Lobotomy

“ . . . the clinical frame for psychosurgery was not defined in reference to a single idealized clinical type but was varied in accordance with the region of the hospital’s clinical ecology in which the patient happened to be located. Tellingly, within each of these different sectors the procedure was used for different functions. Experience had taught the McLean staff that, for the kinds of female patient they referred to as involutionals and manic-depressives, their mental disturbance was likely to clear up on its own and was unlikely to lead to very long-term institutionalization. As there was no immediate pressure, the use of the operation was thus limited to those patient for whom even longer periods of hospitalization were unlikely to yield further hope of discharge. In the case of male schizophrenics and female catatonic schizophrenics, however, an opposite tactic appears. Such patients were operated on after only a moderate waiting period had elapsed, in the hope of preventing them from slipping into the pool of chronic schizophrenics which, in the hospital staff’s experience, was considered certain doom. The most extensive selection was of female paranoid schizophrenics, who presented the worst clinical scenario . . . the strategy here was to operate early and often” (Pressman, 299).