I wanted to write a post about lobotomies, but rather than just giving facts and figures, I wanted to share a story to demonstrate the effect the procedure had on individuals and families. I wasn’t looking for a famous example, but am going to go with it because there are so many articles available about this person that it illustrates a couple of points that I believe are extremely important.
So I’ll share the basics of the story of Rosemary Kennedy, one of the famous American Kennedy family and sister to a U.S. President. Born in 1918, the third of nine children, Rosemary was an easygoing and cheerful child, but developmentally slower than her siblings. I found nothing that states an IQ derived from an IQ test, just guesses based on a standard math problem, three years of diaries and her ability to function in daily life and society. That social life included being presented to King George VI and Queen Elizabeth of England and meeting President Theodore Roosevelt at the White House.
As she matured she became increasingly rebellious and was subject to violent mood swings. At the convent school where she lived and studied, she began to sneak out at night. In 1941, when Rosemary was 23, her father decided to try a new cutting edge neurosurgical procedure to control her rebelliousness and mood swings. It quickly became clear that the lobotomy was unsuccessful. Rosemary was incontinent and could no longer walk or speak intelligibly. She lived at a Catholic institution in Wisconsin until her death at age 86. Yes, that’s 63 years after her surgery.
Most treatments for mental illness throughout history were horrific, and the lobotomy was no exception. The point of this surgery was to sever the connections to and from the prefrontal cortex of the brain, calming the patient.
Dr. Walter Freeman was the foremost lobotomist in the U.S., performing an estimated 2,500 lobotomies, including Rosemary Kennedy’s. Freeman was a showman and was famous for the “ice pick” lobotomy. He placed a tool that looked like an ice pick into the back of the upper part of the patient’s eyeball, tapping it through the thin bone plate with a mallet, and then swirling the tool around to sever the connections. As is obvious from that statement, this procedure was not terribly accurate, with lots of room for error.
Rosemary’s was only one of an estimated 50,000-60,000 lobotomies performed in the U.S. and Western Europe throughout the 1930s, 1940s and 1950s. The eventual downfall of the lobotomy was partly their poor track record, but mostly the development of effective anti-psychotic drugs.
Even after reading a dozen articles about Rosemary’s life, I still have lingering questions because I am not satisfied with speculations included in the articles. Many people, including article and book authors, have a bias, if not an outright agenda. When researching, like when gossiping, consider the source.
- Was Rosemary “mentally retarded”? In the articles I read there were various estimates, in hindsight, as to her IQ. Or was she “mentally ill”, a diagnosis less socially acceptable?
- How do they define “rebellious” and “violent mood swings”? The commonly mentioned concrete example I found was that she was sneaking out at night. I have two sisters and I know all of us snuck out of the house during our teenage years. And mood swings are a requirement for teenagers.
- Did Rosemary’s father arrange for the lobotomy because he was embarrassed by her behavior or because he wanted her to live a better life? Did he purposefully arrange this to happen while his wife was out of the country, or did he feel that it was solely his decision to make? Did he never visit her (if that’s a true accusation) because he felt guilty about the lobotomy, because she was no longer useful to him, or because he simply wanted to keep her situation a secret?
What struck me this week is that we have a tendency to judge historical figures by our current standards. Some of the articles and comments painted Rosemary’s father as a complete monster, ruining his daughter’s life to serve his ambition. That may be true, but it may not. We know now that the lobotomy as it was performed then is not an effective treatment, but the people requesting lobotomies were basing their decisions on what they knew then.
In 1941 mental illness was not understood as it is today, and the stigma attached was incredible. There were no drugs for these illnesses, as there are today. At the time, her father may have been weighing the option of putting his daughter in an insane asylum, a horrible place throughout pretty much all of history, or trying a new cutting edge “cure”.
Don’t get me wrong, her father may indeed have been a self-serving monster who cared about nothing but power. He also may have chosen what he believed to be the best option presented to him at the time. So…read and research wisely by always considering your sources, and don’t judge historical figures by today’s standards.
For a straightforward FAQ about lobotomies, please see this blog post by Miriam Posner. It’s an excellent overview, and if you want to do more thorough research she includes a list of what she considers the best books on the topic. I agree with her about The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness by Jack El-Hai, but I haven’t read any of the others.