November 12, 1935 – On this day, Portuguese neurologist António Egas Moniz (1874-1955) did the first “leucotomy” (better known as lobotomy) brain operation on a psychiatric patient. Because Egas Moniz hands were too deformed by gout to do precision work, he had his assistant Pedro de Almeida Lima (1903-1983) perform the first operations under his direction.
We don’t know the name of his first leucotomy patient, but the first 20 test patients, among them 7 schizophrenics, all came from the Miguel Bombarda psychiatric hospital in Lisbon.
Unlike later lobotomy operations (where the eye sockets were used to access the brain) these first involved operations drilling two holes in the skull and injecting alcohol into the brain’s frontal lobes. Later, Moniz introduced a pick-like instrument with a wire loop to cut some of the synapses in the brain.
When in 1936 he published his first research report on these operations, he claimed that of the 20 patients they had cured 7 patients, brought some improvement to 8, and had not helped 6 of them. He thought that the side effects such as incontinence, apathy and memory loss all were only temporary.
Because at that time it was still very difficult to find effective cures for serious mental disorders, lobotomy was hailed as a great step forward. It soon became popular in many countries. In the USA lobotomy was popularized in the 1940s by Walter Freeman (1895-1972, I’ll write a separate post about him).
But primitive brain operations of this kind were really risky. They often had unexpected, devastating, and permanent effects. One very well-known American victim was the future President Kennedy’s sister, Rosemary Kennedy, who in 1941 (at the age of 23) was completely incapacitated by a failed lobotomy operation. Meant to cure her violent mood swings, instead it left her incontinent and unable to speak for the rest of her life, reduced to the mental level of a two-year-old child.
Rosemary Kennedy before she got a lobotomy
On the other hand, to be fair, there were a few success stories. For an example of a more successful lobotomy, see my post about Canadian singer Alys Robi.
Egas Moniz was awarded the 1949 Nobel prize for his innovative leucotomy idea– just before neurologists, psychiatrists and many others began to seriously criticize his work and the usefulness and ethic implications of lobotomies.
After about 1960, when safer and more effective psychiatric medication became available, this kind of surgical last-resort solutions rapidly fell into disuse. People began to understand that the risks often did not outweigh the benefits.
In Portugal however, Egas Moniz was not discredited. While elsewhere in the world anti-lobotomy activists tried (in vain) to get his Nobel prize revoked, the Portuguese honored his 100th birthday in 1974 with a series of three postage stamps. Here are two of them.
Now take a good look at the left one. It shows the wire-loop bodkin he used to penetrate his patients’ brain:
I’m not sure if I would have liked to put that particular brain surgery stamp on my mail. But the Portuguese went further. They even managed to literally monetize this controversial piece of psychiatric history!
You know, I’m too fond of curiosities to resist this – here is Egas Moniz, together with an anonymous brain, on an old Portuguese 10,000 escudos bill:
Unfortunately in 1949, the same year Egas Moniz got his Nobel prize, a confused psychotic patient fired four shots at him. He never fully recovered from this assassination attempt and had to use a wheelchair until his death in 1955, at the age of 81.
I want to conclude this post in a fitting way: with a melancholic Portuguese fado song. Here is singer Fernando Machado Soares (born 1930 and as I write this, still going strong) with his Balada da Despedida (“Farewell Ballad”).
I won’t translate all the lyrics about the town of Coimbra. But let me note that this sad song includes an observation that “beyond the moonlight, there always is a dark night”.
I play this song here not to honor António Egas Moniz, but rather in memory of the thousands of nameless mentally ill patients who suffered from disastrous consequences of a crude lobotomy operation.
Fernando Machado Soares – Balada da Despedida