[Paleopsych] NYTDBR: The Brain: False Assumptions and Cruel Operations

[Premise Checker]

The Brain: False Assumptions and Cruel Operations
http://www.nytimes.com/2005/01/26/books/26grim.html
January 26, 2005

BOOKS OF THE TIMES
The Brain: False Assumptions and Cruel Operations
By WILLIAM GRIMES

POSTCARDS FROM THE BRAIN MUSEUM
The Improbable Search for Meaning in the Matter of Famous Minds
By Brian Burrell
Illustrated. 356 pages. Broadway Books. $24.95.

THE LOBOTOMIST
A Maverick Medical Genius and His Tragic Quest to Rid the World of
Mental Illness
By Jack El-Hai
Illustrated. 362 pages. John Wiley & Sons. $27.95.

    In the summer of 1849, Walt Whitman walked into an office on Nassau
    Street in Manhattan to have his head read. Lorenzo Niles Fowler, a
    phrenologist, palpated 35 areas on both sides of the skull
    corresponding to emotional or intellectual capacities in the brain.
    Fowler rated each one on a scale of 1 to 7, with 6 representing the
    ideal (7 meant dangerous excess).

    Whitman received a perfect score in nearly every one of Fowler's
    categories, which bore such fanciful names as "amativeness,"
    "adhesiveness" and "combativeness." Thrilled with his report card, he
    became an instant convert to phrenology, defined by Ambrose Bierce as
    "the science of picking a man's pocket through the scalp." Later he
    donated his magnificent brain to the American Anthropometric Society,
    which collected it on his death in 1892 and added it to its collection
    of elite brains.

    There are quite a few such collections, scattered around the globe,
    and Brian Burrell visits all of them in his offbeat scientific tour in
    "Postcards From the Brain Museum." His wanderings take him from the
    Musée de l'Homme in Paris and the Wistar Institute of Anatomy and
    Biology in Philadelphia to the impressively stocked Institute of the
    Brain in Moscow, where the brains of Lenin, Stalin, Eisenstein and
    Pavlov lie in state, or states, having been sliced into thousands of
    paper-thin slices and stained for scientific study.

    But the study of what, exactly? Nothing at all, it turns out. The
    brains, many of them dried to the consistency of coal, or fraying
    badly in their formaldehyde baths, simply take up space in glass jars.
    In many cases they are inaccessible to the general public, relics of a
    bygone age when scientists believed that the brains of geniuses and
    criminals would certainly, when examined, display distinctive physical
    characteristics. They were wrong. But for most of the 19th century it
    seemed as if they might be right. Their doomed efforts provide Mr.
    Burrell with the material for his entertaining, tragicomic tale of
    scientific failure.

    Blame Byron. After his death in 1824, Greek doctors removed his heart,
    a common practice, but his brain as well. It was prodigious, weighing
    in at 6 pounds, at least 25 percent larger than the average, a
    striking confirmation of the theory linking brain size and genius.
    Three years later, Beethoven died. His brain too was examined,
    revealing convolutions twice as numerous and fissures twice as deep as
    the ordinary brain.

    These eminent and distinctive brains set scientists off and running to
    map the brain and the skull and thereby explain the workings of the
    mind. During what the author calls "the golden age of brain
    collecting," from 1880 to 1910, hundreds of eminent men and women
    joined autopsy societies and donated their brains, hoping to receive
    the kind of validation that Whitman received in 1849.

    Unfortunately, the brains did not cooperate. Some geniuses turned out
    to have unusually small brains. Criminals and social degenerates often
    showed the same folds as scientists and artists. Faced with
    conflicting evidence, leading theorists of the brain fudged,
    temporized or dug in their heels. Eventually, the entire jerry-built
    theoretical apparatus simply collapsed, although as a myth or symbol,
    the brain still retained considerable power. As the Germans closed in
    on Moscow, the high command drew up plans to seize Lenin's brain and
    take it back to Berlin. When Einstein died, an overeager pathologist
    in the hospital removed his brain and took it home, intent on
    discovering the secrets concealed within. Alas, there were none to be
    found.

    Walter Freeman worked on more brains than all the 19th-century
    phrenologists and "cranioscopists" put together. From the mid-1930's
    to the late 60's, he performed some 3,500 lobotomies on
    psychologically disturbed patients, a procedure that, thanks to his
    tireless crusading, became a standard method of treatment in mental
    hospitals across the United States before the advent of drugs like
    Thorazine and Prozac.

    In "The Lobotomist," Jack El-Hai's lively biography, Freeman comes
    across as a classic American type, a do-gooder and a go-getter with a
    bit of the huckster thrown in. Trained as a neurologist, he found a
    position at St. Elizabeths, a large mental hospital in Washington,
    D.C., which, like most institutions then simply warehoused the
    mentally ill. Freeman was appalled at this waste of human potential.
    Convinced that mental illness stemmed from organic causes, he searched
    for a neurological solution and found it in a new procedure, developed
    by a Portuguese doctor and eventual Nobel laureate, Egas Moniz, who
    simply cut through neural pathways in the frontal lobes that, he
    believed, produced harmful or obsessive behavior. Freeman, who
    dismissed psychoanalysis as a sheer waste of time, jumped at Moniz's
    new procedure. "Here was something tangible, something that an
    organicist like myself could understand and appreciate," he later
    wrote. "A vision of the future unfolded." He formed a partnership with
    a skilled neurosurgeon, James Watts, and very quickly developed his
    own procedure, prefrontal lobotomy, which entailed drilling two holes
    in the skull, above the left and right frontal lobes, and then
    removing a dozen cores of white neural fibers.

    From the beginning, results varied wildly. One early patient simply
    rose from his hospital bed on Christmas Eve, put on his hat over the
    bandages and headed straight for a local saloon to celebrate. Another
    patient, a 60-year-old woman suffering from agitated depression,
    became paralyzed on her left side a few hours after the operation,
    lost the ability to speak, and fell into a coma. She died six days
    later. More typical were patients who experienced temporary relief
    from anxiety, obsessions, or hallucinations but later slipped back
    into severe metal illness, or who became strangely apathetic and
    lacking in spontaneity. One of his less successful patients was
    Rosemary Kennedy, a sister of John F. Kennedy, who underwent a
    lobotomy for agitated depression in 1941 but remained
    institutionalized for the rest of her life.

    Freeman had a high tolerance for failure. He was taking difficult
    cases and, as often as not, making it possible for them to go home and
    put together some semblance of a normal life. In time, he developed a
    new technique, transorbital lobotomy, that eliminated many of the side
    effects of prefrontal lobotomy by entering the brain through the eye
    socket rather than the cranium. The new procedure was quick. In 1952,
    Freeman once performed 25 transorbital lobotomies in a single day.
    This was the sort of stunt that caused Freeman's professional
    colleagues to eye him suspiciously. "I thought I was seeing a circus
    act," a student nurse said, recalling a performance in which Freeman
    used both hands at once to cut nerve fibers on both sides of a
    patient's brain simultaneously. Psychoanalysts regarded Freeman with
    contempt, and many doctors recoiled at destroying healthy brain
    tissue. Freeman, a flamboyant figure who affected a cane, a
    broad-brimmed hat and a long goatee, invited controversy by his
    slapdash approach to research and his love of the spotlight.

    His enemies triumphed. By the mid-1950's, psychoanalysis and the
    appearance of new drugs like Thorazine spelled the end of the lobotomy
    in the United States. Freeman, once hailed as a visionary, now seems
    little more than a curiosity, another specimen in the brain museum.