We recall lobotomies as they were depicted in the movies - horrifying operations inappropriately used to control mentally ill patients. But in the 1950s, surgeons also used them to treat severe pain from cancer and other diseases.
Now a researcher at Yale University has uncovered surprising new evidence of a famous patient who apparently
received a lobotomy for cancer pain during that time: Eva Perón, the first lady of Argentina, who was known as Evita. The story is an interesting, sad footnote in the history not only of lobotomy, but of pain control.
The nature of Perón's illness was initially shrouded in silence. Her doctors diagnosed advanced cervical cancer in August 1951, but as was common at the time, the patient was told only that she had a uterine problem. According to the biographers Nicholas Fraser and Marysa Navarro, secrecy was so paramount that an American specialist, Dr. George Pack, performed Perón's cancer operation without her or the public ever knowing. He entered the operating suite after she was under anesthesia.
Despite surgery, radiation and chemotherapy, Perón gradually worsened, dying in late July 1952 at age 33. Only then was it revealed that she had died of cervical cancer, but details of her treatment remained concealed. When used for psychiatric illness, lobotomy was once seen as a huge advance.
Dr. Egas Moniz, a Portuguese neurologist who developed the procedure in the 1930s, was awarded the Nobel Prize in Physiology or Medicine in 1949. Surgeons performed many types of lobotomies, but most involved severing nerves that ran from the frontal lobes to other parts of the brain to disrupt supposedly faulty connections that had developed in schizophrenia or depression.
Lobotomies for mental illness fell out of favor in the 1960s because of the development of antipsychotic medications, misuse of the procedure and a growing unease among doctors with the confusion and stupor that resulted from the operation.
But the earliest practitioners saw another potential benefit: relief from severe and resistant pain. Lobotomy, the New York neurosurgeon Dr. Sidney W. Gross wrote in 1953, was a "valuable and humane" procedure that reduced pain by blunting patients' emotional reactions to it. Advocates acknowledged it could make patients "childish, dull, apathetic, with little capacity for any emotional experiences." They believed such a state was preferable to constant pain.
In 2005, the Hungarian-born neurosurgeon Dr. George Udvarhelyi, who claimed to have assisted in Perón's care in the 1950s and later moved to the Johns Hopkins School of Medicine in Maryland, discussed for the first time a lobotomy he said Perón received for intractable cancer pain a few months before her death. But it wasn't until a Yale neurosurgeon, Dr. Daniel E. Nijensohn, himself an Argentine, began to research Dr. Udvarhelyi's assertion that evidence began to accumulate.
Dr. Nijensohn's research turned up several pieces of suggestive evidence. He confirmed details of Dr. Udvarhelyi's story and found other contemporaries of Perón who had said she had had surgery for her pain.
Dr. Nijensohn believes that a lobotomy was performed in May or June of 1952, meaning that Perón may have already had the procedure at the time of her last public appearance.
X-rays of Perón's skull, Dr. Nijensohn found, showed indentations in the areas where lobotomies were usually performed.
One of the ironies of Dr. Nijensohn's story, if true, is that another method already existed for treating Perón's pain: aggressive use of opiates. Doctors of the era, however, so feared that their cancer patients would become addicted to these drugs that they saw lobotomy as a suitable alternative.