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The dangers of the Nobel Prize Why was the inventor of lobotomies given science's highest honour?

There weren't many options for treating depression in the 1940s. Credit: Kurt Hutton/Picture Post/Hulton Archive/Getty Images

There weren't many options for treating depression in the 1940s. Credit: Kurt Hutton/Picture Post/Hulton Archive/Getty Images


October 7, 2021   6 mins

This week, a small selection of scientists have been on tenterhooks, wondering if they’ll get a call from Sweden that’ll instantly change their lives. The most exciting time of year in the scientific community is upon us: it’s Nobel Prize season.

But this year’s winners would do well to consider what happened to many Nobellists after they accepted their prize. Take Kary Mullis, who won his Nobel as the inventor of the Polymerase Chain Reaction, or PCR (a fundamental technique that’s now used not just in Covid tests but in essentially all laboratory genetics research): he spent the last part of his life strenuously denying that the HIV virus causes AIDS. Or Luc Montagnier, who won his Nobel for discovering that very HIV virus — and went on to publish research on what amounts to homeopathy.

More recently, Michael Levitt won the Nobel in 2013 for important computer-modelling work relating to protein structure (his Twitter name “@MLevitt_NP2013”, NP for “Nobel Prize”, helps you see just what a big part of his identity the award is). Throughout the Covid pandemic, he has been drastically wrong in his rosy predictions — and sometimes conspiratorial-sounding theories — about the spread of the disease. In July 2020, for instance, he stated that Covid in the US will be “done in 4 weeks”.

All these brilliant scientists lost their grip on reality after they won their Nobel (and there are many other examples; there’s even a name for the phenomenon: Nobel Disease). But at least, in all those cases, the Nobel itself was awarded for a genuine scientific breakthrough. There’s one case where the prize was given, and has never been rescinded, for a disastrously misconceived “discovery” — one that went on to blight thousands of lives.

In 1949 the Nobel Prize in Physiology or Medicine was awarded to the inventor of a disturbing procedure — an attempt to treat mental illness — where a surgeon either injected pure ethanol directly into the brain to kill a clump of neurons, or used a special instrument with a sharp wire to slice away the connections between parts of the brain’s frontal lobe. Oh, and before they did so, they had to first punch or drill a hole through the skull — usually somewhere near the eye.

The frontal lobotomy (or sometimes “leucotomy”) wasn’t the first ever attempt at “psychosurgery” — the treatment of mental disorders by operating on the brain. But its invention is most strongly associated with the Portuguese doctor, politician and general polymath Egas Moniz. Inspired at least in part by previous research on chimpanzees, who became notably less aggressive and more docile after their frontal lobes were chopped out, in 1937 Moniz reported a case series of 20 patients suffering from conditions like anxiety, depression and schizophrenia whom he’d had lobotomised.

According to Moniz, his “very audacious” and “always safe” procedure — which he couldn’t perform personally due to crippling gout in his hands — worked wonders: the patients were more placid, more rational — and easier to control. He declared some of them “cured”.

But was this evidence any good? As the psychologist Ann Jane Tierney put it on the 50th Anniversary of Moniz’s Nobel Prize:

“A contemporary scientist can find considerable fault in Moniz’s work, including the inadequate follow-up times, absence of control groups, and the superficial and subjective evaluations of patients performed by individuals least likely to be objective.”

That is, even setting aside the upsetting nature of the procedure — and we should set aside our “yuck” reactions, since there are many horrific-sounding medical procedures that are genuinely helpful — the evidence that Moniz put together to support the use of lobotomies was hopelessly unscientific and biased in favour of his desired conclusion that the technique was useful.

And yet the Nobel committee, some years later, decided to give him the award. By this time, the lobotomy had skyrocketed in popularity and was being used across the world. The best-known proponent was the US neurologist Walter Freeman, an almost unreal character who seems straight from a medical-themed horror movie. Across several decades he performed thousands of lobotomies for an ever-widening list of complaints — not just psychiatric conditions, but also things like “being a badly-behaved child” — and did so theatrically, in front of an audience, often making the initial hole in the skull using an ice pick.

