Talk:Lobotomy/Archive 1

Bilateral cingulotomy
Removed


 * Bilateral cingulotomy is a modern psychosurgical technique which has superseded the lobotomy.

I don't think this is true. Modern psychosurgery isn't used very much for the same things that the lobotomy was used for.


 * I completely agree and I am glad to hear someone else say this. Reading down the list of topics, these terms seem to have confused many people, even with the section removed. 70.59.146.117 (talk) 12:07, 8 March 2008 (UTC)

Neutrality Issues
I feel that this article villainizes the practice of lobotomy and over-represents the complications associated with this long-used, controversial and (admittedly) crude surgical practice. As a physician, I feel that the only reason we don't use lobotomies today is that they are done easier with chemicals, not because it is a cruel or unsuccessful way to treat a patient. This article could benefit from the wisdom of an expert on the subject who has actual medical or academic experience. The main section also needs references. —Preceding unsigned comment added by 76.81.218.167 (talk) 04:23, 29 November 2007 (UTC)
 * The anonymous user which posted this is clearly without any idea of what lobotomy employs, and evidently aren't even able to read the article he comments on. Cutting away a large piece of the frontal part of the brain is NOT a good idea. My admittedly very coarse understanding of the brain have given me the understanding that this is the most important part of what constitute one's "self" and one's "I" - the free will and all that. Trying to alleviate any illness by plain and simply cutting away a large part of the brain, and such a central part, should be considered extremely close to murder. The frontal part of the brain dies and is transported away by the lymphatic system - leading to a brain looking like the image in this article where the prefrontal parts are simply cut off. Furthermore, I think that the lobotomy procedure and its ugly history is even worse than what is described in the article: There was done very little after-procedure examinations and statistics on the victims, and no real scientific work was ever carried out to check the actual consequences. Of course, the whole field of psychology was very immature and without much understanding of what actually is going on in the brain - but even then, this whole part of the history of psychology should be considered by everyone as a butchery on the patients. Stolsvik (talk) 20:29, 8 December 2007 (UTC)


 * I removed the pov tag put in place by the anonymous editor. This topic is not under dispute, nor should it be. Lobotomies, in most cases, cause irreperable harm to the subject. The person who put that tag on the article not only said nothing to bolster his case, (such as in what cases a lobotomy is needed) but he has not said anything about it fcr nearly two weeks. There is obviously no dipute here. Primium mobile (talk) 03:15, 12 December 2007 (UTC)


 * Not to mention, everyone on Wikipedia is a doctor. Pah.  Agreed, gents - lobotomies are far more horrifying than any article could possibly convey.  214.13.173.15 (talk) 00:39, 6 March 2008 (UTC)


 * Perhaps, but there should be an attempt made to explain why lobotomy/leucotomy seemed at one time be a reasonable and beneficial proposition and why it was part of the medical mainstream for a almost 2 decades of the twentieth century. The POV of the article, in my opinion, is too retrospective and decontextualised. There also should be a greater emphasis on theoretical basis of the procedure and Moniz's contribution more generally. Freekra (talk) 13:24, 25 November 2009 (UTC)

Moved
I moved Leukotomy here. This is the most common name for the procedure. Lengis 16:24, 7 September 2006 (UTC)

Proposed merge: Lobotomy and Psychosurgery
These two pages have very little difference between them in content; the Psychosurgery page has no real discussion of surgeries other than Lobotomy. The latter is the more familiar concept, so it seems the right page to merge into. --Ogdred 22:27, 9 September 2006 (UTC)


 * No. Regardless of what this article talks about, psychosurgery is the more general term and Lobotomy should be merged into it, if any merge happens at all. I think they're fine being separate. - L&#39;postrophi 20:05, 21 September 2006 (UTC)

It would seem the correct way to apporach this is to work on Psychosurgery to expand it past lobotmies. I'm not an expert in that area, but it seems like it needs some significant improvement. --Perimosocordiae 21:39, 21 September 2006 (UTC)


 * Don't merge - I'm with L'postrophi here. --Jambalaya 16:38, 7 October 2006 (UTC)

Absolutely do not merge these two articles. The Lobotomy is much too specific, and should be considered effectively as a subset of Psychosurgery. --129.59.122.209 01:02, 25 October 2006 (UTC)


 * I agree with the above comment - don't merge (or, if you must, merge lobotomy into psychosurgery). Psychosurgery covers everything from Egas Moniz via Freeman-Watts to the operations that are still being done today - cingulotomies, capsulotomies etc. The psychosurgery article does at least have a paragraph on present-day operations. The problem with lobotomy is that, while some people are prepared to call present-day operations lobotomies, some people think the term should only be used for the Freeman-Watts standard operation or the Freeman transorbital operation. So you get people saying things like "lobotomies haven't been done since the 1970s". There is no such confusion with the term psychosurgery. Also (a minor point perhaps) lobotomy is an American term; in Britain identical operations were called leucotomies.Staug73 08:54, 26 October 2006 (UTC)

Lobotomy is too notable. It must have its own article. SakotGrimshine 08:08, 19 February 2007 (UTC)

The article should be expanded
Lobotomy was an important and controversial treatment in the last century. I would think the subject should earn a bigger article than this. The "popular references" section is almost as big as the rest *shrugs* --Jambalaya 23:31, 21 September 2006 (UTC)

I think that it was an important method for curing our mentally augmented americans DON"T MERGE it --Terrorhunter63 12:13, 13 October 2006 (UTC)


 * The article states that the procedure causes major personality changes, and that it was concluded that, in the majority of cases, the result was positive.
 * I would like to see more information about the nature of these changes, and how they were positive, added to the article. Zuiram 18:21, 22 October 2006 (UTC)

Psychosurgery needs to be expanded to talk more generally and not only to the lobotomy. --Ryckmonster 01:07, 25 October 2006 (UTC)

I hardly knew anything about lobotomies and have just read this article, but somehow I don'T feel content. Can someone, as said above, please expand it! I would like to know why doctors found it neccessary to perform a lobotomy; i.e. any mental abnormality? Any reference to the cases performed today woulf be good as well. Also, how did the patient change? Surely they could not have been cured.. was there a change in IQ, a 'dumbification' (I know, the word doesn't exist, but it's rather interesting). -Thanks!


 * Agreed entirely, theres virtually nothing about the process, impact, reasons for, failures etc of lobotomies at all. Definitely needs expansion! Thedreamdied 21:53, 9 December 2006 (UTC)

Lobotomy and the Invisible Man
I've seen this inkling around a lot, but I think it's fairly clear that protagonist in the book Invisible Man did not in fact have a lobotomy, but an early round of ECT. This is hinted by his memory loss, teeth chattering, convulsions and not in the least from his continued high levels of cognitive function later on in the novel.

Plenty of references can be seen by searching Google with key terms like: "invisible man electroconvulsive therapy"

I will take the liberty in removing this from the bullet list.

Changing the "Popular Culture" section
I have removed the whole section about lobotomy in "Popular Culture". I think it's time that we take a good look at this article and I think most of us will realize that the "Popular Culture" have grown way to big. This should be an article about the neurosurgery method and not line after line with silly song lyrics and various movie references. I don't think the "Popular Culture"-section should be any longer than a paragraph. Let's focus on the neuroscience aspect in this article from now on, OK?? --Jambalaya 11:45, 18 December 2006 (UTC)


 * That's okay by me, it was getting long. But as there has been some recent interest in this section, I've reinstated all the original text on a separate page Lobotomy in Popular Culture. DavidCooke 00:11, 21 December 2006 (UTC)


 * Fair enough! --Jambalaya 01:02, 24 December 2006 (UTC)


 * Certainly most of those music references need to go but at the very least One Flew over the Cuckoo's Nest should be mentioned Ball of pain 01:48, 11 June 2007 (UTC)


 * This section looks awfully long for the text to have been moved to a different page. I'm going to reduce the musical references - there is too much about popular culture and not enough about what happened in the procedure.--Parkwells 19:09, 14 November 2007 (UTC)

Leucotomy is DIFFERENT from Lobotomy
http://pt.wikipedia.org/wiki/Ant%C3%B3nio_Egas_Moniz

Pre-frontal lobotomy and Pre-frontal leucotomy are to distinct techniques. Pre-frontal leucotomy (Egas Moniz, 1936) - from the Greek leuco=white + tomos=cut - means a section of the white matter of the pre-frontal region of the brain. This sections is made by an instrument that was invented by Egas Moniz that is called a leucotome. On the other hand, frontal lobotomy was a technique invented by Walter Freeman (1895-1972) and James Watts (1904-1994) and very used by these two scientists in the USA. (From the greek lobos=portion/part + tomos=cut, i.e. the section of the frontal lobe. The instrument used was similar to an ice pick and the access was trans-orbital. —The preceding unsigned comment was added by 217.129.228.172 (talk) 11:07, 31 January 2007 (UTC).

