Dr. Murray relates the story of another patient, Richard Herrick, whose kidneys were failing and whose life was saved when his twin brother, Ronald, agreed to donate one of his healthy kidneys and made possible the first successful kidney transplant. Throughout his career, Joseph Murray traveled to other countries to help clinicians deal with patients suffering from craniofacial and other deformities, such as patients in India whose hands had been disfigured by leprosy but who, after surgery, were able to use their hands to work as artisans and thus become self-sufficient.
“Surgery Of The Soul”
Joseph E. Murray, M.D. (1919 to 2012), was one of only nine surgeons to have been honored with a Nobel prize. In 1990, he shared the prize in Physiology or Medicine for his pioneering work in organ transplantation. Although Dr. Murray performed the first successful human kidney transplant in an identical twin at the then-named Peter Bent Brigham Hospital in Boston on December 23, 1954, the award was for decades of work advancing the immunology of transplantation rather than his technical execution of transplant surgery.
He completed his general surgery residency in Santa Barbara, California, and is certified by the American Board of Surgery. Dr. Diamond joined the Harvard plastic surgery residency program and was awarded the Resident Teacher of the Year Award in 2019 and served on the Plastic Surgery Executive Committee. He completed subspecialty hand and microsurgery training in the combined orthopaedic and plastic surgery fellowship program at the University of California, Irvine.
It was hailed by the New York Times as "surgery of the soul," a groundbreaking medical procedure that promised hope to the most distressed mentally ill patients and their families. But what began as an operation of last resort was soon being performed at some fifty state asylums, often to devastating results. Little more than a decade after his rise to fame, Walter Freeman, the neurologist who championed the procedure, was decried as a moral monster, and lobotomy one of the most barbaric mistakes of modern medicine.
In 1936, Freeman came across an obscure monograph by Portuguese neurologist Egas Moniz detailing the results of a radical new operation on the brain's frontal lobe that he performed on a group of twenty mental patients. Moniz asserted that after surgery, one third of his patients were cured of their symptoms. For Dr. Freeman, the operation promised hope not only for the treatment of mentally ill patients, but also for his own personal future.
As Dr. Freeman persisted on his crusade to make lobotomy the preferred treatment for mental illness, he enlisted the power of the press to bolster his image. Major publications across the country hailed lobotomy as a miracle surgery, one not damaging the brain, but "plucking madness" from it.
It was hailed by the New York Times as "surgery of the soul," a groundbreaking medical procedure that promised hope to the most distressed mentally ill patients and their families. But what began as an operation of last resort was soon being performed at some fifty state asylums, often to devastating results. Little more than a decade after his rise to fame, Walter Freeman, the neurologist who championed the procedure, was decried as a moral monster, and lobotomy one of the most barbaric mistakes of modern medicine.
Narrator: Lacking a license to perform surgery himself, Freeman hired a willing young neurosurgeon named James Watts. Within months, the pair were ready to attempt their first procedure on a living patient. They chose 63-year old Alice Hammatt who had wrestled for years with insomnia, anxiety and depression.
Narrator: Aware of the power of public relations, Freeman aggressively courted the press. Soon he was receiving glowing reviews in major publications. The Washington Star called lobotomy "One of the greatest surgical innovations of this generation." The New York Times called it "surgery of the soul," and declared it "history making."
Robert Whitaker, Writer: We think of science as having this sober sort of process, something is introduced, it goes to a medical journal, it's peer-reviewed there. Freeman sort of bypassed that process because he in fact knew he was going to get a lot of resistance and he brings the press into it right from the beginning. And the press -- they're always eager for miracle surgery, it sells papers and so, next thing you know, you start having this story out there, not of damaging the brain, but of plucking madness from the brain, and it's such a story of progress.
Robert Whitaker, Writer: Some people can't leave the institutions, and they're almost in a vegetative state. Some people go home, but they're just sort of like children around the home. And at best we could see some people that have jobs, but so often they're not motivated really to go to the jobs. So now we have a longer term, we're ten years, twelve years and it's really starting to harder to justify this as a miracle surgery, just 'cause we see these long-term results.
Jack El-Hai, Writer: Thorazine was initially marketed as a chemical lobotomy. This was seen as a selling point, that it produced results similar to lobotomy but without, of course, all the risks of the surgery.
I have noticed the tendency of other parts to become brittle and inflexible as we age. Our bones. Our learning curve. Our hearts. We get set in our ways, and we become resistant to change, at a time when things are definitely changing. It occurs to me that maybe we develop cataracts on the soul.
The wonder and awe in which we bask when we are children can become jaded as we start to take the blessings and miracles of life for granted. The first time we see the ocean or a dragonfly or a skyscraper or an actual cow can be a staggering experience. But can we remember that far back? Then, as teenagers, we go out of our way to be unimpressed by things we once thought magical. Is adolescence the foretelling of soul cataracts?
As we mature, we are obsessed with making our living, making our families, making our way in the world, making our lasting mark. By the time we are old, everything can seem mundane. Or disappointing. Or permanent. We have suffered setbacks and disillusionment, rejection and failure. We have mourned losses that break our hearts and challenge our faith in a loving God. All of these things can cloud the eyes of our souls. They can lead to spiritual blindness.
I was recently on a 3-week plant dieta, an intensive process unfolding over the course of 3 weeks to undergo this process of sacred surgery, to reconnect with nature, to heal my illnesses and discomforts, and discover the person that lay waiting beneath.
The surgery itself is a 3-step process, similar to how you would imagine a deep invasive surgery unfolding. The first step is cutting open, so that you can begin to operate. The second step is cleaning out, removing the gunk and illness that is manifesting the symptoms. The final step is stitching up, putting the patient back together again once the surgery is complete.
They use a number of tools, things like scalpels, sedatives, and other medical accoutrement to complete their task. Much like the plant doctors of an ayahuasca ceremonies might use visual metaphors, physical sensations, mental thoughts or epiphany moments to complete the psycho-spiritual surgery they are guiding.
As you might imagine, there are many ways in a classic surgery that you could make the process harder than it needs to be. Imagine if you were moving around and goofing off while the doctors were working on something inside of you, trying to extract or amputate something inside of you.
While preparing for surgeries with Col. James Barrett Brown, the chief of plastic surgery, Murray would often discuss the reasons for rejection. Brown thought that a close genetic relationship between the donor and the recipient would slow the rejection and he had, in fact, successfully grafted skin between identical twins in 1937. It was not until the 1950s and 1960s that biologists finally recognized that markers on the surface of cells called human leukocyte antigens, or HLAs, controlled the rejection process.
In October 1954, the dying Herrick was referred to him for potential surgery. After much soul-searching and consultation with ethicists and religious leaders, Murray agreed. Although the hospital planned to keep the operation secret initially, news broke after Murray asked local police to check the fingerprints of the two brothers to ensure that they were twins.
After having performed almost all surgeries, including major surgeries, I gradually found it difficult to deal with and manage the inevitable deaths of certain patients, the unhappiness of families, and the injustice of many situations. I turned to aesthetic and reconstructive plastic surgery, which has become for me a surgery of the soul, of the rebirth of being, and with enormous personal satisfaction. My only goal is to make people happier after the treatment than they were before; if this is not the case then I have failed. 2ff7e9595c
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