430 MICHIGAN QUARTERLY REVIEW
The number of lobotomies did not increase radically in the U.S.
during the first years after Freeman and Watts introduced the procedure in the fall of 1936. Neurosurgeons had to learn the procedure
and it was several years before the demand began to build up. By
that time the Second World War had diverted attention to other
medical problems. Prior to the war, no more than two hundred
lobotomies were performed in any single year, but immediately
afterward a large increase occurred. There were approximately 500
lobotomies performed in 1946 and the number doubled each successive year, leveling off at about 5000 annually in 1949. This rate was
maintained for about five years.
After the introduction of transorbital lobotomies in 1946, onethird of all the lobotomies performed in the United States during the
peak years and 56 percent of those done in state hospitals used this
procedure. More important, however, was the economic and political pressure to find some quick solution for the many veterans suffering from mental problems. Over 55 percent of all the Veterans Hospital beds were occupied by neuropsychiatric patients. This was not
only expensive, but the families and the public conscience were
demanding that something be done for these veterans. In response to
this pressure, the Veterans Administration started training psychiatrists and neurosurgeons in "modern psychiatric treatment methods," namely electric shock, insulin therapy, and lobotomy. About
12 percent of all lobotomies were performed in Veterans Hospitals,
but of more significance, those trained to perform the operation
with VA support used these skills in other hospitals as well.
It is not true, as often charged, that lobotomies were performed
only on indigent patients in state hospitals. Although 56 percent of
all lobotomies were performed in the state hospitals, many advantaged patients - some from prominent American families, given the
"best" medical advice at exclusive private sanitoriums - were also
lobotomized. The medical staff affiliated with many of the most
prestigious university hospitals played leading roles in the practice of
lobotomy at private sanitoria and in state mental hospitals. The
often cited Columbia-Greystone Lobotomy Project, for example,
involved a large team of Columbia University staff - neurosurgeons,
psychiatrists, neurologists, neuroanatomists, and psychologists - but
the patients were inmates at the New Jersey State Hospital in Greystone Park. Neurosurgeons at other major universities and leading
medical research centers-Yale, Duke, Pennsylvania, Minnesota,
