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0:01
Miss Ratched.
I’d like to ask a question, please, go ahead.
This is from The 1975 film.
One Flew Over the Cuckoo’s Nest I takes place in a mid-century mental institution and I’ve never been to a baseball game.
0:18
Well, I think I’d like to see one.
The staff isn’t letting the patient’s, watch the World, Series this infuriates.
Randall McMurphy played by Jack Nicholson.
He starts acting up series.
Raise your hand up to Just raise your hand up a lot.
0:38
McMurphy pretends to watch the game on the blank screen of the TV calling out, fake plays getting the other patients, riled up livers, it’s up the middle.
It’s a base hit, Richard is rounding.
First is going for second, the ball to deep, Right Center.
0:53
There’s an over-the-counter, cut the ball off.
Here comes the throw which is around apparently goes into second decide today.
There he say, it’s a double McMurphy causes trouble throughout the movie.
In the end, the staff, find a way to permanently subdue him.
A surgery, usually two, incisions in the head, cutting through the bone, and into the frontal, lobe, severing it from the rest of the brain.
1:19
They give him a lobotomy.
Nicholson’s character emerges from the surgery as a zombie, a shell of a human.
This isn’t the stuff of fiction.
Lobotomies were performed in real Mental Hospitals.
1:36
On real patients, regularly one state and particular pattern, especially robust program West Virginia.
They wanted to perform lobotomies quickly cheaply and on a massive scale.
1:54
From gimlet media.
This is not past it a show about the stories.
We can’t quite leave behind every episode.
We take a moment from that very same week in history and tell you the story of how it shaped our world.
I’m Simone plannin in mid July of nineteen fifty to seventy years ago.
2:14
This week, Health officials in West, Virginia carried out, a mass lobotomy project over the course of a few weeks.
Hundreds of patients were Bata mised in this episode, we’ll meet the patients who went under the knife, the man who treated them and how the lobotomy was pushed into the American mainstream.
2:36
If you’re eating right now, I am so sorry.
2:54
This is a 1956, documentary called crisis in West Virginia.
The State Board of control was looking to draw attention to the awful conditions of their Mental Hospitals.
So they produced this report in it, they tore one facility called, and I’m just gonna read out the name of this place as it’s written.
3:15
Lakin state hospital for the colored and say In it’s the 1950s eloquent evidence is here of overcrowding the shocking necessity for housing.
These pitiful retarded boys with adult mental patients for patients suffering from physical illness.
3:31
The hospital’s brick walls are crumbling patients are shuffling around the hallways, some are lying on the floor in addition to their clouded mental condition.
There’s only this one.
Tiny room to house.
The bedridden even mattresses are at a premium.
In some areas, the state’s mentally ill.
3:47
All patients, look forgotten.
Where housed in this Hospital people suffering from psychosis and mental illness.
A catatonic patient, completely withdrawn, oblivious to the visitors Huddle’s mute before this broken section of Ward wall.
4:06
This was an age just before antipsychotic drugs were widely available in America and without many treatment options, patients couldn’t be discharged.
Hospitals were Beyond capacity.
The beds were full.
They need something to empty the beds.
4:24
This is Jack el-hai.
He’s a medical writer and author of the book.
The lobotomist he says there was a shortage of psychiatric beds across the country.
So in 1952 West, Virginia state hospital superintendents brought in the services of a one, dr.
4:42
Walter Freeman, Freeman, was a famous, lobotomist, and an evangelist for the procedure.
He was often in the Press, he was this incredible, extrovert, who like, to show off.
So, there’s one thing you need to know about Freeman.
5:01
He wasn’t a surgeon.
He was a neurologist.
Just and a pathologist, the kind of doctors that do autopsies earlier in his career.
Beginning in the 1920s Freeman worked at a huge mental institution.
Freeman, in particular, didn’t like what was happening, he considered it.
5:22
What he called, waste of human potential for all of these people to be permanently, living in psychiatric hospitals, Freeman, saw that many only left through the morgue.
And so he, Set off to find a way to get people out, not to cure them necessarily, but to get them out.
5:41
That’s when Freeman got turned onto the lobotomy.
In the 1930s, scientists around the world were experimenting with different kinds of psycho.
Surgeries, one, early type of lobotomy involved, drilling into the patient’s, forehead to access their frontal.
