Imagine this: a well-known surgeon in your area suggests slicing someone’s brain open, cutting some brain matter here, severing some connections there, and then sewing their brain back up. Good idea, right? The reality of this procedure is what’s known as a lobotomy, an actual surgery that was practiced in the mid-20th century. And yes, it’s still practiced today.
A lobotomy, also called a leukotomy, is described as a surgical procedure in which the nerve pathways in a lobe or lobes of the brain are severed from those in other areas. Historically, the first lobotomies were performed in the 1880s on people with severe mental illnesses as a way to lessen the severity of the illness. They were performed by drilling two holes into a patient’s head and injecting ethyl alcohol into the prefrontal cortex. This surgery was successful in initial patients, whose paranoia and anxiety appeared to subside.
In the 1930s, the lobotomy became known in America as the “miracle procedure,” and it was used on all mental illnesses, regardless of the type or severity. New procedures were created, this time having surgeons sticking an instrument through a patient’s eye socket, cracking a bone behind the nose, and picking out the brains that way.
And while the lobotomy was known as the miracle procedure, the procedure had a dark side too.
Lobotomies often left the patient with a low brain capacity and unable to live independently. In the United States, about 50,000 people were lobotomized. The procedure’s popularity faded out as negativity in relation to the surgery increased. In 1953, the U.S.S.R. banned lobotomies, one Soviet doctor saying that lobotomies turned an “insane person into an idiot.”
Lobotomies faded out of cultural prevalence because of negative results and new prescription drugs that lessened effects of mental illnesses. And though they aren’t popular, they’re still practiced today, and completely legal in the United States. Now referred to as psychosurgery or cingulotomy, the procedure is performed as a last resort when treating mental illnesses.
The part of the brain called the cingulate cortex is where illnesses like obsessive compulsive disorder, schizophrenia, Alzheimers, attention deficit disorder, and chronic pain originate. A stereotactic cingulotomy is a procedure like the lobotomy, it targets a very small portion of brain matter. In the case of a cingulotomy, the targeted matter is in the cingulate cortex. Like a lobotomy, the procedure involves cutting the patient’s head open. But, instead of scooping out brain matter, doctors use more advanced technologies to sever connections that cause the illnesses. Other slightly different versions of cingulotomy uses procedures involving laser technology or radiation technology.
The cingulotomies gained slight popularity in the early 1970s as a way to treat mental illnesses, but a court case in 1973 declared any type of lobotomy-like psychosurgery too damaging to the brain, mind and personality to be performed in state institutions. Since no state institution can perform the procedure anymore, the only two institutions that that still perform cingulotomies are Harvard University and Brown University.
At Brown, cingulotomies have been about 33 percent effective, measured by how the patients meet post-surgery criteria. Slight variations of the cingulotomy have all been 50 percent effective or less. So, the surgeries have worked before, and will probably keep working into the future. Even with the successful surgeries, some argue that the amount of nursing assistance and rehabilitation given to the patient before and after the treatment actually help the patient more than the surgery.
The ethics of the surgery have gotten more refined as more and more is understood about the surgery. Due to the fact that even the modern and more advanced forms of lobotomies sometimes leave patients unable to function independently, the surgeries are performed only as last resort options. When performed, the historic lobotomy and the modern cingulotomy are significant procedures, and whether or not they are effective in their goal, they can leave the patient changed forever.