But, also by the time the Nobel was awarded, the horrific downsides of lobotomy were well-known: the fact that there was no evidence of any long-term benefits in the majority of patients was a quibble in comparison to the most obvious problem: the lobotomised were often changed entirely. Many emerged from the operation with altered personalities or slower-running brains; others lost physical abilities. Still others died immediately due to bleeds on the brain (Freeman claimed a 3.6% fatality rate but other sources suggest it was far higher). Most infamously, John F. Kennedy’s sister Rosemary, who had a learning disability, was lobotomised by Freeman and a colleague in 1941. The procedure, aimed at alleviating her seizures and aggression, was a disaster; it left her, permanently, with the mental capacity, independence, and continence of a small child. The story was hushed up, and Rosemary was kept in a psychiatric hospital and then a special school, far from prying eyes, until she died in 2005.

Even if he never intended for lobotomy to be used so terribly haphazardly, it does seem unlikely that Moniz deserved the world’s most prestigious scientific prize for inventing the technique. But there he is, on the official Nobel website among the other winners. We’re left with questions reminiscent of the ones being asked about statues of less-than-ideal historical figures: should we keep this reminder of a past that had very different values from our own? Should we somehow contextualise it? Or should we get rid of it altogether? Should we — more than 70 years after it was awarded — remove Moniz’s Nobel Prize?

It has been suggested before. There are still people alive today who were lobotomised early in life, often with tragic consequences, and it might be seen as a measure of justice for them and their families to remove the Nobel committee’s endorsement. It’s not unheard of in science: some journals have begun to remove or flag research papers, even very old ones, from scientists who are under serious suspicion of misconduct.

But Moniz’s research — while slapdash, especially by today’s standards — wasn’t deliberately fraudulent, at least as far as we know. If we were to go back and wipe out the historical science that now seems poor-quality to us, we’d have to disown huge swathes of the literature, and rescind any number of prizes awarded over the years. On top of that, context reveals that Moniz might technically have won the prize for lobotomies, but it’s at least plausible that the committee actually wanted to give it to him some years previously, for his work on cerebral angiography (a pre-computer technique, still used to this day, that allows doctors to X-ray the blood vessels in the brain).

Besides, it’s worth asking: what’s the point of rescinding a prize given to a long-dead scientist for a treatment that’s almost extinct? Everyone now knows how terrible a mistake the craze for lobotomies was; psychosurgery in general — almost entirely replaced by drug treatments during the latter half of the 20th Century — is nowadays vanishingly rare. Formally condemning it isn’t going to practically help any of its victims.

Perhaps the least the Nobel organisation could do is provide better context about Moniz’s award. At the moment, his page on their site notes, with some understatement, that the operation “could lead to serious personality changes”. The only other discussion I could find about him on their website is a bizarre essay from a psychiatrist in 1998 who defended Moniz in no uncertain terms:

“I see no reason for indignation at what was done in the 1940s as at that time there were no other alternatives!”

His phrasing isn’t exactly sensitive (the exclamation mark is in the original), but does he have a point? Lobotomy came before reliable psychiatric drugs or other treatments were developed; not all doctors who used it were as flamboyant or clumsy as Freeman. It’s among the worst dead ends in medical history, but shouldn’t we expect missteps and mistakes in our march towards scientific progress?

Maybe the real moral of the story — as well as those of all the Nobellists, who went off the rails — about the pitfalls of honouring scientists. The Nobel Prizes have been criticised as “absurd” in a world of collaborative, cumulative science that relies less and less on individuals. And maybe we shouldn’t expect there to be enough Earth-shattering discoveries for major awards to be given every single year.

That’s not to say we shouldn’t honour our best and most creative researchers; we just shouldn’t turn them into heroes with opinions that are somehow above criticism (a bit more criticism of our top scientists would’ve helped in the early stages of the pandemic, to give one obvious example). Perhaps having Moniz listed among the Nobellists is the greatest reminder possible that even the best scientists don’t comprise a pantheon of divine beings: they’re just humans, and some humans make terrible mistakes. Winning a Nobel doesn’t make someone infallible. It doesn’t even make their prize-winning discovery particularly “true”. The only thing that can do that — the only thing a scientist should really care about — is the evidence.