5:59
Lobe, the thinking was this they’d sever connections between the frontal lobe, and the rest of the brain that disrupted, the part of the brain.
That regulates decision making impulse control and the way you express emotions Andrew skull is a sociology professor at the University of California, San Diego and author of the book dangerous remedies.
6:25
It’s clear that lobotomy change people’s mentality.
Didn’t always degrade people’s intellect.
So when you gave them IQ tests, it didn’t didn’t look as though you smash that portion but what it did do undoubtedly, the frontal lobes are very what need for planning for Initiative for long-term perspective, for part of our essential Humanity, Doctors found that some patients emerged, calm, but emotionally numb.
7:02
They used lobotomies on patients with symptoms of schizophrenia depression and extreme anxiety.
The operation could be tricky.
Doctors had to be careful if you cut too much, you produce to human vegetable.
If you cut too little, the person remains psychotic and the test.
7:23
They devised was that under the operation, they would talk Pull through it.
And when the patient became confused, that was the moment when they stopped operating.
Oh my God.
7:39
Okay, just putting this out there.
If anyone finds themselves doing active.
Brain surgery on me.
Just know, I probably won’t be feeling very chatty.
Anyways Freeman, practice lobotomies on cadavers until he got the hang of it.
7:55
And then in 1936, he and his partner, a neurosurgeon took on their first live patient, a housewife.
With agitated depression after her lobotomy, his patient was able to resume normal activities, like reading sleeping and eating.
8:14
She stopped having nervous breakdowns and she returned to doing housework.
So and Freeman’s eyes success Freeman.
The showman that he was started, inviting reporters to watch his surgeries all their medical writers describe this as a great breakthrough.
8:34
Through the history, paper said it was as easy as removing an infected tooth and as trivial and operation.
Is that the Saturday evening post wrote that?
Freeman’s lobotomy changed.
How patients saw the world.
The world that once seemed the Abode of misery cruelty and hate, is now radiant with sunshine and kindness to them, with all the Press demand for the lobotomy grew.
9:02
It wasn’t just for the institutionalized.
It’s important to realize that this was widely endorsed.
It was not some Fringe intervention.
Most leading lights in universities like Harvard and Columbia and Yale and the University of Pennsylvania and Duke fully endorsed this operation and had active lobotomy programs.
9:29
People were being told this was a medical miracle and a miracle is exactly what West Virginia needed Freeman felt like lobotomies could solve their hospitals, overcrowding problem.
Empty, some beds writer Jack el-hai says Freeman was up for the challenge.
9:46
He was a cowboy.
He just wrote in and did what he thought would work without much thought.
Much consideration of the what could go wrong?
And I think he also believed that if something went wrong.
Well the patient wouldn’t be that much worse off.
10:04
Then they had already been.
Freeman suggested a newer technique designed for Speed and scale called the transorbital lobotomy.
It was easier than the prefrontal lobotomy because you didn’t have to drill into the skull instead.
10:24
He got to the brain Through The Eyes.
Well, sort of not through the eye, but the opening in the skull so that the eye sits in and by placing a tool similar to an ice pick, Beneath the eyelid of the patient and into the eye orbit and into the brain, I got the nickname, The Ice Pick lobotomy, he thought it was just what West Virginia needed.
10:52
It took just 10 minutes to perform could be done.
Quickly could be done in the psychiatric hospitals.
In some patients, exhibited a reduction of their symptoms enough so that they could be discharged quickly, Freeman, performed these ice Pick lobotomies.
11:10
One after the other.
More than 20 in one day, it was almost like an assembly line.
Freeman’s own daughter, dubbed him.
The Henry Ford of lobotomy Freeman thought that lobotomies could be done anywhere, like in a motel room that you didn’t even need to be a doctor.
11:30
He believed that a bartender could learn to do it.
Anyone could Operation, ice pick, took place over the course of a few weeks.
By the end of it.
Freeman lobotomized, more than 200 people and West Virginia, the results were announced in National newspapers and enshrined in prestigious medical journals.
11:55
Like Jama in the journal Freeman, reported that many returned to their lives out in the community, others stayed, institutionalized for died during The operation or soon after two of them because of hemorrhaging with two Freeman and to the administrators, the results were encouraging enough.