Sounds pretty much the same, so the tool had a different name. The end result is still retardation. —Preceding unsigned comment added by 66.97.117.235 (talk) 12:09, 18 October 2007 (UTC)


 * I am familiar with the history of the lobotomy. You are right, but to me this is just semantics as today it is generally accepted that the term "lobotomy" is an umbrella term encompassing all varying techniques (whether done trans-orbitally with an 'ice-pick' or otherwise). Even though the methods are different, it is also generally accepted that the term merely "changed" along with the method, and they are looked upon as being similar enough--in purpose, end result, and even procedure--to qualify under the same term.


 * I should add that I have not read the article here, so this response is not in defense of anything that may be inaccurate about its content. 70.59.146.117 (talk) 10:58, 8 March 2008 (UTC)

IGAS means?
Ok, so I'm reading the 5th paragraph in the history section and come across a sentence that talks about an IGAS report. When I click on the IGAS link, it leads to an article for I've Got a Secret (TV Show). That can't be right, right? —Preceding unsigned comment added by netmaster5k (talk • contribs)
 * From what I can see in the reference section (ref 4) in the source given in the paragraph, IGAS seems to be a journal. It shouldn't link to a TV Show therefore I unlinked it. --Ben T/C 06:34, 1 May 2007 (UTC)

Howard Dully: July 3 2007

Since I underwent a transorbital Lobotomy
There are serval forms of Lobotomy one they removed the skull cap then they drilled through the skull to access the brain and then finally Dr. Walter Freeman, my benifactor, developed a quick method of penetrating through the eye sockets thus the term orbital, the procedure was very crude at best and contrary to what I have read here, most procedures could not have been considered successful in the long term, only in the short term while the patient was still in a mental fog.

For the record
For the record, I think this practice is sick and wrong! I mean, I have seen gruesome videos such as complete human autopsy and suicidal people shooting themselves in the head thus exploding the brain, yet feeling nothing. For some reason I found this ( or precisely the idea of it) is more brutal and disguisting than anything I have seen, considering it is a medical procedure. --Da Vynci 08:22, 20 July 2007 (UTC)

Haha, agreed. Many doctors in the past have found themselves paths to the deepest regions of hell, and I'm sure that there are a few that are doing the same today, in various theatres. Research medicine can be a morally dangerous profession. We must be catious. Thrawn562 00:46, 12 September 2007 (UTC)

I can't believe this pseudo medical procedure is still being used. I mean to poke a hole in someone's eye and then wriggle a blade around in the brain until the patient becomes incoherent hardly sounds like actually helping a person. They're just causing severe brain damage and on purpose. It's insane and unethical. Truly this is a diabolical act to inflict upon another person. It robs them of themselves and their sanity. It should be forbidden. I mean dear god, this is not medicine, it's horrible and monstrous. Marjolijn 22:08, 10 Oktober 2007 (CET)

I can't believe what I'm reading. This "procedure" is barbaric and should be banned. Moniz getting the Noble Prize for this is an outrage and should be denounced. athiel

I agree, reading this article made me physically nauseous. I would like to know a bit more: -Was the practice the exclusive domain of psychological therapy, or was it also used by medical doctors/ -Why the (bleep) isn't this illegal, everywhere? -How did the performers avoid death from massive blood loss? I'm no doctor, but I was of the opinion a lot of blood flows through that area. —Preceding unsigned comment added by 68.230.161.164 (talk) 04:55, 26 October 2007 (UTC)


 * Death was not avoided--some patients did die during or shortly after the procedure. 70.59.146.117 (talk) 11:26, 8 March 2008 (UTC)

The part about Rosemary Kennedy made my very sad and sickened me. I came to this article after watching One Flew Over the Cuckoo's Nest, this practice is nothing short of evil IMO. -- Gяaρнic  03:59, 1 January 2008 (UTC)

Certainly we see it as barbaric in hindsight, and it had plenty of detractors from the very beginning too, but we must not lose sight of the historical context. There is ample evidence that the advocates and practitioners of lobotomy genuinely believed they were helping otherwise hopeless patients. In the future people might look back on our time and say that chemotherapy, essentially poisoning people without actually killing them, is a blunt and barbaric treatment. SquareWave (talk) 14:26, 11 January 2008 (UTC)


 * Square, I like the point you make. I've thought about the lobotomy much--it haunts me--and in this thinking I've not failed to wonder which of today's practices will be considered utterly and categorically inhumane, 100 years from now... 70.59.146.117 (talk) 11:29, 8 March 2008 (UTC)

If it were up to me, I'd categorize this as a crime against humanity. Rokasomee (talk) 07:26, 18 February 2008 (UTC)


 * Your comments are all very interesting but just to point out--this may be just the reason that lobotomies are no longer practiced in most developed countries. Don't point me over to Cingulotomy or Psychosurgery--I'd advise everyone to research these procedures (via scientific journals, not blogs or articles by Joe Shmoe) before beginning to consider all of these terms as interchangeable. Many factors must be taken into consideration with the psychosurgical practices of today. It was much different back in Freeman's time when anybody could bring in their 'annoying' ten-year-old kid and request that a 'blind' lobotomy be performed. Not to be misunderstood here, in my opinion, the lobotomy is the greatest tragedy that the psychiatric field has ever known. Let's just not get too misinformed or freaked out before we're aware of all facts. 70.59.146.117 (talk) 11:26, 8 March 2008 (UTC)

This is a discussion of how to improve the article, not a discussion board for opinions.--Relyt22 (talk) 19:06, 30 April 2008 (UTC)

Why is there not a critism section? —Preceding unsigned comment added by 194.83.96.32 (talk) 09:48, 1 July 2009 (UTC)


 * The whole article is basically a criticism section! Looie496 (talk) 21:57, 1 July 2009 (UTC)

intro
From the introductory paragraph, you'd never guess that using a lobotomy to fix personality disorders is the equivalent of cutting off a hand to fix a spasming finger. 66.57.225.198 08:29, 16 October 2007 (UTC)
 * Dude, it's like cutting of the arm and the leg, and then gouge out the eye. But probably actually worse than that. It is SO EXTREMELY DISGUSTING to think about this rape and butchery of persons (You effectively kill the "I" and "self" of the person with this nice little routine, which with the efficient ice-pick improvements could be performed on up to 12 patients per day in a hospital, up from only 4 with the older technique - check the references, in particular those for Norway!). And to consider that this also was done on people that was forcefully put into such hospitals - it makes me worse than sick, and very angry. Stolsvik (talk) 20:48, 8 December 2007 (UTC)
 * I think the barbarism of the procedure is self-evident. Though, apparently, some people back in the day didn't share that opinion.  —Preceding unsigned comment added by 68.230.161.164 (talk) 04:57, 26 October 2007 (UTC)

Pioneers of Lobotomy
I've removed that section; it's obviously lifted from another source, and badly written and hyperlinked. —Preceding unsigned comment added by 24.14.72.182 (talk) 20:40, 10 November 2007 (UTC)

