The Horrible History of Lobotomizing People
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First month is $30. Bring your number and ID. Offer not available if with T-Mobile or with Metro in the past 180 days. Hello, my friends. Takuya here. And I'm Gabby. Welcome to the podcast. Merry Christmas and happy New Year.

Yep. That right there was the voice of our wonderful daughter, Joya. And thank you all for supporting our family this past year and for multiple years before. Thank you all. Happy holidays. And we're glad you're here. The reason that we're able to make our family so happy, our daughter so happy is specifically because of all of you who have been listening here. And on that very happy, very cheerful note, very thankful note, I think I'm about to ruin a lot of your all's day.

Oh, no. Is this like a dark topic? Is that at least wacky? Look, it is wacky. It is dark. It is kind of both because I mean, you can probably see based off the title for what I'm going to be putting in this thing here in the first place. But yeah, the last year, the previous thing that we did when we did a whole Christmas special is that we did, you know, we did things like, oh, yes, here's these little Christmas traditions and their origin and how they kind of came to be all around the world. And isn't that so lovely and nice?

Yeah, now we're doing something very different. We're going to be picking your brains about a fascinating topic. Lobotomy. Boo! Yeah, okay, look, yeah, I know. I know I deserve boos for that, I'm sorry, but I was really trying to figure out how to make a good intro or like a segue into this topic and nothing came to mind but a surgical rod. Steven? Steven?

Yeah, that was another bad joke. Look, I'm sorry. I'm sorry. So anyway, I said, so I was tweaking earlier this week for no good reason. Actually, I just do that sometimes. And he was like, what's wrong? And I said, I need a lobotomy. And that's how we ended up here. It is true because actually here's the thing. And we're going to be covering this over the course of this episode. But one of the treatments for hysterical women is.

in history... Don't look at me like that. ...was to lobotomize that. No, I'm not looking at you like anything. I'm just looking... You said you were tweaking, so I'm just looking over at you. It's a glance. It's nothing. We did literally nothing extraordinary this week, okay? We did what we did last year. We did what we've done multiple times before. But for some reason...

my heart rate would not come down. Okay. Like I was literally about like, my heart was going to explode. And what might you think caused that? Like, Oh, were you being hunted for sport? Were you, was your life in danger? No, none of that occurred. Um, I just was in a comfy, comfy bed, super welcoming place, but I had to have a moment. So hence the,

A lobotomy was needed. I didn't get one, so it's probably going to happen again. But one of these days, if my insurance would approve that. I don't think that it would, considering how a lot of this goes and plays out. Yeah, this, my friends, is one of the more dark and weird topics that we could possibly cover in the whole medical history of the world and that sort of thing. So I'm warning those of you who are listening right now, if medical history, gruesome actions, and cruelty make you extremely uncomfortable,

You have been warned. Like 50% of our listeners are like, anyway, skip. Yeah, yeah, entirely. Some people absolutely love this stuff. Others cannot stand it. I'm just giving you that heads up right now. We will be talking about what a lobotomy is, how it came to be, what it was used for, how the practice fell out of fashion at insane asylums due to just how incredibly cruel and unnecessary it oftentimes was.

First and foremost, what is it? Exactly. What is a lobotomy? Well, my friends, for those of you who are not exactly sure or may have seen different Gabby, did you ever watch? Oh, God. What is what is the one movie with? It was in an insane asylum. It was a psychological thriller.

Okay, you see where Thriller haven't seen it. It was Leonardo DiCaprio and he was on the in the Isle of Shutter Island. I don't watch thrillers. I don't watch horror. I don't watch Leonardo DiCaprio. First of all. Okay. So first off, there's this whole thing for this plot for this movie, right? Where Leonardo DiCaprio is a detective that is going in and trying to investigate a murder that is supposedly happened at this insane asylum, right?

And he's there to investigate and figure it out. And it turns out by the end of the movie that he was not actually a detective that was there to investigate. He was at one point a detective, but after he murdered his wife, after discovering her, I think, in bed with someone else, he went basically insane. And this was like the last ditch effort by the asylum to snap him back to reality before it is that they lobotomized him. What? Yeah. No, this movie...

freaky as hell. Like it is. It was a good movie. Mind you, if for a thriller and I don't really watch many thrillers, it was a good movie. But holy crap, the premise of that. Now I want to watch it. Yeah. So a lobotomy, my friends, this is a surgical procedure to provide relief to people with severe mental illness who are unresponsive to standard treatment. Also, if you guys think I'm making super light of lobotomies, I just want you to know that I have

BPD. So it's not like super responsive to standard treatment. Just a heads up. Okay, I can I can I'm allowed for clarification. She's referring to borderline personality disorder and I'm not going to go into every single detail naturally. But in short, for people who want to imagine something, think of it like a roller coaster where the highs are very, very high and the lows are very, very low, which can mean that someone can spiral and that is

Not a good thing when that happens. It is a difficult thing to deal with during those moments. In the case of lobotomy, this method was pioneered back in the 1940s and 1950s when treatments for psychiatric disorders were, I mean, few, basically non-existent, pretty much. This is a point in which people were like, okay, this person is experiencing severe psychological distress and is insane. What are we going to do? We're going to put them in a coma.

What? Yeah, so an insulin coma. Okay. They would basically knock people out. A little nappy nap. You know, just like you're chilling now. Yeah. The other thing that would be done. Are you familiar with the whole point in insane asylums or like the images of it where they're like shocking people to like shock them back to reality or like treatment for people with severe mental illness? Yes. Yeah, that is the electroconvulsive therapy. ECT. So they either put you into a coma or

Or they electrocuted you. I feel like the coma is like the one everyone should pick. Yeah, to a degree. If they got a choice. Oftentimes they didn't as it was the not the people who were insane that were able to make the choices. It was their guardians, typically their parents, spouses, loved ones, etc. They were the ones.

