When he finished his reading, Larry’s decision was made. He could not go on as he was, any longer. His mind had become his enemy. It told him that he had no right to relax, to enjoy himself, to live. It entombed him in fear, fear of the next day, of the world around him, of himself. He would cut himself free of this mind. He would go East, at once, and have a prefrontal lobotomy.
Accompanied by Harriet, he went to New Jersey and lived with one of his brothers, who was eager to be of help. Together they consulted two psychiatrists, one in Philadelphia and one in New York City, about the wisdom of a prefrontal lobotomy operation. Both psychiatrists firmly advised against it as “too drastic at this time.” Larry was confused. He had been afraid to live, afraid to die, and the lobotomy had presented itself as a lifebelt, with which to survive as long as fate decreed. Now the lifebelt was being withheld from him and there seemed no other choice. Then, suddenly, overnight, there were a half-dozen choices, and Larry, snatching at anything and everything, began his Dantesque journey through Hell.
While Harriet remained with his brother in New Jersey, Larry entered the special mental clinic of a major New York hospital, in January, 1944. He lived inside the walls of the hospital for one unrelieved year, without once venturing outdoors. He was assigned a woman psychiatrist. It was felt that the change in the sex of his analyst might be beneficial. But after several months, the woman psychiatrist pronounced him beyond the help of psychoanalysis. She, after calling in other doctors for consultation, decided upon insulin and electric shock treatments. The doctors administered sixty shock treatments to Larry. The hospital claimed that they had never before given a patient so many. Before going downstairs for each shock treatment, Larry would stiffen with fright. Yet, after it was over, he never remembered having had it. As time passed, the hospital became Larry’s entire outer world. He occupied himself with reading, Ping-pong, oil painting. He did some handicraft work. And he sank deeper and deeper into his manic-depressive anxiety state. At year’s end, the hospital admitted that no similar case had been confined so long. At year’s end, there was no real improvement in Larry, despite his momentary periods of high elation. He finally left the clinic and rejoined Harriet in New Jersey.
Now, acting on every new suggestion made, Larry began riding a mad merry-go-round of therapy. There was the German refugee psychologist-religionist, a Jew possessing a library of perhaps six thousand books and pamphlets on Jesus, who tried to infuse him with faith in the future and in God. There was a new psychiatrist in Kentucky. And a kindly, perceptive young analyst in East Orange, New Jersey, whose medical summary of Larry read, “He was in an extremely agitated state. He paced about the room, wept, distorted his face grotesquely and complained bitterly about obsessive thoughts. Everything was ‘a torture to me—your shoelaces, your tie, that dresser scarf—the very thought torments me.’ It was felt that he was possibly suicidal, although his anxiety was by far the predominant feature of his mental picture. After four months, we began to change our diagnosis. We felt that the illness was considerably more malignant than a diagnosis of anxiety state would indicate. His illness came to be thought of as Pseudoneurotic Schizophrenia.”
Finally, there was even a miracle man in New England, who worked wonders by inserting strange tubes and rubbing secret compounds. After Larry visited the miracle man, he enjoyed a relatively good period. He even felt, briefly, that the miracle man might save him. But, in the end, it turned out to have been only his manic stage, and when his depressive stage arrived again, with its private hell of crying spells and perspiration baths and twisting abdominal pains, and he threatened suicide, the miracle man was quickly abandoned, as had been all the rest before him.
Larry’s limited social life was equally frustrating. Once, double-dating with an old acquaintance in New York, Larry, in a deep downbeat mood, discussed the ethics and pleasures of suicide. This not only threw a wet blanket on the evening, but infuriated Larry’s friend, until he finally told Larry that he was a fake. If he wanted to commit suicide, why didn’t he? He was just playing on everybody’s sympathy, trying to get attention.
“Harriet later told me how Larry argued back,” Jack says. “The friend just didn’t understand. Most people didn’t. They could look at a man who’d lost an arm or a leg and realize his incapacity. But they couldn’t understand a mental cripple. They couldn’t grasp that, like a man who’s lost a limb, Larry had lost something in his head. They’d see he looked healthy, and that he was smart, and they’d say all he needed was to snap out of it. It was like telling a man without legs to get up and walk. After that, there were no double dates.”
