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Ontario's Leucotomy Program: the Roles of Patient, Physician, and Profession University of Calgary PRISM: University of Calgary's Digital Repository Graduate Studies The Vault: Electronic Theses and Dissertations 2012-10-03 Ontario's Leucotomy Program: The Roles of Patient, Physician, and Profession Collins, Brianne Collins, B. (2012). Ontario's Leucotomy Program: The Roles of Patient, Physician, and Profession (Unpublished master's thesis). University of Calgary, Calgary, AB. doi:10.11575/PRISM/27189 http://hdl.handle.net/11023/294 master thesis University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission. Downloaded from PRISM: https://prism.ucalgary.ca UNIVERSITY OF CALGARY Ontario’s Leucotomy Program: The Roles of Patient, Physician, and Profession by Brianne M. Collins A THESIS SUBMITTED TO THE FACULTY OF GRADUATE STUDIES IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE DEPARTMENT OF PSYCHOLOGY CALGARY, ALBERTA SEPTEMBER, 2012 © Brianne M. Collins 2012 ii Abstract Psychosurgery has a long, colourful, and often tumultuous history in which it has been viewed as both a panacea and a horror-show. Although research on the topic has been conducted in the United States and Europe, very little research exists on psychosurgery in Canada. Where scholars have examined Canada, only a cursory overview of Ontario’s experience has been provided. As a result, many questions remain unanswered including how the program was administrated, how patients were chosen as candidates for the procedure, and who the leucotomized were. In order to address the gap in the literature, this thesis presents a detailed account of psychosurgery in Ontario by investigating the roles of profession, physician, and patient. The leucotomy program in Ontario began in 1941 and continued into the mid-1960s, the process used to administer the treatment was bureaucratically organized and streamlined, and over 1,400 patients were leucotomized during this controversial era. Keywords: Psychosurgery, leucotomy, lobotomy, psychiatry, neurosurgery, mental illness. iii Acknowledgements It is an honour for me to thank my supervisor, Dr. Hank Stam. Without your guidance, wisdom, and encouragement this project would not have been possible. You have been gracious and flexible throughout the process. Thank you for allowing me to research a fascinating topic that proved to be even more exciting and original than we anticipated. I look forward to expanding the project in the years to come! I would also like to show my gratitude to the members of my committee and external examiner—Dr. Goghari, Dr. Stahnisch, and Dr. Bulloch—for your direction and feedback. I am also grateful to the members of the theory program—Dr. Lorrie Radtke, Dr. Dane Burns, Jennifer Moore, Michaela Zverina, and Basia Ellis. You all survived listening to my project repeatedly! Thank you for your valuable insight and ongoing encouragement throughout the process. The completion of this thesis would not have been possible without receipt of the Hewton Bursary from the Centre for Addiction and Mental Health (CAMH) Archives in Toronto, Ontario. The Bursary allowed me to travel to Ontario numerous times to complete my research. I would never have found this funding or a number of archival resources without the help of Jennifer Bazar. I would also like to thank John Court, Archivist at CAMH, for going above and beyond to help me with my research. I would also like to thank the staff at the Museum of Health Care for setting up my visit to see McKenzie’s leucotome and Dr. Ron Pokrupa for sharing your knowledge when we viewed this instrument. I would also like to thank the following for their assistance with my project: the staff at the Archives of Ontario and University of Toronto Archives for considerable assistance and patience before and during my visits, Dr. Mary Mckim for the time you spent sharing your experiences with me, and Jack El-Hai for the gracious provision of an invaluable archival letter from Walter Freeman. I would also like to thank my iv aunt, Stephanie, for your hospitality when I visited Toronto, which allowed me to do my research with limited accommodation costs. Also, thank you for your thoughts and suggestions on my project; you offered valuable insight from another perspective. I owe my deepest gratitude to my parents, Emily and Brian. You have been a constant source of love and encouragement. Thank you for always believing in me, reminding me that I have come so far and that I have the determination to make it. Thank you, mom, for going on the archival trip across Canada with me that made this project possible; it is an experience that I will never forget and a memory I will treasure for the rest of my life. Thank you, dad, for allowing me to steal mom away for a month and supporting our trip from home. I would also like to thank, Kelsey, Brendan, Granny, Robin, Jane, Chrissy, Robby, and Danielle for the laughs, the tears, and the fun. You have all helped me to find balance, positivity, and joy in the last few years. v Table of Contents Abstract ......................................................................................................................................................... ii Acknowledgements......................................................................................................................................iii Table of Contents.......................................................................................................................................... v List of Figures .............................................................................................................................................. vi Chapter 1: Introduction ............................................................................................................................. 1 Chapter 2: Leucotomy Program – Beginning and Development ......................................................... 19 Chapter 3: Leucotomy Process – Admission to Operation ................................................................... 58 Chapter 4: The Recipients of Leucotomy ............................................................................................... 90 Chapter 5: Conclusion............................................................................................................................ 113 References................................................................................................................................................. 118 Appendix A: Leucotomized Patients From Toronto Psychiatric Hospital (1948-1963) .......................... 142 Appendix B: Leucotomized Patients From Ontario, Hospital Hamilton (1952-1966) ............................. 143 vi List of Figures Figure 3.1 Leucotome developed by K.G. McKenzie…………………………………………89 Chapter 1: Introduction Psychosurgery has a long, colourful, and often tumultuous history in which it has been viewed as both a panacea and a horror-show. The term itself can be defined in a number of ways. For the purposes of this thesis, it is defined as “any surgical procedure that attempts to alter, through manipulation of neural tissue, a thought or thought process that is associated with a psychiatric disorder…and that is not caused by any known structural lesion” (Feldman, Alterman, & Goodrich, 2001, p. 945). The most commonly recognized procedure that falls under this description was the prefrontal lobotomy, which was first carried out in 1936. Today, the term describes—though rarely labeled psychosurgery—operations such as cingulotomies used to treat severe obsessive compulsive disorder (e.g., Glannon, 2006) and even deep brain stimulation (DBS) used on treatment-resistant depression (e.g., Kennedy et al., 2011). Although psychosurgical treatments are in contemporary use, there is a lasting negative connotation attached to the term. Despite existing objections or criticisms based on what was done in the past, the development and use of psychosurgery cannot be separated from the context in which it arose and expanded. It is this context, in particular the Canadian context, which is the focus of this thesis. Forays into Psychosurgery Pre-1935 Before psychosurgery began in its most well known form (i.e., lobotomies), there were individuals who began to flirt with the idea that surgical means might be able to ameliorate the plight of those afflicted with mental disease. Gottlieb Burckhardt, a psychiatrist from Switzerland, completed the first contemporary attempt in 1888. His procedure was an attempt to remove portions of the cerebral cortex of half a dozen schizophrenic patients. When he presented his results at a medical congress in 1890, he did not receive a warm reception (Stone, 2001). 2 Despite his meticulous efforts, “Burckhardt’s presentation had shocked the medical community as reckless, reprehensible and clearly immoral” (Stone, 2001, p. 80). Stone (2001) suggested that the response Burckhardt received was a result of very limited knowledge of the brain coupled with hesitation towards the new specialty of brain surgery. The opposition in the medical community proved to be limiting, and Burckhardt was forced to halt his program of research and never operated again (Stone, 2001). Nearly twenty years after Burckhardt’s experimental research in brain
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