Medicine: Kill or Cure

She was a nice-looking young woman, but handsome is that handsome does. Detroit police had picked her up for stealing and arson. When they saw her FBI record, they hastily turned her over to the Wayne County General Hospital as criminally insane.

Her record started at the age of four, when she began to steal. She spent 15 years in reform schools and prisons. She had been thrown out of bordellos for injuring patrons, had hustled outside Army camps, boasted two murders.

She was not insane. But Psychiatrist Louis Lipschutz, clinical director of the hospital, decided to try psychosurgery. (She consented.) A surgeon carefully opened her skull (using a local anesthetic), sliced into the frontal lobes of the brain, cut most of the nerve connections to the thalamus (crossroads of the brain’s nerves). The patient said: “I feel dopey.” After the operation she cried, sucked her thumb, splashed in her bath like a two-year-old. But in a month, she acted like an adult.

The New Woman. Last fortnight members of the Michigan Society of Neurology and Psychiatry gathered to discuss the case, saw an amazing transformation. Neat and demure, the patient answered the psychiatrists’ questions politely. She remembered her lurid past, but wanted to forget it. Said she: “I want to go home and lead a normal life.” The hospital’s report: “The patient is quite friendly, cooperative, seriously interested in the future, somewhat lacking in initiative but adequately responsive when approached. . . . Previous aggressive sexuality has apparently vanished. . . .”

The operation, called pre-frontal lobotomy, is not new. It was invented by Portugal’s Dr. Egas Moniz in 1935, was introduced to the U.S. by Neurologist Walter Freeman and Neurosurgeon James W. Watts of George Washington University (TIME, Nov. 30, 1942). But doctors have kept quiet about it. The operation is a desperate last resort.

Nonetheless, by last week Watts and other U.S. neurosurgeons had performed more than 2,000 lobotomies, with sensational results. Lobotomy is used chiefly for serious mental diseases: schizophrenia and other forms of dementia praecox, compulsive neuroses, chronic, long-standing depression or agitation. Most cases are cured or greatly improved. So far, neurologists have discovered no seriously harmful effects. The operation is dangerous (a slight miscalculation may kill the patient by cutting a cerebral artery), but the skilled surgeons performing it have had very few deaths.

The Operation. The operation is delicate. The surgeon cuts two openings in the skull, one on each side above the temples, removes each bone button (to be replaced later), cuts and folds back the brain covering, the dura mater, then carefully slices through a measured section of the frontal lobes’ white tissue. As the knife cuts the nerve fibers, the patient’s tension visibly relaxes. He grows confused, dull, slow in speech, childish.

After the operation, he tends to overeat, may double his weight if he is not careful. But in six months to a year, as new patterns form, he becomes a cheerful extrovert. Psychologists have found no evidence that lobotomy impairs intelligence, though foresight and initiative are often diminished. At Boston’s Psychopathic Hospital, whose staffmen have done 200 lobotomies, Director Harry Caesar Solomon reports that patients, after lobotomy, have done well as college students, math teachers, businessmen.