University of Michigan Press, 2014, 240 pages.
Jenell Johnson’s 2014 book American Lobotomy: A Rhetorical History provides an accessible and thoroughly enjoyable look at how an infamous medical procedure – the lobotomy – developed, was administered, initially applauded, ultimately loathed, and has had an enduring and profound impact upon medicalization of the mind and public perceptions of medical authority. Johnson expertly intertwines history and detailed biographical information from and about medical professionals and their patients, and contextualizes it all with media and cultural artifacts to synthesize a project that is both entertaining and understandable by readers with little to no prior knowledge of psychiatry, psychosurgery, or public perceptions of the two.
American Lobotomy: A Rhetorical History is aware that the cultural discourse of the lobotomy is largely grounded within “conspiracy theories, political propaganda, radio and television documentaries, autobiographies, biographies, paintings, t-shirts, jokes, and congressional hearings” (1). All of these threaten, in fact, to obscure its initial medical justifications and applications. Yet Johnson’s book and larger project of highlighting significant socio-cultural discourses surrounding medicine provide a case study and argument for why the clouds of mystery that often obscure medical practices ought to be methodically deconstructed. Therefore, while largely historical, American Lobotomy is also forward-looking in that it presents a marvelous argument for why further scholarship exploring the cultural significance of medicine is necessary, perhaps more in the contemporary information age than ever before.
American Lobotomy’s introduction situates the lobotomy as not only a medical procedure, but a mythical one as well, in that its influence upon the American medical-cultural landscape endures despite its disappearance from legitimated medical practice. Chapters one and two delve into detailed explanations of its technical development and initial applications, how it was positively received and framed by media, and even won a Nobel Prize for one of its main proponents. Chapter three complicates the traditional explanation for lobotomy’s decline, which is typically the emergence of psychopharmacology as a “non-intrusive” method for altering undesirable mental states. To this Johnson juxtaposes a persuasive counter-narrative contending that the cultural effects of the Cold War included fears of brainwashing and psychological control; as a result, a large-scale distrust of psychiatry (and the lobotomy in particular) emerged. Chapter four articulates the “return” of lobotomy to the medical forefront when new psychosurgeries emerged during the mid-twentieth century, and here Johnson describes how the activists opposing them rhetorically collapsed psychosurgery with lobotomy, and their practitioner doctors to lobotomists, a strategy that clearly worked to their benefit.
The fifth chapter delves into an explanation of contemporary deep brain stimulation procedures and how they have become rhetorically positioned as different than lobotomies, while chapter six describes the infamous Trans-Allegheny Lunatic Asylum, a contemporary tourist attraction that Johnson herself visits. Here we read about the performative nature of the lobotomy within the present cultural arena, as it has become anthologized within film and horror stories as a warning about medicine, monsters, and medical malpractice. Like chapter six, American Lobotomy’s conclusion is one in which Johnson plays a key role: it contains personal reflections on the work, archival and personal, that was involved in this project, and Johnson’s own haunting realization that perhaps not as much has changed in the world of psychiatry and medicine as we may try to believe.
Methodologically Johnson’s use of rhetorical history neither detracts nor distracts from her project itself. Rhetorical history is a mode of criticism that advocates historicizing the object of critique, in this case the lobotomy, in order to better understand its cultural significance. While the content of the book itself could, I believe, still be informative and enjoyable without any sort of methodological rigor, the inclusion of the rhetorical perspective adds a theoretical dimension that is comprehensible across disciplines and adds increased interdisciplinary appeal to the project.
A potential critique of American Lobotomy is that it attempts to do too much: provide an all-encompassing history of a medical procedure and contextualize these findings from a socio-cultural perspective. Indeed, it is quite a large task to accomplish in fewer than two hundred pages. Yet to this I would respond that medicine and science cannot be divested from the social and cultural milieu in which they emerge and evolve, and to argue that such a thing is even within the realm of possibility is to blind oneself to the importance of social constructions of medicine, and medicine’s constructions of the social, particularly social order, which the lobotomy itself was initially designed to maintain and practiced upon those who threatened its delicate fabric.
All in all American Lobotomy manages to be at once convincing and entertaining, an easy read despite the sometimes dark nature of its subject matter, and highly recommended for anyone interested in the relationship between medicine and culture.
Emma Bedor is a PhD student in the department of Communication Studies at the University of Minnesota. Her research examines intersections of media, medicine, bioethics, and social justice.