Prefrontal Lobotomy for the Relief of Intractable Pain; Value and Limitations: Report of Five Cases

Eva Perón, best known as Evita, underwent a prefrontal lobotomy in 1952. Although the procedure was said to have been performed to relieve the pain of metastatic cancer, the author carried out a search for evidence that suggests that the procedure was prescribed to decrease violence and to modify Evita’s behavior and personality, and not just for pain control. To further elucidate the circumstances surrounding the treatment of this well-known historic figure, the author reviewed the development of the procedure known as prefrontal lobotomy and its three main indications: management of psychiatric illness, control of intractable pain from terminal cancer, and mind control and behavior/personality modification. The role of pioneering neurosurgeons in the development of prefrontal lobotomy, particularly in Connecticut and at Yale University, was also studied, and the political and historical conditions in Argentina in 1952 and to the present were analyzed. Evita was the wife of Juan Perón, who was the supreme leader of the Peronist party as well as president of Argentina. In 1952, however, the Peronist government in Argentina was bicephalic because Evita led the left wing of the party and ran the Female Peronist Party and the Eva Perón Foundation. She was followed by a group of hardcore loyalists interested in accelerating the revolution. Evita was also suffering from metastatic cervical cancer, and her illness increased her anxiety and moved her to purchase weapons to start training workers’ militias. Although the apparent purpose was to fight her husband’s enemies, this was done without his knowledge. She delivered fiery political speeches and wrote incendiary documents that would have led to a fierce clash in the country at that time. Notwithstanding the disreputable connotation of conspiracy theories, evidence was found of a potentially sinister political conspiracy, led by General Perón, to quiet down his wife Evita and modify her behavior/personality to decrease her belligerence, in addition to treating her cancer-related pain. Psychosurgery was purportedly intended to calm Evita and thus avoid a bloody civil war in Argentina. It was carried out in maximum secrecy and involved a distinguished American neurosurgeon, Dr. James L. Poppen, from the Lahey Clinic in Boston. A recorded and videotaped interview with a former scrub nurse and confidante of Dr. James L. Poppen revealed that prior to the lobotomy on Eva Perón, he performed lobotomies on a few prisoners in the prison system in Buenos Aires. Later, Dr. Poppen seems to have regretted his involvement and participation in this sad chapter in Argentine history. The treatment of Evita at the end of her life was influenced by extraordinary circumstances of time and place but also involved general issues of medical professionalism, the ethics of neuroscience, and the risks of being manipulated by labyrinthine byzantine politics. This story serves as a reminder that any physician, even one considered to be one of the best in the world, may act naively and become a pawn in a game he cannot begin to fathom.

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