Why are you looking at me like this now? Okay. If you had to pick one for me, what would you pick? If I had to pick one for you? Yeah. Oh, definitely the insulin coma. Because if there is one thing that you always want, it's a nap. That's real. Like I would know that those would be your wishes. So you would go for a nap. Absolutely.

So lobotomy was something that would be used to treat these patients. These patients being the insane asylums that over the course of the 1800s heading into the 1900s were full of suffering men and women.

The whole point of this operation is that it aimed to sever the nerve fibers between the frontal lobe of the brain and thalamus, the thalmofrontal radiation. And there were many methods that were used, including brain cannulae, which is a thin hollow tube that is used in neurosurgery to access the brain, drilling holes in the skull to access the brain, chemical injection, electrocoagulation using electric currents,

and destructive ultrasonic waves. Okay. None of which, can I say this right here? Before we go any further, I want to stress this right now. These are things that are being done to someone's brain. The most crucial and important part of the person's body besides their heart. And they were doing this back in like the 40s and the 50s with limited understanding of what it actually did. But they did see it as a way to treat people with severe mental disorders. Okay. But they...

didn't even know that much about the brain. No, no, they didn't. This is very shortly after the time period where they thought that, or at least some people thought that if you felt the bumps on someone's head, you'd be able to predict their personality. At least that was in the 1800s. Yeah, we did an episode on that. Phrenology, I think it was. What I'm thinking is they were like, listen, I don't fully understand how this works, okay? But we're going to go in. We're just going to go right on in there.

That is bold. That took a special type of doctor, like someone who is absolutely too self-assured. To be fair.

Yes, this is true. But also it was based off something that was observable science. The problem with the observable science, though, is that you know how people talk about things of like, oh, hey, we've discovered this miracle drug or procedure or something that does something. And then we're just going to go ahead and do it without like any actual test to see what are the long term effects of something. Yeah, that's basically what happened with lobotomy. And we're going to get into that.

I mean, that's what I'm saying. It takes a special type of self-assured person to be like, guys, we're going in. This, mind you, this is back in the day of people...

I don't want to sound like a conspiracy theorist. I don't also want to sound like some of those people who talk about, like, talk down about medical discoveries and science and like a denier in things. But one of the key problems that oftentimes has happened with history is people discovering the next big thing when it comes to medicine or energy or something else. And they think, this is it. We have done it. We have solved it.

The greatest problem in humanity. They did that when it came to electricity. They did that when it came to radiation. Remember the whole thing about all the different radioactive products that were supposed to be miracle cures, but actually killed you? Yeah.

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Yeah, this was the same thing. Lobotomy fell into that exact same category of, well, it's the new biggest thing of medical science. Of course it's perfect. We have figured this out and we are going to fix and cure so many people. They meant well. They did.

They did. Like, none of the stuff was actually being done for egregious amounts of money. Like, that's the thing. It wasn't something that would be a total and absolute scam necessarily. It was genuinely, and we're going to get into this, bad science with heartfelt belief. And that honestly kind of makes it worse than...

Because they thought what they were doing was for the greater good. Like it was genuinely helping people. And like, if you think you're genuinely helping people and you truly believe this, you're going to think, okay, yeah, they don't want it. And like, no matter how evil it seems, it'll be worth it in the end. Exactly. So there was a lot of different conditions that lobotomy could be used for. Obsessive and compulsive disorder. So OCD, severe depressive illness, psychosis, schizophrenia, manic depressive psychosis, heartburn,

chronic neurosis, psychopathic personality, and much, much more. Okay, I'm just going to say I was not going to beat the lobotomy allegations. No, like... You listed at least three things. I didn't want to make a joke about this here, but there is actually a very real possibility that your family possibly would have lobotomized you. They were like, her, take her. This one right here. Yeah, take her. Mm-hmm.

Literally convulsing. Get her out of here. Yeah. So the question is then at this point that one probably has is why? Why the hell would they do this to someone? Well, believe it or not, this is the thing that I mentioned here earlier. There was a fairly logical, if brutal reason.

See, a lobotomy, the thing that it actually does is it disrupts the connections between the frontal cortex and the rest of the brain, particularly the thalamus. And so doctors believed that doing so would reduce abnormal stimuli that would reach the frontal area. And these stimuli were thought to cause impulsive and violent behavior. A lobotomy would make the patient calm and docile so they could be sent home to live with their family instead of being stuck in an insane asylum and being cared for by people that had to restrain them.

And like, look, here's the thing. When you have someone with violent schizophrenic tendencies, this was seen as a safer alternative to letting them exist on their own at a time when there wasn't really any other treatment for said disorders. It's like, what did you have? You put them in a coma or you electrocuted them. This, in many cases, made people docile enough that they could actually be cared for potentially at home.

But that also right there, that's what I'm going to need to explain next. The context of the lobotomy and the horrible history of insane asylums. Oh. Because one of the key strengths of lobotomy is that it reduced the stress on insane asylums. So people that would have been stuck at them were able to go home, freeing up space. I remember growing up, there was an insane asylum on the island where I'm from.

And if you were sent there, it was essentially a death sentence. Like people whispered the name. That's how bad it was. I personally don't know what they did to people there, but I fear nobody really necessarily came back. Oh man. When was it built? Do you know when it came into existence? I have no clue. I have no clue. I can try looking it up, but genuinely...

Yeah. The reason I'm asking that, I'm genuinely curious. We're going to get into this on the history of insane asylums. I didn't put it in here, but when I was doing the research on this, the thing that I found fascinating is just how sad it overall was that in the history of insane asylums, the image that we have of them, like, what do you think of an insane asylum? You said it's a death sentence for this one. It was like probably horribly abusive. There was all these things where it was crazy and almost evil, right?