It was late in 1945. Since abandoning the miracle healer, they had run out of doctors, and Harriet suggested that another change of scenery might do him good. From that moment, they were constantly on the move. They went to Tucson, Arizona, to visit Tim, who had been discharged from the army. The train ride was a nightmare, with Larry in a constant state of terror, shouting, “Kill me! Kill me!” Few onlookers understood his illness. In Tucson, Larry borrowed Tim’s coupe and went out driving alone, to return hours later, soaked with sweat. He had pushed the little car to eighty miles an hour, hoping it would skid off the road. It had not, and he had not let it.
Next, they went to the farming town in Ohio where Harriet’s large family lived. Larry was accepted with simple affection, but, soon tired of reading and of rides on his brother-in-law’s delivery truck, he began speaking wildly of suicide again. They pushed on to New Jersey, to live with another of Larry’s brothers. The East Orange psychiatrist took over again, gave Larry about thirty-five insulin and shock treatments, then refused to give any more. One night, Larry had convulsions and the doctor had to be summoned on the run. As analysis plodded on, without success, Harriet and Jack (who had just been discharged from A.T.C.), suggested hypnosis. The psychiatrist flatly rejected this. In desperation, the family confined Larry to the Veterans Hospital at Lyons, New Jersey. Larry was there several months, unable to keep his mind off himself, steadily growing worse.
In the end, it was neither Larry nor Jack, but a doctor at this Veterans Hospital, who brought up the subject of prefrontal lobotomy once more. The doctor sent a recommendation for lobotomy, along with Larry’s case history, to the Veterans Administration. The VA turned the recommendation down.
Meanwhile, another doctor, in the same hospital, made an off-the-record suggestion that the lobotomy be performed on the outside by private doctors. He recommended an experienced psychosurgery team in the East. For ethical reasons, I shall refer to this team under the fictional names of Drs. Leon Goldsmith and Raymond Rogers, and locate them in Boston. The army doctor thought that Goldsmith and Rogers were among the best, and least expensive, in the country, for the particular job at hand. In desperation, Jack and Harriet asked the opinions of seven different doctors on the advisability of lobotomy. Four were against it. Three were for it.
Who was to make the decision? Larry was too ill, too torn by pain, to care about anything. His wife, Harriet, was too upset and bewildered to decide. And so, the major weight of the decision devolved upon his brother. Inexperienced though he was. Jack weighed both sides of the matter carefully. Doctors, obviously, could not give him a clear-cut answer. Their opinions on lobotomy were split almost down the middle. But there was still one more thing to ask them. Without lobotomy, was there any hope for Larry’s recovery? The answer was unanimously no. A miracle might happen, of course, but they had no statistics supporting miracles. On the other hand, Larry might one day succeed in killing himself, although they held this unlikely. “He’ll soon go into a completely psychotic state,” they agreed, “and have to be institutionalized for the rest of his life.”
This promise of Larry’s future, combined with his relentless decline, suddenly panicked Jack. Lobotomy was useful only if a patient still had his grip on reality. Larry was rapidly losing his grip and might soon be beyond lobotomy. Time had become a factor. Jack could see no other choice. There appeared no less
drastic treatment left. Lobotomy was relatively painless, even less uncomfortable than having one’s tonsils extracted, they said, and it was relatively safe, with a record of only a 3 percent fatality. Whatever else it might do to Larry, lobotomy would relieve him of anxiety. Larry was consulted. He was almost beyond coherence but agreeable to anything, even euthanasia. Harriet and the other Cassidy brothers were consulted, and reluctantly they all agreed that there was nothing else to do.
During the last week in March, 1947, Jack and Harriet journeyed to Boston to consult with Drs. Goldsmith and Rogers. Jack and Harriet waited in a reception room with seven or eight other people, mostly relatives of patients. However, there was one actual patient, a robust, middle-aged woman, who kept conversing with her husband, speaking, at the top of her voice. Since everyone else in the room was silent, her loudness made them stare. Once, she stared back at the others, then yelled, “Don’t worry, I’m fine! Look at me! I’m happy! I feel wonderful!” Jack glanced at Harriet, apprehensively. The woman’s husband caught the glance, and later, managed to sit down beside Jack. “She really is doing quite well, you know,” the husband explained. “Since her lobotomy, she’s taking an interest in housework again. She even does the dishes occasionally.”
