How Brave Should Our Brave New World Be?

I always thought lobotomies were the most evil and fiendish crimes against humanity, against “god,” against nature and the universe and puppies. You get the idea. Lobotomies were bad. The most notorious or infamous name associated with lobotomies is Walter Freeman. Those of you who have seen the movie, Frances, saw an actor playing Freeman as he lobotomized an actress (Jessica Lange) playing Frances Farmer. The story of Frances Farmer is one of betrayal. A proud rebel and brilliant actress, herself, Frances Farmer was railroaded into the mental “hygiene” industry by a venomous mother and some right-wing politicians who found her progressive views offensive. Since we know all along that she is not “mentally ill,” we are outraged when we she this permanent solution perpetrated on this heroic woman.

But this blog isn’t about Frances. It’s about the brain. To most people today, Walter francesFreeman was an arch villain. But in his time, Freeman was lionized. Even the New York Times, which only features “all the news that’s fit to print,” wrote valentines to the brave new cure for “mental illness.” In the fullness of time, we found out that the “lucky” recipients of this “cure” were victims of brain mutilation. Some people were clear-sighted enough in those times to speak out  against it. But the current was definitely in Walter Freeman’s favor. The enormity of Freeman’s crimes makes us reflexively label him a monster. That had been my response before I began studying the subject after coming across a fascinating book by an actual victim of Freeman, Howard Dully, whose book, My Lobotomy, dullygives us insight into exactly what it was like to get a lobotomy. To add outrage to infamy, Dully was lobotomized at the tender age of 12. The only reason this happened to him was the fact that his stepmother hated him. She made him the family scapegoat from the time she took up the role of mother to Howard and his brother and her own sons. Her viciousness was only directed at Howard. Like Joan Crawford, Lou was fanatically clean. She showed traits of an anal retentive. Or “tightass” would do just as nicely. Her treatment or, one could say, persecution of Howard, qualify her as a malicious narcissist.

After years of mistreating the boy, Lou decided to find a psychiatric solution. She went from doctor to doctor, describing his terribleness and her own sainthood. But, to her disappointment, none of them agreed with her. They all said Howard was a normal boy. That is, until she consulted with Walter Freeman. To his credit, Freeman didn’t decide all at once that Howard was a candidate for lobotomy. He interviewed various people who knew Howard. Howard’s brother tearfully told Freeman that Howard was fine. Howard had other people speak well of him. Finally, Freeman interviewed the boy, himself. Howard liked Dr. lobotomyFreeman very much. He opened up to him, feeling safe with him. Nevertheless, Freeman decided Howard needed a lobotomy. A date was set for the operation. It was performed in a hospital, unlike many of Freeman’s lobotomies. Under Freeman’s direction, nobody told Howard what was going to happen to him. He was diagnosed as schizophrenic. The lobotomy was performed. Howard woke up very ill with vomiting, headache, stiff neck. Freeman administered penicillin through an injection into Howard’s spine, a procedure pronounced dangerous by other doctors but which Freeman was fond of. He stuck a modified ice pick under the eyelids and broke through the bone to the brain and moved it around. The fact that I have just had cataract surgery and had someone operating on my eyes makes this closer than otherwise.

Another victim of Freeman’s lobotomy was Rosemary Kennedy. Already disabled by malpractice by a nurse at her birth, the lobotomy left her unable to walk or talk.

The blog is also not a review of this fascinating book which I have not even finished reading. The first question I wish to raise is was Walter Freeman a psychopath? He certainly had charm and charisma. He was incredibly glib. While his private practice as a psychiatrist never really took off, Freeman was a popular lecturer. That’s because he was not only a teacher, he was a showman. He made his lectures entertaining. He could have done well in a circus. But he was dealing with brain surgery, not just marks. But is there really so much difference between carnival marks and regular people who are taken in by flashy and talented showmen?

freemanSurgeon is one of the fields in which many psychopaths make their living. Freeman wasn’t really a licensed surgeon but he performed a procedure which most people would consider surgery. As a surgeon, Freeman had little patience with safety. This is one of the reasons he liked to be able to practice without a bona fide surgeon in the room. He took chances, showed the psychopath’s impulsiveness. He probably thought he could avoid mishaps, had the heart of a gambler. This last quality is grandiosity. He was magic. Other doctors needed precautions. He was above all that. Another quality of psychopaths, a willingness to lie to achieve his ends was also at Freeman’s disposal. The results of his surgery were mixed. There were fatalities. There were also people who became unable to function in the real world after the operation. Freeman suppressed this information. He gave the public a glowing account of how people’s lives were saved by his intervention into their brain.