It's why insane asylums are featured in so many things for ghost hunters, for horror games and movies and other kinds of things. Right? Yeah. So when a lot of these insane asylums were first being founded in the mid 1800s, early to mid 1800s, we're talking the Victorian era.

These things were fancy. They were being given so much public funding. They were being given so much support. With the latest science of the day, people genuinely believed with these asylums that they would be able to cure people, help them, and alleviate stressors that this created with society. The problem was the insane asylums filled up very quickly. Not only did they fill up very quickly, but they kept on having to be expanded, which drained more and more and more money.

To a point where these asylums that were being created that would focus on trying to give people kind of not free reign exactly, but constructively try to build them into better people. They didn't have the resources to actually do any of this, and they couldn't care for people as long as they were.

And so insane asylums for this brief period of like 40 or 50 years were kind of really nice. And then as the 1800s wore on, they became worse and worse and worse until going into the 1900s. They get the image that, well, we kind of have them today. Why are you making a face? I was reading that article and it's not good. Explain. I mean, they're not even like they're regular.

The article goes over like it starts off talking about people with cerebral palsy and it's like the things that have happened to them are horrible. And then just Asperger's and Down syndrome. And it is I mean, it's not great stuff. No, no. It's actually terrible. But the thing is, this article was written in 2023. So this isn't even like old like you're talking about. Obviously, it's not a lobotomy, but still it's not.

positive not a good thing no so it's very it's very sad well that is the important thing that actually leads that's a kind of a strong segue to what it is that I want to talk about next because in order to address the issue of insane asylums because here's the thing in order to talk about lobotomies we have to talk about insane asylums but in order to talk about insane asylums we need to talk about how people used to deal with mental disorders in the first place because here's the thing the study of mental health believe it or not has evolved significantly over time I know

That's shocking. It is something that over the years has been shaped by changes in societal attitudes and advancements in medical understanding. In the past, mental health was not necessarily something that was well understood, and oftentimes in many societies was heavily stigmatized, which would lead to a lot of consequences for those of, well, people that were seeking help.

Early societies would attribute mental illness to all different kinds of supernatural causes like, oh, they're possessed by evil spirits or a curse from the gods, or they're being cursed because a person is not a moral person. This would oftentimes result in harsh treatments such as exorcism, forced surgeries, or just straight up being imprisoned and locked away for years at a time, maybe even forever until they die.

In fact, the crazy thing, and this is one of the examples that they kind of bring up in here that we don't necessarily know why this is done. But Gabby, have you seen the thing where there's been examinations of prehistoric skulls and cave art and they found like thousands of years ago that

people were identified with holes that were drilled into their skull. Yeah. So there's a lot of theories about that, that it could have been the things to relieve headaches that could have been done for a thing of minor surgery to try and repair after someone suffered some kind of grievous injury. What if it was just a torture method? It could be. It could be. It very well could. That's the thing. A lot of people don't know. Other things is that it could be they thought that evil spirits were trapped inside the head and they wanted to

Released them. Around 2700 BC, you had the Chinese medicine's concept of yin and yang, which would attribute mental and physical illness to an imbalance between forces within people. And so they thought by that time that if you had a person that lived a harmonious life with a proper balance of yin and yang, that this is something that would give them good mental health. But if you did not have that, you became both physically and mentally unwell.

Fast forward several hundred years after that into Mesopotamian Egyptian times. And from 1900 BC, there are Egyptian papyri that are describing women suffering from mental illness resulting from a wandering uterus, which sounds crazy, right? But this is the thing that would later evolve with the Greeks, which was labeled from, remember, hysteria coming from the Greek word for uterus. That's one of those. Maybe that's my problem. You have a wandering uterus. It could be.

Yeah, this is one of the most more interesting beliefs in history that carried forward literally until recent times. Like the idea was that the uterus would become dislodged and attached to parts of the body like, oh, the uterus within the woman is just moving around and going into the chest cavity or the liver or other stuff. And this prevented their proper functioning or produced varied and painful symptoms.

As a result, the Egyptians and the later the Greeks would employ varying different treatments, some of which were strong smelling substances to guide the uterus back into its proper location. So the uterus would smell this and be like, I'm out of here. Yes. You're joking. No. Old medicine is weird. I mean, I understand the logic behind it, but did they think it had olfactory effects?

Sensitivity? I don't know. I wish I could interview someone from the time and ask them. I do not know. Or was it just like the uterus would sense this... Well, it would have to smell the smell and be like...

I don't know. I don't know. See, it's one of those things. The whole idea of women being bound by hysteria. This is one of those things that it's like a fun fact. I'm sure that for anyone listening to this. Do you think like premenstrual major depressive disorder existed back then and they were like hysteria? Yes. Literally. Yes. Literally. Yeah. That's what I'm saying. That's what I mean. All of those. They were just tweaking for one week out of every two weeks, two weeks out of every month. And everyone's like, listen, because

And for some, it was severe, which is why they would associate. So with the case of the Greeks, at least there was no saving me. I'd just be out. No, I'd be out. Oh, my God. So for the ones who identify things as more scientific way, like in the case of the Greeks, they would say, oh, yeah, this person is hysteric because of their wandering uterus. And they would try to use medicine to put it back. The thing is, though, the thing is, though.

So I have a chill husband who doesn't care because I'm married to you now. And this...

context of history. But back in the day, you might have been like every other bitch. I'd have been locked up. Yeah. You'd have been locked up. You likely would have been beaten. You look at me losing my mind and you're like, anyway, in two days, you'll be wanting to wear my skin because you're obsessed with me. So I'm going to just leave you alone real quick. Yeah. Every man back then just needed to do that. I don't think we should be talking about wearing skin while also in the context of insane asylums. No, like in a cute way. Like, I love you so much. I just want to be attached to you at all times. Yeah. Yeah.

