Walter Jackson Freeman II, M.D.

http://en.wikipedia.org/wiki/Walter_Jackson_Freeman_II

Walter Jackson Freeman II, M.D. (November 14, 1895 – May 31, 1972) was an American physician who specialized in lobotomy. He was a member of the American Psychiatric Association.

Biography and early years

Walter J. Freeman was born on November 14, 1895 to a privileged family. He was raised in Philadelphia, Pennsylvania by his parents. Freeman was also known for being a bit of an oddball and he complemented his theatrical approach to demonstrating surgery by sporting a cane, goatee, and a wide-brimmed hat. Working in the field of medicine ran in his family and his grandfather, William Williams Keen, was well known as a surgeon in the Civil War. His father was also a very successful doctor. Freeman attended Yale University, which at the time was Yale College, beginning in 1912 and graduated with his undergraduate degree in 1916. He then moved on to study neurology at the University of Pennsylvania Medical School. While attending medical school he studied the work of William Spiller and idolized his groundbreaking work in the new field of the neurological sciences. William Spiller also worked in Philadelphia and was credited by many in the world of psychology as being the founder of neurology. Freeman applied for a coveted position working alongside Spiller in his home town of Philadelphia, but was rejected.

Shortly afterward, in 1924, Freeman relocated to Washington D.C. and started practicing as the first neurologist in the city. Upon his arrival in D.C., Walter Freeman began work directing labs at St. Elizabeth’s Hospital. Working at the hospital and witnessing the pain and distress suffered by the patients encouraged him to continue his education in the field. Freeman earned his PhD in neuropathology within the following few years and secured a position at George Washington University in Washington, D.C. as head of the neurology department.

Lobotomy

The first systematic attempt at human psychosurgery is commonly attributed to the Swiss psychiatrist Gottlieb Burckhardt. Burckhardt's experimental surgical forays were largely condemned at the time and in the subsequent decades psychosurgery was attempted only intermittently. On November 12, 1935, a new psychosurgery procedure was performed in Portugal under the direction of the neurologist and physician Egas Moniz. His new “leucotomy” procedure was used to treat patients with mental illness. Moniz became a mentor and idol for Freeman who modified the procedure renaming it the “lobotomy.” One year after the first leucotomy, on September 14, 1936 Walter J. Freeman performed the very first prefrontal lobotomy in the United States on housewife Alice Hood Hammatt of Topeka, Kansas beginning his now infamous career as a neurosurgeon in the United States. Freeman’s lobotomy procedure was assisted by fellow neurosurgeon and research partner, James Watts. By November after only two months performing their first lobotomy surgery, Freeman and Watts had already worked on 20 cases including several second, follow-up operations. By 1942, the duo had performed over 200 lobotomy procedures and had published results claiming sixty three percent improved, 23 percent were reported to be unchanged and fourteen percent were worse after the surgery.

After almost ten years of performing lobotomies Freeman heard of a doctor in Italy named Amarro Fiamberti who operated on the brain through his patients’ eye sockets, allowing him to access the brain without drilling through the skull. After experimenting with novel ways of performing these brain surgeries, Freeman formulated a new procedure called the transorbital lobotomy. This new procedure became known as the icepick lobotomy and was performed by inserting a metal pick into the corner of each eye-socket and moving it back and forth, severing the connections to the prefrontal cortex in the frontal lobes of the brain. He performed the transorbital lobotomy surgery for the first time in Washington D.C. on a housewife named Sallie Ellen Ionesco. This transorbital lobotomy method did not require a neurosurgeon and could be performed outside of an operating room without the use of anesthesia by using electroconvulsive therapy to induce seizure. The modifications to his lobotomy allowed Freeman to broaden the use of the surgery, which could be performed in state mental hospitals throughout the United States that were overpopulated and understaffed. In 1950 Walter Freeman’s longtime partner James Watts left their practice and split from Freeman due to his opposition to the cruelty and overuse of the transorbital lobotomy.

Following his development of the icepick lobotomy, Freeman began traveling across the country visiting mental institutions in his personal van, which he called the "lobotomobile." He toured around the nation performing lobotomies and spreading their use by educating and training staff to perform the operation. Freeman’s name gained popularity despite the widespread criticism of his methods following a lobotomy on President John F. Kennedy’s sister Rosemary Kennedy, which left her with severe mental and physical disability. A memoir written by former patient Howard Dully, called My Lobotomy documented his experiences with Freeman and his long recovery after undergoing a lobotomy surgery at 12 years old. Walter Freeman charged just $25 for each procedure that he performed. After four decades Freeman had personally performed as many as 3,400 lobotomy surgeries in 23 states, despite the fact that he had no formal surgical training. In February 1967, Freeman performed his final surgery on Helen Mortensen. Mortensen was a longterm patient and was receiving her third lobotomy from Freeman. She died of a cerebral hemorrhage as did many of his other patients[quantify] and he was finally banned from performing surgery. At age 57, Freeman retired from his position at George Washington University and opened up a modest practice in California.

Contributions to psychiatry

However controversial his techniques may have been, Walter Freeman did make a number of important contributions to the studies of psychiatry and neurology. Walter Freeman nominated his mentor António Egas Moniz for a Nobel prize and in 1949 Moniz won the Nobel prize in physiology and medicine. He pioneered and helped open up the psychiatric world to the idea of neurosurgery as a possible treatment for severe mental illness. He also supported and helped to demonstrate the idea that mental events have a physiological basis. Despite his interest in the mind, Freeman was “uninterested in animal experiments or understanding what was happening in the brain”. Freeman was also co-founder and president of the American Board of Psychiatry and Neurology from 1946 to 1947 and a contributor and member of the American Psychiatric Association.

Writings

Freeman, W. and Watts, J.W. Psychosurgery. Intelligence, Emotion and Social Behavior Following Prefrontal Lobotomy for Mental Disorders, Charles C. Thomas Publisher, Springfield (Ill.) 1942, pp. 337.