Dr. Creepen's Dungeon - S1 Ep20: Episode 20: The Mad Lobotomist

Episode Date: March 11, 2021

Dare you come face to face with the mad lobotomist? Do so at your own risk!

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We believe OCT scans are so important they're included with every standard eye exam. Book an eye exam at Spexsavers.cavers.ca.cai. Eye exams are provided by independent optometrists. Visit Spexavers. to learn more. Welcome to Dr. Creepin's dungeon. Now the history of the lobotomy, a medical procedure that involved entering a patient's brain and severing the connections between the front lobe and the remaining sections is, as you'd imagine, quite disturbing. Monitz and Argentinian neurologist was actually awarded a Nobel Prize for inventing the procedure, which was later renamed and simplified,

turning it into the ice pick lobotomy. It was frequently used to treat schizophrenia, compulsive disorders and depression. In the 1940s alone, over 40,000 Americans underwent this procedure, with psychologist Walter Freeman holding the record, having before 20 lobotomies in one single day. All of this should serve to warn you about tonight's feature-length story, The Lobotomist by Chilai 1220. Before we begin, as ever, a word of caution. Tonight's story may contain strong language, as well as descriptions of violence, and horrific imagery.

That sounds like your kind of thing. Then let's begin. From the Journal of Dr. Layland Skinner, clinical director of the Berkshire Psychiatric Hospital near Pittsfield, Massachusetts. March 16, 1953. At the direction of the hospital administrator, I've been asked to compile a list of three suitable patients

who will be the first recipients of a new therapeutic procedure to be adopted by this institution. He informed me that, next third, Thursday, we shall be receiving a visit from one Dr. Alphonse Foreman, who is a specialist in performing both leukotomy and transorbital lobotomy procedures. Evidently, this Dr. Foreman studied under Dr. Manitz himself, the originator of the procedure, and he claims to have worked with both Freeman and Watts in developing recent advances in the transorbital procedure in particular. His intention is to have Dr. Foreman demonstrate the lobotomy procedure for our staff doctors,

and instruct them in performing the surgery themselves. I must say that I am not at all enthused by this decision. I was only informed of the administrator's decision this morning, and I am quite irritated that he did not consult with me before deciding that we should add a new therapeutic option to our current treatment programs. I attempted to voice my objections to this decision, but I found him in one of his peculiar moods of excited intransigence,

and my protests fell low. upon deaf ears. Among my concerns was that our institution is wholly unsuited for any type of surgical procedure, as neither myself nor any of the staff clinicians possess any formal education and training in performing surgery, much less anything as delicate as neurosurgery. However, he claims that he was personally reassured by this Dr. Foreman that the transorbital lobotomy procedure is simple enough that only rudimentary training and instruction are necessary for our staff to perform it successfully and consistently. Of this, I am quite skeptical. Nonetheless, despite my own professional objections, I am still willing

to honour the decision, however hasty it might have been. I have known Philip for nearly 20 years, and all that time he has performed the position of administrator quite admirably, his occasional rash decisions aside. However skeptical I am about his professional assurances regarding Dr. Fombe, his other reasoning for adopting lobotomy, or any new procedure, is actually quite sound. When he speaks of how our institution has unfortunately fallen behind in the latest advancements in mental health, I cannot exactly argue. After all, we are a relatively small and obscure state institution with a none-to-princely budget. and with our limited means, we cannot always stay abreast of new treatment options.

In fact, it was only three years ago that we finally possessed the ability to perform electroconvulsive therapy for our patients, and our hydrotherapy wing has become increasingly dilapidated from neglect. However, when Philip speaks about the need to overcome an inherent resistance to change within the profession, I cannot help but wonder if, perhaps, that was a personal, bar directed at me. Does he really think that I'm a stuffy, stubborn old man, hopelessly averse to the modern? I have practiced psychiatric medicine for 33 years, 19 of them in this very institution, and he really ought to know me better than that. I feel that my own skepticism about having

untrained staff performing amateur neurosurgery should be quite natural, and that skepticism is an integral part of our work. You'll just have to excuse me. me for exercising my ethical and scientific due diligence before adopting a new treatment methodology on the sole basis of its novelty. For my part, I have been recently exploring a new line of research into using pharmacological solutions for treating mental infirmity. Dr. Lehman, at the Douglas Hospital in Montreal, has made some highly compelling researchers into this field, and I myself am hoping to expand their use for our purposes at this institution. However, I will admit that progress in this field has so far been slow, and the results are still far from concrete.

It seems that, for the time being. My research in this direction will be halted to focus on surgical options. March 18, 1953. After much consideration, I believe I have finally produced three ideal candidates to demonstrate the procedure when Dr. Foreman arrives next week. I submitted my recommendations to the administrator this morning, and he seemed to fully concur with my choices, a refreshing change from his earlier behaviour. In the meantime, I think my attitude has softened somewhat towards adopting the lobotomy procedure at this hospital. I'm still concerned with the idea of having to perform the surgeries ourselves, but I've been more objective regarding the other therapeutic benefits. I am already quite familiar with the work of Dr. Watts, whose papers on the procedure I have been

reviewing the past few days to gain some idea of expected results. If the results that he and Dr. Foreman are claiming are accurate, then perhaps we could find some purpose for lobotomy and leukotomy procedures after all. Most of our patients are highly disturbed, and some are actually quite dangerous, including many who have been judged as criminally insane, and our conventional methods of therapy have yet to be fully effective for some. Even if the lobotomy proves to be ineffective and renders these patients wholly incontinent, it might be worthwhile if only to keep them quiet and subdued. Here is a brief list of the three patients I have chosen.

Patient name Hannigan, Martin C. A. Age. age 46. Date of admittance, 8, 10, 38. Diagnosis, schizophrenia, dissociative identity displacement. Hannigan was one of the first patients I thought of when I was asked to find three candidates, and he is the patient for whom I coined the diagnosis, dissociative identity displacement, an illness that I believe I am the first to recognize. The orderly is. and some of the doctors have taken to calling him Father Martin, though I discourage them from using that appellation

anywhere within his earshot. It would only encourage him. Martin Hannigan is one of our criminally insane patients, having been committed here by court order after being charged with murder. In all of his nearly 15 years at this hospital, he has resisted most conventional treatments and clung to his delusions quite firmly.

I recall that he used to occasionally receive visitors during his early years here, but it has been at least a decade since any of his family have seen him, and for that I cannot blame them. Father Martin was living with his parents at the time he committed the murder for which he is committed here. He was a typical case of an adult shut-in, still dependent on his parents, a man with few friends and limited contact with any persons outside of his own family. He almost certainly possessed some pre-existing mental condition. However, he did manage to form a friendship of sorts with his next-door neighbour,

a Catholic priest named Martin Gallagher. And their shared first name is, in my opinion, part of what causes his present condition. Anyhow, the nature of his relationship with his neighbour is difficult to determine, but at some point it deteriorated to an extent which led to the violent, incident in question. Gallagher was beaten to death in his living room. His remains beyond recognition, according to court documents. And young Martin Hannigan was arrested later that day, attempting to flee his neighbourhood in North Boston, in nothing but his underpants, still covered in blood and babbling

nonsense. He almost certainly would have been destined for the electric chair, but his profoundly diminished mental state ultimately swayed the court. and so he was committed here. Regretfully, we were not able to prevent his continued mental deterioration in his first few months in the ward, during which he suffered an almost complete psychotic break. To this day, he is still in his deluded state, having completely dissociated himself from his previous identity, and adopted a new one. He, in fact, believes that he is not Martin Hannigan, but Father Martin Gallagher,

the man he killed. He has adopted this identity so thoroughly that he has proven highly resistant to conventional treatment. If one were to ask him who he is, he would say with complete confidence and assurance that he is Father Martin Gallagher, man of the cloth, and claims to know nothing of this Martin Hannigan character

we attempt to convince his true identity. Since that day, he's lived with a constant delusion of his new identity and attempts at all times to behave in a fashion he associates with it he roams around the ward during the day pretending to be a catholic priest and attempting to preach and proselytize to other patients and orderlies early on he even made a cassock out of torn bedsheets among his possessions is a small journal filled with his scribbling that he refers to as a bible and he will often go into the common room and deliver a sermon of his own made-up quotes from scripture, typically invoking images of doom and divine wrath, something which often disturbs and excites his fellow patients. I do not allow him to have a real Bible, nor do I typically allow patients to possess religious texts in general, as I find that ill minds with minimal ability to judge

between fantasy and reality are quite susceptible to ideas of spiritual and prophetic nature. and it might very well deepen their existing delusions. Despite the disruptive influence of his sermons, Martin is not a violent or dangerous individual, though his behaviour can change radically, depending on his volatile mood. Much of the time, he's quite excitable, even manic, while at others he can be excessively sullen,

and the tone of his sermons often reflects this. However, I have observed that his delusion is a relative, thin veneer, which gives me some confidence about his treatment. Despite his insistence of his assumed identity, it only takes minor prodding and assurance of his true identity to make him profoundly agitated and illicit fervent emotional denials. Some of his other behaviours have been more difficult to curb. Perhaps his most inappropriate and unhygienic behaviour is his tendency to urinate and defecate on the floors in various parts of the hospital.

