The Ice Pick Lobotomy

My wife, Jennifer, and I recently watched a PBS documentary called “The Lobotomist”, which explores the background of the procedure popularization during the 1940’s through the ‘60’s of the prefrontal lobotomy. The neurologist Walter J. Freeman of Washington, DC was primarily responsible for the widespread performance of this surgery in the United States by developing the 10-minute, outpatient “ice pick lobotomy”. Quite literally, an ice pick was inserted beneath the eyelid and over the eyeball of a patient who was rendered temporarily unconscious by electroshock. When the instrument hit the thin orbital plate of the frontal bone, a few taps with a mallet would allow entrance into the intracranial cavity. The ice pick was then advanced upward, after which it was swept back and forth like a windshield wiper blade. The instrument was then extracted and the procedure was repeated on the opposite side. Approximately 30,000 of these procedures were performed before the medical establishment decided that it was ill-advised.

These procedures were designed to sever the connections of the brain with the prefrontal cortex (the anterior-most portion of the frontal lobes, not including the motor and premotor gyri, which does not cause movements when stimulated by electodes). Patients were left with varying degrees of abulia, but with no motor deficits.