The U.S. government lobotomized roughly 2,000 mentally ill veterans—and likely hundreds more—during and after World War II, according to a cache of forgotten memos, letters and government reports unearthed by The Wall Street Journal. Besieged by psychologically damaged troops returning from the battlefields of North Africa, Europe and the Pacific, the Veterans Administration performed the brain-altering operation on former servicemen it diagnosed as depressives, psychotics and schizophrenics, and occasionally on people identified as homosexuals....In a standard lobotomy, the surgeon opens the skull and severs the prefrontal part of the brain from the rest of the brain.
“Realistically looking back, the diagnosis didn’t really matter—it was the behaviors,” says psychiatrist Max Fink, 90, who ran a ward in a Kentucky Army hospital in the mid-1940s. He says veterans who couldn’t be controlled through any other technique would sometimes be referred for a lobotomy. I didn’t think we knew enough to pick people for lobotomies or not.... It’s just that we didn’t have anything else to do for them.”
Much more at the link. It seems that the government was looking mostly at men with what today we would call PTSD and taking advantage of a way to control intractable people. I'd like to see more details on how this related to homosexuals. Presumably, as Fink said "it was the behaviors." This was back in the days before Thorazine, so it's hard for us today to picture what these doctors were seeing.
During eight years as a patient in the VA hospital in Tomah, Wis., [Roman] Tritz underwent 28 rounds of electroshock therapy, a common treatment that sometimes caused convulsions so jarring they broke patients’ bones. Medical records show that Mr. Tritz received another routine VA treatment: insulin-induced temporary comas, which were thought to relieve symptomsMy mother, who is no longer alive, was a WAC who worked in wards like this in the 1940s, but I never heard her say anything about the treatments, only very general things about how the men suffered.
To stimulate patients’ nerves, hospital staff also commonly sprayed veterans with powerful jets of alternating hot and cold water, the archives show. Mr. Tritz received 66 treatments of high-pressure water sprays called the Scotch Douche and Needle Shower, his medical records say....
“You couldn’t help but have the feeling that the medical community was impotent at that point,” says Elliot Valenstein, 89, a World War II veteran and psychiatrist who worked at the Topeka, Kan., VA hospital in the early 1950s. He recalls wards full of soldiers haunted by nightmares and flashbacks. The doctors, he says, “were prone to try anything.”
56 comments:
One reading of the article could be that a Democrat Administration systematically tortured US Citizens in the interest of making them tractable.
This has got to be a bigger story than the Tuskegee Syphilis experiment.
" For decades he has meandered into delusions and paranoid views about government conspiracies."
When Mr. Tritz fears the government he is correct. His "delusions" and "paranoid views about government conspiracies" are true. The US government really did take him against his will and really did lobotomize him!
"This has got to be a bigger story than the Tuskegee Syphilis experiment."
Hey, what are you complaining about? The lobotomized veterans and the patients of the Tuskegee Syphilis experiment all received free government healthcare for life. Happy Happy Happy Both groups of patients were duly discussed by a group of government experts who decided what was the best. Anyone heard of "Death Panels"? Government medicine. Happy Happy Happy
Incidentally, the pagan gods will not be the subjects of death panels. They will be the ones who run the death panels.
"This has got to be a bigger story than the Tuskegee Syphilis experiment."
I don't think it is. Treatment was withheld from the Tuskegee patients so the progress of the disease could be studied (and there was a racial element to the decision to treat them that way).
Here, a bad treatment was apparently sincerely believed to be the best they could do for patients who were suffering.
So if we lobotomized 2000+ Vets
How many did we torture with shock treatments or Hot/ice hoses? 20,000?
Compare and contrast to waterboarding or Abu Graib.
For extra credit, explain why the AMA's position on this, is different than their condemnation of any doctors who assist in Court adjudged Death sentences...
"Treatment was withheld from the Tuskegee patients so the progress of the disease could be studied "
By the standards of its day, it was a solid piece of science. A controlled experiment designed to gather knowledge. That it resembled a Nazi experiment does't change the fact that the Doctors thought they were doing good for society.
Both the Tuskegee experiment and these "experiments" were covered up...
"Here, a bad treatment was apparently sincerely believed to be the best they could do for patients who were suffering."
