The Pennsylvania State University The Graduate School College of the Liberal Arts ECHOES OF THE SOUL: A RHETORICAL HISTORY OF LOBOTOMY A Dissertation in English by Jenell M. Johnson Copyright 2008 Jenell M. Johnson Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy August 2008 The dissertation of Jenell M. Johnson was reviewed and approved* by the following: Susan Merrill Squier Brill Professor of Women’s Studies and English Dissertation Adviser Chair of Committee Michael Bérubé Paterno Family Professor of English Rosa Eberly Associate Professor of Communication Arts and Sciences and English Stephen H. Browne Professor of Communication Arts and Sciences Robin Schulze Professor of English Head of the English Department *Signatures are on file in the Graduate School ii Abstract Using critical techniques drawn from rhetorical studies, science studies, and cultural studies, Echoes of the Soul: A Rhetorical History of Lobotomy examines one of the most controversial chapters in American medicine by analyzing its rhetorical life in biomedical and popular discourses. Rather than divide these sites of discursive production, this project uses their points of articulation to explore the reciprocal relationship between biomedicine and other forms of culture. Echoes of the Soul first argues for the contribution of a rhetorical perspective to the history of medicine, and then presents lobotomy as a compelling case study. Chapter 2 troubles the demarcation between clinical practice and biomedical research by analyzing the arguments for lobotomy’s contribution to neurophysiology in Walter Freeman and James Watts’ Psychosurgery (1942). The next two chapters trace lobotomy’s rise and fall in American medicine by positioning this trajectory next to the shifting evaluation of the operation in popular discourse from the mid-1930s to the mid-1950s. Chapter 3 analyzes lobotomy’s articulation with anticommunist fictions (novels and films, the “brainwashing” panic, and ultraconservative conspiracy theory) in order to argue for a broader contextualization of lobotomy’s displacement by psychopharmacology in the mid-1950s. Chapter 4 examines the rise and fall of lobotomy in the popular press by connecting shifting arguments for its efficacy with a concomitant shift in the gender of case histories used as evidence for its success or failure. The dissertation’s final chapters explore the use of lobotomy as a mnemonic trope in public debates over other forms of psychiatric neurosurgery. Chapter 5 looks at the rhetorical “return” of lobotomy in public campaigns against psychosurgery iii in the early 1970s, and Chapter 6 concludes with an analysis of the use of lobotomy as a rhetorical-historical device in recent press coverage of vagus nerve and deep brain stimulation. Ultimately, Echoes of the Soul shows how biomedicine interacts rhetorically with other forms of culture and argues that this interaction shapes biomedical development, the construction of a useable medical past, and the ethical commitments that guide our vision for medicine’s future. iv Table of Contents 1 Introduction………………………………….………………. 1 A rhetorical history of medicine……………………………8 Lobotomy in American medicine………………………... 16 Chapter outline………………..……………………….......20 2 A “Beneficent Vivisection”…………………………………. 23 The scholarly scientific book……………………………...25 Psychosurgery……………………………………………..27 Mapping the “silent lobe”…………………………………32 A “beneficient vivisection”………………………………. 41 3 Communist Zombies…………………………………………55 Lobotomy as self-annihilation……………………………. 59 Lobotomy as a political tool……………………………… 65 Lobotomy as a communist weapon………………………. 76 4 “A Different Human Being Forever”……………………… 90 Lobotomy and the popular press…………………………. 93 The miracle of the “miracle cure”…………………………103 “A different human being forever”………………………..111 5 The Rhetorical Return of Lobotomy………………………..122 New technologies, new controversies……………………. 125 The rhetorical return of lobotomy…………………………136 The Senate hearings on psychosurgery……………………145 v Conclusion………………………………………………... 152 6 Conclusion……………………...………...…………………...155 References………………………………………………………….167 vi Acknowledgements Thanks are due first and foremost to my committee chair Susan Squier. I simply could not have asked for a better director, teacher, mentor, and friend. It’s a rare honor to work so closely with someone whose scholarship you have long admired, and Susan’s influence can be felt throughout this project. I thank you from the bottom of my heart. Thanks are due immediately second to my dissertation committee: Michael Bérubé, Rosa Eberly, and Stephen Browne. Thank you for your generous support and understanding as I finished this project. Special thanks to Rosa Eberly, whose impromptu reading of Ginsberg’s “Howl” at a committee meeting inspired this dissertation’s title. Thank you to Jack Selzer, Jeff Nealon, and Keith Gilyard, professors at Penn State whose instruction has been invaluable to my development as a scholar. Thanks, also, to my wonderful professors from the University of Illinois, especially Gail Hawisher, Peter Mortensen, Stephanie Foote, Paula