Dr. Walter Freeman

Dr. Walter Freeman Jr. is perhaps one of the most well-known physicians of our time, due to him making the trans-orbital lobotomy popular in the US. Although many think that Freeman invented this surgery, he did not.

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Growing up, Freeman could be described as having an odd personality, despite being born into an affluent family. His father, Dr. Walter Freeman Sr., never showed emotion and was never outwardly affectionate to his wife or children. Freeman Jr. learned to do the same. After his mother’s death, Freeman Jr. confessed he never loved his mother. Sadly, he never had a great example of a loving relationship. Despite this, Freeman Jr. ended up marrying and having 6 children with his wife, Marjorie. Their marriage eventually progressed into an unhappy one. 

In the early 1930s, Dr. Egas Moniz, a Portuguese doctor, was already performing his “leucotomy” – severing connections in the brain’s frontal lobe, in attempts to cure mental illness. Moniz became a mentor to Freeman, and Freeman adopted this surgical method and renamed it the “lobotomy”.

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In the late 1930s, Freeman worked in conjunction with neurosurgeon James Watts to perform prefrontal lobotomies. The early technique still required drilling of the skull and had to be performed by a neurosurgeon in an operating room. Freeman wanted to be able to perform lobotomies on those he thought needed them the most: patients in state hospitals. At this time, state hospitals functioned more as warehouses for the mentally ill, with no real cure. With no operating rooms or formal surgeons in many of these institutions, Freeman was determined to find a simplified way that didn’t require these limitations.

In 1945, Freeman was inspired by the work of Italian psychiatrist Amarro Fiamberti and determined he could also perform lobotomies entering through the eye socket. This was the birth of the trans-orbital lobotomy in the US. To perform the surgery, Freeman would lift the eyelid, and through the eye socket, insert an icepick-like tool, known as an orbitoclast. He would then use a mallet to tap the end of the orbitoclast through the bone and into the brain to sever the neural connections. This new procedure took seven minutes. Freeman performed the trans-orbital lobotomy on the first psychiatric patient in 1946. The first ten lobotomy surgeries were done in an office setting instead of a hospital, so Freeman wasn’t questioned over the procedure or his lack of surgical experience. 

James Watts was horrified at Freeman’s decision to take such a serious surgery out of the operating room. He ended his partnership with Freeman in 1947. Watts wasn’t the only person to question Freeman’s methods. A lot of physicians in the medical community were disgusted with Freeman and his procedure, making him incredibly controversial. 

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