They didn't have a clue. They were just trying shit to make the patients trackable.
I think that because your mother was possibly involved, you might try to paint this in the best light, but if it was good work, why was it hidden away...
It had nothing to do with being a Democrat administration. They were treatments used on mentally ill patients of any sort back in that era. My sister recently retired as a nurse from the VA hospital in Tomah, where they continue to house chronically mentally ill veterans.
As for performing such treatments and considering homosexuality as a mental illness, they did that and more. In those days even deaf, cognitively impaired, Down's Syndrome, autistic and more were housed together and those with non psychiatric diagnosis began to display behavior we used to call "institutionalization", back when I worked at the County Psych hospital in Milwaukee. The same treatments discussed in the article had been performed ( before my time) on the aging chronically ill patients I took care of there. The lobotimized patients were sometimes still quite violent, which is one of the reasons it was performed to begin with.
The baths with the high powered jets of cold and hot water were still present in an older part of the institution. Even small rooms with chains and a metal grate door in which a patient could only crouch, were still present in the basement area. We saw these on the tour we got during our 6 week long orientation.
During the 30s and possibly before, sturdy wooden chairs with leather ankle and wrist restraints were used to subdue agitated patients, the more violent were placed in padded rooms, straight jackets and non padded seclusion rooms, tied to a bed with leather restraints. These seclusion rooms and chairs were still in use in the mid 70's , when I worked there for a couple of years, right out of nursing school. By that time, the wards were being emptied and the patients being dumped into halfway houses, where they eventually ended up on the streets.
Inga,
Yeah, I know it was a cheap shot, but it was systemic and a much bigger deal than 3-4 guards with poor judgment, 12,000 miles from the Oval Office, yet Bush was blamed for Abu Graib in the NYT and the rest of the press, to this day...
The classic book on the subject is "Psychosurgery" by Dr. Walter Freeman, the doctor who popularized this horror in the US. It is replete with dozens of case studies of patients, including perhaps the saddest of a teenage boy lobotomized because he was obstreperous. It's only found in medical libraries.
The surgery was invented by a Spanish doctor Moniz. He did several on animals and perhaps a few on humans. And then he got a Nobel Prize! Doctors had few truly effective ways of treating mental illness, so off they went with lobotomies.
The most horrific were prefrontal lobotomies. They could be performed under local anesthesia, the surgeon entering the frontal lobes through the eye socket. In the book "Great and Desperate Cures," there is a transcript of a patient undergoing such a horror. It reads like HAL in 2001 being disconnected. The patient literally describes horrific pain and then recounts how he can feel his brain functions lessening. The great popularizer Freeman drove from mental hospital to mental hospital in his lobotomymobile and performed these surgeries they way McDonalds makes milkshakes, liquefying brains like ice cream.
And from nearly the beginning doctors knew that the great majority of these surgeries would make patients worse off. More docile, yes.
Finally, if you are really interested in brains, here is a video from BoingBoing showing a neurosurgeon handling and describing a, shall we say, fresh brain for medical students.
Also, even in the days of big 3cc syringes of Thorazine and daily maintainence doses, some of these patients became very violent. I had a sweet little Down's Syndrome patient who had the tip of her nose bitten off by a psychotic patient. 18 year olds from a facility called Southern Colony were dumped into County Psych when they were 18, because they were no longer children and no other facility would accept them.
It wasn't because of cruelty or malpractice that these patients were treated in the manner described, it was because there was no better alternative in those days.
It is things like this that make it hard for me to trust the government. It just sometimes makes really, really bad decisions, like here. Even when there's no actual malice involved. Incompetence is sometimes worse than malice.
The SAME treatments were being performed in posh private psychiatric hospitals back in those days. It was an ACCEPTED treatment. Government had nothing to do with it.
"In those days even deaf, cognitively impaired, Down's Syndrome, autistic and more were housed together and those with non psychiatric diagnosis began to display behavior we used to call "institutionalization", back when I worked at the County Psych hospital in Milwaukee."
I worked in the LA veterans hospital psych unit in 1962 as a medical student. I saw no Down's patients or deaf patents and autism is a diagnosis in children. I did see a few lobotomized patients and I did see ECT used but the patients were antesthetized and given muscle paralysis.
