When Walter Freeman Came to Town: The Prefrontal Lobotomy at Rochester State Hospital

In the United States, frontal lobe lesioning procedures have been uniformly linked to the neurologist Walter Freeman, although the prefrontal lobotomy was investigated in other institutions in the United States, the United Kingdom, Europe, Russia, Japan, and China, mostly in patients with psychosis, obsessive-compulsive disorder, and/or intractable pain syndromes. These procedures were based on earlier reports of improvement of psychiatric symptoms after surgical resection of frontal lobe tumors and led many to infer a causal relationship between frontal lobe dysfunction and abnormal behavior. Freeman first visited Rochester, MN, as a medical student in a gastrointestinal laboratory at the Mayo Clinic. Freeman visited Rochester again many years later, a visit that was received with trepidation but ultimately led to the adoption of his lobotomy method. Freeman's grandfather, W.W. Keen, was a highly respected surgeon credited with the first successful surgical resection of a benign brain tumor in the United States, a connection that may have contributed to Freeman's subsequent interest in performing lobotomies. Keen maintained a close relationship with the Mayo brothers and also advocated for Freeman's initial visit to the Mayo Clinic. In this article, we present a brief historical review of Freeman and the early reports of the prefrontal lobotomy procedure performed by consultants affiliated with the Mayo Clinic and Rochester State Hospital.