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The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness
The Lobotomist explores one of the darkest chapters of American medicine: the desperate attempt to treat the hundreds of thousands of psychiatric patients in need of help during the middle decades of the twentieth century. Into this crisis stepped Walter Freeman, M.D., who saw a solution in lobotomy, a brain operation intended to reduce the severity of psychotic symptoms. Drawing on Freeman’s documents and interviews with Freeman's family, Jack El-Hai takes a penetrating look at the life and work of this complex scientific genius. The Lobotomist explores one of the darkest chapters of American medicine: the desperate attempt to treat the hundreds of thousands of psychiatric patients in need of help during the middle decades of the twentieth century. Into this crisis stepped Walter Freeman, M.D., who saw a solution in lobotomy, a brain operation intended to reduce the severity of psychotic symptoms. Although many patients did not benefit from the thousands of lobotomies Freeman performed, others believed their lobotomies changed them for the better. Drawing on a rich collection of documents Freeman left behind and interviews with Freeman's family, Jack El-Hai takes a penetrating look into the life of this complex scientific genius and traces the physician's fascinating life and work.
362 pages, Hardcover
First published January 1, 2005
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About the author
Jack El-Hai
17 books93 followersJack El-Hai is a widely-published journalist who covers history, medicine, and science, and the author of the acclaimed book The Lobotomist. He is the winner of the June Roth Memorial Award for Medical Journalism, as well as fellowships and grants from the McKnight Foundation, the Jerome Foundation, and the Center for Arts Criticism. He lives in Minneapolis.
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Displaying 1 - 30 of 118 reviews
March 14, 2022
I came into contact with numerous failed lobotomy patients in the big mental hospitals of the 1970s, some were in a vegetated state, others displaying little or no emotion. For this reason alone, I read this critically. Initially, I became aware of what was not being said. The author pointed out that Freeman became aware that the answer lay in severing connections that lead to detrimental emotional responses, and yet didn’t point out that they are actually the same connections that lead to beneficial and necessary emotional responses. I tried to accept, as one reviewer suggested, that this was the ‘dispassionate reserve of a trained journalist’. Certainly, nothing was left hidden. Freeman lobotomized subjects as young as four years old, and at times saw it as an answer to social as well as medical problems, Freeman, it was also noted, lined the patients one after the other, caring little about hygiene. The author noted that someone claimed him to be the Henry Ford of assembly line brain surgery. To be fair, Freeman did seem to care for his patients and did follow them up over the years. It is near the end that the author reveals his true colors. He appears to accept that Freeman was a maverick, but that he was also a genius that paved the way for more precise psycho-surgery of today. I agree with the maverick claim but not the genius claim. There is little of value in the final chapters and much of debatable accuracy. I doubt that the practice of lobotomizing patients disappeared as a result of the anti-psychiatry movement of the 60s and 70s. Its demise is more likely due to the growing recognition of its brutality, to the unconvincing results of the operation, and to the arrival of anti-psychotic medication. Sadly, rather than a completely new approach to the treatment of mental illness, Thorazine and its buddies remain little more than a form of chemical lobotomy. Read, yes, but please read critically.
July 16, 2017
Insert metal icepick into eye socket, hammer through bone with mallet, move pick back and forth to severe connections to the frontal lobes. Repeat procedure other eye if necessary.
Dr. Walter Freeman, neurologist, brought a new form of treatment for the mentally ill to the United States called leucotomy, surgically removing cores from the prefrontal lobe of the brain. Teamed with neurosurgeon James Watts, they eventually developed their own procedure and instrument, the transorbital or icepick lobotomy. From the 1930s through the 1950s, Walter Freeman performed nearly thirty-five hundred lobotomies in a time before medical ethics, in a time when asylums were overflowing with patients admitted by families for everything from legitimate mental illness to excessive masturbation. Did lobotomy help some patients and allow them to return to a life outside the institution? Yes. Did some patients die during the procedure? Yes. Later in his career, Walter Freeman took his procedure on the road, performing lobotomies in institutions and anywhere there was a need in his mind. With an almost fanatical obsession, he tried to locate and follow his patients, documenting their progress or lack thereof. He actually received Christmas cards from a few every year.
Medical genius, dedicated physician, neurosurgical trailblazer, or monster with an icepick? Yes.
Dr. Walter Freeman, neurologist, brought a new form of treatment for the mentally ill to the United States called leucotomy, surgically removing cores from the prefrontal lobe of the brain. Teamed with neurosurgeon James Watts, they eventually developed their own procedure and instrument, the transorbital or icepick lobotomy. From the 1930s through the 1950s, Walter Freeman performed nearly thirty-five hundred lobotomies in a time before medical ethics, in a time when asylums were overflowing with patients admitted by families for everything from legitimate mental illness to excessive masturbation. Did lobotomy help some patients and allow them to return to a life outside the institution? Yes. Did some patients die during the procedure? Yes. Later in his career, Walter Freeman took his procedure on the road, performing lobotomies in institutions and anywhere there was a need in his mind. With an almost fanatical obsession, he tried to locate and follow his patients, documenting their progress or lack thereof. He actually received Christmas cards from a few every year.
Medical genius, dedicated physician, neurosurgical trailblazer, or monster with an icepick? Yes.
October 11, 2022
so many bad things to say about this book... yes it was interesting, yes the life of freeman is fascinating. is it fun to try and get into his head, imagine his reasoning? yes. is it acceptable to go so far in "getting in his head" that you excuse his actions and border on idolizing him as an idealistic hero? i can't get behind it.
el-hai omitted so many details from freeman's life in order to cherry pick stories that showed him as a progressive go-getter rather than a non-licensed man performing assembly-line surgeries with an ice pick. i cannot express enough how much i dislike freeman, and the fact that el-hai didn't provide an objective view of the horrific medical damage he did baffled me.
el-hai omitted so many details from freeman's life in order to cherry pick stories that showed him as a progressive go-getter rather than a non-licensed man performing assembly-line surgeries with an ice pick. i cannot express enough how much i dislike freeman, and the fact that el-hai didn't provide an objective view of the horrific medical damage he did baffled me.
May 1, 2025
As many others have stated in reviews, this biography was extremely concerning. Not only was the biography of his life extremely boring at times — the author dwelling on the backgrounds of people who were not Freeman and mentioning his beard way too many times for it to be deemed as good writing — he was also biased and praised Freeman at the end of his book.
As someone who has contamination OCD, hearing about his fourth patient brought me to tears. I continued reading hoping that the author would end the book with the same conclusions that I had: that Freeman was a deranged, obsessive-compulsive psychopath that damaged healthy human brains to feed his own ego and lust for fame, but instead the author seemed to elevate Freeman and attributed his work to the research being done on new types of psycho-surgery for OCD today.
Overall, I wish I hadn't read this book. I would not recommend it even if the author didn't idolize Freeman, since his life in my eyes was not nearly as remarkable as the author probably thought it was.
As someone who has contamination OCD, hearing about his fourth patient brought me to tears. I continued reading hoping that the author would end the book with the same conclusions that I had: that Freeman was a deranged, obsessive-compulsive psychopath that damaged healthy human brains to feed his own ego and lust for fame, but instead the author seemed to elevate Freeman and attributed his work to the research being done on new types of psycho-surgery for OCD today.
Overall, I wish I hadn't read this book. I would not recommend it even if the author didn't idolize Freeman, since his life in my eyes was not nearly as remarkable as the author probably thought it was.
July 9, 2023
I wanted to like this book much more than I actually did. It was certainly interesting and I learned something about the history of trans-orbital lobotomies. However, I feel that this book takes unnecessary tangents into Freeman’s life that serve no part of the intended narrative. I suppose they’re meant to humanize Freeman in someway but they just ended up slowing down the pace of the book and making me dislike Freeman that much more. Additionally, I think the author could have been more critical of Freeman, his uncritical sense of self, and his carelessness when it came to patient care- his numerous character flaws are mentioned throughout but they are not given nearly enough weight. He killed patients because of his startling, even for the times, negligence. He is romanticized by the author in ways that make me uncomfortable and slightly upset. That is the author’s prerogative, of course - but I think Freeman, and what he inflicted upon his patients, is deserving of much more critical analysis than is provided in this book.
March 13, 2022
Die erste Biographie die ich gelesen habe :)
Gefühlt Schriftgröße 4 und Zeilenabstand 0 beeinträchtigen das Lesevergnügen schon irgendwo.
Insgesamt bin ich etwas überrascht wie gut es dem Autor gelungen ist Walter Freeman Menschlich darzustellen. Weit weg von der Horrorfigur, dem Dämon, zu welchem ihm die meinten medialen Darstellungen machen.
Freeman, der in einer Zeit in welcher psychisch Kranke Menschen quasi überhaut nicht behandelt werden konnten (abgesehen vielleicht von Elektroschocktherapie und Insulinschocktherapie) meinte, er habe eine Lösung. Das Wohl der Patienten schien ihm tatsächlich wichtig, Partieren besuchte er oft, schrieb Postkarten und freute sich wenn diese wieder in der Gesellschaft aufgenommen werden konnten. Wohlbemerkt haben ihn aber auch nur "erfolgreichen Fälle" interessiert.
Das seine eigene Person dabei populär und erfolgreich wurde hat ihm sicherlich unterbewusst sehr gutgetan.