12:19
So that after the summer of 1952 over the next few years Freeman performed an additional several hundred lobotomies in West Virginia and Hospital leaders.
Showcased patients they saw as a success.
12:36
Clinically there has been a marked improvement in the condition of this patient will hear from one of these patients after the break.
13:05
Welcome back before the break.
Dr. Walter Freeman wrapped up operation ice pick and the summer of 1952 State.
Officials were pleased with the results so much so that they invited him to perform hundreds more in the years that followed and that documentary crisis.
13:24
In West Virginia we meet some lobotomy patients.
Like one man named Bernard I’m 26 years old and he has been in the hospital for Out, six years, he has had the electroshock therapy, and also in the bottom e, the staff seemed to think he had improved now.
13:45
He will cooperate over a fan of a few minutes when asked to do something by the attendant, but then he will return immediately to his posture.
Bernard is shown on camera.
He looks at the floor and struggles to answer a couple of questions gives a mumbling response Another day that you would like to go home.
14:08
What about it?
What would you like to do when you go home?
I would be calling us to a movie Magazine.
Still the film refers to Bernards prognosis, as a ray of Hope Andrew skull.
14:23
The professor says, it’s not surprising patients.
Like Bernard were seen as a success.
At least, in the eyes of the state lobotomy was quite transparently used in those settings as a means of social control, just just to render.
14:41
It’s passive and that counted as a success.
Andrew says, the procedure was arguably never about the patients.
It was more about the needs of mental hospital staff.
Lobotomies.
Made patients less prone to belligerent outbursts, in short easier for the state to manage.
15:03
And one other thing about the patient’s, there was a major gender discrepancy.
What significant is that women were dispersed met in a major way.
Disproportionately the victims of this operation.
15:24
So who were these women to find out?
We dug into records, from Spencer, State Hospital in West Virginia.
For from the early 50s, covering several of Freeman’s visits to the hospital.
We found 72% of lobotomy patients in these records were women.
15:43
Schizophrenia was the most common diagnosis.
Almost all of them were Housewives, but there’s also a 59 year old music teacher and 22 year old nurse.
An 18 year old high school student.
Another woman 54 years old.
15:59
Never made it past second grade.
Andrew says, women were seen as ideal patients because their intellect was seen as less useful.
It was thought that men who needed to compete in the public world who needed to hold down jobs, obviously, their brains were more valuable and more important than women who could return to the role of a housewife.
16:26
Something that was looked down on and seen as a very simple task.
The records don’t have information.
How the women did after Freeman operated across the country Freeman lobotomized.
More than 3,400 patients, patients were sent home.
16:45
And their families were given instructions on how to care for their newly lobotomized loved one.
Freeman.
Once, compared them to they were almost like household pets.
And he said, you know, if the lobotomy person starts acting out give them a good smack like a small child discipline like that and they won’t, they won’t mind so much because they’re no longer ashamed in the way they would have been before the operation outcomes of lobotomies varied.
17:21
There were those that could get on with housework or other jobs then Were those who became severely disabled, some returned home lost and childlike families, describe their loved ones as lacking.
Any feelings, some said it was like they lost their souls.
17:44
Eventually lobotomies fell out of favor.
Some 50,000 had been performed by the early 50s but those doctors eventually retired and a new crop of doctors emerged.
They saw lobotomies as archaic.
Plus by the mid 50’s.
18:01
New treatments, were being developed.
A drug called Thorazine, came to the market and 1954.
The antipsychotic was characterized by some as a chemical lobotomy and Did a wonder drug antidepressants soon.
18:17
Followed, and the lobotomies waning years Freeman, fought to remain relevant.
It’s pretty clear.
When reading his personal letters, they came across a letter from Walter Freeman saying, why are we given up lobotomy?
The body was such a great procedure.
18:34
This is dr.
Mahal Roz, physician, and professor of history, and health policy at the University of Rochester.
She found the letter while she was searching for.
Uh, sir, tation topic combing through medical journals in a library and she was shocked by the claims Freeman made.
18:51
We have all these patients who are so grateful and go back to do their work.
I have a violinist, went back to playing violin, you know, why are we giving up lobotomy so easily?
This is a letter from a 70s.
That’s like, whoa, this guy must be lying.
She couldn’t believe it.
