The Case of the Missing Faces

Freeman operating on a patient with his partner, James Watts

As I’ve often mentioned,  I’ve been working for quite some time on a study of the photographs of Walter Freeman. Freeman, a Washington, D.C., based physician, was the world’s foremost lobotomist; it’s estimated that he lobotomized some 3,500 people.

He was also a prolific and dedicated photographer. He almost invariably took photos of his patients before and after the procedure, acquiring reams of these images over the course of his career. In a chapter of my book, Depth Perception, I argue that Freeman was participating in a much longer-standing tradition of psychiatric photography, one that claimed that the human face could reveal the depths of the soul. (You can see a recorded version of the story of Freeman’s photographs here.)
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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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