Patient H.M. summary

It’s never a good idea to underestimate the brain. After all, this most important of organs controls everything about us, from how we walk and talk to how fast our hearts beat.

One of the first to recognize the brain’s importance was the Greek physician Hippocrates, born in 460 BC.

Hippocrates, commonly considered the father of modern medicine, broke with many of the medical assumptions of his day. For instance, he theorized that epilepsy was not an act of the gods, as had long been believed, but rather an impairment caused by the brain.

But even before Hippocrates’s time, Egyptians had learned a thing or two about the brain.

Archaeologists have discovered a fascinating 3,600-year-old Egyptian scroll that offers advice for patients who have open wounds exposing their brains. It says to keep the wound clean and protected so it can heal on its own, instructions that suggest an understanding of the brain’s importance and fragility.

Yet there are those who experimented with ways of tampering with the brain.

Forms of brain surgery may have been attempted some 7,000 years ago; in Ensisheim, France, prehistoric skulls bearing what appear to be small surgical holes have been unearthed from an ancient gravesite.

In 1888, Swiss psychiatrist Gottlieb Burckhardt attempted to cure a patient’s “madness” by removing 18 grams of her brain matter. His peers were appalled. The idea of cutting open skulls and slicing up brains was radical, to say the least.

But fifty years later, in 1935, a Portuguese neuroanatomist named Egas Moniz picked up where Burckhardt had left off and performed the first leucotomy, from the Greek leucos, for white, and tome, to cut, a procedure where white nerve fibers in the brain are cut.

Dr. Moniz’s inspiration was the Yale physiologist John Fulton, who’d been experimenting on chimpanzees. Fulton discovered that his chimps became calmer and more manageable when the frontal lobes of their brains were damaged.

And so Dr. Moniz attempted to help severely depressed patients by drilling two holes in their heads and cutting brain matter from the frontal lobe.

The results of this procedure were published in 1936 and presented as a possible treatment for mental illness, marking the start of a revolution in both psychiatry and surgery.