I+am+a+lobotomised+patient,+hear+me+DERP

By: Anthony Mack Student Number: n8317321 Tutor Name: Judith Meiklejohn Tutor Time: Thursday 12pm-1pm Topic: Controversial Procedures Dealing with Mental Disorders

‘The Extraction of the Stone of Madness’ by Hieronymus Bosch
 The artefact that has been chosen is a painting by Hieronymus Bosch called ‘The Extraction of the Stone of Madness’. The painting depicts a doctor from the 16th century performing a trepanation on a patient. A trepanation is a surgical procedure used to treat health problems related to intracranial diseases. It is done by drilling or scrapping into the human skull, exposing the dura mater. Trepanation has been completed throughout the ages and has been linked to first being trialled in Neolithic times. Cave paintings have been found that were believed to indicate that the practice would cure epileptic seizures, migraines, and mental disorders. Moving forward to the 20th century, a controversial procedure called lobotomy was believed to have branched off from trepanation and was used to reduce the effects of affective disorders, obsessive-compulsive states, chronic anxiety states and other non-schizophrenic conditions, paranoid schizophrenia, undetermined or mixed type of schizophrenia, catatonic schizophrenia, and hebephrenic and simple schizophrenia (Hinsie & Campbell 1970).

__CENTRAL PUBLIC HEALTH ISSUE __
 The artefact is a historical painting that shows and represents the inhuman procedures that have been completed to cure mental health issues. Between the Stone Age and 19th century, medical advances have been limited due to ‘fear of the unknown’ or fear of what may happen. Nonetheless, mankind has continued its endeavour into acquiring the knowledge to cure numerous diseases that have plagued societies throughout time. In the 20th century however, one medical endeavour has had accumulated a mass of criticism based on its outcomes and procedures. This essay will report on this brutal medical intervention (Lobotomy) used throughout time. Also, the side effects of such controversial procedures will be taken into account along with Lobotomy’s current positioning in Australia.

__LITERATURE REVIEW __
 The Merriam-Webster dictionary, defines Lobotomy as a surgical severance of nerve fibres connecting the frontal lobes to the thalamus performed especially for the relief of some mental disorders (Merriam-Webster Free Dictionary, 2011). In the early 1900s, relatives frequently committed their loved ones to long stays in understaffed, overcrowded, and often filthy mental institutions. The therapeutic options for severe mental illness were quite limited. One option, the lobotomy, also known as leucotomy, was devised in 1935 by the Portuguese neurologist Egas Moniz. It involved drilling holes in the skull and using a blade to sever nerve fibres running from the frontal lobes to the rest ofthe brain. Moniz believed that psychiatric symptoms were caused by faulty nerve connections established over a period of time. If these nerves were severed and new connections were allowed to form, he hypothesized, patients' symptoms would improve. Lobotomies were originally used to treat patients with depression but were later often performed to treat schizophrenic patients suffering from agitation and paranoid delusions (Lerner, 2005).

 When people think about lobotomy, they often think about Randle P. McMurphy's vacant face at the end of One Flew Over the Cuckoo's Nest. We rarely think of someone like Alice Hammatt, the sixty-two-year-old woman who received the first prefrontal lobotomy in the United States. Diagnosed with ‘agitated’ depression, Ms. Hammatt ‘complained of nervousness, insomnia, depression of spirits, anxiety, and apprehension,’ and often ‘laughed and wept hysterically’. On the 14th of September 1936, Alice Hammatt's neurologist Walter Freeman and his partner, neurosurgeon James Watts, performed a prefrontal lobotomy in an effort to relieve Ms Hammatt's distress. The operation took about four hours. When Ms. Hammatt awoke from surgery, her doctors reported that her face ‘presented a placid expression’; later that evening, she ‘manifested no anxiety or apprehension’ (Johnson, 2011).

 Between 1936 and the mid-1960s, lobotomy mutilated the brains and permanently altered the emotional lives of tens of thousands of men, women, and children. Lobotomy’s primary objective was to ‘flatten’, ‘blunt’, or ‘bleach’ emotion in persons with psychiatric disabilities in an effort to return them to (what were argued to be) productive positions in their families, communities, and the growing economy (Johnson, 2011).

 Despite concerns raised by many in the medical community about these side effects, the promotion of prefrontal lobotomy by one neuroscientist through his relationship with prominent newspapers and magazines nevertheless brought about early public acceptance of this procedure. The 1949 Nobel Prize provided additional medical legitimization of the technique. Alternative and less traumatic procedures such as ‘transorbital lobotomy’ might have been additional contributing factors to the widespread use of neurosurgical procedures for the treatment of the mentally ill before such methods were more closely scrutinized. Even today, psychosurgery is proposed as an effective treatment for drug refractory cases of schizophrenia and other psychiatric disorders. The enthusiasm with which the public first greeted lobotomy mirrored the initial positive response of the press; the eventual reversal in the press to scepticism, if not outright criticism, predicted a similar shift of the public view. The outcry of those opposed ultimately raised awareness of the potential for misuse, indeed abusive use, of initially misrepresented and sensationalized methods to address social and mental problems with complex causes (Singh, Hallmayer & Illes, 2007).