There’s no way.
19:07
Lobotomies actually worked, right?
It inspired her to go looking for more.
So she went to Gang and Freeman’s archives at George Washington University and found letters from patients messages.
They had sent him after treatment Christmas cards.
19:23
They had exchanged Freeman was obsessed with keeping in touch some letters.
Thanked Freeman for bringing their loved one.
Home from the mental hospital.
One woman, even wrote him begging for another operation.
She was like, what are you going to perform that surgery lobotomy?
19:40
And that, you know, she’s like a prisoner of her own anxiety, waiting for this love.
Bon ami, but prisoners know how long they have to serve but poor me for me, it’s worse than as prisoner because you’re not telling me what you’re going to do.
This third lobotomy to make me feel better now.
To be fair, this is Freeman’s collection patients with the worst outcomes.
20:00
Probably weren’t writing.
When we first started working on this story, I was prepared to see Freeman as Reckless.
The talking to me Hall complicated, his legacy for me, for some of his patients.
20:15
He did offer some semblance of relief, when relief was in short supply.
And I think both can be true, right?
He was certainly a dedicated to his patients.
He was very narrow-minded in his approach.
She didn’t consider evidence.
That may be what he was doing.
Wasn’t that helpful or possibly harmful.
20:32
But he was very Very kind of like a hammer and nail kind of guy only looking at and every patient and his mind he did a lot of me now.
You know, when thinking about mental health care now and sort of the progress that we’ve made since you know, lobotomies have sort of fallen out of fashion.
20:50
Let’s say how far I guess.
Do you feel like we’ve come, if you tell you a story of look, look at these crazy doctors doing crazy things, then it sounds like a one-off story that is never going to happen again.
I look at us, thankfully, our medicine so much better.
McCall says don’t fall into that trap that just because we know more, we’re getting it right in some ways we’ve made progress and others were still struggling with this issue of where there’s a lot that we still don’t know what haven’t really elucidated.
21:18
It’s difficult to stomach.
These lobotomy stories patients emerging as shells of their former selves and yet, I really do think it would be misguided to villainize Freeman.
We call says he’s a product of his time.
Just as we are a product of ours, I’m sure we’ll look back on our own, current treatment of mental illness as Arcane barbaric.
21:42
How did they ever think?
That was, okay, we’re still trying to get this right, how to better care for each other.
We’ve come a long way since the lobotomy hey days, but that doesn’t mean we’re off the hook.
We still have plenty far to go.
22:12
Not passed it as a Spotify original produced by gimlet and zsp media.
This episode was produced by Mary Rose Madden next week we’ll hear the story of the first IVF birth or what they used to call a test-tube baby.
22:28
I didn’t fully understand the intensity of the IVF process.
I knew it was going to be intense I didn’t know how intense and I think if I had known just how intense it was going to I don’t know if I would have actually been ready for it.
The rest of our team is producer, Sarah Craig, our associate producers are Julie, Carly and Ramona Philip Lord Newcomb.
22:49
As a production assistant, the supervising producer is Erica Morrison editing by any Gilbertson and Andrea be Scott fact-checking by Jan akkerman.
Sound design and mixing by Hans Diehl, she and Emma Monger original music by Sachs kicks, Ave Willie Green Day blasts and Bobby Lord.
23:07
Our theme song is Toko Liana by cocoa with music supervision by Liz Fulton, technical Direction by Zach Schmidt show art by Elysee Harvin and Talia Rahman.
The executive producer at CSP media is Zach Stewart Ponte the executive producer from gimlet is Matt schulze.
23:23
Special.
Thanks to the West Virginia state archives, the George Washington archives and the periodicals department staff at the Enoch, Pratt free library and to Lydia Pole Green Abbie ruzicka Dan Behar gen hon, Emily wiedemann list Miles and Joshua Bianchi follow not past it.
23:41
Now to listen for free exclusively on Spotify click the little bell next to the follow button to get notifications for new episodes and while you’re there, right us 5 Stars.
Come on, don’t be shy.
You can follow me on Twitter at Simone palamon.
Thanks for hanging.
23:57
We’ll see you next week, and he loved shocking, and stunning audiences in this way.
So, so much.
So that his medical school classes, Were considered a good date just so they could see what was happening in the classroom.