Ich glaube einzusehen das seine Methode menschlich fragwürdig ist, das ist für ihn ab einen gewissen Zeitpunkt nicht mehr möglich gewesen und so hat er die Realität nur noch aus einen bestimmten Blickwinkel sehen. Einen in dem er vielen Menschen "helfen" kann und auch muss.
Dieser Blickwinkel ist aber irgendwo auch der Blickwinkel der Buches geworden. Zumindest bis zur Entdeckung von einigen Medikamenten, durch welche die Lobotomie obsolet wurde. Ich hätte ich mir da etwas mehr Historischem Hintergrund und moralische Einschätzung des Autoren gewünscht. Vielleicht ist es aber auch dämlich von mir das zu Verlagen.
Der Autor solle der moralische Captain sein durch das moralisch graue Gewässer. Und ich muss dann gar nicht mehr selber denken :)
Freeman moralisch zu verurteilen würde sich sehr gut anfühlen. Dann wäre irgendwo alles abgeschlossen und die Welt wieder gut. Das tut der Autor nicht in großem Maße und ich weiß noch nicht ganz was ich denken soll.
Was ich aber weiß: ich könnte jetzt die GFS meines Lebens halten :D
Gefühlt Schriftgröße 4 und Zeilenabstand 0 beeinträchtigen das Lesevergnügen schon irgendwo.
Insgesamt bin ich etwas überrascht wie gut es dem Autor gelungen ist Walter Freeman Menschlich darzustellen. Weit weg von der Horrorfigur, dem Dämon, zu welchem ihm die meinten medialen Darstellungen machen.
Freeman, der in einer Zeit in welcher psychisch Kranke Menschen quasi überhaut nicht behandelt werden konnten (abgesehen vielleicht von Elektroschocktherapie und Insulinschocktherapie) meinte, er habe eine Lösung. Das Wohl der Patienten schien ihm tatsächlich wichtig, Partieren besuchte er oft, schrieb Postkarten und freute sich wenn diese wieder in der Gesellschaft aufgenommen werden konnten. Wohlbemerkt haben ihn aber auch nur "erfolgreichen Fälle" interessiert.
Das seine eigene Person dabei populär und erfolgreich wurde hat ihm sicherlich unterbewusst sehr gutgetan.
Ich glaube einzusehen das seine Methode menschlich fragwürdig ist, das ist für ihn ab einen gewissen Zeitpunkt nicht mehr möglich gewesen und so hat er die Realität nur noch aus einen bestimmten Blickwinkel sehen. Einen in dem er vielen Menschen "helfen" kann und auch muss.
Dieser Blickwinkel ist aber irgendwo auch der Blickwinkel der Buches geworden. Zumindest bis zur Entdeckung von einigen Medikamenten, durch welche die Lobotomie obsolet wurde. Ich hätte ich mir da etwas mehr Historischem Hintergrund und moralische Einschätzung des Autoren gewünscht. Vielleicht ist es aber auch dämlich von mir das zu Verlagen.
Der Autor solle der moralische Captain sein durch das moralisch graue Gewässer. Und ich muss dann gar nicht mehr selber denken :)
Freeman moralisch zu verurteilen würde sich sehr gut anfühlen. Dann wäre irgendwo alles abgeschlossen und die Welt wieder gut. Das tut der Autor nicht in großem Maße und ich weiß noch nicht ganz was ich denken soll.
Was ich aber weiß: ich könnte jetzt die GFS meines Lebens halten :D
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October 2, 2012(Read for the Loft's 2012-2013 Mentorship Program)
Discussing this book with a group helped smooth out my thoughts about this book. At first, I stomped around, telling my husband it was exhausting to read, with its jumps in time and its lack of variation. There was no dialogue! No interniality! (I was making up words!) The characters weren't characters but lists of facts; it may as well be a sequence of bullet points.
But the group was wise, as it tends to be. One pointed out how a group of medical professionals had this book on a list with a handful of drier material and were celebrating the narrative of it. What a relief! And here we are, mentees in a literary program, searching for elements in craft for a book that would likely make an excellent resource. It wasn't bedtime or bathtime reading, it wasn't bring-to-the-beach, or carry-outside reading. It's the sort of book you read if you are quite curious about the subject--deeply interested--which is why a similarly written book on, say, Emily Dickinson would be deemed successful to me (those random facts thrown in in the oddest of places would have been treasures, perhaps).
But what I think I would look for, no matter the purpose of reading this book, that wasn't present, was any kind of processing: the author can reveal a fact, such as the doctor never loved his mother, and it can be tucked into a paragraph discussing something else and moved on, no development. And lack of development might be fine, if there were some white space--a chapter ending, a break in that particular discussion--to process the importance of something like that, or the fact of his own brother's madness, etc. There are moments, such as when the doctor's son vanishes over the falls, that the author gives life to the situation, or when his partner tells him he cannot perform this particular sort of surgery any more, and the author interjects, stating how that partner must have felt making this request--these are the things that humanize the situation.
Discussing this book with a group helped smooth out my thoughts about this book. At first, I stomped around, telling my husband it was exhausting to read, with its jumps in time and its lack of variation. There was no dialogue! No interniality! (I was making up words!) The characters weren't characters but lists of facts; it may as well be a sequence of bullet points.
But the group was wise, as it tends to be. One pointed out how a group of medical professionals had this book on a list with a handful of drier material and were celebrating the narrative of it. What a relief! And here we are, mentees in a literary program, searching for elements in craft for a book that would likely make an excellent resource. It wasn't bedtime or bathtime reading, it wasn't bring-to-the-beach, or carry-outside reading. It's the sort of book you read if you are quite curious about the subject--deeply interested--which is why a similarly written book on, say, Emily Dickinson would be deemed successful to me (those random facts thrown in in the oddest of places would have been treasures, perhaps).
But what I think I would look for, no matter the purpose of reading this book, that wasn't present, was any kind of processing: the author can reveal a fact, such as the doctor never loved his mother, and it can be tucked into a paragraph discussing something else and moved on, no development. And lack of development might be fine, if there were some white space--a chapter ending, a break in that particular discussion--to process the importance of something like that, or the fact of his own brother's madness, etc. There are moments, such as when the doctor's son vanishes over the falls, that the author gives life to the situation, or when his partner tells him he cannot perform this particular sort of surgery any more, and the author interjects, stating how that partner must have felt making this request--these are the things that humanize the situation.
July 23, 2009
After reading Howard Dully's MY LOBOTOMY: A MEMOIR, I had to read THE LOBOTOMIST. The subtitle--A maverick medical genius and his tragic quest to rid the world of mental illness--speaks volumes. There is no doubt that Walter Freeman was a genius, and a maverick. He came from a family whose menfolk had been physicians back to his great grandfather. If there was one thing he possesed in abundance in was self confidence and the unshakable conviction of his own greatness.
El-Hai does a remarkablly even-handed job of examining Freeman, his world, his times and the fierce war in the world of psychiatry between the behaviorists and the biologists. Along the way, he ponders how so many intelligent people, both physicians and patients could endorse and promote a practice we now consider to be sunk in the depths of barbarism.
In the end, Freeman emerges as a flawed genius whose hubris brought his downfall. Like a tragic hero in a Greek play, he seems larger than life. His rise to fame and prominence was meteoric and his descent into obscurity and ignominy was therefore all the more dramatic. Yet, you have to have at least a grudging respect for the man and his aim of curing the world once and for all of mental illness was commendable.
Jack El-Hai did the history of medicine a distinct service by writing this book. Agree with him or not, like it or not, Walter Freeman is a key figure in the history of modern American psychiatry. Without at least making an attempt to come to grips with his legacy and recognize that Freeman's influence still lives, one's understanding of that history will be incomplete.
El-Hai does a remarkablly even-handed job of examining Freeman, his world, his times and the fierce war in the world of psychiatry between the behaviorists and the biologists. Along the way, he ponders how so many intelligent people, both physicians and patients could endorse and promote a practice we now consider to be sunk in the depths of barbarism.
In the end, Freeman emerges as a flawed genius whose hubris brought his downfall. Like a tragic hero in a Greek play, he seems larger than life. His rise to fame and prominence was meteoric and his descent into obscurity and ignominy was therefore all the more dramatic. Yet, you have to have at least a grudging respect for the man and his aim of curing the world once and for all of mental illness was commendable.
Jack El-Hai did the history of medicine a distinct service by writing this book. Agree with him or not, like it or not, Walter Freeman is a key figure in the history of modern American psychiatry. Without at least making an attempt to come to grips with his legacy and recognize that Freeman's influence still lives, one's understanding of that history will be incomplete.
January 3, 2025
This is…a concerning portrait of a monster. Freeman is portrayed here as a visionary in neurology, doing what others wouldn’t when it came to lobotomies. This author showcases a strong bias in favor of a man who didn’t even have a medical license and practiced some of the most desperately dangerous procedures for his own edification. Just slapping in some fun family roadtrips doesn’t humanize him. Very concerning biography.
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October 31, 2025they go a little too easy on him lol
January 4, 2025
☆1 / ☆4.5
“Is the quieting of the patient a cure?” He asked. “Perhaps all it accomplishes is to make things more convenient for the people who have to nurse them”
-Nolan Lewis
I have really gone back and forth on what to rate this book because my reviews have always been based on how much I have enjoyed reading a book rather than the content. If that’s the case this book would get 5 stars because I loved learning more about this history HOWEVER the author is presenting this story in such a problematic way and I’m concerned.
