The Brain — Much Still To Be Learned And Unlearned
November 22, 2019 at 10:08 p.m.
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Truer words were never spoken.
Although scientists have made progress in learning how the elements and chemicals of the brain function - a great deal remains to be discovered. There is a lot more to it than its constituents, 75 to 80% water, with the rest split between fat and protein. These three substances come together in a way that allows thought and memory and vision and aesthetic appreciation of all the rest. Because of its makeup, the brain is surprisingly soft, not unlike soft butter.
Brain surgery, therefore is an extremely delicate and demanding operation and the ability to perform it has long been considered the ultimate measure of human intelligence. Some surgeons in the past, however, have done their best to disprove that statement. One of them, Walter Jackson Freeman, actually became quite famous. He was influenced by work done by a professor of neurology at the University of Lisbon, Egas Moniz in the mid 1930s and the recipient of the Nobel Prize in 1949.
Moniz experimentally cut the frontal lobes of schizophrenic patients to what he thought would quiet their troubled minds. (The frontal lobe part of the cerebrum, is primarily involved in motor function of voluntary muscles, learning, planning, decision making and purposeful behavior.) He called the operation a leucotomy.
Moniz, however, was not an advocate of the scientific method. There were no animal or cadaver studies, no hypothesis, no risk analysis or patient consent and little if any post-surgery follow up. His major impetus was the results he witnessed following surgery on one chimpanzee.
Despite these shortcomings, Freeman modified the procedure renaming it a lobotomy (a lobotomy is defined as a surgery involving incision into the prefrontal lobe of the brain). With the help of a neurosurgeon James Watt, he performed the first prefrontal lobotomy in the United States on a 63-year-old woman who was suffering from insomnia and agitated depression. The operation consisted of drilling six holes into the top of the woman’s skull and when it was finished she emerged transformed and lived for another five years.
He soon developed a more “efficient” way to perform the procedure by drilling into a patient’s head. It involved rendering him or her unconscious by electroshock before inserting a standard household ice pick into the brain through the eye socket. The instrument would then be hammered into the skull and wiggled back and forth to sever the connections to the prefrontal cortex in the frontal lobes of the brain. His procedure often resulted in patients left in a vegetative state and he may have been responsible for an estimated 490 deaths.
One of the vegetative patients was Rosemary Kennedy, sister of President John Kennedy. She had learning disabilities and was subject to mood swings. In 1941, when she was 23, her father had her lobotomized by Dr. Freeman.
It virtually destroyed her. Rosemary eventually regained the ability to walk, but several times she wandered off on her own. She spent the next 64 years of her life in a care home, unable to speak, incontinent and without any semblance of personality. Her mother did not see her daughter for 20 years, and no family member visited her until 1958, when John Kennedy secretly paid a call while campaigning in Wisconsin.
As described in Jack El-Hai’s book, “The Lobotomist,” Freeman’s most controversial lobotomy patients were the children he treated —nearly all of them diagnosed with schizophrenia, and the controversy dogged him throughout his career. The book provides comprehensive details about Freeman and his ideas. It should be noted that despite much criticism about the procedure, it gained popularity through major publications across the country, hailing the lobotomy as a “miracle” surgery.
By 1949, 5000 lobotomies were being performed annually, up from just 150 in 1945. Freeman would ultimately lobotomize more than 2.900 patients, including 19 children younger than age 18. Long term studies on the effects, however, began to surface and many supporters began to abandon it. Freeman performed the last surgery in 1967 after severing a patient’s blood vessel during the procedure, resulting in death three days later. It is sad, but Freeman clung to his belief for more than 35 years, from the age of shock therapy to the era of psychiatric drugs. El-Hai noted that while today’s remedies are different, some still echo Freeman’s work.
Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels. Eclectic Science, the title of his column, touches on famed doctors and scientists, human senses, aging, various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at [email protected].
Truer words were never spoken.
Although scientists have made progress in learning how the elements and chemicals of the brain function - a great deal remains to be discovered. There is a lot more to it than its constituents, 75 to 80% water, with the rest split between fat and protein. These three substances come together in a way that allows thought and memory and vision and aesthetic appreciation of all the rest. Because of its makeup, the brain is surprisingly soft, not unlike soft butter.
Brain surgery, therefore is an extremely delicate and demanding operation and the ability to perform it has long been considered the ultimate measure of human intelligence. Some surgeons in the past, however, have done their best to disprove that statement. One of them, Walter Jackson Freeman, actually became quite famous. He was influenced by work done by a professor of neurology at the University of Lisbon, Egas Moniz in the mid 1930s and the recipient of the Nobel Prize in 1949.
Moniz experimentally cut the frontal lobes of schizophrenic patients to what he thought would quiet their troubled minds. (The frontal lobe part of the cerebrum, is primarily involved in motor function of voluntary muscles, learning, planning, decision making and purposeful behavior.) He called the operation a leucotomy.
Moniz, however, was not an advocate of the scientific method. There were no animal or cadaver studies, no hypothesis, no risk analysis or patient consent and little if any post-surgery follow up. His major impetus was the results he witnessed following surgery on one chimpanzee.
Despite these shortcomings, Freeman modified the procedure renaming it a lobotomy (a lobotomy is defined as a surgery involving incision into the prefrontal lobe of the brain). With the help of a neurosurgeon James Watt, he performed the first prefrontal lobotomy in the United States on a 63-year-old woman who was suffering from insomnia and agitated depression. The operation consisted of drilling six holes into the top of the woman’s skull and when it was finished she emerged transformed and lived for another five years.
He soon developed a more “efficient” way to perform the procedure by drilling into a patient’s head. It involved rendering him or her unconscious by electroshock before inserting a standard household ice pick into the brain through the eye socket. The instrument would then be hammered into the skull and wiggled back and forth to sever the connections to the prefrontal cortex in the frontal lobes of the brain. His procedure often resulted in patients left in a vegetative state and he may have been responsible for an estimated 490 deaths.
One of the vegetative patients was Rosemary Kennedy, sister of President John Kennedy. She had learning disabilities and was subject to mood swings. In 1941, when she was 23, her father had her lobotomized by Dr. Freeman.
It virtually destroyed her. Rosemary eventually regained the ability to walk, but several times she wandered off on her own. She spent the next 64 years of her life in a care home, unable to speak, incontinent and without any semblance of personality. Her mother did not see her daughter for 20 years, and no family member visited her until 1958, when John Kennedy secretly paid a call while campaigning in Wisconsin.
As described in Jack El-Hai’s book, “The Lobotomist,” Freeman’s most controversial lobotomy patients were the children he treated —nearly all of them diagnosed with schizophrenia, and the controversy dogged him throughout his career. The book provides comprehensive details about Freeman and his ideas. It should be noted that despite much criticism about the procedure, it gained popularity through major publications across the country, hailing the lobotomy as a “miracle” surgery.
By 1949, 5000 lobotomies were being performed annually, up from just 150 in 1945. Freeman would ultimately lobotomize more than 2.900 patients, including 19 children younger than age 18. Long term studies on the effects, however, began to surface and many supporters began to abandon it. Freeman performed the last surgery in 1967 after severing a patient’s blood vessel during the procedure, resulting in death three days later. It is sad, but Freeman clung to his belief for more than 35 years, from the age of shock therapy to the era of psychiatric drugs. El-Hai noted that while today’s remedies are different, some still echo Freeman’s work.
Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels. Eclectic Science, the title of his column, touches on famed doctors and scientists, human senses, aging, various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at [email protected].
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