It is not, as first suspected, a product of urinary or fecal incontinence, but rather an intentional behaviour, unlikely not out of malicious intent. Dr. Rayburn, his primary doctor, instead asserts, and I agree, that Hannigan genuinely lacks the moral and intellectual wherewithal to relieve himself in the appropriate manner. As I've heard that incontinence is a frequent side effect of lobotomy, I am concerned that he may require more strict observation during his first few weeks of recovery from the procedure.

Otherwise, I am hopeful that it might do some good for old father Martin, particularly if lobotomy proves adequately to suppress his volatile emotions, which could make all the difference in treatment, if I could use the psychological opening to break through his deletion. patients. Patient name Snyder, Martha B. Age 60. Date of admittance, 42644. Diagnosis, paranoid schizophrenia, manic depression, personality disturbance otherwise unspecified. Ms. Snyder was probably the first patients I decided will be an excellent candidate for lobotomy. for a number of reasons.

She is, by far, one of our most violent and dangerous patients, notwithstanding her small stature and seemingly non-threatening appearance, and is responsible for a sizable portion of injuries sustained by orderlies and other patients. The other doctors and myself have more or less given up attempting to treat her conventionally, though occasionally one will re-attempt therapy based on a new methodology, which has always failed in her conditionally. case. However, some of these treatment approaches devised for her have actually been reasonably successful when applied to other patients. I suppose that, if nothing else, means that she has

some particular purpose for existing. It may sound harsh, especially from her medical professional, but I genuinely despise ever having to work with her, as do all of the others. If she were not an interesting research subject, she would have no justifiable purpose for even living. It sounds like an unprofessional opinion, but I've simply seen too many orderlies, nurses, doctors and other patients seriously injured by her for me to have any natural sympathy. Ms. Snyder is another one of our criminally insane patients, and the circumstances of her crimes are especially repugnant. She had a history of her. of serious mental illness well before she was committed here, including a number of quite

disturbing incidents prior to her ultimate decline into complete insanity. On several occasions, she was often accused by the authorities of savagely abusing her own children, and more than once the state stepped in to take them away from her. However, she always managed to regain custody by some means, only to continue her pattern of neglect and abuse that often ventured into the extreme. Previous diagnoses named manic depression and constitutional psychopathic inferiority, a diagnosis no longer commonly used, but which still offers some insight into her condition. She's had multiple husbands who have fathered her numerous children,

each one having accused her of considerable mental cruelty and physical violence, for some unfathomable reason she found employment in childcare and domestic service despite her well-documented history of abusive behaviour towards children during a period of about eight months leading to her eventual commitment she underwent a considerable decline in her mental state and her behaviour became more extreme and increasingly bizarre at the time her own children had become adults

and long since abandoned her, and she was taking odd employment caring for her neighbor's children in her home. One day, after a particularly intense and violent fit of rage, she stabbed her latest husband to death, stabbed a four-year-old child she was caring for, who survived, thankfully,

and absconded with a neighbor's infant child. The kidnapping did not go unnoticed for long, and she was quickly pursued by local police, who were informed after neighbours overheard her violent fit. She was found holding the infant at a road bridge, and when cornered by police, she threatened the infant with a knife and dangled her over the edge. She was very nearly shot by the police,

which would have done the world a tremendous favour, but she relented and appeared to surrender before slitting her own throat in full view of onlookers. She survived this fumbled suicide attempt, and to this day she bears that hideous scar on her throat. Ms. Snyder proved to be troublesome almost immediately upon arrival. At first sight, she doesn't seem terribly intimidating, though her frightful physical decline is quite noticeable.

She's about my age, but she appears much older, being quite wrinkled and shrivelled. She's no more than five feet tall, quite emaciated and warm. through the shuffling gate, but when she lashes out, she becomes remarkably swift and spry, leaping like an alley cat. Her head is now almost absent of hair, which she has long since either pulled or scratched out, leaving behind only a few ragged wisps of silver hair on her scalp. Despite her violent behaviour, she has a remarkably chipper demeanour,

though with her injured throat she rarely speaks and can only get out of a horse, gravelly whisper. She always seems to have a small, coy smile on her lips, and she has a distinct tendency to laugh and giggle at strange moments. Indeed, her states of particular excitement are often

a warning of her violent outbursts, during which she can injure others with incredible speed. She keeps her finger and toenails quite long, and though I frequently urge the orderlies to trim them at every opportunity, they rarely oblige this

quest. They are more afraid of her than a rebuke from me. During her attacks, she will leap onto her victim and use these long nails to violently scratch them, while using her yellow crooked teeth to bite at whatever bare flesh she can get her mouth around. One orderly lost most of his left ear during one of her attacks and quit shortly thereafter. Other staff and patience have since learned to never turn their backs on her, which often proceed. She's feared and hated by staff and patient alike and until now we have been at a loss to deal with her effectively We've long attempted to control her behavior by keeping her sequestered and separate from other patients But on occasion one doctor or another will allow her a chance to interact with other patients in the vain hopes she's learned some self-control

This always ends in failure following yet another person patient or staff member being attacked, sometimes within minutes of being released from isolation. She even attempts to attack doctors who attempt therapy sessions with her, meaning that she must always be in restraints during any prolonged interaction with others. I myself have attempted sessions with her, in which she will explosively attempt to leap out of the chair to which she is restrained. When this inevitably fails, she will quickly desist and sit back down, resuming her previously chipper demeanour, even giggling like a schoolgirl, as if it were all a joke.

She almost never speaks during these attempts at therapy, and when she does, it is typically nonsense that can be hardly made out through her damaged voice box. It's difficult to say what good may come of lobotomizing her, but none of the current treatment options have worked. In any case, if the procedure, for whatever reason, and manages to pacifier, that will be good enough for me. Freeman and Watts have claimed a significant margin of success with the procedure, but even if it fails and she is rendered a catatonic imbecile, I believe I might be satisfied.

She could not possibly be any worse than she is now. Patient name, Weatherly, Blake, G, age 25. Date of admittance, age, age, 3.51. Diagnosis, manic depression, borderline personality disorder, antisocial behavior, homosexuality. Young Mr. Weatherly is something of an outlier with regards to the others I have already selected. While the other two patients I have chosen are demonstrative case and indeed are highly disturbed and largely detached from reality, Weatherly is mostly in possession of his logical faculties. Despite this, he is indeed afflicted by mental illness and has thus far proven

resistant to treatment. It is not much of a surprise, as borderline personality diagnoses are notoriously difficult, if not impossible, to effectively treat. Likewise, it has been difficult to determine the origin of his sexual frustrations that is the source of his homosexual behaviour, though the success rate for treating homosexuals is rather low. low regardless. Mr. Weatherly, in stark contrast to many others in this institution, is hereby voluntary commitment, at least in the legal sense. Despite being a legal adult, his parents were granted power of attorney over him and had him committed here about a year and a half ago. The Weatherly family is actually quite affluent and a prominent force in Boston high society,

and why they chose to have him committed here, as opposed to a more luxuriant private institution, is beyond me. Though we strive to provide the highest possible quality care at our facility, we are still an obscure state institution of limited means. I can only imagine that their motive for committing him here is to take advantage of this relative obscurity and keep their son from the public eye. I am acutely aware of how these high society families

will preserve their public image at any cost. Nonetheless, Mr. Weatherly is very much in need of attention for his mental health issues. According to his file, he has attempted suicide on three occasions prior to his commitment, though he has never until now been the subject of an involuntary psychiatric hold. I say involuntary, even though, legally speaking,

he is free to leave whenever his parents come to collect him. His parents do come to visit on occasion, usually just prior to the holidays, and though Mr. Weatherly eagerly anticipates these visits, he becomes quite sullen and angry after they've left. At some point, I would like to monitor these visits and see for myself how he interacts with his parents. Thankfully, he is not physically violent towards staff or patience, but he can be quite quarrelsome and hostile during his agitated and manic episodes and irritable and sensitive during his depressive episodes.

On occasion, or verbally abuse others with considerable ferocity, a typical feature of borderline personalities, and this disruptive behaviour has been troublesome for other patients in the ward. Fortunately, his worst behaviour comes in distinct cycles, and treating him during his more stable and compliant moods has been effective so far, though these cycles have seemingly become shorter and the window for treatment much narrower. For this reason, I am hopeful that the new procedure will have the effect of stabilising his mood swings

and offering a more useful opening for our current treatment options. At first, I only meant to select patients that were particularly violent and troublesome, but Mr. Welley may prove to be an interesting control case for our purposes. In addition, lobotomy is an indicated procedure for treating manic depression, so our efforts may well prove effective. These are challenging times for each and every one of us, a time in which we maybe feel we want to try something new to challenge ourselves, but perhaps there's something interfering with our happiness

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At our weekly staff meeting this morning, the administrator and other doctors discussed my selections for our demonstration next week. I was pleased to hear the complete concurrence of my colleagues regarding the selection of these three patients. The only concern expressed was regarding my third selection, Mr. Weatherley, which I expected and countered with Freeman and Watts' own assertions that lobotomy is approved for treating manic depression. I made this claim even though I am still somewhat skeptical on this point, but for experimental purposes we may just confirm or refute this treatment indication and on that point I am more confident

during our meeting I learned that it was Dr Rayburn and Dr Gillis who somehow persuaded the administrator to invite Dr Foreman to our facility I must say that I am quite irritated that these two went over my head to appear directly to the administrator when professional protocol dictated that they should have consulted me first. I already rather like Dr. Rayburn. I cannot deny his talents as a neuropsychiatrist, it being my own field of training, but his ambitious and high-handed behaviour, not to mention his general disregard for the established professional hierarchy, have all made me question his judgment. He claims to have had a professional correspondence with Dr. Foreman for quite

some time prior, and he swears by his competence and suitability. Not that I put much stock in Rayburn's opinions as of late, but if it is his professional recommendation, I suppose that I am bound to indulge him. Dr. Gillis is a more concerning matter. I've known him for ten years, and I never believe that he would go behind the back of another like this. He is a pleasant and compulsively honest fellow,

but I have observed that he is a definite B-type personality, naturally subservient and easily influenced by others. I suppose that might derive from his upbringing or from the course of his professional career. Most of the doctors on Astaf are society men, science of various affluent families in New York, Philadelphia, or Boston like myself, but Mr. Gillis is a Texan and a true southern good old boy as the parlance goes. his pleasant and amiable nature,

combined with what I assume is a compulsion to prove himself to his well-heeled colleagues, is the likely source of his compliant nature. I wouldn't be surprised if it was Dr. Rayburn who influenced him in this little scheme. And still, I should not be too upset with them. After some thought, I realized that this development was inevitable, that some serious measure would occur to keep our institution abreast of the latest of our vows. in the science of mental health, and perhaps it is just as well that we find ourselves compelled to forge ahead and make several years of progress in one fell swoop. March 23rd, 1953.