Clouded Eyes?
In the film "From Hell", all lobotomy patients have discolored, "clouded" eyes after the operation. Since the film is based on a comic book and the overall style is rather fantastic, I suppose this is just creative liberty. Or is this a fact? -- megA 14:03, 15 November 2007 (UTC)


 * It is fiction. 70.59.146.117 (talk) 11:31, 8 March 2008 (UTC)

Opening statement is false
"lobotomies and other forms of psychosurgery are no longer used." Wall street Journal reports that in China thousands of brain surgery for mental illness. http://online.wsj.com/article/SB119393867164279313.html --Mark v1.0 (talk) 14:35, 19 November 2007 (UTC)

What about Moniz himself?
Did he get lobotomised? Or was he just a hypocritic bastard? Siúnrá (talk) 14:54, 27 November 2007 (UTC)


 * A hypocritical bastard, i guess. He never got lobotomised, but he was put in a wheelchair for the rest of his life (this happened in his older age) by one former patient who seeked him out and shot him in the spine with a shotgun. Although i have to ponder his supposed evilness: In the time, even simple tranquilizers were ineffective and extremely hazardous to your health if taken continuously; on the other hand, the people in hospitals who were, at least initially in Moniz's own time, referred to leukotomy were extremely self-damaging. It's not a problem of merely being a nuisance to hospital staff. They could be (and were) locked down in padded cells; but these people will bite the flesh off their arms and legs and continually pounce their heads into the wall. They are in perpetual suffering. Now, i'm just as glad as anyone else that lobotomies are now unnecessary to help treat these patients, and i have never met any lobotomized person myself; but i have been to the restraint wards of psychiatric hospitals, and, even with modern tranquilizers, let me tell you: Jesus Fucking Christ

What was the purported mechanism of efficacy?
The article does a good job discussing the history of lobotomy. But I don't get a clear picture why it was considered an effective procedure. What exactly was claimed to be the purpose of the cure? For instance, I understand the purported mechanism of SSRIs and I understand the purpose of removing an inflamed appendix. What was being solved here? There must have been some theoretical underpinnings to the procedure that should be expanded upon. &#8756; Therefore | talk 22:28, 21 January 2008 (UTC)


 * I can't tell if you are asking this rhetorically or not, but I'll go ahead with this anyway. Keep in mind I haven't read this specific article, so if I repeat something, then that's that.


 * The reasons for lobotomy "evolved" over time. It really depends on who you ask but theories for why the lobotomy was performed early on range from innocent (for example, wanting to help someone with emotional disturbances after which good results were reported not only by the doctors but even by the lobotomized themselves), to more disturbing theories (e.g., hospital staff were just sick of dealing with annoying, unruly, disturbed mental patients and this was a way of shutting them up, so to speak). In either case, I suppose, the lobotomy served to 'calm' them.


 * The operation was performed "blindly"--and that accounts for the difference in the results. If you look at Dully, a well-known survivor of the Freeman lobotomy (see the links at the bottom of the article), and you listen to him speak, you'll see that, on objective examination, he turned out relatively 'fine' when compared to, say, Rosemary Kennedy. Obvious to us at least now is that you can't just stick an ice pick into someone's brain, swirl it around, and always expect to get the same result--you don't know what you're hitting. Understandably, some suffered far more damage than others.


 * As lobotomies became more popular--as far as the United States goes--the procedure expanded to include a much broader definition of what could be considered 'emotional disturbance'. In Dully's case, if I recall, his mother took him in to get lobotomized because he wouldn't follow her rules, was hyperactive and undisciplined--or something of that sort. From what it appears, Dully seems he was merely being an average kid but his mother was tired or incapable of dealing with the task of disciplining the boy. We don't know for sure, but any rate, I often think about what the implications might be were the lobotomy to be "in style" today: all the kids we have on Ritalin would be standing in line for lobotomies instead. That is the impression one gets when reading about how liberal the doctors seemingly became regarding upon whom they performed the surgery, and for what reason. 70.59.146.117 (talk) 12:00, 8 March 2008 (UTC)


 * This still doesn't explain what the theoretical (hypothetical if you like) mechanisms of why it was supposed to be effective, only the reasons why it was used. For instance, take Ritalin, a product I know is over-prescribed and longitudinal studies (long term) have yet to be done and I know *why* it's over-prescribed. But see the section called "Mode of Action" at Ritalin which describes some of the purported reasons it is supposed to be effective. And that is what is lacking on this page and it is out of my skill level to provide that. &#8756; Therefore | talk 19:39, 30 April 2008 (UTC)

LET'S NOT FORGET: That we may not be doing all that well in checking on the long term effects of the psych medications that seem to enthrall so many. Nearly all of them increase the reaction times, thus increasing the likelihood of crashes and falls; the earlier anti-psychotics often resulted in severe and devastating movement disorders, such as tardive dyskinesia. None of the disorders listed in today's psychiatric bible: the DSM (diagnostic and statistical manual of mental disorders) offers specific and physical lab findings as diagnostic markers--all 900 pages are observational, and thus subject to improvement or deterioration--with similar absence of medically specific findings. One day, and I hope it is soon, the awards for our current fuzzy-mushy pseudo-system that over-prescribes long term medications, will be withdrawn and thrown on the trash-heap of history, right alongside the lobotomy fiasco. Homebuilding207.178.98.26 (talk) 03:25, 22 January 2008 (UTC)


 * I'll try not to forget that. And don't forget that this isn't a blog and that:"This is the talk page for discussing improvements to the Lobotomy article. This is not a forum for general discussion. (read at the top of each talk page)" I wasn't saying that SSRIs are effective (nor am I saying they are not) but that I understood the purported mechanism involved and am suggesting that the article would be improved if the theoretical justification, along with the debunking of same, were added. &#8756; Therefore | talk 04:16, 22 January 2008 (UTC)

Rewrite of cultural references
I've rewritten the "In popular culture" to "Literary and cinematic portrayals" and rewrote it in prose vs. a discouraged list. An example needs to be relevant and to illustrate the subject -- how a work of art portrays lobotomy and in what fashion. I've deleted all references to songs, television shows, etc. that happen to use the word "lobotomy" as a metaphor or a passing mention. These are not relevant to a page dedicated to this serious medical procedure.

Also, an entry must have a verifiable citation from a reliable source. With that in mind, I had to, regrettably, delete this item:"In the 1947 radio play 'Dark Curtain', Veronica Lake portrays a paranoid schizophrenic bride-to-be who receives a failed series of convulsive electroshock treatments followed by a successful lobotomy. The shock treatments and the brain surgery are described in clinical detail. The glowingly positive light in which these 'advances in modern medicine' were depicted make it difficult for a contemporary audience to listen to it." because I could find no reference to these details. Hopefully someone will find one as this is an interesting addition. &#8756; Therefore | talk 23:54, 22 January 2008 (UTC)

I guess this one does not qualify either: Planet_of_the_Apes_(1968_film) where one astronaut gets his noodles scrambled. User:bwildasi Tue Apr 29 20:51:53 UTC 2008 —Preceding comment was added at 23:55, 29 April 2008 (UTC)


 * My opinion is that it isn't notable -- the use of the lobotomy wasn't to comment on the procedure per se but more as a plot device. &#8756; Therefore | talk 02:25, 30 April 2008 (UTC)

I removed two references: Hannibal, where a character has his head opened and bits of brain cut out and fed to him; and Saw, where a nurse is forced to operate on a brain tumor. Neither is a lobotomy. 71.110.159.41 (talk) 17:39, 1 May 2008 (UTC)

Purpose of lobotomy ?
The article fails to explain the goal or purpose of lobotomy. It says that lobotomy causes major personality changes and it was used to treat some illnesses. But it does not says about the intended effects of it. And about the the actual results. Were there any case when it cured anything ? What ? How ? Now it seems, as if surgeons cut brain, expecting some improvement in patients, but nothing useful really (documented) happened. It is like describing a lighter, but failing to mention that it creates a flame and can be used to burn things.

