Instruct: Given a question, retrieve passages that answer the question.
Query: When was the first lobotomy performed?
Leucotomy was first undertaken in 1935 under the direction of the Portuguese neurologist (and inventor of the term psychosurgery) António Egas Moniz.[n 8][58] First developing an interest in psychiatric conditions and their somatic treatment in the early 1930s,[59] Moniz apparently conceived a new opportunity for recognition in the development of a surgical intervention on the brain as a treatment for mental illness.[40]
Side B of the album begins with "Teenage Lobotomy", which deals with the brain surgical operation lobotomy. The lyrics outline how this procedure can cause serious consequences to the brain, with the line "Gonna get my Ph.D, I'm a teenage lobotomy." The composition features more complex melodies than that of other songs from the album, with Stasium proclaiming it to be a "mini-Ramones Symphony". "Rocket to Russia" is the first album to feature two cover songs: "Do You Wanna Dance?" (originally performed by Bobby Freeman) and "Surfin' Bird" (originally performed by The Trashmen).
A series of radical physical therapies were developed in central and continental Europe in the late 1910s, the 1920s and most particularly, the 1930s. Among these we may note the Austrian psychiatrist Julius Wagner-Jauregg's malarial therapy for general paresis of the insane (or neurosyphilis) first used in 1917, and for which he won a Nobel Prize in 1927. This treatment heralded the beginning of a radical and experimental era in psychiatric medicine that increasingly broke with an asylum-based culture of therapeutic nihilism in the treatment of chronic psychiatric disorders, most particularly dementia praecox (increasingly known as schizophrenia from the 1910s, although the two terms were used more or less interchangeably until at least the end of the 1930s), which were typically regarded as hereditary degenerative disorders and therefore unamenable to any therapeutic intervention. Malarial therapy was followed in 1920 by barbiturate induced deep sleep therapy to treat dementia praecox, which was popularised by the Swiss psychiatrist Jakob Klaesi. In 1933 the Vienna-based psychiatrist Manfred Sakel introduced insulin shock therapy and in August 1934 Ladislas J. Meduna, a Hungarian neuropathologist and psychiatrist working in Budapest, introduced cardiazol shock therapy (cardiazol is the tradename of the chemical compound pentylenetetrazol, known by the tradename metrazol in the United States), which was the first convulsive or seizure therapy for a psychiatric disorder. Again, both of these therapies were initially targeted at curing dementia praecox. Cardiazol shock therapy, founded on the theoretical notion that there existed a biological antagonism between schizophrenia and epilepsy and that therefore inducing epileptiform fits in schizophrenic patients might effect a cure, was superseded by electroconvulsive therapy (ECT), invented by the Italian neurologist Ugo Cerletti in 1938.
The use of psychosurgery was narrowed to a very small number of people for specific indications. Egas Moniz performed the first leucotomy, or lobotomy in Portugal in 1935, which targets the brain's frontal lobes. This was shortly thereafter adapted by Walter Freeman and James W. Watts in what is known as Freeman–Watts procedure or the standard prefrontal lobotomy. From 1946, Freeman developed the transorbital lobotomy, using a device akin to an ice-pick. This was an "office" procedure which did not have to be performed in a surgical theatre and took as little as fifteen minutes to complete. Freeman is credited with the popularisation of the technique in the United States. In 1949, 5,074 lobotomies were carried out in the United States and by 1951, 18,608 people had undergone the controversial procedure in that country. One of the most famous people to have a lobotomy was the sister of John F. Kennedy, Rosemary Kennedy, who was rendered profoundly intellectually disabled as a result of the surgery.
After almost ten years of performing lobotomies, Freeman heard of a doctor in Italy named Amarro Fiamberti who operated on the brain through his patients' eye sockets, allowing him to access the brain without drilling through the skull. After experimenting with novel ways of performing these brain surgeries, Freeman formulated a new procedure called the transorbital lobotomy. This new procedure became known as the "icepick" lobotomy and was performed by inserting a metal pick into the corner of each eye-socket, hammering it through the thin bone there with a mallet, and moving it back and forth, severing the connections to the prefrontal cortex in the frontal lobes of the brain. He performed the transorbital lobotomy surgery for the first time in Washington D.C. on a housewife named Sallie Ellen Ionesco. This transorbital lobotomy method did not require a neurosurgeon and could be performed outside of an operating room without the use of anesthesia by using electroconvulsive therapy to induce seizure. The modifications to his lobotomy allowed Freeman to broaden the use of the surgery, which could be performed in psychiatric hospitals throughout the United States that were overpopulated and understaffed. In 1950, Walter Freeman's longtime partner James Watts left their practice and split from Freeman due to his opposition to the cruelty and overuse of the transorbital lobotomy.