Today I gave a brief interview to each of my selected patients before they'll be subjected to the procedure later this week. I believe that my choices are quite sound, and my colleagues are all in tacit agreement. So it seems that these three should be. shall be our first subjects. With the administrator's approval, which I hope to get later today, the decisions will be finalized and formally accepted. In the meantime, it seems that word has gotten out among the rest of the staff of Dr. Foreman's visit.

The staff are quite noticeably excited and have been scrambling to get the hospital in good condition. The doctors in particular are positively giddy as schoolboys. I was hoping that I might stifle air. any open discussion of the lobotopy procedure anywhere within earshot of the patients, a hope that is now fruitless. I'll just have to trust in their discretion. My interviews with the three patients have mostly reinforced my beliefs.

Hannigan was generally incoherent as usual, attempting to regale me with stories about a distant relative of his who he claims was an adventurer in the Old West or some such nonsense. In speaking to him, I was such. suddenly reminded of how he can, on brief and very rare occasions, show remarkable clarity and coherence. He asked me why I'd been seeing him so frequently during these last few days, when Dr. Rabin is his primary doctor.

I must admit that I was rather put off by his question. I have yet to tell him or any of the others about the lobotomy procedure to which they will be subjected. I only told him that I have taken a special interest in his case, and that we might not might be seeing more of each other in the future. It is rather unlike me to lie or withhold the truth from a patient, but in that moment I was caught off guard. It gives me a rather troubling feeling now that I consider it.

The other two patient interviews went more or less as I expected. Snyder once again attempted to attack me, was once again thwarted by her restraints, and once again went back to her giggling and nonsensical croaks through her ruined voice box. Weatherly, I found in one of his despondent moods, quite irritable and hardly in any mood to speak. I fully expected that he would be the one

who showed the most cognizance of something unusual when he was, to my surprise, quite compliant. He expressed no interest in my questions or curiosity about my motives. I feel more confident now in choosing him for this procedure than I had previously. The administrator has already obtained consent from his parents to undergo the lobotomy, so, with no further obstacles, it seems that they will indeed be our subjects.

Still, I cannot help but be bothered by my exchange with Hannigan. What could it mean that I openly lied to him in that way? I've always insisted on complete honesty with my patience, even when their delusions would preclude any appreciation of truth. It has been my firm belief in 33 years practicing psychiatry that lies. Even passive half-truths can only reinforce their delusions, and yet in that one moment I lied to Hannigan out of hand. While I had no intention of explicitly informing him of Volbotti, for which he is scheduled,

I had not expected that he would recognize something amiss. Perhaps I'm overthinking it. After all, you can truly say if my sin of a mission has made any difference. In truth, despite our tireless hours of research and study, our field is still in its relative infancy. I fear that perhaps we may never exactly know just what goes through the mind of people like Hannigan, Weatherley and Snyder. March 26, 1953. At last, the much-celerated doctorate, to Alphonse Foreman has arrived.

My first impression of him is that he is definitely a distinct individual. His arrival, though anticipated for weeks, still managed to surprise our staff remarkably. We were not given any exact time to expect him, so when he presented himself at the front desk of the administration building at precisely nine o'clock in the morning, all of us were taken by surprise. The doctors and I gathered to meet him, and I was able to lay eyes on this man for the very first time. He is quite tall. I would guess around six foot four, and wearing a charcoal grey pinstripe suit, black gloves, a red floral necktie and a black fedora hat, which he doffed at us with a great flourish, like a Victorian gentleman. With great enthusiasm, he went among

us, shaking hands with each doctor in turn, exchanging some hearty pleasantries and words of encouragement. To the administrator, he gave a short bow and shook hands vigorously saying, Dr. Alphonse Foreman at your service with great warmth. He left the entire staff enormously impressed and enthused by his presence, and I admit that for a moment I myself was briefly swept up in the admiration. He asked if I were any relation to the other Dr. Skinner at Harvard. No relation, I assured him. I recognized his type immediately,

the dominating charismatic personality, boisterous, firm, and pleasant to all. He would speak loudly, but not aggressively, always quick to laugh and smile with whomever he conversed. His amiable manner and openness drew in all the others, each jockeying for an opportunity to bask in his pleasing aura, while he suddenly but generously dispensed positive affirmations to all. Even the meek Dr. Murray, who rarely spares a word for anyone,

could not help but chatter excitedly with him whenever the opportunity presented itself. With his natural magnetism, he attracted and left in awe all who spoke to him, no doubt feeling that they each individually had forged a special connection distinct from all the others. I like to think that I'm not so easily swayed by, charismatic and glib individuals like him, but nonetheless I am still somewhat impressed by his pleasant yet powerful demeanour. He was finely dressed, well-groomed, and a generally handsome individual overall, sporting a thin, jet-black moustache and similar coloured hair. In short, he is the sort who attracts attention and easily inspires awe and confidence in all those around him,

precisely the kind of person about whom I naturally feel suspicious. I hope that his glib demeanour does not unreasonably sway the likes of my colleagues, and they will be willing to judge him on his professional competence alone. After introductions were complete, the administrator and Dr. Rayburn insisted on giving him a thorough tour of our facility, to which Dr. Foreman readily agreed. All throughout the tour, Dr. Foreman asked plenty of questions, showing a strong and encouraging interest in nearly every aspect of our institution. We toured the common areas where he spoke to several patients with the same pleasant manner as he had with our staff.

They were just as pleased and awe-struck by this man as the staff, if not more so. Quite often patients are nervous and sceptical about new doctors, but I was surprised and somewhat pleased to see how readily they appeared to trust him. As the tour progressed, he was shown our various therapy wings in which he showed great interest, even in our decidedly outdated hydrotherapy wing. I could see that the administrator was all quite pleased with Dr. Foreman's numerous compliments of our staff and facilities, and by the end he was positively beaming with pride.

At last, Dr. Foreman expressed the wish to examine the three patients for himself. Despite myself, I agreed to his request, although I felt it was unnecessary to have my work double-checked by a newcomer. Perhaps it was relevant to his methodology, so maybe I ought not to complain. As he interviewed the three patients, I thought I could detect an accent that I could not place, perhaps something central European, though his speech was impeccable and eloquent. With Snyder, he was briefly startled by her typical attempt to attack him, but once she desisted he gave a hearty chuckle, seemingly as amused by her behaviour as she was.

as was usual she offered nothing coherent or understandable to say after her was hanigan who had a very strange reaction to him ordinarily hanigan is quite verbose but as he regarded dr foreman he actually became quite meek and silent seeming to shrink away from him despite the doctor's attempts at reassurance the interview with weatherly proved more to my expectations with the young patient becoming quite animated and greatly interested in this new face, as had been all the other patients. After this, Dr. Foreman gathered Rabon, Gillis and myself to explain the lobotomy procedure. Sure procedures will be carried out tomorrow, but for today we engaged in some preliminary instruction. With him he brought a large suitcase,

which I noticed he had at his side throughout the entire tour, and he set it on the table and revealed its contents. in it was apparently his tool kit, which was a variety of surgical tools and other medical devices. Among his tools were a set of scalples, a number of differently sized syringes, an assortment of vials of many substances, a group of charts of human anatomy, and finally were the two main instruments, the orbiter clast and the leukotome. He set himself to explaining the essentials of a procedure, and briefly, demonstrating the proper technique for using the tools. The actual transorbital lobotomy procedure

is as follows. Upon anesthetatizing the patient, the surgeon will place the tip of the orbiter clust underneath the eyelid against the upper sheath of bone that forms the inside of the eye socket. Using a mallet, the point is driven through the thin section of bone into the cranial cavity proper. The instrument is then inserted about five. centimeters into the prefrontal cortex whereupon it will be pivoted upwards about 40 degrees in a sweeping motion to sever all connected brain matter between each hemisphere of the prefrontal cortex and thalamus after this first motion the instrument is drawn back to its initial position inserted two centimeters further and two 28 degree motions upwards and downwards are performed after withdrawing the instrument it is

inserted in the same manner in the other eye socket, and the above motions are repeated for the other hemisphere. Indeed, it does sound like a fairly simple procedure, and it's not extraordinarily intricate, as I'd feared. I am still somewhat bothered by the indelicacy of the first step, using a mallet to insert the instrument, but Dr. Foreman insists the risk of serious unintentional injury or death during the procedure is actually somewhat rare. He assures me that this exact same procedure has been successfully employed in many institutions, where he has demonstrated the procedure himself. For my part, I am still quite unsure of the wisdom of having untrained men performing neurosurgery,

particularly one of such important consequences, but Rayburn and Gillis are insistent of their abilities to replicate this success. I suppose that if any on our staff are suited for performing neurosurgery, than it would be a fellow neurologist like Rayber. The administrator insisted on having Dr. Foreman and several others, including myself, to dine with him this evening at his home. I was hoping that I might use this opportunity to voice my lingering concerns to the administrator, but Dr. Foreman effectively dominated the evening in his larger-than-life fashion.

