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The Cult Dossier · No. 158 · Psychiatry / The Asylum

The Lobotomy

Leucotomy; prefrontal lobotomy; the transorbital or ice-pick lobotomy

1935 – 1967 · Portugal; United States; Britain, Scandinavia, Japan and beyond

XV. THE ASYLUM — WHEN MEDICINE DECIDED WHOSE MIND WAS WRONG

None.

Who led it

ANTÓNIO EGAS MONIZ (1874–1955), Portuguese neurologist, who devised it and won the NOBEL PRIZE IN 1949; WALTER JACKSON FREEMAN II (1895–1972), the American neurologist who industrialised it, with the neurosurgeon JAMES W. WATTS.

What it worshipped and taught

That severing the white-matter connections between the prefrontal cortex and the rest of the brain would relieve mental illness by breaking the circuits that sustained it. THE THEORY WAS THIN AT THE START AND NEVER IMPROVED. What the operation reliably produced was not recovery but flattening — reduced anxiety alongside reduced initiative, judgement and personality.

Who was in it

Egas Moniz and Almeida Lima; Walter Freeman and James Watts; ROSEMARY KENNEDY; HOWARD DULLY; HELEN MORTENSEN, whose death ended Freeman's career.

How it ended, or where it stands

ABANDONED, chiefly because chlorpromazine arrived and offered the same institutional convenience without the knife. Tens of thousands of people in the United States alone were operated on; a precise total does not exist.

The dead

About 14 to 15 per cent mortality among Freeman's own patients. Total deaths worldwide are not reliably established and are not estimated here.

Of note

THE LOBOTOMY WAS NOT FRINGE MEDICINE. THAT IS THE ENTIRE POINT OF THIS FILE.

It was mainstream, prize-winning, taught, and performed in public hospitals on the recommendation of respectable physicians. The Nobel committee gave it their highest honour in 1949, four years before the first serious trials of chlorpromazine. There was no moment at which the profession collectively examined the evidence and found it wanting — IT WAS DISPLACED BY SOMETHING MORE CONVENIENT, not defeated by something more true.

THE TWO CASES THAT MATTER MOST WERE NOT ILL IN THE WAY THE OPERATION CLAIMED TO TREAT. Rosemary Kennedy was a young woman whose family found her behaviour embarrassing and unmanageable. Howard Dully was a twelve-year-old boy whose stepmother found him difficult. IN BOTH CASES THE PROCEDURE WAS REQUESTED BY A RELATIVE, AGREED BY A DOCTOR, AND PERFORMED ON SOMEONE WHO WAS NOT ASKED. Read that beside 160, where the same absence of consent is present with the state paying, and beside 161, where it is present with the state choosing the patient.

Its timeline

  1. 12 NOVEMBER 1935 In Lisbon the neurosurgeon PEDRO ALMEIDA LIMA, under EGAS MONIZ'S direction, performs the first prefrontal leucotomy, on a 63-year-old woman. The pair go on to use a wire-loop instrument, the leucotome, to cut frontal white matter.
  2. 14 SEPTEMBER 1936 WALTER FREEMAN directs JAMES WATTS through the first prefrontal lobotomy in the United States, on a housewife, ALICE HOOD HAMMATT. They begin promoting it energetically.
  3. NOVEMBER 1941 ROSEMARY KENNEDY, aged 23, is lobotomised by Freeman and Watts at George Washington University, at her father's arrangement. The operation leaves her permanently incapacitated and she is institutionalised for the rest of her life. HER BROTHER SIGNED THE COMMUNITY MENTAL HEALTH ACT TWENTY-TWO YEARS LATER — see 163.
  4. 1946 FREEMAN DEVISES THE TRANSORBITAL LOBOTOMY, driving an instrument through the thin bone above the eye socket and sweeping it through the frontal lobe. It requires no operating theatre and no surgeon. Freeman, who was not a surgeon, performed it in offices and hospital wards, sometimes using electroconvulsive shock as the anaesthetic.
  5. 1949 EGAS MONIZ IS AWARDED THE NOBEL PRIZE IN PHYSIOLOGY OR MEDICINE, nominated by Freeman. IT HAS NEVER BEEN REVOKED, despite later campaigns by patients' families.
  6. 1949–1952 The peak years. Freeman travels between institutions in a vehicle the press called the lobotomobile, demonstrating the procedure. Across his career he performed MORE THAN 3,400 LOBOTOMIES BY THE USUAL COUNT, AND POSSIBLY AS MANY AS 4,000, some 2,500 of them transorbital, in 23 states. ABOUT 14 TO 15 PER CENT OF HIS PATIENTS DIED.
  7. 1960 FREEMAN LOBOTOMISES HOWARD DULLY, AGED TWELVE, by transorbital lobotomy, arranged by the boy's father and stepmother for $200. Dully recovered his own records as an adult and told the story on NPR on 16 November 2005, and in a memoir, MY LOBOTOMY, in 2007.
  8. FEBRUARY 1967 Freeman's patient HELEN MORTENSEN dies of a brain haemorrhage after her third lobotomy. He loses his operating privileges. The era ends.

Its people

António Egas Moniz

António Caetano de Abreu Freire Egas Moniz

Originator of the prefrontal leucotomy; Nobel laureate 1949 · 29 November 1874 – 13 December 1955 · active 1935–1955

A Portuguese neurologist and politician who, with the surgeon ALMEIDA LIMA, performed the first prefrontal leucotomy in November 1935 on the theory that severing frontal white matter would relieve mental illness. He also developed cerebral angiography, a genuine and lasting contribution. HE WAS AWARDED THE 1949 NOBEL PRIZE IN PHYSIOLOGY OR MEDICINE FOR THE LEUCOTOMY, on a nomination from Walter Freeman. His follow-up of his own early patients was brief and optimistic, and the outcome measures were his own impressions.