There is a lot of exaggeration in some of these stories. Lobotomy was used before Thorazine was discovered. Thorazine was a pill in 1962.
Michael, you didn't read my comment carefully. I was describing the Milwaukee County Pysch hospital, not the VA hospital.
"It was an ACCEPTED treatment."
-- By 1947/48, there were people writing about it being an ineffective treatment. Imagine today if the government OK'ed a treatment that was known to have a high failure rate and tested it on veterans. It would be a scandal now, it was a scandal then.
Not only that, about 40,000 people received lobotomies (at least, according to the most recent stats from 2005 cited in Wiki. I honestly thought it was higher too.)
That hardly sounds like a very prevalent treatment. Comparatively, millions of people have had Lasik surgery. That's the difference between something that even at the time was a highly questionable process. Just because someone gets a Nobel prize for something doesn't mean they deserved it.
(That's, 40k in the U.S.)
Matthew, I'm not saying it was a good treatment. I'm saying the VA at the time, was following protocol of the day. Perhaps they should've been on the cutting edge of new and innovative treatments of the mentally ill. Im sure if those new and innovative treatments were also not effective, we would be discussing those too today and the bad bad government.
It's all too evident that some are stretching to blame government, once again.
Lobotomy was considered standard practice as late as the 40's, even into the 50's.
If that were the case, how come so few people were treated with it?
I understand that people THINK that lobotomies were considered a main stream treatment, and it is true that they were not as stigmatized as they are today. But, the numbers don't lie. It was a medical fad no different than quack cancer cures, and we'd be ashamed if the government started giving veterans homeopathic herb treatments instead of radiation.
Matthew,
Who knows? Maybe they were being tortured with electric shock therapy or hot and cold water jets instead.
Now I guess I'll have to tell 'em
That I got no cerebellum
Gonna get my Ph.D.
I'm a teenage lobotomy!
It wasn't considered quackery back then Matthew.
Your own source says that there were doctors that spoke against it since the beginning. Just because the Nobel committee was fooled doesn't mean anything. It was quackery, it was practiced, but it was a controversial topic. Again: Today, if the administration agreed to try and treat veterans with cancer with a controversial cure not known to be effective, it would be a scandal.
That the administration then rolled the dice on their veterans' health is equally so. This really isn't up for debate; the administration dropped the ball and should have known better, or tried to learn better. Instead, they took the easy way out.
Bottom line...blame government? No, that's simply the lazy thinker's way out. Or the way of the government is the Bogey Man indoctrinated.
Inga: The government should have PROTECTED the people it allowed to be lobotomized. It is the government's specific duty; there was plenty of evidence at the time to do so. It chose not to.
The government accepts certain responsibilities, and it cannot even fulfill those properly. That's the point; you seem to think the government shouldn't be held to a high standard, "mistakes were made," and don't blame the people in charge.
Sorry. The people in charge get the blame for the veterans being lobotomized. It should never have happened, if the government were paying attention like it should. The remaining 38,000 lobotomies are not at issue here.
"I think that because your mother was possibly involved, you might try to paint this in the best light, but if it was good work, why was it hidden away…"
No, I'm just trying to be accurate. I think I'm pretty clear about that. My mother wasn't involved in decisions about what the treatment would be. She was a sergeant, at the level of providing care, not deciding on surgery.
I want to be exactly as critical of the decisionmakers as is proper. I'm not motivated to hide anything, but I don't want to be anachronistic about what was done and who did the things that were wrong. Maybe the wrong was not putting enough money into veterans' medical care or into drug research or into research into the etiology of mental illness.
I am trying to imagine what the patients might have been like and how desperate the medical professionals were. I really don't know how any human being ever got the nerve to saw open a human skull and cut things in the brain. Brain surgery seems like lunacy, but some of it works. They thought they knew where the impulsive emotion was and that they could sever it. How evil is that?
Inga said:
" No, that's simply the lazy thinker's way out. Or the way of the government is the Bogey Man indoctrinated."
The lobotomies were performed in government hospitals. Why is it mentally lazy or Bogey Man to blame government for what happens in government institutions by government employees?