My questions and concerns will just have to wait until after the procedures are performed tomorrow morning. I instructed our head nurse to get our chosen patients prepped for tomorrow. And I certainly hope that this does not allow them unduly. That's all. It has been a long and eventful day, and I am quite exhausted. I will need rest if I hope to adequately oversee our first procedures. Hey Ontario, come on down to bed MGM casino and check out our newest exclusive. The price is right, fortune pick.

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please contact Connix Ontario at 1866-531-2,600 to speak to an advisor free of charge. Bed-MGM operates pursuant to an operating agreement with Eye Gaming Ontario. March 27, 1953. The fateful day has at last arrived. and this morning I observed as Dr. Foreman demonstrated his technique before all staff doctors. As part of his teaching process, he insisted that the first procedure would be performed by him alone. The second with Dr. Rayburn and Dr. Gillis closely observing and assisting, and the third would be performed by Rayburn, with Foreman taking the place of observing and guiding.

His decision to have Rayburn perform one of the surgeries came as a surprise, and I was taken aback at first until a minor compromise was made. I insisted that Weatherley, originally scheduled last, would instead be operated on first by Dr. Foreman himself. After all, Weatherley's condition is far less dire than the other two, and I would hate to have him suffer any complications at the hands of a novice like Rayburn. Snyder received the final operation, performed directly by Dr. Rayburn. If any were to suffer from grave complications, I would rather it be her.

After witnessing the procedure for myself, I must say that I am astounded by its speed and efficiency. We began at ten o'clock, and finished shortly before lunchtime, with considerable breaks in between to discuss what we had observed, so I can hardly argue with the simplicity of the undertaking. Dr. Foreman demonstrated his own innovation to the procedure, in which he follows up the incisions by using a syringe to apply a mild caustic solution to the side of the severed nerve fibres. According to him, this will ensure that the cuts are scoured of any loose tissue and remaining fibres, thereby reducing the chances of malformed tissue regrowth and allowing the lesions to form more evenly and consistently.

I presume that he was inspired by Dr. Monitz and his first attempts at leukotomy, in which the target fibres are destroyed using an alcohol solution injected into the sites. I suppose that if Dr. Foreman feels confident enough in his work to apply a well-thought innovation of his own, then perhaps my misgivings are not warranted. The operations were so quick and efficient that complete anaesthesia was hardly necessary. Using standard sedatives, we were able to render the patient senseless for a more than adequate time to complete the procedure before. regaining consciousness. For Schneider, we even decided to use alternate anesthesia, using our

electroconvulsive therapy device to render her unconscious, which actually proved quite effective. At my suggestion, we altered the settings and electroplacement to induce electro-narcosis, rather than a seizure, and it proved effective for subduing her long enough to complete our work. Dr. Rabin managed to exceed my expectations and perform quite well. well when supervised by Dr. Foreman. Already, he and Gillis have begun excited discussions about which patients should be scheduled next. I'll have to remind them that, as clinical director, I am the one who must approve all

such decisions, and for the time being we should wait and observe the recovery of our patients before attempting to perform any other lobotomies. It is my hope that we might use this procedure sparingly on only the most untreatable and deranged patients. For now, all that remains is to allow the patients to recover. Apart from bruises around the eye and small spots of blood, which is typical in any surgery in the ocular cavity, they don't bear any superficial marks of their treatment. At the moment, they're still in a deep stupor, which is typical according to other accounts, and they should begin regaining their faculties within a day or so.

The administrator and other doctors are already celebrating this, which I hope is not premature nonetheless I'm confident that whatever changes we observe will be positive we might just be able to guarantee them an improved quality of life March 30th 1953 as quickly as he arrived he is gone dr Foreman left town yesterday evening leaving with the administrator a message expressing his regets that he could not stay longer and offering words of encouragement to our newly minted surgeons, Rabin and Gillis, who will be taking responsibility for all future lobotomies performed within our hospital.

Much of our senior staff was greatly disappointed to see him leave, and I dare say that the administrator seemed almost despondent by the celebrated doctor's departure. For my part, I am disappointed that he did not even remain to observe our patient's recovery, which, in my view, is a curious omission for a medical professional of his standing. I understand that he has numerous similar engagements with other psychiatric hospitals, and his work requires much travel, but I still believe that his sudden departure could have been handled with more decorum intact.

On the subject of recovery, our three patients have been making progress, though the initial results do not seem particularly encouraging. All three remained in a stupor for nearly a day afterwards, hardly reacting to external stimuli. Beginning yesterday, they came out of their catatonia and have been more responsive. Snyder has shown the most definite improvement of the three, though in her case nearly any results might be considered favourable.

She is calmed down considerably, while retaining some vestige of her girlish demeanour, having become a lazy, smiling, dull art who has spent the last few days staring out of the window. However, I am somewhat less satisfied with a condition of Weatherly and Hannigan. Weatherly is far less animated and verbose than his usual self. His emotional affect greatly flattened, and overall his formerly erratic personality is now quite dull,

even schizoid in character. While I had hoped for his radical mood swings to be ameliorated, I was not hoping for his personality to shift to the opposite extreme, as it evidently has. The condition of Hannigan is even more troubling. As of this evening, he is still in a mostly catatonic state, occasionally shifting and showing signs of reaction to indiscernible external stimuli. I fear that perhaps he is engaged in some sort of vivid hallucinations,

possibly even an oneroyed state of mind. I will be personally observing his condition for the time being, I sincerely hope that his condition does not deteriorate any further. While I am moderately disappointed with some of the results, perhaps I'm being too impatient. Various papers on the subject have claimed different recovery times, with some stating that positive alteration should be immediately apparent, others asserting that it may take several weeks for genuine improvements to manifest. Whatever the case, I'm glad to have retained Dr. Foreman's contact information.

If their condition does not significantly improve within a few weeks, I may be forced to contact him personally and voice my concerns directly. April 2, 1953. I was pleasantly surprised today to see that Hannigan's condition has improved considerably in such a remarkably short time. Two days ago he was nearly catatonic and in the midst of what appeared to be powerful hallucinations, but today he has recovered his higher faculties tremendously. I spoke with him at length in my office, and I was pleased that not only was he functionally conversant, but he seems to have become surprisingly coherent.

He spoke in full sentences, was able to comprehend my questions clearly, and gave some entirely cogent, even thoughtful answers. As of yet, I believe he still clings to his long-standing delusion about his identity, but I'm hopeful that the reduction of disordered speech and thought will make it. much easier to breach the barriers of his delusional thinking. I am confident enough in his improvement that I'll be allowing him back among the general patient population. Snyder has shown no great change, though I am more or less satisfied she is no longer as violent or hostile as before. Likewise, Weatherly has also shown little change from the past few days, with distinct

deficits in his emotional affect. More troubling is that he now shows some new impairments in perception and discerning reality from fiction. He has adopted some new behaviours involving repetitive motions, almost like nervous ticks, most notably a habit of pouring imaginary tea from an empty teapot in his room. I attempted to interview him this afternoon, and he showed little interest in talking, a definite departure in his former personality, offering only brief answers of no more than three, three or four words in a drab monotone. During the entire session, he made eye contact only once, and only for a second or two.

Rayburn and Gillis are already consulting with other doctors for recommendations regarding future lobotomy recipients. Although Hannigan's improvement has been quite encouraging, it is still somewhat counterbalanced by the apparent failure of Weatherley's case. If I'm able to have the final say in which patients will receive a lobotomy, then I might be willing to approve the procedure's full adoption and use for future patients. April 6, 1953, we had a very disturbing incident in the ward this morning, one that has left me slightly wounded.

Unfortunately, it's not strictly uncommon for individuals in our profession to be wounded treating patients. particularly when working with highly disturbed and dangerous ones. I myself have been wounded once before in this way. Thankfully, neither that instance nor this one have produced serious injuries other than slightly wounded pride. I was doing my rounds in the common room, speaking with different patients on various topics, and when I turned around for a moment,

I was struck square on the nose by a thrown object, which I later saw was a small ceramic basin normally placed on a nurse's cart. The impact broke my glasses and very nearly broke my nose, instead leaving it bloodied and bruised. When I regained my senses, I saw that it was Snyder who had thrown the object, and was now laughing and giggling in that too familiar girlish manner

while the orderly's restrained her. Weatherly witnessed the whole incident and was off in a corner, laughing hysterically, something I've never known him to do, especially after his lobotomy. His laughter was so emphatic and raucous that it quickly spread among the other patients and before long we had a tremendous disturbance

among the entire common room. Weatherly was restrained and taken away as well which fortunately managed to bring some semblance of calm among the disturbed patients. Both Snyder and Weatherly were sedated and confined to their rooms and I dare say that they shall not be among the general population for quite some time.

