Case File | American Scandal | The Ice Pick Surgeon

From Airship, I'm Jeremy Schwartz, and this is American Criminal. At the end of her story, here's what I told you about Genene Jones. She's a killer who no one truly understands, maybe not even herself.

She felt a strong pull to work in hospitals, which led her to become a nurse.

That part is easy to follow, but then things get murky because although Genene undoubtedly cared for many of her patients, she also actively and repeatedly harmed the most vulnerable of them on purpose. Was it a power trip? A need for attention?

There's no way to say for certain. And what's scary is that Genene's not alone. Serial killers who disguise themselves as doctors, nurses, and paramedics have long fascinated and terrified us.

The ones who, like Genene, use their medical training to kill patients, lovers, friends, and colleagues, who take advantage of the trust society has in their profession to satisfy their own dark urges.

There's a lot to unpack there, and believe me, American Criminal is not done with that subject yet. But what about the medical professionals who don't set out to hurt people, but do so anyway?

Whether they're misguided, blind to their own prejudices, or simply lacking in knowledge, history is full of horrifying examples of good intentions that led to disastrous consequences.

Today, we're bringing you the story of Walter Jackson, a physician who pioneered the practice of the transorbital lobotomy.

In his life, Jackson performed thousands of these procedures, aimed at helping patients live lives free of the psychiatric and neurological disorders that seemed otherwise untreatable. Only the welfare of his patients wasn't Jackson's only concern.

He also wanted his procedure to be fast, convenient, and be able to be performed right there in a psychiatrist's office.

In short, it was a pseudo-scientific recipe for disaster, and our friends over at American Scandal took a deep dive into the story for their series, The Ice Pick Surgeon.

2:36

Apple Podcasts

https://podcasts.apple.com/us/podcast/american-scandal/id1435516849

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This is episode one, Search for a Cure.

A listener note, this episode contains graphic descriptions of medical experiments, and may not be suitable for younger listeners.

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5:56

Lobotomy Patient Search

It's late at night on Christmas Eve, 1936.

In Washington, DC., the streets are quiet and empty. Most people are home enjoying a white Christmas, but not Walter Freeman. Tonight, Freeman is trudging through banks of snow.

He's shivering and miserable with his shoes soaking wet. He'd give anything to be near a fireplace. But Freeman can't return home.

He's looking for someone who's on the loose, and he can't stop because if he doesn't find this man, something bad could happen. Freeman looks over at his professional partner who's following behind him. That man's name is James Watts.

He's balding and wears wire-rimmed glasses, looking very much the part of the job that both men practice. Freeman and Watts are doctors at a nearby hospital.

They're pioneers in psychosurgery, a radical new field in which brain surgery is performed on people with mental illness. Yesterday, the two performed an experimental surgery. It's known as the lobotomy.

Freeman and Watts performed the surgery on an alcoholic who seemed hopeless. But Freeman believed the lobotomy could be a miracle for the patient and reverse his terrible addiction. And at first, the patient seemed to be recovering well.

He said he had no desire for alcohol. Freeman was overjoyed because he was one step closer to proving that lobotomies could cure nearly every mental illness. But everything changed a few hours ago.

A nurse entered the patient's hospital room and found it empty. It looked like the patient had pulled on his coat and hat and escaped through the front door of the hospital.

Freeman knows that you can't just lose a patient, especially one who's been through an experimental procedure. So Freeman has only one option.

He and his partner James Watts have to find the man before he hurts himself and disgraces them and their new procedure. Freeman turns a corner and Watts catches up. Walter, the last thing we need is another failed surgery.

James, this isn't a failure. We don't know that yet. Maybe he just wanted to go home, see his family.

It is Christmas. And why are we trying to find him at bars? Come on, Walter.

You gotta face it. We've done ten lobotomies, we've had one death, and several other failures. It's not a good track record.

Freeman stops and jabs a finger in Watts' face. So what? You want to give up?

These people are sick. They have no hope, no options in medicine. Don't for a second forget our mission.

We're trying to find a cure for the mentally ill. But Walter, it's Christmas Eve. Don't you want to be home with Marjorie?

I thought she's due to give birth any day. Oh, she's doing fine. Doing fine?