Lobotomies were a medical fad which were obviously poorly researched. That makes this situation bad enough but government didn't create the fad. The crime in this case is that the "treatment" was forced on the patients against their will. It is horrifying to read how Mr. Tritz fought for his life and even won a brief reprieve before he was hauled into surgery and lobotomized. That type of forced treatment would be criminal in any circumstances without the acquiescence of the government.
“The general public has long been divided into two parts; those who think that science can do anything and those who are afraid it will.” - Thomas Pynchon
Well the good news is that mental hospitals were considered so old fashioned by the liberals that they were mostly shut down. The "mentally ill" are thus fending for themselves on the streets of America.
I'm just so thankful that todays government isn't doing anything it will be ashamed of 50 years from now.
Anyway, I'm pretty sure all those lobotomies were Bush's fault.
Althouse said:
"I don't think it is. Treatment was withheld from the Tuskegee patients so the progress of the disease could be studied (and there was a racial element to the decision to treat them that way)."
I realize you didn't want to widen the discussion, but I do want to clarify some details about the Tuskegee experiment as I understand them. Its been a few years since I studied up on the experiment but there are few points that stand out in my mind. The Tuskegee experiment began before there were effective antibiotics against syphilis, so there was nothing racist or criminal in the experiment at that time. Tuskegee was founded for the advancement of colored people and many of the people in the team responsible for the experiment were black themselves. The ethical violations were two fold. First, the patients were apparently not informed of their diagnosis at the time the experiment was begun. Second, when effective antibiotics became available the patients were not treated. Instead when the researchers found that the patients had sought outside treatment they would take active steps to block treatment for syphilis. Here is the problem, the experiment lasted so long that the people who started it were not the ones who finished it. Like all government sponsored programs once it was started it took on a life of its own, in which people benefitted by the existence of the experiment, and in which people forgot to question whether the experiment still made sense.
Lobotomies were also performed in PRIVATE posh psych hospitals to non military mentally ill patients. It was standard accepted procedure, which was ALSO forced on private patients. They were involuntarily committed for long periods in those days.
The legacy of the CIA's secret LSD experiments on America from 1953 to 1964.
Exposure to radiation during military service from 1940's onward.
Not Democrat administrations only it seems.
"Treatment was withheld from the Tuskegee patients so the progress of the disease could be studied "
I agree with Illuninati. Most of what popular culture says about Tuskegee is just plain wrong. For instance Rev Wright thinks it shows a pattern that the US Government created AIDS.
It was a Study, not an Experiment- people seem to be under the impression that the government infected people with syphilis to see what happened. Tuskegee is really the story of the life cycle of a bureaucracy. For decades there was *no* effective treatment so institutionally people got into the rhythm that the purpose of their work was to check in on these guys once a year, give them a hot meal and some free health care. After decades it didnt occur to them that they should revisit the purpose of their work.
Inga said:
"Lobotomies were also performed in PRIVATE posh psych hospitals to non military mentally ill patients. It was standard accepted procedure, which was ALSO forced on private patients. They were involuntarily committed for long periods in those days."
The government was directly responsible for these lobotomies which were forced on veterans sometimes if not always against their will and therefore the government and its employees are totally responsible for their actions. Undoubtedly, many of these veterans were suffering from posttraumatic stress syndrome. As I understand the syndrome, the amygdala overpowers the frontal lobe. By destroying the frontal lobe, the amygdala would be freed from the inhibition by the frontal lobe and the patients horrors would be magnified many times over. I can only imagine how those patients suffered as Althouse's mother would say.
I don't know whether private institutions ever treated posttraumatic stress disorder with forced lobotomies or not. I doubt it, but it is conceivable.
If there's no excuse for Tuskegee, there's no excuse for the lobotomies to control "shell shock".
To be fair, they knew far more about syphilis in the mid 20th century than they did about PTSD. Calling it a "routine protocol" ignores that there was no existing evidence that it would work to reduce PTSD symptoms when they started doing it.
They also did it on people without their consent, just like Tuskegee. The ethics are the same. If one is to be condemned, so should the other.
But, I suspect it isn't politically useful for modern Progressives, seeing as how the victims were mostly white, so it won't be pursued as a grievance to be remedied. It just produces shoulder shrugs from those like Inga, as they attempt to explain it away, with a "mistakes were made" tap dance they would never accept when one of their political pets is aggrieved over something that happened in the 1940-50s. Just like past racism is condemned, so should such gross rights violations of any other humans, especially the mentally ill.
