Walter Freeman (neurosurgeon)
Walter Freeman was an American neurologist and a notable figure in the history of psychosurgery, particularly for developing the lobotomy procedure. Born in Philadelphia in 1895 into a family of physicians, he graduated from Yale University and studied medicine at the University of Pennsylvania. After a period working at St. Elizabeth's Hospital in Washington, D.C., he became concerned about the treatment of mentally ill patients and began to explore surgical interventions for mental disorders.
Freeman modified a procedure called the leucotomy, introduced by Egas Moniz, into what became known as the lobotomy. His method involved creating lesions in the brain's frontal lobes to alleviate severe psychiatric symptoms. Although some patients reported improvements, the procedure also resulted in serious side effects, including emotional blunting and cognitive impairment, which led to significant controversy. Freeman conducted over 3,500 lobotomies during his career, but the procedure was largely abandoned by the mid-1950s in favor of medication-based treatments.
Freeman's legacy is complex; while he is often criticized for the adverse effects of lobotomies, some view his early work as a stepping stone to modern neurosurgical techniques. He passed away in 1972, leaving behind a contentious but impactful mark on psychiatric treatment.
Walter Freeman
Neurologist, Father of the Lobotomy
- Born: November 14, 1895
- Birthplace: Philadelphia, PA
- Died: May 31, 1972
- Place of death: San Francisco, CA
Also known as: Walter J. Freeman, Walter Jackson Freeman, Walter Freeman II
Education: Yale University, University of Pennsylvania
Significance: Walter Freeman was a neurosurgeon who performed the first prefrontal lobotomy in the United States. Freeman believed the technique treated neurological disorders such as depression. To perform the procedure, Freeman drilled holes into a patient’s brain, which he used to sever nerves.
While Freeman believed the prefrontal lobotomy significantly helped some patients, it severely harmed others; about 490 of his patients died, and many others were left in a vegetative state.
Background
Walter Freeman was born in Philadelphia, Pennsylvania, on November, 14, 1895, to Walter Jackson Freeman I and Corinne Keen Freeman. Freeman was born into a family of physicians. His father was an otolaryngologist (an ear and throat doctor) and his maternal grandfather, William Williams Keen, was a renowned surgeon.
Freeman attended Yale University, graduating in 1916. Then he studied medicine at the University of Pennsylvania. After earning a degree and completing an internship, in 1923 he traveled to Europe to study neurology.
When Freeman returned to the United States, he accepted a position as the laboratories director at St. Elizabeth’s Hospital, a psychiatric facility in Washington, DC. Freeman was reportedly troubled by what he witnessed there. Like other similar institutions, St. Elizabeth’s was overcrowded and its patients, which included World War I veterans, were housed for decades rather than being effectively treated and released. During the 1930s, physicians believed that mental illnesses stemmed from the unconscious. Freeman, on the other hand, contended that they were caused by a physical problem that could be treated with psychosurgery, brain surgery to treat psychological disorders.
To learn more about mental illnesses, Freeman earned a PhD in neuropathy. He then became the head of the Neurosurgery Department at George Washington University. While there, Freeman initiated new treatments for the mentally ill, including oxygen therapy and several “shock” therapies in which patients were jolted with electricity or chemicals to disrupt unhealthy neurological pathways.
In 1935, Freeman attended a conference in London and was intrigued by a researcher’s presentation on how frontal lobe ablation (destruction) improved the temperament of unruly chimpanzees. After the conference, another attendee, a Portuguese neurologist named Egas Moniz, began performing the leucotomy, a procedure in which he removed a small coring from the frontal lobes of a patient’s brain. The idea was to sever the links between the patient’s thalamus, which was believed to be producing excessive emotions, and the prefrontal lobes, which controlled the patient’s behavior.
