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The novel follows the extremely distressing journey of Howard Dully, who received an ice-pick lobotomy at the age of only 12. As a young boy, his mother loved him unconditionally, so the loss of his mother at a young age destroyed him. He was moved around frequently as a child, and his father worked to make ends meet. Eventually, his father remarried a woman by the name of Lou, and everything started to get worse. Lou was not affectionate, had children from a previous marriage, and was very strict. Not only was she strict, she was especially horrible to Howard Dully. He got punished for things he didn't do, yelled at constantly for wanting more to eat, sent to his room often, and beat physically by both Lou and his father. Howard Dully started to act out at school and explains it perfectly when he says, "maybe that's part of why I behaved badly. I was being treated like a bad boy, so I acted like a bad boy. The rules weren't fair, so I broke the rules" (38). Lou continued to punish him, but Howard Dully was growing larger and naturally had a very large stature at a young age. Lou decided she needed to find another way to punish him since the beatings didn't work, and that was to get him a lobotomy. She went to six, SIX, doctors who said he was a normal kid and four even said it was a problem with her, but she kept going until she met Dr. Freeman, the man specialized in and did lobotomies. She lied in what she told him to make Howard Dully seem worse than he was in order for him to get accepted for a lobotomy. On his 12th birthday, the lobotomy was approved and signed off by both his stepmother and father without him knowing before the operation. After the lobotomy, Howard Dully states that he lost a lot of his memory of the healing period. After he healed from the operation, he hadn't changed enough as Lou wanted him to, so she once again was trying to get him out of the house. Lying about what he had been doing at home, he was set to an asylum, then youth detention centers, and went around for most of his life to different places where he felt he wasn't needed. In the years when he should have been learning his place in the world, he was living in halfway houses or other institutions with no hope of returning home. Due to this, he never learned a lot of skills he needed. He became addicted to drugs and alcohol as he committed rather intense crimes to try and get somewhere in his life. Eventually everything started to find its place once he found his wife and they both needed to quit doing drugs because they could not afford it. Then, he started to reflect more on his lobotomy and wanted to know why it was done to him. He started to research the procedure to try and find more about it, and eventually he found a group of people creating a documentary on Dr. Freeman, the man who gave him a lobotomy. Once he shared his story, the documentary became about him and the impact the lobotomy had on his life. He traveled around despite his fear of flying to get answers and talk to others who were impacted by lobotomies. Howard Dully even interviewed his father, who was very casual and seemed not to realize the impact on his son's life that the lobotomy made. The novel ended with Howard Dully discussing how he wrote the book and through the podcast and everything he had been through, he finally found peace with it. He has a loving wife, children, a job as a bus driver, and the satisfaction that he helped so many people by sharing his story.

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The podcast Howard Dully worked on in 2005 to get his, and others' stories out.

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On Jan. 17, 1946, a psychiatrist named Walter Freeman launched a radical new era in the treatment of mental illness in this country. On that day, he performed the first-ever transorbital or "ice-pick" lobotomy in his Washington, D.C., office. Freeman believed that mental illness was related to overactive emotions, and that by cutting the brain he cut away these feelings.

Freeman, equal parts physician and showman, became a barnstorming crusader for the procedure. Before his death in 1972, he performed transorbital lobotomies on some 2,500 patients in 23 states.

One of Freeman's youngest patients is today a 56-year-old bus driver living in California. Over the past two years, Howard Dully has embarked on a quest to discover the story behind the procedure he received as a 12-year-old boy.

In researching his story, Dully visited Freeman's son; relatives of patients who underwent the procedure; the archive where Freeman's papers are stored; and Dully's own father, to whom he had never spoken about the lobotomy.

"If you saw me you'd never know I'd had a lobotomy," Dully says. "The only thing you'd notice is that I'm very tall and weigh about 350 pounds. But I've always felt different - wondered if something's missing from my soul. I have no memory of the operation, and never had the courage to ask my family about it. So two years ago I set out on a journey to learn everything I could about my lobotomy."