Like you're alive. I'm just chilling inside of you. Yeah. In a not weird way. Totally platonic. Best friend way. You still have a wandering uterus. You just want it to be inside me. Okay. Okay. I'm not even beating these allegations now. So that is their case. Others saw things in a more spiritual light. Like...

Hebrews saw the madness within people as being a punishment from God. So treatment would oftentimes consist of not medicine, but rather people confessing sins and repenting because it was clearly something from God.

Physicians were also able to comfort and cure madness. But the big difference is Greek physicians largely rejected the whole supernatural aspect and explanation of mental disorders. And it's around 400 BC that Hippocrates would actually attempt to separate superstition and religion from medicine by actually creating the system of belief that a deficiency in or, you know, an excess of one of the four bodily

bodily fluids or parts, you know, the whole humor system, this being blood, yellow bile, black bile, and phlegm. This was responsible for not only physical illness, but like the whole thing with the Chinese yin and yang, it was also responsible for mental illness. As an example, someone who was too temperamental and angry and irritable.

They were someone who suffered from having too much blood. You know, like when you see red and you someone has like, oh, their blood is raging. That sort of thing. Yeah. Well, that meant that the treatment was bloodletting. You drain some of the blood. They calm the hell down.

Hippocrates would also classify mental illness into one of four categories. You had epilepsy, mania, melancholia, and brain fever. And like other prominent physicians and philosophers at the time, he didn't believe that mental illness was, you know, something that was inherently shameful and a curse from the gods or that mentally ill people would be punished because, you know, they did this thing and they totally were in control of themselves. They just were sinners, like in the case of some of the more religious societies.

No, instead, he advised the mentally ill individuals would be cared for at home by family members and the state would have no responsibility of it because it was the responsibility of the family.

I know I've gone off quite a bit, especially when this whole thing is supposed to be about lobotomies. The reason that I have gone back that far is that this thought about humors and home care for the insane, that is something that would exist as pretty much the primary thought of Western medicine for over 2,000 years. So they just decided this was good enough for...

Really? For humors, the balancing of the humors, all this other stuff. I know that. Yeah, this was pretty much how people thought about it for the next 2,000 years. For like mental health, surely. I can't even say that because isn't even PTSD something that they were literally sending men off to die in war since the beginning of time and they were like, ah. Correct. This is a new discovery, you guys. PTSD was not necessarily...

really looked at until world war one with shell shock that's literally what i'm saying got so much more brutal and then coconut grove helped with ptsd yeah um research as well but that's what i'm saying um they literally since the since the beginning of humanity men have been dying in war yes and women too i'm assuming but yes they just were like ah you're a little bit

Strange now. Yeah. You just got to get over it. You got to toughen up, my guy. Kind of. Yeah, people experience that. But then again, you're being a little bit cowardly there. War became significantly more brutal as time went on. Once you get to the age of gunpowder and everything. Also casualties. You think about this here in the case of an army, an army losing 10% of its men from a battle was like really high casualties. Like if 10% of the men died, that was huge casualties.

An army by the age of gunpowder losing 10% of its men. Oh, that was light. Dear God. I get that. I get that. I get that. But like to not even like give it a second thought for thousands of years. There were other people that would think things, but this was the standard thought. And also, once you have that orthodoxy encoded, it's not really going to change much. You wouldn't really see things begin to change for views until the late medieval going into the early modern period.

That's the thing. When I said 2000 years, I wasn't kidding. We're talking about the like we're talking about the 1600s. So when did people actually start with mental like, you know, institutions for mental health?

Okay. Like, when did they come out with the stereotypical asylum that we see in horror movies today? That, as I kind of said, arose out of the Victorian era, but it has a bit of a prelude before that. So, going into late medieval period and early modern period, that's where we begin to see the rise of more, you know, mental asylums. But these institutions' mission was to house and confine the mentally ill, the poor, the homeless, the criminal, and the unemployed. They

Well, that is a spread. Yes, it is. We need to discuss. What? For people that would not work. Criminals didn't go to prison. They went to asylums? Yes. Did they have prisons also? Yes. There were all different kinds of things for debtors prisons, but you had some people who literally could not work because of their psychosis, basically.

Okay. I'm sorry. I just have a lot to process right now. That's a choice. Yeah. Like the poor, how is that on the list?

Well, because that's one of the... Okay, this is also a thing, especially going into the Victorian time. If you were poor, like really poor, and your family was like chronically poor, it wasn't a crime, but you were at many points seen as lesser because you would not better yourself. So they sent you to an asylum? In some cases, depending upon how you were, because you had some people who were poor to the point of like they were...

Generationally poor? Criminals, alcoholics, just people who would not better themselves in society. They were seen as mentally incapable of bettering themselves. Do we need to have a talk? I'm not even going to bring that up. I'm not even going to bring that up. I was going to talk about like, you know, the...

concept of being a little bit more privileged because like if people came from money they'd be more likely to have a little bit more money in the next generation versus the people who literally had no parents etc you know you know what i'm saying i'm not even doing a good job explaining it mind you but that it's it's a thing that if anyone is curious about looking into for victorian views on morality and economy and

Yeah, this is one of the reasons why... Do you have it in your sources? Yeah, I'll get a thing because you literally just need to look into a poorhouse. Literally, the whole concept behind a poorhouse, and I'm going to explain this, a poorhouse was not quite an asylum, but a poorhouse was where someone who did not have work could go to work. And what they would do is they would pay you a very, very, very, very, very basic wage, and they would give you basic food, basic shelter, basic water. Is this like Oliver Twist or different?

Was Oliver Twist in a poor house or was he in just like an orphanage? I don't remember. I'll be honest. I do not remember. You weren't traumatized by the story of Oliver Twist in elementary school? I genuinely don't remember. I was like six years old, dude. The whole premise of the poor house, the entire purpose of it, Gabby, is that they wanted to make the conditions in it as uncomfortable as possible to force people to better themselves. He was in a workhouse. Is that the same thing? Yes. Okay. So Oliver Twist was in a workhouse.

