When you think of brain surgery, a few different images may come to mind: doctors standing for hours on end around the operating table, intubated patients with partially shaved heads or even “Grey’s Anatomy’s” Dr. Derek Shepherd’s bright smile as he quips, “It’s a beautiful day to save lives.” The field of neurosurgery is constantly improving. However, these kinds of procedures weren’t always as safe, or humane, as they are today. This fact is exemplified by a now-defunct surgery called a lobotomy.
During a lobotomy, which was a common medical procedure in the mid-20th century, a surgeon would cut into a patient’s brain to remove parts of the frontal lobe, a part of the brain that is integral in forming a person’s personality. These procedures were used to treat various mental illnesses, including clinical depression, schizophrenia and mania. Since this was such an extreme procedure, it may be unsurprising to learn that lobotomies often had catastrophic results. Potential side effects and results included patients seemingly losing their sense of self, becoming apathetic, aloof or lethargic.
Many candidates who were recommended lobotomies were patients who had dealt with mental health issues their entire lives. Although a lobotomy was rarely the first intervention, it was certainly the most devastating. For the cost of taking away a person’s independence and character, doctors could get these patients off their couches and out of the asylums. In other words, the prevalence of the procedure represents a time in medical history when it was acceptable for physicians to prioritize shortening treatment time over a patient’s mental and physical well-being.
The first lobotomy in the United States was performed by the physicians Walter Freeman and James Watt in 1936. The duo remained prominent lobotomists until the surgery fell out of practice in the 1950s. During this time, Freeman and Watt were just two of many surgeons who overwhelmingly performed the procedure on women. Almost 60% of all lobotomy patients were women, despite men making up the majority of psychiatric patients nationwide during this time.
The reason for this broad discrepancy is tied to sexist beliefs about gender roles. The results of lobotomies, which included passivity and lifelessness, were traits men saw as ideal for women. When a woman underwent a lobotomy and came out lacking autonomy and individuality, it was seen as a success. When the same result was achieved with a male patient, the procedure was seen as a failure. The only difference between these opposite ends of the spectrum was the patient’s sex. It was permissible and even admirable to strip a woman of her identity, but never to do the same to a man.
From the time lobotomy first became common practice in the United States in the late 1930s, the procedure was predominantly performed on women. More specifically, it was used as a form of oppression against women. Whether neurologists and surgeons were cognizant of it or not, their actions reinforced societally assigned gender roles that have existed in the United States since its conception. The use of lobotomy is not the only sexist stain on the history of medicine; medical practice incited with sexist beliefs persists today. To prevent such malpractice in the future, patients and physicians alike must recognize and remember the destructive history of lobotomization.