Thursday, August 25, 2005

On Vacation

Christine will be on vacation and will post on this blog again on Sept. 5.

Thursday, August 18, 2005

SERIOUS DECLINE IN MENTAL HEALTHCARE

Here is an interesting article from the Baltimore Chronicle that mentions our fight against the Moniz Nobel.:
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Forgotten Victims of America’s Plutocracy
By Jason Miller

Like wolves among sheep, America's Plutocracy preys on the weaker and less fortunate members of society. Since America's founding, they have leveraged their economic power to dominate the government and the media, the vehicles through which they advance their avaricious agenda.

...

Suffering in silence

Overshadowed and often forgotten is the plight of yet another minority group which has suffered tremendously at the hands of the ruling elite. The “Land of the Free” has not been particularly kind to the mentally ill. People with mental disorders have faced many forms of abuse and discrimination before and since our founders penned the Declaration of Independence and the Constitution.

...

Horror masquerading as healing

In 1935, Antonio Moniz spawned one of the most savage, inhumane "medical procedures" in human history. He performed a type of psychosurgery which involved removing a portion of the frontal lobe of a patient's brain in an attempt to rid them of unwanted anxieties, neuroses, or psychoses. This notorious procedure, known as the lobotomy, usually resulted in impairment of the patient’s sex drive, spontaneity, impulse control, and problem-solving capacity, leaving them a mere shadow of their former selves. Despite the high risks and extremely disturbing after-effects associated with the treatment, the US medical profession raced to embrace the lobotomy as a technique to treat patients with serious illnesses.

Dr. Walter Freeman invented and popularized the Tran orbital lobotomy, which involved placing an ice pick just above the patient's tear duct, driving it into the frontal lobe with a rubber mallet, and wiggling it around to decimate the frontal lobe of the brain. Hailed as inexpensive, simple and non-invasive, US care-givers performed over 40,000 lobotomies between 1936 and 1950. Freeman traversed the country (in his van which he called his "lobotomobile") shamelessly touting his procedure. His advocacy for the "ice pick lobotomy" as a "cure all" even led to its use to manage misbehavior in children. Rosemary Kennedy represents a classic high profile case of the abuse of this twisted form of treatment. Her father, Joe Kennedy, patriarch of the Kennedy clan, authorized a lobotomy for his 23 year old daughter in 1941 to "cure" her mild mental problems. The ice pick lobotomy left her profoundly retarded. For the innovation of this human butchery, Moniz won a Nobel Prize in 1949. Family members of lobotomy victims have lobbied the Nobel Foundation to revoke his award, but their pleas have fallen on deaf ears.

read the rest

Tuesday, August 16, 2005

"The Lobotomist" Review

The Seattle Weekly reviews "The Lobotomist"

As Freud recedes in importance in our age of Prozac and Paxil, psychopharmacology and neuroscience having rendered him a 20th-century crank, we ought to remember that there are limits to the mechanistic view of the brain. No fan of talk therapy, psychiatrist Dr. Walter Freeman (1895–1972) set out to debunk Freud by ridding patients of their mental problems by operating directly on the brain—never mind that he was not, in fact, a trained surgeon. That he eventually simplified his technique to hammering ice picks in above the eye socket (hence transorbital lobotomy), often in a nonsterile clinical setting, has only contributed to his horrific reputation and legacy. To those who even recognize his name, it's associated more with Dr. Frankenstein or Dr. Moreau than with legitimate medical practitioners.

That's why The Lobotomist, though not so brilliantly organized or told by author Jack El-Hai, is still an important book. "Psychosurgery," as Freeman helped to coin the term, is actually making a comeback (though under a different name). Thanks to supercomputers and modern imaging, plus the most delicate of surgical techniques (some of them noninvasive, using gamma knives and the like), surgeons are again operating on people with profound brain disorders. In a sense, since brain maladies like schizophrenia are organic and not neurotic, Freeman paved the way, but he also polluted it as he went. (Incredibly, his mentor, a Portuguese doctor named Moniz, won a 1949 Nobel Prize for originating psychosurgery.)

Freeman was involved with some 3,500 lobotomies in the decades following 1936 (when he helped perform the first such operation in the U.S.). El-Hai makes depressingly clear that the surgery's popularity coincided with the huge and costly increase in the number of institutionalized mental patients, most of whom could not give Freeman their informed consent for the procedure. (The boom ended with the advent of antipsychotic drugs like Thorazine, which Freeman ironically opposed because it only masked the root causes of mental illness, rather than treating them.) This is the climate that also gave rise to electroshock therapy and One Flew Over the Cuckoo's Nest; Freeman's own daughter called him "the Henry Ford of psychiatry." Indeed, he took an assembly-line approach to the surgery, often driving around the country—including a stop at our own Western State Hospital—in search of patients. Of one road trip, he wrote, "I left a string of black eyes all the way from Washington [D.C.] to Seattle." (Black eyes resulted from the ice-pick procedure, which patients generally didn't remember afterward.) Among his patients were Rosemary Kennedy and the sister of Tennessee Williams; bafflingly, El-Hai skims over these sad episodes.

