Freeman performed nearly 3500 lobotomies in 23 states, mostly based on scanty and flimsy evidence for its scientific basis[1][2], but more significantly he popularized the lobotomy as a legitimate form of psychosurgery. A neurologist without surgical training, he initially worked with several surgeons, including James W. Watts. In 1936, he and Watts became the first American doctors to perform prefrontal lobotomy (by craniotomy in an operating room).
Frustrated by his lack of surgical training and seeking a faster and less invasive way to perform the procedure, Freeman invented the "ice pick" or transorbital lobotomy, which, at first, literally used an ice pick hammered through the back of the eye socket into the brain. Freeman was able to perform these very quickly, outside of an operating room, and without a surgeon. For his first transorbital lobotomies, Freeman used an actual icepick from his kitchen. Later, he utilized an instrument created specifically for the operation called a leucotome. In 1948 Freeman developed a new technique which involved wrenching the leucotome in an upstroke after the initial insertion. This procedure placed great strain on the instrument and in one case resulted in the leucotome breaking off in the patient's skull. As a result, Freeman designed a new, stronger instrument, the orbitoclast.
Freeman embarked on a national campaign in his van which he called his "lobotomobile" to demonstrate the procedure to doctors working at state-run institutions; Freeman would show off by icepicking both of a patient's eyesockets at one time - one with each hand.[3] According to some, institutional care was hampered by lack of effective treatments and extreme overcrowding, and Freeman saw the transorbital lobotomy as an expedient tool to get large populations out of treatment and back into private life.
The “ice pick lobotomy†was, according to Ole Enersen, performed by Freeman “with a recklessness bordering on lunacy, touring the country like a travelling evangelist. In most cases,†Enersen continued, “this procedure was nothing more than a gross and unwarranted mutilation carried out by a self righteous zealot.â€