What does that mean? Well, James, technically she's in labor right now. Watts stops and stares at Freeman with a look of shock.

Your wife is in labor? What are you doing out here? You should be with her.

James, in case you have forgotten, we just performed an experimental brain surgery, and our patient got up and ran away. If we don't find him and people find out our careers are over, what do you think is a higher priority?

Walter, no, listen, James, we're going to find this man. We're going to take him back to the hospital. Doesn't matter how cold we are, and it doesn't matter if my wife is about to give birth.

Understand? Watts wipes his nose and looking down, he nods. And one last thing, James, this is very important.

No one can ever know about this. Our reputation is at risk. We have to protect it at all costs.

Watts nods again and together the two doctors continue trudging in the snow, looking for the patient. They hurry down a sidewalk and peer into every bar they pass. As the night gets later, even Walter Freeman feels ready to give up.

But then they approach one last dive bar and see a man slumped against the front window. He is obviously drunk, and Freeman notices that he has bandages slipping off his head. It's their patient.

Freeman begins to fume as he stares at the man. Watts was right. The surgery was a failure.

He did nothing to curb the man's addiction to alcohol. And it's a stinging rejection of Freeman's beliefs that lobotomy is a silver bullet for mental illness. But as Freeman and Watts hoist the man to his feet, Freeman begins to relax.

At least they found the patient. And now that they have him, they can take him back to the hospital in obscurity. Even if this man was a failure, Freeman will keep experimenting and performing lobotomies.

The experimental nature of the procedure guarantees that a few mistakes will be made along the way, but he's close to a breakthrough. He's positive he's going to lead a medical revolution.

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From Wondry, I'm Lindsey Graham, and this is American Scan. One of the core tenets of modern medicine is that it's proven to be safe. New treatments are subject to rigorous clinical trials.

Surgeons receive careful training in their specialties long before using a scalpel on a patient. And government agencies regulate healthcare to make sure that medicine is based on established science.

It's a system that's designed to protect patients. But this wasn't always the case.

In the early 20th century, a physician named Walter Freeman grew famous as a pioneer of the lobotomy, a procedure that involves physically severing connections between different parts of the brain.

He believed the lobotomy was a key treatment for mental health, and he went on to perform the operation 4,000 times. He lobotomized people of all ages, including small children. But his legacy was far from a medical revolution.

Freeman would ruin countless lives and leave a dark stain on medical history. But his story raises a question. How did he get away with performing so many harmful procedures for so long?

In this four-part series based on Sam Kean's new book, The Ice-Pick Surgeon, we look at how one physician charmed a country with the promise of a revolutionary new treatment.

He was a doctor who also earned powerful enemies and caused a fight that would change the future of medicine in America. This is episode one, Search for a Cure.

14:16

Young Freeman's Ambition

It's May 1911 on the Caribbean Sea. It's a cloudless day and a cruise ship sails through the sparkling light blue water. Men and women are gathered on the deck of the vessel and look out at the endless horizon.

Walter Freeman is on board too, but he's not relaxing on deck. Instead, he's crouched inside his small cabin, hanging photos on the wall. Freeman gazes at the black and white photographs and smiles.

He's on a trip around the world and he has the pictures to prove it. He's shot photos of street dancers in Havana, sunbathers in Puerto Rico. For Freeman, life doesn't get much better than this.

He's 15 years old and very far from his home in Philadelphia. He's getting a chance to see the world and just in time. Because everything changes next year, Freeman is going to start college at Yale.

Inside his cabin, Freeman sits down on his bed and keeps scanning through his photos. This is all he ever wants to do. Sit back and look at pictures.

He knows he's a bit of a strange kid, a kind of loner. But there's something magical about photography and developing pictures. It feels more lifelike than life itself.

Freeman has even turned part of his cabin into a dark room. His passion for photography has driven Walter Freeman to break his family's tradition. His father is a doctor, and his grandfather, William Keen, is a famous neurosurgeon.

When he gets to Yale, Freeman is going to take a different path, and he knows it will be hard to share the news with his family. Just then, there's a knock on the door. Freeman's grandfather is calling his name.

Freeman stuffs the photos under his pillow and opens the door. His grandfather enters, filling the small cabin with his imposing presence.

