Mysteries of Mental Illness

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Narrator

After World War II, asylums were reaching their peak, housing more than half a million patients. -

Man

The notion that these were curative places transformed into the notion that they were hell holes, that they were huge institutions that warehoused people. (gentle somber music) People condemned to the back wards of a mental hospital were gonna be there for life, and it was an almost inhuman existence. So anything you might do that would rescue them was perhaps worth trying. -

Doctor

Six centimeters above the zygoma in the coronal suture, the opening is made. (pen scratching) Turning now to the brain, the frontal lobe is bounded by the Sylvian fissure. -

Narrator

The workings of the brain remained mysterious. But after observing patients with head injuries or strokes, a theory emerged that damage to an area of the brain called the frontal lobe, altered personality and behavior. Some wondered, could surgically severing the frontal lobe cure mental illness and possibly even make asylums obsolete? (gentle somber music) -

Andrew

The idea was that madness emerged because the frontal part of the brain, the most distinctively human part of the brain had somehow gone awry. And the connections between the front and the back of the brain had become twisted and distorted. And if we could somehow interrupt some of them, we could interrupt the madness. -

Narrator

In 1936, Washington, D.C. neurologist, Walter Freeman, performed the first lobotomy in the United States. It was widely seen as a kind of miraculous intervention in the course of psychosis. There were some patients who were clearly damaged, but nonetheless had lost their obsessions and their involvement with hallucinations and delusions, were able to function more or less. Perhaps even be discharged from the hospital as quite a number of them were. Many of them became vaguely happy all the time. And so, in the context, some people saw that as a trade-off worth making. (upbeat somber music) There was a huge lobotomy program at Harvard, at Yale, at Columbia, it spread everywhere. -

Narrator

Even far outside the asylums. In 1941, 23-year-old Rosemary Kennedy, younger sister of future president John, became one of Walter Freeman's patients. (upbeat somber music continues) Rosemary was developmentally challenged from birth. She had been very carefully trained and kept on a very, very tight leash, but there was growing concern particularly by Joseph Kennedy, the father, that Rosemary was starting to rebel. (upbeat somber music continues) She wanted to be like everyone else and have a life. It was felt that, you know, she could end up pregnant and this would be a great embarrassment. It was suggested to Joseph Kennedy to lobotomize her, it would make her docile. -

Doctor

The first mark is made three centimeters behind the lateral rim of the orbit. -

Narrator

Rosemary would be unable to walk or speak after her psychosurgery. -

Doctor

Another mark is made in the midline, 13 centimeters from the glabella. -

Narrator

Her parents would send her to a privately-run institution and keep the details of her procedure secret even from her siblings. -

Doctor

Operations can be performed under local anesthesia if the patient is sufficiently cooperative. (gentle somber music) Women tended to be lobotomized more than men. (gentle somber music continues) In part because husbands reported back saying how happy they are that their wife has been restored and will now do housework, and leave their home cleaner than it ever was. (gentle somber music continues) (pen scratching) Because each operation took an hour or two and involved a very scarce commodity, a neurosurgeon. You know, this was not good. -

Narrator

So Freeman found a way to streamline the operation. Instead of accessing the frontal lobe by drilling holes in the skull, he took a shortcut through the eye socket, using a tool modeled after an ice pick. (gentle somber music continues) -

Andrew

That enabled the lobotomy to be done very fast. Most patients were confined in mental hospitals against their will. When that happened, they lost their civil rights. They lost any access to the outside world. Their wishes were considered to be the product of their psychosis. So doctors certainly performed many lobotomies on patients who had no say whatsoever. (gentle somber music continues)