. Walter Freeman, however, that book has yet to be written.

More from Jack El-Hai:
Lost Minnesota: Stories of Vanished Places
Celebrating Tradition, Building the Future: Seventy-Five Years of Land O'Lakes with Eric Mortenson (Photographer)
Memories of a Lifetime: Jostens 1897-1997 with Lory Sutton
Clean and friendly for more than 25 years: The Super 8 story, & more.
(07/17/05)

Dr. Alma Bond
2005©Alma Bond
A RebeccasReads.Com Sr. Associate Reviewer

A RebeccasReads author featured in Authors & Books

Reviewer's Bio:
Dr. Alma Halbert Bond is the author of ten published books, including:
The Deadly Jigsaw Puzzle;
The Tree That Could Fly;
Tales Of Psychology (2005);
I Married Dr. Jekyll And Woke Up Mrs. Hyde (2000);
The Autobiography Of Maria Callas, A Novel (1998);
On Becoming A Grandparent: A Diary of Family Discovery (1994);
Who Killed Virginia Woolf? A Psychobiography (1998);
Profiles of Key West (1996).

She recently recorded her new manuscript, Old Age Is A Terminal Illness, as an audio book.

She is also the author of a just published children's picture book called The Tree That Could Fly.

Dr. Bond teaches Psychology & Writing online at WriterSchool.