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The Patients

Famous Lobotomy Patients
In 1943 Dr. Paul Schrader and Dr. Mary Frances Robinson performed 16 Lobotomies at the State Hospital in St. Joseph, Missouri. The results of these lobotomies were recorded and published in1945 in The Journal of Abnormal Psychology.  The following four case studies are from that article and provide a rare glimpse as to who the patients were and how the lobotomies affected them.

Case No. 3. H.W. is a woman aged 43 with negative family history.  She attended college, was married, and had one daughter.  She was active in social and civic affairs but in 1938 became self-accusatory and suicidal.  Later symptoms showed marked paranoid trends.  She was hospitalized in Missouri State Hospital No. 2 for four years and was given 69 insulin treatments.  For two years prior to her operation she was wildly agitated, required seclusion, and shouted stereo-typed phrases and neologisms.  She was regarded as much deteriorated.

 

After the operation she showed some temporary improvement.  Now she is much quieter than before but of course is still deteriorated and shows urinary incontinence.  She is cooperative as far as she is able but understands very little of what is said to her and cannot remember her own last name.  She is childlike and smiling.

"Only one patient was cooperative enough to make possible the use of local anesthetic."

Case No. 4.  P.P., aged 27 comes of a comfortable, middle-class farm family with no record of mental illness.  He was a quiet, thoughtful boy with a strong sense of duty.  He went through the second year of high school with good grades but had to stop because of his father’s death.  He attempted to operate their two farms for his mother, but they lost heavily in the economic depression, and then he worked at a parking station until his illness five years ago.

 

He was diagnosed schizophrenic, and was given several insulin treatments.  His outstanding symptoms were tension, apprehension, and anxiety to “do the right thing.”  He was very cooperative and courteous but volunteered nothing.  He was obsessed with ideas of running away from the hospital and succeeded twice, the second time just prior to his operation, after his head had been shaved.  He went home, and his mother persuaded him to return to the hospital and undergo the operation, June 30, 1943.  A few days subsequently he developed marked cerebral edema, and it was necessary to reopen the incisions.  After the second operation he was incontinent and confused but invariably answered questions courteously.  When asked how he felt, he always replied with the formula: “Just fine, thank you.  How are you?”

 

After return to the ward he showed marked personality changes.  He became social, asked questions, was observing, and volunteered remarks.  He was less self-conscious and seemed to have lost his apprehensiveness.  He said, “I never worry now.”

 

He was paroled from the hospital August 27, at once applied for his old job, as later.  Is ambition now is to buy a home for his mother and himself.  He does not care much for reading, he says: he prefers to loaf around town.

Case No. 5.  T.H. is a big man, age 61, with one cousin who is psychotic.  He had a common school education and then did some farm work.  His mental trouble began when he was 22 and was diagnosed as schizophrenic, paranoid type.  He rapidly became deteriorated, noisy, and untidy.  He was combative, and his long period of hospitalization – now 39 years in duration – is a record of violence and is marked by frequent injuries inflicted on other patients.  His extreme deterioration and great physical strength made him dangerous.

 

He was difficult to manage after the operation, July 2, 1943, and had to be restrained; even so, he pulled the bandages off his head and infected the wounds superficially.  Ten electric shocks were given him without inducing grand mal reactions.  He was then given four metrazol treatments, which produced no improvement.

 

He is manageable now and is very cheerful, but his mental capacity is slight.  He can give his age correctly but is unable to count even to 3.

Case No. 16. W.C., aged 22, has a negative family history.  His father was a minister and his mother is a college professor.  He was a brilliant student and class leader and was in his third year of college when he became ill.  He was diagnosed in 1941 as schizophrenic.  During his two years in hospitals, he was given a great number of insulin treatments, “an entire series” in one hospital, 31 in another, and 92 here.  Before the operation he was completely inaccessible and occasionally assaultive.  He moved around very little but was over-tense; on two occasions he stood “at attention” all night.

 

The operation, November 29, 1943, revealed moderate bilateral fibrous arachnoiditis, indicating an old brain injury, possibly sustained in early life.  His convalescence included the usual period of confusion and disorientation and proceeded steadily.

 

Three months after the operation he was symptom-free and made high scores on the psychological tests, higher than any other patient in the series.  He is once more a quiet, well-bred student, ready to start back to school after a long vacation, of which he remembers nothing.  At present he is employed regularly in a printing shop.

"The often violent and invasive psychiatric interventions developed during the 1930s and 1940s are indicative of both the well-intentioned desire of psychiatrists to find some medical means of alleviating the suffering of the vast number of patients then in psychiatric hospitals and also the relative lack of social power of those same patients to resist the increasingly radical and even reckless interventions of asylum doctors."  Roy Porter

 

"Of the sixteen, all but two were marked behavioral problems.  Permission to perform the operation was secured from nearest relative."

  

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