 In 1950, a drug named chlorpromazine (sold as Thorazine) was synthesized. This marked the beginning of the end for lobotomies as treatment for mental illness in the United States. Thorazine was the first in a series of antipsychotic drugs, and some have described it as the biggest single advance in the treatment of schizophrenia; on par with what the discovery of penicillin did for the treatment of infectious diseases. Criticism of lobotomies had always existed in the public eye, but concern grew along with its popularity. An editorial in a 1941 issue of the Journal of the American Medical Association read, "No doctor can yet assert that this is or is not a truly worthwhile procedure. The ultimate decision must await the production of more scientific evidence." Still, the Nobel Committee selected Dr. Moniz, nominated by Dr. Freeman, for the Nobel Prize in Physiology or Medicine in 1949. However, while popular publications contained stories of Freeman's surgical precision and patients' miraculous recovery, the medical and scientific community discussed the crude nature of the operation and wondered if it could be truly proven as effective (Freeman, 2011).

 As of today in Australia, the use of lobotomies as a procedure is very limited. In fact, only one case is recorded per year, sometimes none at all. It is recommended to patients in Australia that Lobotomy is an absolute last resort. If another direction can be taken, it will be done promptly (Rosenfold, 2002).

__CULTURAL AND SOCIAL ANALYSIS __
Lobotomised patients are intertwined within the cultural, social and economical facets of society. Once a lobotomy is completed on the patient, he/she will lack many emotions and will often tend to have a very blank expression. Family tending to such people would be inclined to sympathize with the person and make an effort to communicate as much as possible. Some people, who have a family member with numerous mental illnesses like insomnia, depression of spirits or anxiety, will look to lobotomy as a sigh of relief as the person is no longer ‘crazy’ or has the tendency to be a nuisance or cause a lot of noise. While the thought and request of lobotomy surgery is often shone upon within society, many people who act as caretakers to mentally ill people, look towards it as a sort of assistance. Although, as of today, lobotomy is almost a thing of the past and family members who take care of their mentally ill sons/daughters/siblings are often admired through their patience, love and caring personality.

In today’s culture, observing a mentally ill person in public is deemed normal and isn’t a peculiar sight. Although, there are some sections of society that like to make fun of such mentally disabled people which is a very sad fact about today’s times. Take for example, two thugs who assaulted a mentally disabled lady in California. Link: [] However, due to the fact that lobotomy is rarely performed in today’s society, not many instances have occurred whereby a lobotomised patient has been abused by such thugs, which is a good thing. Although, there is still the issue of mentally ill people being abused in public by a selective few in society. Such acts are shone upon indefinitely and are considered to be spiteful, low, unjustified and horrible. This issue needs to be acted upon and stopped now; this can be done through education, harsh penalties towards those showing such behaviour and numerous advertisement campaigns.

<span style="font-family: 'Arial','sans-serif';">While lobotomised/mentally ill patients have a profound impact on the cultural and social aspects of society, it also tends to have an impact on the economy. One out of every five Australians will experience some form of mental illness each year. Given the “ripple effect” of the impact of mental illness on family, friends and community it is probable that one in two Australians are affected directly or indirectly by mental illness. In 2007, almost half (45%) of all Australians had experienced a mental disorder at some point in their lifetime. In Australia it has been estimated that mental health symptoms result in a loss of $ AU2.7 billion in employee productivity. Mental illness is the third largest contributor to the total health burden (13.2%), which is 374,541 years of healthy life lost (Disability Adjusted Life Years) and the largest overall cause of disability (27%). However, only 6.0% of the national recurrent health expenditure is spent on mental illness (Kulkarni, n.d.). While this percent may be smaller than other health risks, it still has an strong impact on the economy and today’s society.

__<span style="font-family: 'Arial','sans-serif'; font-size: 18.6667px;">ANALYSIS OF THE ARTEFACT __
<span style="font-family: 'Arial','sans-serif'; font-size: 14.6667px;">My cultural artefact represents mankind’s medical endeavours into the treatment of mental health via controversial methods. Between the Stone Age and the 19th century, Trepanation had been the procedure of choice to deal with a multitude of mental disorders like <span style="font-family: 'Arial','sans-serif';">epileptic seizures, migraines, depression and schizophrenia. Fast forward to the 20th century and a P <span style="font-family: 'Arial','sans-serif'; font-size: 14.6667px;">ortuguese neurologist Egas Moniz had devised the idea of Lobotomy to deal with such mental illnesses. One neuroscientist through his relationship with well-known newspapers and magazines brought about early public acceptance of this procedure when its side effects were merely ‘nothing to worry about’. Although, as time passed, the controversial procedure was put under more scrutiny, and the emotional redundancy showed by patients after the surgery was put into the spotlight. Luckily by the 21st century, lobotomy has almost become a thing of the past with only a selected few clinics and hospitals in the world offering the procedure. However, the surgery itself is rarely completed and is only used as a last resort for certain mental disorders.

