In 1935, eminent scientists from around the world converged in London for the Second International Neurological Congress, an event that would one day spiral down to a small point: an apartment in Roxbury.
John Fulton, Sterling Professor of Medicine at Yale, traveled to the Congress on the Normandie, the new ocean liner that was the latest word in luxury, its first-class dining room longer than the Hall of Mirrors at Versailles. Packed away with his J. Cross ties and his favorite 1848 Madeira was the paper Fulton was to deliver on two chimpanzees, Becky and Lucy. Back in his New Haven primate laboratory, the chimps had been violent, mean, fouling their cages when they didn’t get what they wanted. But when Fulton and his colleagues surgically removed their frontal lobes for an experiment unrelated to the chimps’ moods, they were astonished to see that Becky and Lucy came out of the operation, in the words of Fulton’s associate, “as though they had joined a happiness cult.” They were calm, docile, and spookily compliant.
Another neurologist, Egas Moniz, took the train from his native Lisbon; awaiting him at the Congress was a display that covered the entire exhibition hall of the Congress, a celebration of his discovery of cerebral angiography, a technique that yielded images of how blood flows through the brain. Debonair and cultivated in the Iberian tradition of the citizen-diplomat, he had represented his country at the signing of the Treaty of Versailles.
At a special session on the frontal lobes, a young American pathologist, Walter Freeman, sat next to Moniz. Freeman was attending the events on the coattails of his grandfather, William Williams Keen, America’s first brain surgeon; at the Congress Walter was called—not always fondly—“The grandson.” Already he was known for disdaining routine work; as a student he had poured urine samples down the drain so that he could concentrate on more interesting tasks of his own devising.
When the medical men listened to Fulton’s presentation, the frontal lobes were relatively unknown territory; Phineas Gage, the railroad man of iconic fame from the iron rod that blasted through his skull destroying a frontal lobe, remained a nineteenth-century cluster of symptoms. As his friends said, “Gage was no longer Gage,” but why this personality change had occurred wasn’t yet known. Becky and Lucy’s reactions to their surgeries suggested that moods could be altered but not why.
After Fulton’s presentation, Moniz stood up to ask (and this is supposedly his exact language, as reported years later by Fulton): “If removal of the frontal lobes eliminates experimental neurosis in animals, would it not be possible to bring relief to human beings through such surgical means?” It’s a good story, screen-worthy in the tradition of thirties biographical films: Paul Muni as Emile Zola rising from his seat to argue on behalf of Alfred Dreyfus. With his black toupee perfectly parted down the center, his air of being equally at home at elegant dinner parties as with patients, Moniz was well positioned to gain the attention of the assembled scientists who themselves may have had similar as yet unexpressed thoughts. It is odd then that there is no record of this question in the notes of the Congress; everything else was meticulously documented. It may have been, however, only Fulton’s latter-day attempt to impose a narrative, or perhaps to assign blame.
But in the year the Congress took place blame was far from anyone’s mind. London was celebrating George V’s Silver Jubilee, setting out to show its guests a good time while ignoring the stirrings of fascism. Moniz’s Portugal was already under the right-wing rule of Antonio Salazar; the Spanish Republic was about to fall to Franco; a report by the Gestapo issued a few months before the Congress stated that the Nazi Party would be setting in motion a solution to the “Jewish problem.” A month and a half after the Congress, Germany would put into effect the Nuremberg Race Laws.
Scientists and spouses danced to the tune of the musical then playing at London’s Palace Theater, Anything Goes:
The world has gone mad today
And good’s bad today
And black’s white today
And day’s night today
It is tempting to see Cole Porter’s song as background music to the story of lobotomy. But to do so would require the proverbial eyes in the back of one’s head. For the participants, especially those who traveled to the Congress and sat in on that fateful session, no such perspective troubled them. Instead a grand vista lay ahead—anticipation for a glorious future in which these men had every hope and expectation of making their mark.
In 1940, Abraham Myerson knocked at our family’s door once again. In the years since he had diagnosed Bennie, his reputation had soared. He held prestigious posts, among them professor of clinical psychiatry at Harvard University. He was director of his own research laboratory, had authored several influential books and chaired the American Neurological Association’s Commission on Eugenics. He achieved even greater prominence when Time magazine hailed his discovery of the first antidepressant, a new drug that gave patients renewed energy and motivation. His entrance heralded stupendous news: at last, something could be done for Bennie.
Word of lobotomy had reached American shores. After the Congress, Egas Moniz had headed back to Portugal, where he devised an instrument for entering the brain; he called it a leucotome from the Greek word for white, referencing the white matter that was to be cut, the connective tissue that was to be interrupted. It was soon nicknamed the apple corer because it looked so much like that household implement. Moniz selected eleven female patients from the Lisbon insane asylum for the experimental operation. There was no such thing then as informed consent; the postwar code that set out guidelines for ethical human experimentation would not come along for another eleven years, but even if regulations had been in place, I doubt they’d have made a difference. Limits were conveniently overlooked before and have been since. For several weeks following the operations, Moniz observed the changes in his patients, becoming more and more jubilant as the women became as docile and undisturbed as Becky and Lucy. Eager to plant his flag on this new territory, Moniz quickly wrote a monograph proclaiming his procedure a success and rushed to the post office to get it out on the last train that night.