So, in my little heart this book gets ☆4.5 (-.5 because I wanted less road trips, more info on the lobotomobile, more on Rosemary Kennedy, and more of the tales of patients that went wrong) but this book is getting ☆1 because SCREW YOU JACK EL-HAI (we all say in unison)
I want to touch on two major things in this book: The content as a whole, and the author of this book
I think I should start with what I thought of the author of this book
Right out of the gate I’m going to say: He was way too empathetic towards Freeman. I mean, no kidding look at the subtitle of the book: a MAVERICK medical GENIUS and his TRAGIC quest to RID THE WORLD OF MENTAL ILLNESS. All of those words are compliments towards freeman.
Even without the obvious clues in the heading, you can spot the slant towards pro freeman in the book itself. Sometimes it’s sneaky and you’ll only notice it if you’re looking for it, other times it’s so obvious the author is trying (and failing) to make Freeman sound good that it’s laughable. Look at the prologue:
Notice how he specifically phrases this in a way that shows that disagreeing with lobotomy is an opinion that comes from a lack of knowledge that will be changed when enlightened. Believing lobotomy can be harmful to a patient is an “old notion” The language used here clearly tells you what the author thinks of lobotomy and what he wants the reader to think of lobotomy-and by extension Freeman-by the end of this book.
The book shows Freeman in a clearly positive light sprinkled with criticisms from other scientists on this procedure, I can’t think of a time when the author reprimands Freeman himself.
Look at the segment where Freeman first decides to use an ice pick for his lobotomies. This is the definitive point where you start to feel that Freeman is losing his mind. I mean, he takes an ice pick from the back of his kitchen drawer and decides “This would be the perfect thing to shove into someone’s eye socket to reach the brain and swish around in there blind” It is the point where Freeman will easily lose favor with readers of this biography (if he hasn’t lost them already)
Freeman’s ice pick is introduced in Chapter 9 titled “Waterfall” It is introduced on page 181, he’s shown to really start losing it when he performs a lobotomy with his ice pick in the shared office of Freeman and Watts on page 191 and then the author does something very interesting. On page 201, within the same chapter of these two major events, the author recounts the story of Freeman losing his 11 y/o son when he tragically dies via waterfall.
This story is very oddly placed. The entire chapter talks about the ice pick, the falling out between Freeman and Watts, the invention of the orbitoclast and the first transorbital lobotomy patients which are all huge parts of the history of lobotomy and then tacked on at the end is this story of Freeman losing his son. Not only that, but the author thinks this so important that he names the chapter waterfall. The author pairs Freemans most inhumane moments with his most humane and tragic one to try to keep the reader empathetic toward Freeman. You end the chapter with this story, and the chapter title suggests that what the author wants you to remember from this is the waterfall, none of the other concerning things that are stated in this chapter.
Could I be looking too much into this and could the author have included this because it took place at the same time as these other events? Sure, but I find everything to be very purposeful and I will keep my tin foil hat on for this.
I think what really made me dislike El-Hai’s writing was how he put so much effort into humanizing Freeman, and humanizing his patients that improved, but then made the patients who were worse off feel like an afterthought.
This is most evident on page 277 in the case of Violet Silver. El-Hai states she was a violin player before she was plagued by schizophrenia and lost her passion for the violin. After her lobotomy, she returned to playing the violin where she performed “numerous recitals” and taught several students. She even wrote an operetta. This story is then juxtaposed with Josef Hassid who was also a violin prodigy with schizophrenia who was lobotomized, only the lobotomy had complications and he died from infection. What is truly gross about these stories is, this could have been a very powerful example of how lobotomies were very hit or miss. It could lull the reader into a false sense of siding with Freeman at the improvement of Silver for them to then be smacked in the face with the fame of Hassid that never was. What did the author do instead? He wrote about Violet’s story and then included Josef’s IN PARENTHESIS. The patients who were harmed seem like an afterthought that the author only threw in so he could say “Look! I included the bad stories, too!” to escape criticism.
I found great enjoyment from El-Hai trying to make Freeman seem alright during the whole ice pick thing though:
HE USED A FREAKING ICE PICK FROM THE BACK OF HIS KITCHEN DRAWER, JACK. BE FOR REAL.
DON’T EVEN PRETEND AN ICE PICK IS SURGICAL YOU’RE BETTER THAN THIS.
Personally, I think it’s important to note 2 things about Freeman: 1 He was egotistical and prideful to a fault where he endangered his patients and ignored clear warning signs and 2 He’s a fun guy to read about.
I can’t sit here and act like I don’t enjoy his showmanship and his brash nature and disregard for critics that’s so fun to read. I can acknowledge that I love how he’s so passionate about his work that he comes off as insane while also acknowledging he’s in the wrong 100% of the time and has definitely harmed a large majority of his patients because of his “quirks.”
Freeman is someone you can relate to, he’s passionate, he’s brazen. I love reading about him and from the context in this book you can start to understand why he was so stubborn about lobotomies. I’m talking specifically about the shotgun story. A soldier obsessed with suicide went for a lobotomy and then 2 years after the operation, the patient returned with a long narrow box.
Freeman’s operations can make anyone hate him but when you see the positive impact some lobotomies had, it makes sense why Freeman was so passionate about it. So many patients reached out to him via letters thanking him for “giving them their life back” which is another reason why I’m so mad El-Hai didn’t spend more time with the people with negative effects because having both of those present gives the reader this story that isn’t black and white.
Freeman is a man whose passion for helping people is abused and you watch as he slowly becomes more and more stubborn in his ways, denouncing treatments that would help a patient more than a lobotomy would just because he’s so attached to it. He felt that some day lobotomy wouldn’t be so controversial and he’d finally get recognition but that never came and the lobotomy became obsolete.
These are all things you can empathize with which then makes you question everything you knew about lobotomy and about the man behind it which I LOVE in media because it really reminds you that life is never black and white. WHICH IS ALSO WHY I’M SO MAD THIS BOOK IS SLANTED TOWARDS FREEMAN BECAUSE GIVE ME AN ULTIMATUM DAMMIT!! DON’T SUGAR COAT THIS DUDE HE ACTS LIKE A TODDLER.
This is also just…. Concerning?? I’ve looked into lobotomies outside of this book and know how damaging they can be to the patient so there was never a point where I thought “Wait actually lobotomies are probably really good” but not everyone will have that same experience. This biography paints lobotomies and Freeman himself in such a “misunderstood” way that I can’t help but feel worried about what conclusions people will come to at the end of this book.
I also want to note how insane the reviews plastered on the cover are: “In Jack El-Hai’s lively biography, Freeman comes across as a classic American type, a do-gooder and a go-getter with a bit of the huckster thrown in”
Freeman ridiculed the use of chlorpromazine because of side effects like runny nose, diarrhea, tremors, and muscular rigidity while his lobotomies had side effects like death.
Freeman's grandfather pioneered antiseptics and he, quote: “...his later partner recalled Freeman's exhortations against ‘all that germ crap’ and his annoyance with sterile procedures” Even with this statement, he still had the gall to compare himself to his grandfather because people were against antiseptics just like they were with lobotomies.
During a presentation about lobotomies where he received criticism during questions, he spilled out a box containing over 500 Christmas cards he had received from lobotomy patients and said “How many Christmas cards do you get from your patients?”
Freeman decided an ice pick from the back of his kitchen drawer would be a good tool to use in a medical procedure involving an organ with the least amount of information known about it.
Freeman performed lobotomies on children, cutting healthy tissue of a brain that was nowhere near being fully developed.
Freeman is not the classic American hero, he is a passionately dangerous idiot who has done so much harm and you’re over here like “do-gooder 🤭 and go-getter 😘with a bit 💅of the huckster😜 thrown in✨” Did we read the same book?
I really disliked how the author presented his text, but I do enjoy how engaging this biography was. I can’t lie, I really enjoyed reading this book because of the history so let me get on to those parts.
I became interested in the history of lobotomies back in February and dove into any details I could find. Unfortunately most articles just regurgitated surface level information but I wanted to know more so I ordered this book. It really accomplished what I wanted: a more in depth look at the history of lobotomies. I really enjoyed this read because I knew the main framework and the turning points in the story which helped me fit all of the details together. Having these parts of the narrative show up had me giggling and kicking my feet. I’d definitely recommend knowing something about lobotomy before reading this book just so you can keep everything straight in your head but it’s not necessary.
I was giggling and twirling my hair when I read that
I also just have to dedicate something to John Fulton because I love him. Take a shot every time he randomly shows up in this memoir. When I read the whole story of lobotomy he was shown as the catalyst from his experiments with primates and then is never mentioned again when really he was a friend to both Freeman and Watts and comes back throughout the book to be the only sane person. He’s my pookie, if Fulton has 100 fans I’m #1, if he has 0 fans I’m dead, you get the point.
I love him.
He literally presented primates he lobotomized like “Yea and this concludes that the frontal lobe is the source of thought and reason” “Cool cool cool so when are we doing this on the mentally ill?” “What.”
Also note that this story ^ is wildly disputed and this account was told by Fulton himself but like come on, that makes me love him more. He just insinuated he was the main inspiration for Moniz’s leucotomy and that could 100% be a lie you’ve gotta admit that’s a little bit iconic of him.