Yes. So that you didn't have to read like the kid. You know how they did those little hardcover like mini, mini, mini books. And they were doing like basic tasks that were continuously repetitive and didn't really do all that much. I'm just saying, like, did you have to read Oliver Twist at like the age of six? The moment you learn to read in like those little hardcover books? No. No. OK. You had a different childhood, my guy. No, I did. I didn't have to do that. Yeah.

Good for you. Yeah, that's... So that is basically what would happen here. So war and economic depression. War and economic depression. And oh God, we wanted a poor house. See, this is tangier than tangier because this is like so many things that are related. Sorry, it's like it's actually related because somehow they're all connected and I need to know how because we started with lobotomies, but now... We are getting there. It's all tied together with insane asylums. Did they lobotomize the poor?

No, no. Because lobotomies were not invented until much later. But this is the context that... I'm sorry. I know this is a long episode now at this point. This is the context that it arises from. Exactly. So two of the most well-known institutions from this time period are the St. Mary of Bethlehem in London, known as Bedlam, and the Hôpital Général of Paris, which began... That was terrible. Oh my God, I know. Look, it's the General Hospital of Paris. That's the whole point. I'm not going to speak French for this. But they began housing mentally ill patients in the mid-16th and 17th centuries as...

Confinement laws focused on protecting the public from the mentally ill. That was kind of the whole point. Governments became more responsible for housing and feeding undesirables in exchange for them, well, not really having any personal liberty to be able to do anything. So these point, they're not patients, they're inmates.

These inmates would be institutionalized against their will. And oftentimes they would live in horrible filth, in just complete and utter poverty. They would be chained to walls. There was even many cases where people who were insane would be exhibited to the public for a fee in order to generate revenue. Yeah, I'm not even kidding. They would turn the insane into a kind of circus show.

Welcome to history, people. I want to say it's like creative problem solving, but like it's really fucked up. Like, I get they needed funds, but surely they could have done something else. Like, here, guys, let's do some art. It's art therapy and we'll sell it. Yeah. There were other options for sure. Exactly.

So around the beginning of the 1800s, then, because this is the way that things were for literally 300 years, that's pretty much how it was. Reformers would begin to spearhead a series of changes in attitude towards mental health care. And for the first time, local authorities had a legal responsibility to actually care for mentally ill people in purpose built homes and accommodation rather than jail cells that were just converted in order to be able to house them.

And that shift in emphasis from custody, control, and control

What would another word be here in this case? Enslavement, essentially. Pretty much for some of these would literally be enslaved. Like it was actually just gross mistreatment of individuals. Yeah. And that changed from custody to care or cure. They wanted to actually help mentally ill people, which resulted in many different legal changes. So first off, mental illness was changed from something that someone was afflicted with or cursed with and doomed to have to

to being something that could be like it was recognized as something that could be cured or at least the worst symptoms of it could be alleviated. Second, it was no longer acceptable to keep mentally ill, poor people in workhouses and prisons. So state provision of asylums became mandatory. The state actually had to pay to take care of people.

And because of these changing attitudes, there was a massive, unprecedented program in the 1800s of just building asylum after asylum after asylum. And this was based off of, you got to think, this is Victorian England, largely that is being one of the big ones that's pushing this here at the time. They are at the forefront of at least what they imagine, scientific and medical knowledge. The 1800s was the Wild West of, well, both the actual literal history

Wild West. And also we say the Wild West of medical technology. You've heard all the stuff that has come out of here during that time. And so they thought, hey, we can cure mental illness.

Were they able to do it quickly and efficiently or were they just trying their best? Both, sort of. It's kind of complicated. Admittedly, this whole system was not perfect or great, especially by today's standards. But it was something. It was a start. It was a drastic improvement from literally having insane people chained to a wall for entertainment. Yeah. That's something. The biggest problem then...

was treatment. People could be prayed over. They could be isolated from triggers of their anxiety that could send them spiraling. They could be given therapy and minor jobs such as baking or pottery to keep them occupied and much more. But the problem with most severe mental illness is that it just it doesn't have a cure that the treatment would take far too long to even begin to alleviate things.

Years or even decades to do this in which the asylums would fill up and become very difficult, expensive to manage. So is this where they decided, hey, let's go in their brains and just fix it from the inside? Yeah, this is where people started to figure out how to mess with the brain. And that's where the lobotomy comes into play. How did I know that?

So look, there is evidence of different types of surgical manipulation of the brain that could calm patients, being something that would emerge in the late 1880s. This being when Swiss physician Gottlieb Burckhardt, who supervised an insane asylum, would go and remove parts of the brain cortex in patients that were suffering from auditory hallucinations and other symptoms that were like synonymous with schizophrenia, pretty much. And when he performed his auditory

operation on six patients with the specific purpose of not returning them to a state of sanity, but rather trying to put them in a position where they were calm. It worked. It didn't mean that they were going to be suddenly able to like, oh, my God, I'm cured. I can have so many different conversations now. But hey, they're not incredibly violent and trying to attack people who are simply trying to change their shirt.

So yeah, Bukhar. One of Bukhar's patients died several days following the operation, and another would later commit suicide. Though it's not exactly clear whether or not the suicide was associated with the surgery, we don't really know, but remember, these are people that were severely mentally ill. However, several of the patients were easier to manage following the surgery.

And so his idea, the operation had been influenced by another German physiologist, a guy by the name of Friedrich Goltz, who performed brain ablation, which for those of you who are curious, that is simply when there is a surgery to remove tissue. And these were experiments that he ran on dogs and observed distinct changes in the animal's behavior. So, yeah, go figure. If you take out pieces of something's brain, their behavior is going to change.