<span style="font-family: 'Arial','sans-serif'; font-size: 14.6667px;">By looking into this research topic, I have learned about a few of mankind’s medical endeavours into the unknown. Throughout time, risks have been taken to combat a multitude of mental health disorders, most of which being very controversial in the public eye. While we together have not found an indefinite cure for mental illnesses like schizophrenia or anxiety, medical drugs have been formulated to subdue the effects and make life easier. The essay has raised my awareness to the trials and tribulations into medicine and the amount of risks we take to cure a disease (even if the procedure is unsuccessful).

__<span style="font-family: 'Arial','sans-serif'; font-size: 18.6667px;">REFLECTION AND LEARNING __
<span style="font-family: 'Arial','sans-serif'; font-size: 14.6667px;">Wiki Title: **<span style="font-family: 'Arial','sans-serif'; font-size: 14.6667px;">The Invisible Plague. Mental Illness on The Rise ** <span style="font-family: 'Arial','sans-serif'; font-size: 14.6667px;">Sam, good work on the assignment! It was interesting and insightful as I never really looked into the true meaning of that song. Some of the statistics you present are worrisome, particularly the one that states '3.2 million Australians or approximately 20% of the population had a mental disorder in the twelve months prior... and at least 10 to 15% of young people in any one year'. You made a good point how hard a family is hit by having a family member with a mental disorder. You went on, in detail, how they were affected physically, emotionally, mentally and spiritually. Great detail! Like yourself, your assignment has also raised my awareness of mental health and its huge role in society. Thanks for that! Keep up the great work!

<span style="font-family: 'Arial','sans-serif'; font-size: 14.6667px;">Wiki Title: <span class="wikipagemenutitle" style="font-family: 'Arial','sans-serif'; font-size: 14.6667px;">**Mental Health and the affects of Cyber Bullying in Teenage Australians** <span style="font-family: 'Arial','sans-serif'; font-size: 14.6667px;">Brent, like the previous assignment I commented on, I never knew the true meaning of Adam's Song by Blink 182, until you showed me! I found your work engaging and astute! I am well aware about the issues of cyber bullying, as I have seen it done first hand on Facebook. It's horrible and I wish it would all stop! I found it alarming that 'Australians, between the ages of 12-24 is then most at risk of developing a mental health disorder’. I’m in that age bracket and I hope I don't succumb to such a thing! I found it particularly interesting when you made the point about the 'positives signs' on how negatively current society looks down upon mental health sufferers and you backed yourself up well! Great job on the assignment!

__<span style="font-family: 'Arial','sans-serif'; font-size: 18.6667px;">REFERENCE LIST __
(n.d.). Retrieved November 1, 2011, from Merriam-Webster Free Dictionary: http://www.merriam-webster.com/dictionary/lobotomy

Freeman, S. (2011). //How Lobotomies Work//. Retrieved October 31, 2011, from How Stuff Works: A Discovery Company: http://science.howstuffworks.com/environmental/life/human-biology/lobotomy4.htm

Hinsie, Leland E. & Campbell, Robert Jean (1970). //Psychiatric Dictionary//. Fourth Edition. Oxford University Press.

Johnson, J. (2011). Thinking with the Thalamus: Lobotomy and the Rhetoric of Emotional Impairment. //Journal of Literary & Cultural Disability Studies// //, 5// (2), 185-200, 227.

Kulkarni, J. (n.d.). //The Cost of Mental Illness.// Retrieved November 2, 2011, from MAPrc: http://www.maprc.org.au/sites/www.maprc.org.au/files/THE%20COST%20OF%20MENTAL%20ILLNESS%20FINAL_0.pdf

Lerner, B. H. (2005). Last-Ditch Medical Therapy - Revisiting Lobotomy. //The New England Journal of Medicene// //, 353// (2), 119-21.

//Medical Staff Profiles//. (2011, October 19). Retrieved November 1, 2011, from Alfred Health: http://www.alfred.org.au/neurosurgery/medical_staff_profiles/

Raz, M. (2008). Between the Ego and the Icepick: Psychosurgery, Psychoanalysis, and Psychiatric Discourse. //Bulletin of the History of Medicine// //, 82// (2), 387-420.

Raz, M. (2009). THE PAINLESS BRAIN: lobotomy, psychiatry, and the treatment of chronic pain and terminal illness. //Perspectives in Biology and Medicine// //, 52// (4), 555-65.

Rosenfeld, J. (2002, Febuary 3). The Legacy of the Lobotomy. //All In The Mind.// (N. Mitchell, Interviewer) ABC.

Singh, J., Hallmayer, J., & Illes, J. (2007). Interacting and paradoxical forces in neuroscience and society. //Nature Reviews. Neuroscience// //, 8// (2), 153-60.