Stuart Ritchie is a psychologist and a Lecturer in the Social, Genetic and Developmental Psychiatry Centre at King’s College London

StuartJRitchie

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Johann Strauss
Johann Strauss
2 years ago

The comment in the article regarding Michael Levitt is completely uncalled for and a pure ad hominem attack for absolutely no reason. All it does is reflect poorly on the author and his confirmation bias. It is perfectly true that quite a number of Levitt’s predictions proved to be wrong. But then so did everybody else’s, included the lauded good Dr. Ferguson at Imperial whose predictions were not only way off but actually lead to the implementation of disastrous public health policies in the entire Anglosphere. The key is to learn from mistakes.

Last edited 2 years ago by Johann Strauss
Alan Thorpe
Alan Thorpe
2 years ago
Reply to  Johann Strauss

Ferguson will never learn from his mistakes and is still hard at work creating more. The government is still listening to him and many other fake scientists in other fields. In the field of making scientific predictions the scientists should not use models that have not been confirmed against reality. All the climate and pandemic models are useless.

Jon Redman
Jon Redman
2 years ago
Reply to  Alan Thorpe

Well, except in providing jobs and prestige to climate and pandemic modellers. In this their main purpose they are quite effective.

Virginia Durksen
Virginia Durksen
2 years ago
Reply to  Johann Strauss

Ha ha, what a hoot. it isn’t an ad hom attack to point out that Levitt has little ability to predict the future of anything. He is in good company. The reality is that no one has been able to consistently predict the future outcomes of any events that are worth trying to predict. Dr. Ferguson is another example of an incredibly poor modeler whose hubris causes actual harm and has for a really long time.
Another Nobel winner, Daniel Kahneman and his colleagues demonstrated that much simpler predictions than climate or disease progression, he was merely dealing with the ability of market experts to predict the market. In his research he found that the experts were no better than monkeys throw darts at a stock page when it came to investment success.
The very idea that Levitt and the rest could predict anything about a disease that was entirely novel, was difficult to diagnose, had no treatments, and little available information of what its cause was and how it was spread, is rich indeed.
It was found the in the case of Ferguson and the Washington State modeling, that their software was outdated, did not function well, was buggy, and predicted the same outcomes when Monte Carlo numbers were input. Their models were pure fiction, just like Mikey Mann or as I like to refer to him, Dr. Fraud.

Johann Strauss
JS
Johann Strauss
2 years ago

Totally agree. But the difference with Ferguson and the Washington State modeling is that Governments (or at least the US and UK) took them literally and as a result they caused real damage to the public. In Levitt’s case, however, the powers that be paid no attention to anything he had to say.

Alan Thorpe
Alan Thorpe
2 years ago

Why were Obama, Al Gore and the IPCC given prizes? It’s become a bigger joke than Boris.

Vijay Kant
Vijay Kant
2 years ago

Science progresses by making mistakes and then learning from them. We shouldn’t cancel our mistakes. We should acknowledge them and then move on.

Last edited 2 years ago by Vijay Kant
Jorge Espinha
Jorge Espinha
2 years ago
Reply to  Vijay Kant

In fewer words, you were far more eloquent than I was.

Jon Redman
HJ
Jon Redman
2 years ago

I would rather have a full bottle in front of me than a full frontal lobotomy.

– Fred Allen (1894 – 1956)

Vic Pearson
VP
Vic Pearson
2 years ago

The latest winners apart from 1 are climate scientists (what else these days ! ) claiming to have proved manmade Global warming with their latest computer models. Astonishingly we still view them with credibility after 50 years of failed ones. So sadly for science the committee have been coerced by the UN Globalists into doing as they are told with COP26 coming up !?

