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A while ago I was looking for some good pages to reference about some of psychiatry’s more barbaric procedures. Along the way, I stumbled across the Washington Post’s peculiar profile of Dr. Walter Freeman, the pioneer of the ice-pick lobotomy and one of the most controversial figures in the past few decades of clinical psychiatry.

For those who aren’t familiar, Freeman performed thousands of lobotomies on people suffering from depression, anxiety, obsessive-compulsive disorder, schizophrenia, mental retardation, and other disorders. Sublimely apathetic to the fact that there was no actual evidence that his treatment worked, he carried on mutilating people’s brains–knocking them out by electroshock or anesthesia, and then hammering an icepick through the tear duct and swinging it around in the frontal lobe to destroy the connection with the thalamus.

Freeman made his fame, and a great deal of money, by refining Egas Moniz’s techniques for human lobotomy and touring the country evangelizing its use to psychiatric hospitals. Because lobotomy succeeded in making some trouble-making patients more docile, it was widely adopted by psychiatric hospitals after presentations by Freeman. It didn’t seem to bother them that most patients suffered severe losses of functioning after the procedure, that adult patients ended up pissing on themselves and having to be re-taught how to eat. It didn’t even matter to them that Freeman had forcibly anesthetized patients in order to carry out his assault on their brain whether they wanted it or not. What mattered to them was that patients were docile and manageable, not whether their humanity was being respected or their underlying mental conditions improved. In the period of Freeman’s greatest activity, between 1936 and the late 1950s, somewhere between 40,000 and 50,000 Americans were subjected to lobotomies.

Along the way, Freeman managed to kill several of his patients in surgery and to try bizarre experiments to refine his technique, such as a case where he followed the lobotomy of 14 patients with an injection of hot water into the brain, in which he was prepared to accept two fatalities. Prior to his career as a lobotomist, he had also personally introduced electroconvulsive therapy and insulin shock therapy to the hospital in which he worked.

A few of the incidents are recounted by the Post:

When the day arrived, Mrs. Hammatt tried to change her mind when she found out that her head had to be shaved. Freeman and Watts promised to spare as much of her hair as they could, before forcibly anesthetizing her. Later, Freeman recorded that her last words before surgery were, Who is that man? What does he want here? What’s he going to do to me? Tell him to go away. Oh, I don’t want to see him, followed by a scream.

The Post doesn’t bother to point it out, but what Freeman and Watts had just done was to cut into a person’s brain against her will, committing a bizarre and wantonly cruel surgical assault. Later in his brain-slicing career, he committed what could only be called murder from depraved indifference to human life:

At Cherokee State Hospital in Iowa, he accidentally killed a patient when he stepped back to take a photo during the surgery and allowed the leucotome to sink deep into the patient’s midbrain.

We’ll leave alone the question of why he was never put in prison for his crimes; so many atrocities against mental patients have gone unpunished. But why is it that the Washington Post has decided to portray Dr. Freeman, whose wanton disregard for human life and barbarous procedures should put his medical influence alongside that of Dr. Josef Mengele, as some kind of unheralded psychiatric innovator? They conclude their profile by writing:

Lobotomy also raised high hopes in its day. During the late 1950s, when the new tranquilizing drugs had grown popular in state hospitals, Freeman wrote letters to his psychosurgical colleagues around the world, praying for a time when brain operations would again gain wide favor in the battle against mental illness. It didn’t happen in his lifetime.

Now that it might happen in ours, Freeman’s presence is unwelcome. He flits around, a pesky spirit looking for the recognition he believes he is due, an unwanted ghost causing sighs and regret.

Poor Walter Freeman! As to the reason for these sighs and regret, the Post writes that The answer lies in the complex tangle of Freeman’s personality and motivations, and in the public’s fear of past abuses.

Perhaps the Post should reconsider the possibility that Freeman is discredited not only because of a grating personality and lingering public hysteria. Maybe it also has something to do with the fact that he was an irresponsible, sadistic asshole who killed several people and ruined the lives of tens of thousands more with a procedure that was completely useless, cruel, and barbaric.

Of course, methods which are not much more refined are carried on today–the ice-pick lobotomy was replaced with the chemical lobotomy of tranquilizers and other disabling psychiatric medications. The article would have been no more responsible if it had stridently condemned Freeman but uncritically endorsed these modern methods. But I really have to wonder what could have blinded the Post to something so thoroughly obvious as the evil that Freeman perpetrated on innocent people. It’s a fucking ice-pick driven through the skull. Even some of his psychiatric contemporaries, who regularly used electroconvulsive therapy and insulin shock, fainted at the sight of Freeman’s procedure. Can’t we expect at least that much sympathy out of those of us who have lived to have the benefit of hindsight on the horrors that Freeman wrought?