What Is a Lobotomy? Procedure, Effects & History Explained

When a Portuguese neurologist won medicine’s highest honor in 1949, he had already performed a procedure that would later be condemned as one of the most controversial in medical history. The lobotomy — a surgery that severed connections in the brain’s prefrontal cortex — was once celebrated as a breakthrough for treating mental illness, then abandoned as a nightmare of irreversible damage. Yet the story doesn’t end with its decline: survivors lived for decades afterward, carrying the consequences of an operation that promised calm and delivered something far more complicated.

First performed: November 1935 by António Egas Moniz · Nobel Prize awarded: 1949 · Primary target: Prefrontal cortex connections · Status today: Discredited and rarely used · Known survivors: Yes, including cases from 1960s

A data summary highlights the procedure’s key attributes and historical scope.

What does lobotomy do to a person?

The procedure was designed to disrupt nerve pathways in the prefrontal cortex — the brain region governing personality, decision-making, and emotional regulation. Moniz pioneered leucotomy in November 1935 by drilling holes into the skull and using a leucotome instrument to sever white matter connections in the frontal lobe (Our Health Journeys). Initially, he injected alcohol into the frontal lobe before developing the leucotome alongside colleague Almeida Lima (Psych Central).

Effects on brain function

The surgical assault on prefrontal connections produced documented neurological consequences. In a British survey of patients who underwent lobotomy between 1942 and 1954, outcomes ranged widely: 13% fully recovered, 28% significantly recovered, 25% showed no change, and 4% died (Wikipedia). Common effects recorded in clinical follow-up studies included epilepsy in 12% of patients, personality defects in 91%, apathy, reduced initiative, incontinence, seizures, and weight gain (PMC — The Lobotomy Patient). A 1948-1952 study of 150 lobotomy patients found that 67% improved enough to live outside hospital, though 26% eventually relapsed (PMC — The Lobotomy Patient).

Changes in personality and emotions

Moniz’s earliest patients displayed complications within one to ten weeks post-operation, including fever, incontinence, apathy, and kleptomania (Wikipedia). Transorbital lobotomies — the faster method Freeman popularized — frequently produced reduced tension alongside apathy, passivity, poor concentration, and blunted emotions (Wikipedia). Personality, memory, and IQ varied wildly post-lobotomy; outcomes were fundamentally unpredictable (YouTube — What It’s Actually Like).

Is lobotomy still used today?

The procedure is discredited and no longer part of standard psychiatric practice. Lobotomies declined sharply in the mid-1950s with the introduction of antipsychotic medications, and Freeman’s reputation suffered as media portrayed the procedure negatively (Wikipedia). By the late 1950s, lobotomy had fallen into disrepute entirely, evolving instead into stereotactic neurosurgery — precise, minimally invasive techniques that bear no resemblance to the ice-pick method (PMC — Violence, mental illness).

Modern alternatives

Contemporary psychosurgery operates under strict ethical constraints. Procedures like cingulotomy and capsulotomy target specific brain regions with millimeter precision using radiofrequency ablation or radiation, and are reserved for severe, treatment-resistant cases only after exhaustive review by ethics boards (PMC — Violence, mental illness). No routine use exists in standard medicine anywhere in the developed world.

Rare contemporary cases

While some countries may retain older statutes permitting psychosurgery, actual practice is extremely rare and typically limited to experimental or exceptional clinical scenarios. The Soviet Union banned lobotomies in December 1950 following public criticism — earlier than Europe or the United States — setting an early precedent for skepticism (Wikipedia).

Did anyone survive lobotomy?

Yes — and some lived for decades afterward, providing haunting testimony to both survival and suffering. Freeman performed his last transorbital lobotomy in February 1967 on Helen Mortensen, her third procedure, which resulted in death from hemorrhage; Freeman was subsequently banned from operating (StoryCorps). But countless others survived with varying degrees of impairment.

Survivor stories

Howard Dully, lobotomized at age 12 in 1960, became one of the most documented survivors. His StoryCorps account describes the ice-pick procedure and its lifelong aftermath (StoryCorps). A child survivor who underwent the procedure in 1963 recounted experiences post-lobotomy in a 2005 CNN interview that brought renewed public attention to the practice’s human cost (CNN). Rosemary Kennedy, lobotomized in 1941, was reduced to an inability to talk, walk, or dress independently for the remainder of her life (YouTube — What It’s Actually Like).

“Some patients seemed to improve, some became ‘vegetables,’ some appeared unchanged and others died.”

— Dr. Elliot Valenstein, neurologist and author, via StoryCorps

Long-term impacts

Survivor effects included grand mal epilepsy, loss of taste and smell, alcoholism, poor impulse control, and what observers described as a “frozen vocabulary” (STAT News). One patient’s daughter recounted: “I never knew my mother when she was well, but I do know that after the lobotomy, she was never the same. She developed grand mal epilepsy” (STAT News). Some survivors appeared childlike and less worried; others became vegetative or unchanged — outcomes varied unpredictably (StoryCorps).

