Walter Freeman

Dr. Walter Jackson Freeman II (November 14, 1895 – May 31, 1972) was an American physician. He is mainly remembered as a prolific lobotomist and an advocate of psychosurgery.

Freeman was born in Philadelphia, Pennsylvania into an affluent and distinguished family. His father was a successful doctor and his grandfather, William Keen, was President of the American Medical Association. He graduated from Yale and the University of Pennsylvania Medical School. He was president of the American Association of Neuropathologists 1944-1945, president of the American Board of Psychiatry and Neurology 1946-1947, and a member of the American Psychiatric Association.

Career
Freeman performed nearly 3500 lobotomies in 23 states, mostly based on scanty and flimsy evidence for its scientific basis, but more significantly he popularized the lobotomy. A neurologist without surgical training, he initially worked with several surgeons, including James W. Watts. In 1936, he and Watts became the first American doctors to perform prefrontal lobotomy (by craniotomy in an operating room).

Seeking a faster and less invasive way to perform the procedure, Freeman adopted Amarro Fiamberti's transorbital lobotomy and began to perfect it, initially by using ice picks hammered into each frontal lobe through the back of each eye socket ("ice pick lobotomy"). Freeman was able to perform these very quickly, outside of an operating room, and without a surgeon. For his first transorbital lobotomies, Freeman used an actual icepick from his kitchen. Later, he utilized an instrument created specifically for the operation called a leucotome. In 1948 Freeman developed a new technique which involved wrenching the leucotome in an upstroke after the initial insertion. This procedure placed great strain on the instrument and in one case resulted in the leucotome breaking off in the patient's skull. As a result, Freeman designed a new, stronger instrument, the orbitoclast.

Freeman embarked on a national campaign in his van which he called his "lobotomobile" to demonstrate the procedure to doctors working at state-run institutions; Freeman would show off by icepicking both of a patient's eyesockets at one time - one with each hand. According to some, institutional care was hampered by lack of effective treatments and extreme overcrowding, and Freeman saw the transorbital lobotomy as an expedient tool to get large populations out of treatment and back into private life.

The “ice pick lobotomy” was, according to Ole Enersen, performed by Freeman “with a recklessness bordering on lunacy, touring the country like a travelling evangelist. In most cases,” Enersen continued, “this procedure was nothing more than a gross and unwarranted mutilation carried out by a self righteous zealot.”

Freeman's most notorious operation was on the ill-fated Rosemary Kennedy, who was permanently incapacitated by a lobotomy at age 23. Another of his patients, Howard Dully, has now written a book called My Lobotomy about his experiences with Freeman and his long recovery after the surgery he underwent at 12 years old.

With the advent of antipsychotic drugs, notably Thorazine, in the mid-1950s, lobotomy fell out of favor as a treatment, and Freeman saw his reputation crumble quickly. His license to practice medicine was revoked when a patient he was lobotomizing died. He continued to drive cross country in his "lobotomobile" to visit his former patients until his death from cancer in 1972.

Frances Farmer legend
The urban legend that Freeman operated on actress Frances Farmer has been conclusively disproven: the author who initially alleged this admitted in a court proceeding that he had made it up. Farmer's medical records show she was never operated on while institutionalized, and Freeman biographer Jack El-Hai (The Lobotomist), who had access to Freeman's patient records, found no reference to Farmer.

Other sources

 * El-Hai, Jack (2005), The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness; Wiley.