Jack El-Hai’s detailed biography of Dr. Walter Freeman, the brilliant but controversial doctor behind the taboo procedure known as the lobotomy, is an unflinching, balanced glimpse into the life, mind, and career of a man whose shadow still lingers over psychosurgery. The Lobotomist is as much a history of psychosurgery as it is a study of the man who was “in the tempest of the long-running historical conflict between the biological and behavioral camps of psychiatry” (134).

Mr. El-Hai presents Freeman not as a monster maniacally wielding a gold-plated ice pick. Instead, Freeman is given even-handed treatment as a fully fleshed man, fallible, stubborn, genius, and devoted to both his family and his patients. The biography unfolds chronologically, beginning with a brief history of Freeman’s grandfather, who himself was instrumental in the medical community, and follows Freeman’s childhood, education, family life, and career. This was a man who was a consummate showman. He was theatrical, dramatic, charismatic, and intelligent. And above all, he was driven both by a genuine feeling of social responsibility toward those with mental illness and by a deep, insatiable craving for the limelight.

Freeman was a talented doctor whose knowledge of the brain was unparalleled but who could not be bothered with the ethics of practicing medicine. He was a neurologist who contentiously ignored the lines between neurology and neurosurgery, an organist whose extreme methods appalled psychiatrists. This was a man driven to make a mark, a doctor who wanted to become “a scientific renaissance man, impervious to criticism, whose strikingly original arcs of thought would bring him international acclaim despite his location outside the world’s most prestigious centers of neurological research and learning” (107). He savored situations in which “he could display his skills, pass his knowledge to others, and salvage people trapped in the worst and most hopeless medical facilities in America. He could act as innovator, teacher, savior, and commonsense man of action” (243).

And whereas pop culture would portray an ice-pick wielding lobotomist as a ruthless engineer of forced mental subjugation, Freeman wholeheartedly “believed that [his] lobotomy patients would lead better lives when some parts of their brain were unable to communicate with others” (135). Though not driven by altruism, Freeman is shown to be a man who tirelessly invested his time and money in following up on his patients decades after their procedures. He was a solitary man, emotionally distant even as he was devoted to his children, preferring his own company above others, tireless and dogged in campaigning for first prefrontal and then transorbital lobotomy, immune to criticism, and unquestionably talented. In his later years, he is shown to be a man who “refused to open his eyes to the possibilities that the new medications offered. He had staked his career on the efficacy of lobotomy, and he would not let go of his beliefs. The stubbornness, egotism, and ambition that directed his thinking were his greatest flaws” (254).

Though the procedure Freeman championed is one that makes a modern reader cringe in horror, my takeaway from Mr. El-Hai’s biography is that Freeman was a product of the natural evolution of the exploratory field that is medicine. In many ways, he was a pioneer ahead of his times. In his day, “neurosurgery was among the newest of medical specialities, but in a few short decades neurosurgeons had successfully laid claim to all types of physical intervention in the brain. Not only had Freeman threatened that medical monopoly, but he had done so by introducing a procedure that seemed appallingly primitive and unaesthetic” (209). Though extreme in measure, Freeman’s procedure was still a scientific—if misguided and blindly pursued—reaction to the growing epidemic of mental illness.

This work of nonfiction is thoroughly researched, engagingly told, and humane in its treatment of both the infamous doctor and the questionable medical practice he championed. Mr. El-Hai is a talented storyteller, recreating Freeman’s life and ambitions in a way that the biography read like a medical drama. I particularly enjoyed the extracts from Freeman’s own extensive writings and the insights provided by his contemporaries and his children. I appreciated the detailed bibliography the author included, and my only complaint is that the timeline jumped back and forth in several places. In the end, the bittersweet irony is that in his hubris and craving for public attention, the driven doctor is indeed remembered for his pioneering work in psychosurgery, though not with the reverence for which he always hoped.

The Lobotomist is a brilliant read, haunting and poignant, harrowing and informative. I highly recommend this biography for anyone interested in the history of psychosurgery as a treatment for mental illness.