Portuguese neurologist António Egas Moniz developed the prefrontal leucotomy in 1935, severing connections in the frontal lobes to treat severe mental illness. In 1936, American neurologist Walter Freeman and neurosurgeon James Watts adapted the technique, renaming it the prefrontal lobotomy, and performed the first such operation in the U.S. on September 14 at George Washington University Hospital on Alice Hood Hammatt, a woman with agitated depression. Their Freeman-Watts standard procedure involved drilling holes in the skull and using a leucotome to disrupt neural pathways between the frontal lobes and other brain regions.
Lobotomy gained traction amid overcrowded asylums, limited effective treatments for conditions like schizophrenia, depression, and anxiety, and postwar pressures including care for veterans. Freeman aggressively promoted it through media as a potential “miracle” cure.
Early results were mixed: some patients became calmer and more manageable, allowing discharge, but many suffered personality changes, apathy, cognitive impairment, seizures, or death. In 1945–1946, Freeman refined a faster, less invasive version—the transorbital (“ice-pick”) lobotomy—inspired by Italian work. An instrument was inserted through the eye socket to sever frontal lobe connections, often after electroconvulsive shocks for sedation; no traditional operating room was required.
The first U.S. transorbital procedure occurred on January 17, 1946, on Sallie Ellen Ionesco. Watts opposed the office-based approach and eventually parted ways with Freeman. Freeman then traveled widely, performing or supervising thousands of procedures (estimates around 3,400–3,500 of his own, including some on children) and training others. Roughly 40,000 to over 50,000 lobotomies occurred in the U.S., with the peak (“lobotomy boom”) in the late 1940s to early 1950s—around 5,000 annually at the height, many in state hospitals.
A high-profile case was Rosemary Kennedy’s 1941 lobotomy, which left her severely incapacitated. Joe Kennedy (JFK's dad) submitted his daughter to the procedure without even telling his wife that he was doing this. The procedure was carried out by Freeman and Watts at the George Washington University Hospital, which provided a high degree of respectability to this action. The operation, however, was a catastrophic failure. Rosemary’s mental capacity was reduced to roughly that of a two-year-old. She initially could not walk or speak intelligibly and became incontinent. She was shuttled off to an institution in Wisconsin, out of sight, out of mind. Joseph and Rose Kennedy never visited her for 20 years. Believe it or not, she lived till 2005 and died at age 86. This story was, of course, kept hush-hush for many years.
Ethical concerns regarding lobotomy grew over consent, indiscriminate use, and irreversible harm. The American Medical Association had already expressed skepticism by the early 1940s.
The procedure’s popularity collapsed after the 1954 introduction of chlorpromazine (Thorazine) and other antipsychotics and antidepressants, which offered safer pharmacological alternatives. Lobotomies dwindled; Freeman performed his last in 1967 on Helen Mortensen (a repeat patient), who died of hemorrhage. By then the era had effectively ended. Lobotomy is no longer practiced in the U.S. and stands as a cautionary chapter in psychiatric history, illustrating both desperate therapeutic innovation and the risks of uncritical adoption of invasive treatments.
This above story came to mind when I read Michael Shellenberger's Substack yesterday calling out some facts about "gender-affirming care" that are seldom talked about.
For years, he wrote, many of America's most influential medical organizations, along with much of the news media, Democratic leaders, hospitals, progressive advocacy groups, and celebrities, have argued that "gender-affirming care" can save lives. This care can include puberty blockers, cross-sex hormones, and surgeries that alter a child's body. The guiding belief has been that if a child sincerely believes he or she is the opposite sex, medical treatment should help bring the body into alignment with that inner identity.
However, a newly released report from the U.S. Department of Health and Human Services (HHS) paints a much grimmer picture, writes Shellenberg. According to the report, adults who underwent gender-related surgeries had 12-fold higher rates of suicide attempts than those who did not. It also cites a long-term Swedish study that followed patients for up to 30 years and found that those who had undergone gender reassignment surgery died by suicide at a rate 19 times greater than the general population. If these findings hold up under continued scrutiny, they raise serious questions about whether these medical interventions have delivered the long-term benefits that many advocates have claimed.
In the future, will messing with children's hormones and pushing puberty blockers be looked at the same was as lobotomy is viewed today? Let's hope so.
