Walter Jackson Freeman II

Walter Jackson Freeman II (November 14, 1895 – May 31, 1972) was an American physician who specialized in lobotomy.[1]

For his son, see Walter Jackson Freeman III.
Walter Jackson Freeman II
BornNovember 14, 1895
Philadelphia, Pennsylvania, United States
DiedMay 31, 1972(1972-05-31) (aged 76)
EducationYale University
University of Pennsylvania Medical School
Occupationphysician, neurologist, psychosurgeon
Known forPopularizing the lobotomy
Invention of the transorbital lobotomy
ChildrenWalter Jackson Freeman III
Parent(s)Walter Jackson Freeman I
RelativesWilliam Williams Keen, maternal grandfather

Biography and early years

Walter J. Freeman was born on November 14, 1895, and raised in Philadelphia, Pennsylvania, by his parents. Freeman's grandfather, William Williams Keen, was well known as a surgeon in the Civil War. His father was also a very successful doctor. Freeman attended Yale University beginning in 1912, and graduated in 1916. He then moved on to study neurology at the University of Pennsylvania Medical School. While attending medical school, he studied the work of William Spiller and idolized his groundbreaking work in the new field of the neurological sciences. Spiller also worked in Philadelphia and was credited by many in the world of psychology as being the founder of neurology. Freeman applied for a coveted position working alongside Spiller in his home town of Philadelphia, but was rejected.[2]

Shortly afterward, in 1924, Freeman relocated to Washington, D.C., and started practicing as the first neurologist in the city.[2] Upon his arrival in Washington, Freeman began work directing laboratories at St. Elizabeth's Hospital.[2] Working at the hospital and witnessing the pain and distress suffered by the patients encouraged him to continue his education in the field.[2] Freeman earned his PhD in neuropathology within the following few years and secured a position at George Washington University in Washington, D.C., as head of the neurology department.[2]

In 1932, his mother died at the Philadelphia Orthopedic Hospital in Philadelphia, Pennsylvania.[3]

Lobotomy
Main articles: Psychosurgery and Lobotomy

The first systematic attempt at human psychosurgery – performed in the 1880s–1890s – is commonly attributed to the Swiss psychiatrist Gottlieb Burckhardt.[4] Burckhardt's experimental surgical forays were largely condemned at the time and in the subsequent decades psychosurgery was attempted only intermittently.[5] On November 12, 1935, a new psychosurgery procedure was performed in Portugal under the direction of the neurologist and physician Egas Moniz.[6] His new "leucotomy" procedure, intended to treat mental illness, took small corings of the patient's frontal lobes.[7] Moniz became a mentor and idol for Freeman who modified the procedure and renamed it the "lobotomy".[6] Instead of taking corings from the frontal lobes, Freeman's procedure severed the connection between the frontal lobes and the thalamus. Because Freeman lost his license to perform surgery himself after his last patient died on the operating table, he enlisted neurosurgeon James Watts as a research partner.[7] One year after the first leucotomy, on September 14, 1936, Freeman directed Watts through the very first prefrontal lobotomy in the United States on housewife Alice Hood Hammatt of Topeka, Kansas.[6][7] By November, only two months after performing their first lobotomy surgery, Freeman and Watts had already worked on 20 cases including several follow-up operations.[2] By 1942, the duo had performed over 200 lobotomy procedures and had published results claiming 63% of patients had improved, 24% were reported to be unchanged and 14% were worse after surgery.[2]

After almost ten years of performing lobotomies, Freeman heard of a doctor in Italy named Amarro Fiamberti who operated on the brain through his patients' eye sockets, allowing him to access the brain without drilling through the skull.[6] After experimenting with novel ways of performing these brain surgeries, Freeman formulated a new procedure called the transorbital lobotomy.[6] This new procedure became known as the "icepick" lobotomy and was performed by inserting a metal pick into the corner of each eye-socket, hammering it through the thin bone there with a mallet, and moving it back and forth, severing the connections to the prefrontal cortex in the frontal lobes of the brain.[8] He performed the transorbital lobotomy surgery for the first time in Washington, D.C., on a housewife named Sallie Ellen Ionesco.[6] This transorbital lobotomy method did not require a neurosurgeon and could be performed outside of an operating room without the use of anesthesia by using electroconvulsive therapy to induce seizure.[8] The modifications to his lobotomy allowed Freeman to broaden the use of the surgery, which could be performed in psychiatric hospitals throughout the United States that were overpopulated and understaffed.[8] In 1950, Walter Freeman's long-time partner James Watts left their practice and split from Freeman due to his opposition to the cruelty and overuse of the transorbital lobotomy.[6]

