In 1936 with the help of Dr. James Watts, Dr. Walter Freeman conducted the first lobotomy in the United States.  Within two months the duo had lobotomized 20 patients and by 1942 they had performed over 200 prefrontal lobotomies.

 

Freeman experimented with new ways to perform the surgeries and in 1946 performed the first transorbital or "ice pick" lobotomy on Sallie Ellen Ianesco, a 29 year old housewife and mother.

 

This transorbital lobotomy did not require a neurosurgeon and could be performed outside of an operating room without the use of anesthesia by using electroconvulsive therapy to induce seizure.  These transorbital lobotomies could easily be performed in state mental hospitals throughout the United States that were overpopulated and understaffed.