Lobotomy Software was founded in 1993, when a group of friends working at Nintendo of America left to form their own company, becoming the creative department of Lobotomy, with the engineering talent coming from Manley & Associates (Manley & Associates was later acquired by Electronic Arts in 1996, renamed Electronic Arts Seattle, and subsequently shut down in 2002). They originally worked out of co-founder Paul Lange's apartment, but after a few months set up an office in Redmond, Washington. The team began working on various game demos, one of which later became the first-person shooter game, "PowerSlave".
Freeman performed the first transorbital lobotomy on a live patient in 1946. Its simplicity suggested the possibility of carrying it out in mental hospitals lacking the surgical facilities required for the earlier, more complex procedure. (Freeman suggested that, where conventional anesthesia was unavailable, electroconvulsive therapy be used to render the patient unconscious.)[136] In 1947, the Freeman and Watts partnership ended, as the latter was disgusted by Freeman's modification of the lobotomy from a surgical operation into a simple "office" procedure.[137] Between 1940 and 1944, 684 lobotomies were performed in the United States. However, because of the fervent promotion of the technique by Freeman and Watts, those numbers increased sharply towards the end of the decade. In 1949, the peak year for lobotomies in the US, 5,074 procedures were undertaken, and by 1951 over 18,608 individuals had been lobotomized in the US.[138]
The film tells the story of young woman Anna (played by Michelle Williams) in an American suburbs of the 1950s. Her brother comes home devastated after World War II and her father rejects him. The girl is lured into a relationship with Billy, a local mob boss. When her brother dies and she witnesses Billy murder a local nightclub owner, she is driven to the edge of insanity. She develops a fixation with mental health that drives her to seek out a transorbital lobotomy. When Dr. Harold Ashton, the foremost practitioner of this brand of lobotomy, comes to town, the entire community is buzzing. He starts performing the icepick lobotomy on alcoholics, veterans and other troubled outsiders. Influenced by the hyperbole surrounding the
instant cure for a range of problems, Anna announces to Bill that she wants one.
The film contains a shot-by-shot remake of a real life lobotomy performed by Walter Freeman, the inventor of the transorbital lobotomy.
Robert Penn Warren's 1946 novel All the King's Men describes a lobotomy as making "a Comanche brave look like a tyro with a scalping knife," and portrays the surgeon as a repressed man who cannot change others with love, so he instead resorts to "high-grade carpentry work".[162] Tennessee Williams criticized lobotomy in his play Suddenly, Last Summer (1958) because it was sometimes inflicted on homosexuals—to render them "morally sane".[5] In the play a wealthy matriarch offers the local mental hospital a substantial donation if the hospital will give her niece a lobotomy, which she hopes will stop the niece's shocking revelations about the matriarch's son.[163] Warned that a lobotomy might not stop her niece's "babbling," she responds, "That may be, maybe not, but after the operation who would believe her, Doctor?"[164] In Ken Kesey's 1962 novel One Flew Over the Cuckoo's Nest and its 1975 film adaptation, lobotomy is described as "frontal-lobe castration", a form of punishment and control after which "There's nothin' in the face. Just like one of those store dummies." In one patient, "You can see by his eyes how they burned him out over there; his eyes are all smoked up and gray and deserted inside."[162] In Sylvia Plath's 1963 novel The Bell Jar, the protagonist reacts with horror to the "perpetual marble calm" of a lobotomized young woman.[162] Elliott Baker's 1964 novel and 1966 film version, A Fine Madness, portrays the dehumanizing lobotomy of a womanizing, quarrelsome poet who, afterwards, is just as aggressive as ever. The surgeon is depicted as an inhumane crackpot.[165] The 1982 biopic film Frances depicts actress Frances Farmer (the subject of the film) undergoing transorbital lobotomy (though the idea[166] that a lobotomy was performed on Farmer, and that Freeman performed it, has been criticized as having little or no factual foundation).[167]
In the US, psychosurgery was taken up and zealously promoted by neurologist Walter Freeman and neurosurgeon James Watts. They started a psychosurgery program at George Washington University in 1936, first using Moniz's method but then devised a method of their own in which the connections between the prefrontal lobes and deeper structures in the brain were severed by making a sweeping cut through a burr hole on either side of the skull. They called their new operation a lobotomy.
Freeman went on to develop a new form of lobotomy which dispensed with the need for a neurosurgeon. He hammered an ice pick-like instrument, an orbitoclast, through the eye socket and swept through the frontal lobes. The transorbital or "ice pick" lobotomy was done under local anesthesia or using electroconvulsive therapy to render the patient unconscious and could be performed in mental hospitals lacking surgical facilities. Such was Freeman's zeal that he began to travel around the nation in his own personal van, which he called his "lobotomobile", demonstrating the procedure in psychiatric hospitals. Freeman's patients included 19 children, one of whom was 4 years old.