Life’s Work
Freeman modified Moniz’s procedure and called it a lobotomy. In 1936, he sought help from James Watt, a neurosurgeon at George Washington Hospital, to perform the first lobotomy. The patient was sixty-three-year-old Alice Hood Hammatt, a housewife from Topeka, Kansas, who suffered from severe anxiety, depression, and insomnia. Freeman and Watt drilled six holes into the top of Hammatt’s skull and used them to create lesions in her brain. Then they rinsed the holes with a saline solution and sutured them. The procedure seemed to have helped Hammatt, who was no longer agitated afterward. Hammatt lived for five more years, which her husband said were the happiest of her life. By 1942, Freeman and Watt had performed more than 200 lobotomies. By this time, other surgeons were also performing lobotomies.
Freeman modified the procedure after learning about an Italian physician who used the eye socket to access the brain, eliminating the need to drill into a patient’s skull. To perform a trans-orbital lobotomy, Freeman first knocked out his patient using electroshocks. He then hammered an instrument similar to an ice pick into the patient’s eye socket above the eyeball. He moved the instrument back and forth to sever the nerves connecting to the prefrontal cortex in the frontal lobes of the brain. Then he repeated the procedure on the other eye socket. This type of lobotomy took only ten minutes.
Freeman performed trans-orbital lobotomies to treat a myriad of mental disorders, including depression, obsessive-compulsive disorder, manic-depression, and schizophrenia. He believed that he could use the procedure to return institutionalized mentally ill patients to productive lives. His motto was “Lobotomy gets them home.”
Freeman began traveling across the country, speaking about the procedure and even performing it in front of audiences. Freeman relished the attention he received and to shock audiences, he sometimes inserted two picks into an eye socket or did the procedure on both eyes simultaneously.
While the lobotomy seemed to help some patients, it had little or no effect on others. Some patients experienced a deadening of all emotion after the lobotomy or were reduced to a child-like state. Others were incapacitated or died after undergoing a lobotomy. Among the most famous debilitated patients was Rosemary Kennedy, sister of President John F. Kennedy. Rosemary was born with mild learning disabilities. Freeman gave her a lobotomy in 1941, which left her incapacitated. Freeman estimated that only one-third of the 3,500 lobotomies he performed were successful and 490 resulted in fatalities.
In the mid-1950s, neurologists began using medications instead of lobotomies to treat patients with mental disorders. Freeman stopped performing lobotomies in 1967 after a patient suffered a cerebral hemorrhage during the procedure. Freeman died of cancer in 1972 at the age of seventy-six.
Impact
The lobotomy is no longer performed in the United States. Most neurologists feel that Freeman and his famous procedure cast a dark shadow on the history of the field. However, some credit Freeman’s work with paving the way for more beneficial, safer procedures such as the deep brain stimulation used to treat patients with Parkinson’s disease.
Personal Life
Freeman married Marjorie Lorne in 1924. The couple had two children: Walter Jackson Freeman III (1927–2016) and Keen Freeman (1934–1946).
Principal Work
(Coauthor with James Watts) Psychosurgery: Intelligence, Emotion, and Social Behavior Following Prefrontal Lobotomy for Mental Disorder, 1941.
Bibliography
Day, Elizabeth. “He was bad, so they put an ice pick in his brain.” The Guardian, 13 Jan. 2008, www.theguardian.com/science/2008/jan/13/neuroscience.medicalscience. Accessed 18 Sept. 2018.
El-Hai, Jack. “The Lobotomist.” Washington Post, 4 Feb. 2001, www.washingtonpost.com/archive/lifestyle/magazine/2001/02/04/the-lobotomist/630196c4-0f70-4427-832a-ce04959a6dc8/?noredirect=on&utm‗term=.28a1be941bc7. Accessed 18 Sept. 2018.
“Walter Freeman: The Father of the Lobotomy.” Medical Bag, 21 May 2015, www.medicalbag.com/despicable-doctors/walter-freeman-the-father-of-the-lobotomy/article/472966/. Accessed 18 Sept. 2018.
Wright, Jennifer. “The 1930s Scientist Who Popularized a Terrifying Brain Surgery,” The Cut, 21 Feb. 2017, thecut.com/2017/02/the-1930s-doctor-who-popularized-a-terrifying-brain-surgery.html. Accessed 18 Sept. 2018.