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WWII Vets Lobotomy Story: Tragic But Not Scandalous

lobotomy-tools

Some 2000 veterans of World War II were lobotomized by the VA. While tragic, it’s not a scandal.

The story was broken yesterday by WSJ as part of a series called “The Lobotomy Files: Forgotten Soldiers.”

The U.S. government lobotomized roughly 2,000 mentally ill veterans—and likely hundreds more—during and after World War II, according to a cache of forgotten memos, letters and government reports unearthed by The Wall Street Journal. Besieged by psychologically damaged troops returning from the battlefields of North Africa, Europe and the Pacific, the Veterans Administration performed the brain-altering operation on former servicemen it diagnosed as depressives, psychotics and schizophrenics, and occasionally on people identified as homosexuals.

The VA doctors considered themselves conservative in using lobotomy. Nevertheless, desperate for effective psychiatric treatments, they carried out the surgery at VA hospitals spanning the country, from Oregon to Massachusetts, Alabama to South Dakota.

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.

This is not news in the sense of having been previously unknown. Rather, as the title suggests, we’ve simply let it slip down the memory hole.

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.

When told about the program recently, the VA issued a written response: “In the late 1940s and into the 1950s, VA and other physicians throughout the United States and the world debated the utility of lobotomies. The procedure became available to severely ill patients who had not improved with other treatments. Within a few years, the procedure disappeared within VA, and across the United States, as safer and more effective treatments were developed.”

Musty files warehoused in the National Archives show VA doctors resorting to brain surgery as they struggled with a vexing question that absorbs America to this day: How best to treat the psychological crises that afflict soldiers returning from combat.

Between April 1, 1947, and Sept. 30, 1950, VA doctors lobotomized 1,464 veterans at 50 hospitals authorized to perform the surgery, according to agency documents rediscovered by the Journal. Scores of records from 22 of those hospitals list another 466 lobotomies performed outside that time period, bringing the total documented operations to 1,930. Gaps in the records suggest that hundreds of additional operations likely took place at other VA facilities. The vast majority of the patients were men, although some female veterans underwent VA lobotomies, as well.

Lobotomies faded from use after the first major antipsychotic drug, Thorazine, hit the market in the mid-1950s, revolutionizing mental-health care.

The main focus of the WSJ feature, rightly, is on the individuals whose lives were destroyed by this barbaric treatment. That’s a genuine tragedy. The professional charge of physicians, predating by centuries the professionalization of physicians, is to “do no harm.” The VA doctors failed in that duty with heartbreaking consequences.

But this is not another example of government doctors treating our soldiers as subhuman guinea pigs. This is not another Tuskegee Experiment. It was, in fact, the opposite. The VA was applying state-of-the-art medicine with great compassion. Unfortunately, the Dark Ages of mental health treatment ended in living memory; indeed, it’s quite possible they haven’t actually ended.

When World War II began, the U.S. military thought it knew how to stave off the psychiatric issues that had ravaged men in the trenches in the previous world war. It began screening potential recruits for psychological trouble signs and ultimately rejected some 1.8 million American men for World War II service on that basis.

Nevertheless, the military and VA soon found their hospitals overflowing. A 1955 National Research Council study counted 1.2 million active-duty troops admitted to military hospitals during the war itself for psychiatric and neurological wounds, compared with 680,000 for battle injuries.

Desperate for an effective treatment for the worst-off patients (including some mentally ill World War I veterans) the VA embraced lobotomy. At the time, tens of thousands of the procedures were being performed in civilian hospitals, a wave inspired by two of lobotomy’s most avid promoters, neurologist Walter Freeman and neurosurgeon James Watts.

“In practical use, the operation has been found of value in eliminating apprehension, anxiety, depression and compulsions and obsessions with a marked emotional content,” VA Assistant Administrator George Ijams wrote to his boss in July 1943, urging the agency to approve the procedure.

Within a month, VA headquarters set guidelines. It ordered doctors to limit lobotomies to cases “in which other types of treatment, including shock therapy, have failed” and to seek permission of the patient’s nearest relative.

In the late 1940s and early 1950s, there existed no diagnosis of post-traumatic stress disorder, a term that came into vogue after the Vietnam War. Back then, the term was “shell shock” or “battle fatigue.” Many lobotomy patients, however, exhibited symptoms that might now be classified as PTSD, says Dr. Valenstein, the former VA psychiatrist.

“Realistically looking back, the diagnosis didn’t really matter—it was the behaviors,” says psychiatrist Max Fink, 90, who ran a ward in a Kentucky Army hospital in the mid-1940s. He says veterans who couldn’t be controlled through any other technique would sometimes be referred for a lobotomy.

“I didn’t think we knew enough to pick people for lobotomies or not,” says Dr. Fink. “It’s just that we didn’t have anything else to do for them.”