Presently, Jack and Harriet were ushered in to meet Dr. Goldsmith, a serious, bespectacled, middle-aged man, gaunt and lanky. In preparing for the lobotomies, he was the psychiatrist of the team. He diagnosed the illness and plotted the operation. Dr. Rogers, a heavyset, easygoing lowan, was the surgeon.
When Jack finished his recital of Larry’s ills and previous treatments, he asked Dr. Goldsmith one question. “Will the operation do Larry any good?” Dr. Goldsmith reassured him that they were most successful in handling cases of Larry’s type, that is, anxiety cases. Dr. Goldsmith said that prefrontal lobotomy would definitely free Larry from his fears and anxiety, but he reminded Jack and Harriet that the operation might also make Larry lose his sense of responsibility, as well as his knowledge of social graces. For example, shortly after the operation, he might urinate while in the living room, instead of going to the bathroom. Also, he would lack initiative and have a confused sense of time. He would remember his nervous illness, but it would be a faraway thing. He would remember the lobotomy itself, but only when reminded, and only as something that seemed to have happened to someone else. Finally, he would never be able to do creative work, like writing, again. At best, he might succeed at holding a clerical position.
Doggedly, Jack reiterated that they all wanted the operation performed at once, before Larry went insane or committed suicide. Dr. Goldsmith promised to let them know as soon as he was free, as soon as a scheduled operation was canceled. The very next day, in New York,’ Jack received a telegram stating that a cancellation had come through.
Two weeks later, during the late morning of April 14, Larry, accompanied by Harriet, Jack, another brother who dwelt in New Jersey, and his old roommate, Burt, boarded a Boston-bound train in Newark. As the train sped on, Larry became more and more agitated. They all took turns sitting beside him, trying to distract him. But his mind kept coming back to the operation. He was afraid to have it; he was afraid not to have it. “I’ll wind up an idiot,” he kept muttering. Burt tried to reassure him. “Larry, this operation is the most wonderful thing in the world.” Larry shrugged. “I don’t care, don’t care if it kills me. Anyway, if it doesn’t, at least I won’t have to be myself any more.”
They reached Boston in the afternoon. It was an overcast day. They took a taxi to the hospital, where a bed had been reserved for Larry. The hospital telephoned Dr. Goldsmith. Before the doctor arrived, the others in the party were permitted to see Larry once more. They tried to give him pep talks.
It was early evening when Dr. Goldsmith appeared, carrying photographic equipment. Dr. Goldsmith was alone with Larry for an hour. Later, they were joined by Dr. Rogers. Talking to the doctors, Larry was severely depressed. He alternately cried, perspired, and choked out his desire to die. When the talks were ended, Dr. Goldsmith set up his photographic equipment and took several shots of Larry. The portraits showed a fearful, haunted man.
The next morning, it rained. Burt had returned to New York to go to work. Jack, Harriet, and the other brother, who had spent the night in a hotel across the street, were in the waiting room of the hospital early. Dr. Goldsmith and Dr. Rogers had a prior lobotomy scheduled for nine o’clock. Larry was second on the list. At eleven o’clock, the first operation was completed. At eleven-fifteen, Larry, head shaved, drowsy under a basal anesthetic, was swiftly wheeled past his wife and brothers into the operating room.
Harriet gasped, then began weeping. She cried almost steadily during the next two hours. The worried brother from New Jersey watched her in stunned silence. Jack fought tears, as he saw Larry disappear into surgery. Jack remembers, to this day, the thought that went through his mind that last, helpless moment. He thought: I will never see him again as I’ve known and loved him all my life. He will soon be returned from that room, the same name, the same face, the same body, but a different human being, forever, for the rest of his life and ours.
