It was decreed “the worst idea on the mind” in history in a public debate at the Royal Institution in 2006. Yet it seemed like such a good idea at the time—so good, it won its devisor the Nobel Prize. Portuguese neurosurgeon Dr Egas Moniz—whose gout-scoured face one graced the 10,000 Escudo banknote—won the most prestigious award in science in 1949 for developing the “leucotomy”.
Better known as “lobotomy” (a new label conjured up by American psychiatrists), the revolutionary technique seemed to be the first way psychiatrists could dramatically alleviate madness and suffering in people thought to be incurably deranged, violent, and psychotic. Extreme but—in its way—effective, the technique involved slicing tiny slivers through the frontal lobes of the brain, which surgeons reached through holes bored in the top of the skull.
Grim it may sound, but before antipsychotics, sedatives, and all the other ingredients in our pharmaceutical repertoire, psychiatrists had few options to treat any form of severe mental illness. Moniz theorized that obsessive, depressive, and delusional behaviours were caused by excessively tight associations between neural circuits, which could be alleviated by slicing through the deep white matter of the frontal cortex, “soft as warm butter”.