Wikipedia notes that, “The originator of the procedure, António Egas Moniz, shared the Nobel Prize for Physiology or Medicine of 1949 for the ‘discovery of the therapeutic value of leucotomy [the then-accepted name for the practice] in certain psychoses.’” Not surprisingly, then, “he use of the procedure increased dramatically in some countries from the early 1940s and into the 1950s; by 1951, almost 20,000 lobotomies had been performed in the United States. Following the introduction of antipsychotic medications in the mid-1950s lobotomy underwent a gradual but definite decline.”

Indeed, lobotomy wasn’t the only barbarous mental health procedure of the era:

In the early 20th century, the number of patients residing in mental hospitals increased significantly[n 2] while little in the way of effective medical treatment was available.[n 3][9] Lobotomy was one of a series of radical and invasive physical therapies developed in Europe at this time which signaled a break with a psychiatric culture of therapeutic nihilism that had prevailed since the late nineteenth-century.[10] The new “heroic” physical therapies devised during this experimental era,[11] including malarial therapy for general paresis of the insane (1917),[12] deep sleep therapy (1920), insulin shock therapy (1933),cardiazol shock therapy (1934), and electroconvulsive therapy (1938),[13] helped to imbue the then therapeutically moribund and demoralised psychiatric profession with a renewed sense of optimism in the curability of insanity and the potency of their craft.[14] The success of the shock therapies, despite the considerable risk they posed to patients, also helped to accommodate psychiatrists to ever more drastic forms of medical intervention, including lobotomy.[11]

The clinician-historian Joel Braslow argues that from malarial therapy onward to lobotomy, physical psychiatric therapies “spiral closer and closer to the interior of the brain” with this organ increasingly taking “center stage as a source of disease and site of cure.”[15] For Roy Porter, once “the doyen” of medical history,[16] the often violent and invasive psychiatric interventions developed during the 1930s and 1940s are indicative of both the well-intentioned desire of psychiatrists to find some medical means of alleviating the suffering of the vast number of patients then in psychiatric hospitals and also the relative lack of social power of those same patients to resist the increasingly radical and even reckless interventions of asylum doctors.[17] From the perspective of the present, lobotomy has become a disparaged procedure, a byword for medical barbarism and an exemplary instance of the medical trampling of patients’ rights.[18] This viewpoint is to ignore, however, the belief shared by many doctors, patients and family members of the period that, despite potentially catastrophic consequences, the results of lobotomy were seemingly positive in many instances or, at least, they were deemed as such when measured next to the apparent alternative of long-term institutionalisation. Lobotomy, if always controversial, was also for a time part of the medical mainstream, even feted, and regarded as a legitimate if desperate remedy for categories of patients who were otherwise regarded as hopeless.

So, while the “forgotten soldiers” story is awful, it’s not outrageous. It’s simply a reflection of a much different, if nonetheless quite recent, time.

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About James Joyner
James Joyner is the publisher of Outside the Beltway, an associate professor of security studies at the Marine Corps Command and Staff College, and a nonresident senior fellow at the Atlantic Council. He's a former Army officer and Desert Storm vet. He has a PhD in political science from The University of Alabama. Views expressed here are his own. Follow James on Twitter.

Comments

  1. Scott says:

    A 1955 National Research Council study counted 1.2 million active-duty troops admitted to military hospitals during the war itself for psychiatric and neurological wounds, compared with 680,000 for battle injuries.

    What caught my eye was this factoid. There is a tendency to believe that WWII veterans were citizen-soldiers who went, fought, and came home to resume their normal lives. Vietnam and later veterans were somehow “weaker” than the Greatest Generation because they had issues resulting from combat.

    The issues resulting from combat, particularly mental health issues, have always been there but are more forthrightly and publically dealt with today.

    Like or Dislike: Thumb up 8 Thumb down 0

  2. grumpy realist says:

    Also don’t forget that people in mental institutions ended up being used as guinea pigs for a lot of treatments.

    In my family, we have suspicions that the early death of one of my uncles back in the 1950s was linked to some medical experimentation that the family never knew about.

    Like or Dislike: Thumb up 2 Thumb down 0

  3. michael reynolds says:

    Tragedy is the right word.

    Like or Dislike: Thumb up 6 Thumb down 0

  4. David Hamm says:

    Judging by the level of stupidity in the “Government” school system, I think the majority of the lobotomized became School Board members, Principals, Vice-Principals and Administrators.

    Like or Dislike: Thumb up 2 Thumb down 8

  5. Ron Beasley says:

    @Scott: You are absolutely correct. What everyone forgets now is that the Hells Angles started out as veterans who could simply not adjust to normal society.

    Like or Dislike: Thumb up 3 Thumb down 0

  6. Barry says:

    @Scott: “What caught my eye was this factoid. There is a tendency to believe that WWII veterans were citizen-soldiers who went, fought, and came home to resume their normal lives. Vietnam and later veterans were somehow “weaker” than the Greatest Generation because they had issues resulting from combat.

