The LobotomistWord格式.docx
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The LobotomistWord格式.docx
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Heretheskullisthinenoughtotransmitlightanditcanusuallybeperforatedeasilywithasharpinstrument.
Hailedbysomeasanangelofmercy,hewasdenouncedbyothersasamedicalmonster.
EdwardShorter,MedicalHistorian:
Hewasanapostle,hewasacrusader.Hewasgenuinelyconvincedoftheeffectivenessofwhathewasdoing.
Theinstrumentuponremovalappearsclearandshiny.
GarrettSwain,M.D.:
IthoughthewasthenearestthingtoageniusthatIhadevermet;
Ialsothoughthewascrazyashell.
WhydidmainstreammedicinegoalongwithWalterFreeman?
RobertWhitaker,Writer:
Thelessonhereisnothowamancangoofftherails,butishowsciencecangoofftherails.
Physicianswereseenasdemigodsinwhite.Theywerealllordsofthemanor.Theycouldallorderitbedone,whatevertheywantedtobedone.
Waslobotomyamedicalbreakthroughoramonstrousmistake?
FranklinFreeman,sonofWalterFreeman:
Youcouldnevertalkaboutasuccessfullobotomy.Youmightaswelltalkaboutasuccessfulautomobileaccident.
ElliotS.Valenstein,ProfessorofNeuroscience:
Somepeopledidshowconsiderableimprovement,anddidresumesomekindofnormallife.
Hewasallowedtogohomeagainandobtainemploymentasadoor-to-doorsalesman.
Janice:
Myfathersaidthatdoctorswouldoperateonherbrainandthiswouldtaketheviolenceoutofher--thatshewouldbedocileafterthat.
Istheabsenceofpainwhatweshouldlookfor?
Istheabsenceofsuffering?
That'
swhatthisraisessomuchiswhatdowevalueaboutbeinghuman?
TitleCard:
TheLobotomist
OnacoldJanuarydayin1946,EllenIonesco,a29-year-oldhousewifeandmother,arrivedattheWashington,D.C.officeofDr.WalterJ.Freeman.Withherwashersix-year-olddaughterAngelene.
AngeleneForester,daughterofpatient:
Mymotheralwaysactedalittle,sortofaloof.Andyoujustaccepted,that'
sMommy.Mommy'
sthatway.Butitgotmoreandmore.Andthetimecamewhenshewassodepressedshewouldstayinbedforliterallydays.Irememberherpointinguptotheceilingandsaying,doyouseethosewires,that'
swhattheytorturemewith.Thenshestartedgettingmoreviolentandaggressive.Andonedayshetriedtosmotherme.AndfinallywetookhertoseeDr.Freeman.
ReadingfromaWalterFreemanpatientrecord:
ExaminedEllenI.thismorning.Shehassuicidalideas.Shebecamemoreandmorenoisy,shouting,"
I'
msotired,I'
msotired."
Idecidedshewasquiteinaccessibleandwouldrequireimmediatetreatment.
Whenwewentintohisofficethewholewallwaslikewindowsandsunlightstreamingin.Itwasbrightandcheerful.AndDr.Freemancameoutandhelookedkindlyandgentle,very,verygentleandIfelt,we'
regoingtobeokay.
FreemanescortedEllentoabackroomandshutthedoor.
Ihadnoideawhatwasgoingonbehindthatdoor.Butshechangedsoradicallyforthebetteroncehehadseenher.Shenevermentionedsuicideagain.
EllenIonescowasthefirstpatienttoundergotheprocedureDr.Freemanhadperfectedonlyweeksbefore.Hecalledit"
transorbitallobotomy."
JackEl-Hai,Writer:
Inatransorbitallobotomy,Freemanwouldfirsthavethepatientrenderedunconsciousthroughtheuseoftheelectroconvulsiveshockmachine.
Justbeforehethrewtheswitch,weallhadalayingonofhands.Andwewentforalittleride.
Usuallythreesuccessiveconvulsionsarenecessarybutinoldpeopleasingleonemaybesufficientwhileinasturdyyoungpersonfourorevensixconvulsionsmaybeadministeredwithoutdanger.
AndrewScull,ProfessorofSociology:
Thepatientwouldthenenterunconsciousnessforarelativelybriefperiodbutseveralminutes.
Nowthattheconvulsionhassubsidedthenurseholdsatoweloverthenoseandmouthofthepatient.
Freemanwouldpeelbackeacheyelid,inserthisicepickandwithahammertapthroughthebrain,wiggleitabout,severthefrontallobes,withdrawit.Andwhenthepatientcameto,heorshewouldbegivendarkglassestohidetheblackeyesthey'
dbeengiven.
Ifeltlikehehadgivenmeatremendousgifttogivemymotherbacktome.Hegaveyouhope.Everythingwillbebetteranditwas.
