Reviewer: Robert P. Hudson, BA, MA, MD (University of Kansas School of Medicine)Description: Psychosurgery was a major innovation in America during the 1940s and 1950s, just as the new specialty of psychiatry was seeking identity and acceptance. Despite its flimsy scientific basis, crude techniques, and many failures, tens of thousand of persons underwent frontal lobotomies, often as office procedures.Purpose: Historical assessments of the lobotomy story usually dismiss it as a medical catastrophe and a warning of the consequences of science running amuck. The author demonstrates that this depiction is not only simplistic, but wrong-headed. He shows that lobotomy was based on a reasonable application of contemporary science, that it was done in the psychiatric mainstream rather than by a few peripheral zealots, and that many results were perceived as beneficial, particularly in overcrowded state hospitals where lobotomy rendered difficult patients manageable, even at the price of severely altered personalities.Audience: The history of therapeutics is generally underdeveloped at present, despite its critical importance to the current scene, where the naive acceptance of everything called alternative medicine threatens to return medicine to the chaos of the nineteenth century. Practical matters alone should recommend this book to healers of all stripes at any stage of their careers, to social planners, historians of the life sciences, and the immense population most affected by the vagaries of medical practice, the consumer.Features: The story of the rise and fall of lobotomy demanded an explication of the forces shaping psychiatry as we know it today. This story is integrated seamlessly and economically into the overriding account of a fledgling specialty seizing on the unscientific destruction of normal brain tissue in quest of scientific legitimacy. Assessment: Many studies document America's scientific illiteracy. Most of us fail to understand the methods, capabilities, and limitations of science. As a nation we need more books like this one. Reading the remarkable epilogue, "Last Resort," alone would be a good place for anyone to begin.
4 Stars! from Doody
Last Resort is medical history at its best....This book is much more than an important contribution to medical history (as if that were not enough). Every student and practitioner in psychiatry, psychology, and social work -- in short, any student who wants to understand contemporary psychiatry and medicine -- will find Last Resort extremely rewarding. It should become required reading for all psychiatric house officers.
New England Journal of Medicine
Psychosurgery was a major innovation in America during the 1940s and 1950s, just as the new specialty of psychiatry was seeking identity and acceptance. Despite its flimsy scientific basis, crude techniques, and many failures, tens of thousand of persons underwent frontal lobotomies, often as office procedures. Historical assessments of the lobotomy story usually dismiss it as a medical catastrophe and a warning of the consequences of science running amuck. The author demonstrates that this depiction is not only simplistic, but wrong-headed. He shows that lobotomy was based on a reasonable application of contemporary science, that it was done in the psychiatric mainstream rather than by a few peripheral zealots, and that many results were perceived as beneficial, particularly in overcrowded state hospitals where lobotomy rendered difficult patients manageable, even at the price of severely altered personalities. The history of therapeutics is generally underdeveloped at present, despite its critical importance to the current scene, where the naive acceptance of everything called alternative medicine threatens to return medicine to the chaos of the nineteenth century. Practical matters alone should recommend this book to healers of all stripes at any stage of their careers, to social planners, historians of the life sciences, and the immense population most affected by the vagaries of medical practice, the consumer. The story of the rise and fall of lobotomy demanded an explication of the forces shaping psychiatry as we know it today. This story is integrated seamlessly and economically into the overriding account of a fledgling specialty seizing on the unscientific destruction ofnormal brain tissue in quest of scientific legitimacy. Many studies document America's scientific illiteracy. Most of us fail to understand the methods, capabilities, and limitations of science. As a nation we need more books like this one. Reading the remarkable epilogue, ""Last Resort,"" alone would be a good place for anyone to begin.
"The physician's maxim to 'do no harm' never clashes more with the desperate need to 'do something' then in the case of psychosurgery. Jack Pressman's thorough analysis in Last Resort has deep implications for the decisions that doctors make every day." Dr. Michael Brown, Nobel Laureate, University of Texas Southwestern Medical Center at Dallas
