Egas Moniz, the inventor of the lobotomy

We are not going to go into a complete biography, but I will tell you that before taking an interest in human physiology, he was devoted to the politics of his country, and he became the Portuguese ambassador to Spain and the Minister of Foreign Affairs. But he had studied medicine, and at age 51, in 1926, he decided that he would rededicate himself to his initial vocation. And be careful, here I do not want to question either the ability or some of Moniz’s achievements, but what it was worth

It should also be noted that he was a very man of his time, who was quite brutal. One of the curiosities of his case is that he was close to winning the Nobel for his first great contribution to science, and it would have been much more deserved. Moniz’s study area was the brain, and he was the first to develop angiography, which is the introduction of a liquid into the brain to be able to see the state of its blood vessels, and thus be able to visualize if there were tumors.

Although in his first three patients he used a solution that not only did not work, but caused the death of one of them. But come on, what I was saying before, that science advances like this, and more so in the first half of the 20th century. But the point is that he did not win the Nobel with this contribution to science. But Moniz went on to focus his interest on brain imbalances that are the cause of psychic imbalances.

And his theory was that by removing matter from the frontal lobe, the mental health of patients with conditions like schizophrenia would be improved. In other words, with a surgical procedure on the brain, the way a person acts could be altered. The idea seems to be that it came to him from a study by two Yale physiologists, who removed the frontal lobes of a chimpanzee named Becky, who had been volatile in temperament, and who after the procedure was much more tame and collaborative.

At present it is a procedure that we know as a lobotomy, although Egas Moniz initially called it a “leukotomy”. Egas Moniz himself had a gout problem that prevented him from moving his hands well, and he also had no training as a surgeon, so it was not he who carried out the procedure.

Moniz’s first patient, or victim, was a 63-year-old woman who suffered from depression, anxiety, hallucinations, and insomnia. In November 1935, Moniz’s assistant not only trepanned her skull to remove tissue from her frontal lobe: they also injected her with alcohol. Two months after the procedure, a psychiatrist examined the patient and noted that her anxiety and nervous state had improved.

Moniz did more procedures, and it didn’t take long for followers of his technique to emerge. Two American neurologists imported it to the United States and renamed it a “lobotomy.” On December 10, 1949, Moniz received the Nobel Prize in Physiology or Medicine for his contributions to psychosurgery and psychiatry.

Initially it was a great success. Although there were voices warning of the side effects of this practice, a neurologist named Walter Freeman did a great promotion of the procedure in the media, defining it as a miracle cure. There was also a let’s say almost cynical use of the procedure: it was easier to monitor psychiatric hospital patients after the procedure. But the scary thing about the United States is that it was not only touted as a cure for people with severe diagnoses, but that it even worked for people who only had certain problems when it came to relating. It is estimated that more than 5,000 were performed in the United States alone. Among them, one to John Fitzgerald Kennedy’s sister, Rosemary. By the way, it was this same Freeman who presented Moniz as a candidate for the Nobel Prize. That obviously he did not do it in a disinterested way: it directly benefited him that a procedure was considered as safe as it was revolutionary.

Rosemary Kennedy’s case, for example, was publicized as a success but later found to be severely disabled both physically and mentally. Up to 15% of Freeman’s patients died after the procedure, and many had an initial improvement and later looked much better. The last operation Freeman performed was in 1967 on a patient who died. But to give us an idea of ​​the disrepute that the practice had already then, let’s think that the book One Flew Over the Cuckoo’s Nest was published in 1962, and there the lobotomy is already portrayed as the destruction of the patient’s personality.

Moniz died in 1955, so he did not live it fully, he did not see his invention fall out of favor. The funny thing is that his reputation, let’s say, has two aspects. On the one hand, in the world of psychiatry there have been many voices asking for the Nobel Prize to be withdrawn, among them those of the association of victims of the process, but on the other hand, in Portugal he is still seen as a national hero, and to this day there is still a statue of him in front of the Faculty of Medicine of the University of Lisbon.