Bolts from the past

‘Hello, you probably don't remember me. I'm one of your first patients. I had two leucotomies’, boomed a familiar voice down the telephone. There are not many psychiatrists who have had patients who have had two leucotomies and I immediately recognised who this person was. She wanted to touch base with me after all these years to let me know how she was doing. This seemed a perfectly reasonable request and so we arranged to meet when she next came to London. The appointment was duly made and I went to the interview in a state of some trepidation, not least because my former patient, probably because of her two leucotomies, was not exactly backward in coming forward. ‘I've been told I'm like a saucepan on which they forgot to put on the lid’ she told me at our meeting. But there she was, 42 years older than when I last saw her, but looking surprisingly youthful and, despite the alleged effect of leucotomy, showing no significant deviation from the personality that I became aware of all those years ago. ‘You haven't changed a bit, you're exactly the same patient I saw over 40 years ago’, I said in a genuine search for accuracy. ‘Nonsense’, she boomed again, ‘you told me I was your most difficult patient’. ‘Yes, that's what I mean’, I said, ‘you haven't changed’. She playfully struck me and I told her she was acting outrageously. ‘You're the one to talk’, she countered, ‘I've an excuse to be outrageous; I've had two leucotomies’. And so our conversation continued. What she wanted to impress on me was that the consultant who recommended her leucotomies, Dr William Sargant, was a lovely man and she had no hard feelings about him recommending two leucotomies as she would have been ‘an absolute pain without them’. Perhaps this last message was the most important one. We read repeatedly about the vegetable-like existence of many of those who received leucotomies in the past, but even the most maligned of treatments is not universally awful.