How Lobotomies Work

I am glad to be alive. Yes, so, Chuck, Yes, I think this could arguably pan out to be our greatest podcast ever. No, I really don't think so. Chuck did the cheek thing twice before this one. It's kind of enough to do it a second time. And I don't think we've ever had a topic that Chuck and I were more intensely interested in than this one. I know.

It kind of just came out of nowhere, and it's really well, not out of nowhere, because it's historical, but um in our eyes, out of nowhere, which if in our eyes? Yeah, a little foreshadowing from Charles Bryant. Nice one, Shuck, If you will get off of L O L Cats for a second and go check your iTunes. You'll find that the title of this one is how lobotomies work, And that's what we're gonna be talking about our lobotomy. Fascinating,

it really is. Lobotomy is kind of exist in h this little um segment of twentieth century culture, medical madness, I guess you could say, right right, and pop culture, because you still hear it being thrown around like boys might lobotomize me, scramble my brain. But it's kind of exactly the way it happened. Yeah, yeah, So, Chuck, you're a lover of great cinema, right, of course, of course you've seen one flew over the Cuckoo's Nest, right, I have a poster, you do, Yeah, a good one, Yeah,

the one in Jack Nicholson laughing with the watch cap on. Yeah, it's a good one. Um. So, of course you remember the the pivotal scene of the movie where McMurphy is um lobotomized for being unruly, tries to kill them their hatchet because nurse ratchet, Nurse ratchet hatchet. That was a Freudian slip right there. It was. She was a Hatchet. Yeah. Um so, uh she was mean, and I'm totally with you. It was the Freudian slip part that got me. I had like eight jokes going in my head at once,

and I was like, I can't say that. I can't say that. I can't say that. It's like the terminator. Yeah, um so yeah. So he tries to kill Nurse Ratchet because she was a terrible nurse and kind of evil, very evil, And so he gets lobotomized and they don't show the procedure. Don't worry if you ever want to know what one was like, we're going to go into

grizzly detail in a minute. Um. And he comes out just kind of this drooling imbecile, which I have to remind everybody was actually a medical term before it was imbecile, moron and idiot were all degrees of mental retardation. Isn't that weird? Yeah? Of course this is at the same time that people were performing the bottom those It seems like very archaic, even though it wasn't that long ago. Yeah, well,

let's set the scene. Okay, all right, So we're talking in the nineteen thirties, and the nineteen thirties were a terrible time to be nuts. Basically, you got locked up in a straight jacket to keep you from eating your own thess um or throwing it at orderlies or doing anything really crazy. And that was about it. Um. They had certain um, certain techniques like shock therapy. Right, what do they use? Uh they still use shock therapy here

and there? Actually, so well you have like electro convulsive therapy, and you had apparently they also used to use insulin. Okay, insulin, right, we know how bad that is from I can't remember one of our aging podcasts, right, Um. And they would basically inject a hefty dose of insulin into a patient. Um too the okay, chuck my paper wrestling was going to get the wrath and Jerry, they know we used

crypt sheets, buddy. Um. So they inject the patient with the hefty dose of insulin and um would basically shock their system, possibly causing convulsions. There was another drug just to subdue them. Hold on, I'm getting to that. This is the craziest part. This is this was the grasp that medical science had on mental illness at the time. There's another drug called metrozol, which was a respiratory and um circulatory stimulant and then hefty doses it to produce

shock and convulsions. So if you'll notice, all three of these produced convulsions shock therapy. And the reason that they did that was because there was a suspicion that there is a link between epilepsy, convulsions, and mental illness and that if you had one, you couldn't have the other. So by producing convulsions, they thought that they were treating mental illness. Unbelievable. Yeah, so you could have just had epilepsy and that that they would sit you in the

elect show convulsive shock therapy chair and to treat you. Yeah, they'd stick a little paddle in your mouth and turn on the juice to tell you what man, I like. I sometimes look back and say, boy, the nineteen fifties, that would have been cool to look back then, But then you hear stories like this and you kind of forget about the downside. Yeah. Ect is definitely one of the downside of this era, right all right? So um, another problem with this was that the mental um mental care. Wow,

