Transorbital Lobotomy Orbitoclast
Two things warrant the inclusion of the transorbital lobotomy orbitoclast on any list of tools that most changed medicine: what it did and what it spawned.
Invented in 1946 by Walter Freeman, an American physicist, as a faster, easier way to perform a lobotomy, the orbitoclast was controversial from the start. Lobotomies surgically destroy connections and tissues in the brain’s prefrontal cortex to treat depression, panic disorders, schizophrenia and other manias.
Many in medicine already viewed lobotomies as barbaric. And Freeman’s orbitoclast made the procedure quick and easy. He would simply lift the upper eyelid away from the eyeball, insert the sharp point of the orbitoclast (essentially a modified ice pick), hammer it through the back of the socket, and pull it back and forth. The patients, sedated but still conscious, were usually sent home with sunglasses to hide any bruising.
The medical advance of the orbitoclast was unquestionable. It turned what had been major brain surgery into an outpatient procedure. Freeman, a fervent evangelizer of his invention, personally performed over 4,000 of the 60,000 lobotomies done in the U.S. and Europe between 1936 and 1956. One study showed that 63 percent of lobotomized patients saw improved symptoms, 23 percent had no improvement, and another 14 percent got worse or died. But the horror of the procedure was too much to allow that many neutral or negative results.
By the 1950s, the medical community and the general public wanted options. This is how the orbitoclast changed medicine again: It led to a search for options, spurring the psychiatric community to develop psychoactive drugs and new talk therapies.
Chlorpromazine to treat schizophrenia became available in the U.S. in 1955. The antipsychotic Haloperidol followed in the 1960s, marking the first wave in drug therapy.
Freeman used his cherished orbitoclast for the last time in 1967 on a longtime patient — a woman he had already twice lobotomized. She died of a cerebral hemorrhage, and he was banned from further operations.