Up@dawn 2.0

Sunday, February 12, 2017

Patient H.M. Quiz and Discussion Questions


1. Burckhardt states that “doctors are different by nature,” falling into two distinct categories. Under which of the two natures does Burckhardt consider himself to belong?

2.Walter Freeman experimented with the full battery of shock treatments, but he was never satisfied. Why?

3. What did Freeman name the new field of psychiatric surgery?

4. What are the root words that make up the word “lobotomy” and how are they significant to the surgery?

5. As a general rule, when Freeman performed a lobotomy, what was the simple strategy to which he adhered?

6. After studies had been performed upon primates, what was the suspected outcome of removing the uncus and what was its purpose?

7.What happened to patient D.M.’s demeanor immediately after her uncotomy, the term Scoville used to describe the procedure?

8.What was ironic about the effect of the extensive accidental damage to patient I.S.’s behavior compared to the lesioning of the uncus in Scoville’s other four patients?

9.What question was Scoville trying to answer when he removed a total of twenty-five grams of brain tissue from one of his patient’s?

10.What section of the brain did Scoville suction from patient A.Z. that produced a “positive” result, and what were the immediate negative side effects?

Discussion Questions:

  • Walter Freeman, the inventor of the lobotomy, looked for signs that his treatment helped people. He visited with his patients after their procedures, took before-and-after photos, and generally found adequate (for himself) confirmation that his patients were better off post-lobotomy. How easy do you think it is to fall for these kinds of self-fulfilling prophecies, to only see what you want to see?
  • There was an imbalance in the number of male and female lobotomies, due to women being expected to behave in a specific way. How do gender roles still affect modern healthcare and medicine?
  • Part of the motivation for lobotomizing so many patients was the overcrowding of asylums, a problem the wealthy, with access to private asylums, did not face. Because of this, lobotomies were more prevalent among the poor. What’s your opinion on social class dictating the quality of care?
  • Scoville referred to interesting cases, like a dwarf with misfiring adrenal glands that he studied, as “material” he could work with. Does the study of unique human cases to advance scientific understanding necessitate reducing them to being a means to an end? Is there any way to do human experimentation without violating Kant’s ethics?
  • Freeman wanted to create a lobotomy that anyone could do, so that they could be more widespread. This is a gross example of choosing quantity over quality. What kind of balance do you think is healthy in medicine, when it comes to quality and quantity?
  • The patients upon whom lobotomies were performed could hardly be said to have been consenting. But because of their mental state, their doctors did not value their consent. Issues regarding mental health make the process of consent murky. How would you decide if the doctor really does know best?
  • Health vs. wellbeing: patients post-lobotomy were more docile and accepted by society, but their quality of life was irrefutably less. With this in mind, should healthcare professionals focus more on the physical conditions of a patient or the mental and emotional conditions?
  • At the Institute of Living, a private mental asylum, the author’s grandmother was subjected to regular electric shocks in order to ‘cure’ her. Because the Institute’s residents were growing increasingly fearful, the head of the asylum tried to change the name of the treatment from ‘shock’ to ‘sleep’, as it induced a brief coma. Do you believe simply changing the name of the treatment was the solution to the issue or was there something faulty about the treatment as a whole?


  1. I apologize for the late upload of this post. I couldn't seem to upload the photos for a while. I hope everyone is able to view the entirety of the post without any complications, and we look forward to presenting on Tuesday.

  2. It's fine. Y'all have raised lots of great questions.

    Does anyone else find this old Ramones song (https://www.youtube.com/watch?v=6ssoBUb2cJk) crowding into your brain as you read about Patient H.M.? Or am I dating myself? (V's Day is also a milestone birthday for me this year, btw, if you'll pardon my blatant & pathetic appeal for sympathy...)

  3. "Health vs. wellbeing: patients post-lobotomy were more docile and accepted by society, but their quality of life was irrefutably less. With this in mind, should healthcare professionals focus more on the physical conditions of a patient or the mental and emotional conditions?"

    A pure focus on "physical" (construed as non-mental) health would presumably mean discontinuing psychopharmacology and psychotherapy. Maybe the question should be whether the more invasive forms of mental therapy, specifically those requiring physical incursion into the brain, should be discouraged or discontinued?

    In that vein, I wonder what we think of the recent appeal by Michael and Kitty Dukakis in support of electro-shock therapy? https://www.nytimes.com/2016/12/31/us/kitty-dukakis-electroshock-therapy-evangelist.html

  4. Here are some interesting and relevant articles:





  5. It is common among the sciences that if an experiment does not have enough data that false conclusions can be drawn. In fact the history of sciences is full of cases where the wrong conclusion has been drawn. As such I believe it is extremely easy for the wrong conclusion to be drawn.