My Lobotomy

Survivor recounts lobotomy at age 12
Procedure once considered legitimate medical treatment
By A. Chris GajilanCNN

(CNN) -- Howard Dully was 12 years old when he was told he was going to the hospital for some tests.

"I remember having big black swollen eyes one day and staying in the hospital for a few days because apparently I had an infection," recalls Dully, now 57, who lives in San Jose, California.
That's all Dully can remember of the transorbital or "ice pick" lobotomy performed on him more than 40 years ago.

Many in the medical community consider lobotomies barbaric by today's standards, but there was a time when the procedure was an accepted treatment for those suffering from severe mental illness.

Throughout the 1930s, '40s and most of the '50s, the main route of treatment for most of these patients was to keep them institutionalized in often filthy, deplorable conditions until they got better on their own. Many remained for years, even decades.

Then came the lobotomy. It was first performed in 1935 in Portugal by Dr. Egas Moniz, who later would win the Nobel Prize in physiology and medicine for the technique.

Neurologist Walter J. Freeman quickly brought the lobotomy to the United States, first performing it in 1936. A few months later the procedure made the front page of The New York Times with the headline "Surgery Used on the Soul Sick."

"The medical treatments were not effective, and it was an advanced step over what was previously available," says Dr. Robert Lichtenstein, a neurosurgeon who performed lobotomies for treatment of severe pain.

Lobotomy was a welcome treatment based on the premise that symptoms of mental illness were caused by faulty connections between the frontal lobes and another part of the brain -- the thalamus. The idea was that severing those connections and regrowing them could treat symptoms of the mental illness.

"It wasn't a case of removing sections of the brain or cutting out pieces, it was severing particular neural pathways," says Jack El-Hai, author of "The Lobotomist," a biography of Freeman.

At the time, it was practically the only effective treatment for severe depression, schizophrenia, suicidal tendencies and other mental disorders.

Tens of thousands had lobotomies

Over the years, lobotomies were done on about 40,000 to 50,000 people in the United States in mental institutions and hospitals, El-Hai says. About 10,000 of those procedures were transorbital or "ice pick" lobotomies, as Freeman himself referred to the procedure. (Doctors used a long, ice pick-like device inserted above the eye through the thin layer of bone, penetrating into the brain's frontal lobe.)

Freeman performed about 3,400 transorbital lobotomies himself, according to El-Hai; many others were done by psychiatrists trained by Freeman as he traveled across the country.
While the older, far more invasive prefrontal lobotomy involved anesthesia, then drilling into the skull, the transorbital lobotomy was performed in 10 minutes without any major incisions. According to El-Hai, Freeman performed an all-time high of 24 lobotomies in one day in West Virginia.

"The transorbital one could be done much more economically and quickly, and it was worthwhile to do it that way," Lichtenstein said.

According to estimates in Freeman's records, about a third of the lobotomies were considered successful. One of those was performed on Ann Krubsack, who is now in her 70s.
"Dr. Freeman helped me when the electric shock treatments, the medicine and the insulin shot treatments didn't work," she said.

Krubsack said she endured schizophrenia for eight years until she had her lobotomy in 1961.
But the majority of patients did not do well -- some died, many were paralyzed and in the cases in which patients were well enough to leave the hospital after the procedure, many were left childlike and devoid of personality.

"What did success mean in [Freeman's] mind? Mainly it meant getting out of the hospital, and these people who returned home from the hospital came home with severe disabilities from their lobotomies," El-Hai says.

Doctors opt for nonsurgical procedures

Finally in 1954, Thorazine, an antipsychotic medication, became available in the United States, and fewer lobotomies were performed as doctors opted for nonsurgical treatment.
But Freeman disagreed with the new trend and continued to perform lobotomies after most of the medical community considered the procedure obsolete.

"He began advocating lobotomies for patients like Howard Dully who, if they had psychiatric disorders at all, were not seriously ill, and he began advocating it as an early intervention," El-Hai says.

According to medical records, Freeman diagnosed Dully as a schizophrenic -- a diagnosis that would not have held today, Dully's current doctors say.
Dully was lobotomized before any other treatment or medication was tried.

Now an adult, Dully has one question for Freeman: "Why did you go that far when it was plainly evident to the rest of the world that it was not a good thing? Why did you continue?"

Dully says he will never know what his life would have been like if he hadn't had the surgery. "I think I'm intelligent enough now," he says. "I probably would have been as intelligent enough then. But what specifically have I lost that I'm not capable of doing mentally, I can't answer that."

In 1967, Freeman performed his final lobotomy on a patient who died from a brain hemorrhage. He was never allowed to operate in another hospital again and died of cancer in 1972.