Treichler, Mark Micale, and Debbie Hawhee, who remains a dear mentor and academic role model. Graduate study can be a lonely endeavor without the support of your fellow student travelers. It’s impossible to name them all, but a few deserve special mention: Scott Herring, Angela Ward, Joshua Weiss, Kevin Browne, Shannon Walters, Marika Siegel, Melissa Littlefield, Abram Anders and the incomparable and brilliant Melissa Girard. Thank you to the family of Wilma Ebbitt and their generous endowment of the fellowship and research award that allowed me to travel to the Freeman and Watts archives at George Washington University. I hope that this project honors her memory. vii Thank you to Steven Schiff and the department of Neurosurgery at the Pennsylvania State University medical school, who provided me with the incredible opportunity to present my work in front of practicing psychiatrists and neurosurgeons. I’ve been fortunate to find a home at the University of Wisconsin-Madison while I completed this project. Thank you to the department of Communication Arts, especially Steve Lucas, Chris Garlough, Sue Zaeske, and Rob Asen. Rob Howard and Megan Zuelsdorff, thank you for being my best friends. I’ll miss you. Thank you also to the UW History of Medicine program for letting me sit in on their colloquia. My family has supported my academic career without ever asking when I was going to get a “real” job. Thank you to my parents James and Joy, my sisters Jenna and Jodi, honorary sisters Robyn and Suzanne, and my grandparents: Leonard and Bernice Johnson and Juell and Annabelle Chervestad. And finally, thanks to my husband Michael Xenos, my partner, my best friend and my most valuable colleague. One beautiful day back in Seattle, when he was a graduate student and I was in limbo, we picnicked in the grass and watched the clouds in Lincoln Park. At this point, I had decided to pursue a career in either law or medicine. After I told him of my plans, he said, “you know, you just seem more like an academic to me. Are you sure that’s what you want to do?” Thank you for that, and for everything else. This dissertation is dedicated to my parents, and to my grandfather, Leonard Johnson. viii Pilgrim State’s Rockland’s and Greystone's foetid halls, bickering with the echoes of the soul… Allen Ginsberg, “Howl” ix 1 Introduction: A Rhetorical History of Medicine In 1949, Beulah Jones entered Pilgrim State Psychiatric Center and was diagnosed with dementia praecox, a condition that contemporary psychiatry would diagnose as paranoid schizophrenia. After living at Pilgrim State for four years, Beulah received a prefrontal lobotomy. Recalls daughter Janice Jones-Thomson: My father said that doctors would operate on her brain and this would take the violence out of her, that she would be docile after that. Well, my recollection was there was no change in her behavior other than she lost her higher intellect. She could not sit down and read anymore. She could barely write. She had no long- term memory, it was like everything was right here in this minute, her attention span was thirty seconds (Jones-Thomson). Beulah spent the next forty years in and out of state institutions and halfway houses. After Beulah died in 1989, her granddaughter, medical librarian Christine Hamilton, made it her mission to discover why her grandmother had received the operation. She wrote a number of letters to Pilgrim State requesting her grandmother’s medical records and eventually discovered that lobotomy had been prescribed for Beulah not to cure or even treat her mental illness, but because she had become a “difficult” patient. Hamilton writes that Pilgrim State was “a factory, a warehouse, a prison, and they had no interest in dealing with a rambunctious patient who was making life difficult.” Outraged at the 1 treatment her grandmother and other lobotomy patients had received at the hands of their medical caregivers, Hamilton decided to take action. “As a librarian and historian,” she writes, “I know that this tragedy cannot be glossed over. It must be brought to light and examined by society, the same way the Thalidomide tragedy and the Tuskegee study have been exposed” (Hamilton “Learning”). One of Hamilton’s first actions was to mount a campaign to strip Egas Moniz, the Portuguese neurologist who developed leucotomy (lobotomy), of the Nobel Prize he was awarded for Medicine or Physiology in 1949.1 In Alfred Nobel’s will, the document that established the parameters of the famous competition, Nobel stipulated that the prize for Medicine or Physiology should honor the discovery in the previous year that “conferred the greatest benefit on mankind” (Lindsten and Ringertz). Moniz’s critics do not challenge his claim to be the first to develop a surgical intervention for mental illness. They charge that what it “conferred on mankind” was not benefit but grievous harm. Hamilton’s campaign began after she read an essay on the Nobel Foundation’s website that dismissed criticism of Egas Moniz because there were “no effective alternative therapies” for mental illness when it was developed (Jansson).