And so the funny thing is, in the decades following this kind of work that Bukhar did, there wasn't really anything else that was done. There weren't really all that many attempts at surgeries to do things with the human brain. But this is what then brings us to Yale. Yes, of all places, the famous institution, the famous school, the Ivy League institution, Yale. The history of lobotomy starts right there.

So within the field of experimental neurology, with the up and coming arrival of the physiologist John Fokker Fulton, who joined Yale's academic staff at the age of only 30 in 1929, this guy became the institution's youngest professor.

Like this guy was in his prime and he had ideas. Under his leadership, the Yale School of Medicine would build up easily one of the most prominent research laboratories pretty much in the entire world. And this was the first one in the United States to conduct research on primates.

So, you know, that whole stereotype that is associated with not just medicine, but science in general and experimenting on monkeys and apes and chimps and that kind of thing. Yeah. That is specifically started here by this guy. And so Fulton was interested in the workings of the different parts of the nervous system. And he gradually came to focus on the brain, specifically the frontal lobes of the brain.

And that's where the monkeys come in. I say monkeys. It's not actually monkeys. It's primates because they're chimps. So you have these two chimps, Lucy and Becky, that they were easily the most famous primates that were studied.

Both underwent a frontal lobectomy, which means that they were they had part of their frontal lobes removed. And this was shown to cause the loss of some functions as it affected their performance in tests where they had to rely on things like, you know, short term memory or doing simple tasks. However, despite these limitations, the thing that ended up exciting and attracting more attention for the researchers was

was their observed behavior changes. Because it seemed as if, you know how when it's like you're supposed to be doing something, it's like a small task. Gabby, you know me. You know me every time I'm doing something, how easily frustrated I get when it comes to things. Yeah. Well, the chimps no longer cared.

Once it is that they would normally have been demonstrating issues or frustrations or all these different things, the little tasks that they would have whenever they failed a test, they didn't seem to care before they would be get frustrated and aggressive. But now they were indifferent to their own mistakes. In Fulton's own words, quote, it is as though they had joined a happiness cult.

And so John Fulton went to present his findings to the International Neurological Congress of London in 1935. And one of the delegates that was attending there was a Portuguese neurologist by the name of Antonio Moniz. Now, Moniz would go and return home from that Congress in London, convinced that, you know, this, this is it.

This is the thing. This is going to be the thing that is going to actually help all of humans. He could transfer this knowledge from the ape experiments to treatments for people. So he quickly initiated a collaborative relationship with a neurosurgeon by the name of Almeida Lima. And over the next year, 20 patients were going to be operated on. They didn't need like

Special permission? Nope. Well, it's a little bit... Ethics committee? Here's the thing. Here's the thing. We're talking about people that are potentially severely mentally ill with asylums that are not regulated like what you'd potentially have nowadays.

Wow. Yeah, it's not it's not pleasant here. So Moniz would develop something called a lucetone, which was a long instrument with a steel strip for severing the connection of the frontal lobes. And this would be used after drilling holes into the patient's heads. And then with a side sweeping maneuver, the lobes would be separated.

That's disturbing. Yeah. Yeah. It sounds so barbaric, right? At least it's like such a basic thing. It's like, oh, yeah. Stick steel rod inside head gone. There you go. And so Moniz and Lima reported no deaths or serious complications in the first series that they did.

The second series included 18 patients, all of whom suffered from schizophrenia. And they reported that three of these patients were almost cured and that two became much better. They concluded that prefrontal lucidomy was a simple, fail-safe operation that was useful in the treatment of some mental disorders. They also wrote that it was particularly effective against depression and melancholy, and the procedure was then named psychosurgery.

It is such a simple and fast thing that they did. They would operate on nearly 40 patients by 1937. But even though they reported all these positive findings, the actual results were fairly mixed with some patients improving, others showing no change at all, and others either getting worse or relapsing back into what they were before.

Despite this, the practice was very quickly widely adopted, largely because there wasn't really anything else that anyone else could do. I mean, remember, what did we have before for treating people? You either put them into a coma or you electrocuted them. I mean, yeah. So the fact that this actually showed results was actually something. Now, the thing is, when I talk about this, you have a lot of people that are, you know,

You got a lot of people that are angry. You got a lot of people that are hard to deal with. So this is something that people are going to try to utilize in order to calm people down. But there are some doctors that really think that they can take this to the next step. And that is going to be the next people that we have to talk about. The American neurologist, Walter J. Freeman, the second and James W. Watts.

The prefrontal leukotomy procedure that was developed by Moniz and Lima was modified by these two guys.

See, Freeman preferred to use the term lobotomy, not leukotomy. And so he would go and rename the procedure prefrontal lobotomy, which for anyone who's curious, that is why we are talking about lobotomies there at that point. That is where that specifically comes from. The American team soon developed the Freeman-Watt standard lobotomy, which laid out the exact protocol for how a

In this case, a spatula was supposed to be inserted and then manipulated during the surgery because they would use this metal tool that had like a little flippy bit that looked like a spatula, you know, like what you'd flip burgers. Except in this case, they were flipping brains. I know you're looking at me like that. I know. So.

By 1942, the pair had lobotomized more than 200 patients and published the results. They reported that 63% of the patients had improved, while 24% saw no change and 14% became worse. One of the early patients treated by Freeman and Watts was actually John F. Kennedy's sister.

Yeah, that's right. The president, John F. Kennedy, his sister, Rosemary Kennedy, was lobotomized in 1941 at the age of 23. And look, I know this is not entirely related to this. This whole thing is so sad. So, Gabby, when you and I were doing the research for the podcast yesterday, or not yesterday, but a couple days before, and we were writing about this, and you were like, oh, man, I have this really screwed up thing that I can tell you. And I was like, oh, yeah, I have this really screwed up thing that I could tell you. Mine was more screwed up, though. Yeah, admittedly, because in terms of scale, yes. But this, to me...