What is most disturbing about this incident is Snyder's apparent and sudden relapse into her past violent behaviour. But even this incident was a definite outlier compared to her previous violent tactics. For the past week, she had been entirely placid and barely cognizant of events going on around her. But to see her now resume her typical pattern of violence and hostility has left me admittedly shaken. The sudden reversal of Weatherley's behaviour, with his amused hysterics, has also utterly perplex me. Though I was disappointed with their initial reactions to being lobotomised, I see now that, in their cases, the procedure has failed.

And yet, in Hannigan's case, it has been remarkably successful thus far. I cannot remember ever reading that lobotomy could produce such vastly opposing results. This is something I wish I had learned before. for approving the lobotomy of Mrs. Sellers this morning. The operation will take place tomorrow afternoon. I have to consider what happened today and suggest possibly postponing it. Roberta Sellers is not exactly an urgent case,

although, based on her primary doctor's observations, she does fit the bill for a typical lobotomy case. She is a borderline personality with pronounced manic-depressive features, who has thus far not responded to any treatment, which is typical with individual suffering with borderline personality disorder. I imagine the orderlies who have long suffered her often extreme verbal abuse will be disappointed if I put off her lobotomy any longer.

I am afraid they must simply have to wait. If what occurred today is any indication, subjecting her to the procedure could potentially prove worse than useless. April 7, 1953. I am positively outraged right now. This morning I suggested to Dr. Rayburn that we should postpone Mrs. Sellers' lobotomy until after careful consideration.

But Rayburn went completely over my head and appealed directly to the administrator to proceed with the operation anyhow. And I was overruled by the administrator himself. My professional concerns were entire. written off, and as scheduled, Mrs. Sellers was lobotomized this afternoon. The administrator's reasoning was that we had put off further procedures for too long, claiming that Dr. Foreman's visit would be wasted if we did not resolve to make use of the

procedure quickly enough. The whole discussion reminded me of his specific habits and ticks that I have noticed all through the years. He's always been something of a stickler for protocol, always referring to me as Dr. Skinner, evening quite informal social settings. But when he attempts to broach a difficult subject, he will almost always call me by my Christian name, Layland. So I knew that when he sat down saying, Now, Layland, I knew instantly that he had overruled me and decided in Raben's favour.

I very nearly lost my temper in his office, yet fortunately maintained my composure. however much I wanted to berate him and Philip. I was especially aggravated to see that Rayburn seemed almost smug after having gotten his way, and by God I had to fight the urge to throw hands with him then and there.

Of course, I realised that doing so would have been disastrous for my position, not to mention juvenile and entirely unbecoming of me. I'm greatly troubled by what this all might mean. If I am losing, status and influence with the administrator, then I wonder what other decisions might be made against my advice.

I hesitate to think what the likes of Dr. Rayburn or his loyal pet Dr. Gillis might do if they were to have free run of this institution. The only option I may have is to speak with Philip privately and voice my objections in person, well away from the noxious influence of certain men seeking to undermine me. April 10, 1953. This morning I finally had the opportunity to speak alone with the administrator. For some reason, he took a brief absence in the middle of the week with no clear explanation, but he arrived yesterday evening.

My assumptions proved correct, and speaking to him alone proved far more effective than in their presence of others. He seemed to take my concerns to heart, and promised to be more mindful of my advice in the future, and as clinical director, my advice ought to take presidents anyway. For the time being, I believe that I have gotten through to him, a state which I hope will last. It comes at an opportune moment as well,

as Dr. Rayburn today had the audacity to send me a written list of 20 patients he believe should be lobotomized, asking for my approval. I approved only three names on the list, and later today I will personally deliver his list, and discussed my disapproval of his other suggestions. For heaven's sake, he wanted to lobotomize Ernest Sobel, a harmless individual who has never been violent or disrupted to any others since he's been here.

He's only a relatively simple case of a deteriorated schizophrenic, a poor man who has lived on the streets for many years, and is only here because he cannot adequately care for himself. He is also over 70 years old, and it would be an utter waste of him. to lobotomize a man in his later years. Meanwhile, I've been keeping a closer eye on Weatherly, Snyder and Hannigan to see if any other negative manifestations arise. Weatherly is not demonstrably improved and is still sequestered in his room, mumbling to himself and occasionally

having short bouts of manic laughter. I visited him yesterday again and saw that his dull, emotional disdemeanor has not improved in the slightest, which makes his occasional laughter even more jarring and unpleasant. Snyder has been more difficult to judge. Like Weatherly, she has been sequestered for the past few days and has not had any opportunity to be violent to others, but after the incident last week, I know that her apparent calmness and placidity is no indication whether or not she may be violent. Hanigan has remained quite stable, and has even ceased his gloomy sermons that he once delivered for the other patients. However, he has become quite sociable and conversational,

particularly with his fellow patients, and I've seen him having conversations with some others for hours at a time. I've been hoping to overhear one of these conversations to gauge his progress, but he's also manifesting a new habit, secrecy. Whenever orderlies or doctors are with an earshot, he quickly silences himself or whispers conspiratorily with his interlocutor. If Snyder and Weatherly manage to calm themselves, I may consider releasing them from sequestration

and allowing them back with the general population. If their misbehavior was an isolated instant, well and good. But in any case, are we keeping a much closer eye on their behaviour from now on? April 13, 1953. I spoke with Doctorate, Dr. Rayburn today, and I see that the growing enmity between us has not softened in the slightest. My only intention was to obtain Dr. Foreman's contact information, which I can't seem to find

anywhere in my office. And, in so many words, he all but demanded an explanation of my refusals to improve his latest selections to be lobotomized. Why he decided to engage in a debate right there in the hall, rather than in my office, is concerning. but his increasingly bold and impertinent behaviour is beginning to irk me. In fact, he seemed inordinately incensed at what he perceives is a professional discurtesy on my part, all to a point where I thought it would become a full-blown argument. All I could do was state my firm belief that the lobotomy procedure is to be used sparingly, and this would be the practice for as long as I am the clinical director of this institution.

Needless to say, I doubt he was convinced of this, but for the moment he has desisted. I've been hoping to establish contact with Dr. Foreman for some time now, to express my dissatisfaction with his services. Of the three lobotomies performed by him on our patients, two are showing no discernible signs of improvement. Only Hannigan has displayed a positive outcome. I cannot say if it is because the procedure itself is flawed, or if Dr. Foreman's technique was inadequate to produce results. But what is certain is that current outcomes leave much to be desired and that I hold him responsible. I drafted a letter to this effect, which I will send him at the first available opportunity. Admittedly, I have

not discussed my intentions with the administrator or any other staff, but for good reason. At this time, I am currently alone in my belief that Dr. Foreman's teaching has been insufficient, even though the therapeutic shortcoming should be obvious to them. Perhaps they still feel some lingering personal connection, still swayed by his charm and confidence. I know that Matilda, the head nurse, still speaks fondly of him even two weeks after his departure. Speaking of the head nurse, today she informed me that we're running rather low on our supplies of sedative drugs, namely thio-pental and amobarbital. It was curious that she informed me, rather than directing her concerns to Dr. Stanton, our staff pharmacologist, who normally supervises

all drug procurement. I suppose it is a bit odd that we should be running low at this time, but then again we might be using a bit more of these substances than usual. With these drugs being needed for anesthetizing lobotomy recipients and an increase in patient disturbance, incursances requiring sedation, I can imagine that we have been depleting our stocks with greater frequency. Either that, or Dr. Stanton has been slacking and failed to maintain an adequate long-term stock of required drugs. It is best that we have several months' worth of these substances in inventory whenever

possible. I inform the head nurse to redirect her concerns to the appropriate department, and only inform me when a shortage becomes especially grave. April 14th, 1953. This afternoon I observed Hanigan in the ward, and to my surprise I see that he is taken to conversing with both Weatherly and Snyder with some frequency. I've never known these three patients to ever interact with one another,

and indeed their only previous connection is coincidentally being the first three lobotomized patients in the hospital. Unfortunately, I was not able to overhear what they were discussing, but I think that I've finally determined the nature of Hannigan's radical transformation. I am certain that he still clings to his delusion of being Father Martin of the Catholic Church, but I also believe that he's taken on a self-appointed role as chaplain of sorts, that his once incoherent sermons had been replaced by genuine attempts at personal ministrations. Quite soon I will attempt further therapy with him, and see if I can break his deluded state now that he is,

in a more agreeable state of mind. The only troubling thing is his increasingly secretive behaviour. While he is showing interest in interpersonal reactions, he seems to go to great lengths to conceal them from casual observation. When doctors, nurses or orderlies get within earshot, he will abruptly cease conversation and avoid eye contact with his interlocutor, as if he were discussing something conspiratorial in nature. However, having not overheard his conversations, no one can say if anything untoward is being discussed.