have you had a little botomy? I had a little bit of and yeah, um no, I had some metro's whole earlier. I'm all jacked up. UM. The the the state of mental hospitals in the US in the in the thirties and forties was that they were overcrowded, right, because I mean, if you can't treat anybody, really, you

can't treat their mental illness, which they come in there in. Yeah, right, they wanted docile patients, they wanted people that didn't cause trouble and really anyway that they could get there was kind of okay at the time. And this right, and this was also before drug therapy was created, So in the thirties, nineteen thirty six, this new procedure comes about, right, Well, it was the thirty five in Portugal, you're right, Yeah,

sorry about that. Yeah, that was doctor Antonio IGAs Monies and Dr Almida Lima in Portugal performed the first lobotomies by drilling holes into the skull on either side of the prefrontal cortex and injecting alcohol and there to destroy the fibers connected. And this was actually based on um an earlier study from nineteen thirty three by a couple of Yale researchers who removed the prefrontal cortex is from

a pair of monkeys and the other one Binkie will say. Yeah, Um, these two monkeys had their prefrontal cortex cort texas removed, and um, the researchers found that they could still they still had intellect, but they were lacking the emotion. Led to violent outbursts when they didn't get their way. Zey, by the way, I like Binky better. Um, can we stay with Binki? Okay? So the the doctor, um, oh, the Portugue Fulton and Carlisle, I'll know you're going back

to Portugal. Yeah. Dr Moniz saw Fulton present. Um, one of the Yale researchers saw Fulton present his findings and he thought, huh, my mental patients act like monkeys, you know, violent outbursts when they don't you know, when they see things that aren't really there. Right, So let me get my hands on a cadaver and see what I can see,

what I can work out with the Brian. So this early, this early, that was called the pre frontal lobotomy, right, started out, like you said, by drilling holes in the school and adding alcohol. And the whole reason why chuck the prefrontal cortex, Why the funnel loab? What's so important about that? Well? The pre funnel lob but cortex Josh has a number of complex functions um called executive functions as they're known as we're talking high level decision making, planning, reasoning,

understanding personality, it's personal expression, that right thing. So basically your personality, the way you create things, the way you see the world, and how you react to the world, g emotions, this is all this is all generated here. It's originates in the prefrontal court. And you're stabbing the

front of your head right now speaking. Uh and so that as we all know that the brain is connected, it's all connected together, sure, sending and receiving signals like like mass email and uh So, what you have here, You've got two types of matter, gray and white matter. Gray matter includes neurons and brain cells and blood vessels and things like that. White matter is axons and nerve fibers, and they connect the gray matter and carry messages with

electric impulses. So the gray matter is where these impulses are generated. The white matter translates them or transfers them, transmits, it transmits one of the trans uh So a lobotomy. What that does is it's intended to sever the white matter between the different areas of gray matter, thus interrupting the transmissions. Right. And the problem, um with dr monies is technique. The early technique using alcohol is like you said, the brains all connected, and alcohol, being a liquid is

kind of hard to keep in one place. So it started to go and destroy other areas, right. But he was onto something. He was onto something by destroying the white matter, right, So instead he decided to be a little more precise and he kept with the whole drilling method actually based on an ancient um ancient method of brain surgery called trepidation, which actually what Gosha we could I'm gonna be in trouble here. We had a fan right in and suggest trepidation and that's what got me

on the botomies in the first place. And I apologize. So if you're out there listening, oh you don't remember the fans, thank you, nameless fans. We love you bank or Becky um. Yeah. And actually in the article how the botomies work, um, there's a cool relief from a horonymous box Um painting of some early physician trepanning a patient and he's got like a little segment of the skull lifted off in the brain's exposed and he's just

poking around in there. Um. But okay, so he's still dr Monis is still using the drilling method, but now he's inserting instruments in there. He inserted this one that sounded like, um, it's a handle with a little loopy wire that comes out. But yes, so when you when you push it, when you push down the back of it, the loop extends out and then you can pull it in and just basically removed hunks of prefrontal cortex, right, and that's exactly what hopefully matter. Yeah, you would say, um,