Neurologist Egas Moniz performed the first brain surgery to treat mental illness in Portugal in 1935. The procedure, which Moniz called a "leucotomy," involved drilling holes in the patient's skull to get to the brain. Freeman brought the operation to America and gave it a new name: the lobotomy. Freeman and his surgeon partner James Watts performed the first American lobotomy in 1936. Freeman and his lobotomy became famous. But soon he grew impatient.

"My father decided that there must be a better way," says Freeman's son, Frank. Walter Freeman set out to create a new procedure, one that didn't require drilling holes in the head: the transorbital lobotomy. Freeman was convinced that his 10-minute lobotomy was destined to revolutionize medicine. He spent the rest of his life trying to prove his point.

As those who watched the procedure described it, a patient would be rendered unconscious by electroshock. Freeman would then take a sharp ice pick-like instrument, insert it above the patient's eyeball through the orbit of the eye, into the frontal lobes of the brain, moving the instrument back and forth. Then he would do the same thing on the other side of the face.

Freeman performed the procedure for the first time in his Washington, D.C., office on Jan. 17, 1946. His patient was a housewife named Ellen Ionesco. Her daughter, Angelene Forester, was there that day.

"She was absolutely violently suicidal beforehand," Forester says of her mother. "After the transorbital lobotomy there was nothing. It stopped immediately. It was just peace. I don't know how to explain it to you, it was like turning a coin over. That quick. So whatever he did, he did something right."

Ellen Ionesco, now 88 years old, lives in a nursing home in Virginia. "He was just a great man. That's all I can say," she says. But Ionesco says she remembers little about Freeman, including what he looked like.

By 1949, the transorbital lobotomy had caught on. Freeman lobotomized patients in mental institutions across the country.

"There were some very unpleasant results, very tragic results and some excellent results and a lot in between," says Dr. Elliot Valenstein, who wrote Great and Desperate Cures, a book about the history of lobotomies.

Valenstein says the procedure "spread like wildfire" because alternative treatments were scarce. "There was no other way of treating people who were seriously mentally ill," he says. "The drugs weren't introduced until the mid-1950s in the United States, and psychiatric institutions were overcrowded... [Patients and their families] were willing to try almost anything."

By 1950, Freeman's lobotomy revolution was in full swing. Newspapers described it as easier than curing a toothache. Freeman was a showman and liked to shock his audience of doctors and nurses by performing two-handed lobotomies: hammering ice picks into both eyes at once. In 1952, he performed 228 lobotomies in a two-week period in West Virginia alone. (He lobotomized 25 women in a single day.) He decided that his 10-minute lobotomy could be used on others besides the incurably mentally ill.

Anna Ruth Channels suffered from severe headaches and was referred to Freeman in 1950. He prescribed a transorbital lobotomy. The procedure cured Channels of her headaches, but it left her with the mind of a child, according to her daughter, Carol Noelle. "Just as Freeman promised, she didn't worry," Noelle says. "She had no concept of social graces. If someone was having a gathering at their home, she had no problem with going in to their house and taking a seat, too."

Howard Dully's mother died of cancer when he was 5. His father remarried and, Dully says, "My stepmother hated me. I never understood why, but it was clear she'd do anything to get rid of me."

A search of Dully's records among Freeman's files archived at George Washington University turned up clues about why Freeman lobotomized him.

According to Freeman's notes, Lou Dully said she feared her stepson, whom she described as defiant and savage looking. "He doesn't react either to love or to punishment," the notes say of Howard Dully. "He objects to going to bed but then sleeps well. He does a good deal of daydreaming and when asked about it he says 'I don't know.' He turns the room's lights on when there is broad sunlight outside."

On Nov. 30, 1960, Freeman wrote: "Mrs. Dully came in for a talk about Howard. Things have gotten much worse and she can barely endure it. I explained to Mrs. Dully that the family should consider the possibility of changing Howard's personality by means of transorbital lobotomy. Mrs. Dully said it was up to her husband, that I would have to talk with him and make it stick."

Then on Dec. 3, 1960: "Mr. and Mrs. Dully have apparently decided to have Howard operated on. I suggested [they] not tell Howard anything about it."

