Oversimplification: There Are Hidden Risks Inside Quick And Easy Solutions

Since the 1920, for over a period of 40 years a doctor named Walter Jackson Freeman performed lobotomies—a surgical process of severing connections in the brain’s prefrontal cortex in order to cure mental disorders—on whoever was brought to him.

His methods were so simple, swift, and brutal that it would make any respectable doctor recoil. Instead of any surgical instrument he inserted a standard household ice pick into the brain through the eye socket, tapping it through the skull bone with a hammer, then wriggled it vigorously to sever neural connections.

He painted a nonchalant description of the procedure in a letter to his son: “I have been…knocking them out with a shock and while they are under the ‘anaesthetic’ thrusting an ice pick up between the eyeball and the eyelid through the roof of the orbit actually into the frontal lobe of the brain and making the lateral cut by swinging the thing from side to side. I have done two patients on both sides and another on one side without running into any complications, except a very black eye in one case. There may be trouble later on but it seemed fairly easy, although definitely a disagreeable thing to watch.”

The procedure was so crude that an experienced neurologist from New York University fainted while watching a Freeman operation. But it was quick: patients generally could go home within an hour.

It was this quickness and simplicity that dazzled many in the medical community. Freeman was extraordinarily casual in his approach. He operated without gloves or a surgical mask, usually in street clothes. The method caused no scarring but also meant that he was operating blind without any certainty about which mental capacities he was destroying. Because ice picks were not designed for brain surgery, sometimes they would break off inside the patient’s head and have to be surgically removed, if they didn’t kill the patient first.

What is perhaps most remarkable is that Freeman was a psychiatrist with no surgical certification, a fact that horrified many other physicians. About two-thirds of Freeman’s subjects received no benefit from the procedure or were worse off. Two percent died. His most notorious failure was Rosemary Kennedy, sister of the future president.

In 1941, she was twenty-three years old, a vivacious and attractive girl but headstrong and with a tendency to mood swings. She also had some learning difficulties, though these seem not to have been nearly as severe and disabling as has sometimes been reported. Her father, exasperated by her wilfulness, had her lobotomised by Freeman without consulting his wife. The lobotomy essentially destroyed Rosemary. She spent the next sixty-four years in a care home in the Midwest, unable to speak, incontinent, and bereft of personality.

Even after the emergence of psychoactive drugs, Freeman had a steady flow of patients, and he went on performing lobotomies up until his 70s. Unlike the drugs, it was cheap and quick, and therefore took quite some time to fall out of fashion. It was only after it became evident that Freeman was leaving trails of human wreckage with his quick fix that the medical community became seriously concerned.

Lobotomy did actually work up to a point. People with lobotomies generally became less violent and more tractable, but they also routinely suffered massive, irreversible loss of personality. The hidden risks in the procedure were simply too high, and the long-term consequences, as was later discovered, were disastrous. Yet, lobotomies were popular—because of its simplicity and swiftness.

This simplistic method was originally devised by physician Egas Moniz whom Freeman idolised. Moniz was no better. He undertook operations without having any idea what damage they might do or what the outcomes would be. He conducted no preliminary experiments on animals. He didn’t select his patients with particular care and didn’t monitor outcomes closely afterward.

He didn’t actually perform any of the surgeries himself, but supervised his juniors—though freely took credit for any successes. Despite the many shortcomings of the procedure and Moniz’s lamentable clinical standards, he was feted around the world and in 1949 received the Nobel Prize.

Despite their popularity and recognition, Freeman and Moniz’s methods are perfect demonstrations of what Einstein warned us about: “Everything should be made as simple as possible, but not simpler.”

It cannot be said with certainty if Einstein actually said it, but it makes a lot of sense nonetheless. Einstein’s ideas and theories could get complex, as was his theory of relativity of which, at least initially, he was the only one who was able to understand the maths completely. But if one is to fully understand the essence of the theory, then that understanding must be conveyed as simply as possible for the sake of good communication. But making it simplistic just for the sake of communication would make it easily comprehensible, but it won’t convey what the theory actually is. Based on this, Freeman and Moniz basically demonstrated how science shouldn’t be done.

As a principle, you should be weary of quick fixes that seem to solve a big problem—such as mental disorder—in an easy and simplistic manner. It’s bound of have a lot of hidden risks that are likely to cause long term disasters in the future. It is true that simple and easy-to-comprehend business models, medical procedures, financial plans, and growth strategies are highly revered, but that’s only because human beings are gullible.

Humans—even the people at the Bank of Sweden who gave Moniz a prize in memory of Alfred Nobel—understand a direct, unswerving, and straightforward answer rather than a nuanced one. Therefore, it’s a good strategy to remain paranoid of things that appear too simplistic, especially when the downsides are high if the plan fails—such as in lobotomy where you are very likely to end up as a vegetable, if not dead. Even if all goes well, you would definitely lose your personality.

People often oversimplify things to sound good or make their ideas easily comprehensible. It’s common in professions where they are rewarded for perception, not results. Think MBAs. Don’t be fooled! Just because something sounds comprehensible, or just because a lot of people subscribe to it, or just because it’s recognised by an authority, doesn’t make it right. Always remember to do your own research, engage yourself in second-order thinking, and be a better judge for yourself—be it in business, finance, or health.

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