Freeman certainly was an inspiration to Brill and his colleagues, Harry J. Worthing and Henry Wigderson. Pilgrim's first lobotomy was performed on March 20, 1945, after the hospital's "Department of Mental Hygiene" okayed the travel of a senior staffer to observe Freeman and Watts in action. Contrary to recent press reports on the horrifying lobotomy era, the procedure wasn't necessarily a "last resort" when "all else failed." As the three Pilgrim docs noted, "...the best results are obtained when treatment is instituted as early as possible." And the people who were lobotomized weren't necessarily schizo. Many of them were simply "neurotic" or unmanageable— or they didn't respond to repeated "treatments" of electric shocks and insulin-induced comas.

Pilgrim's first lobotomy, the docs said, was performed on a man who was a "severe chronic schizophrenic, markedly negativistic and refusing food." "Massive defect persisted" even after the lobotomy, but that didn't stop his madness or theirs. One thing was almost certain: Most of the lobotomized patients were much easier to control after their brains had been drilled— most became zombies. "Assaultiveness and negativism are most strongly affected [by lobotomies]," they wrote, "while idleness and unproductivity are least improved."

Wigderson did the cutting and drilling, but Worthing and Brill got top billing for selecting patients and supervising. Astoundingly, the Pilgrim trio persisted even after they themselves said that lobotomies didn't even improve the patients most of the time. "The chief disadvantage of the procedure," they wrote, "seems to be that it fails to produce any improvement in about 25 percent of the operated cases and produces only a limited improvement in somewhat less than half of the patients." But it was better than nothing. "In spite of its limitations," the docs wrote, "the operation seems to be therapeutically active and fills a real need while we await a better treatment."

While they waited for something better— drug therapy started in the '50s— they referred to these human beings they experimented on by case numbers. Here are some highlights from their reports:

CASE NO. 4 Woman, 49 at the time of her lobotomy, "assaultive and noisy; she wet and soiled and was a feeding problem." Lobotomy on June 10, 1947. "She is now obese, quiet, smiling, friendly, does a small amount of work. There is massive regression and chronic hallucinations, but she is clean."

CASE NO. 6 Man, 28, IQ of 88. "He was assaultive, regressed, had filthy habits but did not wet or soil." Years of drug-induced coma therapy and electroshock treatments. Lobotomy on June 30, 1947. Released from Pilgrim on Sept. 7, 1947, "free of hallucinations, quiet, odd, bashful, manneristically to work as a delivery boy...a basic intellectual limitation also was obvious."

CASE NO. 24 Woman, 39, "had 'adequate' shock treatment without response and remained highly disturbed. She was physically powerful and a serious problem." Lobotomy on Oct. 22, 1947. "She was disturbed afterward and had electric shock with good response." Released on March 28, 1948. "She seems to be recovered. Her husband finds no trace of difference from her 'normal' level."

CASE NO. 33 Woman, 34, hospitalized at Pilgrim on March 11, 1947. "She was highly disturbed and suicidal. There was a homosexual conflict. She gnawed off the anterior part of her tongue. Shock treatment was without effect." Lobotomy on Dec. 6, 1947. Released from Pilgrim on Feb. 29, 1948. "Apparently in complete remission. She is working with no trace of defect."

CASE NO. 49 Man, 25, "actively hallucinating for more than a year." Lobotomy on Feb. 19, 1948. "Striking improvement." Released April 18, 1948. "He was well-adjusted, working, without any apparent residual defect; but he began drinking and is said to have indulged in marijuana. There was a full relapse and he was re-certified [insane]."

CASE NO. 50 "Mentally-defective man," 28, became "regressed, wetting and soiling, and was destructive." Lobotomy on Feb. 19, 1948. Released July 18, 1948. "Well-behaved at home, he worked in a protected location as a stone-cutter. He had a disturbed episode with return to the hospital on May 10, 1949. Here he is quiet, clean, withdrawn, does some work on the ward, and is not hallucinated."

CASE NO. 114 Woman, 26, "diagnosed as a tension neurotic" but "was not influenced by shock treatment." On re-admission to Pilgrim, diagnosed as "psychoneurotic." She was "disturbed, with rapid deterioration of her physical condition, and compulsive screaming; she beat herself against the walls." Lobotomy on July 2, 1948. Released Sept. 19, 1948. "She is again visiting a psychiatrist, complains that the lobotomy should not have been done, 'the effect did not last,' but she is keeping house again for her husband."

CASE NO. 130 Man, 44, with a "history of epileptoid seizures." At Pilgrim, "he was consistently hallucinated, delusional, withdrawn, irritable and assaultive on little or no provocation. He fractured the nose of a physician attending him for a physical ailment in 1936. ...He remained neat and a good worker." Lobotomy on July 30, 1948. "Since the operation, this patient has been mild, pleasant and quiet. He continues to be a good ward worker and is no longer under 'explosive paranoid tension.'"

CASE NO. 169 Woman, 28, had a "psychotic attack" at age 22. "Electric shock was without benefit; her behavior was disturbed....The patient became a ward worker." Lobotomy on Oct. 26, 1948. "She is making a good adjustment with some mild personality loss."

CASE NO. 231 Man, 57, with "delusions of persecution, economic incapacity, withdrawal from the family, letters to authorities." Admitted to Pilgrim in 1947. "In the hospital, he was furiously resistive, actively hallucinated, resentful, grandiose, unapproachable....he went on a hunger strike for several months." Lobotomy on Feb. 8, 1949. "The patient admitted that he had been 'imagining things.' He became friendly and approachable. On close examination, residual psychotic content was noted. There was cessation of paranoid letter-writing." Released June 4, 1949. "He was comfortable, but economically dependent. He was well-behaved. 'No loss of intelligence in conversation' was observed, but 'no will to work.'"

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