50,000 lobotomies performed in U.S. from '30s to '70s

The lobotomy was introduced in 1936 by a Portuguese physician, Dr. Egas Moniz. Some 50,000 lobotomies were performed in the United States from the 1930s to the 1970s.

The original method, called prefrontal lobotomy, involved boring open the patient's skull to cut the connection between the prefrontal region — an area concerned with emotion, learning, memory and social behavior — and the rest of the brain. While it often relieved symptoms of severe mental illness, it also blunted emotion, leaving patients listless and childlike.

Dr. Walter J. Freeman invented an easier way, the transorbital or "jiffy" lobotomy, which left no obvious scars. It could be done in a few minutes as an outpatient procedure.

He traveled the United States promoting the technique, performing up to 25 lobotomies a day — some 3,400 of them in his career, according to Jack El-Hai, whose biography of Freeman came out this year.

Some of Freeman's patients said they felt better after the procedure and kept in touch with him until his death in 1972.

But others died or were severely damaged. They included Rosemary Kennedy, sister of John F. Kennedy, who was mildly impaired before the operation but had to be institutionalized afterward.

In 1954 Freeman moved from the East Coast to California, where he helped found El Camino Hospital in Mountain View.

Dr. Robert Lichtenstein, 77, shared an office with Freeman for a few years. In the early days, he said, when there were no effective treatments for the mentally ill, lobotomy seemed plausible.

"In the Santa Clara Valley, Agnews State Hospital was filled with thousands of psychiatric patients, and a lot of them were uncooperative and belligerent and would attack the caretakers," Lichtenstein said. "So the idea of trying to render some of these people more cooperative was one of the major goals of management."

However, by the time Freeman operated on Howard Dully, medications were available for mental illness and lobotomy had fallen out of favor.