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Most neurosurgeons now' agree that the lobotomies which were performed in the thousands in the 1950's were hatchet jobs which invariably brought disastrous side effects. Present day psychosurgeons say that their surgery does not entail bad side effects because they destroy only small numbers of cells in localized parts of the brain. Opponents of psychosurgery say that neurologists still know too little about the brain and that performing these operations is, as State Senator Chester Atkins [D-Concord] has said, the equivalent of using a sledge hammer to tune a piano.
Three doctors at the Harvard Med School have promoted the potential application of the research in psychosurgery for social control. By making the projections, they opened the channels for both government funding and public protest.
After the Detroit riots of 1967, in a letter to the Journal of the American Medical Association, Doctors Vernon Mark, associate professor of surgery, William Sweet, professor of surgery, and Frank Ervin, former professor of surgery, cited brain dysfunction in certain individuals as a possible factor in urban riots. They called for intensive research to diagnose and treat "those people with low violence thresholds before they contribute to future tragedies".
The type of treatment they suggest in the book Violence and the Brain published in 1970 included localizing areas of brain dysfunction with the use of electrodes and EEG recordings and then destroying small areas of cells. They claim only to have experimented on diseased individuals.
Yet Sweet states in a foreward to their book that, "The ability to treat these persons holds out the hope that knowledge gained about emotional brain function in violent persons with brain disease can be applied to combat the violence-triggering mechanisms in the brains of the non-diseased".
These ideas received immediate recognition. Life magazine in 1968 ran a cover story on the "Psychobiology of Violence" which described the work of the doctors and praised psychosurgery as a possible cure to random violence in the streets. When the three doctors went to the National Institute of Mental Health for money to set up a "violence unit" at Boston City Hospital, they were at first turned down. William Sweet then applied to Elliot L. Richardson '41, then Secretary of HEW, who had discussed the violence project with him when Richardson had been attorney general of Massachusetts. Richardson put pressure on NIMH which finally accepted the proposal.
Sweet, as chairman of the Neuro-Research Foundation, also sent two funding proposals to the Law Enforcement Assistance Administration (LEAA), the research and development arm of the Justice Department. LEAA granted them $188,000 in 1971 for a study of the biological basis of criminal behavior and a study of the possible linking of gene abnormalities with criminal behavior.
At the same time that the doctors were receiving funding support for their project, they also began to face determined opposition. A psychiatrist, Peter Broggin, began a one-man campaign against psychosurgery in 1971. Ralph Nader's raiders began to monitor the project. As the national controversy increased, Dr. David Allen at Boston City Hospital set up a review committee in September 1972 composed of professionals in many fields which acted as an advocate for the patient, ensuring that he had full knowledge and was giving full consent. State Senator Chester Atkins (D-Concord) introduced a bill into the legislature December 1973 which proposed to establish a review board of different specialists and three members of the public with the power to grant or deny permission for an operation for experimental neurosurgery and revoke a physician's license in connection with an infraction of their decision.
The core of Violence and the Brain consisted of the case histories of four patients who received psychosurgery. The core of the opposition lies in the long-term follow-ups of two patients-Thomas R. and Julia S. The doctors themselves now admit that there have been no long-term positive results of their operations in the patients.
Thomas R.'s mother is now suing Mark for $2 million with a charge of negligent malpractice. In Violence and the Brain, the doctors said that Thomas was wild and unmanageable when they suggested making destructive lesions in his brain. He first agreed to the operation while stimulated by electrodes in his brain which induced a hyper-relaxed state, as he described "a feeling like Demerol, like floating on a cloud."
Thomas' mother also claims that his life was ruined by the 1966 operation. Before the operation, Thomas had been an engineer and inventor who held patents on the Land camera. After the operation, in 1968, a Veterans Administration hospital declared Thomas totally disabled for the first time in his life. In 1971, the courts declared Thomas an incompetent and his mother became his legal ward. Thomas has been hospitalized four times since the operation, the most recent for attacking his father.
Julia S. is an epileptic with a long history of seizures and assaultive behavior. Dr. Mark's operation on her did reduce her violent behavior but her seizures and psychotic behavior have continued. A nurse who had known her before and after the operation made these statements, "He (Mark) implanted a couple of electrodes and proceeded to burn out sections of her temporal lobe. The only problem was that her impulsive behavior did not leave her and she began to deteriorate in front of my eyes...She stopped her wonderful guitar playing. She stopped wanting to engage in long intellectual discussions. She became more and more depressed. Suicidal."
The opposition to Mark's operation began to have effects when several members of Congress opposed and blocked the renewal of the government funding. Mark recently applied for a $2 million grant to resurrect the Violence Clinic at Boston City but was turned down due to pressure from black groups and radical scientists at the National Institutes of Health. Ervin attempted to start a Violence Center at UCLA but the funding has been held up by political and legal hassles.
There are other neurosurgeons in the country who conduct private brain operations to cure mood states such as depression and neurosis. They claim that their work is standard and non-experimental, yet, it also is potentially very controversial.
Mark, Ervin, and Sweet distinguished themselves from the beginning by emphasizing the connection between their work and criminal behavior of the non-diseased. As a result, they were able to receive substantive federal funding but also they called down upon themselves heavy public opposition which has led to the temporary drying up of funds.
The doctors now claim that their original statements connecting experimentation on diseased brains, urban riots, and the brains of the non-diseased was a "clinical" error. They will now restrict their research and treatment to patients with a specific type of brain disease-violence in temporal lobe epileptics, and in the course of their research find out more about the structure of the brain. In their book, however, two of the patients were not epileptics but were diagnosed as diseased because of violent behavior or because of abnormal brain wave patterns.
Is Mark's, Ervin's, and Sweet's change in focus of research the result of a change in clinical judgement, moral judgement, or public relations?
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