Monday, January 12, 2009

A Walk Down Lobotomy Lane

"My Lobotomy" by Howard Dully is a stark, unapologetic look at the life of a boy whose mother had tragically died of cancer when he was only five and the devastation that had followed him when his father remarried a woman named Lou who was incapable of handling the affliction that plagued her step-son Howard that is simply known as "being a boy". After going to six different psychologists and psychiatrists, four of whom said Lou was the one with a mental disorder, she found Dr. Walter Freeman, the biggest proponent of psycho-surgery in America. Howard Dully was diagnosed with schizophrenia and was lobotomized at the young age of twelve.

After Howard recovered from the stupor associated with the brain mutilation, Lou became increasingly frustrated over the fact that the surgery didn't "work". In my opinion this begs the question, how can one cure normal? She sent her step-son out of the house where he spent the rest of his adolescent years in institutions, juvenile prison, and half-way houses. The book then goes on to tell of the numerous mistakes and legal complications Howard Dully, himself, had perpetrated during his adult life until he decided to turn his life around with the help of his wife Barbara.

The book is very compelling, and I appreciate the writer's candor in not sugar-coating what was done to him and the things he had been guilty of, and how he put his life on a track that gave everything meaning and how he has helped other victims of the tragic brutality of lobotomies. However, as a medical geek, I wanted more. As I read the book, I often wondered what his MRI would show. In the Afterword I was not left disappointed. He was approached by two research doctors who wanted to perform an MRI of his brain. Before the MRI was done, they thought maybe Dr. Freeman had changed his mind and not gone through with the surgery because of how completely normal, intelligent, and articulate Mr. Dully is. When they looked at the imaging results, they saw a severely damaged brain. Dully asked them if they had seen the MRI results without any foreknowledge of the patient what would they think. They told him they would think the patient would have to have been institutionalized for the rest of his life because it would have been impossible for him to have functioned in society. He would have been a vegetable.

After further analysis, what they discovered was that the parts of the brain that weren't damaged had grown stronger, which would not have happened with an adult brain. However, because Howard Dully was only twelve at the time of his operation, his brain had not finished growing, and it compensated for the damaged areas. This has compelled me to want to look further into the effects of lobotomies in adult brains. Unfortunately, I have gotten mixed results. While the prevailing wisdom is that lobotomies are barbaric and an unfortunate blight on our medical history, there are still case histories where it has stated in extreme cases of depression or OCD, it has had some benefit without damaging the patients' intellect, but it has had no effect on those with schizophrenia. So why in Dully's case it should have had a strong impact on intellect if he were an adult, but in other patients there was no affect?

I came across a study that was done in Japan on 8 schizophrenics that had had lobotomies some 40 or 50 years ago. For me this was especially exciting because not only did they post the MRI results, but they actually published the MRI pictures of three of the patients, and it was clear from looking at them that in all of them there was a certain amount of atrophy in the frontal lobes. However, because lobotomies were done in a "blind" fashion, there was no accuracy as far as how much or how deep the cutting was to take place. The study did not publish the outward affects of each of these eight patients, which is unfortunate, but I would surmise that the greater the damage, the greater the impact on cognition and certain abilities controlled by the pre-frontal cortex.

There is one other thing I am curious about and that is why did Harvard conduct lobotomies on 15 patients in the 1980's, what was the technique used, and what were the outcomes? So far, I have found nothing except mentions of it having happened, which begs another question- did it actually happen on our shores in such recent history or was it a rumor? I do know that there is now a more precise psycho surgery called the cingulotomy, which inserts a laser or live electric wire through the skull to destroy small areas of the brain, but it is only used with relative success on those who are resistant to other treatments.


Blogger Howard D said...

Interesting, I am glad it stirs research from others great !!!!
And thanks for the mention and review.

Howard Dully

10:25 PM  
Blogger Lanette said...

Thanks for leaving a comment. I'm flattered you found the post interesting. Your book was very inspiring. I have made a career of pharmaceutical research, but that can get boring at times, so it was the most natural thing in the world for me to get excited about your unusual situation.

Thank you for being a voice to those who have suffered in silence for years. It is cases, such as yours, that has changed the research and medical professions for the better.

8:22 AM  
Blogger Howard D said...

Just a update, Stanford is getting ready to publish their MRI study

1:23 AM  

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