Other than John Fulton I enjoyed a lot of things from this book which I’ll list here along with other random notes I had while reading:
1. Freeman fangirling over Moniz will never not be funny to me
Bros got a lil crush
2. The way Freeman was never a surgeon???? Ever????? In this book???? Are we just gonna keep glossing over that????
3. Freeman wanted his procedures to be done by any psychiatrist in any setting so he would canonically support getting your lobotomy at Claire’s
4. The China doll phenomenon is so freaking interesting to me
5. THE OPENING OF WATTS AND FREEMANS BOOK???? WITH A WHIPPING CREAM BLENDER IN THE SKULL??? WHO THOUGHT THIS WAS A GOOD IDEA???
6. THE FREEMAN WATTS LOBOTOMY IN THE OFFICE DESCRIBED BY WATTS ACTUALLY HAS ME ROLLING. When are we gonna get an odd couple-esc sitcom except it’s Watts and Freeman’s shared office?
I can’t stop reading “astounded to see Freeman standing over an unconscious patient who had an icepick protruding from his face” to the pace of “Shocked and slightly embarrassed at the sight of Larry in a towel…” from silly songs with Larry.
7. The way Henry Stack hates this man, I relate hard-core to him.
He’s so real for that reaction
8. He doesn’t like Chlorpromazine because of the side effects like…girl the side effects of lobotomies include death what are you yapping about
9. The dramatic highschool breakup of Freeman and Watts
10. FREEMAN HAVING THE AUDACITY TO ASK MONIZ FOR A PICTURE OF HIS CRIPPLED HANDS??????????? 😭 FOR WHAT????
11. THE LIMERICK DISS TRACKS. Why was everyone so obsessed with Limericks in 1950/60s medical circles and why were they all fire?
Eminem has been real quiet since this dropped
12. Freeman consistently acting like a toddler
Freeman is genuinely so absurd. He is a monster who has ruined the lives of mental patients confined to insane asylums which is why I can do nothing but laugh at the absurdity of his ignorance and misplaced confidence in himself.
ANNOTATIONS:
He may be ableist but he draws the line at racism
Someone finally has a freaking brain in this book (...... ok bad saying for a book about lobotomies but you get my meaning)
This line goes so hard and wasn’t brought up enough in the debates around lobotomy.
My friend group
You’re right get me the salt I’m sending this fucker back to hell
TLDR: I wanted a history of lobotomies, I got a history of lobotomies. I hate the author, Fulton is my favorite, Freeman can go die in a pit, family road trips are so immensely boring to read about. 4.5 stars because I like the history 1 star for the author being terrible at everything.
☆1 / ☆4.5 ▪︎ 312 pages
“Is the quieting of the patient a cure?” He asked. “Perhaps all it accomplishes is to make things more convenient for the people who have to nurse them”
-Nolan Lewis
I have really gone back and forth on what to rate this book because my reviews have always been based on how much I have enjoyed reading a book rather than the content. If that’s the case this book would get 5 stars because I loved learning more about this history HOWEVER the author is presenting this story in such a problematic way and I’m concerned.
So, in my little heart this book gets ☆4.5 (-.5 because I wanted less road trips, more info on the lobotomobile, more on Rosemary Kennedy, and more of the tales of patients that went wrong) but this book is getting ☆1 because SCREW YOU JACK EL-HAI (we all say in unison)
I want to touch on two major things in this book: The content as a whole, and the author of this book
I think I should start with what I thought of the author of this book
Right out of the gate I’m going to say: He was way too empathetic towards Freeman. I mean, no kidding look at the subtitle of the book: a MAVERICK medical GENIUS and his TRAGIC quest to RID THE WORLD OF MENTAL ILLNESS. All of those words are compliments towards freeman.
Even without the obvious clues in the heading, you can spot the slant towards pro freeman in the book itself. Sometimes it’s sneaky and you’ll only notice it if you’re looking for it, other times it’s so obvious the author is trying (and failing) to make Freeman sound good that it’s laughable. Look at the prologue:
What I heard of Richard’s experience supported my old notions of lobotomy, and they stayed with me for a long time. And I still maintained them when I drew up my proposal for this book. Then I faced the mountain of documents left by Freeman
Notice how he specifically phrases this in a way that shows that disagreeing with lobotomy is an opinion that comes from a lack of knowledge that will be changed when enlightened. Believing lobotomy can be harmful to a patient is an “old notion” The language used here clearly tells you what the author thinks of lobotomy and what he wants the reader to think of lobotomy-and by extension Freeman-by the end of this book.
The book shows Freeman in a clearly positive light sprinkled with criticisms from other scientists on this procedure, I can’t think of a time when the author reprimands Freeman himself.
Look at the segment where Freeman first decides to use an ice pick for his lobotomies. This is the definitive point where you start to feel that Freeman is losing his mind. I mean, he takes an ice pick from the back of his kitchen drawer and decides “This would be the perfect thing to shove into someone’s eye socket to reach the brain and swish around in there blind” It is the point where Freeman will easily lose favor with readers of this biography (if he hasn’t lost them already)
Freeman’s ice pick is introduced in Chapter 9 titled “Waterfall” It is introduced on page 181, he’s shown to really start losing it when he performs a lobotomy with his ice pick in the shared office of Freeman and Watts on page 191 and then the author does something very interesting. On page 201, within the same chapter of these two major events, the author recounts the story of Freeman losing his 11 y/o son when he tragically dies via waterfall.
This story is very oddly placed. The entire chapter talks about the ice pick, the falling out between Freeman and Watts, the invention of the orbitoclast and the first transorbital lobotomy patients which are all huge parts of the history of lobotomy and then tacked on at the end is this story of Freeman losing his son. Not only that, but the author thinks this so important that he names the chapter waterfall. The author pairs Freemans most inhumane moments with his most humane and tragic one to try to keep the reader empathetic toward Freeman. You end the chapter with this story, and the chapter title suggests that what the author wants you to remember from this is the waterfall, none of the other concerning things that are stated in this chapter.
Could I be looking too much into this and could the author have included this because it took place at the same time as these other events? Sure, but I find everything to be very purposeful and I will keep my tin foil hat on for this.
I think what really made me dislike El-Hai’s writing was how he put so much effort into humanizing Freeman, and humanizing his patients that improved, but then made the patients who were worse off feel like an afterthought.
This is most evident on page 277 in the case of Violet Silver. El-Hai states she was a violin player before she was plagued by schizophrenia and lost her passion for the violin. After her lobotomy, she returned to playing the violin where she performed “numerous recitals” and taught several students. She even wrote an operetta. This story is then juxtaposed with Josef Hassid who was also a violin prodigy with schizophrenia who was lobotomized, only the lobotomy had complications and he died from infection. What is truly gross about these stories is, this could have been a very powerful example of how lobotomies were very hit or miss. It could lull the reader into a false sense of siding with Freeman at the improvement of Silver for them to then be smacked in the face with the fame of Hassid that never was. What did the author do instead? He wrote about Violet’s story and then included Josef’s IN PARENTHESIS. The patients who were harmed seem like an afterthought that the author only threw in so he could say “Look! I included the bad stories, too!” to escape criticism.
I found great enjoyment from El-Hai trying to make Freeman seem alright during the whole ice pick thing though:
Freeman coveted the role as the bearer of a new safe and more widely available psychosurgical procedure
HE USED A FREAKING ICE PICK FROM THE BACK OF HIS KITCHEN DRAWER, JACK. BE FOR REAL.
…when he inserted his surgical ice pick
DON’T EVEN PRETEND AN ICE PICK IS SURGICAL YOU’RE BETTER THAN THIS.
Personally, I think it’s important to note 2 things about Freeman: 1 He was egotistical and prideful to a fault where he endangered his patients and ignored clear warning signs and 2 He’s a fun guy to read about.
I can’t sit here and act like I don’t enjoy his showmanship and his brash nature and disregard for critics that’s so fun to read. I can acknowledge that I love how he’s so passionate about his work that he comes off as insane while also acknowledging he’s in the wrong 100% of the time and has definitely harmed a large majority of his patients because of his “quirks.”
Freeman is someone you can relate to, he’s passionate, he’s brazen. I love reading about him and from the context in this book you can start to understand why he was so stubborn about lobotomies. I’m talking specifically about the shotgun story. A soldier obsessed with suicide went for a lobotomy and then 2 years after the operation, the patient returned with a long narrow box.
“Take this Doc,” he told Freeman. “I’ve decided not to kill myself.” After he left, Freeman opened the box and discovered a rifle and a supply of ammunition. “I have a nice souvenir of a death weapon that might have been”
Freeman’s operations can make anyone hate him but when you see the positive impact some lobotomies had, it makes sense why Freeman was so passionate about it. So many patients reached out to him via letters thanking him for “giving them their life back” which is another reason why I’m so mad El-Hai didn’t spend more time with the people with negative effects because having both of those present gives the reader this story that isn’t black and white.
Freeman is a man whose passion for helping people is abused and you watch as he slowly becomes more and more stubborn in his ways, denouncing treatments that would help a patient more than a lobotomy would just because he’s so attached to it. He felt that some day lobotomy wouldn’t be so controversial and he’d finally get recognition but that never came and the lobotomy became obsolete.
