Walter Jackson Freeman II | |
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 Walter Jackson Freeman II in 1941 | |
| Born | (1895-11-14)November 14, 1895 Philadelphia, Pennsylvania, U.S. |
| Died | May 31, 1972(1972-05-31) (aged 76) San Francisco, California, U.S. |
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| Children | Walter Jackson Freeman III |
| Relatives | William Williams Keen (maternal grandfather) |
Walter Jackson Freeman II (November 14, 1895 – May 31, 1972) was an American physician who claimed that he specialized inlobotomy.[1] Wanting to simplify lobotomies so that it could be carried out by psychiatrists inpsychiatric hospitals, where there were often no operating rooms, surgeons, oranesthesia and limited budgets, Freeman popularized atransorbital lobotomy procedure. The transorbital approach involved placing anorbitoclast (an instrument resembling an ice pick) under the eyelid and against the top of the eye socket; a mallet was then used to drive the orbitoclast through the thin layer of bone and into the brain. Freeman's transorbital lobotomy method did not require aneurosurgeon and could be performed outside of an operating room, often by untrained psychiatrists without the use of anesthesia by usingelectroconvulsive therapy to induceseizure and unconsciousness. In 1947, Freeman's partnerJames W. Watts ended their partnership because Watts was disgusted by Freeman's modification of the lobotomy from a surgical operation into a simple "office" procedure.[2]
Freeman and his procedure played a major role in popularizing lobotomy; he later traveled across the United States visiting mental institutions. In 1951, one of Freeman's patients at Iowa's Cherokee Mental Health Institute died when he suddenly stopped for a photo during the procedure, and the orbitoclast accidentally penetrated too far into the patient's brain. After four decades Freeman had personally performed possibly as many as 4,000 lobotomies on patients as young as 4, despite the fact that he had no formal surgical training.[3][4] As many as 100 of his patients died ofcerebral hemorrhage, and he was banned from performing surgery in 1967. Freeman's procedure eventually spread across the world.
Walter J. Freeman was born on November 14, 1895, and raised inPhiladelphia, Pennsylvania, by his parents. Freeman's grandfather,William Williams Keen, was well known as a surgeon in theCivil War. His father was also a very successful doctor. Freeman attendedYale University beginning in 1912, and graduated in 1916. He then moved on to studyneurology at theUniversity 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. Freeman applied for a coveted position working alongside Spiller in his home town of Philadelphia, but was rejected.[3]
Shortly afterward, in 1924, Freeman relocated toWashington, D.C., and started practicing as the first neurologist in the city.[3] Upon his arrival in Washington, Freeman began work directing laboratories atSt. Elizabeths Hospital.[3] Working at the hospital and witnessing the pain and distress suffered by the patients encouraged him to continue his education in the field.[3] Freeman earned his PhD inneuropathology within the following few years and secured a position atGeorge Washington University in Washington, D.C., as head of the neurology department.[3]
In 1932, his mother died at the Philadelphia Orthopedic Hospital in Philadelphia.[5]
The first systematic attempt at human psychosurgery – performed in the 1880s–1890s – is commonly attributed to the Swiss psychiatristGottlieb Burckhardt.[6] Burckhardt's experimental surgical forays were largely condemned at the time and in the subsequent decades psychosurgery was attempted only intermittently.[7] On November 12, 1935, a new psychosurgery procedure was performed inPortugal under the direction of the neurologist and physicianEgas Moniz.[8] His new "leucotomy" procedure, intended to treat mental illness, took small corings of the patient's frontal lobes.[9] Moniz became a mentor and idol for Freeman who modified the procedure and renamed it the "lobotomy".[8] Instead of taking corings from the frontal lobes, Freeman's procedure severed the connection between the frontal lobes and the thalamus. Because Freeman was a neurologist and not a neurosurgeon, he enlisted the help of neurosurgeon James Watts.[10] One year after the first leucotomy, on September 14, 1936, Freeman directed Watts through the very firstprefrontal lobotomy in the United States on housewife Alice Hood Hammatt ofTopeka, Kansas, who suffered from anxiety, insomnia, and depression.[8][9] By November, only two months after performing their first lobotomy surgery, Freeman and Watts had already worked on 20 cases including several follow-up operations.[3] By 1942, the duo had performed over 200 lobotomy procedures and had published results claiming 63% of patients had improved, 23% were reported to be unchanged and 14% were worse after surgery.[3]