So incredibly sad because, all right, side note on this, I just I have to explain the story of what exactly happened to her. The reason this happened is because she was a bit of a wild child. According to Kennedy's sister Eunice, when Rosemary returned to the United States from the United Kingdom in 1940, she became, quote, increasingly irritable and difficult at the age of 22.

Kennedy would often experience convulsions and fly into violent rages, during which she would hit and injure others. And so after being expelled from a summer camp in Massachusetts and staying only a few months at a Philadelphia boarding school, Kennedy was then sent to live at a convent school in Washington, D.C. Basically, her parents were trying to do anything they could to calm her down and control her. But she began to sneak out of the convent school at night.

And the nuns of the convent were freaking out because they thought that, oh, she might be involved with, you know, sexual dalliances and partners that that could allow her to get some kind of STD or something or get pregnant.

And this erratic behavior frustrated her parents so much. And her father was especially worried, considering how much the family was into politics at this point, that it was going to embarrass the family and would damage his and his children's political careers. So at the advice of a doctor, what was the big medical thing that just came into the scene and was fixing people with severe mental issues? Abotomy. Abotomies. They believed...

that it would calm her down. However, the operation was not successful.

She required care for the rest of her life and could no longer walk or talk after the intervention. Wow. So they ruined her life. Oh, they did. They wanted to control her. They completely destroyed her life. Like it is such a horrible thing. Several patients would suffer from serious complications, but Freeman nevertheless remained convinced that lobotomy was a major medical advancement and that it was fine. In fact, I didn't even put the rest of this in the stuff for her story, but it's, it's, it's horrible. So for years, for literally years afterwards, she,

The siblings had no idea what happened to their sister. So it's just your father making a unilateral decision because he couldn't control his daughter. That's a parenting issue. That's a skill issue, dude. Yes. Yes.

Yes, it is. Not only that, he didn't even tell his wife that he lobotomized their daughter because after it happened, that's genuinely nothing. That's something you can't come back from. Nope. You literally can't. I'd be like a lobotomy for a lobotomy, bro. Yeah. So after he had her lobotomized, he then told his wife what he did. She was cool with it.

No, no one was. But they had to keep it under wraps at this point because the political career, the political careers. Yeah, it's really screwed up. In fact, Kennedy, like John F. Kennedy himself, he did not find out ever what happened to his sister because she just disappeared. She went off to live somewhere where she was being taken care of because that's what had to happen. So completely out of the public eye, just disappeared off the trip. They did not discover what happened to her or he did not until after he became president.

Only then was it allowed to be revealed to him what happened. So they kept that hidden for like 20 something years. And for the longest time, they were just told she was estranged. She wanted nothing to do with the family. She ran away. I am not even you're looking at me right now like this can't be real. It is. That is exactly what happened. So, yeah.

Here's the thing. As I said, several patients, such as in the case of Kennedy, suffered very serious complications. But Freeman was convinced that, you know, this was the perfect thing. It was the new big science. It was going to work. But the problem with him, what he had, the issue, was that he thought that the low number of patients that were undergoing the surgery, that that was a problem. Because he was so convinced that this thing, this was it. This was going to fix everyone's problem. And so he pushed for it.

as hard as he possibly could. The problem is, lobotomy required collaboration with a neurosurgeon and other personnel, and it was therefore only available at large university hospitals. But he had this idea that he wanted to make lobotomy so big that it was just common, that anyone could do it. Vending machine lobotomies. I am not even kidding.

That is possibly something that he would have pushed if he had the option. But considering what it is that he was able to do, this is what brings up the stereotype for how lobotomies were going to work. So according to his own account, what we today associate with lobotomy is based on the idea that came to him while he was cutting ice for his drink with an ice pick.

I don't like how that started off. No, no, but that is where this whole thing came to be. The technique that he developed was then named the transorbital lobotomy. And the objective was to sever the connection between the free frontal cortex and the thalamus by using a thin surgical instrument and orbital clast to cut through the thin layer of bone above the eye socket. A small hammer would be used to drive the instrument into the brain.

According to Freeman, the operation could be performed without general anesthetic and no surgical expertise was required. That's the thing. Strictly speaking, the way that he was developing this thing, oh, it wasn't even necessary to use a qualified doctor for brain surgery. He personally would go and perform the first transorbital lobotomy on a patient in 1946.

However, his partner, Watts, did not like the way that things had been going, both with this new method and also with his constant push for lobotomies. So he actually ended their partnership in 1947.

The transorbital lobotomy procedure, which Freeman performed very quickly, sometimes literally in less than 10 minutes. I'm not. It was that fast for a surgery was used on many patients with relatively minor mental disorders that Freeman believed did not warrant traditional lobotomy surgery. So basically, the difference was, oh, do they have major schizophrenia or are they just a little depressed? If you get a little depressed, we'll just shove a steel rod through your eye and then it's fine.

Yeah, so a large proportion of such lobotomized patients exhibited reduced tension or agitation, which was good, but many also showed other effects, such as apathy, passivity, lack of initiative, poor ability to concentrate, and a generally decreased depth and intensity of their emotional response to life. They became muted. Some died as a result of the procedure.

However, those effects were not widely reported in the 1940s. And at the time, long-term effects were largely unknown because guess what? They just started doing this crap without actually testing and seeing over the course of a decade or so what actually happens to patients. They just kind of ran with it. Because the procedure met with seemingly widespread success, Moniz was actually awarded the 1949 Nobel Peace Prize for Physiology and Medicine. That's right.

You always mess with Nobel Prize and Nobel Peace Prize. I did. It's the Nobel Prize. They're different. I don't know why I said Peace Prize. I'm sorry. He got the he got the prize. So, yeah, this guy, this is this is one of the big shames in medicine that he specifically got that award for.