In an entry dated Jan. 4, 1961, two and a half weeks after the boy's lobotomy, Freeman wrote: "I told Howard what I'd done to him... and he took it without a quiver. He sits quietly, grinning most of the time and offering nothing."

Dully says that when Lou Dully realized the operation didn't turn him "into a vegetable, she got me out of the house. I was made a ward of the state.

"It took me years to get my life together. Through it all I've been haunted by questions: 'Did I do something to deserve this?, Can I ever be normal?', and most of all, 'Why did my dad let this happen?'"

For more than 40 years, Howard Dully had never discussed the lobotomy with his father. In late 2004, Rodney Dully agreed to talk with his son about the operation.

"So how did you find Dr. Freeman?" Howard Dully asks.

"I didn't," Rodney Dully replies, adding that Lou Dully was the one. "She took you... I think she tried some other doctors who said, '...there's nothing wrong here. He's a normal boy.' It was the stepmother problem."

Why would a father let this happen to his son?

"I got manipulated, pure and simple," Rodney Dully says. "I was sold a bill of goods. She sold me and Freeman sold me. And I didn't like it."

The meeting proves cathartic for Howard Dully. "Although he refuses to take any responsibility, just sitting here with my dad and getting to ask him about my lobotomy is the happiest moment of my life," Howard Dully says.

Rebecca Welch's mother Anita was lobotomized by Freeman for postpartum depression in 1953. After spending most of her life in mental institutions, Anita McGee now lives in a nursing home in Birmingham, Ala. Rebecca visits her every week. She believes Walter Freeman's lobotomy destroyed her mother's life.

"I personally think that something in Dr. Freeman wanted to be able to conquer people and take away who they were," Welch says.

At a meeting in the nursing home, Welch and Howard Dully find common ground in their experiences with Freeman. "It does wonders to know that other people have the same pain," Dully says.

Howard Dully's two-year journey in search of the story behind his lobotomy is over. "I'll never know what I lost in those 10 minutes with Dr. Freeman and his ice pick," Dully says. "By some miracle it didn't turn me into a zombie, crush my spirit or kill me. But it did affect me. Deeply. Walter Freeman's operation was supposed to relieve suffering. In my case it did just the opposite. Ever since my lobotomy I've felt like a freak, ashamed."

But now, after meeting with Welch and her mother, Dully says his suffering is over. "I know my lobotomy didn't touch my soul. For the first time I feel no shame. I am, at last, at peace."

After 2,500 operations, Freeman performed his final ice-pick lobotomy on a housewife named Helen Mortenson in February 1967. She died of a brain hemorrhage, and Freeman's career was finally over. Freeman sold his home and spent the rest of his days traveling the country in a camper, visiting old patients, trying desperately to prove that his procedure had transformed thousands of lives for the better. Freeman died of cancer in 1972.

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On Jan. 17, 1946, a psychiatrist named Walter Freeman launched a radical new era in the treatment of mental illness in this country. On that day, he performed the first-ever transorbital or "ice-pick" lobotomy in his Washington, D.C., office. Freeman believed that mental illness was related to overactive emotions, and that by cutting the brain he cut away these feelings.

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Dr. Freeman often liked to take pictures before, during, and after the lobotomies, and this is a picture of him doing one with several people watching.

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The novel follows the coming-of-age memoir of Howard Dully throughout his life and the turmoil that went with it until he finally came to peace with it after the age of 50. The book is a very eye-opening, in depth look at the horrifying truth behind lobotomies and their impact on people who they were given to. Especially as Howard Dully tells in the novel, the time period showed a lot of the "successful" lobotomies which made people shells of what they once were. His novel and his story on the podcast show the terrifying truth about the procedure which completely flipped his life upside down. I think another large main idea of the book is centered around a need for more empathy. Howard Dully struggled so hard even from a young age and acted out due to it, but so few people showed him empathy or care. He lost his mother at a young age, was being abused at home, and beat, but no one was told to reach out to him and try to help. No matter how someone acts, they deserve understanding. Other lobotomy patients, including Howard Dully himself, were often given the operation to make them easier to control and not to deal with what issues they may have. The novel also expresses the importance of taking care of one's self and especially their mental health. Mental health issues are a large topic in the book, as Howard Dully himself struggles and goes to different asylums with other people struggling. These people who struggle have their own mental health conditions and no matter what, they deserve the same empathy as discussed above. A harshness only makes a lot of conditions worse.