and it was successful. Well yeah, to too again to very degrees and maybe not again because I think that's the first time we've said that. But yeah, the lobotomy was successful to varying degrees, vary varying degrees. But there was this guy who went and saw, um, dr Monies perform one of these. Yeah, this work gets good. And

this guy was named Dr Walter Freeman. And for probably about what fifty thousand people, uh in the U s Alone, this meeting between these two men was the worst thing that ever happened in the history of humanity, because that's about how many people were lobotomized between for about over about a seven year period in the US. Was it just seven years? Okay? So then there was many many more actually, um, but yeah, the Dr Walter Freeman became

an immediate UM evangelists. He was called for Lobotomyes. Um. He he tried monies as technique with a with a partner um and did it successfully for a while. But the problem is it was still surgery. It required a surgeon to do it um operating room. Right. If Freeman was actually not a neurosurgeon, he was a neurologist, required anesthetic. Yeah, so there there were some some drawbacks to it in Freeman's of pain, right, expense being one of them. Time

and resources. So he created something that was a lot handier, a lot easier, and a lot quicker. And that is what we call the transorbital or ice pick lobotomy, right, Can I say that this is he determined that if you took something which is technically called an orbito class but it really looks sort of like an ice pick. You said it yesterday on our web test, Uh, call

it arose by any other name exactly. So you put this ice pick over over the eyeball but under the bone there what's that called between the eyeball and the eyelid, but ill on the eye until the back of the orbital bone. Right, So, once you get to the back of the orble orbital bone, there's a little resistance there because it's bone, and so enter a little silver hammer and so he just pinks on that thing until it cracks through. And then he's got a pretty clean passageway

to the frontal cortex. And so you've got an ice pick sticking out of your eye. He uh, he scrambles it up a little bit once it's in there, and then he does the same thing on the other side, and ten minutes later if you're lobotomized, literally, so he do both sides right right. Um, he got kind of good at this, Yeah, Dr Freeman got really I guess

you could say good at this, or at least very fast. Um. In one two week period in West Virginia, he performed lobotomy is on two people, and in one day he performed lobotomies on twenty five patients right one day and one day. So he's just basically bringing him in and sending him out. He's exactly doing that. Actually read an interview with one of his assistants at the time, and he said he would literally not take breaks. As the

patient left, another one would be brought in ten minutes later. Boom. And I don't think we mentioned yet he before he does this, he doesn't use anesthetic. He knocks him out with electro shock, right, So it's making use of too extremely primitive and violent techniques right time. And the result was,

like we said, varied. I mean, it ranged anywhere from people being satisfied and you know, seemingly successful, like a highly emotional people suicidal all of a sudden, being more docile and not so worried to uh to death, and people rendered vegetables literally. So yeah, well the map. Dr Freeman actually referred to lobotomyes um, informally as soul surgery. Yeah. I hate that. The reason why is because he was basically removing what kind of what makes us human. People

could still function under a successful lobotomy. People could still function, they could still talk, but they weren't They weren't doing anything, they weren't bringing anything to the table. There was no reason for them to exist so much anymore for the personality surgery exactly right, um and uh he would Uh he did it, um again so fast, it's so so often. And he had a touch of a showman to him that he basically did. He had a lobotomobile in which

he performed demonstrations. Right. He toured the country all over the place. I think he ended up doing His estimates run from two thousand to five thousand between nineteen six and nineteen sixty seven, transorbital lobotomies UM in twenty three states in the US. Right, he performed with both hands. He would stick the ice picks in with both hands at once to add a little flare showmanship. Yeah, so he was basically performing shows, lobotomy shows. Um. And not

everybody reacted well to these. Um. There's season surgeons who had seen tons of gore and blood and horrible things in their lifetimes. Um would vomit watching these things. Some had to leave. Um. There was a nurse whose account I read of watching a lobotomy said, uh, the when he moved the ice picks back and forth, it made the sound of tearing cloth. Um. Later on in the USSR, which actually banned lobotomies, and I think nineteen is embarrassing. Yeah, well,