--Xerces8 (talk) 09:46, 3 June 2008 (UTC)


 * I guess the lobotomy was intended for the person to cease doing things they weren't supposed to do. If they were crazy, then the lobotomy made them stop acting crazy. If they were depressed, the lobotomy stopped them from being depressed. The problem was, it also made them stop doing anything else for that matter. Turned them into a vegetable. ScienceApe (talk) 02:09, 6 June 2008 (UTC)


 * In the early 20th century, Freudian psychoanalysis was giving way to biological psychiatry; that is to say, a belief that psychiatry is organic in nature. A consequence of this was a growing school of thought in the 1920s and 1930s that said psychiatric illnesses were the result of neurological pathways gone awry, in sort of a feedback loop. Proponents of that theory thought that by surgically cutting nerve fibers, those pathways could be interrupted and the brain would be forced to establish new ones. Of course, the hope was that the new neurological pathways would not be "defective" like the original ones. Freeman considered the obsessive-compulsive and manic-depressive disorders to be potentially treatable in this way; he was less optimistic about schizophrenic disorders. To answer your other question, yes there are a few documented cases where the patient experienced some relief of symptoms, sometimes dramatic improvement, but there are many more cases with a grossly overstated success. Freeman's best "success" was probably Ellen Ionesco, whose daughter maintains that the procedure yielded dramatic improvement. Contrary to popular perception, lobotomy did not produce a "vegetable" unless the surgeon made a mistake. This did happen, of course, but for the most part lobotomy did not affect the cognitive part of the brain. I've refrained from addressing any of these points in the main article because I'm not qualified to discuss it in a scholarly sense, this is just some of what I have learned by reading the biography of Freeman and related materials. SquareWave (talk) 20:02, 23 September 2008 (UTC)

Lena Zavaroni
The sad case of the singer Lena Zavaroni, who was lobotomized at the university of Wales hospital in Cardiff UK should be mentioned in the article. It is of interest because she was lobotomized in 1999. Nothing is mentioned in the article about it's use after the 80s decade, it is implied it died out.

In the following article concerning Zavaroni dated December 2005 it was reported that there are two hospital sites in the UK still performing lobotomies. Does it still go on?

http://www.psychosurgery.org/2005/12/lena-zavaroni.html

"In September 1999, she underwent a psychosurgical operation in the University of Wales hospital in Cardiff, one of only two centres in the UK that still perform such operations. Three weeks later, still in hospital, she died of an infection. She was thirty-five years old." —Preceding unsigned comment added by 92.6.10.193 (talk • contribs) 17:48, July 11, 2008


 * The link you provided said this about Zavorni's operation:"A special surgical procedure is available as a last-resort treatment for the most severe cases of chronic clinical depression. It's not a treatment for anorexia and it's not a lobotomy.[emphasis added]" I know the press at the time of her death (in particular the BBC) said "it is understood to have been a leucotomy", although the hospital did not discuss the operation. Later on, after the inquest, the BBC no longer referred to it as a leucotomy.. Therefore, I don't believe she should be mentioned. &#8756; Therefore | talk 00:57, 12 July 2008 (UTC)

The article "leucotomy" links directly to "lobotomy". Also the article starts: "A lobotomy (Greek: lobos: Lobe of brain, tomos: "cut/slice") is a form of psychosurgery, also known as a leukotomy or leucotomy (from Greek leukos: clear or white and tomos meaning "cut/slice").". My question is relevant. (User:92.6.10.193)


 * Yes, that is correct -- leucotomy and lobotomy are synonyms for the exact same procedure. And, yes, the BBC at the time of her death stated that "it was believed" that she received a leucotomy but subsequently did not do so. As your source makes clear, the reason why the BBC no longer referred to it as such in subsequent coverage is because of the simple fact that her surgery was not a leucotomy. &#8756; Therefore | talk 01:29, 12 July 2008 (UTC)

Cinematic portrayals
We should mention the film Total Recall about lobotomy. Because my English is not quite good, I hope that other contributors will do that. Thanks! -Nicolae Coman (talk) 12:58, 26 July 2008 (UTC)


 * My opinion is that it isn't notable -- the use of the lobotomy wasn't to comment on the procedure per se but more as a plot device. &#8756; Therefore | talk 13:34, 26 July 2008 (UTC)

Nobel Foundation
I've just read the Nobel Foundation's article on their award to Moniz, apparently written in 1998 by a then 66-year old psychiatrist. I was shocked to see such a disgustingly one-sided misleading article. It seems to be a notable fact for this Wikipedia article that the foundation is apparently defending the procedure?

"the leukotomy managed at least to make life more endurable for the patients and their surroundings" - Um, where's the evidence for "endurable" - I guess they referring to being a mental vegetable? "Surroundings" seems to be a euphemism for patient's families or society - perhaps an underhand implication of dangerousness - so, well, as long as it gave others a peaceful time eh...I think a lot of people didn't find it that endurable finding their loved ones turned into slobbering idiots with a decimated personality (which apparently was a "side" effect of shoving sharp implements in the brain)

It says the procedure "became rather popular in many countries all over the world" with no mention of countries banning it or all the individuals being disgusted from seeing the experiments. It says "I see no reason for indignation at what was done in the 1940s as at that time there were no other alternatives!" - Oh jolly good! I suppose they were only mentals so let's just do whatever we can think of to them then.

It refers to the "successful period" of lobotomies, quotes in apparently agreement statistics purporting to show that most either "recovered" or were "greatly improved", quotes without judgement Moniz saying it was "simple" and "always safe", implies it was only ethically dubious if done against patient's wishes but even then "what is it exactly that such a patient wants" anwyay!!! (hmm well maybe they wanted a chunk of their brain removed, yeah that must be it).

Although it credits Moniz with inspiring the enthusiasm for the later mass use and icepick methods etc, which by most accounts were barbaric unethical practices done with sickening disregard, making neurologists/psychiatrists faint at hte sight and rousing protests from groups etc, it calls them "sophisticated" and says "there is no doubt that Moniz deserved the Nobel Prize" (oh right, no doubt eh....none at all...? I'm sure there were some Nazi experimenters who made similar progress in this area, seems a bit unfair to them no?) EverSince (talk) 21:37, 10 September 2008 (UTC)

Not to mention that this is from a country that forcibly sterilized its psychiatric patients until as late as the 1970s, which that Swedish psychiatrist was presumably involved in... EverSince (talk) 22:16, 10 September 2008 (UTC)

Found a view on this Why Nobel should rescind the prize and dedicate it instead to the victims. Also cites a science magazine article/later Nobel laureate that "The jury failed to appreciate how widely discredited the procedure had become by the time it tapped Moniz." "It was a terrible mistake that caused permanent damage to thousands of patients," And points out that while Sweden and the Nobel Foundation defend it, Norway awarded compensation to surviving lobotomy patients.EverSince (talk) 23:52, 10 September 2008 (UTC)


 * Apart from a small bit at the beginning and end, the Nobel artice was not actually written by the Swedish psychiatrist. It was copied from an article a few years back in the American Journal of Psychiatry by an American psychiatrist - I think his name was Victor Swayze. Interesting that they couldn't find anyone to write an original article defending the prize.81.102.15.200 (talk) 08:55, 11 September 2008 (UTC)


 * I see he cites Swayze among others, one-sidedly it looks like even from the abstract that also mentions "mixed" results (slight understatement). Found the URL for another view arguing for withdrawal of this prize (a "no brainer") - Should they de-Nobel Moniz? - and also this British Medical Journal-published medical student] who can't apparently see the point of withdrawing it and after all he did some other work for which he was previously nominated (though a responder points out that he wasn't awarded for that 'cos they didn't think it was the best technique). EverSince (talk) 16:09, 11 September 2008 (UTC)

Francis Farmer
75.164.208.6 removed this from the article: Whether a lobotomy ever occurred or whether it was performed by Dr. Freeman himself is a matter of much debate. with the comment:"Farmer article contains numerous cites verifying no lobotomy; previous cite ignores original author's recantation of lobotomy claim)" I reverted their edit stating that the source here used ("Myths and Mysterious of Washington") asserted that whether she had a lobotomy is, in fact, in debate.

