Gray Matters: Brain Injury: the Inside Perspective Book

"My name is Howard Dully. I'm a bus driver. I'm a husband, and a father, and a grandfather.
I'm into doo-wop music, travel and photography. I'm also a survivor: In 1960, when I was
twelve years old, I was given a trans orbital or 'icepick' lobotomy. My stepmother arranged
it. My father agreed to it. Dr. Walter Freeman, the father of American lobotomy, told me he
was going to do some 'tests'. It took ten minutes and cost two hundred dollars. The surgery
damaged me in many ways...."


There are events that occur over the course of a lifetime in which people, upon reflection, describe as life-altering. In this memoir, 'My Lobotomy', Howard Dully (with the assistance of journalist Charles Fleming), describes such an event. In 1960, when Howard was 12-years-old, he was taken to a California hospital by his stepmother Lou and his father Rodney Dully and was given an 'icepick' lobotomy by Dr. Walter Freeman. To attempt to fully describe the impact this dubious procedure had on his life, Howard explains how the procedure was done and the reason the procedure was, for a time, a 'popular' one in treating a variety of psychoses which were not understood or considered treatable by any other means. In Howard's case, in particular, an icepick-like instrument was inserted about three inches into each of his eye sockets and was twirled around, cutting connections between his frontal lobe and the rest of his brain. Howard makes the point a number of times throughout the book that he has no memory of the lobotomy. Rather, he has relied on the memories of family members and the case notes and records of Dr.Freeman.. records which he had been given access to at George Washington University. It is Dr. Freeman's notes which provide a shocking description of what Howard experienced the day of his lobotomy. To sedate patients in preparation for lobotomies, Dr. Freeman administered electroshock. In his notes regarding Howard, he wrote.... "Howard came around quickly after the first shock. I eventually gave him four, after which he was quite slow in recovering. I think it was one more than necessary....". His notes regarding Howard's lobotomy and the hours immediately following the procedure describe.... ".. there was an escape of a small amount of blood-stained fluid from each eye socket.... He had a considerable amount of vomiting during the night and I prescribed 50mg Dramamine for its control. He resisted efforts to get his eyes open and complained about the needles that were being given him. His temperature, pulse and respiration were quite normal."

Although Dr. Freeman described Howard's vital signs as 'normal', Howard's life became far from normal and he would spend the next 40 years trying to piece together what had happened to him and why it had happened, with he hope that that obtaining this information would help him build a happier and productive life. So why DID Rodney and Lou Dully decide to have Howard lobotomized at the age of 12? Had Howard been suffering from mental illness? And what were the consequences of the lobotomy on the remainder of Howard's childhood and young adulthood? In this memoir, Howard attempts to provide answers to these questions. He attempts to reconstruct the chronology of his life ... from what he, himself, remembers and from what he has been told by people who have known him at various stages of his life.

As you might imagine, attempting to reconstruct your life through the recollections of other people would not be a fully satisfying experience. You wouldn't be able to FEEL any of the emotions that correspond with these recollections. And I have to admit that this distance that Howard experienced also transferred to my own experience of reading his story. There were times while reading this book that I felt emotionally disconnected from the events he was describing, mainly because he didn't seem to be attaching any particular emotion to the events either. Having said that, I still found this book difficult to read. Although Howard seems to have made peace with what had happened to him and has built a happy life with his wife, their sons and grandchildren, I couldn't help but feel outraged on his behalf. His life story and experiences illustrate all too well the awful reality that families AND society often fail to protect our most vulnerable people.

From all the information that Howard was able to gather, it was clear that he had never been mentally ill; nor had he been engaged in such problematic behaviors as a child to have warranted a lobotomy, Howard, whose mother had died when he was just 5 years-old, lived with his father Rodney and younger brother in a kind of nomad-like existence until Rodney met and married his second wife Lou, who also had a sin from a previous marriage. The reasons aren't clear but from the beginning, Lou seemed to have taken an intense dislike to Howard and she never attempted to keep her feelings secret.. not from Howard or the rest of the family. She frequently singled Howard out for punishment for behaviors which didn't seem all that unusual to me... behaviors such as failing to clean up after himself, complaining about his bedtime, and not being attentive in the classroom at school. Howard writes of constant beatings and verbal abuse. And Howard's father was cold and distant; and given that he worked 4 jobs, he was not available to provide emotional support, even if he HAD been willing.