    The issues resulting from combat, particularly mental health issues, have always been there but are more forthrightly and publically dealt with today. ”

    And that just covers hospital admissions. It doesn’t cover alcoholism and other problems which didn’t result in hospitalization.

    Like or Dislike: Thumb up 5 Thumb down 0

  7. JKB says:

    @Scott:

    Well, after the Progs in the media had been successful in turning the combat win over the NVA Tet Offensive, they certainly couldn’t have heros returning to make people question the lie. So they pushed the “baby killer” meme and promoted the mentally disturbed vet theme through TV, movies and books. It was all part of the propaganda campaign to turn victory into surrender into loss.

    It is interesting, the promotion of the VA as the height of government, single provider, medicine. it was only 1992 when the movie Article 99 came out with a much different view.

    Like or Dislike: Thumb up 1 Thumb down 5

  8. Jenos Idanian #13 says:

    It wasn’t just veterans, either…

    Like or Dislike: Thumb up 0 Thumb down 0

  9. michael reynolds says:

    @JKB:

    Sorry to upset your Limbaugh-based world view, but I was alive back then, my father was in Viet Nam and I was paying close attention. Said father, a career soldier, told me when I became eligible for the draft that he would personally drive me to the Canadian border. He knew – everyone but right-wing morons knew – that Viet Nam was a lost cause for a very simple reason: they live there, we don’t. Sooner or later we go home and they don’t.

    The point of Tet was not that we won the battle (we did) but that the NVA and the Viet Cong still had so much reach. They came very close to taking our embassy. We’d been fed lines of b.s. about how the communists were weakening. They weren’t. And how we were getting near the end. We weren’t. That was the lesson of Tet, that we were looking at years and decades and in the end would still, eventually, go home.

    Like or Dislike: Thumb up 6 Thumb down 0

  10. Franklin says:

    @David Hamm: Useless, off-topic, and dumb is no way to go through life, Mr. Hamm.

    Like or Dislike: Thumb up 1 Thumb down 0

  11. Ron Beasley says:

    @michael reynolds: If you listen to or read the Johnson White House tapes you will find that Johnson and McNamara knew the war was unwinnable as early as 1964 or 1965.

    Like or Dislike: Thumb up 3 Thumb down 0

  12. michael reynolds says:

    @Ron Beasley:

    Yep. Speaking of tragedy.

    Like or Dislike: Thumb up 2 Thumb down 0

  13. jd says:

    @michael reynolds:
    No. Speaking of scandal!

    Like or Dislike: Thumb up 0 Thumb down 0

  14. JohnMcC says:

    @JKB: Having actually experienced the VietNam War (37th ARRS, DaNang, ’66-’67) I have to tell you that it just royally p*sses me off when jerks like you and whoever told you that lie expose so much ignorance of MY war in pursuit of some unworthy political objective of your own. There is a pretty good archive of media from the VietNam era available to you on that screen in front of you and you could quickly document your nasty, self-centered remark. So do it, *ssh*le. Or be known as a fool and a coward from this minute on.

    Like or Dislike: Thumb up 6 Thumb down 0

  15. Sanna Huebschmann says:

    What strikes me is, ‘why now?.’ Why, after all these years, did the WSJ just happen to stumble on this?? Something more (or less), to this story…particularly the timing of it.

    Like or Dislike: Thumb up 0 Thumb down 0

  16. wr says:

    If chopping apart the brains of soldiers because they were attracted to other men is not a scandal, then what is? Why get outraged over the Scottsboro Boys? Heck, that was just a product of the thinking of the time. And Nazi medical experiments — they were just working with the attitudes of their time, too.

    Basically the only way to reach Doug’s philosophical approach is to decide we’re the good guys, so whatever we did is good. Which is of course the same way every dictatorial society thinks, too… but that’s okay, because we’re good and they aren’t.

    No matter what we actually do.

    Like or Dislike: Thumb up 0 Thumb down 1

  17. wr says:

    What’s tragic about dopes like JKB and Bit is that the truth about Vietnam is all around them. Robert MacNamara comes out and admits in The Fog of War — not some obscure position paper, but a popular documentary easily available on Netfllix — that everyone in the Johnson administration, up to and including Johnson, knew the war was a lost cause, but they had to keep fighting it or face having Republicans say mean things to them.

    Do you understand, JKB? They knowingly sent youung men to kill and die simply because they didn’t want people talking smack about them.

    And this is the war you continue to defend. Because even though you know the truth, you choose to deny it to fit your obscene philosophy.

    Like or Dislike: Thumb up 2 Thumb down 0

  18. rich winkel says:

    Scandalous is the word for institutionalized munchausen by proxy. The first step toward understanding is an acknowledgement of ignorance, something that psychiatry is no more willing to admit now than it was 60 years ago. Their treatments now are more sophisticated than icepicks, but many are no less degrading and destructive of human potential. Their appointed task and business is to “fix mental illness”, regardless of what that term actually means. And so innocents suffer on the altar of medical arrogance.

    Like or Dislike: Thumb up 0 Thumb down 0