75.164.208.6 commented on my talk page:

"The book you are citing completely ignores the fact that Arnold, the only person to allege a lobotomy, stated in a court case that his claim was fiction. If you're going to insist on things being 'debatable,' you need to include that salient piece of information, which is included in the Farmer article (the actual court records are cited in a footnote). Or the fact that Jack El-Hai, Freeman's biographer and the only person to be given unlimited access to Freeman's extensive papers and, more importantly, patient records, found no mention of Farmer whatsoever.75.164.208.6 (talk) 15:49, 6 March 2009 (UTC)" and then added to the article:"William Arnold later admitted in a court case that many elements of his book, including the lobotomy episode, were 'fictionalized.' Freeman's biographer, Jack El-Hai, the only person to be granted unlimited access to Freeman's files and patient records, found no mention of Farmer whatsoever." unfortunately with no sources. So I went to the Frances Farmer article to see where the user is getting this information. Apparently they are relying on this source: SHEDDING LIGHT ON SHADOWLAND. This is not a reliable source. A reliable source is one that comes from a third-party published source known for its fact checking -- a published book, newspaper, magazine or scholarly journal. This source is the equivalent of a blog from a jazz musician which is not considered a reliable source on Wikipedia.

The book (a reliable source) "Myths and Mysteries of Washington" gives many reasons why this assertion is debatable, including that Freeman told his son that Farmer was the woman in the famous photograph which El-Hai confirmed but then added: Twenty years later, Franklin Freeman felt less certain and recalled only that he had heard the identification of Farmer in the photo secondhand. El-Hai, a credible reliable source, doesn't come down affirmatively on this issue. In other words, it is debatable.

My point is this: that it is debatable seems to be a sufficient assertion without fleshing out all of the pros and cons in this article. If we add in all of the cons as you desire, then for the sake of neutrality, then we would have to add all of the cons pros. And this article is an inappropriate article for such detail. I would argue that we should add in the El-Hai and the Arnold books as additional sources for the truthful statement that this is debatable. The Kaufmann article is not a reliable source. Thoughts? &#8756; Therefore cogito·sum 19:02, 6 March 2009 (UTC)


 * A couple of spelling corrections--it's Frances Farmer (with an E), and I believe the reporter who wrote Shedding Light on Shadowland is spelled Kauffman. However, you do not address my specific points in adding material--first off, that Arnold recanted, as is not only shown in the Shedding Light article but, long ago (probably before you started editing) was actually linked in the Farmer article directly to Nexus/Lexis legal database.  That's important information that should be included if you're going to link to a book which mentions Arnold as the source of the information.  Also your characterization of El-Hai is not entirely accurate.  He states explicitly in the Freeman biography that there was no mention of Farmer in any of Freeman's patient records.  Again, an important part.  I'm not "debating" the "debatable" issue, just your selective sourcing which ignores important supplementary information.  There's no reason to make the additions huge, but Arnold's recantation at least should be included.  75.164.208.6 (talk) 19:47, 6 March 2009 (UTC)


 * P.S. I just got out my copy of The Lobotomist to confirm the above information and was reminded that El-Hai thanks Kauffman in his acknowledgements, so evidently El-Hai feels he's a reliable source.  75.164.208.6 (talk) 19:50, 6 March 2009 (UTC)


 * P.P.S. Sorry--this will be my last post on the subject, but I just took time to skim over the Shedding Light material again as well as reviewing the Farmer talk page.  I guess some could argue about whether the Shedding article itself is "reliable," but it contains numerous sources (most of them print, with dates, etc.) that certainly would be considered reliable by WP standards.  Interestingly (it has been years since I looked at the article and I had forgotten about this), the whole issue of the picture is dealt with exhaustively and that section is completely sourced, with actual reprints from the original Seattle Post-Intelligencer that carried the photo(s).   Best wishes, 75.164.208.6 (talk) 20:12, 6 March 2009 (UTC)


 * All excellent points and I hang my head sadly about my poor spelling -- I should be a bit more careful! :)


 * I think that we can be satisfied with a simple restatement rather than exhaustively hashing out in this article all of the pros and cons (leave that for the Frances Farmer page (see? I'm educable at least. ;) ). How about this change: Whether a lobotomy ever occurred or whether it was performed by Dr. Freeman himself is a matter of much debate was asserted by her biographer William Arnold but others find his claim dubious with little or no supporting evidence. Let the Farmer page layout the entire argument scheme. Thoughts? &#8756; Therefore cogito·sum 22:24, 6 March 2009 (UTC)


 * I'd like to add, I think it would be problematic to attempt to characterize Arnold's statements as explicitly recanting his belief that she had a lobotomy. This isn't really the right forum to discuss this as it would be more appropriate for the Farmer talk page. He never said in his trial that he fabricated whether she had a lobotomy. He didn't say, "I made up out of whole cloth that she had a lobotomy". He argued that he had "fictionalized" much of her story, which is not the same thing. How much of his testimony was legal strategy in order to win a lawsuit? Again, more a proper subject for Farmer's page than here, I would think. &#8756; Therefore cogito·sum 22:34, 6 March 2009 (UTC)


 * Can you provide page numbers from the El-Hai book so that I may add it to the reference? That would be very helpful! &#8756; Therefore cogito·sum 23:01, 6 March 2009 (UTC)


 * Thank you for being reasonable. With your many edits on this article I was afraid this was a case of WP:OWN.  Vis a vis El-Hai's book, he thanks Kauffman on page p. 314, but pps. 241-42 really are (no offense) completely counter to your snippet above, which is a characterization of Frank Freeman's feelings, not El-Hai's.  Don't want to get into copyright violations here, but among El-Hai's assertions are:  "There is no evidence in Freeman's voluminous writings about his former patients that he ever met Farmer.  Nor is there any evidence Farmer ever had a lobotomy."  Further on he states "Given Farmer's personal accomplishments after her release from Western State. . .Freeman would probably have mentioned her with pride had she been his patient."  I didn't want to get into this, since it's perhaps a matter of personal opinion, but the book you cite indicates "flatness of affect" and in copious archival footage I've seen of Farmer from 1958-64 there simply isn't any.  Just because it's printed "don't make it so"--and that's another reason I have a problem with that book being cited.  It makes allegations which are blatant POV, not "just the facts."  I think your change above is fine, though I would argue that calling Arnold a "biographer" is stretching it, as the judge in his case against Brooksfilms discussed in some (blistering) detail.  I might just make that the more neutral "writer."


