[HN Gopher] My Lobotomy: Howard Dully's Journey (2005)
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       My Lobotomy: Howard Dully's Journey (2005)
        
       Author : Red_Tarsius
       Score  : 84 points
       Date   : 2023-09-30 07:32 UTC (15 hours ago)
        
 (HTM) web link (www.npr.org)
 (TXT) w3m dump (www.npr.org)
        
       | tetris11 wrote:
       | I wonder if medical journals took their origins from this
       | tragedy. I also wonder if it's still a viable treatment for the
       | violently suicidal.
        
         | burnished wrote:
         | It was never a viable treatment. It was a horrorshow inflicted
         | on the powerless and inconvenient.
        
           | tetris11 wrote:
           | The article gives one case where it had the desired outcome.
           | Indeed it is just one, but given how it was administered
           | willy-nilly for all kinds of ailments, it does make one
           | wonder if the other violent suicidal cases had improvements.
        
             | burnished wrote:
             | No, the article gives one case where someone had reported
             | success, do we get the words of the person who had the
             | spike in their brain? I would caution you against assuming
             | best intent in this context because describing her as being
             | at peace.. it describes some one as going from difficult to
             | control to compliant. We don't have reason to believe it
             | was a miracle cure, except possibly from the perspective of
             | her caregivers.
        
             | vore wrote:
             | I would think we know more about the brain now to have
             | better treatments than random stabbing. Would you like to
             | get stabbed literally randomly in the brain to treat
             | suicidal tendencies?
        
               | tetris11 wrote:
               | Good question. In much the same way that cancer patients
               | literally have to poison themselves with chemo drugs to
               | fight a greater ailment with sporadic success rates, I'd
               | argue that if there was no other alternative and that the
               | road I was on would lead to a violent death, then... yes?
        
               | vore wrote:
               | I don't know why you are so insistent on this.
               | 
               | With chemotherapy, we have literally have so much
               | empirical evidence that the benefits far outweigh the
               | risks. We understand the mechanism of action of
               | chemotherapy enough to assess its risk profile.
               | 
               | With lobotomies, we understand enough about the brain now
               | to know that the risk profile is extremely bad.
               | Additionally, empirical evidence has shown that outcomes
               | are pretty bad anyway! We have better tools and ways to
               | understand the brain now to not give people a brain-
               | destroying "treatment" that is basically a random, low
               | chance of success. Would you reasonably prescribe getting
               | shot in the head as a treatment if it had worked on one
               | person?
        
               | tetris11 wrote:
               | (Sorry, I'm not trying to be beligerent, only to keep an
               | open mind.)
               | 
               | It's kind of why I wanted to know more about the stories
               | of the people the procedure worked for, just in case
               | there really is some evidence it provides a benefit in
               | some niche category. Though, yeah, I'm not betting on it.
        
               | burnished wrote:
               | You aren't wrong to be curious, but you are going to get
               | unhelpful and emotional answers when asking about this.
               | 
               | You should genuinely read the wikipedia page on this
               | topic: https://en.m.wikipedia.org/wiki/Lobotomy it will
               | answer your questions and reveal the horror of what you
               | are asking about and why people respond the way they do.
               | 
               | To sum up though; the procedure was mostly performed on
               | women and children, who were also frequently not aware of
               | what was being done to them (not consenting), on men it
               | was mostly performed on homosexuals. The best case
               | outcomes came at the cost of 'decreased psychic
               | complexity', a sort of 'permanent childhood'. The worst
               | cases don't bear repeating here.
               | 
               | I would also like to caution you, when reading on this,
               | note whose voice is present; is it ever the subject who
               | reports positive outcomes?
        
         | vore wrote:
         | Given that lobotomy was putting a large needle in someone's eye
         | socket and swinging it around in their brain to destroy a bunch
         | of tissue at random, I would hope not.
        
       | BossingAround wrote:
       | Absolutely insane, that someone believes that randomly destroying
       | parts of the brain will "cure one's depression", or other
       | illnesses (like mental health issues or migraines). This is an
       | insanely depressing read.
        