The clinician-historian Joel Braslow argues that from malarial therapy onward to lobotomy, physical psychiatric therapies "spiral closer and closer to the interior of the brain" with this organ increasingly taking "center stage as a source of disease and site of cure."[32] For Roy Porter, once the doyen of medical history,[33] the often violent and invasive psychiatric interventions developed during the 1930s and 1940s are indicative of both the well-intentioned desire of psychiatrists to find some medical means of alleviating the suffering of the vast number of patients then in psychiatric hospitals and also the relative lack of social power of those same patients to resist the increasingly radical and even reckless interventions of asylum doctors.[34] Many doctors, patients and family members of the period believed that despite potentially catastrophic consequences, the results of lobotomy were seemingly positive in many instances or, at least they were deemed as such when measured next to the apparent alternative of long-term institutionalisation. Lobotomy has always been controversial, but for a period of the medical mainstream, it was even feted and regarded as a legitimate if desperate remedy for categories of patients who were otherwise regarded as hopeless.[35] Today, lobotomy has become a disparaged procedure, a byword for medical barbarism and an exemplary instance of the medical trampling of patients' rights.[3]
In the United States, approximately 40,000 people were lobotomized. In England, 17,000 lobotomies were performed, and the three Nordic countries of Finland, Norway, and Sweden had a combined figure of approximately 9,300 lobotomies.[139] Scandinavian hospitals lobotomized 2.5 times as many people per capita as hospitals in the US.[140] Sweden lobotomized at least 4,500 people between 1944 and 1966, mainly women. This figure includes young children.[141] In Norway, there were 2,005 known lobotomies.[142] In Denmark, there were 4,500 known lobotomies.[143] In Japan, the majority of lobotomies were performed on children with behavior problems. The Soviet Union banned the practice in 1950 on moral grounds, and Japan and Germany soon followed suit. By the late 1970s, the practice of lobotomy had generally ceased, although it continued as late as the 1980s in France.[144].
Farmer's family, her former lovers, and her three ex-husbands all denied, or did not confirm, that the procedure was completed. Farmer's sister, Edith, said the hospital asked her parents' permission to perform the lobotomy, but her father was "horrified" by the notion and threatened legal action "if they tried any of their guinea pig operations on her." Western State Hospital recorded all the lobotomies performed during Farmer's period there. Since a lobotomy was considered a ground-breaking medical procedure, the hospital did not attempt to conceal its work. Although nearly 300 patients received the procedure, no evidence supports a claim that Farmer was among them. In 1983, Seattle newspapers interviewed former hospital staff members, including all of the lobotomy ward nurses who were on duty during Farmer's years at Western State, and they all stated Farmer was never a patient on that ward. Dr. Walter Freeman's private patient records contained no mention of Farmer. Dr. Charles Jones, psychiatric resident at Western State during Farmer's stays, also stated that Farmer never underwent the lobotomy procedure.
Rosemary Kennedy, sister of President John F. Kennedy, underwent a lobotomy in 1941 that left her incapacitated and institutionalized for the rest of her life.[154] Howard Dully wrote a memoir of his late-life discovery that he had been lobotomized in 1960 at age 12.[155] New Zealand author and poet Janet Frame received a literary award in 1951 the day before a scheduled lobotomy was to take place, and it was never performed.[156] Josef Hassid, a Polish violinist and composer, was diagnosed with schizophrenia and died at the age of 26 following a lobotomy.[157] Swedish modernist painter Sigrid Hjertén died following a lobotomy in 1948.[158] American playwright Tennessee Williams' older sister Rose received a lobotomy that left her incapacitated for life; the episode is said to have inspired characters and motifs in certain works of his.[159] It is often said that when an iron rod was accidentally driven through the head of Phineas Gage in 1848, this constituted an "accidental lobotomy", or that this event somehow inspired the development of surgical lobotomy a century later. According to the only book-length study of Gage, careful inquiry turns up no such link.[160] In 2011, Daniel Nijensohn, an Argentine-born neurosurgeon at Yale, examined X-rays of Eva Peron and concluded that she underwent a lobotomy for the treatment of pain and anxiety in the last months of her life.[161]
When her mother is murdered by a killer, an amnesiac woman is sent to a mental institution presided over by a power-crazed female doctor who performs lobotomies on the patients.