Because look, in 1949 alone. I wouldn't say it's like a shame. I feel like they had incorrect information that they acted on. But then obviously, once people realize, hey, we shouldn't lobotomize people, they stop. Well, because what ended up happening here, and this is the conclusion that people came to afterwards, is that the entire thing was really bad science, that they discovered this thing and just ran with it instead of actually doing any extensive tests to see what happens.

And because here's the reality, right? He got that price in 1949. In 1949 alone, more than 5000 lobotomies were performed in the United States. 5000 people. This happened to Freeman when he did a lot of these lobotomies because he was the big one who was pushing it. He did thousands of lobotomies himself. He did not wear gloves. He did not wear a mask when performing the procedure and was oftentimes not very diligent in sterilizing his equipment.

This is actually one of the big things that was one of the reasons why Watts was very critical of his procedures and wanted to leave because he would do that same kind of thing. We literally had this discussion before where what would happen with that one surgeon. I can't remember the name of the guy, the one doctor who really wanted to push people to do hand washing that you were talking about. And everyone was making fun of him because it's like, oh, why would I wash my hands after delivering a baby and then go performing surgery? You know? Yeah.

For whatever reason, this guy who was doing surgery didn't freaking sterilize things. He just went and did them. And so that is why, despite a mortality rate of 14%, Freeman would go on and perform 3,439 lobotomies over the course of his life, with the last one being not in the 1950s, but 1967.

And that right there is something important to touch upon. The last one being in 1967 for Freeman. The reason for this is not because he didn't want to do them anymore. Oh, no, he absolutely wanted to do them anymore. He wasn't allowed to. I need to stress at this point that the entire time lobotomies were being performed, not everyone was happy about them. And there was quite a bit of pushback in the 40s and 50s.

The criticism was strongest in actually the Soviet Union, ironically enough, where a complete ban on lobotomies was introduced in 1950. This being on the grounds that the treatment was inhumane. Wow. When the Soviet Union tells you it's inhumane. I know that that when I saw this, I was just like, oh, dear God, because the amount of things that were Soviet communist science that they would push that were.

I mean, horrible and led to the mass starvation and killing of millions. The fact that this is what they would label inhumane, like I get it. Obviously, this is where they drew the line. This is where they drew the line. Yeah. More importantly, in the 1950s, the big thing that created an issue for those advocating for lobotomies is that other things were

came to exist. Psychiatry saw the introduction of neuroleptic drugs, which could be seen as an alternative to an invasive surgery where a steel rod is shoved into your brain. And so with the development of antidepressants and other such things, having that steel rod just shoved inside of your brain was increasingly seen as just straight up barbaric.

Because to be honest, it kind of was. But over the course of that time, Freeman would still push lobotomies religiously right up until the day he died. Even when, you know, he couldn't do them anymore after one of them went horribly wrong. In February of 1967, Freeman would perform his final surgery on a woman named Helen Hortensen.

Mortensen had actually been a long term patient for him and had been receiving her or was receiving her third lobotomy from Freeman. That's the thing. She already had two other lobotomies. She was getting her third. And so she ended up dying of a cerebral hemorrhage, as did many of the hundred other patients that died.

And when this happened, the backlash was so great that he was finally banned from performing the surgery. His patients, even the ones that worked, oftentimes had to be retaught how to eat and use the bathroom. Relapses were common. Some never recovered. And 14 to 15% of all the procedures that he did, remember, he did thousands, died. Still, he was adamant that he was doing the right thing, that the science was good. But no.

In the end, in the United States, approximately 40,000 people were lobotomized. In England, 17,000 lobotomies were performed. According to one estimate, in the three Nordic countries of Denmark, Norway, and Sweden, a combined figure of approximately 9,300 lobotomies were performed, which is crazy because the thing is, when you look at the population, right, the United States has a significantly bigger population.

So Scandinavian hospitals were lobotomizing per capita 2.5 times as many people as the United States was. That's insane. In Japan, the majority of lobotomies were performed on children with behavioral problems. In Germany, it happened a couple times, but not really all that many. And the thing is, as time went on, the practice fell out of favor.

By the late 1970s, the practice of lobotomy was pretty much over. It had stopped. It did technically continue as late as the 1980s. And do you want to guess where that took place? France. France. And also parts of Scandinavia. It's kind of insane. At the end of this, you may expect me to tell you, oh, this is the part where lobotomy was banned in the United States. But no. In short, it officially never actually was. At the federal level, it was not banned.

It wasn't until the discovery of the first antipsychotic, you know, drug, I'm going to butcher the pronunciation for this, flumeprazine, flumeprazine, that the use of lobotomy started to die down. Even by 1954, about 2 million patients in the U.S. had already received this drug, which ushered in a new era of medications as being psychiatric treatment. Drugs were seen as safer, cheaper, and way more effective in comparison to straight up lobotomy.

The last known lobotomy in the U.S. would occur in 1967 with Freeman, and as we said, that resulted in the patient's death. Today, technically speaking, lobotomies remain legal in the United States, but there are regulations depending upon whatever state you are in. Some states like California or Tennessee have very heavy restrictions, but others like Colorado and Delaware don't.

Don't really have anything. Maybe because it just has not come up. Yeah, it probably didn't really come up. They don't appear to, you know, actually happen anymore, at least not that we know of technically. But there is nothing at the federal level that stops them from taking place. This part of bad medical history was effectively just swept under the proverbial rug. There was nothing. There's no major outcry that shut it all down. It just kind of disappeared with a whisper.

And so that then ends the dark chapter of humanity. There was lobotomies. Well, with that, my friends, I hope that you all had a very merry holiday here for Christmas. And I hope that you have a lovely new year. Go in thinking about the world and what's to come. Because you, unlike some people of the past, actually have your brain intact. I hope. I don't really know if that's absolutely the case, but I hope that that is the case. My friends, thank you all very much for listening. I appreciate all of you.

Thank you, and we'll see you next time.