A Neuroscientist Reads Foucault 4: Discipline and Punish & Howard Dully’s memoir, “My Lobotomy”

Having read now portions of Abnormal, History of Madness, and Discipline and Punish, I’ve been noticing important overlapping themes – imprisonment, exile, the relationship between the pathological and the criminal.  In Discipline and Punish, the first section traverses the dislocation of punishment from the body to the mind. In a similar vein, in Abnormal, we witness the dislocation of abnormality, or pathology, from the societal body, to the individual within his kin group, finally narrowing down to the child and his parents and doctors.

I’d like to bring these themes to bear on the 2012 book by Howard Dully, “My Lobotomy”. I read this book for reasons unrelated to Foucault, but was struck by how Dully’s account of his life seems to reflect Foucaultian notions of power, punishment, and the medico-legal apparatus.

In this memoir, we see these two processes come down to bear on a single pressure point, a 12 year old boy. Conspiring together, his step-mother and a physician she tracked down, Walter Freeman, decide to cut the connections between Howard’s prefrontal cortex and the major thalamic radiation using a modified ice pick. It was thought, at the time, that the frontal lobes were the seat of reason. By damaging them, the surgery promised to make the patient more docile and tractable. A physical violence on the body that was intended to “correct” the mind.

“If the penalty in its most severe forms no longer addresses itself to the body, on what does it lay hold? The answer of the theoreticians – those who, about 1760, opened up a new period that is not yet at an end – is simple, almost obvious […] if it is no longer the body, it must be the soul. The expiation that once rained down upon the body must be replaced by a punishment that acts in depth on the heart, the thoughts, the will, the inclinations.” (Discipline and Punish, p. 16)

“The first time Mrs. Dully saw the boy she thought he was a spastic because of his awkward swing of the arms in walking and a peculiar gait. He seems to have poor muscular control but he’s good at many of the athletic games at school. He dislikes to work with his hands; he doesn’t build […] He objects to going to bed but then sleeps well. […] He does a good deal of daydreaming and when asked about it, he says: ‘I don’t know.'” (Walter Freeman’s medical notes from his interview with Mrs. Dully before the procedure, as quoted in My Lobotomy, p. 77)

Previous to the surgery, Howard was in school and other than having been caught stealing a yo-yo, seemed like a fairly unremarkable pre-teen. He was enrolled in school, and was passing his coursework. After the lobotomy, things are very different. Howard goes from a child who had occasional disciplinary issues to a teenager who doesn’t belong anywhere. He cannot stay at home. His parents cannot afford to send him to foster care. And so he ends up being institutionalized.

“Because I was not a criminal, because I had not been charged with anything, the people at Juvenile Hall couldn’t hold me. Because they’d determined I wasn’t psychotic, Napa State Hospital wouldn’t make room for me there. Because my dad wouldn’t allow me to be adopted, I couldn’t go live with the McGraws – the only family that seemed to want me. So, somehow, the people in charge of my welfare decided I should be sent to Agnews, the great asylum for the insane.” (My Lobotomy, p. 131)

It’s during this portion of the book that we witness the themes of Discipline and Punish, Abnormal, and History of Madness converge on one individual’s life. He is sent to juvenile hall (a form of prison). Later, he is institutionalized in an insane asylum. Then, as an adult, he returns to prison. Then back to the asylum. He also spends time in halfway houses and has periods of homelessness. The book, ultimately, and necessarily, spends the bulk of its pages retracing Dully’s hard-won climb back into society, and his reclaiming of himself. His rapid movement between spaces for delinquents, for criminals, for special education, and for the insane reveals how transmutable the diagnosis is.

In reading the memoir, you get the distinct impression that the lobotomy made the criminal, the abnormal. Dully describes feeling like a “freak” because he had a lobotomy, not a freak who had a lobotomy, or a delinquent who was cured by lobotomy.

Which is not what I was expecting. I read the book looking for some kind of deep insight into what lobotomy does to the person, a sort of before-and-after scenario. But, of course, the person being lobotomized cannot tell you what has changed inside him or her. It is precisely the substrate that would form these impressions that is being traumatized. Howard Dully cannot tell us if or how the lobotomy changed him. When Dully says he felt like a freak, it is not because of the way the lobotomy made him feel – it is because of the shame of knowing what happened to him. What the lobotomy may or may not have done ends up being much less important than what having a lobotomy meant.

And it turns out what having a lobotomy means – for an individual, and for the community they exist in – is difficult to figure out. Howard Dully’s life and particularly, the events surrounding the lobotomy are curiously obscured and yet exposed at the same time. Foucault talks about how the “theater of the scaffold” implicated and included the public with the punishment of the condemned; and how this disappeared to be replaced with forced isolation and labor behind closed doors, hidden from the public. With Dully’s story, we see a surprising juxtaposition – the choice of lobotomy was done behind closed doors, discussions between Dr. Freeman and Howard’s stepmother which did not include Mr. Dully or Howard. Howard himself was admitted for the procedure without the intent disclosed to him. In fact, he was not told about his lobotomy until after it was performed. And yet –

“Freeman was a great keeper of notes […] Freeman didn’t write much about what he thought. But he wrote a lot about what other people said. Unlike the psychiatrists [Dully’s stepmother] had already seen, Freeman didn’t seem interested in talking to her about her. The file was about me. In fact, the first interview with Lou read like testimony in a murder trial. Freeman even referred to it as “the articles of indictment” (My Lobotomy, p. 77)

It didn’t stop there. Besides pages of quotes from Freeman’s journals, we also discover that Freeman always took pictures of his patients. In Dully’s case, there are before, during, and after pictures. He was so insistent on the photography that he lost a patient after he inserted the leucotomes (as he called them) and, being by himself, left them there while he set up the camera. the knives moved and ended up killing the patient on the table. Here’s the during picture from Howard’s lobotomy:

From the George Washington University Gelman Archives.

From the George Washington University Gelman Archives.

Freeman also wrote his patients, even going so far as to cart around hundreds of Christmas cards to show off at conference presentations. Many of these documents are also at the GWU archives, where Dully read the patient histories quoted from above and first saw the picture here. Freeman was “an archivist’s dream” (p. 226), having saved photos, correspondence, and case files on hundreds of patients. Freeman even presented patients at conferences as examples of his therapeutic success.

Freeman seems to have occupied an unusual space between the medical and the legal, the psychiatrist and the surgeon, the intellectual and the flimflam man. There are theatrical aspects, but no group accountability. Freeman seems to relish documenting and demonstrating his techniques, but the outcome of the treatment/punishment is uncertain. What is certain is that many patients end up being institutionalized after the procedure. Dully remarks that he reacted little, as an adult, when first seeing the pictures of the procedure. But he did become emotional after reading Dr. Freeman’s notes, those that appear to have been the deciding factor for going forward with the procedure. Information that was given, it was noted, by Mrs. Dully when Mr. Dully had left the room.

References

Foucault M. 1977. Discipline and Punish: The Birth of the Prison. Translated by Alan Sheridan, London: Allen Lane, Penguin. First published in French as Surveiller et punir, Gallimard, Paris, 1975.

Dully H & Fleming C. 2007. My Lobotomy: A Memoir. New York: Crown Publishing Group.

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