 * If you access the court records of Arnold's lawsuit you'll find that while he may have couched his verbiage in more politesse, yes, he basically did say he made up many elements "out of whole cloth" (that's actually a direct quote from the Judge's verdict against him).75.164.208.6 (talk) 23:34, 6 March 2009 (UTC)


 * I try to avoid taking ownership per se over pages although my first reversal certainly would give that indication. I see this as the standard cycle of WP:BRD. I have no problem changing the verbiage to read: Whether a lobotomy ever occurred or whether it was performed by Dr. Freeman himself was asserted as claimed by her biographer the writer William Arnold is considered by others as  but others find his claim dubious with little or no supporting evidence. I'll go ahead and make this change but am more than willing to amend further. I do prefer that the details be left to the Farmer page itself. Although I'm tempted to pick nits with the implications of the lawsuit (whether trial strategy is really a good indication of truth because the primary point of the strategy was if everything in it was true, then there would be no lawsuit -- the judge concluded as much) I'll leave that to others on the Farmer page. As I'm sure you know, using the lawsuit transcripts is not appropriate for Wikipedia (WP:PSS) -- a published third party would need to evaluate its usefulness. And I'm sure that El-Hai found Kauffman useful; his online article was well written and apparently well researched. It still shouldn't be used as a source for the Farmer page. I have faith that El-Hai confirmed Kauffman's assertions which is why he is useful. Thanks for the page numbers -- I'll add them to El-Hai reference. &#8756; Therefore cogito·sum 19:22, 7 March 2009 (UTC)


 * FWIW, my only real ownership was to rewrite the literary section from this horrid version: and do vandalism patrol. I wish that someone with a more authoritative knowledge of lobotomy would come in improve the article. Maybe you? It would be more than welcome! If you review the entire talk page, you will see that many have problems with the article. Anyway, thanks for the great ideas to tighten up this section. &#8756; Therefore cogito·sum 19:35, 7 March 2009 (UTC)


 * I personally would not trust Kauffman's material beyond the point where it is verified by others. He is a person with no research background who is obsessed by a topic, and such people can't be trusted to balance sources properly.  Regarding the court case, I believe the judge's summation should be considered a good source, although the testimony itself would not be. Looie496 (talk) 19:37, 7 March 2009 (UTC)


 * Coming into this one late, but I have some personal expertise in both the general subject and this particular sidebar which I won't get into, but you're quite mistaken if you feel Kauffman doesn't have a research background. He's a widely published author in a number of different genres.  His "obsession" is perhaps more provable, LOL, though I agree with the above IP that there is certainly a lot of sourced material in his article. 173.50.147.215 (talk) 21:12, 7 March 2009 (UTC)
 * Well, I was going by his own web site. I don't see any indication of research-related writing there, except regarding Farmer.  And my experience with motivated non-specialists -- I'm a scientist -- is that they often don't have any difficulty coming up with sources, they just have trouble putting them into appropriate context. Looie496 (talk) 23:03, 7 March 2009 (UTC)

Photos
Didn't we used to have a photo of a lobotomized brain? The current photo is of a 'non-lobotomized brain'. Isn't that like having a photo in an article on automobiles titled 'not a car'? --UnicornTapestry (talk) 05:04, 5 April 2009 (UTC)


 * It was deleted. . &#8756; Therefore cogito·sum 23:48, 5 April 2009 (UTC) [Comment: "Therefore" apparently means "...deleted from Commons."]

Not sure what an image of an ice pick was for, but I deleted it. (Unsigned comment by User:75.148.113.57)


 * If you had read the article, you would know. I'm restoring the "icepick" photo, with a clearer caption this time.  On the other hand, removing the "not an automobile" photo, per comments above,. EEng (talk) 18:28, 26 June 2009 (UTC)

Historical Context
This section needs development on: 1. Medical paternalism and culture, especially in relation to therapy and patient consent (to what extent was patient consent seen as necessary in any medical field). Psychiatric patients and diminished responsibility. Dehumanisation of psychiatric patients (particularly in the context of large public asylums). 2. Growth of asylum populations from the 19th to the early mid 20th century. Problems associated with this. Also, eugenics and psychiatric populations. 3. Population of "chronic" patients in psychiatric hospitals. 4. Licence for radical therapies was granted due to perceived inevitable terminal degeneration of patients diagnosed as schizophrenics. If such a patient was likely to end their days as a dement, according to the medical opinions of the day, then radical interventions (as with General Paralysis of the Insane and Fever Therapy) were seen as justified. 5. Association of these interventions, seen, at least, in the popular press as "cures" (rather than as, at best, treating certain symptoms) with modern medicine and positive developments. 6. Desire of psychiatrists to reintegrate with mainstream medicine. "Heroic therapies" - were seen as potential routes to this reintegration. Freekra (talk) 16:21, 25 November 2009 (UTC)


 * Excellent efforts, Freeka, toward improving an abysmal article on an important subject. However, there's a real problem with any section that opens (as it currently does), "Properly considered in its historical context..."   This implies there are multiple ways to consider the context, a particular one of which is being offered by the article as the proper one.  Also, I completely understand the argument that severe mental illness had at the time few treatments, and that some of those few were almost as scary-seeming as lobotomy, so lobotomy wasn't such a big jump as it might otherwise sound --- but there must be some way to get that across without all the detail about Metrazol and so on --- there's way too much detail on earlier treatments and the physicians that developed them --- this stuff belongs in other articles on those specific topics, linked from here.  (And why does it matter which doctors were Jewish, or Nazis?)  Please don't let this discourage you &mdash; I commend you for taking on the very difficult task of improviong the mess that is this article.  But it will be, well, difficult work.  One last point: if you know how to archive the Talk page so far (I don't) I think it would be a good idea to do that and start fresh --- it's an even bigger mess than the article itself.  EEng (talk) 05:16, 26 November 2009 (UTC)

Thanks for your comments EEng, they're very apposite. OK. I'll see about severely condensing down that first paragraph on historical context and the development of heroic psychiatric treatments. Also points about Jewish doctors and Nazi sympathesisers are well made. Thanks again and if you have any time to pop in occassionally and make other useful observations I'd much appreciate it. Unfortunately, I don't know how to archive I talk page, but I'll look into it.Freekra (talk) 10:49, 26 November 2009 (UTC)

Eventually figured out how to archive talk page. See the link above for the archive. I've kept this section as the only existing current discussion. Freekra (talk) 11:46, 26 November 2009 (UTC)


 * I see now I've been spelling your nom de plume incorrectly. Sorry, Freera Freekra!  Article looks much better already!  EEng (talk) 21:35, 26 November 2009 (UTC)

Freaky. Thanks again EEng ;) Freekra (talk) 22:06, 26 November 2009 (UTC)


 * Freekra, apparently I still couldn't get your name right (now corrected above) --- long day. I counsel you not to feel you have to take on all the tasks you list (below) on your own, or you may burn out.  I would be very careful using The Lobotomist, which is specifically on Freeman's life and work, shouldn't be considered a comprehensive source on lobotomy in general --- not saying don't use it, but bear its limitations in mind. There's been amazingly little in the way of book-length treatments in the last few decades; you'll certainly need to include Valenstein and Shutts but you're probably going to need to bring in journal articles as well.  Re "patients' points of view" sooner or later you'll run into Dully, My Lobotomy, but again it's just one experience.  Like I said, this is going to be a big, big job.  EEng (talk) 09:04, 27 November 2009 (UTC)

The major reason I'd like someone to have a look at El Hai's book is so that some statements about Freeman can be accorded a proper citation with page numbers. It would be easier to rewrite the section on Freeman if it could be ascertained what is currently factual in the text. In regard to doing everything myself, I was hoping that by putting up a to-do list I might encourage other editors to participate. I'm not quite sure about the process of recruiting other people to help. For myself, I have a deadline looming so I might have to leave this article as it stands for a week or so. In regard to other sources, it is easier for me to locate journal articles, at the moment, than books. So, if someone else has access to Valenstein and Shutts that would be wonderful. Patient experiences are a major problem. Dully is exceptional as he was a child when he had his lobotomy performed and was able to recover in a way that most adult survivors would not have been able to. First place to start, I guess, is with the psychiatric literature on side-effects, critiques of the procedure, etc. Thanks again for your comments EEnd Freekra (talk) 09:32, 27 November 2009 (UTC)


 * It's EEn g , if you don't mind, Mr. or Ms. Freaky. For recruiting, well, just see who shows up; there's no deadline for getting this done.  I advise avoiding the term lobotomy survivor because it's implicitly critical of the procedure.  For comprehensive evaluations of the safety and effectiveness (or otherwise) of the procedure, retrospective papers of the last 30 years at the earliest will be the only ones, I suspect, with sufficient distance (earlier sources, of course, might be used to illustrate early enthusiasm, later debates, and then growing criticism as lobotomy began to fall from grace, as those happened). I'd use Kotowicz with caution, it being a mix of cited fact and uncited assertion.  For example, he states (without futher discussion, or even citation that I can see) that soon after Moniz' Nobel Prize the USSR banned lobotomy, presumably for the protection of its citizens.  Given the substantial evidence that psychiatry was abused for political purposes in the USSR, and the well-known disconnect there between lofty legislation and daily reality, such a naked statement is problematic.   EEng (talk) 20:14, 28 November 2009 (UTC)

Suggested To-Do List
I'm going to keep plugging away at this article but any help in editing the article with sourced and non-biased material would be appreciated. Whatever one's feelings about the procedure there should be no need to say that it is "barbaric" etc. Simply describing the procedure, its history and outcomes should be sufficient to allow the reader to make up their own minds.