He also fails to integrate much current medical knowledge as he tells Freeman's bizarre saga. Since Freeman surgically violated the brain's frontal lobes, he often succeeded in abating the symptoms of mental illness without addressing their cause; the procedure amounted to "salvage, not rescue," one contemporary noted. Yet El-Hai doesn't really address why the medical establishment went along with lobotomies for so long—despite any evidence-based studies on their efficacy.

Still, there's a great story in here. Freeman is like a dark doppelgänger to Kinsey—well-intentioned, more banal than evil, and a bit of a showman. While performing a prefrontal lobotomy on a conscious patient under local anesthetic, he asked, "What's going through your mind?" On the operating table, the patient replied, "A knife." BRIAN MILLER

Marilyn Lukach Column

Some want Nobel Prize revoked from man who developed lobotomy

Lobotomy. Just the word conjures up a nightmare that was all too true for many psychiatric patients between the 1930s and 1970s.

In the current New England Journal of Medicine, an editorial discusses lobotomies and notes the "procedure was a desperate effort to help mental patients." The historian from this editorial admitted in a later interview that the "numbers that were harmed were quite substantial."

The lobotomy was first performed in November 1935 under the direction of noted Portuguese neurologist Egas Moniz. In the book "The Lobotomist" by Jack El-Hai, it was noted that Moniz did not actually perform the operation. His hands crippled by gout, he was unable to hold surgical instruments. The surgery was performed by Almeida Lima under Moniz's direction. Another interesting point to note:I could not find any articles that stated he was a surgeon, so operating should have been a moot point even without the gout.

Moniz had already refined techniques using radioactive tracers or cerebral angiographies that helped doctors visualize blood vessels in the brain. He felt that some mental illnesses were caused by abnormal stickiness in the nerve cells that caused neural impulses to actually get stuck. This caused, in his opinion, a repeat of pathological ideas in the patient. There was no real evidence for his theory, but Moniz was determined to push on.

The first attempt at psychosurgery drilled holes in the skull and gave a series of alcohol injections into the frontal lobe (which controls thinking). The switch was made to cutting the lobe with wire and severing the connections. Nothing in the brain was removed.

read the rest

Tuesday, August 09, 2005

NPR Interview August 10th

On August 10th an interview with Jack El Hai, Dr. Baron Learner, and me will be broadcast on the NPR radio program Day to Day.

If you miss the show, or live someplace where it isn't aired, it will be available here .

Friday, August 05, 2005

Trust the Professionals

New York makes good after having allowed some shocking abuse to happen to some of our most vulnerable children ...
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New law aims to protect children at out-of-state centers
BY LAUREN TERRAZZANO
STAFF WRITER

August 4, 2005

One Great Neck girl hanged herself in 2002 from a bunk bed at the dorm of her Pennsylvania treatment center.

Another 15-year-old Suffolk County girl was sexually assaulted by a worker at the St. Anne Institute in Albany, an event so traumatic she hitchhiked home to Long Island
because she was so distraught.

And a Brooklyn teenager, Vito "Billy" Albanese, while in a wheelchair for a traumatic brain injury, was beaten and tied down at a New Hampshire center and received 40 stitches from a fall when he was a resident at a New Jersey brain injury center.

There are 1,400 disabled and emotionally disturbed New York State children in out-of-state treatment centers as far away as Florida and as close as the Berkshires who cannot be helped closer to their homes because there are simply not enough beds in New York.

But because of a law signed late Tuesday by Gov. George Pataki, that could soon change. Pataki said "Billy's Law" would better protect vulnerable children across the state, "from Long Island to Buffalo," and bring many of them home.

He said the law "takes aggressive steps to help people with unique needs by directing state entities to work even more closely to ensure the treatment provided ... is the best it can be."

The law, developed after a year-long task force assembled by Pataki, calls for better scrutiny of out-of-state centers, more frequent inspections by state agencies and an attempt to create more beds in-state for disabled children. Many are placed there by school districts, local social service agencies and Family Court systems.