Using Dr. Freeman's case notes and his own scattered memories, Howard discovered that Lou began visiting psychiatrists, telling them that Howard was out of control and that she was afraid to have him living in the family home. Over and over, the psychiatrists came to the conclusion that Howard was not emotionally troubled and did not display signs of mental illness. Rather his behaviors were consistent with other pre-adolescent boys his age. Lou didn't give up, however. Instead she obtained an appointment with Dr. Walter Freeman and although Freeman seemed to initially agree with his colleagues' opinions, his case notes demonstrate that after repeated consultations with Lou and finally, Rodney, he proposed that Howard was schizophrenic and his behavior might improve if treated with a prefrontal lobotomy. He proposed that a lobotomy might make Howard more docile and manageable and less argumentative and disruptive to the household. Howard discovered many years later when examining Freeman's notes just how far Lou had been willing to go and how easily persuaded his father had been to give permission for the procedure. Freeman had written.... ".. things have gotten much worse and she (Lou) can barely endure it." Freeman also wrote that Howard was tormenting the family dog, sticking pins in his little brother and suffering from delusional ideas that everyone was against him. Lou also told Dr. Freeman that Howard had been stealing things, breaking into homes along his paper route and that he had to be kept separated from his brothers to "avoid something serious happening".

Howard's lobotomy and subsequent personality changes did not satisfy his stepmother. She reported to Dr. Freeman that the procedure had NOT turned Howard into a 'vegetable' as she had expected and she wanted him removed from the family home. Rodney Dully was given an ultimatum: remove Howard from the home or Lou would divorce him. Rodney chose to remove Howard from the home and turned him over to the Santa Clara County Juvenile Hall in 1963. Because Howard hadn't been charged with a crime, they couldn't legally hold him in detention and since he hadn't been declared psychotic, he also couldn't be admitted to the state hospital for the 'mentally insane'. An assessment written by a psychiatrist for the Juvenile Probation Department interestingly provides a more insightful look at what had been transpiring in Howard's life and the Dully family home.... "The stepmother has always seen him as a problem and not nearly as good as her own son. In the home at this time, he is always looked on with skepticism and is never allowed to be alone with his younger brothers. Neither parent feels they can trust him... In the best interest of Howard, he should be removed from his home in that his stepmother seems determined to destroy him."

Howard was sent to Napa State Hospital, an institution for children with mental and cognitive difficulties and delays. Although Howard was occasionally visited by his father, he would never again return to his family home. He spent the remainder of his childhood in state institutions and although his maternal grandmother expressed interest in adopting him, Rodney Dully refused to allow him to be adopted. After being released from the state institution, Howard spent the next 20 years wondering why his life had taken such a turn. Had he done something so terrible that he simply had no memory of? Why had his father allowed this to happen? Why did Lou dislike him so much? Howard's questions were heartbreaking but unfortunately he wouldn't find any of the answers for many years.

When he was finally released from the institution, Howard set out to build a life for himself but without guidance, support or even basic life skills knowledge, he son found his life out of control. He drank heavily, abused drugs, had trouble with police and drifted from one bad romantic relationship to the next. His last relationship, which resulted in fatherhood, was characterized by jealousy and incidences of violence. Howard knew he had to make a change but his impulsivity seemed to get in the way of his making better decisions. Finally, he met Barbara... the woman he would marry and whom he credits with inspiring big changes in his life. It was Barbara, the newfound stability in his life and a heart attack which he suffered around his 50th birthday which brought back all the old questions he had pushed away regarding his lobotomy and his family's betrayal.

Perhaps by chance (or was it fate?), Howard heard of a documentary being developed for NPR about Dr. Walter Freeman. He contacted the documentarian, whose name was David Isay. It was through Howard's involvement in the making of this documentary.. which ultimately aired on NPR's 'All Things Considered' in 2005... that he obtained permission to access Dr. Freeman's notes and records and where he discovered, written in the doctor's own hand, many of the answers he had been searching for for so many years.

Of course, this book was inspiring to read. Howard Dully overcame huge obstacles to build a productive and happy life for himself and that IS uplifting. But I admit that I couldn't help but 'hear' the 12-year-old Howard's bewilderment and unfathomable pain behind every word that he wrote. Despite Howard's apparent resilience, I couldn't help but be reminded of the many vulnerable people trying to cope with mental illness and finding so little societal support available to them. This book WAS compelling and was not only about one man's personal experiences but was also a fascinating and troubling (if abbreviated) history of mental illness, the dubious treatments and the institutionalization of the mentally ill in our society. Although lobotomies are rarely done these days (and apparently are NEVER done using icepick-like tools), they remain a controversial 'treatment'. Some patients and their families are adamant that lobotomies changed their lives or loved ones lives for the better; while others (like Howard Dully) believe the procedure brought only damage and pain. One thing seems clear: society seems to have little understanding (or perhaps little WILL) as to how people with mental illness should be cared for. We need to do better.