Authors: Richard Hollingham
California, 1960
It was a child's worst nightmare. Howard Dully's mother died when
he was five, and she was replaced by a stepmother, Lou, who never
loved him; she didn't seem even to like him. She was intolerant and
criticized Howard, punishing him for things he didn't do, treating
him differently from his brother.
Howard was no angel. He resented his new mother's presence.
He could be moody, disrespectful and argumentative, but then so
can most young boys. There was nothing particularly unusual about
Howard. He was a perfectly healthy boy.
Howard's father was away for long periods of time, and even
when he
was
around, he appeared oblivious to what was going on.
As the years progressed, the relationship between Lou and Howard
deteriorated further. The boy was getting into trouble at school; his
stepmother would yell or hit him for the most petty of reasons, and
the boy would yell back. They were constantly arguing, slowly driving
each other up the wall. Howard loathed his impostor of a
mother, and Lou was fed up with her stepson. Sooner or later something
had to give.
Over the years, Lou had consulted doctors, psychologists and
psychiatrists (six psychiatrists in 1960 alone) about Howard. All of
them assured her there was nothing wrong with him. His behaviour
might sometimes be challenging, but he was perfectly normal. Even
Howard's father couldn't see anything wrong. Angry, and increasingly
frustrated, Lou was eventually referred to Walter Freeman,
who had set up his offices in Los Altos, California. Perhaps he
would find something wrong with the boy?
Howard's stepmother had her first meeting with Freeman in
October 1960. She went alone. Lou told Freeman about Howard's
behaviour. Some of it was true, some of it made up. She explained
how when she had first seen Howard she thought he was a 'spastic'
because of 'a peculiar gait' (the boy was then five and later turned
out to be good at sports). She recounted how Howard didn't play
with toys, but was destructive with them (much of the time Howard
played on his own, so how would she know?). She told Freeman that
Howard hated to wash (he was a boy!), she said he daydreamed and
scowled if the TV was tuned to some programme other than one he
liked, as if this were some sort of damning indictment. Tellingly,
Freeman referred to the notes he made of this first meeting as 'the
articles of indictment'.
The doctor's notes ran to several pages. He seemed to accept
everything he was being told, including Lou's claim that Howard
urinated on his bedroom wall or defecated in his trousers. She
would make up anything to convince the doctor that Howard was
mentally ill, and it seemed to be working. Freeman noted that the
indictment was 'sufficiently impressive' and that Howard was suffering
from childhood schizophrenia.
Over the coming days, in the manner of some sort of selfappointed
judge, Freeman took 'evidence' from Howard's aunt, the
school janitor and finally the boy's father. Much of it contradicted
what Lou had said. Howard met Freeman for the first time on 26
October and, like many patients before him, felt relaxed in
Freeman's presence. The doctor seemed kind and gentle, willing to
listen to what the boy had to say.
Taken together, Freeman's notes paint a picture of an eleven-year-old
boy living in a dysfunctional family. Today they would
probably be offered counselling, but Freeman had other ideas.
He told Howard's father that the boy was schizophrenic and that
something needed to be done 'pretty promptly'. He offered to
change Howard's personality (for a reasonable fee). The decision to
operate was made on 30 November 1960 – the date of Howard's
twelfth birthday.
Howard Dully was admitted to a small private hospital in San
Jose on Thursday 15 December. The next day he was taken into
the operating room, where he was given four jolts of electricity from
the ECT machine. Freeman noted that he thought it was 'one more
than necessary'. Then the doctor stuck in his 'orbitoclasts' (he had
moved on from ice picks to these specially designed instruments)
and jiggled them around in Howard's brain. He took a picture of
the two orbitoclasts protruding from the boy's head before pulling
them out again. A small amount of bloodstained fluid oozed from
each bruised eye socket.
When Howard's brother saw him shortly after the operation he
thought Howard looked like a zombie. The boy was listless and staring.
