One of the most controversial medical procedures in history - Jenell Johnson

翻译人员: Cisy Li 校对人员: Sue Lu

In 1935, neurophysiologist John Farquhar Fulton

1935年，神经生理学家 约翰·法夸尔·富尔顿

presented some shocking new research.

介绍了一些令人震惊的新研究。

After removing the frontal lobes of two chimps,

在切除两只黑猩猩的额叶后，

he found they no longer experienced frustration or anxiety.

他发现它们不再感到沮丧或焦虑。

As his research associate noted, it was as if they’d joined a “happiness cult.”

正如他的研究助理指出的， 他们好像加入了“幸福邪教”。

Admittedly, the surgery had cost Fulton’s chimps some cognitive functions.

诚然，手术使富尔顿的 黑猩猩失去了一些认知功能。

But to Portuguese neurologist Egas Moniz,

但是对于葡萄牙神经学家 埃加斯·莫尼兹来说，

this was a small sacrifice for what seemed to be eternal happiness.

这只是为了看似永恒的幸福 而做出的微不足道的牺牲。

Moniz believed that replicating this procedure in humans

莫尼兹认为， 在人体中复制这种手术

could cure mental illness.

可以治愈精神疾病。

And it was this therapeutic intention

正是这种治疗意图

that led to one of the most controversial and destructive

才导致了一种 最具争议和最具破坏性的

medical treatments of the 20th century:

20 世纪的医学疗法：

the lobotomy.

叶切断术。

Today, we know mental illness comes in many forms and emerges for many reasons.

今天，我们知道精神疾病 有多种形式，其出现的原因有很多。

But in the early 20th century,

但是在 20 世纪初，

these complex conditions weren't clearly delineated,

这些复杂的病情尚未被明确地界定，

and researchers had various theories about their origins.

研究人员对其起源提出了各种理论。

Moniz believed the symptoms of what we now call depression, OCD, and bipolar disorder

莫尼兹认为，我们现在所谓的 抑郁症、强迫症和躁郁症的症状

stemmed from negative ideas getting fixed in the neural fibers

源于那些固定于 神经纤维中的负面观念。

which connect different parts of the brain.

神经纤维连接着大脑不同部分，

Specifically the thalamus and frontal lobes,

特别是丘脑和额叶，

which regulate emotion and sensation.

它们负责调节情绪和感觉。

He proposed that severing these fibers could eliminate the associated conditions,

他提出了将这些纤维切断 就可以消除相关病情，

which led him to invent the prefrontal lobotomy.

并由此发明了脑前额叶切除术。

In this procedure, a surgeon would drill into the skull and cut the white matter

在这个手术中， 外科医生将钻入头骨，

connecting the prefrontal cortex to the rest of the brain.

切开连接前额叶皮层 和大脑其他部分的白质。

Initially, his peers were skeptical.

最初，他的同行都持有怀疑态度。

Moniz’s fundamental theory was already controversial.

莫尼兹的基本理论 已经引起了争议。

And psychiatrists advocating for treatments like psychoanalysis

主张精神分析等治疗 的精神科医生们

criticized this invasive surgical solution.

也批评了这种侵入性手术解决方案。

But Moniz was undeterred.

但是莫尼兹并没有气馁。

He lobotomized 38 individuals with conditions including anxiety,

他对 38 人 进行了 脑叶切除术，他们均患有焦虑、

schizophrenia, and depression.

精神分裂症和抑郁症等疾病。

And his hastily written results reported that two-thirds of these patients

然后他匆忙写出的结果显示， 这些患者中有三分之二

had become tranquil, amicable, and free from distressing hallucinations.

已经变得平静、友善， 没有出现令人痛苦的幻觉。

At the time, psychiatrists saw calm behavior as a sign of recovery,

当时，精神科医生将冷静的 行为视为康复的标志，

so when Moniz brashly declared the treatment a success,

因此，当莫尼兹大胆 宣布治疗成功时，

his peers agreed.

他的同行表示了认同。

Newspapers celebrated the surgery;

报纸纷纷称赞这一手术；

Moniz was awarded the Nobel Prize;

莫尼兹也为此获得了诺贝尔奖；

and his procedure became especially popular in the US

他的手术在美国备受欢迎,

thanks to neurologist Walter Freeman and neurosurgeon James Watts.

多亏了神经科医生沃尔特·弗里曼 和神经外科医生詹姆斯·沃茨的帮助。

As a country that had institutionalized nearly half a million people

美国精神机构曾收容近五十万人，

for mental health reasons,

这些人都有心理健康问题。

many hoped the new treatment would allow this population

大家希望新疗法能够让这些人

to live relatively normal lives.

