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January 27, 2015

Meet Dorothy, a WWII nurse who was lobotomized at the VA

Daily Briefing

Writing for the Wall Street Journal, Michael Phillips profiles former Navy nurse Dorothy Ludden, one of the last living veterans to be lobotomized following World War II.

Origins of the program

In the aftermath of World War II, the VA lobotomized approximately 2,000 veterans with mental illnesses.

At the time, psychiatric care was in its infancy, and doctors had few tools to treat the large number of veterans who had been scarred by the war. After the program ended in the 1950s, the VA did not track lobotomized patients, and little is known about the programs long-term effects. 

In 2013, the Wall Street Journal profiled Roman Tritz, who at the time was the only living person to have been part of the program that the paper could locate. Congress subsequently directed the VA to track down remaining patients, and reassess the care they were receiving. None were found, until the family of Dorothy Ludden came forward.

Thousands of military veterans were lobotomized after WWII

Dorothy's story

Dorothy began to experience signs of mental distress while still enlisted as a nurse with the Navy during the war. Late in the war, her medical records show that she suffered a nervous breakdown at a naval hospital in the Pacific Northwest. She was discharged from active duty in 1946 and was later admitted to the Madison Rural Sanitarium in Tennessee.

Doctors suspected Dorothy suffered from psychosis and schizophrenia. Initially, shock therapy was administered. But her condition did not improve, and she was eventually lobotomized by the VA. The procedure involves opening the skull and severing the connection between the frontal lobes and the rest of the brain.

In the procedure's aftermath, social workers wrote her family to say "she has cooperated with the ward personnel, has been obedient, easily directed." An official guide released by VA social workers for the families of lobotomized patients was more circumspect. "Only time can tell" if a lobotomized patient will be completely well, it read.

Inside the White House's psychiatric ward

Although Dorothy did marry after being discharged from the hospital, her sons note she lacked emotional depth and had an "emotional disconnect" for most of her life.

When one of her sons committed suicide in the 1990s, members of the family said her grief was "not something coming out of the very, very, very deepest part of her heart." Other times, she displayed erratic and delusional behavior. In one instance, Dorothy chased a friend out of the house with a butter knife, and she sometimes believed she was an aristocrat with a maid whom she would order to perform chores.

Bruce Ludden, a son of Dorothy's, says things were difficult growing up but manageable. "I didn't have a sane mom, but I had one who was adequate to get me through life, and for that I'm grateful," he says.

Late last year, a blood vessel burst in Dorothy's skull, and her cognitive condition declined. She is now confined to a nursing home. David Sultzer, a VA psychiatrist who has examined Dorothy's records, says her lobotomy may have increased her risk for the hemorrhage, but it is unclear by how much.

A VA spokesperson says it is important to view Dorothy's story in context. "As safer and more effective treatments were developed, the procedure disappeared within VA and across the United States," she says (Phillips, Wall Street Journal, 1/23).

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