While the three sat in dreadful silence, in the lonely waiting room. Dr. Goldsmith and Dr. Rogers bent over Larry inside the operating room. Dr. Rogers had marked out areas on Larry’s shaved scalp for the trephine openings. These areas had been injected with Novocain. Nothing that followed physically hurt Larry. The localized anesthetic, as well as the fact that the human brain is insensitive to pain, fortified him. Following his earlier markings. Dr. Rogers made the necessary incisions at each temple, above the ears. A button of bone, smaller than a dime, was removed on each side of his skull and now the brain lay exposed. Silver clips were applied to bleeding vessels, as excess blood was sponged away.
Now Dr. Rogers probed inside the holes in Larry’s forehead with a special type of cannula rod. This done, he inserted another instrument, the leucotome, a long thin dulled knife. He moved the knife in a fan-shaped arc, downward, then upward, slicing into the nerve fibers that connected the frontal lobes with the thalamus to the rear. As Dr. Rogers made his drastic incision, Dr. Goldsmith talked continuously with Larry, who lay drowsily awake. Dr. Goldsmith kept questioning Larry, who tried to answer as best he could. This question-and-answer session, during the operation, was part of the technique. From Larry’s answers. Dr. Rogers could tell when he was sufficiently disoriented, when the cutting was deep enough and should be halted. As the operation proceeded, Dr. Goldsmith asked Larry, “Why are we operating?” Larry answered, “I don’t know.” Dr. Goldsmith asked, “Where are you now?” Larry answered, “Baltimore.” Dr. Goldsmith asked, “Do you know who I am?” Larry squinted up, saw the gaunt face, and replied, “Yes, you’re Jesus Christ.”
The cutting was done. The prefrontal lobes had been sufficiently disconnected from the other brain centers. The cutting had been deep—a profound lobotomy—and Larry would no longer be dominated by fears and anxiety. The thin knife had removed his worries. It had also removed his old personality. After the wounds were given a final check, to be sure all bleeding had stopped, the buttons of skull were replaced and the flesh stitched. The prefrontal lobotomy was over.
It was now afternoon, ten minutes after one. The operation had taken almost two hours. Dr. Rogers emerged first He went directly to Harriet, Jack, and the other brother, and said, “It’s all done. It went well.” Harriet and the brother both cried. Jack turned away, walked hurriedly down the corridor to the men’s lavatory, pushed inside, leaned against a wall and sobbed for twenty minutes.
A short time later, they had all composed themselves. They waited anxiously to see Larry. He was wheeled out of the operating room. He was asleep and his head was bandaged. They could tell nothing. They returned to their hotel until evening, then crossed back to the hospital again. Larry was awake now, and they were admitted to his room. They stared down at him. He opened his eyes, met theirs, then averted his eyes. They were led out of the room. The followi
ng morning. Jack went in to see Larry first. He looked at Larry, who still seemed faraway, then asked, “Who am I?” Larry’s eyes fastened on him a moment, then he whispered, “Hello, Jack.”
Larry, attended by special nurses day and night was in the hospital two weeks in all. Jack and Harriet visited him twice a day, and though he never spoke unless spoken to, he gradually became more responsive. His docility shocked Jack, who could not forget his wild agitation of a few days before. Jack thought that he seemed entirely too disinterested, but Dr. Goldsmith explained that Larry’s mind was disoriented and that it would take some months to reintegrate itself.
Jack says he first fully realized the remarkable change that had come over Larry when, a week after the operation, he tried to converse normally with him. During the years of Larry’s illness. Jack had adopted a bantering manner. Also, before ever saying a single word. Jack had learned to censor his conversation automatically. “I was careful never to say anything that might upset or depress him, or make him moody,” Jack recalls. “I learned never to ask him, ‘How are you feeling mentally, Larry?’ Well, when I saw him in the hospital, I was still conditioned by the past. I said, ‘How’s about a set of tennis, Larry?’ I’d wanted to ask how he felt, but from habit suppressed it. When he didn’t react to my patter, I suddenly realized that I didn’t have to be evasive. On impulse, I asked him, ‘How do you feel mentally, Larry?’ He simply nodded, quite normally, and replied, ‘Fine, fine.’ Then, the full impact really hit me. I knew he was a changed person.”
The Sunday Gentleman Page 20