The bipartisan legislation, considered landmark because New York is believed to be among the first in the nation to enact such a measure, was named after Albanese. But mostly it was born of the years of kitchen-table advocacy by his 67-year-old father, Vito, of Bay Ridge. Billy was neglected, according to state findings, at the Bancroft Neurohealth Center in Haddonfield, N.J., that was recently the subject of a widespread investigation by the New Jersey child advocate's office.

more

Wednesday, August 03, 2005

CHICAGO PREMIERE!

CHICAGO PREMIERE!

ONE WEEK ONLY!

A HOLE IN ONE

AUGUST 5-11

The Facets Cinémathèque, 1517 W. Fullerton Ave. is proud to present the Chicago Premiere of A Hole in One, directed by Richard Ledes, for one week only, Aug. 5-11. Showtimes are Fri. at 7 & 9 p.m., Sat. at 5, 7 & 9 p.m., Sun. at 3, 5, 7 & 9 p.m., and Mon., Tues, and Thurs. at 7 & 9 p.m.

Set in small-town America circa 1953, A Hole in One is a romantic drama starring Michelle Williams(Imaginary Heroes) as Anna, a young woman whose desire for mental health leads her to covet the latest fashion-a trans-orbital lobotomy. Anna is haunted by her family's insensitive treatment of her brother when he returns "shell-shocked" from World War II, followed by his unexpected suicide.

Raised in a pre-feminist era, when women were not expected to think for themselves, Anna is courted by Billy (Meat Loaf Aday, Fight Club), a small time gangster, when she is just barely old enough to be considered an adult woman. Desperately, Anna looks for a way to relieve her pain, while yearning for fulfillment, clarity and calm as madness flickers around the edges of her life.

Shot in Nova Scotia, featuring exquisite photography, rich period detail, an evocative score by Stephen Trask (of Hedwig & The Angry Inch fame) and based on meticulously researched "stranger than fiction" historical facts and medical practices, A Hole in One is a film that meticulously balances a rich original style with a captivating story and visuals that complement its intelligent humor and dialogue, as a young woman struggles against the madness of Cold War America.

Directed by Richard Ledes, U.S.A, 2004, 35mm, 97 mins.
Tickets are $9, $5 for members.
For additional information, call 773-281-4114 or visit www.facets.org

Tuesday, August 02, 2005

Magical Mystery Cure

This is an excellent article by Danielle Egan, a friend of Psychosurgery.org. It appeared in This Magazine earlier this year:

Magical Mystery Cure

What would you do if a lobotomy was your only hope for happiness? Today the procedure is called psychosurgery and it continues to be prescribed to treat mental illness, though many psychiatrists argue the mentally ill need it like a hole in the head

“I remember when I was having the surgery, they had put a lot of drugs in me and I was feeling heavily drunk. They said, ‘How do you feel?’ I said, ‘I feel drunk.’ They were trying to put this jig on my head, and these guys couldn’t get it on. I’m going, ‘Oh my god, what am I doing here in this operation room? This is crazy. You’re going to drill holes in my head and you can’t get this thing on!’ I didn’t think it was funny. I was a lot worried.”

Bruno (not his real name) and I are having lunch at a Chinese restaurant on the main drag of a small town just south of Edmonton. The neatly dressed 33-year-old speaks in a loud, calm voice as he describes a psychiatric neurosurgery, or psychosurgery, performed on him in November 2002 as a last resort treatment to curb his obsessive-compulsive disorder (OCD). The disorder appeared as excessive hand-washing when Bruno was 10, but eventually became debilitating. He dropped out of university during his third year and started seeing Dr. Lorne Warneke, an Edmonton psychiatrist who specializes in OCD. They spent the next 10 years trying dozens of pharmaceutical treatments, in addition to cognitive behaviour therapy, while Bruno worked on and off selling insurance. But Bruno, like about 20 percent of people who try the standard methods of treatment for mental illness, found they didn’t help him. So Warneke told him about a type of surgery that could treat his OCD by destroying pathways in his brain thought to be overactive in people with anxiety disorders.

“At first I couldn’t think of someone drilling a hole in my head and frying my neurons, you know,” says Bruno, letting off a loud booming laugh. “I talked about it with Dr. Warneke. Finally, I guess, I thought that’s what I should do.”

Performed at University of Alberta Hospital in Edmonton, the surgery, called a stereotactic bilateral anterior capsulotomy, is one of four psychiatric neurosurgeries used around the globe to treat people with severe depression and anxiety disorders. Specialists in the field aren’t sure how or why these surgeries work, and all four operations target different parts of the brain. The goal is to interrupt the neural pathways between the frontal lobes—known as the seat of personality and the brain’s CEO because they’re involved in higher functions like problem-solving, motor-control, language, memory-sorting and impulse-control—and the so-called “lower” areas of the brain, including the thalamus, amygdala and hippocampus, which initiate mood, hormones and emotions ranging from sexual pleasure to fear.

