A Procedure Born from Desperation
The origins of lobotomy trace back to the 1930s, when Portuguese neurologist António Egas Moniz pioneered the leucotomy, a surgical technique designed to sever connections in the prefrontal cortex to relieve severe psychiatric symptoms. Moniz was awarded the 1949 Nobel Prize in Physiology or Medicine for this work.
In the United States, lobotomy found its most notorious champion in Dr. Walter Freeman, a neurologist without formal surgical training. Determined to revolutionize psychiatric treatment, Freeman modified Moniz’s technique and developed the transorbital lobotomy. In this procedure, a sharp metal instrument—often an ice pick—was inserted through the patient’s eye socket into the skull. With a quick motion, he would sever neural connections, all while the patient remained awake under local anesthesia. Freeman claimed he could complete the operation in just ten minutes, making it an attractive, albeit reckless, solution for overcrowded asylums.
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| A 49-year-old patient before and after undergoing a lobotomy performed by Walter Freeman. |
The Faces of Lobotomy
Freeman was not only a practitioner but also a self-promoter. He meticulously documented his patients, capturing their expressions before and after the procedure. These before-and-after lobotomy photographs, originally meant to validate his work, now stand as haunting evidence of the irreversible damage inflicted by lobotomy.
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| A photograph taken on May 6, 1942, shows a patient before lobotomy, quoted as saying, "God, I’m getting ready to blow up." The after picture, taken in September 1946, states that he is "Employed and going to night school." |
Some images show individuals with forced, vacant smiles, their faces betraying the cognitive and emotional toll of the surgery. Others depict the profound physical and psychological decline that many patients endured.
One of the most disturbing cases involved a young woman diagnosed with schizophrenia. Before the operation, she was described as agitated and difficult to manage. Afterward, her caregivers noted that she had become a “veritable household pet”—a chilling testament to the dehumanizing effects of the procedure.
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| Freeman stated that this woman was schizophrenic and that all that could be done was to turn her into a 'veritable household pet.' |
Despite mounting evidence of lobotomy’s devastating consequences—including a significant fatality rate—the procedure surged in popularity. By 1951, nearly 20,000 lobotomies had been performed in the United States alone. Women were disproportionately targeted; studies from the early 1950s revealed that nearly 60% of lobotomy patients in the U.S. were female, while in Ontario, Canada, between 1948 and 1952, that figure rose to 74%.
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| Photo of an 8-year-old boy before and after lobotomy, diagnosed with schizophrenia, performed by Dr. Walter Freeman. |
The Fall of a Medical Horror
By the late 1950s, the tide began to turn against lobotomy. The Soviet Union was among the first to ban the procedure, condemning it as “contrary to the principles of humanity”. In Europe and North America, advancements in psychiatric medication, such as chlorpromazine (Thorazine), offered safer and more effective alternatives for treating mental illness. Gradually, this gruesome practice faded from mainstream medicine.
Yet, its legacy lingers. The haunting lobotomy photographs taken by Walter Freeman serve as a reminder of an era when medicine, driven by ambition and flawed understanding, inflicted irreversible harm in the name of progress. They capture not just the faces of patients but the haunting cost of misplaced faith in a medical revolution that, in the end, left far more suffering than salvation.
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| Freeman’s caption on this photograph reads: "The change in personality suggested here is typical of that which usually follows prefrontal lobotomy. The patient is shown before the operation in the picture on the left, and seventeen months after lobotomy on the right." |