Al M
AP
Al M
2 years ago

Setting aside the Nobel awards of recent years, as a graduate of the natural sciences and sometime professional scientist, how we view those who were lauded at the time, but also profoundly wrong, matters, especially when the consequences ruined or extinguished lives. As Vijay Kant notes below, science is a matter of trial and error; you have to move on from mistakes, but also learn from them. Hubris is a trait found in many scientists who made remarkable progress in their field (and the comparison to the present day is valid), but also present in many failures. If, for example, Edward Jenner’s hunch about smallpox had backfired, how would he be remembered today, if at all? Consider also how many people were killed by early jet planes, or indeed railways.
There is nothing to be gained from cancelling an award such as this, when you consider the academic standards of the time and the intentions of the recipient. If anything, the way to address this is to broaden the science curriculum, to include classes in the history and philosophy of science, which should cover both the academic and political culture of previous eras, along with how professional practice has evolved. Indeed, has it evolved? If treatments for cancer are most likely to be needed for the elderely, is testing them on healthy young people potentially more harmful? These questions should be put to our future scientists and doctors from the outset. Anyway, perhaps this does happen now, but my experience was a 9-5 schedule of lectures, labs and doing your sums for tutorials – no loafing about in bed or spending all day smoking Gauloises and watching obscure French cinema for the likes of us! And surely better than the current screeching (from complete and utter lunatics) demands to ‘problematise’ the likes of Newton, Darwin or Linnaeus, or that we ‘decolonise’ the science curriculum – and replace it with what, for crying out loud?

Last edited 2 years ago by Al M
Michael Loudon
SD
Michael Loudon
2 years ago

“Should we remove… Moniz’s Nobel Prize.” Serious quibble. I think you mean: Should we ask the Nobel Committee to withdraw Moniz’s NP? Please avoid this “we are all guilty now” mentality.
Otherwise, many thanks for this interesting article.

Julian Farrows
Julian Farrows
2 years ago
Reply to  Michael Loudon

I’ve noticed this trend in the media too. It’s a gimmick to make readers feel complicit by the use of the word ‘we’.

Chris Mochan
Chris Mochan
2 years ago

The public tend to misunderstand the Nobel Prize as a gong given out to people on the basis of their general brilliance in a subject, when it is awarded for specific works. As a result, economic arguments usually end up in someone quoting an economist who agrees with their position with reference to their ‘Nobel laureate’ status. The fact that anyone could find the opposite opinion from a different Nobel laureate is never considered.
The Nobel Peace prize is the biggest joke of all, given to the flavour of the month for political reasons. The man currently orchestrating mass rape and butchery in Tigray won it a few years ago.

ralph bell
RB
ralph bell
2 years ago

I wonder how many other medical procedures that were once seen as ground breaking are now obsolete?
Great insightful article.

Alan Thorpe
Alan Thorpe
2 years ago
Reply to  ralph bell

At least Hitler and his scientists didn’t get any recognition.

rodney foy
rodney foy
2 years ago
Reply to  ralph bell

Scientific “knowledge” has the equivalent of a half-life, depending on the discipline, of typically a few decades, where half of it is found to be false.

This should be seen as one of the strengths of science, not a weakness. I wish people could admit that many of our cherished political ideas will turn out to be wrong

Jorge Espinha
JE
Jorge Espinha
2 years ago

The winner of the Nobel prize ( Egas Moniz) for lobotomy was Portuguese. Keep this in mind, because I’m Portuguese and I do have skin in the game. I’m biased. I don’t understand an article such as this written by a man of science. Moniz didn’t simply “invented Lobotomy” he also mapped the vascular network of the brain (at least in part) developing early imaging techniques by using contrast chemicals (stated in the articles but treated as if it was something trivial). Science is built on the shoulders of giants and part of the present knowledge of the brain was built on research by Moniz. And at the time (as it’s stated in the article) there were no treatments for schizophrenia and the really extreme cases were very hard to take care of. Keep in mind that Moniz took part in a revolution in the treatment of mental patients, up until Moniz’s time, mental patients were treated in the most inhumane of ways.
Science goes forward it’s never finished and at best we get an approximation to the truth.
I’m not a fan of Moniz, he was a left-wing radical, anti-catholic he defended that the Christian faith was to be treated as a mental disease. But he was an important scientist and as it’s often the case he got things wrong.
What pisses me off in articles such as this is the virtue signalling of somebody with the benefit of hindsight. Our ancestors didn’t have the benefit of hindsight.

Last edited 2 years ago by Jorge Espinha