         | bowsamic wrote:
         | [flagged]
        
           | gus_massa wrote:
           | From Wikipedia:
           | 
           | > _by 1951, almost 20,000 lobotomies had been performed in
           | the United States_
           | 
           | > _On average, there was a mortality rate of approximately 5%
           | during the 1940s._
           | 
           | > _He described one 29-year-old woman as being, following
           | lobotomy, a "smiling, lazy and satisfactory patient with the
           | personality of an oyster" who could not remember Freeman's
           | name and endlessly poured coffee from an empty pot._
           | 
           | It helped in many cases, but it was bad in many cases. I'd
           | like to see an statistic and also read carefully what is the
           | definition of a "success" case.
        
           | 221qqwe wrote:
           | Define worked.
           | 
           | Turning a 'violently suicidal' person into a zombie might
           | seem like a success from the perspective of those who have to
           | live with/take care of them/etc. Then again euthanasia should
           | also be very effective if that's your only goal.
        
           | BossingAround wrote:
           | Yes; in the article, there were some lucky cases, some not so
           | lucky:
           | 
           | > Anna Ruth Channels suffered from severe headaches and was
           | referred to Freeman in 1950. He prescribed a transorbital
           | lobotomy. The procedure cured Channels of her headaches, but
           | it left her with the mind of a child, according to her
           | daughter, Carol Noelle.
           | 
           | On the whole, I'd say it's an utterly barbaric, even idiotic,
           | procedure. As I said, believing that random tissue damage has
           | "healing properties" is so idiotic I cannot believe it. At
           | least if it was specific to some parts of the brain, e.g.
           | "for depression, destroy this part of the brain," it'd be a
           | bit more understandable (not by much though).
        
         | quickthrower2 wrote:
         | Snake oil! He had to believe it to make money.
        
         | nick__m wrote:
         | The insanity is with the randomness! Precisely destroying a
         | small part of the brain with focused ultrasounds is almost
         | miraculous for people with debilitating essential tremors and
         | research are underway to fine tune that technique for parkison.
        
         | guraf wrote:
         | Electro convulsive therapy is still routinely performed when
         | pharmaceutical options have been exhausted, and damaging the
         | brain is the intent.
         | 
         | I went through a few rounds myself in modern day America where
         | we pride ourselves in not being barbarians. The first time I
         | did not even consent, my spouse did it for me (in the 80s). To
         | this day I never fully recovered. And yet if I complain people
         | will just point to "studies" that say it works. Guess what,
         | such studies also existed for lobotomy.
        
       | Borrible wrote:
       | After Rosemary was mildly sedated, "We went through the top of
       | the head," Dr. Watts recalled. "I think she was awake. She had a
       | mild tranquilizer. I made a surgical incision in the brain
       | through the skull. It was near the front. It was on both sides.
       | We just made a small incision, no more than an inch." The
       | instrument Dr. Watts used looked like a butter knife. He swung it
       | up and down to cut brain tissue. "We put an instrument inside",
       | he said. As Dr. Watts cut, Dr. Freeman asked Rosemary some
       | questions. For example, he asked her to recite the Lord's Prayer
       | or sing "God Bless America" or count backward... "We made an
       | estimate on how far to cut based on how she responded." When
       | Rosemary began to become incoherent, they stopped.
       | 
       | https://en.wikipedia.org/wiki/Rosemary_Kennedy
        
         | at_a_remove wrote:
         | Yeah, this and HAL 9000 doing the "Daisy Bell" routine are tied
         | together in my mind.
        
         | dav_Oz wrote:
         | If you have a hard time understanding what type of rigor
         | thinking guided this; one on-the-fly "theory" from Freeman is
         | offered by the wiki article on lobotomy[0]:
         | 
         |  _Walter Freeman coined the term "surgically induced childhood"
         | and used it constantly to refer to the results of lobotomy. The
         | operation left people with an "infantile personality"; a period
         | of maturation would then, according to Freeman, lead to
         | recovery. In an unpublished memoir, he described how the
         | "personality of the patient was changed in some way in the hope
         | of rendering him more amenable to the social pressures under
         | which he is supposed to exist." He described one 29-year-old
         | woman as being, following lobotomy, a "smiling, lazy and
         | satisfactory patient with the personality of an oyster" who
         | could not remember Freeman's name and endlessly poured coffee
         | from an empty pot. When her parents had difficulty dealing with
         | her behaviour, Freeman advised a system of rewards (ice cream)
         | and punishment (smacks)._
         | 
         | [0]https://en.m.wikipedia.org/wiki/Lobotomy
        
           | mynameishere wrote:
           | I like how lobotomies ended, not because the professionals
           | decided to quit being barbaric, but because Thorazine got you
           | the same results on a subscription basis.
        