In 1977 the US Congress, during the presidency of Jimmy Carter, created the National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery—including lobotomy techniques—was used to control minorities and restrain individual rights. The committee concluded that some extremely limited and properly performed psychosurgery could have positive effects.[152]
The use of the procedure increased dramatically from the early 1940s and into the 1950s; by 1951, almost 20,000 lobotomies had been performed in the United States alone and proportionally more in the United Kingdom.[6] The majority of lobotomies were performed on women; a 1951 study of American hospitals found nearly 60% of lobotomy patients were women; data shows 74% of lobotomies in Ontario from 1948–1952 were performed on women.[7][8][9] From the 1950s onward lobotomy began to be abandoned[10], first in the Soviet Union[11] and Europe. The term is derived from Greek: λοβός lobos "lobe" and τομή tomē "cut, slice".
The prefrontal leucotomy, a precursor to lobotomy, was performed by cutting a trephine hole into the skull, inserting an instrument, and destroying parts of the brain. This was later made unnecessary by the development of the "orbital transit" lobotomy where a spike was inserted through the eye-sockets.
In 1955, Ball returned to Maryland as a research psychologist associated with the now controversial lobotomy research project at the Veterans Administration Hospital in Perry Point, Maryland. Given that most lobotomies were conducted between 1947 and 1950 and the procedure fell out of favor as tranquilizer drugs became available in the mid-1950’s, it is unlikely that Ball was involved in performing lobotomies. She did, however, research their effects in a large-scale study. She was lead author on the paper, “The Veterans Administration study of prefrontal lobotomy,” published in 1959. In 1959, she left lobotomy research to work as a clinical psychologist at the Veterans Administration Hospital, focusing on gerontology. She remained in this position until her retirement in 1967.
"PowerSlave" was Lobotomy Software's first full game, with development starting in May 1995 for the PC. Lobotomy co-founder Brian McNeely recounted: 
Old documents from the hospital show that the hospital lobotomised approximately 770 individuals, which is more than any other in the world. Lobotomy wasn’t performed solely on the mentally ill, but on people suffering from dementia, epilepsy and even deaf-mutes and visually impaired are found among those lobotomised. Others were simply considered as feebleminded and/or imbecile (Swedish: "sinnesslöa"). 63 percent of the lobotomised patients were female, and journals also show that lobotomy was performed on adolescents and mentally retarded. Although being described as lucrative, the mortality of lobotomy is calculated to have been around 7.4 percent.
Amarro Fiamberti (10 September 1894 – 1970) was an Italian psychiatrist who first performed a transorbital lobotomy (by accessing the frontal lobe of the brain through the orbits) in 1937. The technique remained rarely practised until his reports were discovered by his contemporary, the American neurologist Walter Freeman, who improved the surgical technique, initially by using ice picks (hence the name "ice pick lobotomy") and later employing more refined equipment. Fiamberti was later named Director of the Psychiatric Hospital of Varese when it was opened in 1964.
In the 1940s the Burlingame Research Building was constructed on the northwest corner of the IOL grounds, which contained operating suites. Lobotomies were performed there until the 1960s. These operating rooms were constructed because neurosurgeons were not allowed to perform lobotomies at Hartford Hospital, which is located across Retreat Avenue. Special elevators were installed in the building to transport patients without jarring bumps from the operating rooms on one floor to the recovery rooms on a different floor. Today, no research is performed in the Research Building.
Howard Dully (born November 30, 1948) is one of the youngest recipients of the transorbital lobotomy, a procedure performed on him when he was 12 years old. Dully received international attention in 2005, following the broadcasting of his story on National Public Radio. Subsequently, in 2007, he published a New York Times Best Seller memoir, "My Lobotomy", a story of the hardships of his lobotomy, co-authored by Charles Fleming.
The first systematic attempt at human psychosurgery – performed in the 1880s–1890s – is commonly attributed to the Swiss psychiatrist Gottlieb Burckhardt. Burckhardt's experimental surgical forays were largely condemned at the time and in the subsequent decades psychosurgery was attempted only intermittently. On November 12, 1935, a new psychosurgery procedure was performed in Portugal under the direction of the neurologist and physician Egas Moniz. His new "leucotomy" procedure, intended to treat mental illness, took small corings of the patient's frontal lobes. Moniz became a mentor and idol for Freeman who modified the procedure and renamed it the "lobotomy". Instead of taking corings from the frontal lobes, Freeman's procedure severed the connection between the frontal lobes and the thalamus. Because Freeman lost his license to perform surgery himself after his last patient died on the operating table, he enlisted neurosurgeon James Watts as a research partner. One year after the first leucotomy, on September 14, 1936, Freeman directed Watts through the very first prefrontal lobotomy in the United States on housewife Alice Hood Hammatt of Topeka, Kansas. By November, only two months after performing their first lobotomy surgery, Freeman and Watts had already worked on 20 cases including several follow-up operations. By 1942, the duo had performed over 200 lobotomy procedures and had published results claiming 63% of patients had improved, 24% were reported to be unchanged and 14% were worse after surgery.