Someone has to mention Rosemary Kennedy so it might as well be me.
I think it's foolish to apply today's standards to yesterday's care.
When did the coverup actually happen -- a long time after the treatment, I'll suggest.
Professor--
My recollection from reading book on lobotomies (ah, such fun) is that the medical community realized fairly soon that the operation was more likely to fail than succeed, and the side-effects were often catastrophic--loss of bowel/urinary control, zombie-type behavior. Pretty horrible stuff.
The procedure's popularizer Dr. Freeman made big bucks doing the surgery. Wiki says he did at least 3,400 procedures himself. He had no training as a surgeon and was ultimately banned in California from performing surgeries there. These transorbital lobotomies were performed without anesthesia, presumably so he could tell how much of the brain to scramble.
A doctor with no surgical training doing this? Sounds evil to me.
I do want to make a correction on my previous post. Apparently some researchers now dispute whether frontal lobe damage enhances the effects of posttraumatic syndrome.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771687/
Incidentally, in the near future responsible doctors may be destroying tiny sections of the amygdala to relieve posttraumatic stress disorder. Also, electroconvulsive therapy is still an effective treatment for intractable depression. The crime described in the VA hospitals was that war heroes were taken by force and subject to permanent destruction of parts of their brains against their wills. None of the other horrors described in their treatment rises to this level of criminal conduct.
"The procedure's popularizer Dr. Freeman made big bucks doing the surgery. Wiki says he did at least 3,400 procedures himself. He had no training as a surgeon and was ultimately banned in California from performing surgeries there. These transorbital lobotomies were performed without anesthesia, presumably so he could tell how much of the brain to scramble."
If you read the article at the link, you'll see that the Freeman type of lobotomy - icepick through the eye socket -- was not what the veterans' doctors did. The did the "standard lobotomy" which required opening the skull and cutting in a more normal-seeming brain surgery way.
Don't confuse the 2 procedures.
This psychiatric surgery is a forerunner of the Death Panels made the law for the sick elderly and the Downs Syndrome patients.
EST is a generalized all lobe lobotomy by electricity for the emotionaly break down folks.
The justification is that the trash people must be disposed of.
Psychiatry yesterday: Trust us, we know what we're doing!
Psychiatry today: Trust us, we know what we're doing!
OK, so some of the psych. drugs seem to work. But to psychiatrists really understand why?
The DSM grows and grows, even though its contents are the result of consensus and not necessarily science.
How much of psychiatry today can truly be called "science"?
PTSD has a name now, but it's not a new thing, nor is its recognition as a medical condition new.
My great grandfather was a Civil War vet who had been imprisoned at Andersonville. One hundred nineteen members of his unit had been captured. With the exception of two officers, all were imprisoned at Andersonville. Over 80 of these men died during captivity. The rest were in terrible condition physically and mentally when released via a prisoner exchange.
My great grandfather managed to navigate the civilian world for a while, but from the 1880's onward he spent nearly all of his life in three different Federal Veterans Homes. This even though he had a wife and four children.
I have read the surviving files regarding his case. He is described as suffering from extreme nervousness, anxiety and agitation. He abused alcohol, a common problem at the Veterans Homes. He was a difficult patient but had an iron constitution and survived until 1924.
These symptoms were well known as consequences of military service by the veterans. In many cases, including that of my great grandfather, they served as the basis for awarding a disability pension.
Well, Professor, I'd rather have a bottle in front of me than a frontal lobotomy.
I would think that the larger scandal is that we used this form of treatment on shell shocked combat veterans. I would highlight this and not it's use as a treatment for homosexuals........if you're stuck with an intractable and burdensome disease, you keep grasping at straws. Both the patient and the doctor.
I want to add a voice in support of those commenters who are trying to put this story into perspective. My father was a psychiatrist -- graduated from med school in 1936, worked for the VA both before and after WW II, served in the Army Medical Corps during the war, worked in a highly regarded private psychiatric hospital, and then in private practice until a year before his death in 1976. I recall his talking about lobotomies and criticizing the procedure. This was probably in the late '50's. I would put him in the category of those who were critical of the procedure from the beginning. But he knew doctors in the '40's at least who thought this was something worth trying, when there were no apparently better options. My father accepted other procedures that are criticized in the article, in particular shock therapy. It didn't always work, but sometimes it was the only thing that did.
