Frequently asked questions about lobotomy

Image from the manuscript for Walter Freeman and James Watts' second edition of Psychosurgery (1950).
Image from the manuscript for Walter Freeman and James Watts’ second edition of Psychosurgery (1950).

Over the years, I’ve spent a lot of time investigating the history of lobotomy, and particularly the kinds of visual evidence doctors used to support this practice. It’s part of the book I’m finishing, Depth Perception, which is broadly about the ways doctors have used film and photography during the twentieth century. In one of my chapters, I write about the lobotomist Walter Freeman, who was a prolific photographer, describing what he thought his patient photographs showed, and how our understandings differ today.

I get a lot of questions about lobotomy from people who find me on the Web, and I know other people who specialize in the subject do, too. I thought it might be helpful for me to write down some of the answers to the most frequent questions I get about the practice of lobotomy in the United States.

I’m sorry to say that I can’t answer individual questions on this subject, but I do provide references to some excellent books on the subject below.

What is a lobotomy?

The term “lobotomy” (often used interchangeably with “psychosurgery” during the period in which it was practiced) refers to an operation that severs the connections to and from the prefrontal cortex, in the anterior part of the brain’s frontal lobe. Generally, it was performed in one of two ways. From 1936 to 1945, lobotomies were generally performed by drilling two holes in the skull, near the patient’s temples, inserting a long instrument called a leucotome, and severing the connections to and from the prefrontal cortex. From 1945 until 1967, lobotomies were generally performed by inserting a long, thin instrument into the back of a patient’s eyeball, puncturing the thin orbital plate above the eye and rotating the instrument so that it destroyed the connections to the brain’s frontal lobe. This second type of lobotomy is called the transorbital lobotomy.[1. Pressman, Jack David. Last Resort: Psychosurgery and the Limits of Medicine. Cambridge History of Medicine. Cambridge, U.K: Cambridge University Press, 1998.]

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My Ada

Dora Goldstein
Dody at a PFLAG (Parents and Friends of Lesbians and Gays) rally in 2008. This was her Facebook profile photo!

Today is Ada Lovelace Day, which celebrates women in science, technology, engineering, and mathematics by honoring Ada Lovelace, whom many name the first computer programmer.

My Ada is Dora B. Goldstein, or Dody, as everyone called her, who died Sunday. She was a pioneer in so many ways: one of the first women to enroll in Harvard Medical School, a leading expert on the pharmacology of alcohol, and a professor at Stanford. She was also a civil rights activist who campaigned for women in the academy and, later in life, a leader in the gay rights movement.

She was also my husband’s grandmother, which is how I knew her — a great cook and attentive listener who was so interested in what we were up to. She punctuated our stories with “How wonderful!” and made us feel important and loved. She was a person of endless compassion, curiosity, and intelligence, a role model for me. We’re lucky to have known her.

Anatomy on film: the imaginary archive

Frame from Circulatory System (1924)
Frame from Sarnoff's Circulatory System (1924)

A lot of my research is on medical filmmaking: films that physicians and other medical professionals made for each other. It turns out that there are a lot of these. Doctors have been making movies since the invention of the medium.

I’m fascinated by a strain of thought that recurs frequently in discussions of anatomical films. Here’s an example from 1919:

The films of the Surgeon General’s Library will be available to teachers in the army and medical schools and the profession, just as the books in the Surgeon General’s Library are for study and reference.¹

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