It landed on the desk of Walter Freeman, who had been asked to review it. Sitting in his office at Washington DC’s St. Elizabeth’s Hospital, the doctor in Freeman was excited: at last, a way to help the mentally ill; even as the snubbed grandson in Freeman saw the way to make a reputation that would be his and his alone. Even before the first lobotomy was performed in the United States, Freeman began to promote this new operation, waylaying reporters, talking up its wonders, giving them scoops. In turn they wrote articles with headlines like: “Psychosurgery Cured Me”; the crazily wrong-headed, “No Worse Than Removing A Tooth”; and my own favorite, evocative of those Disney animations, “Wizardry Of Surgery Restores Sanity To Fifty Raving Maniacs.”
Imagine Myerson, pedagogical to the core, sitting in Minna’s living room, explaining the new operation to my aunts: “There are two prefrontal lobes deep behind the eyebrows where other parts of the brain send signals, like the ones from Bennie’s emotional centers that tell him a person is dangerous. The signals travel through the white matter; when they reach the lobes, they turn into a plan of action and Bennie attacks. Think of the white matter as a switchboard. We will interrupt it so that one part of Bennie’s brain can’t send messages to the other. I promise you: nothing will be removed—only disconnected.”
Disconnected. Damnedest thing about lobotomy. Even though the operation is viewed with horror, it was also a creative leap into the understanding of mental illness, surmising that it was a problem with communication between areas of the brain. Lobotomy itself, however, was a premature and crude application of a brilliant insight that had become corrupted by the pursuit of personal glory. Several months after Moniz sent out his monograph, many of his patients relapsed, as did John Fulton’s Lucy, the unfortunate chimpanzee who went back to being as hostile and destructive as before. The world heard nothing about these reversals and none of the already-published findings were modified….
When my mother and aunts sat down in Minna’s living room to discuss their brother’s fate, Minna, always the reader, might have cited an article that appeared on the front page of a 1939 issue of the New York Times: “There must be at least 200 men and women in the United States who have had worries, persecution complexes, suicidal intentions, obsessions, indecisiveness, nervous tension, cut out of their minds . . .”
“They say it works,” Minna said. “But will it be good for Bennie?”
“Myerson says so. But what if it doesn’t work?” Helen, my mother, replied.
“Look, what if we do it?” Jen asked, restless, always in favor of the unknown. “Suffering isn’t doing him any good.”
Helen said, “But it will take money—they say he’ll need a caretaker.”
Jen had begun to realize that her talent lay in making money. “I can help with that,” she assured her sisters.
Did they understand that ridding Bennie of his unbearable feelings would mean that he’d be left with no feelings at all? Could anyone comprehend such a condition, such a life?
“Is there anyone else we can talk to?” Minna asked.
It was then that the sisters took on the family roles that would characterize them for the rest of their lives, traits that I grew up thinking were their natures but now understand were also formed and deformed by their lives: Minna unsure but wanting everyone to pull in the same direction; Jen leaning toward action without a safety net; Helen combining diffidence with practicality.
Minna added, “What do you think will happen if we don’t do it?”
“What do you think?” Jen answered in her no-nonsense way. “He’ll keep hurting people.”
Minna took offense at the implied rebuke: hadn’t she learned anything after what Bennie did to Dan?
When Minna gave birth to little Dan, the first child in the family, all the sisters were at the ready to watch over his cradle, keeping him under their eyes like loving hawks. But the circle of protection didn’t hold. In the midst of a longish lull in Bennie’s madness, Minna told herself it was all right to drop off four-year old Dan at her mother’s apartment, just for a few minutes while she ran a quick errand. But Minna hadn’t counted on how fast Bennie’s good spells could turn bad. Alone in the living room with his little nephew, Bennie hit him. He kept on trying to hurt him. Dan scrambled behind a chair, where he was still crouched when Minna came home. She picked up her son and held him against her thin chest while he burrowed his head under her arm. She was anguished for her suffering child and frightened too about what Sam might do when he came home later.
Bennie’s blows must have gone on landing in Dan’s mind. Years later, when Dan was a grown man, I could hear the bitterness in his voice when he said that this—not a goodnight kiss, not a rubber duckie—was his first memory.
“What was my mother doing,” Dan asked angrily years later, “leaving me with that madman?”
It’s a good question. Minna had been trying to make that normal life for her family, and that life included her love for Bennie, the brother he had been and the suffering creature he’d become.
Now she was horrified. She blamed herself for what had happened; she’d already known there was a demon inside him. What kind of a person was she, to put her child in danger?
Brother and son. It’s almost Biblical. Which do you choose to sacrifice?
From WHITE MATTER. Used with permission of Hawthorne Books. Copyright © 2015 by Janet Sternburg.