fourteen years before we did right. Yeah. Um. A physician named Nikolai or Serinsky, thanks dusky, um he called. He said that lobotomies violate the principles of humanity and change an insane person into an idiot. Again remember a medical tournament at the time. Um, So there, I imagine that

there was something that affected you. Were you human being, like a real human being seeing this this rough, violent, um misguided or unguided procedure being performed, that it would affect you in some way, like some very primal party of you would say, that's not supposed to happen. Plus, there was no official scientific basis for this. It was basically, hey, look at the result in some cases. That is what

they were kind of basing this whole thing on. And also, as we were saying about Freeman being a showman and doing it so fast, there was one visit to a mental institution in Iowa. I don't remember what year it was, um, but Freeman killed three people in one visit, and one of the people this is so awful. Um. He was doing his little show off thing with the two picks at once, instead of as his own procedure dictated one and then the other side. He was doing two picks

at once. So the patients on the table um with two ice pick sticking out of his eyes, and Freeman says, I'm going to take a photo of this, steps back to take a photo. One of the ice pick slips and kills the patient instantly. So apparently Freeman was said to have basically just packed up right then and moved on to the next place without missing a bead or staying. Geez, that's packed up the lobotomobile. Yeah, hit the you know one person he lobotomized, Josh, I know you do. He

lobotomized John F. Kennedy's sister, Rosemary. Dr Freeman did in Uh. Rosemary was twenty three years old and uh, early on her childhood she was shy and easy going, they say, but as a teenager, shocker, she became rebellious and moody, which and that's what struck me in a lot of these cases is so many of them we're just normal human emotions, like anything from postpartum depression to you know,

an overactive child. You know, it's just unbelievable. So she was lobotomized and afterward was rendered basically she couldn't speak, She had the mental capacity of an infant couldn't control or bodily functions, and the Kennedy family basically from that point on said that she Ah was mentally retarded, which they claimed that she may have been before, but who knows. You want to talk about another guy, Howie, Chuck and

I have a shared hero. He is an indomitable three fifty pounds six ft three bus driver who has this gentle, tender personality. And his name is Howard Dully. And at the age of twelve, Howard Dully met Dr Freeman under unfortunate circumstances, meaning Dr Freeman had a couple of ice picks on him when they met, and um, Howard ended up under Freeman's care because of his stepmother, right, Chuck, Yeah, he It was the kind of the classic story the father gets remarried to a stepmother who is not very

patient and understanding with her son. That sounded like you, It sound like he may have been a little ryanbunctious, but what twelve year old boy isn't. And I think you have some good notes, actual notes. Yeah, well in Freeman's notes that Dully turned up later, and we should say, how are Dully created this great radio piece that's an MPR. You can actually find um by typing in my lobotomy and Google. I think it's the first thing that comes up.

It's one of the most amazing things you've ever heard, where he just goes and retraces the steps of his lobotomy that he got when he was twelve and tries to get to the bottom of what happened. We typically don't recommend people go listen to other things that it's not us. But that's how good it is, right, yeah, exactly, it is that good. Uh, it's way better than I

actually um. But he finds the Dr. Freeman's notes on his case and apparently a stepmother pled her case to get him lobotomized by pointing out that he day dreams a lot, and when you ask him what he's daydreaming about, he says, I don't know. Uh, he doesn't want to go to bed, and when he does he sleeps well. In my personal favorite, he turns on the lights in

rooms when there's broad daylight streaming in unbelievable. I know that kid deserves the lobotomy, but one of the things that I think one of the reasons why you and I both look up to Howard Dolly was because he has wondered his whole life how different would he be? Like I lived hard and fast as a younger man, right right? Yeah, actually way way harder and faster. Um So, but I've I've often wondered, you know, how much sharper would I be had I not lived like that? But