For all we know, it might just be nonsense. After all, these are clinically insane patients, and strange behaviour is to be expected. The only odd thing is that his newfound coherence and stability would seem to suggest that he would be talking about something more substantial and meaningful. In the future, we'll have to formulate. a new plan to eavesdrop on one of his conversations and form a better idea of what's going through his mind of late. April 16, 1953. We had a very disturbing, violent incident last night. Shortly before going to bed, I received a phone call from the night staff, informing me that an orderly was attacked by a group of patients and was in very grave condition. By the time I arrived, the situation was

mostly under control, but it seemed as if the entire patient population was overcome with extreme agitation. The orderly, Clarence Bradshaw, was being taken away in an ambulance as I came through the front gate. Thankfully, he did survive the attack, though according to the staff, he was very gravely wounded and not likely to recover soon. He suffered 18 stab wounds, numerous cuts and lacerations, a broken left arm and an especially nasty wound on his face that will likely cost him his left eye and leave much disfigurement. By some stroke of good fortune, the stab wounds were mostly shallow, and only a few did any serious damage to his innards. The patients responsible were subdued and sedated, and will be kept in sequestration for some time, if I have anything to say about it.

I have only just received any clear and concise report as to the nature, for the attack, which, very few other than the perpetrators, actually witnessed. Oddly enough, Hannigan was among the witnesses and was able to give probably the most detailed account of what happened. According to him, Mr. Bradshaw was escorting him and another patient through the ward after lights out, when all patients should have been secure in their rooms. As they made their way down the hallway, Bradshaw was set upon by six patients emerging from the shadows who proceeded to stab and slash at him using improvised weapons, which we later found out were shards of broken glass and sharpened fragments of tile. Somehow, Hannigan avoided being

attacked himself, where the six patients managed to severely wound Bradshaw in a very short time. It was Bradshaw screams that alerted the other orderlies, who arrived on the scene to investigate and were forced to aggressively subdue his attackers. I have reviewed the file. of the six patients who attack Bradshaw, I am astounded that this particular group of patients would do anything this vile. While all of them were involuntarily committed patients, only two of them have any history of violence in this institution, incidents that were neither as recent nor as hideously violent as this one. However, one of them is a recent recipient of a lobotomy, and should not, according to his primary doctor, have the capability to perform

such a cruel and violent act. I fear that this only confirms my previous suspicions, that lobotomy, as practiced in our hospital, is not proving effective. While I have no reason to doubt that Freeman and Watts have demonstrated great success with its use, I have every reason to doubt the amateur surgical skills shown by Dr. Rabin and Dr. Gillis.

It seems that I was correct to oppose having men untrained in surgery performing such a delicate and precise operation. There is no telling if the procedure has failed, or if it has actively made the patients worse. But one thing is clear. Our methodology is greatly flawed. April 20, 1953.

I decided to visit Mr. Bradshaw in hospital today. It's a bit unusual, I know, but I felt compelled to visit him and offer some kind words. He's been one of our orderlies for fifteen years and knows his job better than any other person we employ. The other doctors might find it odd that I would take an interest in him, as they most look down on the likes of orderlies and nurses. But I pride myself on not heeding class consciousness like they do. I found Bradshaw in low spirits, though he seemed somewhat restored at the sight of me. I must say he was a frightful sight, with most of his talk.

also swathed in bandages, his shattered arm in a cast, and the left side of his face covered in stitches, dressed with gauze and more bandages. Thankfully, I have a strong stomach. I served in the Great War and have worked with dangerous individuals my entire career, so I am well accustomed to seeing grotesque injuries. He had some difficulty speaking, as his badly slashed left cheek was mostly immobilized by the sutures, but he made himself understood and he was, and actually seemed very intent to explain what had happened. His account of the incident was much as Hanigan described it, with the six patients descending upon him without warning

and attacking with incredible viciousness. However, when I mentioned that Hannigan had told a similar story, he became quite agitated and insisted that Hannigan was not telling the truth. According to Bradshaw, Hannigan was indeed present at the scene of the attack, but because he was already waiting there, not because he was escorted there by Bradshaw. Instead, Bradshaw insisted that he believed he heard Hannigan having a hushed conversation with unseen individuals,

and as it was after lights out, he was determined to investigate, whereupon the attack occurred. During the attack, Bradshaw asserts, Hannigan did not attempt to intervene or summon help, but instead impassively watched the carnage unfold more a spectator than a witness Bradshaw's radically different account leaves me greatly perturbed he makes it sound as if Hannigan were a co-conspirator to his attackers

and if his account is to be believed then it certainly appears that he was but could this really be true Hannigan's tremendous improvement in the last few weeks makes it seem unlikely his occasionally violent and disruptive behaviour had all but ceased at the time of the incident, while his secretive habits were somewhat concerning, I had not considered a sign of anything sinister, and the nature of the attack itself is even more strange. By all accounts, it was quite sudden and obviously deliberate.

It occurred by surprise without any warning. When virtually all violent incidents in the hospital are preceded by general unrest and agitation, In contrast, this was a well-calculated ambush against one of our most experienced orderlies, a man who is well-versed in how to deal with dangerous and disturbed patients, and not the kind who had let his guard down in their presence. But these patients managed to drop on someone like Bradshaw is at once astonishing and deeply alarming. Trouble as I am, there's work to be done still.

The question of what to do with the six patients responsible has yet to be answered, though I have some idea what the answer might be. Dr. Rabin naturally has suggested lobotomizing all of them, excluding the one already lobotomized, though he insists that a repeat performance of the procedure might be called for. At this point, I'm hard-pressed to argue with him. Clearly these patients have shown a profound regression and deterioration if they were capable of doing this horrible deed, and lobotomy may be our own. only logical option. As for his comment about repeating the procedure on patients who've already undergone it,

I'm also not inclined to argue. If my previous suspicions were correct, then the lacklustre results come down to a simple failure to perform the lobotomy correctly, then repeating it might prove effective. Still, I should not concede any of this to Dr. Rabin. He's the last person I'd want to encourage at a time like this. April 24th, 1953. For the past few days the patients have been extraordinarily agitated and quarrelsome,

and we're at a loss to uncover why. This morning, in the common room, there was a brief three-way brawl that left two patients and an orderly, lightly wounded. At lunch, one of the patients stood up in his chair and began singing a chorus of the battle hymn of the Republic. Before long, the entire room was engaged in similar hysterics. before another patient swiped a soup ladle and used it to attack several others. All day, Ms. Snyder has been skipping around the ward, clapping her hands in time with an inane song she hummed all the while.

For hours, Audleys and doctors have been trying to restore calm, while patients are contenting themselves with urinating and defecating on the floors, screaming and singing, throwing things, and generally waging a slow, burning riot across the entire hospital. The only one not participating in the disgusting revelry is Hannigan. This is not surprising. He seems to be a common denominator whenever another incident occurs, always seeming to observe everything, yet never seemingly to actually take part in anything.

Dr. Foreman still has not sent a reply to my concerns. As the ward spirals out of control, I had a loss on how to resolve it. Something is obviously going wrong, and I am convinced that our troubles coincide perfectly with his visit and the first lobotomies performed. Granted, I have never heard of lobotomies causing anything approaching the violence and chaos that now threatens to overtake this hospital. But I want to make my dissatisfaction known, because even if the use of lobotomy has not caused our predicament, it most certainly has not helped. With few exceptions, our lobotomized patients have shown no such. signs of recovery and little signs of diminution in their violent tendencies. At present, we seem to be out of options for stifling the nascent rebellion that appears to be

taking place within our halls. We're not a well-funded institution, and our security measures are not as adequate as they should be. So, when I find myself being ignored by the men I consider singularly responsible for our troubles, I am left utterly infuriated. At this time, there's nothing for it but to have all patients collected and sequestered in their rooms until the disturbance is being quelled. What I fear is that with our limited staff, the orderlies and nurses will be put at risk of grievous physical harm in the process of forcing the patients into their rooms. After seeing what happened to Mr. Bradshaw, I'm especially reluctant to give an order to that effect,

knowing what it may cost some of them. I recall a friend of mine that I served with in France in 1918 a young lieutenant in command of an infantry platoon he told me of the time he ordered his men over the top at San Mihil

and after witnessing the carnage he would regret giving that order for the rest of his life I suppose I'm experiencing much the same feeling as I agonise over my decision it seems that we are effectively alone in solving this problem

but mark my word I will see to it that Dr. Alphonse Foreman will be held accountable for whatever may happen. April 25, 1953. The cat, as they say, is out of the back. The situation of the past few days has not improved. Despite the valiant efforts of the nurses and orderlies, only a few patients have been brought back under control, while most of the rest are still running a mock in the hall.

From what I hear, they've now begun damaging some property, and a few have been seriously wounded by the others. But this is all news, as they say. Today I learned something new, something far more shocking and utterly revolting, that our current troubles have been put in a far more accurate perspective. When I assumed that Dr. Foreman's departure meant the end of any interaction, I was wrong. I knew that Dr. Rayburn had a pre-existing correspondence with Dr. Foreman, a correspondence that led to his engagement at this institution. What I did not know was that Dr. Rayburn had continued this correspondence for several weeks after he left.

