Sorting by

Skip to main content

Hope and Horror–Horror and Hope

The word lobotomy strikes terror in the heart of most of us today, despite the fact that the procedure was once the darling of mental health professionals–and the fact that Antonio Egas Minoz, inventor thereof, won the Nobel Prize for medicine in 1949 for his contribution. In this country 40,000 lobotomies were performed in the two decades when the procedure was considered a godsend. Today, however, the word even sounds medieval.

It looks worse. What Minoz designed, and dozens, even hundreds of practitioners copied, was gaining entrance to the brain and then simply messing things up inside, disconnecting connections between the prefrontal cortex and the rest of the brain. Someone determined to call the procedure “ice-pick surgery” because those who performed it gained access to the brain via–gulp!–extra long nails. A couple of days ago, I saw such nails, behind glass, at St. Joseph’s (MO) Glore Psychiatric Museum, in a display that included pictures and drawings I’ve unfortunately not forgotten. 

The whole operation, I’m told, took ten minutes, no more; and for twenty years it seemed a perfect blessing to mental health professionals. Right from the get-go, the procedure had its detractors, some registering criticism simply on the basis of the repulsive nature of procedure–poke something sharp through the eye and into the cranial cavity, then stir things up.

The truth is, success was, from the start, a mixed bag. A third of the patients’ conditions didn’t change a bit. Another third came out of the lobotomy changed–for the worse, often badly for the worse. But the behavior of yet another third clearly improved. 

Lobotomy never became the miracle cure its proponents claimed it would. Worse, in some high profile cases like that of Rosemary Kennedy, sister of JFK, the failure was far worse than awful. Her father, Joseph, determined a lobotomy would cure his often petulant daughter of her violent mood swings. It was November of 1941, and approximately 80 lobotomies had been performed in this country. Tragically, Rosemary Kennedy’s operation was an appalling failure, leaving her in a state for which we have no words easy to use. 

Still, seen in context, the immense and immediate popularity of the lobotomy is somehow humanly understandable, despite the unspeakable disasters. During the Depression, when money was tight, funding for mental hospitals was frequently the first government expenditure to go. Mammoth institutions found themselves crowded with thousands of patients, but operating on fiscal budgets that became, with each passing year, more draconian. In the era of “insane asylums,” as they were called, many Americans–and mental health professionals–advised new patients’ families to pack clothes proper for burial since signing family members into mental health facilities–many of those institutions cities in-and-of themselves–meant the patient would likely leave only in a casket years later. 

The lobotomy, an incredibly cheap and quick procedure, offered a miracle fix we all still search for in the face of our own intractable problems. We’ve come a long way in our treatment of mental health–or so museums like the Glore amply display. As many of us sadly know, however, coping with significant mental and emotional distress is too often no easier today than it was before the lobotomy. Hope, the “thing with feathers,” flits alluringly through all of our dreams, but it’s ever fragile, easily broken.

Almost as if by chance, I’ve been in two mental health museums in the last few weeks, seen all kinds of hope demonstrated in a hundred bizarre historic procedures and therapies that, throughout the years, appeared to offer nothing less than miracles. But even most recently with pharmaceuticals, the dark corners of our mental problems remain shrouded. Those sprawling facilities we built long ago in places like Cherokee, Iowa, and St. Joseph, Missouri, those massive ornate structures (the distance around Cherokee’s is more than a mile!) were once a huge alternative world where the rest of us could file away those we judged insane or lunatic, words today considered obscene.

 The history of mental health treatment is full of false starts, misplaced enthusiasm, and stunning failures. Still, walk through those old institutions sometime, and it’s hard not to be taken by an undercurrent of unyielding hope in those people who weren’t themselves as evil as they might well seem, men and women who did their best with what they had, which wasn’t much, did their best simply to hope. Once upon a time, given the circumstances, the word lobotomy had to have been a perfect thrill.

The stories in such old, odd places may well be scary as ice-picks; but the hope in those wide hallways is as much ours as the nightmares. Their stories belong to us too.


The painting at the top, “Removing the Stone of Madness,” belongs to Hieronymus Bosch.

James C. Schaap

James Calvin Schaap is a retired English prof who has been something of a writer for most of the last 40 years. His latest work, a novel, Looking for Dawn, set in reservation country, is the story of two young women joined by their parents' mutual brokenness and, finally, a machine-shed sacrament of reconciliation. He writes and narrates a weekly essay on regional history for KWIT, public radio, Sioux City, Iowa. He and his wife Barbara live on the northern edge of Alton, Iowa, the Sgt. Floyd River a hundred yards or so from their back door. They have a cat--rather, he has them.

One Comment

  • This history is so fascinating. I often wonder what practices of our time will be looked back on in 75 years as unbelievable. A 30% success rate must have been encouraging enough to some of them, but it’s hard to understand how these things could have happened.

Leave a Reply