A doctor drove around America in a van with an ice pick and a hammer. He would put a patient under with an electric shock, lift the eyelid, and drive the pick in through the top of the eye socket. Walter Freeman did about 3,500 of these. He kept no meaningful notes. The transorbital lobotomy. Freeman developed it in the 1940s so that the operation could be done without a surgeon, without an operating theatre and without anaesthesia, in about ten minutes. He travelled in a vehicle he called the lobotomobile and performed them in state hospitals across the country, sometimes a dozen or more in a day, sometimes in front of an audience. He was not a surgeon. He had no surgical training. He operated on about 3,500 people. At least nineteen of them were children; the youngest was four years old. Now the part that belongs on this account. The transorbital lobotomy was performed overwhelmingly on the people least able to refuse it — patients in underfunded, overcrowded public institutions, where the appeal of a ten-minute procedure that made a difficult patient quiet was administrative rather than medical. In the segregated American South and in segregated wards elsewhere, that population was disproportionately Black. Black patients in state institutions were more likely to be committed on thin grounds in the first place — you have had Crownsville in this feed, where a man was institutionalised for startling a horse — and once inside, they were in exactly the pool Freeman was operating on. The documentation of who specifically received these operations is poor, which is itself part of the story: the records of what was done to people in segregated state hospitals are patchy because nobody was required to keep them well. He kept operating into the 1960s. He was finally stopped in 1967 when a patient he was operating on for the third time died of a brain haemorrhage. A man with an ice pick, a van, and no surgical qualification, working his way through the wards of American public hospitals for twenty years. These are the histories that must not disappear. Get our book and uncover the painful stories too often left out of the record. savvypurchase.samcart.com/pr…