             | unyttigfjelltol wrote:
             | A solid datapoint suggesting distrust of things medical. By
             | no means the only one. Inane practices come in arrogant
             | packages.
        
             | brewtide wrote:
             | I have zero doubt we will look back at the current
             | medication pushing for "results" in the future, as we do at
             | the physical implementations of the past.
             | 
             | AFAIK, we are pretty unsure how many medications actually
             | work in the mental health field instead only seeing if they
             | return 'results' similar to what we are originally aiming
             | for.
        
             | BossingAround wrote:
             | I'd take subscription to irreversible damage any day of the
             | week, to be honest. At least you can stop taking Thorazine
             | and return to your self.
        
               | funnym0nk3y wrote:
               | That's not entirely clear. Psychopharmacology changes the
               | brain long term.
        
               | galangalalgol wrote:
               | Yeah, apparently stimulants for adhd also make some
               | permanent changes to personality, generally in the
               | direction desired by those choosing to take them. The
               | question brought up is if now as then, the pressures of
               | society bias that choice to coerce confirmity.
        
       | questinthrow wrote:
       | Good thing we evolved from our brutal past and can now lobotomize
       | people with no physical injury via pills. You dont want your
       | slaves to be depressed in this inhumane society we have now do
       | you
        
         | 221qqwe wrote:
         | > inhumane society we have now
         | 
         | Arguably still more 'humane' than it ever was.
        
         | funnym0nk3y wrote:
         | Psychiatric diseases did exist thousands of years ago. OCD is a
         | disease I know of. Yes, medication does not cure the underlying
         | illness. And yes, it allows a patient to function in society.
         | Which is, considering everything, a good thing. Being so
         | depressed that you are bed ridden and your body hurts, or so
         | agitated that you could not sleep for days puts a temporary
         | chemical lobotomy in relation.
        
       | emmelaich wrote:
       | What terrifies me is the possibility of psychosurgery only
       | removing the _ability_ to express inner turmoil.
       | 
       | Imagine the despair of a mind unable to express itself through
       | voice or other action.
        
         | bmulcahy wrote:
         | [dead]
        
       | davidthewatson wrote:
       | To the credit of the poor adjunct who taught my freshman psych
       | 101 course in college, and assigned reading Thomas Szasz as part
       | of it, what I've learned is that Thomas Szasz, while outspoken,
       | was not wrong:
       | 
       | https://www.google.com/books/edition/Coercion_as_Cure/hYdLS6...
        
       | isoprophlex wrote:
       | That reminds me of the deeply troubling lobotomy storyline in
       | Bojack Horseman. 2500 lobotomies by a single doctor. Makes you
       | wonder how many were used to conveniently silence difficult
       | people -- people whose mental illnesses were seen to be a burden
       | to their surroundings.
       | 
       | https://medium.com/the-dot-and-line/we-need-to-talk-about-bo...
        
         | kelseyfrog wrote:
         | ABA gets much the same criticism today.
        
       | jdietrich wrote:
       | We're still doing psychosurgery - far more precise and advanced
       | than Freeman and Watts's lobotomies, but not fundamentally
       | different. Today the most common targets are in the cingulate
       | gyrus rather than the prefrontal cortex, but we're still
       | basically cutting or burning out bits of brain. It has become
       | comparatively rare due to the wide array of treatment options now
       | available for severe mental illness, but psychosurgery may still
       | be the least-worst option for people with debilitating and
       | intractable depression, OCD or chronic pain where all other
       | treatments have failed.
       | 
       | Freeman was undoubtedly a cowboy, but his poor practice has
       | warped our understanding of psychosurgery. Freeman didn't invent
       | the lobotomy and was widely condemned by many of his
       | contemporaries, including his former surgical partner James
       | Watts. We overlook the extraordinary suffering caused by severe
       | mental illness and forget just how few treatments existed prior
       | to the great pharmaceutical revolution of the 1950s. Freeman's
       | more conservative contemporaries were, for the most part,
       | responsible clinicians trying to do their best for patients who
       | were experiencing unbearable suffering and had no better options.
       | 
       | https://en.wikipedia.org/wiki/Psychosurgery
        
         | goodluckchuck wrote:
         | That's horrifying.
        
