American Lobotomy: A Rhetorical History by Jenell Johnson (review)

When I received my copy of Jenell Johnson’s American Lobotomy: A Rhetorical History, the lyrics to the song by the Ramones called “Teenage Lobotomy” immediately popped into my head: “DDT did a job on me/Now I am a real sickie/Guess I’ll have to break the news/That I got no mind to lose.” The song tells the story of a teenager who loses his mind (and later his “cerebellum”) to a lobotomy, and it draws on misconceptions that have become associated with what was once praised as a revolutionary new psychiatric procedure. American Lobotomy corrects some of these (and other) popular misconceptions—that lobotomies were performed with ice picks, that they were used in Communist countries as a form of mind control, and that (as the Ramones suggest) lobotomies turned patients into mindless zombies. However, the book does more than that—it helps to explain why and how lobotomy came to occupy such a prominent place in American cultural imagination.

To do so, Johnson engages with lobotomy as a medical marvel. As she puts it, a medical marvel “offers a glimpse into the affective, social, and political contours of a culture’s relationship with medicine: our fervent hopes and trenchant fears about medicine’s power to alter our bodies and psychiatry’s power to change our minds” (15). The book proceeds by tracing some of those contours, moving in a roughly chronological fashion but often circling back to show how lobotomy’s rhetorical past continues to shape its rhetorical present.

In chapter 1, Johnson examines how the first lobotomies performed in the 1930s were justified by the argument that they successfully diminished strong emotions. In early accounts, mental illness was framed as a problem of intense emotions that overpowered one’s reason (26); lobotomies were lauded for their ability to render patients—usually female patients—more docile. At the same time, medical rhetors deployed a similarly dispassionate rhetoric. Johnson demonstrates how, in a medical debate over the use of lobotomy, rhetors were quick to accuse each other of letting their emotions cloud their judgment. In scientific discourse, after all, “an emotional attitude did not just signify an absence of reasons, but a threat to reason, a violent unreason, an emotional impairment to the dispassionate judgment of medical science” (36). The ideal for medical rhetors participating in the lobotomy debate was much the same as the ideal for the patients undergoing the procedure—to display an affect marked by rational thought and devoid of excess emotion.

Chapter 2 demonstrates how, between 1936 and 1955, the popular press used gendered characters to present lobotomy. Initially, positive stories tended to feature female recipients of the procedure who transgressed gender norms by displaying aggression or excessive (or extramarital) sexual desire, consuming alcohol, using foul language, or neglecting care of the home and family (51). Lobotomies were deemed successful if women could return home, adopt feminine norms of behavior, and bear children (55). Later, negative stories appeared that portrayed men whose masculinity was damaged by lobotomization and who became overly docile or childlike after the procedure (63). These negative portrayals ultimately positioned lobotomy as a threat to society.

Chapter 3 shows how, in the context of the Cold War, lobotomy came to epitomize the external threat of communism and the internal threat of “agency panic,” or “the fear that the individual has lost autonomy and uniqueness in the face of pervasive social control” (74). Johnson argues that it was not simply the case that lobotomy was superseded by a more effective treatment in this time period: “It is more accurate to say that psychiatrists, presented with a number of treatment options in the mid-1950s, were persuaded away from surgical treatments for mental illness and toward something else” (73). The rhetorical linkages between lobotomy and agency panic during the Cold War period explain why the procedure became less and less defensible. Johnson examines the case of the anticommunist Cardinal J...