However, the introduction and wide acceptance around this time of other shock therapies such as metrazol (the fear drug), sodium amytal (the truth drug) and insulin-coma shock therapy soon began to create a climate in which the lobotomy might seem more acceptable Freeman was a neurologist, and neurologist had traditionally taken the view that there were physical causes for mental illness, and that i required physical treatment. Psychiatrists, on the other hand, had argued that mental disorder was a problem of the mind exclusively. The two groups had bickered over whose property madness was, and the psychiatrists were initially Freeman’s greatest opponents. But in the face of soaring mental hospital populations and the lack of rapid cures, both sides in this bizarre dispute began to adopt increasingly extreme therapies. It was not long before overcrowding an limited mental health budgets began to persuade the superintendents of mental institutions to adopt lobotomy. The economic arguments were very strong: a lobotomy could be performed for $250, while it could cost $35,000 or more a year to maintain a patient in hospital.
To overcome the initial professional prejudice against the operation, Freeman travelled tirelessly and gave presentations across the nation. He was also a skilful manipulator of the media; his ability to communicate directly wit the public was a crucial asset. In 1936, before Freeman had even disclosed details of his firs operations to his professional colleagues, h had lunch with a reporter from the Washington Evening Star, whom he had asked if he “wanted to see some history made. We’ve done a few brain operations on crazy people with interesting results.” The reporter was also given chance to see the two men in action, and so Freeman and Watts were on the front page of the New York Times, their technique – barely tried and already with some dubious results – was hade as a “shining example of therapeutic courage”.
Freeman featured on the front page of the New York Times and other national dailies an periodicals regularly over the following years undoubtedly persuading many surgeons t adopt the technique, and many thousands of patients and relatives of patients to opt for it. The popular coverage was universally optimistic, with headlines such as: “Psychosurgery Cured Me”, “Wizardry Of Surgery Restore Sanity To Fifty Raving Maniacs”, and, memorably (and tragically incorrectly), “No Worse Than Removing Tooth”.
A sanitized version of the operation and it consequences was invariably given, and never more so than in an influential article, entitled “Turning The Mind Inside Out”, published in the Saturday Evening Post in 1941. The writer the science editor of the New York Times, began in dramatic fashion by stating that there must be at least 200 men and women in the Unite States who had had worries, persecution complexes, suicidal intentions, obsessions and nervous tensions literally cut out of their minds with a knife. Freeman had explained the operation to the writer, Waldemar Kaempffert, as one which separated the pre-frontal lobes – “the rational brain” – from the thalamic brain, or “emotional brain”. ‘ne writer warmed to his theme, saying: “Man must balance emotion and reason. According to the Freeman-Watts theory, the preservation of that balance is a matter of nicely adjusting the ‘thalamic’ feeling with prefrontal logic.” It made it sound disarmingly simple, the brain no more complex than the innards of a watch or a radio. The word “irreversible” was avoided.
Psychosurgery began to gain in popularity in the United States, though in Europe its acceptance was more limited. Basing their work on the Freeman-Watts system, American neurosurgeons rapidly developed a myriad of variations. It was five years since Moniz’s first operation, and there had still been no long-term study of those who had undergone surgery.
Up until 1945, Freeman had never actually performed a lobotomy himself. He had always worked in tandem with Watts, and his surgical experience was limited to performing “spinal taps”. What was still lacking, for Freeman, was a version of the operation that could be performed not just by neurosurgeons, but by anyone, anywhere, in a few minutes: an off-the-peg, rapid technique, so that one could pop down to the local psychiatrist and get lobotomized in the lunch-break.
He had heard of the work of an Italian called Amarro Fiamberti, who had developed a trans-orbital attack on the frontal lobes; one that went in through the front of the skull, directly over the eyeball. He had perforated the orbital plate of the skull behind the eyes, and injected caustic solutions to destroy the brain tissue, but these had sunk down and caused rather severe damage elsewhere. Fiamberti had also punctured the orbital plate directly through the eye sockets and tried to use the original leukotome in this method with few good results, and a lot of mess. The potential advantage of such an approach was that it did not require holes to be made in the skull; everything could, in theory, be performed by one individual administering a simple stab through the back of each eye socket into the white matter of the brain. ‘Mere would be nothing to set up. The patient would be left with nothing worse than black eyes and a splitting headache – plus the usual effects. It would be very easy, very fast and very cheap.