this is my own doing. It was my own choosing. Howard Dolly had to think that same thing, like is there something wrong with me? Is there a part of me missing? Through no choice or fault of his own? We should also say that, um, when Howard's stepmother found that he was not a vegetable, she just got him out of the house and he became a ward of

the state. So he went all around lady so um again in the end he finds, you know, there there really isn't something wrong within the He's a pretty terrific person as as as it turned out, lobotomy or not. It took him a long time though, I mean he battled addiction and various forms of mental illness his whole life after this, and uh, I think going this the special that air and he wrote a book and went

and talked to his father. After forty years. He actually finally spoke to his dad about it, and that seems to have been the thing to get him over the edge to not feeling like a freak anymore, as he called it. Yeah, you can actually hear him working it out in my lobotomy. Yeah, a big, deep voice. Yeah, he sounds kind of like Sam not Sam Shepherdson. What's the guy? Uh, big lebowski, Sam Elliott? Sam Elliott? Yeah, that's what are you reminded me of the dude. Yeah.

He also had that big mustache too, sort of like Sam Ello, that handlebar biker mustache. So, Chuck, whatever happened to Lobotomy's why where? Why did they go the way of the dinosaur? Well? Uh, A couple of reasons. I mean, one, there was a lot of gaining steam with the criticism of it because they found that they were lobotomizing criminals.

They were lobotomizing soldiers from World War Two because criminals against their will sometimes right, But they lobotomized soldiers because hospitals were overcrowded veterans unbelievable, and so that that was kind of gaining steam. And then the introduction of uh thorizine basically everything um I believe that somebody said that thorzine was to the treatment of schizophrenia, that insulin, I'm sorry, that penicillin was to the treatment of infectious diseases, which

is a pretty big comparison. So thorzine was developed in nineteen fifty and as it began to to fall into widespread use, um lobotomy kind of fell out of widespread use. Dr Freeman himself he uh, he had one last one, one last lobotomy in nineteen sixty seven, right, yeah, he killed a woman with the brain hemorrhage after the third try. I think this is her third lobotomy, and uh, she wasn't just you know, some mental patient in Iowa. This

is a housewife. And when she died of I believe of hemorrhage after the procedure, that third procedure, that was it. He was banned from surgery, performing any kind of surgery from that that point on, and actually spent the rest of his days until he died in nineteen seventy two, traveling the country in a camper. If it was his lobottomobile, I don't know. He wasn't pitching it. He was actually going around trying to um find he was visiting old

patients to prove that he had done good. And he had done some good in a couple of cases, in several cases, I imagined. His first one was a woman I can't remember her first name, but it was ian Esco and she, uh, she was violently suicidal, as described by her daughter, and afterwards she went on to to

live a happy, fulfilled life. Yeah. But you know, every every successful case I read about, they would say things like they weren't violently suicidal anymore, and they were just, you know, kind of happy, but it still seemed to be that lights wrong. But no one's home thing like the couple, Yeah, the married couple was the husband had his wife lo bottom eyes because she was so emotional and she was suicidal. Yeah, and she says that she's

happy as a clam, and he was satisfied. He said that she came home and she never calls any more trouble and she was just happy and she could still yeah, she could still cook and clean and do all the things she could do before. And she agreed, I just haven't been worried about things since then. And she was in her eighties. But you know, you read that emotions

are normal, mood swings are normal. It's h agreed, but I do I do think that there is a certain threshold and if you're violently suicidal, you know, maybe a lobotomy was a better option. Yeah, but I also want to know what the criteria for all this was. Back then there wasn't any so yeah, so put that in your pipe. And but one of the most unsettling things, one of the most unsettling things that I found from

this article is that lobotomies are still performed today in England. Right, the UK is one of a few countries UM where it's it's no longer called the botomies because lobotomy is such a horrible stigma attached to it for good reason. Neurosurgery for a mental disorder and m D and today apparently they use m r s as guides to be more precise. But pretty much this type of surgery, psychosurgery as it's called UM is, it's pretty much the same thing.