Twenty-twoyearsearlier,in1924,neurologistWalterFreemanarrivedatSt.ElizabethsinWashingtonD.C.,oneofthenation'
slargesthospitalsforthementallyill.At28,FreemanwastheyoungestlaboratorydirectorinSt.Elizabeths'
history.Butheconfrontedaninstitutionincrisis.Likemanyotherstatehospitals,St.Elizabethshadseenyearsofdecline.Ithadbecomeadumpinggroundforpatientssufferingfromagitateddepression,dementiaandpsychosis.
Itwasclearinthosedayswhenyouwerecommittedtoamentalhospital,thiswasnotavoluntaryaffair,therewasnowayout.Therewouldbenotreatmentbecausethere'
snothingseriouslythatanyonecoulddo.Thesewerewarehousesforpeoplethatsocietywantedtoforget.
Youhavethisenormouspopulationofpatientssmearingtheirexcrementonthewalls,tearingofftheirclothes,sittingbefuddledonthefloor,dayafterendlessday.Yousay,"
Howcouldpeoplelivelikethis?
Howcouldtheybeforcedtolivelikethis?
"
AshewanderedSt.Elizabethsvastpatientwards,Freemanlaterwrote,hewasfilledwitha"
weirdmixtureoffear,disgustandshame."
Hewasrepelledbywhathesaw.Hewasalmostnauseatedbywhathesaw.Hesaw5,000peoplewhoselivesweregoingnowhere,wouldgonowhere.Andhewanted,Ithink,rightawaytotryanddosomethingaboutit.
Freeman:
Hesawthenatureofillnessnotassomethingthatrequiredsympathybutassomethingthatrequiredaction.Dosomething.Hewantedtosolvetheproblemsofpsychiatry,andhewantedtodoitfast.
Likemostneurologists,Freemanbelievedthatphysicaldefectsinthebraincausedmentalillness.Scientistshadalreadyshownthatthebrainwasmadeupofdistinctregions,eachcontrollingdifferentphysical,behavioralandemotionalreactions.Buttheyhadstillnotfoundthelocusofmentalillness,andwerenearlypowerlesstotreatit.
Theywouldtrytotreatsymptoms.Andtheycouldn'
ttreatallthesymptoms.Ifyouwereonthevergeofsuicide,therewasnothingthattheycoulddoexceptwatchyouuntilyoufinallyrecoveredspontaneouslyfromyourmelancholia.Andanepisodeofmelancholiacouldgoonforsevenoreightmonths.Andthatissevenoreightmonthsofhell.
Inthe1930s,researchersbeganexperimentingwithanumberofso-called"
shocktherapies"
meanttoreroutethecircuitryinthediseasedbrain.Patientswerebroughttotheedgeofdeaththroughanintentionaloverdoseofthehormoneinsulin.OthersweregivenMetrazolwhichtriggeredseizuressoviolenttheyoftenfracturedvertebrae.
Ifyoulookatthepatientwritingsafterthis,theytalkedabout,"
Doctor,whyareyoutorturingme?
Areyougoingtokillme?
Please,"
theywouldbeg,"
don'
tdothistomeagain."
Butafterpeopleleftthattabletheywerequieter,theyweremoresubdued,andtheywouldoftengobacktotheirwardsandnotbebothersomeforaperiodoftime.
Theseshocktherapiesoftenworkedbythestandardsthattheywereoperatingonatthattime,notacureforthedisease,notmakingsomeonecompletelybetter,butreducingsomeofthesymptoms.Andyes,theshocktherapiesachievedthatatacost.
ForFreeman,shocktherapiesprovedthatmentalillnessresultedfromadefectsomewhereinthebrain,andhewantedtobetheonetofindit.ThescionofaprominentmedicalfamilyfromPhiladelphia,WalterFreemanhadalwaysbelievedhewasdestinedforgreatthings.HisgrandfatherWilliamKeenwas,foratime,America'
smostfamoussurgeon,thefirsttosuccessfullyremoveabraintumorfromalivingpatient.Keenwasashowmanwholovedtoperformhiscomplexoperationsinfrontoflargeandadmiringaudiences.
Hewasjustoneofthesemenwhohadjustboundlessenergyandenthusiasm,apioneerbrainsurgeon,atonetime,apresidentoftheAmericanMedicalAssociation.Asayoungmanmyfatherwasdeterminedtobeassuccessfulashisgrandfather.
AftergraduatingfromtheUniversityofPennsylvaniamedicalschoolin1920,FreemanmarriedMarjorieFranklin,aneconomist.ThecouplemovedtoWashington,DC,wheretheyhadfourchildreninasmanyyears.ButFreemanwasincreasinglyobsessedwithasearchforaneffectivetreatmentformentalillness.
HewantedtobeagreatfigureinAmericanmedicine.Sothisisamanwhoisconvincedthathe'
sborntomedicalgreatness,desperatetoachieveit,lookingforarouteforward.
Leavinghisgrowingfamilybehind,FreemanspentlongdaysandnightsinSt.Elizabeths'
basementmorguemeasur
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