Freeman then "developed a transorbital approach"[2] based on the work of an Italian doctor,Amarro Fiamberti, who operated on the brain through his patients' eye sockets, allowing him to access the brain without drilling through the skull.[8] In 1937, Fiamberti, the medical director of a psychiatric institution in Varese, first devised the transorbital procedure whereby the frontal lobes were accessed through the eye sockets. After experimenting with novel ways of performing these brain surgeries, Freeman formulated a new procedure called thetransorbital lobotomy.[8] His new procedure allowed him to perform lobotomies without the use ofanesthesia, because he usedelectroconvulsive therapy to induceseizure: "[Freeman] used a mallet to tap an orbitoclast (a slender rod shaped like an icepick) through the orbital roof. Following penetration of the orbital roof, Freeman would sweep the orbitoclast laterally to obliterate frontal lobe tissue. Additionally, he was able to perform the procedure in an office setting because he anesthetized patients with a portable electroshock machine."[2] He performed the transorbital lobotomy surgery for the first time in Washington, D.C., on a housewife named Sallie Ellen Ionesco.[8] In 1950, Walter Freeman's long-time partnerJames Watts left their practice and split from Freeman due to his opposition to the transorbital lobotomy.[8]
Freeman traveled across the country visitingmental institutions, performing lobotomies and spreading his views and methods to institution staff. (Contrary to myth, there is no evidence that he referred to the van that he traveled in as a "lobotomobile".)[11] Most of these operations Freeman performed for free as demonstrations.[12] Freeman's name gained popularity despite the widespread criticism of his methods following a lobotomy on PresidentJohn F. Kennedy's sisterRosemary Kennedy, which left her with severe mental and physical disability.[3] A memoir written by former patientHoward Dully, calledMy Lobotomy, documented his experiences with Freeman and his long recovery after undergoing a lobotomy surgery at 12 years of age.[13] After four decades Freeman had personally performed possibly as many as 4,000[14][15][16] lobotomy surgeries in 23 states, of which 2,500 used his ice-pick procedure,[17] despite the fact that he had no formal surgical training.[3] In February 1967, Freeman performed his final surgery on Helen Mortensen,[8] a long-term patient who was receiving her third lobotomy from Freeman.[8] She died of acerebral hemorrhage, as did as many as 100 of his other patients, and he was finally banned from performing surgery.[8] His patients often had to be retaught how to eat and use the bathroom. Relapses were common, some never recovered, and about 15%[18] died from the procedure. In 1951, one patient at Iowa'sCherokee Mental Health Institute died when Freeman stopped and stepped back to take a photo of the patient with theleucotome, as was his usual practice, and the surgical instrument accidentally penetrated too far into the patient's brain.[19][20] Freeman usually wore neither gloves nor mask during these procedures.[20] He lobotomized 19 minors, including a four-year-old child.[21] Freeman often stayed in contact with his former patients and his families, and would check on their condition during his trips.[22]
At 57 years old, Freeman retired from his position atGeorge Washington University and opened up a modest practice in California.[3]
An extensive collection of Freeman's papers were donated to TheGeorge Washington University in 1980. The collection largely deals with the work that Freeman andJames W. Watts did on psychosurgery over the course of their medical careers. The collection is currently under the care of GWU's Special Collections Research Center, located in the Estelle and MelvinGelman Library.[23]
Freeman was known for his eccentricities and he complemented his theatrical approach to demonstrating surgery by sporting a cane, goatee, and narrow-brimmed hat.[3][15]
Freeman died of complications arising from an operation for cancer on May 31, 1972.[24]
He was survived by four sons: Walter, Frank, Paul, and Lorne, two of whom entered the medical profession; the eldest,Walter III, becoming a professor of neurobiology at theUniversity of California, Berkeley.[15]
Walter Freeman nominated his mentorAntónio Egas Moniz for aNobel Prize, and in 1949 Moniz won the Nobel Prize in Physiology and Medicine.[8] He pioneered and helped open up the psychiatric world to the idea of what would becomepsychosurgery.[1] At the time, it was seen as a possible treatment for severe mental illness, but "within a few years, lobotomy was labeled one of the most barbaric mistakes of modern medicine."[1] He also helped to demonstrate the idea that mental events have aphysiological basis.[1] Despite his interest in the mind, Freeman was "uninterested in animal experiments or understanding what was happening in the brain".[3] Freeman was also co-founder and president of theAmerican Board of Psychiatry and Neurology from 1946 to 1947[3] and a contributor and member of the American Psychiatric Association.[1]
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