He has, in secret, been in contact with Dr. Foreman this whole time, for the purposes of what Rayburn calls continuing consultation. consulting with what exactly and that's when he let slip that not all lobotomies performed in this hospital were done with my consent in fact in the grand scheme relatively few were done with my consent this whole time

Dr Rayburn and Dr Gillis have been secretly performing lobotomies on patients without my knowledge or approval as many as 20 of them by his own estimate in my time I have witnessed many breaches of professional ethics, some relatively benign, some more malicious, but I have never known of a breach this egregious, this disgusting and repugnant. Yet this was not the worst of it. During the exchanges between Rayburn and Dr. Foreman, they discussed and formulated

experimental techniques, posited their new theories, proposed new innovations to the procedure, and these experiments were inflicted on the patients they lobotomized in secret. They would resect entire portions of the brain, inject exotic chemicals, probe with electrodes and wreak other havoc in the craniums of their hapless patients, patients that are now running loose in the halls, deranged in ways we could not possibly understand. It explains many things, really. The alarming disappearance of sedative drugs,

drugs, evidently used for their unauthorised surgeries, the spontaneous, unaccountable outbreaks of violence and chaos over the past few weeks. Rayburn's constant insistence on using lobotomies excessively, all of it now makes perfect sense. The irresponsible fool has effectively violated our ethical principles in the most heinous way possible. But even through all of this, one thing remains. Ultimate responsibility still falls with me. I should have known this was happening, or might happen. And if I weren't so wrapped up in comparatively trivial matters, I would have perceived it far sooner.

This is my hospital. I am the clinical director. It is my job to know everything that goes on within our walls, and yet I missed something so colossal, so repugnant and irresponsible. I did. what was demanded of the code of ethics of my profession, and my sworn duty to do no harm. I tendered my resignation on the spot, and I strongly suggested that Dr. Rayburn do the same. I did not stay to listen to their replies.

They know perfectly well what I was obliged to do in this situation, and they know that I have always, and will always abide by my obligations to my profession. What I shall do after this, I do not know. I am 61 years old, but not exactly fit for any other occupation. But if I were to continue practicing medicine, I will always bear the taint of what transpired under my nose. That shall be my cross to bear. April 25, 1953, addendum. I received a phone call a few minutes ago from the administrator, begging for my assistance at the hospital.

It seems that the situation has now gone. gotten completely out of hand and that a virtual riot is taking place. He's tried to contact the state's police, but to no avail, and he was convinced that only I knew how to properly quell the insurrection going on in the ward. Even though I've tended my resignation and faced no employment obligation to heed these request, I still feel my professional obligation to return and do what I can. after all I cannot ignore that

despite recent events I have spent the best years of my career at Berkshire and to abandon them under these circumstances will be entirely unbecoming of me I will leave in a few minutes to see what I can do

perhaps it is fitting that it should be this way that I should herald my departure with one last great effort to save an institution I've dedicated my life to building from the writings of Geoffrey Calloway, patient at Berkshire Psychiatric Hospital,

near Pittsfield, Massachusetts. Friday, April 10th. They don't let us have journals or notebooks, so I have to use drawing paper from the art room to write this. My name's Jeffrey. I've been here eight months. I'm writing this now because the way things are going, I might not get another chance.

I think people should know what goes on here. I'm not like the rest of these people. These people are actual nutcases. I don't belong here. I got my own problems, but I have nothing compared to what I see and hear. I've tried to kill myself a few times. I've got real bad nerves. I can't concentrate on anything.

I get scared real easy, and sometimes when I get to screaming, I can't stop. They hear voices in my head sometimes. They call me stupid, worthless, that I'll never be anything or anything. anybody that no girls will ever want to fuck me no matter how hard I try. The doctors say the voices aren't real. They just come from my own mind. Maybe that's true, but the voices are never wrong about me. Everything they say is true.

And if the dogs are right, it comes from my own head. And maybe that proves the voices are right because they know the truth. I try not to leave my room when I don't have to. The only places I go are the art room. cafeteria and my doctor's office. I don't like being around these other people. There's this one lady, ooh, cuckoo crazy. I'll see her jump on people and bite them before.

Nobody likes her, and she keeps coming back, and she keeps attacking people. She's actually not so bad anymore, but she still gives me the creeps. There was one guy who thought he was a priest, and he wouldn't shut up about the Bible, even though he didn't know anything from it. he's not so bad anymore either

but he keeps trying to talk to me even when I don't talk back yeah there's a few homos in here as well and sometimes I make a pass at me one of those guys has been real different that past couple of weeks all he does now is sit in his chair

in the common room when he used to always scream at the nurses it's not all bad though some of these people in here are like me they aren't nuts like the rest of these people being here's hard for them too there's an old guy named Ernest who used to tell me stories about

when he fought in the Philippines 50 years ago he said he's also been to China this is one girl who's actually really nice but she has a problem where she yells out really nasty stuff and you can't stop herself first time I talked to her

she called me cockface but she apologized later we're actually friends now and there's this guy in the room next to me called Pete He's pretty much my best friend in this place. He's pretty normal. I don't really know why he's here.

Some say it's because he's a sex pervert and he whipped it out in front of a nurse. I don't think any of that's even true because he's actually a good guy. Last couple of weeks, Dr. Rabin's been coming up here and looking around at us. He never used to do that before.

Didn't even know his name until he started showing his face in our hall. Sometimes he talks to the other, but he never tried with me. I already don't like him all the way he looks at us. Like we're pieces of meat. Sometimes he has the other doctors with him

and talks about us like we're not even there, even when we can hear him. He's always talking about procedures, something like that. I don't know why he's hanging around all of a sudden, but I hate him and I don't care who knows it. Anyway, the reason I'm writing this is because I've been getting a real weird, weird feeling.

about this place for a few weeks. I already don't like it here, but something about this place got real strange, and I don't really know why. Some people are acting a lot different, like that priest guy, or the crazy lady, or that one homo just sits and stares at the wall. My doctor says it's good to write stuff down, or you don't feel right about something, which I didn't really think about doing until now. I just think if something like that starts happening to me, somebody He might know that I used to be different, but I don't know for sure if that's just it. A lot of people are acting different than they used to. But all these doctors keep looking us over when only Audleys used to do that.

I've been seeing that doctor's skinner a lot more. When before, I only saw him twice since I'd been here. I don't like him either. When he comes down here, he always looks like he's smelling something that stinks real bad. Also, that bow-tying glasses makes him look like an old teacher that I used to hate. If I'm seeing him around, then something's not quite right. I got problems, but I'm not stupid. If something funny ends up happening here, I want people to know what happened.

Monday, April 13th. I used to hardly ever see the doctors over the weekend. The Dr. Rabin came in on Saturday and Sunday. Today one of the people from our hall wasn't in their room this morning. I haven't seen her all day. Nobody can tell me what's going on or if she's coming back. Some people said maybe she was let out of here, but I don't think they'd do that in the middle of the night.

I remember it was a lady named Margaret. It was actually kind of mean and used to yell a lot. One day at lunch she screamed in my face. She said I was using the wrong fork, so I think maybe she was a rich lady because that's the, kind of thing rich people worry about. Even though I didn't like her, I don't like seeing her gone, especially when other weird stuff is going on. I'm pretty sure that Dr. Rayburn hanging around and her being gone has to be connected.

I'll have to see if she's still gone tomorrow. Tuesday, April 14th. That Margaret lady is still gone. What's worse? Another person from the hall is gone too, just like her. This time it was an old guy named Jennings or something like that. Nobody knows what happened to him either. Talk to Pete about it, and he agrees with me that it's really weird all this stuff that's going on.

That girl who yells nasty stuff, Tracy, said somebody from her hall went missing last week and showed up again yesterday, so maybe they'll come back eventually. But Tracy says that when the lady from her hall came back, she had bruises on both eyes and drooled a lot, could barely stay awake and keeps peeing herself. What do they do to that lady? Is that what they're doing to the other two right now? The black eyes sound weird to me.

Like, maybe they're beating these people up for some reason. Hope that doesn't happen to me. I'm not brave or anything. I don't think I could stand getting beaten up. Friday, April 17th. Both the missing people from my hall were back this morning. But now another person is. gone. And they turned out just like what Tracy told me a few days ago. They got real big

shiners on both eyes and they just stay real empty at us now. One guy keeps acting like he hears something. He's always looking around. Like maybe he hears the voices too, but he doesn't know what they are. These people are getting beaten up. Is it hurting their brains? I've heard that can't happen. My cousin knew a guy who punched somebody in the face and the other guy died from it. So if that happen. I wonder if that's what happens to these people. But the guy missing this morning is probably getting beaten up as we speak. I hope they don't come for me. Dr. Rabin doesn't usually pay attention to me, but he's been doing a lot of stuff he doesn't usually do. Maybe if I act like I'm already stupid, he won't bother with me. One day, April 20th. Jesus Christ, they took Pete.

He was there yesterday Today, today He's not It's real quiet for a few days too The only thing that happened Was they brought back the guy they took A couple of days ago And now Pete's gone

Right now they're doing God knows what to him People have been saying different things About what happens to people They take away in the night One lady was saying that They do some kind of witchcraft And put a curse on them Another guy was saying that

What happens is the people get knocked out And a dot will trick and ice-picks through their eyes and scramble their brains with it. Somebody else was saying they poke holes in the skull. Stick electric wires in the brain, and they light it up with electricity. I don't know if any of that's true, but I'm goddamn scared right now. Whatever they're doing, definitely messes people up, and they won't get better either. I don't want to think about what's happening to peeve right now.

When people come back, they're practically as good as dead. I bet that's how he'll turn out too. Right now, I'm pretty sure that's what will end up happening to me. April 21st, Tuesday. That man who thinks he's a priest came around to my room today. Normally, I don't want to talk to him, but hardly anyone is left to talk to. He said his name's Martin. He's been waiting to talk to me for the past couple days.