Before the law. No proceedings.

Where things stand. Deceased 1955. THE NOBEL PRIZE HAS NEVER BEEN REVOKED despite campaigns by patients' families; the Nobel Foundation has declined to withdraw it.

  1. 1927 Develops cerebral angiography.
  2. NOVEMBER 1935 First prefrontal leucotomy, Lisbon, with Almeida Lima.
  3. 1949 AWARDED THE NOBEL PRIZE for the leucotomy.
  4. 1939 Shot and wounded by a patient; uses a wheelchair thereafter.
  5. 1955 Dies.

Checked 2026-09-05

Walter Freeman

Walter Jackson Freeman II

Populariser of the lobotomy; deviser of the transorbital procedure · 14 November 1895 – 31 May 1972 · active 1936–1967

An American neurologist — NOT A SURGEON, WHICH MATTERS — who brought the lobotomy to the United States with the neurosurgeon JAMES WATTS and then, in 1946, devised the transorbital version that needed no operating theatre and no surgical training. He performed more than 3,400 operations by the usual count, and possibly as many as 4,000, about 2,500 of them transorbital, across 23 states, travelling between institutions in a vehicle the press called the lobotomobile. About 14 to 15 per cent of his patients died. He demonstrated the procedure to audiences, sometimes operating on both sides at once, and used electroconvulsive shock in place of anaesthetic.

Before the law. Never prosecuted. He lost hospital operating privileges in 1967; that was the extent of any sanction.

Where things stand. Deceased 1972. HE BELIEVED IN THE PROCEDURE TO THE END and kept in touch with former patients, compiling follow-ups he regarded as vindication.

  1. 1936 First US prefrontal lobotomy, with James Watts.
  2. NOVEMBER 1941 Lobotomises ROSEMARY KENNEDY, aged 23; she is incapacitated for life.
  3. 1946 Devises the TRANSORBITAL LOBOTOMY.
  4. 1949 Nominates Egas Moniz for the Nobel Prize, which he receives.
  5. 16 DECEMBER 1960 Lobotomises HOWARD DULLY, aged 12, at the stepmother's request.
  6. 1967 His patient HELEN MORTENSEN dies of a brain haemorrhage during a third lobotomy; he loses operating privileges.
  7. 1972 Dies of cancer.

Checked 2026-09-05

Rosemary Kennedy

Rose Marie Kennedy

Lobotomy patient; sister of President John F. Kennedy · 13 September 1918 – 7 January 2005 · active 1941–2005

The third child of Joseph and Rose Kennedy. Described as having learning difficulties and, in her early twenties, mood swings and behaviour her family found unmanageable and embarrassing. IN NOVEMBER 1941, AGED 23, HER FATHER ARRANGED A LOBOTOMY, performed by Freeman and Watts. It left her permanently incapacitated, unable to speak intelligibly or walk properly, and she was institutionalised for the remaining 63 years of her life, at Saint Coletta in Wisconsin. Her mother did not visit for around twenty years. HER SISTER EUNICE FOUNDED THE SPECIAL OLYMPICS; HER BROTHER SIGNED THE COMMUNITY MENTAL HEALTH ACT IN 1963.

Before the law. No proceedings. Nothing done to her was unlawful at the time, which is the point.

Where things stand. Deceased 2005, aged 86, having outlived the President, the Attorney General and the procedure itself. SHE WAS NOT ASKED, AND SHE WAS NOT MENTALLY ILL IN ANY SENSE THE OPERATION CLAIMED TO TREAT.

  1. 1918 Born in Brookline, Massachusetts.
  2. NOVEMBER 1941 Lobotomised at 23 at her father's arrangement.
  3. 1949 Placed at Saint Coletta, Jefferson, Wisconsin.
  4. 31 OCTOBER 1963 Her brother, as President, signs the Community Mental Health Act.
  5. 1968 Eunice Kennedy Shriver founds the Special Olympics.
  6. 2005 Dies aged 86.

Checked 2026-09-05

Howard Dully

—

Lobotomised at twelve; later recovered and published his own records · 30 November 1948 – 11 February 2025 · active 1960–2025

Lobotomised by WALTER FREEMAN ON 16 DECEMBER 1960, AGED TWELVE, in San Jose, California. He was not mentally ill. His stepmother found him difficult, took him to several doctors who declined, and found Freeman, who agreed after a handful of consultations and recorded that the boy was to have the procedure without being told. Dully spent decades in institutions, foster placements and homelessness, worked as a bus driver, and in his fifties obtained Freeman's own case notes on himself. HE TOLD THE STORY IN A 2005 NPR DOCUMENTARY AND IN MY LOBOTOMY (2007), which became a bestseller.

Before the law. No proceedings were ever brought. The operation was lawful and was requested by his stepmother.

Where things stand. DECEASED 11 FEBRUARY 2025, AGED 76. THIS FILE WAS WRITTEN AFTER CHECKING, AND THE CHECK MATTERED: he was widely described as living in sources written before 2025, and an entry drafted from those would have been wrong.

  1. 1948 Born.
  2. 16 DECEMBER 1960 Lobotomised aged 12 at Doctors General Hospital, San Jose.
  3. 1960s–90s Institutions, foster care, homelessness, then long employment as a bus driver.
  4. 2005 Recovers Freeman's records and tells the story for NPR.
  5. 2007 MY LOBOTOMY published.
  6. 11 FEBRUARY 2025 DIES, AGED 76.

Checked 2026-09-05

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