Summary:
Perhaps no topic in the history of
medicine has been explored as much as the lobotomy. Psychiatrists, historians and journalists have
weighed in on this controversial topic, and the procedure has been featured in a
number of Hollywood films.
Yet there is nothing like a
narrative of a specific lobotomy patient to draw us into the subject anew. And that is why Kate Clifford Larson’s new
book, Rosemary: The Forgotten Kennedy
Daughter, is so compelling—even if we already know the sad outcome of
Rosemary Kennedy’s life.
Originally devised in 1935 by the Portuguese neurologist Egas Moniz, the
lobotomy involved drilling holes in the skull and using a blade to sever nerve
fibers running from the frontal lobes to the rest of the brain. Moniz believed that psychiatric symptoms were
caused by longstanding faulty nerve connections. Severing them, and allowing new connections
to form, he postulated, would help treat patients with intractable mental
illness, such as schizophrenia and its paranoid delusions.
America’s chief proponent of lobotomy
was Washington, D.C. neurologist Walter J. Freeman who, working with
neurosurgeon James W. Watts, reported in 1937 that 13 of 20 patients undergoing
the operation had improved. Freeman
would later devise his own procedure, the transorbital lobotomy, in which he actually
used a mallet to pound an ice pick through the patient’s eye socket into the
brain, then moved the pick around blindly to cut the nerve fibers.
Among the first histories of
lobotomy was psychologist Elliot S. Valenstein’s Great
and Desperate Cures (1986), which strongly criticized Freeman and his
contemporaries as overzealous physicians who did far more harm than good,
creating docile and apathetic individuals no longer capable of caring for
themselves. Physician-historian Joel
Braslow’s Mental Ills and Bodily Cures (1997)
argued convincingly that a main motivation for the popularity of lobotomies—roughly
40,000 would be performed in the United States by the 1960s—was to enable staff
members to maintain order in crowded, understaffed institutions. In Last Resort (1998), historian Jack D.
Pressman made the provocative claim that lobotomy represented the best science
of the day and that, at least in some cases, it allowed patients to return home
with fewer psychiatric symptoms.
Rosemary Kennedy was born in 1918,
the third of what would eventually be nine children of Joseph and Rose Kennedy. Joe was a successful businessman and investor
who later entered politics, first as chairman of the Securities and Exchange
Commission from 1932 to 1935 and then as U.S. Ambassador to Britain from 1938
to 1940. At an early age, it was clear
that Rosemary was not as mentally sharp as her two older brothers, Joe Jr. and
John. Larson hypothesizes that
Rosemary’s “intellectual disability” occurred at birth, when a nurse forcibly
kept her in her mother’s womb—perhaps without adequate oxygenation—while
waiting for the doctor to arrive.
It was Rosemary’s blessing and curse
to be born into the high-powered and prominent Kennedy family. Her parents left no stone unturned in trying
to help their daughter, sending her to special schools and programs around the
world. But they simply could not
tolerate her lack of improvement.
Rosemary was a terrible speller and writer, socially awkward and at
times unruly. Joe Sr., in particular,
worried about the negative ramifications to his sons’ possible political
careers if word got out about their “retarded” sister.
Reading about Rosemary’s first two
decades, and knowing that her lobotomy is approaching, is truly
heartbreaking. Writing letters home from
her various placements, she was so eager to please. “I would do anything to make you happy,” she
told her father in 1934 at the age of 16.
“I hate to Disppoint [sic] you in anyway.”
When the Kennedys first arrived in
England in 1938, Rosemary, her mother Rose and her younger sister Kathleen were
presented to the king and queen. For
once, the circumstances tilted in Rosemary’s favor. The event was smashing. Photographs show Rosemary, who had become a very
attractive young woman, resplendent in a “picture dress of white tulle.” She felt, she said, like Cinderella.
But when the family returned to the
United States in 1940, with war approaching in Europe, the situation was no
different than it had always been. Plus,
now in her early twenties, Rosemary’s moodiness and emotional outbursts were
becoming more frequent.
Lobotomy had gotten a lot of press
in 1941, particularly in a May article in the Saturday Evening Post that highlighted the work of Freeman and
Watts. And while this piece warned about
the dangers of the procedure, it mostly praised its ability to make people with
mental illness into “useful members of society.” At some point, Joe Kennedy met with Freeman
and decided that Rosemary should undergo the operation. Larson does not unearth exactly how the
decision was reached—or what Rosemary was told.
But it seems to mostly have been Joe’s doing.
The
problem, of course, was that lobotomy was not meant for what Rosemary
had—essentially a low IQ. But Joseph
Kennedy, in conjunction with her doctors, had convinced himself she had an
“agitated depression,” and thus was a candidate. That Freeman was a zealot for the operation,
as is well documented in journalist Jack El-Hai’s The Lobotomist (2005), did not help. Most tragically, when Rosemary underwent her
lobotomy some time in November 1941, something went “horribly awry.” Patients were kept awake during the procedure
and asked to talk or sing to help guide the surgeon’s scalpel. But in Rosemary’s case, when Watts made his
final cut of brain tissue, she became incoherent. “The operation,” Larson writes, “destroyed a
crucial part of Rosemary’s brain and erased years of emotional, physical and
intellectual development, leaving her completely incapable of taking care of
herself.”
The rest of Rosemary discusses her life after the lobotomy until her death in
2005. She spent most of these years at a
Catholic residential institution in Wisconsin.
Most cruelly, family members rarely visited, trying to render invisible
what had happened. To the Kennedys’
credit, in later years they corrected this error and brought Rosemary for
visits to Hyannis Post and other family outposts. There are only a few photographs in the book
from this later era, but they help to humanize the woman who suffered for so
long.
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