These are all things you can empathize with which then makes you question everything you knew about lobotomy and about the man behind it which I LOVE in media because it really reminds you that life is never black and white. WHICH IS ALSO WHY I’M SO MAD THIS BOOK IS SLANTED TOWARDS FREEMAN BECAUSE GIVE ME AN ULTIMATUM DAMMIT!! DON’T SUGAR COAT THIS DUDE HE ACTS LIKE A TODDLER.
This is also just…. Concerning?? I’ve looked into lobotomies outside of this book and know how damaging they can be to the patient so there was never a point where I thought “Wait actually lobotomies are probably really good” but not everyone will have that same experience. This biography paints lobotomies and Freeman himself in such a “misunderstood” way that I can’t help but feel worried about what conclusions people will come to at the end of this book.
I also want to note how insane the reviews plastered on the cover are: “In Jack El-Hai’s lively biography, Freeman comes across as a classic American type, a do-gooder and a go-getter with a bit of the huckster thrown in”
Freeman ridiculed the use of chlorpromazine because of side effects like runny nose, diarrhea, tremors, and muscular rigidity while his lobotomies had side effects like death.
Freeman's grandfather pioneered antiseptics and he, quote: “...his later partner recalled Freeman's exhortations against ‘all that germ crap’ and his annoyance with sterile procedures” Even with this statement, he still had the gall to compare himself to his grandfather because people were against antiseptics just like they were with lobotomies.
During a presentation about lobotomies where he received criticism during questions, he spilled out a box containing over 500 Christmas cards he had received from lobotomy patients and said “How many Christmas cards do you get from your patients?”
Freeman decided an ice pick from the back of his kitchen drawer would be a good tool to use in a medical procedure involving an organ with the least amount of information known about it.
Freeman performed lobotomies on children, cutting healthy tissue of a brain that was nowhere near being fully developed.
Freeman is not the classic American hero, he is a passionately dangerous idiot who has done so much harm and you’re over here like “do-gooder 🤭 and go-getter 😘with a bit 💅of the huckster😜 thrown in✨” Did we read the same book?
I really disliked how the author presented his text, but I do enjoy how engaging this biography was. I can’t lie, I really enjoyed reading this book because of the history so let me get on to those parts.
I became interested in the history of lobotomies back in February and dove into any details I could find. Unfortunately most articles just regurgitated surface level information but I wanted to know more so I ordered this book. It really accomplished what I wanted: a more in depth look at the history of lobotomies. I really enjoyed this read because I knew the main framework and the turning points in the story which helped me fit all of the details together. Having these parts of the narrative show up had me giggling and kicking my feet. I’d definitely recommend knowing something about lobotomy before reading this book just so you can keep everything straight in your head but it’s not necessary.
What happened immediately after remains one of the most debated sequences of events in the history of psychiatric medicine
I was giggling and twirling my hair when I read that
I also just have to dedicate something to John Fulton because I love him. Take a shot every time he randomly shows up in this memoir. When I read the whole story of lobotomy he was shown as the catalyst from his experiments with primates and then is never mentioned again when really he was a friend to both Freeman and Watts and comes back throughout the book to be the only sane person. He’s my pookie, if Fulton has 100 fans I’m #1, if he has 0 fans I’m dead, you get the point.
Fulton chastised his friend. "What are these terrible things I hear about you doing lobotomies in your office with an ice pick?" He wrote. "I have just been to California and Minnesota and heard about it in both places. Why not use a shotgun? It would be quicker!"
I love him.
He literally presented primates he lobotomized like “Yea and this concludes that the frontal lobe is the source of thought and reason” “Cool cool cool so when are we doing this on the mentally ill?” “What.”
Also note that this story ^ is wildly disputed and this account was told by Fulton himself but like come on, that makes me love him more. He just insinuated he was the main inspiration for Moniz’s leucotomy and that could 100% be a lie you’ve gotta admit that’s a little bit iconic of him.
Other than John Fulton I enjoyed a lot of things from this book which I’ll list here along with other random notes I had while reading:
1. Freeman fangirling over Moniz will never not be funny to me
He found himself struck by “the scientific genius of the man”
Bros got a lil crush
2. The way Freeman was never a surgeon???? Ever????? In this book???? Are we just gonna keep glossing over that????
3. Freeman wanted his procedures to be done by any psychiatrist in any setting so he would canonically support getting your lobotomy at Claire’s
4. The China doll phenomenon is so freaking interesting to me
5. THE OPENING OF WATTS AND FREEMANS BOOK???? WITH A WHIPPING CREAM BLENDER IN THE SKULL??? WHO THOUGHT THIS WAS A GOOD IDEA???
6. THE FREEMAN WATTS LOBOTOMY IN THE OFFICE DESCRIBED BY WATTS ACTUALLY HAS ME ROLLING. When are we gonna get an odd couple-esc sitcom except it’s Watts and Freeman’s shared office?
Earlier, [Watts] had asked Freeman not to give lobotomies to patients in the offices that Watts and Freeman shared. An office assistant, he said, informed him of Freeman’s experimental surgeries. On the occasion of the tenth transorbital lobotomy, Watts walked upstairs and-astounded to see Freeman standing over an unconscious patient who had an icepick protruding from his face- interrupted the operation in progress. Without showing any surprise at this intrusion, Freeman gamely asked Watts to hold the ice pick while he snapped a photograph
I can’t stop reading “astounded to see Freeman standing over an unconscious patient who had an icepick protruding from his face” to the pace of “Shocked and slightly embarrassed at the sight of Larry in a towel…” from silly songs with Larry.
7. The way Henry Stack hates this man, I relate hard-core to him.
In the spring of 1948 at a cocktail party during the annual meeting of the American Psychiatric Association in Washington, Freeman approached psychoanalytically oriented opponent Henry Stack Sullivan with the greeting “How goes it, Harry?” Sullivan’s response shocked Freeman. “He raised his fists overhead, contorted his face, thoroughly enraged, saying, “Why do you persist in annoying me?”
He’s so real for that reaction
8. He doesn’t like Chlorpromazine because of the side effects like…girl the side effects of lobotomies include death what are you yapping about
9. The dramatic highschool breakup of Freeman and Watts
Freeman’s departure saddened Watts, who continued to admire his old partner despite their conflict over the use of transorbital lobotomy. “When he left Washington, some of the sparkle left,” Watts later declared
10. FREEMAN HAVING THE AUDACITY TO ASK MONIZ FOR A PICTURE OF HIS CRIPPLED HANDS??????????? 😭 FOR WHAT????
11. THE LIMERICK DISS TRACKS. Why was everyone so obsessed with Limericks in 1950/60s medical circles and why were they all fire?
A fellow named Freeman said: “I’ve
A sharp little knife that I drive;
If you want to be dead
I’ll bore holes in your head
And then you won’t know you’re alive”
Eminem has been real quiet since this dropped
12. Freeman consistently acting like a toddler
Freeman spilled out a box containing more than five hundred Christas cards he had received from lobotomy patients. “How many Christmas cards did you get from your patients?” He challenged his main critic in the audience
“When the laughter subsided, I paused for a moment and began: ‘What I am going to talk about is not funny. It’s serious’...
Freeman is genuinely so absurd. He is a monster who has ruined the lives of mental patients confined to insane asylums which is why I can do nothing but laugh at the absurdity of his ignorance and misplaced confidence in himself.
ANNOTATIONS:
When Freeman became president of the society a quarter-century on, he worked to overturn the remaining barriers to the admittance of doctors who were not white
He may be ableist but he draws the line at racism
White questioned the ability of a mentally ill patient to competently authorize a hazardous procedure like a lobotomy, and he knew that patients’ families might have ulterior motives for allowing the surgery
Someone finally has a freaking brain in this book (...... ok bad saying for a book about lobotomies but you get my meaning)
Playing with a patient’s personality amounted to tampering with his or her human essence. Lobotomy threatened to alter a patient’s emotions, sense of altruism, and sense of humor- all traits that separate humans from animals
This line goes so hard and wasn’t brought up enough in the debates around lobotomy.
“Therefore, we have to fall back upon cripples, women and foreigners ”
My friend group
We should not allow Walter Freeman’s ghost to flicker unnoticed in the shadows
You’re right get me the salt I’m sending this fucker back to hell
TLDR: I wanted a history of lobotomies, I got a history of lobotomies. I hate the author, Fulton is my favorite, Freeman can go die in a pit, family road trips are so immensely boring to read about. 4.5 stars because I like the history 1 star for the author being terrible at everything.
☆1 / ☆4.5 ▪︎ 312 pages
February 24, 2025
The Lobotomist
⭐️ ⭐️ ⭐️ ⭐️
I finished this book up last night. Other than the book jumping around chronologically, which can be a bit confusing, this book was very interesting.
Dr. Walter Freemab ranks as the most scorned physician of the twentieth century aside from the Nazi doctor, Josef Mengele (which is saying a lot)!
I really do think he was a very intelligent man during this time period, however, I think he let the need of recognition and applause by his peers get in the way that he ignored the negative outcomes on the pts and only focused on the thriving ones.
This author also showed the progress of psychosurgery, psychiatry, and neurosurgery and how they almost fought each other over territory.
Another interesting fact, in the 1960s Dr. Freeman devoted an intensity and energy to the state of WV that he surpassed nowhere else (wow) this result that its per capita rate of lobotomy was the highest in the nation. His top hospitals in WV were located in Huntington, Spencer, and Lakin.