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Pictures such as these were shared at conferences or in newspapers with their captions to encourage the usefulness of the procedure.

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Video with Real Lobotomy Patients (1944)

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Video with Real Lobotomy Patients (1944)

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This video is honestly sickening to watch, but it features real film of real lobotomy patients. It is so sad to see these people almost all become basically zombies after the operation.

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Prefrontal Lobotomy in Chronic Schizophrenia [Silent](Bishop Clarkson Memorial Hospital, 1944)

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This book connects to the class as Howard Dully underwent an operation to give him a traumatic brain injury. In addition, it is possible that he had something like ADHD before the lobotomy. He states it himself throughout the book that he had trouble paying attention, often did bad in classes he didn't care about, and would act without much thought before doing something. Despite the possibility of him maybe having ADHD, that in no way means he needed the lobotomy to "fix" him. In addition, we talk a lot about not judging students or anyone for their behavior, and Howard Dully was definitely one of those cases. He acted out, but no one at school attempted to talk to him or see why he acted the way he did. While I cannot say he might not have gotten the lobotomy if someone did talk to him and try to understand, it may have helped him a lot. He felt very unloved by his stepmother and craved that comfort and someone supplying that would have most likely meant so much to him.

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Several before and after images were used to state how helpful the lobotomies had been, but they neglected to discuss the horrible side effects.

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Dr. Loboto (left) and the main character Raz (right)

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A personal connection I have seen in media is one in a game titled Psychonauts. While the story of the game is unrealistic, it often talks about difficult topics, such as mental health and addiction, very respectfully. The game follows a group of psychics, but the main antagonist of the first game is an unlicensed doctor and also unlicensed dentist by the name of Dr. Caligosto Loboto. The name tells enough about what happened to him. When he was a child, his parents realized he was a psychic and sent him to have an ice-pick lobotomy to "fix" him and rid him of the powers. While the operation seemed to cure him of the psychic powers, he completely lost his mind since the operation damaged his brain. As an adult, he went on to be an unlicensed dentist before being sent to an asylum after hurting his patients. The asylum was destroyed, so he went to work as a scientist for hire, working odd jobs such as removing psychic children's brains for them to operate brain tanks (much like his lobotomy may have felt for him). Again, the game isn't very serious nor realistic in some aspects. Especially with the first game coming out in 2005, it isn't as careful with some of his story. There are some offensive comments, but the second game released in 2021 is much nicer to him. The characters are more gentle and understanding of him. Dr. Loboto is very isolated and gets manipulated throughout the games from people who swear they "want the best for him." Throughout the series, those playing can feel real sympathy for what happened to him as a result of his lobotomy. While the representation may not be the best, it was another time I saw lobotomies discussed.

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I can admit that I originally decided to read the book due to its very striking title. After finishing it, I am so glad I did. The book at times was hard to read and made me feel sick to my stomach due to the treatment Howard Dully received from his family and doctors. Several times I did have to put the book down and step away since it made me feel nauseous. No person, especially no child, deserved to go through something so difficult. Howard Dully writes about how he spent 40 years wondering what he did to deserve the lobotomy, and there was no good answer, since he didn't deserve it. I cannot believe such a practice was normalized and completely okay for all ages of people. Even with all the deaths and horrible effects of it exposed, it still continued. Part of the novel discusses how Dully's stepmother went to 6 doctors, who all refused to say he needed a lobotomy before he got one. The stepmother was so persistent to make him cooperate and easy that she just kept going until she met with Freeman. That made me feel so frustrated with the stepmother. She wanted that little boy to suffer so bad that nothing stopped her. Overall, the book made me so upset, frustrated, and sick at the treatment Howard Dully received. At the end, I was so glad he could live in peace with what happened to him and helped others with it as well.

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A quick overview about Traumatic Brain Injuries and their impacts on learning, life, and how to help people with them

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Educational Video: Introduction to Brain Injury