Jean Heuser – The Transorbital Lobotomy

Jean Heuser as a young girl, from the files of Viola Paradise.

Jean’s story is told through her relative’s, Penelope Scambly Schott’s, poetry. The poetry is based upon primary sources such as letters and diaries written by or about Jean. The information that follows is from these quoted primary sources within the context of Schott’s interpretation of Jean’s disease. Schott visited Jean as a young child and witnessed her spiraling regression after her lobotomy. Schott’s mother described Jean’s behavior as raging recalling that, “she took off her clothes and lay on the floor screaming.”[1] It is through Schott’s verses that the reader learns that Jean was a schizophrenic as Schott penned I Shall Never Repeat “panic frantic chronic schizophrenic the story: authentic.”[2] Later, in a poem entitled Do You Hear Voices, Schott writes, “You know, Doctor, her father was crazy too. He’s been institutionalized for years.” [3] This verse indicated that Jean’s schizophrenia could have a genetic cause. The following poem in the series, Starvation, recounts Jean being tube-fed because she refuses to eat. Her symptoms included drastic changes in weight. Aunt Viola wrote to Jean asking her, “Are you dieting, to get back your slimness.”[4] Together these sources indicate the power Aunt Viola had over her niece. If Aunt Viola thought Jean should be dieting, then Jean refused to eat to the point where she needed to be force fed through a tube. Jean reflects upon her relationship with her aunt stating, “now that she is fond of me again. I can take the burden with less despair.”[5] Jean feels that, with her family’s support, her psychological troubles are less burdensome.

Family support was necessary for her because, at the time, the treatment for schizophrenia was simply custodial care, “there is no cure for schizophrenia only confinement.”[6] In Hillside Hospital Clinic, Jean’s descriptive letters to her Aunt Viola were published in which Jean describes the routine she kept under the care of her family. This routine consisted of chores, occupational therapy, rest, doctor consultations, meals, and entertainment. This treatment was characteristic of the moral treatment of schizophrenia.

The moral treatment was combined with insulin shock therapy which was given to the patients daily in order to sedate them. Jean writes to her Aunt stating the effects of the insulin causing her to have “little energy to do anything.”[7] Lobotomies were performed, with precautions, when more extensive therapy was necessary. In 1949, the superintendent from Rockland State Hospital in New York wrote to Aunt Viola reaffirming that a lobotomy treatment was not a miracle cure, “but she can in way become worse.”[8] Despite this precaution, Jean underwent a transorbital lobotomy performed by Dr. Freeman on February 15, 1954. A note from the hospital director was sent to Aunt Viola stating, “the operation was apparently satisfactory and she is progressing normally.”[9] Although, Jean’s symptoms did not worsen, she remained a sixteen year old for the remainder of her life and, at the recommendation of the Manhattan Society for Mental Health, Jean was committed to the Manhattan State Hospital for her remaining days.[10]

Jean’s story is emblematic of the major mental illness cases brought before doctors during the peak of psychosurgery’s popularity. Dr. Freeman reported that 88% of patients who were operated on from 1952 to 1955 were schizophrenic.[11] Yet, success with the procedure was not the norm. Dr. Kolb’s case studies reported that, of 158 schizophrenic patients, only 36 were discharged as having recovered. He further reported that 46.8% of patients treated by lobotomy still had psychotic post-surgical tendencies. “Some state that the periodic catatonic type responds best and the hebephrenic, paranoid, and simple reactive types respond less well in the order mentioned.”[12] Similarly, Dr. Miller found in his case studies that 33% of those lobotomized required constant hospitalization.[13] While these doctors all support the notion that schizophrenia was the most difficult mental illness to cure, they believed that the lobotomy would result in a decrease in erratic behavior. A 1952 experimental study by the University of Oklahoma using a control group found that schizophrenic patients showed, “less tension and emotional concern about this ideation.”[14]   Like Jean, whose countenance remained at the level of a sixteen-year-old, patients in this study had less inner tension, less self-awareness, and a less active interest in life. Doctors believed that such outcomes were positive and, much like Jean, these patients would have been reported to have improved. The improvement was seen in terms of familial relief as the patients were more manageable. Historical and author of The Lobotomy Letters describes unsuccessfully surgery as, “even if the results of the lobotomy were so extreme that the patients developed emotional flatness … to their family members it was more important to know that their suffering had been reduced.”[15] Most of these patients were able to be released to the care of more willing families now that they render docile post operation.

Below is one of the films created by Dr. Freeman in order to promote and teach the transorbital lobotomy. This is the procedure that Jean would have undergone. * Warning this video is graphic!

[youtube]http://www.youtube.com/watch?v=ziC9skl2Zn4[/youtube]

Schott, Penelope. Jean Heuser as a Young Girl.  Courtesy of Viola Paradise. In The Pest Maiden: A Story of Lobotomy. Cincinnati, OH: Turning Point, 2004.