The Dark side of Science: The Lobotomy, the worst surgery in history? (Documentary)

scientists have tried to conquer the mind through many different ways for many different reasons one such is in the treatment of mental disorders experimental science has in some of its most controversial studies shed a light into how the brain works we have seen this in this very series with the monkey mother baby albert and milgram experiments but how about the treatment of mental disorders in a world before modern-day medicinal drug-based therapy around the mid-20th century a form of invasive surgical procedure would gain praise for being able to tackle the problem of overcrowding mental hospitals and treat the previously untreatable it would eventually be known as the lobotomy the surgery would go down in the annals of time as a barbaric and cruel procedure which would leave behind thousands of patients in its wake with devastating side effects including confusion incontinence seizures and in some cases even death one of the main characters in the story of his surgical procedure would describe the operation as surgically induced childhood eventually the surgery will become synonymous with the mishandling of mental health and the running rough shot over patient's rights as such i'm going to rate this dark page in scientific history a nine on my plane difficult ethical scale welcome to the dark side of science it is the turn of the 20th century mental health institutions throughout europe and the usa have become dangerously overcrowded during the 19th century where scientific discovery took leaps and bounds many attempts to treat the mentally ill had failed leading to a large population of incurable patients this was due to many industrialized countries having national systems of regulated asylums these institutions sought out care for patients that had been disposed of in the system by their families poor houses and the criminal justice system with no proper ways of treating inhabitants of the asylums many different forms of medical procedure were tested on the unfortunate patients there are many gruesome types of treatment on offer in the early 20th century in 1917 malaria therapy was introduced where a patient would be deliberately infected with the zoonotic disease to induce fever to fight neurosyphilis in 1920 the barbiturate induced deep sleep therapy for premature dementia aka precocious madness or in its modern name form schizophrenia this treatment use drugs to keep patients unconscious for days or even weeks in 1927 you might have been given insulin shock treatment which used the peptide hormone to introduce daily comas in 1934 patients could be prescribed with the first type of seizure therapy where a patient would be deliberately induced into convulsions by the use of ptz this therapy would be superseded by the more familiar electro shock therapy although these treatments could cause long-term lasting psychological and physical trauma the patient had not undergone a surgical procedure to eradicate the disorder but in 1935 in portugal a doctor named antonio monis would change this when he performed the first leukotomy on a patient the leukotomy in its most basic form was the deliberate damage of brain tissue in order to treat mental illness the name would later be changed to a more recognizable name when a procedure spread across the atlantic ocean but that will come later on in our story the thinking that inspired monies was that mental illnesses originated from abnormal neural connections in the frontal lobe moniz had seen the after effects of soldiers had received injuries to the front lobe in which the veterans would show a calm and quiet disposition the brain is made up of two types of matter gray and white gray matter is the brain's neurons and associated blood vessels and extensions the white matter is the nerve fibers that connected to the areas of gray matter and carry messages between them through electrical impulses monies theorized that by severing the white matter fibers from the frontal lobe would improve the patient's mental illness although in theory this might make sense the connections within the brain in reality are far more complex than what was fought at the time the grim procedure in its first form would involve drilling holes in the skull either side of the prefrontal cortex and injecting the connecting fibers with alcohol to destroy them monies found this method to not yield very good results due to the solution damaging much more than the white matter a tool was developed called a leukotome which looked like a long stick with a retractable wire loop inside it allowed the operator to insert a metal loop into the brain which was used to sever the white matter by extending and then retracting said loop the process cut six cores in the white matter of each hemisphere using a new tool procedure involved cutting through the skull the patient had to be operated on in a proper operating theatre under general anaesthetic to test the theory moniz enlisted neurosurgeon almedia lima to conduct a surgery on 20 test subjects of these initial 20 patients who were suffering from depression schizophrenia and anxiety monis claimed seven cures seven improvements and six unchanged cases although the results were open to interpretation monies claimed that the risk of some behavioral and personality deterioration outweighed the debilitating effects of severe psychiatric illness which is understandable when taking mental health care at the time as a contextual background a second set of patients were operated on due to the success of the first trial these 18 patients all suffered from schizophrenia and three were considered as almost cured and another two had also become improved monis did conclude that patients that had deteriorated considerably from a condition pre-procedure did not benefit much from the operation in a well-known quote from moniz he described his radical new surgery prefrontal leukotomy is a simple operation always safe which may prove to be an effective surgical treatment in certain cases of mental disorder the procedure would eventually earn monies a nobel prize in 1949 but initially monas's new way of treating the thought to be untreatable was widely derided by the medical community in 1936 moniz published his results through articles in the medical press and a monograph but to little attention on the 26th of july 1936 one of his assistants gave a presentation at the parisian meeting of the society medical psychologique on the results of the second test subjects the 18 people suffering from schizophrenia leukotomised by lima this meeting wouldn't go down well as the lead doctor at the institute in lisbon who had supplied the first set of patients to monis was also in attendance and widely denounced the after effects of the surgery saying that patients who had returned to his institute post-operation were diminished and had suffered a degradation of personality further adding that the initial results of calmness and improvement were more likely attributed to the severe shock of the surgery and ultimately from the horrible brain trauma that the procedure induced on its victims many other physicians denounced the procedure but bizarrely this isn't the end as several individual clinicians fought leukotomy could be useful on an experimental basis on severe patients and as such the surgery would spread throughout europe and even to the us during the mid to late 1930s and this leads us down an