过上相对正常的生活。

But from the beginning there were problems.

但是从一开始就有不少问题。

First, the notion of a “normal life”

首先，“正常生活” 的概念

was determined by this period’s restrictive social mores,

由这一时期严格的社会习俗所决定，

which had led huge numbers of people to be institutionalized

从而导致很多人被送进精神机构

simply because they didn’t conform.

仅仅是因为不顺从那些习俗。

So, while many people in these facilities did need medical help,

因此，尽管这些机构中的许多人 确实需要医疗帮助，

some lobotomy recipients had no mental illness whatsoever.

但一些肺叶切除术患者 并无任何精神疾病。

Second, the details and timeline of the surgeries’ results

其次，手术结果 的细节和时间线

were unpredictable and inconsistent.

既不可预测也不一致。

In 1941, when future US President John F. Kennedy’s sister Rosemary

1941 年，当未来的美国总统 约翰·肯尼迪的姐姐罗斯玛丽

underwent a prefrontal lobotomy,

在接受前额叶切除术后，

it permanently impaired her ability to speak and walk.

她的语言和行走能力都永久地受损了。

And even when the surgery did help patients manage

而且，即使手术帮助患者控制了一些

overwhelming emotions and hallucinations,

难以承受的情绪和幻觉，

they often experienced significant side effects.

它们也经常带来严重的副作用，

These included apathy, abrupt personality changes, and cognitive impairment.

包括冷漠、暴躁的 性格变化和认知障碍。

Tragically, the stigma around mental illness kept people from discussing

不幸的是，对精神 疾病带来的耻辱感让人们不愿讨论

their negative experiences,

自己的负面经历。

so the procedure kept happening.

于是，这一手术一直在持续进行。

But prefrontal lobotomies required a team of surgeons and specialized equipment,

但是前额叶切除术需要一支 专业的外科医生团队和专业设备，

making them out of reach for most patients.

这使得大多数患者都无法获得治疗。

At least until 1945,

直到 1945 年，

when Freeman began developing a simpler and cheaper alternative.

弗里曼开始开发一种更简单、 更便宜的替代方案。

In his new transorbital lobotomy,

在他新的经眶脑白质切除术中，

the patient was first rendered unconscious via electroshock therapy.

患者首先通过电休克疗法失去知觉，

Then, an ice pick-like instrument

然后，一个类似冰锥的工具

was pushed through the thin bone of their eye socket

被插入眼眶的薄骨层，

and manipulated to sever the fibers

用来切断神经纤维，

between the thalamus and frontal lobes.

这些纤维位于丘脑和额叶之间。

Transorbital lobotomy was intended to be performed by physicians

经眶脑白质切除术本来是 为普通医生定制的，

without surgical training in under ten minutes.

他们没有手术培训也能 在不到十分钟内完成手术。

And Freeman proved his procedure’s efficiency during a hospital visit,

弗里曼在一次医院探访时 证明了他的手术的高效性——

where he performed the surgery 228 times in just 12 days.

短短 12 天内 他做了 228 次手术。

Transorbital lobotomy was immediately controversial.

经眶脑白质切除术立即引起了争议。

Even Freeman’s long-time collaborator James Watts

即使是弗里曼的 长期合作者詹姆斯·沃茨

was against making such a consequential surgery

也反对将如此重要的手术

quick, dirty, and accessible to amateurs.

以快速、邋遢的方式进行， 并对不专业的医生开放。

But the procedure remained popular throughout the Western world

但这种手术在 西方世界一直很受欢迎，

until the 1950s,

这种情况持续到了 1950 年代。

when tranquilizers began offering a less permanent

当时，镇静剂开始作为 一种不那么持久，

and more predictable alternative.

却更可预测的替代品出现。

By the mid-60s, lobotomies were most often found in science fiction and horror films,

到 60 年代中期，肺叶切除术最常 出现的地方是在科幻小说和恐怖片中，

where they became a potent metaphor

它们成为一种有力的象征，

for brutally controlling those who don't fit the norm.

用于比喻那些残酷操控 不符合社会规范者的情形。

Today, lobotomy serves as a chilling reminder that scientific progress

如今，肺叶切除术成为令人不寒而栗的 警示，提醒我们，科学进步

requires transparency and clear ethical standards.

需要透明和明确的道德标准。

Because without honest reflection,

因为如果不进行诚实的反思，

even efforts to alleviate human suffering can cause serious harm.

即使是减轻人类痛苦的努力， 也可能造成严重伤害。