Friday, July 13, 2007

The Ice pick leucotome - Ice pick lobotomy

Dr. Walter Jackson Freeman II (1895 –1972) designed what he called a orbitoclast which he used to do transorbital prefrontal lobotomy – once a popular form of psychosurgery.

Initially, he actually used an icepick from his kitchen. Although he had no formal surgical training, he perfected the technique of transorbital lobotomy which was “fast and less invasive” and required no burr holes. This essentially consisted of thrusting an icepick behind the supraorbital ridge and sweeping it within the brain to sever the connections of the prefrontal lobe as an office procedure which could be completed within a few minutes with little or no sterile precautions under local anesthesia. He, along with James W Watt [neurosurgeon, who later distanced himself from this procedure], popularized lobotomy as the “Freeman-Watt procedure” in the US and did more than three thousand cases often traveling in his “lobotomobile”!

Interestingly, the famous portugese neurologist Egas Moniz had applied Fulton’s animal research findings to human patients to initially perfect the technique of lobotomy [leucotomy] for which he received the Nobel prize for medicine in 1949.

With the advent of the antipsychotic drug thorazine in the 1950s, lobotomy fell into disrepute. By that time more than forty thousand people had been lobotomized in the US alone, many for trivial indications.

Rosemary Kennedy, sister of John F kennedy is the most famous victim of this notorious procedure. She was rendered incapacitated at the age of 23 after undergoing this procedure to control her “mood swings”. Lobotomy reduced Rosemary to an infantile mentality that left her incontinent and staring blankly at walls for hours. Her verbal skills were reduced to unintelligible babble.

May be one day, they might look back in horror that neurosurgeons used to resect gliomas ...

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