His lack of guilt or remorse would complete the picture. One objection is the fact that Freeman really seemed to believe he was doing good. You don’t have to be a psychopath to feel no guilt for acts of virtue (or even acts one believes are virtuous). But, if he really believed lobotomy was so wonderful, why did he conceal results that didn’t support the glowing report he gave the press (which loved him).

brainscanAnother question raised by the phenomenon of lobotomy is what is the change in personality invoked by “successful” lobotomy compared to psychopathy. The brain of a psychopath has less connection between emotional situations and the pre-frontal lobes. Psychopaths are less emotional than the NT (neuro-typical) brain. James Fallon, a neurologist who discovered by looking at his own brain scan, that he was a psychopath, explains, “in psychoanalytical language, …the ego (dorsal prefrontal cortex) adjudicates the conflict between id drives (amygdala) and the moral context of the superego (orbital/ventromedial cortex).” In lobotomy, “doctors believed that by severing the connections that the frontal lobes, or prefrontal cortex, had to the rest of the brain, they could calm patients’ emotions and stabilize their personalities without doing away with their intelligence and motor functions.” At first glance, it seem like lobotomy promises the same kind of detachment from the activities of the orbital cortex. People do become less inhibited after having a lobotomy. But they certainly lack many of the other skills of a psychopath. Though I am a lay(wo)man and can’t explain all the complexities of the difference, I can show the brain scans of lobobraineach and they are clearly different. First, we can see the difference of a psychopath’s brain from that of an NT. Next, let’s see what a lobotomized brain looks like. The sever-age in the latter is different from the difference in function seen in the brain of a psychopath.

Kevin Dutton wondered what it felt like to be a psychopath. He had some friends who were neurologists. They were able through a connection in his teeth (I’m not making this up) to tweak his amygdala so that he experienced the consciousness of a psychopath for half an hour. In his own words:

It isn’t long before I start to notice a fuzzier, more pervasive, more existential difference. Prior to the experiment, I’d been curious about the timescale, how long it would take me to begin to feel the rush. Now I had the answer: about ten to fifteen minutes. The same amount of time, I guess, that it would take most people to get a buzz out of a beer or a glass of wine.

The effects aren’t entirely dissimilar. An easy, airy confidence. A transcendental loosening of inhibition. The inchoate stirrings of a subjective moral swagger: the encroaching, and somehow strangely spiritual, realization that hell, who gives a shit, anyway?

There is, however, one notable exception. One glaring unmistakable difference between this and the effects of alcohol. The lack of attendant sluggishness. The preservation—in fact, I’d even say enhancement—of attentional acuity and sharpness. An insuperable feeling of heightened, polished awareness. Sure, my conscience certainly feels like it’s been spiked with moral Rohypnol, my anxieties drowned with a half dozen shots of transcranial magnetic Jack Daniel’s. But, at the same time, my whole way of being feels like it’s been sumptuously spring-cleaned with light. My soul, or whatever you want to call it, immersed in a spiritual dishwasher.

So this, I think to myself, is how it feels to be a psychopath. To see through Gary Gilmore’s eyes, To cruise through life knowing that no matter what you say or do, guilt, remorse, shame, pity, fear—all those familiar, everyday warning signals that might normally light up on your psychological dashboard—no longer trouble you.

My mad scientist within can’t help wondering about changing the personality surgically, as an option, not a monstrosity. Of course, the greatest danger, and it is something we must take seriously, is the question of who gets to choose? There are, even as I speak, Frankensteinian fascists who want to “cure” psychopathy by fiddling with our brains. If we could (somehow) guarantee that only the individual whose brain is in question decides what changes, if any, be performed on their brain. People wracked by conscience could become psychopaths. Or psychopaths could choose to get a conscience. Yeah, right. There’s no end to the fantasy possibilities that would unfold if we had the technology in our hands. First, we would have to find a way to cure mankind of the penchant to control others. Which will probably never happen. But we already experiment in changing ourselves. What else do drugs do but that? And some of the best drugs were developed by the army. Talk about turning weapons into plowshares.  I have just heard about a “new” drug called DMT. New to us, perhaps, but not to shamans. It is supposed to be the most powerful psychedelic in the world. I’ve done my psychedelics and now I feel as if I’m missing something. See the Luck Otter Haven blog.

Kristin Hovet, writing in The Establishment, discussed Ethical Dilemmas in Putting An End to Psychopathy. My mind jumped immediately to the nightmare of brain surgery to implant chips or otherwise for people to change radically. These ideas have actually been discussed. Kristin Hovet linked to Biologizing Psychopathy: Ethical, Legal, and Research Implications at the Interface of Epigenetics and Chronic Antisocial Conduct. Unfortunately, the title of this article is almost longer than the article itself. I want to know exactly what might be unethical. How far would they go? But Ms. Hovet’s article is mostly focused on prevention by intervening in the lives of children with “callous unemotional” traits. She sees psychopathy as the product of epigenetics, heredity plus environment working interactively. The article is vague about what these interventions would entail. “It’s easy to imagine a situation where both testing and treatments become forced on lower-class citizens, due to widespread misconceptions about psychopathy, criminality, and the impoverished.”

Another drug worth notice is Provigil, aka Modafinil. It promotes focus and alertness but isn’t a stimulant. It has been liked to the (fictitious) drug in Limitless.

The bottom line is in whose hands should the ability to change the brain reside. In the hands of the scientists who make it possible? Of course. They should have the negative power to refuse to use their skills if they wish. But only the person whose brain is to be changed should have the positive power of choice. We should be able to chose what is done to our brains (providing the creator of the technology agrees). Nobody should ever force this change on anyone else.

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