         | bigger_inside wrote:
         | Before we make idealizing comparisons between "barbaric pasts"
         | and seemingly enlightened presents (the "arrogance of the
         | present" in which we assume that whatever we do now is
         | knowledgable, good, just, right, at the end point of progess),
         | let's remember that today's "medications" were largely chance
         | discoveries, where the "chance" consisted of the recognition
         | that they would calm patients and make them more manageable -
         | and in this light, they were praised, in their time, as
         | "chemical lobotomy".
         | 
         | Joanna Moncrieff makes this explicit in her book, "The
         | Bitterest Pills". Also elaborated on here:
         | https://www.psycovery.com/images/Postpsychiatrys-challenge-O...
         | 
         | We're still doing the same thing, just without knives (and, as
         | the comment noted, often also WITH knives).
        
       | CafeRacer wrote:
       | Technically, if you think about that, we're doing neurosurgeries
       | to remove parts of the brains when necessary. I could imagine
       | that severing the connection between lobes could affect someone's
       | mental state in a positive way.
       | 
       | However, 2500 surgeries, some of them with great results, some of
       | them resulted in deaths and many in between. It's a game of
       | chances, not a science. Seems like this dude did not understand
       | what is it exactly he is doing and randomly poked holes in people
       | hoping it would work.
       | 
       | It would have been interesting to read a journal of someone who
       | had the procedure.
        
         | Mistletoe wrote:
         | I'm reminded of this article. There are very rarely placebo
         | surgeries done, so it is an entire arm of medicine that is
         | running wild without proper controls being done.
         | 
         | https://www.skepdoc.info/ian-harris-on-surgery-the-ultimate-...
         | 
         | If you've had a lobotomy surgery, you have a huge tendency to
         | believe it maybe did something positive. An interesting study
         | would have been just tell people that they had a lobotomy. If I
         | had to guess, I bet the success rate would be much higher that
         | actual lobotomy.
        
           | jprete wrote:
           | You're writing as though lobotomy is a legitimate procedure
           | that might be a placebo, instead of a nonsensical operation
           | of random brain destruction.
        
         | belk wrote:
         | I think the only think he knew was that he was offering a
         | procedure to turn problematic family members into vegetables,
         | that was the whole business model
        
       | phatskat wrote:
       | Behind the Bastards has a good couple episodes about Walter
       | Freeman[1]. If you want a good review of exactly how fucked up
       | lobotomies are and what kind of person decides "yeah I could jam
       | an ice pick in a brain", take a listen.
       | 
       | [1] https://spotify.link/rS6ePKIXvDb
        
       | quickthrower2 wrote:
       | Lobotomy, or attempted murder by a stepmother? Hard to guess.
        
       | boringuser2 wrote:
       | There's a lot to be morally repulsed by in this article, but
       | shockingly little scientific discussion of the actual procedure.
       | Kind of feels like a "wow, just wow" article.
        
       | xattt wrote:
       | > As those who watched the procedure described it, a patient
       | would be rendered unconscious by electroshock.
       | 
       | This makes me think that something akin to electroconvulsive
       | therapy would have caused remission.
        
         | smeej wrote:
         | Electroshock therapy _was_ also a common treatment for mental
         | illness.
         | 
         | My grandma received it several times...to try to deal with her
         | emotions about my abusive alcoholic grandfather.
         | 
         | For as much as older generations criticize Millennials and Gen
         | Z for being "snowflakes," I'm not sure my grandma's "Greatest
         | Generation" actually handled things better.
        
           | bowsamic wrote:
           | Electroshock therapy is still common in some places, such as
           | Australia
        
             | coolvision wrote:
             | novadays it's done with general anesthesia and muscle
             | relaxants, so it is quite different from what people know
             | from the movies. good ted talk about it: https://www.ted.co
             | m/talks/sherwin_nuland_how_electroshock_th...
        
             | defrost wrote:
             | FWiW modern ECT is _much much_ milder than 1960s light
             | dimming electroshock treatments.
             | 
             | https://www.healthdirect.gov.au/electroconvulsive-therapy-
             | ec...
        
