Set against the backdrop of changing attitudes toward mental illness in the 20th century, El-Hai's scholarly biography of Dr. Walter Freeman is a moving portrait of failed greatness. Born to a distinguished family of physicians, he rose to become one of the most celebrated doctors of his generation. Best known as the doctor responsible for the widespread adoption of lobotomy in America after WWII, he also made signal contributions to the science of medicine through his career-long involvement with George Washington University Medical School and St. Elizabeth's Hospital in Washington, D.C. Yet, despite his achievements, the procedure he helped develop and tirelessly champion would ultimately become his undoing. As physicians sought other, less drastic means to treat mental illness, Freeman's unorthodox methods, which often included an ice pick and carpenter's hammer, came to seem barbaric. When he died in 1972, the sharply negative view of psychosurgery expressed in books like One Flew Over the Cuckoo's Nest (1962) had become commonplace; a mere decade later, movies like Frances (1982) would openly portray lobotomy as institutionalized torture. Although the title of El-Hai's biography might suggest otherwise, he eschews such lurid oversimplifications and portrays Freeman in all his human complexity. To this end, he chronicles Freeman's crusade to help millions of asylum patients who might otherwise remain incarcerated indefinitely; his indefatigable postoperative commitment to his patients; and his flamboyant personality and macabre sense of humor in and out of the operating room. El-Hai's book succeeds as both an empathetic, nuanced portrait of one of America's most complex public figures and as a record of the cultural shifts that have occurred in the treatment of mental illness over the last century.
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Though the word lobotomy conjures chilling images of brain-piercing ice picks and vacant-eyed, zombielike patients seemingly sleepwalking through the halls of mental institutions, El-Hai tackles the controversial procedure and its inventor, Walter Freeman, with the dispassionate reserve of a trained journalist. Relying heavily upon Freeman's notes, letters, and journals, El-Hai reconstructs the life of a man whose main mission, aside from personal glory, was to help the helpless. That he selected what many consider little short of brain butchery to do so demonstrates, more than anything, the sort of man Freeman was. Driven, egotistical, brilliant, and focused, Freeman is as fascinating as the chronicle of twentieth-century psychiatry in which El-Hai sets his story. Freeman's procedure inspired many, not always to the good. Soviet as well as American intelligence officials experimented with lobotomy to control political insurgents. Fortunately, it sickened others. Generally, lobotomy was considered to have improved the lives of many but damaged those of many others. Even today, it remains at the center of ongoing controversy between two factions of psychiatry. Donna Chavez
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