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The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness Hardcover – Jan 17 2005
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From Publishers Weekly
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.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
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
Copyright © American Library Association. All rights reserved
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Equally repellent are Freeman's colleagues in the medical establishment who kept their criticisms to themselves while the carnage continued for decades. Can you imagine (as in the case of Freeman's cohort Dr. Watts) seeing your colleague (who is not even a licensed surgeon) sticking an ice pick into the head of a patient in an office setting and doing no more than ending your partnership? This sounds more like organized crime than medicine.
The author makes much of Freeman's bizarre and obsessive followup of his patients as if it evidenced caring rather than a guilty conscience and a pathological need to be liked by his victims.
It takes an enormous leap of faith to believe Freeman's primary motivation was the good of his patients. Handing a camera to a colleague so he could record Freeman's ability to bore holes into the brains of his patients with both hands is not the mark of devoted physician.
Unfortunately, neither Freeman nor his accomplices were ever called to account in their lifetime. On the contrary, they were honored as distinguished gentleman of the medical profession. The medical establishment as a whole owes a belated apology to the thousands of victims and their families.
mid 1960s. This was a time when "psychosurgery" meant "lobotomy". While lobotomies were invented by Egas Moniz it was Freeman who advanced the research and tirelessly publicised it as the solution to almost all psychological ills.
It would be all too easy for an author to write Freeman off as an uncaring villain of the first order, a Josef Mengele like figure who mutilated the brains of his victims/patients in an attempt to make them conform to societal norms by amputating their personalities. However Jack El Hai presents Freeman as a man desperate to improve the lives of his patients, a self-promoting man, but nonetheless someone who cared. It is this portrayal by El Hai that makes Freeman an even more horrible character. When El Hai describes how Freeman almost obsessively kept in touch with his patients you have to contrast this caring image with that of Freeman performing lobotomies in his office with an ice-pick and then sending the patients home in a taxi. Freeman doesn't come off as a two-dimensional monster, instead he is revealed to be an all to real three-dimensional, deeply and desperately flawed man.
El Hai avoids scrutinizing larger questions such as to what degree lobotomy was used as an instrument of societal control of troublesome individuals, but others have speeculated on that question, instead he provides new englightenment on that issue by examining Walter Freeman and his times.
Jack El-Hai tells Freeman's story with fairness, grace and a novelist's understanding of character and human frailty. I recommend this fine book not only to readers interested in the subject but to anyone who enjoys, as my friend suggested, "a great story."
From a researcher's standpoint, it is astounding to read about the highly suspect levels of evidence that Dr. Freeman was willing to accept and pass on to argue for the widespread use of lobotomy. It would be comforting to think that research standards are much more rigorous today, but recent disclosures into the problems with highly marketed pharmaceuticals put the lie to that idea. In fact, in some ways, Dr. Freeman acted more ethically than today's pharmaceutical companies in the sense that, whatever his motives, he was not driven by financial greed. His devotion to his patients, his long road trips to visit them, and his enormous efforts to keep tabs on them are amazing, especially considering that his patient database was boxes of index cards and charts.
Still, Dr. Freeman's arrogance is breathtaking. His willingness to carve up sections of healthy brains is astonishing. And it is clear that he, who was a physician but not a licensed surgeon, took terrible liberties in performing the "ice pick" procedure on his own on the grounds that no general anesthesia was needed.
My only (minor) complaint about the book itself is that the last third seemed overly long. All in all an excellent read.
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