               | funnym0nk3y wrote:
               | It's still highly controversial.
               | 
               | Effects don't last that long (long enough though to get
               | someone out of debilitating depression or mania and time
               | for proper treatment) and need repeated courses to
               | sustain.
               | 
               | There are still issues with memory, where one looses
               | maybe a few days, but also could loose years.
        
           | jmbwell wrote:
           | They call it electro-convulsive therapy now, or just ECT. The
           | objective is to induce a seizure. The idea is that electrical
           | activity in the brain has been observed to be more stable
           | following a seizure. ECT is still applied and apparently
           | there are documented improvements.
           | 
           | It's not generally done like in One Flew Over the Cuckoo's
           | Nest. The pulses, voltages, and currents are apparently small
           | and precise.
           | 
           | More recently, "transcranial magnetic stimulation" has been
           | reported similarly effective and seems to be considered
           | something of an evolution beyond ECT, using magnetic fields
           | instead of electric current, and avoiding the need for
           | sedation etc.
           | 
           | I don't fully understand it all, and I gather there are still
           | a lot of questions about the exact mechanism. The research
           | done so far is said to support some beneficial outcomes in
           | hard-to-treat cases.
           | 
           | As with so many mental health issues, however, doing rigorous
           | double blind studies for example is difficult or impossible.
           | 
           | Anyway, better practice is no longer to just strap people in
           | and shock people in the brain.
        
             | smeej wrote:
             | My grandma was born in the 1920s. Hers very much was the
             | old-school electroshock therapy.
        
       | euos wrote:
       | I wonder what current medicine will be looked at with horror in
       | 50-75 years. My bet is chemo (let's poison entire body and hope
       | the cancer dies first) and "gender-affirming" care (wrecking
       | natural development of kids body, mutilating healthy bodies of
       | adults)....
        
       | clnq wrote:
       | There's a memoir Dully co-authored and published not too long
       | after this article. There was also another article where, if
       | memory serves me right, he spoke about what it felt shortly after
       | the lobotomy. Although I might be misremembering and it could
       | also be another patient's account. Regardless, it is horrific.
       | 
       | Another atrocity is the reason a Freeman colluded with a
       | controlling and abusive step-mother to lobotomize her son.
       | 
       | > According to Freeman's notes, Lou Dully said she feared her
       | stepson, whom she described as defiant and savage looking. "He
       | doesn't react either to love or to punishment," the notes say of
       | Howard Dully. "He objects to going to bed but then sleeps well.
       | He does a good deal of daydreaming and when asked about it he
       | says 'I don't know.' He turns the room's lights on when there is
       | broad sunlight outside."
       | 
       | I cannot possibly imagine a physician being so incompetent. It
       | really feels like he was the contrarian Ivermectin proponent of
       | his time. This is an interesting read:
       | https://en.wikipedia.org/wiki/Walter_Jackson_Freeman_II#Medi...
        
         | chasil wrote:
         | You must understand that families of these times endured the
         | mentally ill with no hope of improvement for the entirety of
         | their lives.
         | 
         | Yes, reading the article makes me gasp with the information and
         | experience that is enabled by a century of neuroscience, but
         | people in that period had no such option.
         | 
         | The particular subject of the article, a normal child who was
         | lobotomized by a "wicked stepmother" (who later rendered him
         | homeless), was enabled by profound medical malpractice. The
         | surgeon cannot have doubted that the child was completely
         | normal, and the procedure uncalled-for, equivalent to
         | performing a triple bypass on a healthy heart.
         | 
         | Even in modern epilepsy, there is sometimes recourse for
         | "resective surgery" in the hope of quelling seizures, but this
         | is far more informed and exact than the subject of this
         | article.
         | 
         | Unfortunately, it had to start somewhere.
         | 
         | https://en.m.wikipedia.org/wiki/Epilepsy_surgery
        
       | cj wrote:
       | > Newspapers described it as easier than curing a toothache.
       | 
       | In a way, it's comforting to know that newspapers back in the
       | 1950's were as susceptible to BS as modern day TikTok
       | influencers.
       | 
       | Maybe the technology / form factor isn't the underlying issue
       | afterall.
        
         | bigger_inside wrote:
         | > In a way, it's comforting to know that newspapers back in the
         | 1950's were as susceptible to BS as modern day newspapers.
         | 
         | fixed it.
        
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       (page generated 2023-09-30 23:02 UTC)