Also, I forgot to mention that majority of the pts who were lobotomized were schizophrenic. I think also having some of the pts that were lobotomized in this book would have been very useful for a full picture review but none were provided only the info he had on some pts. I do have a book to read of a lobotomy that was performed by him which is a memoir so I can’t wait to read his outcome.
⭐️ ⭐️ ⭐️ ⭐️
I finished this book up last night. Other than the book jumping around chronologically, which can be a bit confusing, this book was very interesting.
Dr. Walter Freemab ranks as the most scorned physician of the twentieth century aside from the Nazi doctor, Josef Mengele (which is saying a lot)!
I really do think he was a very intelligent man during this time period, however, I think he let the need of recognition and applause by his peers get in the way that he ignored the negative outcomes on the pts and only focused on the thriving ones.
This author also showed the progress of psychosurgery, psychiatry, and neurosurgery and how they almost fought each other over territory.
Another interesting fact, in the 1960s Dr. Freeman devoted an intensity and energy to the state of WV that he surpassed nowhere else (wow) this result that its per capita rate of lobotomy was the highest in the nation. His top hospitals in WV were located in Huntington, Spencer, and Lakin.
Also, I forgot to mention that majority of the pts who were lobotomized were schizophrenic. I think also having some of the pts that were lobotomized in this book would have been very useful for a full picture review but none were provided only the info he had on some pts. I do have a book to read of a lobotomy that was performed by him which is a memoir so I can’t wait to read his outcome.
November 9, 2021
With this book Jack El Hai does the seemingly impossible, he takes a reviled American 'monster' and turns him into a three dimensional human, with the same loves, wants, needs and ambitions that we all share to some degree. He also places Walter Freeman's obsessive focus on prefrontal/ocular lobotomy within context of the medicine of the time, which is incredibly important in understanding both the man himself and the cultural medical need for psychosurgery.
I came to this book with headline knowledge of Dr Freeman from a couple of documentaries including interviews with former patients and families of patients, where certainly harm had been caused, which had given me a definite dislike for the man, and much to my surprise (and I think much like the author) I found a human, flawed like the rest of us, who I quite admired in some ways.
An incredibly intelligent man who was doing his best with the knowledge he had, in the early years, before sadly hubris & a deep egoistic need for significant recognition by his peers led him to focus so intently on his chosen path he ignored all evidence against it's success, focusing only on patient outcomes that reinforced his beliefs. He forgot the science.
I found particularly poignant a sentence partway through the book where either the author or one of Walters children says something like "if only he'd have turned that incredible intelligence and energy in another medical direction" and I think this is probably the saddest thing about Dr Freeman's life - he really could have been great.
This truly is a fascinating read about a fascinating period in American medical history, it totally brings alive the zeitgeist of the early progress of psychosurgery & psychiatry & neurosurgery, and the way they almost fought each other for territory over mental health conditions before medication like prozac became available.
I have two small criticisms of this book - the first is that it jumps around quite a lot chronologically, which can become a bit irritating & confusing. The second is that I feel the author played down the serious harms caused by Dr Freeman (and others) through lobotomies - there are plenty of patients stories out there & I feel it would have been useful and fair to have included some for a balanced picture.
I came to this book with headline knowledge of Dr Freeman from a couple of documentaries including interviews with former patients and families of patients, where certainly harm had been caused, which had given me a definite dislike for the man, and much to my surprise (and I think much like the author) I found a human, flawed like the rest of us, who I quite admired in some ways.
An incredibly intelligent man who was doing his best with the knowledge he had, in the early years, before sadly hubris & a deep egoistic need for significant recognition by his peers led him to focus so intently on his chosen path he ignored all evidence against it's success, focusing only on patient outcomes that reinforced his beliefs. He forgot the science.
I found particularly poignant a sentence partway through the book where either the author or one of Walters children says something like "if only he'd have turned that incredible intelligence and energy in another medical direction" and I think this is probably the saddest thing about Dr Freeman's life - he really could have been great.
This truly is a fascinating read about a fascinating period in American medical history, it totally brings alive the zeitgeist of the early progress of psychosurgery & psychiatry & neurosurgery, and the way they almost fought each other for territory over mental health conditions before medication like prozac became available.
I have two small criticisms of this book - the first is that it jumps around quite a lot chronologically, which can become a bit irritating & confusing. The second is that I feel the author played down the serious harms caused by Dr Freeman (and others) through lobotomies - there are plenty of patients stories out there & I feel it would have been useful and fair to have included some for a balanced picture.
October 5, 2019
"The Lobotomist" is an interesting portrait of Walter Freeman and I believe can be summarised in the saying, 'the road to hell is paved with good intentions'. Freeman is compelled to liberate thousands of patients from affective disorders and schizophrenia by use of lobotomy. His intentions are to help patients re-integrate back into society by destroying segments of the pre-frontal cortex. This procedure markedly reduces symptoms of anxiety and paranoia, leaving the patient free to focus on more desirable emotions. An extreme procedure for patients where all else has failed...or at least that is how Freeman's journey begins.
As Freeman's career progresses, he begins performing ice-pick lobotomies in his own private practice unassisted by a trained surgeon. He also worryingly advocates for the use of lobotomy on teenagers and other patients who may be better suited to less invasive surgical methods. Freeman's downfall was his outspoken advocacy for the wide spread use of the lobotomy after alternate methods were supported to yield better patient recovery outcomes.
The author has presented a well-rounded portrait of Walter Freeman, despite how easy it would have been to demonise Freeman's actions and career. Freeman's work is also placed in context of the medical landscape during the popularisation of the lobotomy. While it is an interesting subject, I did find myself becoming lost in the finer details and the sheer amount of information crammed into "The Lobotomist". It was not a light read, that's for sure. However, Freeman's work laid much of the early research into psychosurgery and was an important milestone to understanding the brain's role in regulating mental health.
As Freeman's career progresses, he begins performing ice-pick lobotomies in his own private practice unassisted by a trained surgeon. He also worryingly advocates for the use of lobotomy on teenagers and other patients who may be better suited to less invasive surgical methods. Freeman's downfall was his outspoken advocacy for the wide spread use of the lobotomy after alternate methods were supported to yield better patient recovery outcomes.
The author has presented a well-rounded portrait of Walter Freeman, despite how easy it would have been to demonise Freeman's actions and career. Freeman's work is also placed in context of the medical landscape during the popularisation of the lobotomy. While it is an interesting subject, I did find myself becoming lost in the finer details and the sheer amount of information crammed into "The Lobotomist". It was not a light read, that's for sure. However, Freeman's work laid much of the early research into psychosurgery and was an important milestone to understanding the brain's role in regulating mental health.
October 17, 2011
I like books that debunk "what everybody knows." This is one of those books. Walter Freeman emerged as a fascinating person. He was no saint in his personal life, with an extra helping of the mid-20th century American strategy of focusing intently on work, excercise, and travel in order to forestall any dangerous introspection that might undermine his bluff self-confidence. He was impatient to get out there and start helping people, with his brand-new tool that seemed to work. It was touching how he followed up with former patients for the rest of his life, but significant that all of his "research" and follow-up was anecdotal. He was making a case for psychosurgery, because he saw it as his chance to be remembered as a genius - as opposed to trying to determine whether the surgery benefited patients.
I didn't know much about mental institutions and the lives of mentally ill Americans in the years before pharmaceutical treatments were available. This book explained the origin of some torturous treaments formerly used to treat people with a wide range of illnesses. If my options were to live with untreated schizophrenia, transorbital lobotomy, insulin shock, or repeatedly induced hypothermia, I might have gone with a lobotomy too.
I didn't know much about mental institutions and the lives of mentally ill Americans in the years before pharmaceutical treatments were available. This book explained the origin of some torturous treaments formerly used to treat people with a wide range of illnesses. If my options were to live with untreated schizophrenia, transorbital lobotomy, insulin shock, or repeatedly induced hypothermia, I might have gone with a lobotomy too.
August 12, 2011
Probably really more of a 3.5, but I'm just not enthusiastic enough about it to round up to a 4. I found this book informative and easy to read, and the topic was unique enough to hold my interest, but ultimately I think that this was the story of an ordinary person--one who was self-centered, privileged, and just smart enough to be dangerous--who, through a combination of hard work, ego, and pursuit of the American dream, managed to shit all over medical ethics for years. And unfortunately, I think this kind of thing happens all the time, in a wide variety of fields, and it's something we in this culture kind of glorify, this reckless ambition and desire to achieve that put rules and restraints on the back burner, and I think it usually ends up hurting more people than it helps. El-Hai seems to be aware of this (I mean, just read the title), and I think he does a respectable job with his source material, but this sort of thing is not something I look forward to going back and rereading, and it's not the sort of thing I'm eager to recommend to friends, and that's what's holding this book back from being a 4.
August 1, 2013
Fascinating biography of Freeman and his campaign to make lobotomy a common practice for the cure of mental illness, especially mood disorders.
Reading this, it's kind of horrifying to think that Freeman's transorbital lobotomy was such a common practice - especially given that he didn't always work in aseptic conditions, and didn't hesitate to lobotomise young children, or to lobotomise some patients two or three times. Especially given that there was so little actual evidence that it did anything at all. He claimed that his patients were mostly helped, and you have to admire how much he tried to follow up with them, but there was little actual data on the befores and afters (except Freeman's portraits).
