It is impossible to avoid dark stories when talking about one of the most famous psychiatric treatments of the past, lobotomy. Norway is no exception, and the stories presented in this article is by no way a happy part of our history. You have been warned.
“There’s a hole in the fence at Gaustad — and that’s why you are here” is a common joke to someone acting strange, which also states all the fear and horrors attached to Gaustad and its treatment of their patients. Gaustad performed around 482 lobotomies of a total 2500 lobotomies done in Norway, compared to Sidsjøen Hospital in Sweden and Viborg and Sct. Hans Hospital in Denmark with around 450 lobotomies each. As a difference to Denmark and Sweden, Norway performed lobotomy surgeries in psychiatric hospitals and not in the neurosurgical wards in general hospitals, which often led to untrained itinerant surgeons with no training in neurosurgery doing the lobotomies. In Western Norway it was even worse, with itinerant orthopaedic surgeons doing lobotomies. Due to geographical distances and long transportation routes, Norway even had the phenomenon of “travelling lobotomists” who went from one psychiatric hospital to another performing lobotomy, instead of transporting the patients to the neurosurgical wards.
The white cut
Reports have shown that Norway was the only country in Scandinavia that performed transorbital lobotomy as well. The method was developed under Dr Walter Freeman in the U.S and consisted of forcing a steel ice-pick through the upper eye socket with a twisting movement. The surgeon could not observe the course of incision, but it saved time and money for the Norwegian hospitals. Compared to the standard “drill and scalpel” method where they could do four surgeries in a morning, they could now do twelve.
“Most people who have had the surgery become more ethically passive, but with their carefree good humour and their amiable indulgence towards fellow human beings, they are still pleasant to be around” (Dr Ødegaard)
Another reason why Norway chose transorbital lobotomy, is that the director of Gaustad hospital between 1950 to 1971, Ørnulv Ødegaard (1901–1986) were a pro-lobotomist and had links with American psychiatry. He claimed that any “psychiatrist can perform lobotomy with the tools he may have in his pocket”. His assistant Carl W. Sem-Jacobsen went to the U.S to complete his studies of psychosurgery, and Gaustad hospital established a department for psychosurgery from the 1960’s with financial support from the Ford Foundation and the United States Department of Defense. Transorbital lobotomy were seen as both radical and primitive, and Freeman’s assistant James W. Watts distanced himself from it. The same opinion was held by Dr Johan Bremer, head of female psychiatric ward at Gaustad hospital, where it was nicknamed “the white cut”. No female patients at Gaustad were lobotomized under his care between 1955–1981.
In the early stages of lobotomy surgery at Gaustad, mortality was high: 18 of the first 35 women lobotomized died and the patients succumbed almost immediately after the surgery was done. Death rate was up to 27% at Gaustad hospital in the beginning, and the patients were put in unmarked mass-graves at Riis cemetery close by the hospital. The family of the patients received no information of their whereabouts or what caused their deaths. the National Health Authorities had leading doctors working both in Gaustad and in the government health departments, so it is reasonable to assume that the mortality rate was well-known in government circles. Still, it was kept secret from the public. In the western world in general, mortality rate was between 1 to 5–6% in the same period (1940–1950), but the trend was that more women than men were lobotomized, while in Norway it was more equal between the genders. By 1960, Gaustad was the only hospital in the country still performing lobotomy, and with funds supporting their surgeries and approval from the National Health Authority it continued until 1974.
Ellinor Hamsun is an example of how lobotomy was used for mental illness and for women. She was the daughter of well-known Nobel prize winner and author Knut Hamsun, and was brought up in a well-off family. As her father believed women were to be shielded and admired, she was sent to boarding schools in Europe learning languages, and trying to succeed as an actress like her mother. Ellinor also struggled with alcohol abuse, bulimia and depression and her mother’s quote “if you want to be an actress, you should not eat much” affected her greatly. After WW2 and the divorce of her German husband her eating disorder became worse, and she was sent off to a mental hospital in Denmark in 1952. Here she was lobotomized in 1953 and in 1956, despite the criteria for lobotomy to be done was severe mental disorders, not depression and bulimia. Ellinor “lacked initiative and became lifeless” after the lobotomies according to her family, and also suffered from epileptic seizures the rest of her life, which was also side-effect of lobotomy. The Hamsun family left her in care in a nursery home in Jylland, Denmark, where she died in 1987 only 70 years old.
Going public
Most patients who survived the incision were sent home or demanded permanent care for the rest of their lives in nursing homes like Ellinor Hamsun. Little is known how their families handled the situation and few witnesses have come forward to the public until recent times. In the 1990’s Dr. Joar Tranøy wrote a stencil for the department of Criminology at University of Oslo, named “Forfalskningen av lobotomiens historie på Gaustad sykehus” (The falsification of the history of lobotomy at Gaustad hospital) which sparked a public debate in news media. Gaustad hospital denied Dr. Tranøy further information after the scandal was out, leading to even further investigations from other researchers. In 1996 the Norwegian Parliament passed a temporary compensation for living victims of lobotomy, where about only 500 individuals were compensated.
Gaustad hospital still runs today and has a lot of speculation and secrecy surrounding it’s past and information still not available to the public. Every year the Romani organization holds a memorial at the unmarked mass grave at Riis cemetery on the 7th of May, for their victims who were subjected to crimes by the Nazi government and psychiatric treatment. The day is also in memory of other unknown patients and victims of Gaustad hospital.
Sources:
Lobotomy in Norwegian Psychiatry, Joar Tranøy and Wenche Blomberg, University of Oslo, 2005
Hofmo and Gaustad and the doctor who went against lobotomy, Psykologtidsskriftet, 2005
What happened to Ellinor — Knut Hamsun’s daughter, Psykologisk.no, 2020