The older man is only five foot two, but with his straight posture and bright white mustache, he carries himself like a world leader. And it's not just empty posturing.

On this trip, the two went to visit the Panama Canal, currently under construction. Most people weren't allowed in, but Freeman's grandfather is a famous doctor and got them a tour. The entire time, they were flanked by smiling officers from the US.

Army. Freeman admires his grandfather and the way everyone seems to be in awe of the older man. But Freeman also fears his judgment.

And so inside this small cabin, when his grandfather sees the photos sticking out from underneath the pillow, Freeman panics. He tries to hide them, but it's too late. His grandfather grabs a few and begins looking through them.

The old man takes his time as he shuffles through the pictures. Finally, he looks up with a smile. He tells Freeman that they're excellent and Freeman feels himself teeming with pride.

In this moment, Freeman finds the courage to admit the truth. He looks directly at his grandfather and says he's made a decision. When he gets to Yale University, he plans to study photography.

His grandfather frowns. He agrees that Freeman is talented, but he's seen the boy work with his hands. He watched Freeman deftly fix a broken saddle.

So won't he consider going into medicine? Freeman shakes his head and says no. Medicine isn't appealing.

He's worried he'd get sick of the work. His grandfather nods, says it's true. Sometimes you do get tired of your patients.

But he tells Freeman that he's also operated on three US presidents. He never gets sick of that. Freeman points out that people also photograph presidents.

His grandfather chuckles and tells Freeman that he's a clever boy. But there's no glory in snapping photos. As a surgeon, he didn't just operate on presidents.

He also invented new surgical techniques. He performed the first successful operation on a brain tumor. Medicine offers a real glory.

You get to blaze new trails. You hold life and death in your hands. How do you get that with a photograph?

In the distance, the ships bells ring, and Freeman's grandfather moves to the door. He says he has work to finish before dinner, but Freeman should think carefully about what he said.

His grandfather walks out of the cabin, and as the door clicks shut, Freeman again picks up his photographs. For as long as Freeman can remember, he's wanted to do this, to make these, to be a photographer.

But now, with his grandfather's words ringing in his head, he's questioning his path. Photographers might be on the wrong side of the lens.

They're never the center of attention, and Freeman wants to be more like his grandfather, bold, assertive, doing new things. His conviction has suddenly shaken.

Maybe when he gets to Yale, he will study photography, or maybe he'll train to become a doctor. Seven years later, Walter Freeman hurries through a sick ward at an army hospital in New Jersey.

18:53

Wartime Medical Calling

Freeman goes from patient to patient, taking temperatures and readings of blood pressure. Patients are coughing, fevers through the roof. It's a terrifying sight, but Freeman pushes past his fears.

He can only focus on the work in front of him. Walter Freeman is technically still in medical school. Med students don't normally work at army hospitals, but the world has recently turned upside down.

The United States joined World War I, and the army needed medical personnel. So with his grandfather's encouragement, Freeman enlisted. For weeks, he did nothing but grunt work, like running tests on urine samples.

He began to worry again that medicine wasn't the right path. Maybe he should have pursued photography after all. But everything changed last week.

The first case of Spanish flu arrived. Now the virus has spread everywhere. It looks like the start of a pandemic.

The hospital wards are lined with soldiers who are hacking and spitting up phlegm. It's become an incredible matter of life and death. Freeman has to be honest with himself.

He's the happiest he's ever been. He's drawn to the action because it's thrilling. It's a fight, a quest, a crusade.

And he's hoping to be a hero. In the army hospital, Freeman continues down a long row of beds where he hears someone call. Freeman, over here.

Freeman turns to see his commanding medical officer approaching. Look, Freeman, we're getting killed here with this flu. I've got orders.

We're going to run some new tests. Freeman has used mouth pipettes before. They're thin glass tubes, inserted into a patient's veins.

Then a doctor has to suck the blood partway up the tube. Sometimes it's the only way to get a sample. Yes, Freeman, which means you're going to have to take your mask off around the flu victims and get very close to them.

But at this moment, there's no other choice. So let me ask you again. Are you in?

For a moment, Freeman considers their request. It's dangerous and maybe even reckless. He could catch the Spanish flu, become sick, even die.