It was as if a fog had settled across his mind. But gradually
Howard started to recover. However, the operation that his stepmother
had hoped would make him docile and obedient seemed to
have the opposite effect. He became increasingly disruptive until his
parents could take it no more. Howard was sent away, first to other
people's homes, then, even though he had committed no crime, to
a juvenile detention centre. Finally, he ended up in a psychiatric
institution, the only child in a hospital full of mentally ill adults.
Howard has spent most of his life coming to terms with what
happened to him. He suffered problems with work, relationships
and money. He drifted in and out of jobs and in and out of jail.
Gradually, he was able to piece his life back together. Today he holds
down a job as a bus driver. There is absolutely nothing about him to
suggest that he has two black holes in his brain. What saved him
from going completely off the rails was probably his youth. Howard's
young brain was able to rebuild neural pathways and compensate
for the damage Freeman had inflicted.
Dr Freeman operated on a total of nineteen children, including
a four-year-old. By the time of Howard Dully's operation in
1960, even as surgery of 'last resort' lobotomy should have been
confined to the history books. Drugs were available that did much
the same thing only without the danger or permanence of surgery.
Some drugs were even marketed as 'chemical lobotomies'. These
new treatments should have put Freeman out of a job and saved
Howard Dully. They almost did. By the mid-1950s the weight of
criticism was piling up and Freeman had fallen out of favour in
Washington. This prompted his move to California, where he
offered his transorbital lobotomies to all-comers, as a quick fix for
neurotic housewives or disruptive children. Somewhere between
devising the procedure in the 1930s and practising it on children,
Freeman had lost sight of the reasons for developing the lobotomy
operation in the first place.
Some have described Freeman as a monster, sometimes in those
same newspapers that sang the praises of his 'miracle' surgery in the
1930s. Even his own son, who witnessed the terrifying spectacle of
one of Freeman's transorbital lobotomies, described the operation
as 'diabolical'. But it is difficult to reconcile the image of a monster
with the kind and gentle doctor his patients encountered. When the
lobotomy was conceived it seemed to provide the only treatment for
chronic mental illness. It certainly transformed some people's lives
for the better.
But Freeman's greatest failure of judgement was not knowing
when to stop. Nor, to be fair, did anyone step in to stop him. Where,
for instance, were the authorities who should have prevented the
operation on Howard Dully? The fact that Freeman kept performing
transorbital lobotomies when the procedure was discredited and
opposed by almost the entire medical establishment makes it difficult
to forgive him for what he did to so many people. Rosemary
Kennedy, Howard Dully and hundreds of others would have had
very different lives were it not for Walter Freeman.
Freeman performed his last transorbital lobotomy in 1967. He
was seventy-two. His patient suffered a haemorrhage and died three
days later. The hospital where he was operating finally decided that
enough was enough and stopped him from performing any further
lobotomies. It was the end of his career. The lobotomist had lost his
purpose in life. But rather than stay at home, he got back in his
camper van and headed off for one final road trip.
Over the next few years he covered some fifty thousand miles,
tracking down his former patients. It was as if he were seeking
redemption. Perhaps he was beginning to have doubts about his
treatments and wanted to prove that he had helped people, had
improved his patients' lives. He visited homes and hospitals; he saw
people who were very sick and those whose lives had undoubtedly
been changed for the better.
Walter Freeman died in 1972. The transorbital lobotomy died
with him, but to the end of his life he believed in what he had done,
and he believed it was right.
Freeman was not completely misguided. Lobotomies are no
longer performed, but psychosurgery – using surgery as a treatment
for mental illness – is still practised in hospitals around the world.
Once again, it has become a treatment of last resort. Although the
lobotomy is undoubtedly one of the most disturbing operations in
the entire history of surgery, when it comes to matters of the mind
it is by no means the only controversial therapy.
Córdoba, Spain, 1964
Dr José Delgado was brave. There is no doubt about that. Few scientists
would attempt to do what he was about to do. Delgado claimed
he knew a little bit about bullfighting, and was also reasonably confident
that he knew about the workings of the brain. But combining
the two? That was a different thing altogether.