I've already made some changes - inserting the Historical Context, dividing the history of the procedure into the contributions of Buckhardt, Moniz, Freeman and a Reaction Section. The latter should probably moved into a separate section and extensively re-edited. I don't think Norbert Weiner's reaction is particularly relevant. There were plenty of other critical reactions from parties more closely related to the subject. I've also expanded the section on Buckhardt and begun editing the section on Moniz.

Proposed To-do list.


 * Introduction Removal of sentence: "There is significant evidence that the procedure was used as a means of controlling persons whose behavior (such as "moodiness" or "youthful defiance") was considered annoying or embarassing, often without the patient's informed consent in the modern sense." I think that this sentence could be removed. The most frequent application of lobotomy was in a asylum setting. In regard to inappropriate usage this was mostly directed at patients who were considered to be management issues. There are plenty of cases where social prejudice and clear abuse of medical power impacted on the use of the procedure but I think that this would need to find better support in the main body of the text. At the moment I don't see major support for the contention in the article itself.
 * Moniz An elucidation of theoretical basis for his procedure.
 * Freeman El-Hai, Jack (2005). The Lobotomist. Wiley. ISBN 0471232920. This is the major source for this paragraph as it stands. I don't have access to this book currently. If anyone does they might add page numbers to the citation - particularly with reference to Freeman practicing transorbital lobotomy on grapefruit (from memory - unreliable - I think this is true?).
 * Reaction Needs development. I think also some consideration of reviews of the treatment in the medical literature, reported side effects, etc, would be most useful.
 * Patient Experiences Not sure what sources to use, but I think that a section attempting to recount the procedure from the patient's point of view would be worthwhile.

Any comments, help, etc, would be much appreciated. Freekra (talk) 12:48, 26 November 2009 (UTC) It might also be an idea to have a section outlining the varous types and techniques used. Freekra (talk) 13:06, 26 November 2009 (UTC)

"The most frequent application of lobotomy was in a asylum setting" - Actually this appears not to have been the case, at least in regard to those procedures performed by Freeman and Watts pre 1943Freekra (talk) 15:19, 26 November 2009 (UTC)

Moniz section now expanded and almost finished. Need a bit on how his leucotomies were initially received. Freekra (talk) 04:05, 27 November 2009 (UTC)

Most people will come upon this page looking for two basic pieces of information: 1. what a lobotomy is and 2. why the procedure was traditionally undertaken. I suggest that someone edits the Introduction or that first paragraph at the top of the page making it more accessible to ordinary people, while leaving the rest as technical or detailed as necessary. The page also feels a bit more like a college-level essay than an encyclopaedia entry (use of sentences such as "As per personX's description, a lobotomy was traditionally performed by blah blah" rather than using something along the lines of "A lobotomy was traditionally performed by blah blah [insert citation to personX]")--82.32.195.84 (talk) 22:57, 23 March 2010 (UTC)

Images
Apart from some more images of icepicks and hammers used by Freeman for the transorbital lobotomies, I haven't been able to find any non-copyrighted images to cover the other aspects of the procedure and I have no experience in sourcing such items. What I'd really like to use are the images from the following article which is public access but still under copyright: Bilateral Frontal Lobe Leucotomy in the Treatment of Mental Disease This article has some excellent images - particularly Fig. 2 which visually demonstrates the conception of mental processes at that time which supported the procedure. Does anyone know if it's even possible to get a release on such images? Freekra (talk) 21:48, 26 November 2009 (UTC)
 * You would have to get written permission from the publisher. Looie496 (talk) 19:27, 27 November 2009 (UTC)

Does anyone have any experience of doing this? What's the likelihood of the publisher granting a release on an article that was published in the late 1940s? Freekra (talk) 19:34, 27 November 2009 (UTC)
 * There are editors who have a knack for finding useable (in terms of permissions) images for various articles. I suggest you mention desired images here on Talk, and concentrate on the text (on which you contiue to do an excellent job, by the way).  Images are fun and eyecatching, but they should have a purpose directly related to the article.  Portraits of doctors and pts belong in articles on those people; but the photo of Freeman and Watts "in action" seems right on point, and something like the "Fig. 2" you mention sounds like it would as well (though I doubt you could get permission for it --- see below).  Re "icepicks and hammers," lots of surgical instruments look like refugees from a torture chamber, but articles on other procedures don't usually illustrate tham; including such photos here plays into the sensationalist angle and I don't see what they add to the understanding of the subject.
 * One way around your "Fig. 2" permissions problem would be to describe what the reader will see in the figure then link to the paper itself (which as you point out, is luckily open-access); but this is awkward and the figure in question better be really, really worth the reader's trouble. (By the way, the McKenzie paper you link to gives one of the weirdest illustrative examples I've ever seen, whether in a medical context or any other: "When both [frontal lobes] are removed, the individual...could operate a simple boat. He would require his frontal lobes, however, to be taught anything more than the rudiments of sailing." So maybe it works this way: zero frontal lobes = rowboat; 1 frontal lobe = sailboat; 2 frontal lobes = ocean-going yacht?)  EEng (talk) 20:14, 28 November 2009 (UTC)

Point taken re photos of doctors etc. I guess I was just looking for anything visually I could include and really that's all there is available. If you disagree with any current photos or any textual changes I've made delete/rewrite without compunction. I actually hadn't read the maritime analogy in the article until you brought it up. I wonder how many frontal lobes McKenzie would think that it takes to change a lightbulb? It's bizarre.Freekra (talk) 02:17, 29 November 2009 (UTC)

New Section: Medical Case Histories
Added this section and, while I personally think it might improve the article, I'm not sure if it's appropriate for an encyclopedic entry. Any feedback would be welcome.Freekra (talk) 00:38, 28 November 2009 (UTC)


 * Recitation of case histories weighs the article down, unless a particular case is especially enlightening on the subject of lobotomy; if the case is notable mostly because the patient is notable (e.g. Rosemary Kennedy) then the article on that patient is a better place for details (especially since the topic may be controversial and is best worked out in one place instead of two). Take a look at WP:MEDMOS which I think you'll find helpful in general.  (In the case, it suggests a home for case histories outside the article.) EEng (talk) 20:14, 28 November 2009 (UTC)

I agree entirely with your pruning of the notable non-notables. Dully, I believe is mostly useful in terms of the info he provides regarding Freeman from the radio doc he did. That's now the source for the grapefruit story etc until I can get another written one. What I was wondering about, though, were the medical case histories I took from that journal article. Are they appropriate here or outside the article? I'm asking again cause I'm a little confused as to which section you're referring to in your comments above - the notable non-notables or to the medical case histories? Thanks again for all your help and "sage advice". :) Freekra (talk) 02:09, 29 November 2009 (UTC)
 * I meant the "medical case histories" --- jargon-filled, not sure what they tell the reader. I removed them.  You can always get the text back (e.g. for use in Wikisource) from the article history. Re "notable non-notables," you'll notice I didn't (a few days ago, when I adjusted the "notable cases" section) remove any items, just cut down the detail, leaving it to articles on those individual persons to explain.  BTW, I wonder if special attention should be given to Frances Farmer  --- long before the film, it was a common idea that Farmer had been lobotomized --- so perhaps this issue should be discussed more prominently than in "cinematic/literary portrayals section" (maybe something like the way Phineas Gage is treated -- with details removed except to say that it was once reported, now there is serious reason to doubt etc etc, with link "see Frances Farmer" article for full discussion; there's similar text at Psychosurgery that ought to be similarly cut down and linked to Farmer article). EEng (talk) 12:45, 30 November 2009 (UTC)


 * You're probably right in that they're primary source and don't really belong here unless there's a secondary source to comment on them. Possibly same is true of 1970 dictionary entries which, as it stands at least, is a bit confusing in terms of what the article is saying. Freekra (talk) 13:52, 30 November 2009 (UTC)

Effects of lobotomy
It doesn't seem like there's a lot of empirical information here about the effects of lobotomy, either intended or unintended. Is the 1970 medical dictionary excerpt intended as an authoritative and still-current description of lobotomy's typical effects, or is it intended to be historical? This is especially important because the article does describe popular depictions of lobotomy, and it should comment on to what extent they are accurate.

