Doctor Ice Pick

by Claire Prentice

He preferred to use electric shock rather than an anesthetic, he said, because of the ease with which it could be administered to unruly patients and because it “hastens blood coagulation, and the patient regains consciousness rapidly and needs no nursing care afterward.”3 He typically gave each patient between two and four jolts of electricity to induce seizures, depending on the patient’s size and level of resistance. Sometimes a young child or an elderly person needed only one jolt to knock them out.

Without a break, Freeman lobotomized eighteen men, women, and children that afternoon, one after another, photographing them first and then cutting into their brains with breezy efficiency. His youngest patient was thirteen years old.

That summer, in just twelve days, he would lobotomize 228 men, women, and children from West Virginia’s five public hospitals.8

Freeman and Watts used women as their guinea pigs at a time when docility and compliance—both common outcomes of lobotomy—were upheld as feminine virtues. Of their first twenty patients, seventeen were female. This bias would continue for decades, with doctors across the country and internationally lobotomizing women disproportionately, at a rate estimated variously to be between 60 and 84 percent,16 even though men slightly outnumbered women as patients in America’s psychiatric hospitals.

Freeman and Watts diagnosed Rosemary with agitated depression. Joe Kennedy asked them to lobotomize her and insisted the operation be kept a secret. Rosemary was never consulted; not even her mother knew about the planned operation. As Watts cut, Freeman had Rosemary sing “God Bless America.” When she reached the chorus, he joined in. When Rosemary became incoherent, Watts stopped cutting. The operation had disastrous results. Rosemary could no longer look after herself. She was incontinent; her speech was slurred, and she walked with a limp. One of the nurses who witnessed the procedure was so horrified by what she saw that she left the medical profession. Rosemary would be dependent on caregivers for the rest of her life.

Lobotomy was given a further boost in 1949 when Moniz was awarded the Nobel Prize in Medicine for his groundbreaking use of the procedure. The prestigious prize helped give lobotomy greater legitimacy and a higher international profile.

Freeman’s competitive side manifested itself in childish rivalry. He wrote rude limericks about his professional foes and once remarked that he would “rather be wrong than be boring.”

Doctors at that time did not categorize and tabulate their patients according to sex, race, or socioeconomic background. But in time, it became clear that the procedure was being carried out disproportionately on the poor, who made up the majority of state hospital patients, and on women, not just by Freeman but by doctors across the country.

Freeman’s notes on his first patient, Alice Hood Hammatt, reveal his misogynistic attitude toward women: “She was a master at bitching and really led her husband a dog’s life. She worried if he was a few minutes late in coming from the office and raised the roof when things did not suit her. She was a typical insecure, rigid, emotional, claustrophobic individual throughout her mature existence.”75 If a housewife came to him complaining of anxiety or depression, Freeman suggested a lobotomy. In his notes, he recorded outcomes in which a female patient returned home to a life of domesticity and subservience as very successful. Underneath a photograph of a female schizophrenic patient, Freeman wrote: “Entranced by voices, this lady came down to earth and went back to keeping house.”76 He boasted to a reporter of another two women who, as a result of his surgical intervention, “have since married and become mothers of normal children.”77

Though he did not keep a statistical record of the ethnicity of those he operated on, race and racist stereotypes were factors in patient selection. Freeman expressed the view that Black psychiatric patients—especially women—made ideal candidates for lobotomy due to his belief that Black families provided a high level of aftercare for lobotomized relatives—or, in his words, because of “the greater family solidarity manifested by these people.”78

Tennessee Williams’s play Suddenly, Last Summer, inspired by his sister’s lobotomy, debuted on Broadway in 1958. It showed a wealthy, manipulative woman maneuvering to have her young niece subjected to lobotomy against her will. The film of the same name, starring Katharine Hepburn, Elizabeth Taylor, and Montgomery Clift, came out the following year. In 1962, Ken Kesey’s One Flew over the Cuckoo’s Nest was published. A damning indictment of psychiatric hospitals and the effects of lobotomy, it became a bestseller, was adapted for Broadway, and later was turned into a film starring Jack Nicholson. It fixed in the popular imagination the idea of lobotomy as barbaric and cruel and of lobotomists as sadists in white coats. The following year, Sylvia Plath’s novel, The Bell Jar, was published. Plath’s central character, hospitalized with depression, meets a young woman subjected to a lobotomy whose face has the eerie expression of “perpetual marble calm.”

Throughout his career, Freeman experimented disproportionately on female patients, and his career was bookended by operations on women. His very first patient was Alice Hood Hammatt in 1936. A decade later, Freeman selected a woman, Sallie Ellen Ionesco, to be his first patient to undergo a transorbital lobotomy. His last patient was Helen Mortensen.