‘Leucotomy’, i.e. the severing of the connections between the frontal lobes and the rest of the brain was first practised by the Portuguese neurologist Egas Moniz in 1935. Based on the 19th century belief that mental illness is located in certain brain regions (Joanette, Stemmer, Assal G et al., 1993; Shorter, 1997; Berrios, 1991), leucotomy was considered a way of altering a patient’s behaviour (Berrios, 1991). The operation was extremely risky and it was soon recognised that ‘every patient probably loses something by this operation, some spontaneity, some sparkle, some flavor of the personality’ (Freeman & Watts, 1937). Between 1942 and 1954 over 10,000 patients underwent the operation in England and Wales (Tooth & Newton, 1961), attesting to the enthusiastic welcome the procedure received in British mental hospitals. Its alleged success, however, was reported before any long-term effects of the operation could be studied.
First trials with psychosurgery began in the DCMH in 1943, targeting amongst patients suffering from melancholia especially those placing the greatest strain on nursing staff. The Medical Superintendent was happy to experiment: ‘I am now making a selection of patients of both sexes who are chronically ill and who are very difficult to nurse, and propose to have the operation done, if the consent of the relatives is given. After that series is completed it will be possible to assess the results’ (Medical Superintendent’s Monthly Report, April 1943). Despite all good intentions to contribute to research into mental illnesses, the DCMH study will have been compromised by the selection of his patients who represented a minority who, despite several other therapies, remained extremely disturbed, thus requiring considerable nursing attention, as well as the lack of evidence on potential long-term consequences. It is also clear that the Medical Superintendent did not allow himself to be pressurised to carry out this treatment. The new procedure received considerable media attention – particularly after Moniz was awarded the Nobel Prize – and some relatives enquired about their family members receiving this kind of treatment. Such requests were declined without exception. The Medical Superintendent seemed to have been less cautious when it came to funding the operation: ‘with the consent of the Committee, I think it would be fair if I asked the relatives to contribute towards the cost of the operation’ (Medical Superintendent’s Monthly Report, April 1943). After treating a number of other patients, the Medical Superintendent had to admit in 1944 that ‘leucotomy has been performed in five patients up to date, but so far without any striking success’ (Medical Superintendent’s Annual Report, 1944). Only a minority of Devon patients left the hospital recovered after the operation, several died, a few were relieved of their symptoms and several re-entered the hospital with ‘post-leucotomy personality disorder’.