This left me with the possible idea that maybe Freeman was as il as some of his patients. He was certainly an obsessive, and the level of showmanship he incorporated into his displays just boggles the mind.
I do wonder what a world would be like where psychiatric drugs didn't come into common use, though, since it was their rise, in part, that led to the downfall of lobotomy.
Reading this, it's kind of horrifying to think that Freeman's transorbital lobotomy was such a common practice - especially given that he didn't always work in aseptic conditions, and didn't hesitate to lobotomise young children, or to lobotomise some patients two or three times. Especially given that there was so little actual evidence that it did anything at all. He claimed that his patients were mostly helped, and you have to admire how much he tried to follow up with them, but there was little actual data on the befores and afters (except Freeman's portraits).
This left me with the possible idea that maybe Freeman was as il as some of his patients. He was certainly an obsessive, and the level of showmanship he incorporated into his displays just boggles the mind.
I do wonder what a world would be like where psychiatric drugs didn't come into common use, though, since it was their rise, in part, that led to the downfall of lobotomy.
July 14, 2014
Lots of interesting tidbits here about the man who popularized the lobotomy in the U.S. I've been fascinated by this topic for a few weeks now, and this book didn't disappoint. Most sources take a very negative view of Dr. Freeman, but this biography was more sympathetic. I found I admired some of his good qualities while still reviling the destructiveness of the procedure that brought him fame.
July 2, 2023
Increíble lo que se consideró "ciencia" en un momento dado y como experimentos basados, más en los deseos de los médicos que en evidencia, marcó el tratamiento por muchos años. A veces me pregunto: ¿qué tanto sabemos hoy en día, que tan firme es nuestra "ciencia"?
January 15, 2009
For a journalist, this guy has the worst organizational writing skills I've ever seen. Am 5 chapters in and still haven't even gotten to the first lobotomy.
January 10, 2010
A quibble, but I would have enjoyed the book more if it had been a history of lobotomy rather than a biography of Freeman.
July 17, 2019
A good look at the history of lobotomy, but at times it was difficult to get through this book.
November 17, 2023
The butler did it.
March 26, 2023
first, some comments on the organisation of this book: it was generally chronological, and therefore rather repetitive. we learn thru multiple people and multiple events that Walter Freeman was a showboat, almost a carnival barker within the medical profession. He presented models at conferences rather than papers, preferred demonstrations and leaned heavily on shock value to keep the classroom attentive. He once operated on 25 female patients in a single day for a challenge. With dramatic flair, he once used a carpenter's hammer (instead of a surgeon's silver-coated mallet) and lay it upon the patient's chest as he manoeuvred to the other side. He was an avid amateur photographer and photographed his own patients and procedures, even killing one as his instrument sunk further into the brain tissue as he set up the photograph. For instructional purposes and for publicity, he film himself doing his famous procedure. One of his most treasured possessions was a portrait of himself he commissioned.
It was Egas Moniz that pioneered the practise of what was then called leucotomy, a drilling into the skull and removal of thin cores of brain tissue, but it was Freeman, with his partner James Watts, who further refined the technique numerous times to the procedure that is known today as lobotomy. A procedure that originally took hours was ultimately altered to an ice pick through the eye socket and required less than 10 minutes to perform.
He travelled extensively. In the early days in was to locate patients, later it was to up his numbers and gain a reputation, and at the end it was to visit past patients and note their results. Even for his vacations time, he took his children in a RV and criss-crossed the country. Later still, he travelled with his grandchildren when delivering talks and visiting former patients. When not actively working or attending conferences, he would be hiking. He had a manic-like drive in all aspects of his life. He took copious notes - on kilometres driven, on places been, on numbers of patients, diary entries, patient records. He wrote books that skewed closer to anecdotes than true scientific inquiry. He used the press - calling on a journalist to witness a leucotomy - to short-cut public perception of lobotomies
with the controversial removal of healthy tissue from patients, lobotomies laid bare the conflict between biological and behavioral camps of psychiatry but Freeman was certain he was doing a public good- performing almost 30,000 himself and teaching many other surgeons. at the height of the lobotomy acceptance, the US Veterans Administration embraced it and VA hospitals were performing an average of 48 lobotomies a month. even more crazy, the CIA secretly investigated using this psychosurgery as a political tool, reporting that a lobotomized communist would "retain their interest in communism but their drive, zeal, and ability to organize would be substantially reduced." It took the invention of psychiatric medicines like chlorpromazine which gave similar results without surgery for lobotomies to finally be curbed.
it was hard to rate this book objectively. Freeman left so many documents and I guess the author did a through job of collating them without bringing his own judgement upon him or the documents, but - as I said at the start of the review - it was repetitive and I felt my time was wasted learning all the minutiae of his life. the only benefit to detailing this man's dedication is in it's comparison to the current zeal for gender medicine: this time it's numerous doctors certain they are embarking on a crusade to better their patients' lives. Time will tell if they were as deluded as Freeman.
It was Egas Moniz that pioneered the practise of what was then called leucotomy, a drilling into the skull and removal of thin cores of brain tissue, but it was Freeman, with his partner James Watts, who further refined the technique numerous times to the procedure that is known today as lobotomy. A procedure that originally took hours was ultimately altered to an ice pick through the eye socket and required less than 10 minutes to perform.
He travelled extensively. In the early days in was to locate patients, later it was to up his numbers and gain a reputation, and at the end it was to visit past patients and note their results. Even for his vacations time, he took his children in a RV and criss-crossed the country. Later still, he travelled with his grandchildren when delivering talks and visiting former patients. When not actively working or attending conferences, he would be hiking. He had a manic-like drive in all aspects of his life. He took copious notes - on kilometres driven, on places been, on numbers of patients, diary entries, patient records. He wrote books that skewed closer to anecdotes than true scientific inquiry. He used the press - calling on a journalist to witness a leucotomy - to short-cut public perception of lobotomies
with the controversial removal of healthy tissue from patients, lobotomies laid bare the conflict between biological and behavioral camps of psychiatry but Freeman was certain he was doing a public good- performing almost 30,000 himself and teaching many other surgeons. at the height of the lobotomy acceptance, the US Veterans Administration embraced it and VA hospitals were performing an average of 48 lobotomies a month. even more crazy, the CIA secretly investigated using this psychosurgery as a political tool, reporting that a lobotomized communist would "retain their interest in communism but their drive, zeal, and ability to organize would be substantially reduced." It took the invention of psychiatric medicines like chlorpromazine which gave similar results without surgery for lobotomies to finally be curbed.
it was hard to rate this book objectively. Freeman left so many documents and I guess the author did a through job of collating them without bringing his own judgement upon him or the documents, but - as I said at the start of the review - it was repetitive and I felt my time was wasted learning all the minutiae of his life. the only benefit to detailing this man's dedication is in it's comparison to the current zeal for gender medicine: this time it's numerous doctors certain they are embarking on a crusade to better their patients' lives. Time will tell if they were as deluded as Freeman.
September 14, 2023
El-Hai is jarringly sympathetic to Dr. Freeman. I'm not.
I think some of this sympathy results from El-Hai frequently citing Dr. Freeman's children as sources. This is despite the fact his kids became what the Guardian called "staunch defenders" of their father's legacy.
And to some extent, I get it. I mean, their dad invented the ice-pick lobotomy. What a time bomb of an inheritance. So, I think a family legacy that thorny is something family members would either make half-assed efforts to defend, or a grenade to run the hell away from. I think Dr. Freeman's kids should have done the latter instead of so vigorously defending their dad. But I can at least see why they closed ranks.
That said, I think a biographer cannot just accept those kinds of positive narratives unquestionably. And as a result, I think El-Hai's book suffered from major journalistic neutrality problems. I don't think it suffers from the author trying to promote an agenda. I think he tried hard to be neutral.
Rather, I think the author tried tried too hard to stay neutral. It seemed that at nearly every morally ambiguous juncture, El-Hai chose the far-fetched, charitable explanation over the obvious, morally suspect one. And that quickly became frustrating and predictable.
You can get away with that a few times, for the right reasons. But do that too frequently, without sufficient justification, and you'll torpedo your own neutrality. And I think that holds even here, where the author seems to have repeatedly done this in a well-intentioned effort to stay neutral about a reviled guy.
Let's get back to the facts, though. There were real reasons Dr. Freeman was and is reviled. The guy performed crude brain surgeries on over 4,000 patients over multiple decades. And these are just the thousands he himself did, not the ones he convinced other doctors to perform. He performed many of his surgeries in his own office, without sterilization, and with no formal surgical training. By estimates I've read, Freeman's operations had a 15% fatality rate, but he buried or outright concealed that grim figure behind a tidal wave of anecdotal accounts of alleged success stories.
Conservatively, the guy killed hundreds by his negligence, or perhaps by his wilful blindness to the wreckage he left in his wake. And where patients did not die, it is hard to say they were improved by the surgeries. That is, not improved except maybe in the eyes of state hospital administrators or fed-up families who ended up with more docile, if not deadened, charges. And at least these days, thankfully, sacrificing mental patients' sentience for ease of care hardly seems a noble goal.
So, I don't think Dr. Freeman was a "maverick medical genius" on a "tragic quest to rid the world of mental illness," as the title claims. Okay, a maverick, sure. But I'm not giving Dr. Freeman any more honourifics than that.
I think some of this sympathy results from El-Hai frequently citing Dr. Freeman's children as sources. This is despite the fact his kids became what the Guardian called "staunch defenders" of their father's legacy.