I don't know why he wanted to talk to me, but I think that if anyone knows what's happening, it's him. Remember when I first saw him, thought he was just another lunatic. But after talking to him, I realized he actually makes a lot of sense. He said that he knew what was going on around here, that what happened

to everyone else is what happened to him. Asked him why he didn't turn out like the others. Why he seemed like he got better after what they did to him, not worse. He told me the story of what happened to him when they took him away.

He said they drugged him, brought him into a room with a doctor he didn't recognize, one who had a bunch of surgery tools. When he was drugged, they stuck something into his eye and he could feel it going into his brain, felt it moving around. While this was happening, he said that he had a dream, vision, something he didn't think was possible. He said that at first he thought he was seeing God. It was like an image of a perfect human being. but he realized it was something different. Wasn't God at all, but something he called the next man. But he didn't tell me what he meant.

Before I would have thought he was just crazy, but when he told me his story, he didn't sound crazy at all. He talked about a lot of sin, about how humans were flawed and would become extinct at the hands of the people who replaced us. That's what happened to the Neanderthals, he said. They were killed off by people who were smold. and stronger, and the same will happen to us when something even stronger and smarter comes along, and that day will definitely come. To be honest, he scared the hell out of me with that

kind of talk, but I just couldn't help but listen to him. One point he asked when he thought all this was going to happen. He said that the next man was already here on earth, in the last place that anyone would expect it. He told me what happened to him will happen to me eventually. but that it doesn't have to be this way. I asked what he meant. He said he's been talking with the others, talking about taking charge of this place and running out the doctors and orderlies

and everyone who tries to tell us what to do. He says that we're better already than them, that they are the Neanderthals now. I'm still wrapping my head around what's been going on around here, but I know I don't want to have my brain scrambled like all the rest. Maybe getting the head out of this place will mean how to be.

having to trust him. That might sound crazy, but there's no one else around here you can trust. Doesn't seem so crazy after all. Friday, April 24th. Now there's definitely something crazy going on around here. I've been saying that a lot, but this time I really mean it.

The people here have gone nuts. Everyone's running around the hall, screaming and crying. The old ladies look like they don't know whether to shit or go blind. I remember Dr. Rabin was running around, all pissed off about something yesterday, but now he won't come here even. I'm staying in my room for now, but I'm wondering if this is something to do with whatever Martin was talking about a few days ago. To be honest, I'm having some second thoughts about being part of his little revolution or whatever he was talking about. The loony's running around the hall don't seem like they care too much about who's who. What I don't get is that the craziest bunch of the ones lobotomized or whatever Martin called it.

Even though a few days ago they were still like vegetables, drooling and staring at the wall. Yesterday they just started going nuts, chanting and singing and banging on the walls. And then there was that fight at lunch day where that one guy tried to hit me with a soup label. If Martin's around anywhere and he hasn't gone nuts like the rest of them, I might consider coming out. For now, I'm staying put in hoping I don't have to take my chances with the loonies or the brain scramblers. Sunday, April 26th. Yesterday was absolutely nuts. It was pretty bad the last few days, but then yesterday morning it was total anarchy.

The loonies were attacking the orderlies. The orderlies were trying to fend off the loonies and the doctors were running around in a goddamn panic. It was like that the whole day. when it was evening Martin came around to my room and asked why I wasn't coming out I told him it was because I was scared to death of what was going on

didn't seem to like I was scared at all he saw the other loonies weren't paying attention to him so I thought I would come out just so I could escape this madhouse at the time I came out the loonies were pretty much in control of the place

but they were still fighting going on in different parts of the hospital Martin escorted me through the place And I saw just what he had in mind for his uprising I don't know how or why But the Looney's actually listened to him I don't think these people even knew what planet they were on But when Martin spoke

The Loonies would shut up and listen And when he told them to do something They did it I didn't want to follow him I didn't want to see what these people were up to Or the carnage there were reeking everywhere But Martin was like my shield, my only guarantee that I would be safe from what was going on. So I had no choice.

Many of the Ordlies were taken hostage by the Loonies. As I followed Martin on his tour of this place, I saw what his revolution was all about. I saw an orderly have a scalpel stuck through the side of his head so far he came out of the other side. They gouged eyes, disembowled people. but what was apparently their favourite was sticking those scampals and ice-picks through people's heads I get sick just thinking about it all I could do was watch but when I looked marred in the eye I just knew what he was expecting me to join in in be a part of this insanity I just couldn't as we wore through the bodies littered around the ward

I recognised the faces of doctors who worked here I saw Gillis Murray Stanton and the head nurse. I saw that stuffy bastard Skinner with his throat slashed so deep that his head was nearly hanging off. And that damn bowtie of his packed into the wound. And then we found Rayburn. I hated him. I was afraid of him. Even though I once saw him as the devil in the flesh.

I now saw he was just a pathetic shell of himself. All hollow eyes covered in blood that I don't think was his. By now there was a raging fire going on in another part of the hospital. I could definitely tell that the fire was getting closer by the minute. I wanted more than anything, just get the hell out of there and save myself, but I was too terrified to leave Martin's side. He grabbed Rayburn by the face and looked him square in the eye for close to a minute. He spoke some words I couldn't quite understand into Rayburn's Inn,

but I managed to pick up the words, run, leave. and the seed Rabin got to his feet and with a final look at the carnage he fled the building through the front entrance and disappeared into the night I still don't know why Martin let Rayburn of all people get away

seeing as he was the one most responsible for everything that had happened or maybe that was why Martin let him go like in some perverted way he was grateful to him like none of this would have been possible if it weren't for Rayburn in that way

maybe he was right Martin muttered himself that Rayburn was the seed that he was releasing the seed into the outside world and I have no clue what he meant we were outside watching Rayburn disappear into the woods

and when I saw that I was out of immediate danger I decided to get the hell out of there and said nothing he only watched from the doorway as I walked out of there and when I turned back I saw that the entire building was covered in fire. And Martin turned around and disappeared into the building without a word,

walking into the flames and out of sight. Of all the possessions I could have saved from that burning wreck, all I took were my papers and writing tools. Absolutely nothing else walked out of that building except for me and Rayburn. Maybe it should be that way. I found a little campground where I can hide out for a while. That's where I'm writing this now I'm writing this

even though I don't know what I'm going to do with it I escape from a mental hospital and I bet nobody who reads it will believe it I guess it really doesn't matter all I wanted was to be free and out of that place now I am the only reason I wrote all of this down was in case I didn't make it out before I could get my brain scrambled

like the rest of them maybe I'll just leave this stuff here I don't know what anybody will think if they find it, but that's their problem, not mine. I'm alive. I'm alive and I'm free. Anybody who wants to call me nuts can do it all they like. I don't care what they think, because I'm the one who survived when nobody else did. I can smell that morning air. I could just drink it like a fine wine.

From the journal of Dr. Charles Tremaine, director of the Oneida State Secure Hospital, Oneida County, New York, June 10th, 1954. It seems we will be receiving yet another guest at our facility, and a most unusual one at that. I have here his file referred to me by the state Mental Health Board. Patient name, Rayburn, Dennis M. Age 41. Date of admittance, 610.54. Diagnosis, schizophrenia, severe personality disturbances. As it just so happens, Mr. Rabin, or Dr. Rabin, I should say, is a fellow psychiatrist,

or was a fellow psychiatrist, until his recent and unfortunate deterioration. He was a staff doctor at the Berkshire Hospital over in Massachusetts, which I heard burned down last year. I imagine the poor fellow must be despondent for not having any way to occupy himself after losing his former place of employment. Such is life, and unfortunately not all individuals are mentally equipped for such tribulations. Contrary to the prevailing public perception, we proverbial head-shrinkers are not in fact immune to troubles of the mind and soul, and I'm afraid that poor Dr. Rabin is living proof of such. From what I understand, the fire at

Berkshire was alleged to be arson, so seeing him here fills me with all sorts of questions. He goes through varying phases of waxy catatonia and nonsensical hysterics, and from my first impressions I was not able to discern any meaning from his ramblings. For now, I think that a trial course of a new drug to treat psychotic episodes will suffice, but patients showing signs of heapheronic type schizophrenia often require more thorough measures. I suppose one could say that Rayburn's arrival is a happy coincidence, as later this week we will host Alphonse Foreman, one of the foremost experts and instructors in the field of lobotomy surgery, which has shown significant promise in clinical trials.

I think Mr. Rayburn will provide an excellent case study for Dr. Foreman's demonstration. I think he will benefit considerably from the procedure. We don't exactly have a proper operating theatre, but the transorbital lobotomy is said to be simple enough that dedicated facilities are, unnecessary to perform it properly. I have studied many promising cases in which lobotomy has proven highly effective for quelling disordered minds and keeping patients more calm and satisfied than their normal state. I must say, I couldn't have asked for a better subject than Rayburn, a man whose profile is almost exactly what we're looking for in a solid case study for

successful lobotomy outcomes. I doubt the poor fellow even knows it, but he will play a tremendous role in advancing our work. Oh, Rayburn, if only you knew just how much you will contribute to the science of mental health. And so there ends podcast 20 from Dr. Creepin's Dungeon, and next week I'll be returning to the anthology

format with a bunch of tales from Alaska. Now, if you enjoyed tonight's podcast, please consider leaving a lovely review and a five-star rating. Wherever you get your podcast from really helps me to gain popularity and to keep the whole thing going.

Well, that's enough for one week, but I'll be back again, same time, same place. I do so hope you'll join me again next week. Until then, very, very sweet dreams, and bye-bye.