What is a Lobotomist?

A lobotomist is the type of specialist who performs lobotomy procedures. A lobotomy is a form of psychosurgery that was popular from the late 1930s to the early 1950s, and it was meant to treat various psychological defects.

Why would you need a lobotomist?

A lobotomist was required to perform psychosurgery in order to treat various serious mental disorders. The most common of these were:

• depression
• schizophrenia
• chronic pain
• catatonia
• bipolar disorder

Since the discovery of the lobotomy procedure, it spread around the world and became the standard treatment for these conditions, as well as others. The widespread use of the lobotomy led to the training of many lobotomists in the world, and one could find a lobotomist in any major psychiatric facility.

What does a lobotomist do?

According to the inventor of the lobotomy procedure, Egas Moniz, he believed that the mental disorders above were caused by fixed brain circuits due to misfiring neurons in the brain. To treat these conditions, he argued, these fixed circuits had to be destroyed.

Therefore, to access the brain, the lobotomist would drill a hole through the skull about 2 - 3 cm in diameter. Ethanol was then injected into the brain in order to destroy the fibers that connect the frontal lobe to other parts of the brain. Later, leucotome was invented by Moniz, too. A leucotome was a surgical instrument, which, when rotated, would create a circular lesion in the brain. After drilling holes through the skull, the leucotome was inserted through the hole, which would be about 11 cm long and 2 cm in diameter. After reaching the section in the brain between the prefrontal lobes and the thalamus, a wire would be pushed through the hollow gap inside to create a small loop at the end.

Upon twisting the leucotome, this wire loop would cut through the fibrous matter of the brain and create space. Several twists would be made until the lobotomist was sure the two parts of the brain were completely separated. To prevent healing, ethanol would then be injected into the space to create a permanent barrier.

The use of the leucotome was an improvement over the previous instrument, which was cruder and looked just like an ice pick. To complete the operation, this tool would be wiggled around to separate the parts of the brain.

Who invented the lobotomy?

The lobotomy was invented by a Portuguese neurologist Antonio Egas Moniz in 1935. Moniz won the Nobel Prize in Medicine for his invention in 1949. Many years later, a movement was created to revoke the Nobel Prize, but this movement didn’t succeed.

He believed that by severing the connections between the frontal lobes and the rest of the brain, the patient emotions would be calmed down, and their personalities would start to stabilize without affecting their motor functions and intelligence.

The frontal lobe and the prefrontal cortex are known to have some complex functions in the brain, usually known as executive functions. These parts of the brain are also connected to other parts, including the thalamus.

Moniz reported very good improvements for his first 20 patients treated with a lobotomy. The American neurologist Walter Freeman was enthusiastic about the procedure, performing his first lobotomy in 1936 in the US and spreading it later across the globe.

Walter Freeman’s role in the lobotomy

Even though Egas Moniz was the inventor of the procedure, and he even received a Nobel Prize for it, Walter Freeman will always be the image of the lobotomist. He took the idea of the procedure from Moniz and made it more common not only in the US, but in the entire world. Besides his vigor to make the procedure more common, he also made adjustments to the procedure by inventing the transorbital lobotomy.

This was a break from regular lobotomy in that the procedure was done through the eye rather than the side of the skull. It was a simpler process, and it did not require an operation room, and that made the lobotomy more accessible, especially in areas without an established hospital enterprise.

Walter Freeman, together with neurosurgeon James Watts, refined the technique used and created by Moniz. They destroyed not only the white matter like Moniz did, but they also destroyed the gray matter. This new technique could be performed within 10 minutes, and it did not require anesthesia.

By the end of 1949, in the US, the number of lobotomies performed annually reached to more than 5,000. However, in 1945, just four years earlier, the number of lobotomies performed in the US annually was only 150.

Before he died in 1972, Walter Freeman had performed lobotomies in more than 2,900 patients in 23 states across the US, among which 19 of the patients were children under the age of 18.

The modern day lobotomist

Today, the lobotomy procedure has been outlawed in most countries, but that didn’t put an end to psychosurgery. To date, surgical operations are still being done on the brain to treat various medical conditions. The only difference is that the equipment is more advanced with the use of imaging technology such as X-rays, and we know a lot more about the brain’s functioning.

The lobotomy today is considered to be a barbaric and absurd procedure without any success in treatment. It disappeared due to its unsuccessful treatment of the conditions it was used for in the first place. This was also due to a discovery of more successful and effective treatments, such as antidepressants and antipsychotics.

Lobotomy quick facts and summary

• The lobotomy is a type of neurosurgery.
• Lobotomy was first invented in 1935 by a Portuguese neurologist Antonio Egas Moniz.
• In 1949, Moniz won the Nobel Prize in Medicine for his invention.
• In the US about 50,000 lobotomies were performed.
• The most well-known lobotomist was an American neurologist named Walter Freeman.
• Freeman performed about 3,500 to 5,000 lobotomies himself.
• In most of the cases, lobotomies were unsuccessful, having permanent negative effects on the patient.
• Mental dullness was the main long-term side effect of a lobotomy.
• In the mid-1950s, the practice started to subside, nowadays being illegal worldwide.