It also doesn't have much information on what the experts actually concluded -- were lobotomies sometimes effective, but too damaging? Were they too often used inappropriately to justify cases where they helped? Were they (as a few sources in the article suggest, but do not support with evidence) completely destructive, but for a time therapists mistook the effects of brain damage for improved mental health? Or was the whole thing a monstrous fad that was built on nothing at all?

I apologize for asking these questions when I can do nothing to help answer them, but since this page seems to have a number of active editors, I thought I'd mention it. Inhumandecency (talk) 23:50, 29 November 2009 (UTC)

Please don't apologise they're all good questions. Empirical information is scant on the efficacy of the treatment although I will be inserting more material of fairly large studies drawn from the 1940s and 1950s. So far as I can ascertain there are no double-blind trials or any studies approaching contemporary standards in the medical literature from when the procedure was current. This is not that surprising as this was true of a lot of the production of medical knowledge it would seem until at least the 1950s (open to correction on that). Mostly these type of physical therapies were introduced with quite a bit of fanfare in the medical press claiming huge recovery rates. Other clinicians tried to reproduce this, rarely succeeding, but were at least pleased to get any therapy that might achieve recoveries over the average spontaneous remission rate. There doesn't appear to have been a lot of control for selection bias here (taking acute cases for insulin shock therapy etc). Once there was an international acceptance of the procedure as effective - on whatever grounds that actually stood - there was little incentive to challenge the therapy. Psychiatrists had a huge investment in procedures that held out the promise of a cure or alleviation of symptoms because they had so little else in their medical armoury. Moreover, cardiazol shock therapy, insulin coma therapy and surgical leucotomy (not the office procedure of Freeman who has a bit of the medical mountebank about him) were avenues for asylum doctors to attempt to reintegrate with the wider medical profession. Asylum doctors (as distinct from Psychoanalysts - although they too could embrace physical therapies by Freudianising their mode of action) had a huge investment and, as with the case of insulin in 1957, when good evidence was produced calling a procedure into question they fell back on the authority of their clinical experience to rebut it. Empirically they were right in any case with ECT, it would seem, and probably cardiazol too.

However, I'm sure there are later follow-up studies of lobotomy procedures. I haven't gone looking for them yet, but I will.

I wouldn't think it was built on nothing. Undoubtedly, in the context of large asylums especially, and from a management point of view some of the results were "positive". Difficult to manage patients could become much less of a drain on resources and that is made explicit in the literature, as are a lot of the more unpleasant side-effects (something is always lost of the person etc). However, these are mostly drawn from clinical observations rather than any robust statistical studies. Psychiatrists at this time were much more trained in reading and drawing inferences from case studies - and taught through that means - than through large statistical studies.

The 1970s dictionary is intended not as authority on the actual effects of lobotomy but of the contemporary medical understanding. I intend to supplement it with stuff drawn from each decade of the procedure's existence.

'''The short answer is that the article is not yet complete and I'll be looking to find as much authoritative info as possible on the actual impact of lobotomy. But I'll need a little time and any help would be appreciated'''Freekra (talk) 01:19, 30 November 2009 (UTC)

Ok. Got one follow-up study 2009 Longterm outcome of leucotomy on behaviour of people with schizophrenia from Journal of Social Psychiatry of 87 lobotomised schizophrenics, all army vets avg. age 71 yrs, who had had the procedure approx. 45 years previously. Study briefly goes through the historical medical literature on the subject. States that need for controlled trials wasn't recognised until 1000s of people had had the procedure. No contemporary objective assessment of cognitve or psychosocial outcomes. Little can be drawn from contemporary studies claiming positive outcomes: not robust studies. Strict criteria for surgery not applied - often indiscriminate usage. This study measured 87 lobotomised schizophrenics against one control of non-lobotomised schizophrenics and another control group with multiple othe diagnosis. Little significant difference between the two groups other than that the lobotomised group were somewhat more irritable. Study states one of the proposed impacts of the surgery was to reduce irritability - so a fail on that point. Concludes that long-term effects of chronic schizophrenia had more impact on them than long-term effects of leucotomy. Refers also four other studies on long-term effects of leucotomy which, it says, generally supports their results that re schizophrenia over the long haul having more impact that the lobotomy. Will track these studies down.

The truth, I suspect, is that you're not going to get a proper answer to how effective it was. The best you might be able to say is that the procedure was used on 1000s of people with no proper evaluation of its effects. Freekra (talk) 02:36, 30 November 2009 (UTC)

Relationship to Psyschosurgery article
There's naturally a lot of overlap of potential content between Lobotomy and Psychosurgery. Even now 'Psychosurgery' has lists of lobotomy pts, the Frances Farmer story, etc. Meanwhile, this article (Lobotomy) is getting quite long. Perhaps Psychosurgery should be thought of as a main article (not sure that's the right term) and lobotomy and certain other things as sub-articles to it. At the very least, discussion of work leading up to lobotomy could be moved out of here and into Psychosurgery (or into an "early work" sub-article to Psychosurgery). Also, discussion of opposition/concerns re lobotomy could be discussed with that re psychosurgery in general -- that would be another sub-article perhaps. Same for ethical/abuse issues, lists of pts and so on. This way Lobotomy article could be pretty narrowly on things about that procedure (that includes plenty -- Moniz, Freeman, Freeman's version of procedure, etc) with Pschosurgery containing material (or pointing to sub-articles) on historical context and all that other stuff, including newer psychosurgery techniques. EEng (talk) 16:50, 30 November 2009 (UTC)
 * There's also the article History of psychosurgery in the United Kingdom. Some of it appears to be lifted straight from another website - as I point at Talk:history of psychosurgery in the United Kingdom - but if the rest wasn't lifted from somewhere (I do have my suspicions but perhaps its unfounded) it looks to be a good article with, again, a lot of overlap. But I agree, merger makes the most sense, with one long article on psychosurgery and related shorter articles. Freekra (talk) 23:33, 30 November 2009 (UTC)

I have to disagree about the UK article -- it's a numbing recitation of dates and hospital names and numbers of patients; and saying Dr. X "volunteered his pts as guniea pigs" is a very, very bad sign. There are some useful facts here, and on general principle it's likely the Psychosurgery and Lobotomy articles will need more non-American material, but probably, if we're going to pursue our megalomaniac merge-it-all-together plan, there's no justification for a separeate "in the UK" article. EEng (talk) 01:23, 1 December 2009 (UTC)
 * Well you'll have to forgive my review. I didn't actually read it all - just the references really which look pretty good. Anyhow I bow to your opinion on this. Freekra (talk) 01:29, 1 December 2009 (UTC)

Yes, the references might be useful. As to the "bowing" --- I think I should be clear: I'm no expert on all this. Your opinion counts just as much. EEng (talk) 13:49, 1 December 2009 (UTC)

I think this part can be divided into positive expected outcomes and comment more on the side effects —Preceding unsigned comment added by 189.230.9.179 (talk) 06:13, 16 February 2011 (UTC)