It's destroying white matter connections and you're removing people's emotional cells. Right. I mean, there may be something too to that, but certainly it was so non specific and non technical to jam Ice picks and and just blindly move them back and forth. Said, no, wonder that was all kinds of results. So, Chuck, we are both kind of nuts. And I'm really glad it's not like ninety. Yeah, my wife Emily and I would both be on the the lobotomy table. I think

I drive you to see Freeman. Thanks, sure, I appreciate that. Yeah, well that's it. That's it for lobotomies, buddy. Yeah. I encourage people to go out and listen to Howard Dully's uh radio show there. It's really great. Hopefully you guys enjoyed this one. You can read all about lobotomies on how Stuff Works dot com. You know what to do, uh, you know, handy search bar, etcetera. Uh, And Chuck, let's u let's talk some audible stuff. So our sponsor, audible

dot com hit it. Okay, So if everyone goes to www. Dot audible podcast dot com slash stuff and sign up to get one free download from audible dot COM's fifty thousand plus titles of audio books, stand up comedy, spoken word speeches, pretty much anything you can listen to is

right there. And I was on their browsing just this morning and I found one of my all time favorite books by Charles man Good One great one man runs around um the America's basically two archaeological sites and gets the scoop on the most recent findings and finds that there were way more people in the America's before Columbus showed up than we realized. Uh and yeah, there's a lag between the arrival of Columbus uh to Hispaniola and the the second wave that followed within the next fifty years.

The second wave found that this, you know, that was Virgin Territory. There's almost no one there. Turns out it's because about a hundred million people died of smallpox from Columbus's first arrival between then and the second wave. It's fascinating, right there. You just did one. Well, maybe we'll do a bigger subed on it, a bigger Yeah. What about you you've been on? Yeah, I'm gonna recommend uh just quickly. Stephen Colbert of the Colbert Rapport. Oh, I saw his portrait,

his National Gallery Portrait a Stithonia recently. It was awesome with this familiar scowl. Yeah. I love that guy. So yeah, he has a very popular book that he reads himself called I'm an American and so can you. And that's all I need to say about that. It's hysterical. Nice check. So you can get either one of those titles for free by going to www. Dot audible podcast dot com slash stuff and signing up and that is audible right there, Baby, let's do Let's do it, Josh. I'm just gonna call this.

We got a lot of great feedback for the high Food toost Corn Serup. Yeah, so much so we're gonna have probably like three podcasts in a row. We're gonna be and some of that mail, I don't know what it is. We should I can bring back Haikus, all right. So I'm just gonna call it intelligent listener mail because Max is a smart guy, and I like these most of all. I'm a graduating senior in the Business College, but when I'm not in class or listening to podcast,

I almost always enjoy listening to philosophy. It's more or less my passion. More specifically, I'm interested in world religion, medical metaphysical theory, and man's relationship to nature in the universe. So this guy is obviously smarter than we are to say that fruit dose, corn serve, or any other man made chemical compound does not occur naturally. You're speaking with

the basic assumption that man is something different than nature. Unfortunately, for those who can find themselves above nature and importance or authority, this is not the case. It's our Western culture and religion that strengthens this point of view. Man didn't PLoP into nature as a separate and flawed phenomenon in a stupid natural universe. Man came out of nature. Man is nature. Man is the universe. To borrow a quote from my favorite philosopher Alan Watts, and you're seeing,

you're hearing, you're talking, you're thinking, you're moving. You express that which it is which moves the sun and other stars. So to perceive yourself as something different is only an inability to identify yourself with the cosmos. So Josh Man's manipulation of compounds is really the world's manipulation of itself, or perhaps the universe manipulating itself. And that is certainly a natural occurrence. Boom, And that is what happens when I off handedly say something is man made? Nice? Well,

what's the guy's name? Max? And I think philosophy too, so I thought, what's gonna call? We dig you, Max, and we really dig anybody who sends us something, especially if it's as intelligent as that. Uh. If you want to show off your ginormous brain, send us an email to Stuff Podcast at how stuff works dot com. For more on this and thousands of other topics at how staff works dot com. H brought to you by the reinvented two thousand twelve Camry. It's ready, are you