Lobotomies and Stomach Surgery

By Randi Hutter Epstein

Recently, I came across a few newspaper articles about the stomach-constricting band to cure obesity. At the same time, I was immersed in a book about lobotomies to cure insanity. Sure, one is news and the other is history, but I couldn’t help but see the parallels. Not about being obese and insane, but about cowboy medicine and about lowering the threshold for treatment.

First the history: Jack El-Hai’s The Lobotomist (Wiley: 2007) is a titillating tale of Dr. William Freeman, the neurologist who promoted lobotomies in the middle years of the 20th century. Simply put, he and his colleagues scooped out bits of brain with something that seems to resemble a metal straw. The idea was to cut off dysfunctional brain connections.

The book is not simply one man’s crusade but a wonderful read about the growth of neurology and psychiatry. Freeman was a persevering, clever doctor who truly believed that he would revamp the treatment of the mentally ill, who all too often languished in mental hospitals. (He also wanted to make a name for himself.) His most outrageous procedure (I don’t want to give all the crazy experiments away) was outpatient brain surgery – he would knock patients out with electroshock therapy and then, as Freeman put it, cure them by “thrusting an icepick between the eyeball and eyelid through the roof of the orbit.”

The guy wanted to surgically fix personality defects, anxiety, and schizophrenia kind of like the way we are trying to fix obesity (caused by faulty genes, or overeating, or whatever) by a surgically implanted corset. According to the New York Times, the FDA panel voted to “expanded” use of a stomach-restricting device. (pun intended, presumably.) Allergen’s Lap-band used to be limited to the morbidly obese but now it’s going to be for fat people, too. This could double the number of folks who opt of surgery and spend the rest of their lives vomiting when they over-eat. (And truly expand Allergen’s revenue.)

Finding more people who need treatment – or widening the scope of illness – is always a good way to broaden the patient population, whether it be labeling more anxious folks as insane or the overweight as obese.

I couldn’t help think while I was reading about both stories that it’s easy to poke fun of strange quick-fixes of yesteryear, but we just can’t see the absurdity about 21st century remedies. Perhaps today’s young medical historians should be saving these stomach-band stories for a book they’ll write in their retirement about the silly things we did in the early years of the 2000s.

About the author: Randi Hutter Epstein, MD is a medical writer and adjunct professor at The Graduate School of Journalism, Columbia University. She is also the managing editor of the Yale Journal for Humanities in Medicine. Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank is her first book.