[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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