The VA's sad record of lobotomies

Lobotomy
Two Tulsa, Okla., neurosurgeons are shown using the stereotaxic guide for prefrontal lobotomy on August 17, 1951 at Eastern Oklahoma Hospital in Vinita, Oklahoma.
AP Photo

The U.S. government lobotomized roughly 2,000 World War II veterans, according to unearthed records in a Wall Street Journal investigation. These men suffered from diseases including schizophrenia, depression and psychosis. Some men who identified as homosexual were also lobotomized.

Journal reporter Michael M. Phillips joined The Daily Circuit to discuss the story. Some highlights of that conversation:

World War II left VA overwhelmed with cases
"They thought they were prepared for World War II. They had done mental analyses of recruits; more than a million potential soldiers were told they couldn't serve. But of course what happened is what happens in every war. The military, and after the war the Veterans Administration, were absolutely swamped by psychiatric cases. These were probably in some cases people we would say had PTSD, but also more severe diagnoses of schizophrenia and psychosis. And the VA was really overwhelmed by soldiers coming home with mental problems they just couldn't handle."

Few treatments were available
"Very typical treatments at the time were electroconvulsive therapy, to try to jolt the system somehow and jolt the mental illness out of people; insulin shock therapy, in which doctors would inject insulin into a psychiatric patient, put them into a coma, and then bring them out of the coma again and see if that did anything. I ran across documents of cases of veterans who'd had more than 100 rounds of insulin coma therapy, and yet these treatments were not very effective. They also had hydrotherapy, which involved spraying patients with high-pressure hoses of hot and cold water to see if that somehow made them better, made the symptoms ease. Psychiatry didn't really have anything to do to make these guys better, and there was a sense of desperation."

To 'cut mental illness out of the brain'
"At that time lobotomies were practiced in the civilian world, in state mental hospitals, which were just as ill-equipped to deal with psychiatric patients as were the veterans' hospitals. ... What they were trying to do was essentially cut mental illness out of the brain by severing certain neural pathways. It was surgery to fix mental illness ... as if it were a broken bone or something. But that was at the time certainly acceptable. On the other hand, it's quite clear that there was debate about the wisdom of lobotomy at the time. The doctors at the VA and elsewhere knew that they were taking a real risk, that they were essentially gambling that they would be able to improve certain aspects of a person's life even though they knew they would likely be sacrificing that person's personality. Almost scrubbing them clean of adulthood, in a sense."

Roman Tritz, who describes himself as "mentally injured, not mentally ill," underwent a lobotomy on July 1, 1953. He's now 90 and lives in La Crosse, Wis.

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The Tritz family's fear
"He was given a clean bill of health by the military, they said he was fine. But very soon after that he began to develop psychiatric symptoms that really frightened his family. He was hallucinating and delusional. He sensed conspiracies against him. They began to worry that he would attack his younger sister. ... so they eventually had him committed to the VA hospital in Tomah, where he went through years of those therapies ... and none of it worked. In 1953, eight years after the war ended, the doctors finally said, 'I think it's time for a lobotomy.'"

Nerves were thought to control strong emotion
"Roman had what was called a standard lobotomy, in which they sawed two holes in the front sides of the head, left and right, and they'd insert a tool ... a knife kind of a thing, and they would manipulate it to sever the nerves that connected the very front of the brain to the rest of the brain. And those nerves, according to the doctors who performed lobotomies, controlled excessive emotions. So if they severed them, then they would get rid of the excessive emotions, according to the theory."

Perhaps the procedure worked, in a sense
"The question of whether it worked is of course central to the whole thing. And it really comes down to, what does 'work' mean? If you have a loved one, a vet who's come back from the Pacific or something, and he is anguished and maybe violent — and hitting his head against the wall, or just rocking back and forth — and the surgery, the lobotomy, makes him stop being violent or stop hitting his head against the wall, you might say, 'Hey. That surgery worked.' On the other hand, what if his personality was gone after that? And he was unable to function independently for the rest of his life? He had the manners and the mannerisms of a child, but in the body of an adult? Did the surgery work? When we look back at this time period and at the doctors who made this decision, and the families who took their advice and decided to go ahead with the surgery, we're really asking ourselves, were they correct in saying that they were able to make that decision about a tradeoff? Are they better after the surgery? In some sense, maybe. And in other senses, definitely not."

An unknown number of survivors
"We don't know how many of them are still alive ... Often these vets did not live very long after their surgery. I don't know if that was a cause or not, but it was frequently the case. ... The VA doesn't know how many there are."

More from Phillips' WSJ report:

The VA's practice, described in depth here for the first time, sometimes brought veterans relief from their inner demons. Often, however, the surgery left them little more than overgrown children, unable to care for themselves. Many suffered seizures, amnesia and loss of motor skills. Some died from the operation itself.

Mr. Tritz... is one of the few still alive to describe the experience. "It isn't so good up here," he says, rubbing the two shallow divots on the sides of his forehead, bracketing wisps of white hair.

The VA's use of lobotomy, in which doctors severed connections between parts of the brain then thought to control emotions, was known in medical circles in the late 1940s and early 1950s, and is occasionally cited in medical texts. But the VA's practice, never widely publicized, long ago slipped from public view. Even the U.S. Department of Veterans Affairs says it possesses no records detailing the creation and breadth of its lobotomy program.