And to some extent, I get it. I mean, their dad invented the ice-pick lobotomy. What a time bomb of an inheritance. So, I think a family legacy that thorny is something family members would either make half-assed efforts to defend, or a grenade to run the hell away from. I think Dr. Freeman's kids should have done the latter instead of so vigorously defending their dad. But I can at least see why they closed ranks.
That said, I think a biographer cannot just accept those kinds of positive narratives unquestionably. And as a result, I think El-Hai's book suffered from major journalistic neutrality problems. I don't think it suffers from the author trying to promote an agenda. I think he tried hard to be neutral.
Rather, I think the author tried tried too hard to stay neutral. It seemed that at nearly every morally ambiguous juncture, El-Hai chose the far-fetched, charitable explanation over the obvious, morally suspect one. And that quickly became frustrating and predictable.
You can get away with that a few times, for the right reasons. But do that too frequently, without sufficient justification, and you'll torpedo your own neutrality. And I think that holds even here, where the author seems to have repeatedly done this in a well-intentioned effort to stay neutral about a reviled guy.
Let's get back to the facts, though. There were real reasons Dr. Freeman was and is reviled. The guy performed crude brain surgeries on over 4,000 patients over multiple decades. And these are just the thousands he himself did, not the ones he convinced other doctors to perform. He performed many of his surgeries in his own office, without sterilization, and with no formal surgical training. By estimates I've read, Freeman's operations had a 15% fatality rate, but he buried or outright concealed that grim figure behind a tidal wave of anecdotal accounts of alleged success stories.
Conservatively, the guy killed hundreds by his negligence, or perhaps by his wilful blindness to the wreckage he left in his wake. And where patients did not die, it is hard to say they were improved by the surgeries. That is, not improved except maybe in the eyes of state hospital administrators or fed-up families who ended up with more docile, if not deadened, charges. And at least these days, thankfully, sacrificing mental patients' sentience for ease of care hardly seems a noble goal.
So, I don't think Dr. Freeman was a "maverick medical genius" on a "tragic quest to rid the world of mental illness," as the title claims. Okay, a maverick, sure. But I'm not giving Dr. Freeman any more honourifics than that.
October 8, 2025
I've read through some of the 1 and 2 star ratings for this book and would like to address some of the comments. The majority of these reviews claimed the author 'idolized' Dr. Freeman, or 'put him on a pedestal', which upset them for obvious reasons. What they wanted was a depiction of a mad scientist, a monster who preyed on the ill. Instead, they got a rather neutral depiction of the life of a visionary doctor.
Was Freeman a visionary? Yes. As horrific and upsetting as his methods were, chemical lobotomies are widely used today. The author discusses the first of these, chlorpromazine, the invention of which negated the use of surgical lobotomy.
My take away, is that Dr. Freeman was, in general, a regular doctor. Driven, to be sure, to find a solution to the overcrowding of mental institutions, to provide some level of relief for his patients, and by a desire for personal recognition. He didn't intend to be evil, or to be a mad scientist, though he pushed boundaries and often ignored safety protocols, as visionaries tend to do.
And that's the scary part. There have been dozens of Dr. Freeman's over the centuries, and there are dozens alive and practicing now. There are surgeries being preformed today that are as horrifying as lobotomy, and many of the same arguments are made for and against them. The consent issues remain and have been fought over in court with sometimes shocking results.
We pretend as a society that we have moved beyond these horrors, but we haven't. And that's where the value of this biography lies. As a warning.
The biography itself was well written and engaging. It isn't a flowery narrative, but a presentation of the facts. It often takes a sidebar to describe other surgeons of the era, present scientific theories of the time, and provide relevant personal details of Freedman's family members.
Personally, I wanted more detail about the children who received trans-orbital lobotomies. They were mentioned and the author went into some detail about the children who received pre-frontal lobotomies. This interest may come from my current read, which is an autobiography by someone who received a trans-orbital lobotomy from Dr. Freeman as a child.
Overall, the book is worth the read, even if it is difficult and shocking at times.
Was Freeman a visionary? Yes. As horrific and upsetting as his methods were, chemical lobotomies are widely used today. The author discusses the first of these, chlorpromazine, the invention of which negated the use of surgical lobotomy.
My take away, is that Dr. Freeman was, in general, a regular doctor. Driven, to be sure, to find a solution to the overcrowding of mental institutions, to provide some level of relief for his patients, and by a desire for personal recognition. He didn't intend to be evil, or to be a mad scientist, though he pushed boundaries and often ignored safety protocols, as visionaries tend to do.
And that's the scary part. There have been dozens of Dr. Freeman's over the centuries, and there are dozens alive and practicing now. There are surgeries being preformed today that are as horrifying as lobotomy, and many of the same arguments are made for and against them. The consent issues remain and have been fought over in court with sometimes shocking results.
We pretend as a society that we have moved beyond these horrors, but we haven't. And that's where the value of this biography lies. As a warning.
The biography itself was well written and engaging. It isn't a flowery narrative, but a presentation of the facts. It often takes a sidebar to describe other surgeons of the era, present scientific theories of the time, and provide relevant personal details of Freedman's family members.
Personally, I wanted more detail about the children who received trans-orbital lobotomies. They were mentioned and the author went into some detail about the children who received pre-frontal lobotomies. This interest may come from my current read, which is an autobiography by someone who received a trans-orbital lobotomy from Dr. Freeman as a child.
Overall, the book is worth the read, even if it is difficult and shocking at times.
July 28, 2017
The content of this book really seemed like it would be an interesting read. Indeed the information is fascinating but the way it is presented is chaotic. In just the first few chapters the author is constantly bouncing around different ideas and facts, sometimes with no understandable relevancy between them. The first chapter about Freeman's family becomes confusing when the author consistently switches between Freeman, his father, and grandfather without clearly distinguishing exactly whom is he talking about when. I have no doubt the author did extensive research in writing this book, as there are fascinating details, but it seems he struggled with exactly how he wanted to communicate that information. If you are a die-hard fan of psychosurgery and neurology then I suggest picking it up and looking through it to see if it's your cup of tea. If it is, you may also consider reading at least one chapter per sitting because it is a lot to digest and fairly hard to follow along or pick up later. Otherwise I can't suggest this book to your average fan of psychology. There are other places to get information on Walter Freeman and lobotomies that are much easier to follow.
May 1, 2025
This book was interesting but also irritated me almost immediately. i don't like el-hai, i think he's too subjective and sympathetic. There were so many times where the book went off on tangents about people and events that didn't really matter. this book could've been half the length it is. I get that el-hai was trying to humanize freeman or whatever but even with all those anecdotes about his life and family it's so obvious that he was a sociopath who was just fucking with people's brains and then STALKING THEM YEARS LATER. The last nonfiction book i read that pissed me off this much was The Immortal Life of Henrietta Lacks, but that one pissed me off because of the amount of injustice that that woman and her family faced. This one pissed me off because it was just about a guy hacking into people's brains for attention.
Things i found particularly appalling were freeman stalking his patients, his disregard for sterility, ELECTROCUTING HIS PATIENTS UNCONSCIOUS BEFORE SURGERY, the fact that he was NEVER trained as a surgeon, his parading patients in front of classes he taught, and his desperation for acclaim that was honestly just pathetic.
Things i found particularly appalling were freeman stalking his patients, his disregard for sterility, ELECTROCUTING HIS PATIENTS UNCONSCIOUS BEFORE SURGERY, the fact that he was NEVER trained as a surgeon, his parading patients in front of classes he taught, and his desperation for acclaim that was honestly just pathetic.
January 16, 2018
You probably picked up this book because you’re interested in neurology, psychology, psychiatry, and/or the evolution of related treatments over the years. Avoid this book and don’t waste your time wading through tangential vignettes about personal relationships and historical happenings that detract from the book’s purported purpose of exploring mental illness and lobotomies as treatment. Honestly, the best part of this book was the inside cover. It gave a fairly succinct explanation of the author’s goals – if only he had stayed as succinct and focused in the writing of the actual book, perhaps it would have been a worthwhile read. It appears El-Hai did an impressive amount of research for this book, but unfortunately decided to stuff nearly everything he learned into his writing, regardless of true relevance or necessity. I’m sure a more objective, concise account of Dr. Walter J. Freeman and his impact on the world of psychiatric treatment exists. No need to wade through this exhaustingly dry attempt.
November 19, 2023
biography of Walter Freeman, aggressive proponent of lobotomy as a treatment for difficult psychiatric problems. While we can look back and declaim the barbarity of his procedure, we are still doing much the same thing now with the advantages of technology and experience making the procedure more precise and acceptable. With the advent of computer aided diagnosis, analysis of diagnostic imaging and the ability to document changes in behavior and physical results of brain trauma, we can now better pinpoint areas that are causing problems in behavior and other psychiatric issues and address them with focused surgical therapies.
all pioneers risk being the scapegoat for failures in implementing their vision, and Dr Freeman is a prime example.
well written with an extensive notes and bibliography.
Photos would be interesting, but with HIPAA rules in effect, patient photos might be an issue.
all pioneers risk being the scapegoat for failures in implementing their vision, and Dr Freeman is a prime example.
well written with an extensive notes and bibliography.
Photos would be interesting, but with HIPAA rules in effect, patient photos might be an issue.
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