With the anterior capsulotomy, the target is the internal capsule, an area dense with nerve connections between the frontal lobes and the thalamus. About four such procedures have been done each year at University of Alberta Hospital since Warneke started referring some of his most severe treatment-resistant patients to neurosurgeon Dr. John McKean in the early 1990s. In order to be referred, the patients must have failed a number of years of standard treatment, including pharmaceuticals and psychotherapy, and be “considerably debilitated.” Psychosurgery, Warneke explains, is “a very simple procedure that effectively cuts nerve fibres. It’s a bit like cutting some wires in a telephone trunk line to reduce the amount of messages getting through.”

His explanation is similar to that of Portuguese neurologist Dr. Egas Moniz, who developed the first psychosurgeries (then called prefrontal leucotomies) in the 1930s. Moniz claimed the procedure was necessary to “change the paths chosen by the [dysfunctional] impulses … and force thoughts into different channels.” While tools and technologies have certainly evolved over the years, the premise of severing pathways in order to treat psychiatric illnesses remains the same as it was back in the early days of lobotomy.

The “jig” placed on Bruno’s head is a large metal device that makes it easier for surgeons to pinpoint the coordinates of the spots to be destroyed. When the neurosurgeon arrived and showed the attendants how to work the stereotactic frame, “there was a sigh of relief,” Bruno says, laughing heartily before taking a few bites of his buffet lunch. Bruno’s skull had already been locally anaesthetized so that he wouldn’t feel pain from the drill, and two spots on the top of his head just above the hairline had been shaved. The brain itself doesn’t feel pain, so Bruno was wide awake as doctors drilled two dime-sized holes in his skull. “I remember the sound of the drill, but no pain, just a little pressure. Then I remember the doctor going, ‘How many fingers?’ It felt like I was only there 15 minutes. I was in and out.”

read the rest

Monday, August 01, 2005

Moniz Lobotomy Stamp



This is an actual Portuguese stamp.

Letter to the Editor of the OC Register

A psychiatric no-brainer

The article, "Lobotomy foes seek to revoke Nobel Prize" [News, July 14], about Portuguese neurologist Egas Moniz's Nobel prize for devising lobotomy as a purported solution to human problems, shows again how psychiatry has betrayed the trust of people in need. As with other cruel psychiatric methods, such as electric shock therapy, forced mind-altering drugging, etc., psychiatrists "twist the knife" once it is firmly imbedded in the body of a too-trusting victim while picking the pocket of the taxpayer for ill-gotten appropriations.

Pat Mattison
Tustin
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Thank you Pat!
link

Editorial from the Lufkin Daily News

EDITORIAL: Nobel Foundation should revoke prize given to doctor who began lobotomiesThe Lufkin Daily News
Thursday, July 14, 2005

It seemed like a good idea at the time.

Egas Moniz in 1936 came up with the idea of cutting through nerve fibers connecting the brain's frontal lobe — which controls thinking — with other parts of the brain, with the hope mental illnesses would go away once the new nerve connections were formed.
Lobotomy hasn't been used since the 1970s, but now some relatives of people who underwent the procedure are trying to get Moniz's 1949 Nobel Prize revoked because of modern views about how barbaric the procedure was, according to an Associated Press story.

It seems pointless to take away the medal now, considering Moniz has been dead for 50 years. Except for one thing: “How can anyone trust the Nobel Committee when they won't admit to such a terrible mistake?”

That's a question posed to the AP by Christine Johnson of Levittown, N.Y., whose grandmother was lobotomized in 1954 after other treatments for her delusional behavior were unsuccessful. Johnson, a medical librarian, started a campaign to have Moniz's prize revoked.
Truth be told, there's not much chance the Nobel Foundation will act on the request. Its charter includes no provision for appealing a prize that has been awarded, and the foundation traditionally ignores criticism of its awards — such as in the case of Palestinian leader Yasser Arafat's Peace Prize, according to Nobel Foundation executive director Michael Sohlman.

We think now's a good time to come up with an addition to the Nobel Foundation's charter that lets it correct the committee's occasional error in judgment. Then it could take away the 1949 prize, or at least admit the committee was wrong to award it — for integrity's sake, as Johnson suggested.

Thankfully, there are medicines and procedures today that help people cope with mental illness more effectively, in much more humane ways. It's unfortunate that the Nobel Foundation still has a prize on record for the horrible treatment that was lobotomy.
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Thank you Lufkin Daily News!
http://tinyurl.com/buq8n