Following his development of the transorbital lobotomy, Freeman traveled across the country visiting mental institutions, performing lobotomies and spreading his views and methods to institution staff. (Contrary to myth, there is no evidence that he referred to the van that he traveled in as a "lobotomobile".)[9] Freeman's name gained popularity despite the widespread criticism of his methods following a lobotomy on President John F. Kennedy's sister Rosemary Kennedy, which left her with severe mental and physical disability.[2] A memoir written by former patient Howard Dully, called My Lobotomy documented his experiences with Freeman and his long recovery after undergoing a lobotomy surgery at 12 years of age.[10] Walter Freeman charged just $25 for each procedure that he performed.[8] After four decades Freeman had personally performed possibly as many as 4,000[11][12][13] lobotomy surgeries in 23 states, of which 2,500 used his ice-pick procedure,[14] despite the fact that he had no formal surgical training.[2] In February 1967, Freeman performed his final surgery on Helen Mortensen.[6] Mortensen was a long-term patient and was receiving her third lobotomy from Freeman.[6] She died of a cerebral hemorrhage, as did as many as 100 of his other patients, and he was finally banned from performing surgery.[6] His patients often had to be retaught how to eat and use the bathroom. Relapses were common, some never recovered, and about 15%[15] died from the procedure. In 1951, one patient at Iowa's Cherokee Mental Health Institute died when Freeman suddenly stopped for a photo during the procedure, and the surgical instrument accidentally penetrated too far into the patient's brain.[16] Freeman wore neither gloves nor mask during these procedures.[16] He lobotomized nineteen minors, including a four-year-old child.[17]

At fifty-seven years old, Freeman retired from his position at George Washington University and opened up a modest practice in California.[2]

An extensive collection of Freeman's papers were donated to The George Washington University in 1980. The collection largely deals with the work that Freeman and James W. Watts did on psychosurgery over the course of their medical careers. The collection is currently under the care of GWU's Special Collections Research Center, located in the Estelle and Melvin Gelman Library.[18]

Freeman was known for his eccentricities and he complemented his theatrical approach to demonstrating surgery by sporting a cane, goatee, and a narrow-brimmed hat.[2][19]

Death

Freeman died, of complications arising from an operation for cancer, on May 31, 1972.[20]

He was survived by four children — Walter, Frank, Paul and Lorne — who became defenders of their father's legacy. Paul became a psychiatrist in San Francisco and the eldest, Walter Jr., became a professor emeritus of neurobiology at University of California, Berkeley.[19]

Contributions to psychiatry

Walter Freeman nominated his mentor António Egas Moniz for a Nobel prize, and in 1949 Moniz won the Nobel prize in physiology and medicine.[6] He pioneered and helped open up the psychiatric world to the idea of what would become psychosurgery.[1] At the time, it was seen as a possible treatment for severe mental illness, but "within a few years, lobotomy was labeled one of the most barbaric mistakes of modern medicine."[1] He also helped to demonstrate the idea that mental events have a physiological basis.[1] Despite his interest in the mind, Freeman was "uninterested in animal experiments or understanding what was happening in the brain".[2] Freeman was also co-founder and president of the American Board of Psychiatry and Neurology from 1946 to 1947[2] and a contributor and member of the American Psychiatric Association.[1]

Writings
  • Freeman, W. and Watts, J.W. Psychosurgery. Intelligence, Emotion and Social Behavior Following Prefrontal Lobotomy for Mental Disorders, Charles C. Thomas Publisher, Springfield (Ill.) 1942, pp. 337.