even darker path it is here that we are introduced to american doctors walter freeman and james w watts inspired by monash's new surgical procedure in 1936 the duo performed their own luchotomy walter had learned of the procedure after a chance meeting of moniz at the london hosted second international congress of neurology in 1935. the american was fascinated by the surgical technique upon returning to the u.s freeman started communicating with the portuguese doctor moniz during the correspondence promised to send a monograph on leukotomy and urged him to purchase a leukotone of his own upon receiving the paper on the procedure freeman reviewed it and set about with his colleague watts on experimenting with the surgery which led to september 1936. seeing flaws in the surgery watson freeman developed their own variation which renamed the procedure the standard prefrontal lobotomy to differentiate it from the monads method this version severed more of the white matter and would be the de facto method moving forward for lobotomies performed in operating theaters water thought that the lobotomy could be streamlined even further still the new standard procedure had the same shortcoming of the monies method and that was access to the brain you see cutting through the patient's skull required the operation to be conducted in an operating theatre with all the trappings anesthesiologist qualified surgeon hygiene and so on and so forth walter had heard of an italian doctor amarello vyamberti who had performed the leukotomy by accessing the prefrontal lobe through the eye socket in 1937. fire and bertie's method was to puncture the thin layer of orbital bone at the top of the eye socket and then much like monis's early experiments inject alcohol into the white matter or in later surgeries cutting the white matter with a hypodermic needle walter took this process and modified it using probably one of the most unlikely of tools this is a surgical tool or is this a surgical tool it's hard to tell as one was used in psychosurgery and the other is an ice pick well the similarity is not a coincidence as freeman's improvements on amarillo fire bertie's trans-orbital lobotomy replaced a needle with a nice pick in development of this new method freeman took an ice pick from his own kitchen and started practicing on a watermelon you'd eventually graduate to using cadavers the thinking was that if the lobotomy could be performed without exposing the brain then it could be performed by psychiatrists in psychiatric hospitals allowing more people to be operated on these are the tools used to the freeman trans orbital lobotomy a new tool called the orbiter clast essentially a nice pick with markings along the side and a hammer the method would involve the patient being either under anesthetic or electroconvulsive therapy used to render the subject unconscious then the orbiter class sharp end is placed under the eyelid and against the top of the eye socket the hammer is then used to penetrate the surgical instrument through the thin layer of bone and into the brain along the line of the bridge of the nose eventually going five centimeters deep the orbiter clast was then pivoted 40 degrees at the orbital perforation so the tip cut towards the opposite side of the head after this the tool was then hammered in a further two centimeters into the brain again the orbiter class was pivoted around 28 degrees each side to cut outwards and again inwards once this was complete it was removed and the process was repeated on the other eye socket the first patient to receive the procedure was in 1946 but once freeman's partner watts had heard about this new method he left their practice disgusted at the transorbital lobotomy but like every other chapter in this story this would not hamper the procedure's prevalence the lobotomy had now been transformed from a serious surgical procedure of last resort to a 10-minute doctor's office job along with this came a severe lack of follow-up care and monitoring which led to high relapse rates because of this towards the end of the 1940s nearly 20 000 people in the us have received a procedure but not only that but trans-orbital lobotomy would spread across the world and even back to the leukotomy's home grounds of europe spreading further still to the soviet union and japan to get a lobotomy in its late 1940s peak you really didn't need to have much of a mental health condition with the treatment touted for all kinds of ailments the list of treatable illnesses with a lobotomy included but was certainly not limited to add ocd anxiety ptsd postnatal depression chronic pain alzheimer's criminality and violent outbursts freeman evidence showman was responsible for a patient's death in 1951 when causing a lobotomy to pose for a photo in doing so causing severe brain hemorrhaging he was even known to lobotomize two patients at the same time one with each hand the doctor even performed the operational minors including children as young as four in total around 15 percent of patients who received a lobotomy died but many more were changed for life a shell of what they once were for those who survived the ordeal relapse would often follow but like its first unveiling to the world in paris in 1936 the procedure didn't go uncriticized in the late 1940s as moniz was set to receive his nobel prize multiple voices in the medical community spoke out on a barbaric procedure but it wouldn't be the criticism for the december banning of the procedure in the ussr but the synthesization of chlorpromazine the first antipsychotic as a side note soviet psychologist dr nikolai orozewski was quoted saying that lobotomies violate the principles of humanity and that was from an official from 1950s ussr the procedure gradually fell out of vogue but freeman would continue to perform the lobotomy all the way until 1967. when after their third lobotomy one of walters patients died of a hemorrhage this final procedure would get him banned from performing it ever again the ussr wouldn't be the last to ban lobotomies as even monas's portugal would disallow the procedure from use with further developments in drugs such as ssris antipsychotics and types of therapy like cbt the need for surgical intervention slowly faded away and by the 1980s lobotomy became a thing of the past now how would you rate the lobotomy on my ethical scale one being good and nine being pure cruelty let me know in the comments this is a plain difficult production all videos on the channel are creative commons attribution share like licensed plenty cool videos are produced by me john in a sunny south eastern corner of london uk help the channel grow by liking commenting and subscribing check out my twitter for all sorts of photos and odds and sods as well as hints on future videos i've got patreon and youtube membership as well so if you fancy check them out to support the channel financially and all that's left to say is thank you for watching [Music]

Channel: Plainly Difficult

Views: 4,860,740

Keywords: transorbital lobotomy, Walter freeman, Dark side of science, Plainly difficult science documentary, Psychosurgery, Baby Albert Experiment, Bobo Doll experiement, Plainly difficult disaster documentary, plainly difficult documentary, scientific documentary, fascinating horror, history documentary, Dark docs, Scientific history, qxir

Id: u1MDFdk5FEI

Length: 17min 9sec (1029 seconds)

Published: Sat Oct 02 2021

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