The bull is charging across the ring towards Delgado, its nostrils
steaming as it kicks up the dirt in the arena. Bred to be aggressive,
it is an awfully big, angry bull, its head bowed down as it charges, its
horns hard and sharp. If Delgado gets this wrong, there is a good
chance he'll be killed.
Delgado concentrates as he grasps the matador's red cape in his
right hand. He stands by a wooden barrier that he can duck behind
if the experiment goes wrong, but there is no guarantee he will
make it in time. In his left hand he holds what looks like a transistor
radio – a small box with a long aerial extending from the top. If
anything, Delgado is holding this tighter than the cape.
The bull's hoofs pound. Delgado stands his ground. The bull is
getting closer. Delgado remains still. Ten feet, five feet. The bull
is almost on top of him. Then Delgado presses a button on the box.
The bull stops in its tracks, turns round and wanders away. It is an
audacious stunt: a demonstration of the power of technology.
The previous day Delgado had anaesthetized the bull and
implanted electrodes in its brain. When he pressed the button on
the remote control he had been holding, it sent a signal to a
receiver on the bull's head. This stimulated the electrodes deep
inside the brain, changing the bull's normally violent behaviour.
At the flick of a switch, Delgado had control of a ferocious animal.
By the 1960s, developments in electronics and a better scientific
understanding of the workings of the brain were making such
impressive demonstrations possible. Delgado used an implant device
consisting of a sealed capsule about the size of a small watch. This
contained the receiver and all the electronics. Wires emerged from
the side of the capsule and these were sunk into particular regions of
the brain. Thanks to advances in the understanding of brain
anatomy and localization, Delgado could surgically implant the electrodes
in specific places to get particular responses.
The doctor's other experiments were equally impressive,
although somewhat less dangerous. Implants in the brain of a
monkey could be stimulated to control the diameter of the pupil in
the animal's eye. When the doctor pushed the button on the
remote, the pupil would contract and dilate – it was almost like
controlling the aperture of a camera. He could get other monkeys
to yawn on demand or even perform a complex sequence of movements.
He also experimented on cats. He could induce expressions
of rage – an electrical stimulation caused them to hiss and bare their
teeth. The cats even learnt to turn off the stimulation by rotating a
wheel Delgado had installed in their cages.
It was the experiments on groups of animals that revealed the
potential of the technology. Delgado discovered that he could use
implants to control aggression in monkeys. He could also get other
monkeys to do the controlling. In one demonstration he installed
electrodes in the brain of Ali, the boss of a small monkey colony.
When Ali's brain was stimulated it inhibited his normally aggressive
behaviour. Delgado installed a lever in the experimental cage the
monkeys lived in. When the lever was pressed, it activated the electrodes.
Soon a passive monkey named Elsa learnt that pressing the
lever could stop Ali's aggression. She now had control over Ali.
Whenever he threatened her, she pushed the lever and Ali stopped.
Elsa had become the boss.
It was one thing to operate on bulls, monkeys or cats, but what
would happen if electrodes were implanted in human brains? Could
human behaviour be controlled in the same way? Delgado hoped to
use the technology to help patients suffering from severe mental
illness, epilepsy or chronic pain. Rather than change behaviour by
removing bits of the brain as the lobotomists had done (Delgado
found the idea of lobotomy abhorrent), he planned to insert his
devices in the brain instead.
When he tried the technology on humans the results were
astonishing. With receivers attached to people's heads, he found he
could stimulate a whole range of human emotions from fear
through lust, hilarity and rage. One of his researchers is said to have
narrowly avoided serious injury during an experiment conducted
on a young woman with epilepsy. She was playing the guitar when
the device was activated and promptly flew into a rage, throwing her
guitar against the wall.
Soon other doctors were taking up Delgado's work. In 1965
psychiatrist Frank Ervin and neurosurgeon Vernon Mark tried out
the technology on a sixty-three-year-old man dying of cancer. The
patient was in the most terrible pain, and surgeons had run out of
treatment options. Injections of morphine were no longer doing
the trick, and what remained of his life was a living hell.