Can a lobotomy cause death?

Yes — the procedure carried significant surgical mortality risk. Lobotomies peaked in the 1940s with a documented 5% average mortality rate (Wikipedia). Freeman’s final procedure in February 1967 ended in patient death from hemorrhage, leading to his permanent ban from operating (StoryCorps).

Mortality rates

The British survey data from 1942-1954 showed 4% of lobotomized patients died post-operatively (Wikipedia). Gottlieb Burckhardt, who performed the earliest psychosurgeries in the late 1880s on six schizophrenia patients, saw one die post-operation and one commit suicide (Britannica). Surgical risks included infection, hemorrhage, and the cumulative neurological damage from deliberate brain tissue disruption.

Complications

Beyond mortality, lobotomy produced a spectrum of complications. Common effects included epilepsy (12%), personality defects (91%), apathy, reduced initiative, incontinence, seizures, and weight gain (PMC — The Lobotomy Patient). Freeman performed over 3,500 lobotomies by the late 1960s, with many documented complications along the way (Britannica). His “road lobotomies” — mobile procedures performed in hospital parking lots without proper surgical facilities — represented an extreme of cavalier practice that would be unthinkable today.

Can people with lobotomies still feel emotions?

Yes — but the emotional range was typically reduced and blunted. Transorbital lobotomies frequently caused apathy, passivity, and blunted emotions, though some patients did experience reduced tension (Wikipedia). The procedure targeted the prefrontal cortex, which governs emotional regulation, meaning the capacity for emotional experience was deliberately compromised.

Emotional changes

Survivors reported dulled feelings as a consistent experience. Some patients appeared childlike and less worried — a condition Freeman initially marketed as a positive outcome (StoryCorps). But what looked like peace was often profound emotional poverty: the inability to experience the full spectrum of human feeling, from joy to grief to anger. Research from follow-up studies spanning 1952-1962 showed maximum response typically occurred at six months post-operation, often maintained thereafter — suggesting that emotional blunting was not temporary but permanent (PMC — The Lobotomy Patient). For more information on mental health, consult this Mielenterveysopas huoli-ilmoituksesta.

Reported experiences

Accounts from survivor families paint a consistent picture. A patient’s daughter described her mother’s post-lobotomy state as fundamentally altered: personality, affect, and capacity all diminished (STAT News). The subjective experience of lobotomy survivors themselves — how they described their inner emotional lives — remains underreported, partly because the procedure often compromised the very cognitive capacities needed to articulate such experiences.

The history of lobotomy

The story begins before Moniz — with Gottlieb Burckhardt, a Swiss psychiatrist who performed the earliest psychosurgeries in the late 1880s on six schizophrenia patients; one died post-operation, one committed suicide, and the results were not considered promising enough to continue (Britannica). Moniz revived the concept nearly fifty years later, developing his leucotomy technique in November 1935 by drilling holes into the skull and using a leucotome to disrupt frontal lobe white matter (Psych Central).

The procedure spread rapidly. Walter Freeman and James Watts performed the first prefrontal lobotomy in the United States in September 1936 (Psych Central). Freeman then modified the leucotome for precision, with anterior targeting for affective disorders and posterior for schizophrenia (PMC — Violence, mental illness). By 1945, Freeman had invented the transorbital method — hammering an instrument through the eye socket in about ten minutes without anesthesia or sterile conditions — and traveled the country performing what he called “road lobotomies” (Our Health Journeys).

How lobotomy was performed

Two distinct surgical approaches emerged, each reflecting different philosophies about access to the prefrontal cortex. Moniz’s original leucotomy involved drilling holes into the skull above the eyebrows and inserting a leucotome — a special instrument — to cut white matter tracts connecting the frontal lobes to other brain regions (Psych Central). Freeman and Watts later modified this with a burr hole procedure using a 1 centimeter hole above the zygomatic arch to access the frontal lobe more directly (BCMJ).

Freeman’s 1945 transorbital variation was radically different in execution. Using what looked like an ice pick, he would hammer the instrument through the roof of the eye socket — the thin orbital bone — and sweep it to sever frontal connections, all without proper surgical sterilization or anesthesia. The entire procedure took approximately ten minutes (Our Health Journeys). This speed and simplicity made “road lobotomies” possible — Freeman literally traveled between hospitals performing procedures in parking lots and janitorial closets.

Regional variations existed alongside the dominant American practice. In New Zealand, surgeons Gilmour McLachlan and Murray Falconer performed 65 lobotomies between 1944 and 1950 on chronic patients in hospital settings — a more controlled environment than Freeman’s mobile operations (Our Health Journeys). Ontario, Canada saw 74% female patients from 1948-1952, reflecting gender disparities present across Western practice (Wikipedia).

The data reveals how procedure adoption varied dramatically by geography and provider philosophy — from hospital-based protocols in New Zealand to Freeman’s unregulated mobile operations in the United States.

“The frontal lobotomy procedure could have severe negative effects on a patient’s personality and ability to function independently.”

— Wikipedia editors, Wikipedia Lobotomy article