Walter Jackson Freeman II

Walter Jackson Freeman II (November 14, 1895 – May 31, 1972) was an American neurologist who claimed that he specialized in lobotomy. Wanting to simplify lobotomies so that it could be carried out by psychiatrists in psychiatric hospitals, where there were often no operating rooms, surgeons, or anesthesia and limited budgets, Freeman popularized a transorbital lobotomy procedure. The transorbital approach involved placing an orbitoclast (an instrument resembling an ice pick) under the eyelid and against the top of the eye socket; a mallet was then used to drive the orbitoclast through the thin layer of bone and into the brain. Freeman's transorbital lobotomy method did not require a neurosurgeon and could be performed outside of an operating room, often by untrained psychiatrists without the use of anesthesia by using electroconvulsive therapy to induce seizure and unconsciousness. In 1947, Freeman's partner James W. Watts ended their partnership because Watts was disgusted by Freeman's modification of the lobotomy from a surgical operation into a simple "office" procedure.

Freeman and his procedure played a major role in popularizing lobotomy and spreading it around the world; he later traveled across the United States visiting mental institutions. After four decades Freeman had personally performed possibly as many as 4,000 lobotomies on patients as young as 12, despite having no surgical training. As many as 100 of his patients died of cerebral hemorrhage, and he was banned from performing surgery in 1967.

Early years Walter J. Freeman was born on November 14, 1895, and raised in Philadelphia, Pennsylvania, by his parents. Freeman's grandfather, William Williams Keen, was well known as a surgeon in the Civil War. His father was also a very successful doctor. Freeman attended Yale University beginning in 1912, and graduated in 1916. He then moved on to study neurology at the University of Pennsylvania Medical School. While attending medical school, he studied the work of William Spiller and idolized his groundbreaking work in the new field of the neurological sciences. Freeman applied for a coveted position working alongside Spiller in his home town of Philadelphia, but was rejected.

Shortly afterward, in 1924, Freeman relocated to Washington, D.C., and started practicing as the first neurologist in the city.

Medical practice

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".

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, who suffered from anxiety, insomnia, and depression.

Freeman then "developed a transorbital approach" After four decades Freeman had personally performed possibly as many as 4,000 lobotomy surgeries in 23 states, of which 2,500 used his ice-pick procedure, despite the fact that he had no formal surgical training.

Freeman usually wore neither gloves nor mask during these procedures. In 1951, one patient at Iowa's Cherokee Mental Health Institute died when Freeman stopped and stepped back to take a photo of the patient with the leucotome, as was his usual practice, and the surgical instrument accidentally penetrated too far into the patient's brain.

Freeman often stayed in contact with his former patients and his families, and would check on their condition during his trips. In a 1957 retrospective of his work, Freeman boasted that, "The receipt of a wedding or a pink or blue baby card from a former patient arouses a certain pleasurable reaction in the recipient." In 1972 he lamented the growing use of antipsychotic medications for schizophrenia, contending that lobotomy was more effective at reducing antisocial behavior in patients.

An extensive collection of Freeman's papers were donated to The George Washington University in 1980. The collection largely deals with the work that Freeman and James W. Watts did on psychosurgery over the course of their medical careers. The collection is currently under the care of GWU's Special Collections Research Center, located in the Estelle and Melvin Gelman Library.

Freeman was known for his eccentricities and he complemented his theatrical approach to demonstrating surgery by sporting a cane, goatee, and narrow-brimmed hat. Frances, the 1982 film version of that book, depicted a Freeman-like psychosurgeon actually performing the operation on Farmer; and Martin Scorsese's 2010 thriller Shutter Island, seemingly inspired by the earlier film, also used the transorbital lobotomy and a Freeman-style doctor as an element of cinematic horror. Both Jack El-Hai's 2005 book The Lobotomist and the 2008 PBS documentary adapted from it

Works