Is Brain Surgery a Sure Cure for Anxiety?

Over the years, many people have crossed my professional path, but a few of them remain much more clearly drawn than others. For instance, there's the cook about whom I wrote recently, a young man with autism, another who had Kleinfelter's Syndrome, a mildly retarded man and an older woman who was one of the first to receive the then-newly-discovered surgery of prefrontal lobotomy. The surgery, which had also been performed on President Kennedy's sister Rosemary, was seen as a wonderful advance in modern medicine and it was hoped that it would help those who seemed unreachable.

One-third of the patients in the sample had problems with what we call "executive functioning," meaning judgment and planning. They also appeared apathetic, developed epilepsy and disinhibition. The latter can mean they might give in to impulse and act as they wish. Certainly sounds like the woman I knew in that mental health setting years ago.

The one patient I saw had had a lobotomy to help with her angry rages that endangered everyone around her. They later found that it hadn't handled the rages at all. Seems she had a form of epilepsy and a strong antisocial streak. I found her harmless and that might not have been a good thing, but she never showed her anger to me.

Intractable obsessive-compulsive disorder is another disorder where surgeons have tried to intervene with brain surgery. There, too, the watchword has to be caveat emptor or let the buyer beware because a new report from the Karolinska Institute detailed their having followed records of patients over 23 years. The procedure, called capsulotomy, was supposed to stop the behaviors and thoughts, but new evidence seems to point to problematic side effects.

I remember being at a psychiatric hospital where the surgical suite had been closed many years before I ever came there. One of the staff told me about the patients with schizophrenia who had had lobotomies there. In the enormous, oak-paneled room where staff meetings were held there were photos on the wall of surgeons with lobotomy patients. But it wasn't to be.

So far, it seems like brain surgery has not proven to be a cure.

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