In April 2023, a Twitter post discussed the inventor of the lobotomy and how he was lauded for what was a controversial and often poorly done procedure.
Eli David, who also has expressed anti-vaccination views on his Twitter account, wrote, "'The science was settled'", and the inventor of lobotomy received the Nobel Prize for medicine in 1949. The science is never settled. Never blindly trust the experts, and never 'believe in science'."
"The science was settled", and the inventor of lobotomy received the Nobel Prize for medicine in 1949.
The science is never settled. Never blindly trust the experts, and never "believe in science". pic.twitter.com/My30CSNnOm
— Dr. Eli David (@DrEliDavid) April 30, 2023
Egas Moniz, a Portuguese scientist who pioneered the use of the lobotomy to treat mentally ill patients, did indeed win the Nobel Prize for this work in 1949. Per the Nobel Prize website, he was awarded "for his discovery of the therapeutic value of leucotomy in certain psychoses."
However, the apparent "advertisement" in David's post appears suspect. Terms like "PTSD" also known as "post traumatic stress disorder (PTSD)" were first used in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-lll) by the American Psychiatric Association. Around this time lobotomies had grown rarer and operated in a totally different medical landscape than in their heyday. While the above post is correct in its claim about the Nobel Prize, the "ad" it is sharing is likely fake.
Leucotomy, which was later termed lobotomy, consisted of incisions that destroyed connections between the prefrontal region and other parts of the brain, and was often used in the treatment of schizophrenia, among other mental disorders.
According to a 2014 paper on Moniz in the Singapore Medical Journal, Moniz believed that "certain obsessive and melancholic persons could be helped if their frontal lobes were excised." The paper detailed his first operation that was lauded by the Nobel committee:
In order to accomplish the leucotomy, Moniz again worked with Lima to develop a needle-like instrument with a retractable wire loop. The instrument, named a leucotome, allowed the wire to travel through the posterior aspect of the frontal lobe, cutting through the white matter fibres of the brain. In earlier procedures, Moniz used absolute alcohol to destroy the frontal lobe. Moniz's first psychosurgery, performed on 12 November 1935, was described by the Nobel Committee as one of the most important discoveries ever made in psychiatric medicine. In that case, the patient was a 63-year-old woman suffering from depression, anxiety, paranoia, hallucinations and insomnia. Barahona Fernandes, a psychiatrist, evaluated the patient two months following the alcohol injection to the frontal lobes, remarking that "the patient's anxiety and restlessness had declined rapidly with a concomitant marked attenuation of paranoid features".
While it is true that Moniz was awarded for a controversial procedure, his win should be taken into context. At the time it was considered by many scientists as a good solution because the alternative was seen as worse: mental asylums filled with patients who were mistreated and often subjected to physical violence. However, the procedure also had increasingly poor results, and scientists turned their backs on it by the 1950s.
Henry Marsh, a former psychiatric nurse who used to see lobotomized patients and later became an eminent neurosurgeon, told the BBC, "It reflected very bad medicine, bad science, because it was clear the patients who were subjected to this procedure were never followed up properly. If you saw the patient after the operation they'd seem alright, they'd walk and talk and say thank you doctor. The fact they were totally ruined as social human beings probably didn't count."
The Singapore Medical Journal also noted, "Unarguably more manageable post lobotomy, lobotomised patients were also left with irreversible changes in their persona, and were described as mental invalids and drooling zombies. Moniz himself came under attack for understating the complications, inadequate documentation and poor patient follow-up."
According to the Nobel Prize website, "The operation was widespread during the 1940s and 1950s, but it became apparent that it could lead to serious personality changes. The use of lobotomies declined drastically when medications for mental illness were developed during the 1950s."
While poor scientific practice has long been a part of human history, that should not be a reason to encourage a blanket distrust of scientists and doctors today. Comparing a scientific invention from almost a century ago to innovations today ignores necessary context.