We knew less about mental/emotional illness in the 1940's and '50's than we do now. A generation from now, our descendants will look back on the early 21st century and marvel at how ignorant and barbaric we were. Yet each age must do its best with the flawed knowledge and tools available to it.
I want to add a voice in support of those commenters who are trying to put this story into perspective. My father was a psychiatrist -- graduated from med school in 1936, worked for the VA both before and after WW II, served in the Army Medical Corps during the war, worked in a highly regarded private psychiatric hospital, and then in private practice until a year before his death in 1976. I recall his talking about lobotomies and criticizing the procedure. This was probably in the late '50's. I would put him in the category of those who were critical of the procedure from the beginning. But he knew doctors in the '40's at least who thought this was something worth trying, when there were no apparently better options. My father accepted other procedures that are criticized in the article, in particular shock therapy. It didn't always work, but sometimes it was the only thing that did.
We knew less about mental/emotional illness in the 1940's and '50's than we do now. A generation from now, our descendants will look back on the early 21st century and marvel at how ignorant and barbaric we were. Yet each age must do its best with the flawed knowledge and tools available to it.
Here's some detail about this procedure and its evil popularizer:
"He had a buccaneering disregard for the usual medical formalities - he chewed gum while he operated and displayed impatience with what he called 'all that germ crap', routinely failing to sterilise his hands or wear rubber gloves. Despite a 14 per cent fatality rate, Freeman performed 3,439 lobotomies in his lifetime.
For the survivors, the outcomes varied wildly: some were crippled for life, others lived in a persistent vegetative state. Rose, John F Kennedy's sister, was operated on by Dr Freeman in 1941 at the request of her father. Born with mild learning difficulties, she was left incapacitated by the procedure and spent the rest of her life in various institutions, dying in 2005 at the age of 86. Yet occasionally, the operation appeared to have a calming, desensitising effect on the mentally ill. The lobotomy's mixed success rate was a symptom of its imprecision: it was a hit-and-miss procedure developed at a time when little was known about the very specific nature of the brain's structure."
A 14 percent fatality rate! And institutions allowed him to continue performing the procedure. He didn't believe in germs?
The banality of evil. People in charge either knew and didn't care or they didn't care enough to know.
14 percent fatality rate. Almost one in five.
Detailed article here on Rosemary Kennedy's lobotomy, done at the hands of Charles Freeman. It's noted that Joe Kennedy first took her to a Boston physician, who refused to recommend one -- that would seem to indicate it was not a standard accepted procedure.
Terribly sad: "The lobotomy, an indisputable disaster, left the 23-year-old Rosemary inert and unable to speak more than a few words. Freeman had cut too deeply. She eventually regained the ability to walk but permanently lost the initiative and mental capabilities she needed to live with even partial independence."
Make that Walter Freeman, not Charles.
Lobotomy: a history ofhe controversial procedure.
"For several decades it became a mainstream procedure..."
"It was largely because of Freeman that Lobotomies became so popular during he 40's and 50's."
It was an awful procedure, didn't work, but was not at all out of the mainstream in treatment of the mentally ill.
Psychiatry yesterday: Trust us, we know what we're doing!
Psychiatry today: Trust us, we know what we're doing!
Scientology is definitely not my thing, but L. Ron Hubbard did understand the hit and miss nature of psychiatry, especially back in the day.
Drill SGT I'm sure is more conversant on this, but it seems to me at least that what is now called post traumatic stress, was for the WW2 returning veterans something not fully appreciated or recognized, or if it was, it wasn't publicly discussed. It seems it became recognized with the returning Viet Nam war veterans.
I saw an old 1949 movie Home of the Brave that depicted a soldier suffering from stress but there was an added racial component, other than that I don't recall any other movies.
So what were their combat assignments?
Ether you buy the bandwagon argument, or you fail, pun intended. Patients self-medicating much?
The nose-biting incident bears the mark of a management issue: too few staff on duty.
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