But Freeman feels a tickle of adrenaline. Something about the danger is exhilarating. It's exactly what his grandfather talked about.

Facing off against death, taking risks, this more than anything suddenly makes Freeman feel fully alive. So Freeman agrees to perform the test and he gathers the pipettes. He turns back to the hospital ward and looks out at a row of patients.

They're grievously sick, some of them dying. This Spanish flu is a human catastrophe. But as Freeman lowers his surgical mask and prepares to administer the tests, he feels electric.

It's time to do something dangerous. Six years later, Walter Freeman walks through Vienna, Austria.

22:06

Asylum Reform Vision

It's a beautiful city with Baroque architecture and Freeman passes buildings that look older than time itself. Still Freeman hardly notices any of the sights.

He's too deep in thought because he's facing a tough choice, one that could decide the course of his young career. Freeman is now officially a doctor. And for the last year, he's been training in Europe to be a neurologist.

It's been a whirlwind tour. He's traveled through France, Italy, Austria. All the while, he's been learning exciting new techniques and even helped with surgeries.

His future had seemed bright and clear. But that changed last week when a letter arrived from his grandfather with what had sounded like promising news. The famous neurosurgeon had pulled some strings and secured a job for Freeman at St.

Elizabeth's Hospital in Washington, DC. The job offer should have been good news. But when Freeman asked around, he learned a stunning truth.

St. Elizabeth's is an insane asylum. Freeman knows that asylums are medical backwaters.

At best, the patients are neglected. At worst, they're beaten, tortured, locked in padded cells. The so-called medical treatment sounded more like something from Edgar Allan Poe.

He's heard stories about doctors drugging patients into a stupor, even injecting them with horse blood. Freeman knows that if he agrees to the job, he'll be trapped in the most miserable corner in all of medicine.

But if he says no, he'll disappoint his grandfather, who he still admires. The decision is tearing him up, and Freeman needs some help making up his mind.

So he's walking through this city, closing in on the large brick facade of the Vienna Insane Asylum. Freeman is hoping if he gets a good look around, he'll gain a little clarity about his future.

Freeman approaches the round building and peers up at the windows. They're small and narrow, like those of a prison. He squints and tries to make out the faces of patients, but he can't see anything.

He only hears muffled shouts coming from the distance. Freeman begins circling the perimeter of the building. It's closed off, and once again, it reminds him of a penitentiary.

It's impossible to believe that this is a place of medical care, that insane asylums are actually supposed to help people get better. Freeman can imagine the patients inside, bound in straight jackets or shackled with other restraints.

He can imagine the hospital staff pushing gurneys loaded with dead bodies and shoveling the bodies into a truck like sacks of potatoes. He's heard stories. Freeman knows that asylum staff can be callous.

That patient might have a serious mental illness and refuse to eat. But in asylums, the staff might just laugh it off and let the patient die. As Freeman walks around the asylum, he begins to feel sick with rage.

The people inside this building could be somebody's daughter, somebody's mother. And instead of getting help, these patients are just locked away. And it's not just here in Vienna.

This is the case all around the world. This is how the mentally ill are cared for. Freeman glances again at the asylum, and inside him, something flips.

This asylum no longer looks like a prison or a place to be afraid of. It looks more like a castle that he can storm. Walter Freeman has a sudden burst of clarity.

He knows that if he wants to live a meaningful life, he has to do something great in medicine. And what could be greater than helping patients who are trapped in asylums like these?

If he takes the job, he will have the chance to do something big and meaningful. He could change things. Freeman knows it will be a daunting challenge, but he could follow in his grandfather's footsteps.

He could transform medicine for the mentally ill, if he succeeds.

If you want to hear more about Walter Jackson and his impact on the field of psychology, follow American Scandal on the Wondry app or wherever you get your podcasts.

You can also binge all episodes of American Scandal, The Ice Pick Surgeon, early and ad-free right now on Wondry+. American Criminal is a co-production of Airship and Evergreen Podcasts. It's hosted, edited, and produced by me, Jeremy Schwartz.

Audio editing and sound design by Sean Ruhl-Hoffman, music by Frum. This episode is written and researched by Joel Callan, managing producer, Emily Burke. Executive producers are Joel Callan, William Simpson, and Lindsey Graham.