References
  1. "The Lobotomist". American Experience. Retrieved July 10, 2011. In the 1940s Dr. Walter Freeman gained fame for perfecting the lobotomy, then hailed as a miracle cure for the severely mentally ill. But within a few years, lobotomy was labeled one of the most barbaric mistakes of modern medicine.
  2. Rowland, Lewis (April 2005). "Walter Freeman's Psychosurgery and Biological Psychiatry: A Cautionary Tale". Neurology Today. 5 (4): 70–72. doi:10.1097/00132985-200504000-00020.
  3. "Mrs. Walter J. Freeman. Daughter, Widow and Mother of Physicians Was Philadelphian". New York Times. October 28, 1932. Retrieved 2013-12-16. Walter Jackson Freeman, daughter of the late Dr. W.W. Keen, died today in the Orthopedic Hospital.
  4. For example: However, Kotowicz notes a difference, irregularly observed, among medical historians and medical practitioners in their location of the origin of psychosurgery. The latter group, he contends, tend to favour beginning the narrative with Burckhardt whilst the former group favour starting with Moniz. In the context of early psychosurgery, Berrios unusually also refers to the operations performed in 1889 by a surgeon (Harrison Cripps) at the behest of the British psychiatrist Thomas Claye Shaw in which fluid was drawn from the brain of a patient diagnosed with General Paralysis of the Insane. While the purpose of the operation was aimed towards the alleviation of mental symptoms attendant on the condition the procedure did not aim to interfere directly with brain tissue and therefore it has been excluded from most conventional accounts of psychosurgery.
    • Berrios, German E. (1991). "Psychosurgery in Britain and elsewhere: a conceptual history". In Berrios, German E.; Freeman, Hugh (eds.). 150 Years of British psychiatry, 1841-1991. Gaskell. pp. 181–5. ISBN 978-0-902241-36-7.
  5. Kotowicz, Zbigniew (2005). "Gottlieb Burckhardt and Egas Moniz–Two Beginnings of Psychosurgery". Gesnerus. 62 (1–2): 79. doi:10.1163/22977953-0620102004.
  6. "A Lobotomy Timeline". NPR. Retrieved July 10, 2011.
  7. "The Lobotomist: Complete Program Transcript". PBS. Retrieved December 15, 2013.
  8. Cordingley, Gary. "Walter Freeman's Lobotomies at Athens State Hospital". Retrieved July 12, 2011.
  9. El-Hai, Jack (2016-03-16). "Fighting the Legend of the "Lobotomobile"". Retrieved November 20, 2017.
  10. Dully, Howard (2007). My Lobotomy. Crown. ISBN 978-0-307-38126-2.
  11. Edwards, Rem B.; Breggin, Peter R. (1982). "The Return of Lobotomy and Psychosurgery" (PDF). Psychiatry and Ethics: Insanity, Rational Autonomy and Mental Health Care. Prometheus Books. p. 363. ISBN 978-0879751784. Archived from the original (PDF) on 29 August 2017. No one knows for sure how many persons were mutilated in the "first wave". Walter Freeman, America's dean of lobotomy, has given me a personal and probably reliable estimate of 50,000. Most chronic mental hospitals—and there are hundreds in the country—have a caseload of old lobotomy patients. The past literature contains hundreds of articles, and many lobotomists and hospitals accounted for several thousand at a time. Freeman, for example, says that he did about 4,000.
  12. Day, Elizabeth (2008-01-13). "He was bad, so they put an ice pick in his brain". The Guardian. Retrieved 26 December 2013.
  13. Breggin, Peter R. (24 February 1972). "The Return of Lobotomy and Psychosurgery" (PDF). United States Congressional Record. 118 (5): 5570. Archived from the original (PDF) on 1 December 2017.
  14. "Top 10 Fascinating And Notable Lobotomies". 2009-06-24. Retrieved 26 December 2013.
  15. Howard Dully; Charles Fleming (2007). My Lobotomy: A Memoir. Three Rivers Press. p. 66. ISBN 9780307407672. Alt URL
  16. "The Lobotomy Files: One Doctor's Legacy". WSJ.
  17. "Lobotomy - PBS documentary on Walter Freeman". PBS. Retrieved 27 December 2013.
  18. Guide to the Walter Freeman and James Watts Papers, 1918-1988, Special Collections Research Center, Estelle and Melvin Gelman Library, The George Washington University
  19. Day, Elizabeth (13 January 2008). "He was bad, so they put an ice pick in his brain..." theguardian.com. Retrieved 27 December 2017.
  20. "Walter Jackson Freeman, Father of the Lobotomy". 27 September 2017. Retrieved 27 December 2017.
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