James W. Watts
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James Winston Watts (January 19, 1904 – November 15, 1994) was an American
neurosurgeon Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty that focuses on the surgical treatment or rehabilitation of disorders which affect any portion of the nervous system including the brain, ...
, born in
Lynchburg, Virginia Lynchburg is an independent city (United States), independent city in the Commonwealth (U.S. state), Commonwealth of Virginia in the United States. First settled in 1757 by ferry owner and Abolitionism, abolitionist John Lynch (1740–1820), J ...
. He was a graduate of the
Virginia Military Institute The Virginia Military Institute (VMI) is a public senior military college in Lexington, Virginia, United States. It was founded in 1839 as America's first state military college and is the oldest public senior military college in the U.S. In k ...
as well as the
University of Virginia School of Medicine The University of Virginia School of Medicine (UVA SOM or more commonly known as UVA Medicine) is the graduate medical school of the University of Virginia. The school's facilities are on the University of Virginia grounds adjacent to The Lawn, ...
. Watts is noteworthy for his professional partnership with the neurologist, psychiatrist and psycosurgeon Walter Freeman. The two became advocates and prolific practitioners of
psychosurgery Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental disorders. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under ...
, specifically the
lobotomy A lobotomy () or leucotomy is a discredited form of Neurosurgery, neurosurgical treatment for mental disorder, psychiatric disorder or neurological disorder (e.g. epilepsy, Depression in childhood and adolescence, depression) that involves sev ...
. Watts and Freeman wrote two books on lobotomies: ''Psychosurgery, Intelligence, Emotion and Social Behavior Following Prefrontal Lobotomy for Medical Disorders'' in 1942, and ''Psychosurgery in the Treatment of Mental Disorders and Intractable Pain'' in 1950. He is also known for carrying out the lobotomy of
Rosemary Kennedy Rose Marie "Rosemary" Kennedy (September 13, 1918 – January 7, 2005) was the eldest daughter born to Joseph P. Kennedy Sr. and Rose Fitzgerald Kennedy. She was a sister of President John F. Kennedy and Senators Robert F. and Ted Kennedy. ...
under the supervision of Freeman. Kennedy's mental capacity diminished to that of a two-year-old child. She could not walk or speak intelligibly and was considered incontinent.


Career

After completing medical school in 1928, Watts worked as a research fellow at
Yale Yale University is a private Ivy League research university in New Haven, Connecticut, United States. Founded in 1701, Yale is the third-oldest institution of higher education in the United States, and one of the nine colonial colleges ch ...
before joining the faculty of the Department of Neurosurgery and Neurological Surgery at The George Washington University Hospital in 1935. He remained in this position until his retirement in 1969. Watts was recruited into a medical partnership by his colleague Walter Freeman, who needed the collaboration of a trained surgeon in order to practice the
leucotomy A lobotomy () or leucotomy is a discredited form of neurosurgical treatment for psychiatric disorder or neurological disorder (e.g. epilepsy, depression) that involves severing connections in the brain's prefrontal cortex. The surgery causes ...
, a technique pioneered by the Portuguese neurologist
António Egas Moniz António Caetano de Abreu Freire Egas Moniz (29 November 1874 – 13 December 1955), known as Egas Moniz (), was a Portuguese neurologist and the developer of cerebral angiography. He is regarded as one of the founders of modern psychosurgery, ...
. In the procedure developed by Moniz, the "
white matter White matter refers to areas of the central nervous system that are mainly made up of myelinated axons, also called Nerve tract, tracts. Long thought to be passive tissue, white matter affects learning and brain functions, modulating the distr ...
" in the
frontal lobe The frontal lobe is the largest of the four major lobes of the brain in mammals, and is located at the front of each cerebral hemisphere (in front of the parietal lobe and the temporal lobe). It is parted from the parietal lobe by a Sulcus (neur ...
s was severed using a
leucotome A leucotome or McKenzie leucotome is a surgical instrument used for performing Leucotomy, leucotomies (also known as lobotomy) and other forms of psychosurgery. Invented by Canada, Canadian neurosurgeon Dr. Kenneth G. McKenzie in the 1940s, the ...
, an instrument Moniz designed specifically for the procedure. Freeman and Watts acquired several of the instruments and performed their first operation in 1936. They eventually modified the procedure to sever more of the white matter, and renamed it ''lobotomy'' in order to distinguish it from the earlier procedure developed by Moniz. Their technique soon became the standard form of the operation, and was known as the "Freeman-Watts Procedure". Watts' colleague, however, was less conservative and sought other ways to access the frontal lobes of the brain without the complications associated with conventional brain surgery. Inspired by the work of the Italian psychiatrist
Amarro Fiamberti Adamo Mario "Amarro" Fiamberti (10 September 1894 – 31 August 1970) was an Italian psychiatrist who was the first to perform a transorbital lobotomy (by accessing the frontal lobe of the brain through the orbits) in 1937. The technique was wi ...
, Freeman developed, without the knowledge or participation of Watts, a procedure for reaching the frontal lobes by inserting a probe under the eyelid and above the tear duct, then hammering it through the thin bone of the eye socket. The instrument was swished around, severing the white matter, and was then repeated on the other side. The whole operation took only minutes under local anesthesia or by using an electroshock machine to render the patient unconscious by passing a large electrical current through the brain, inducing a seizure, then leading to a brief period of post-seizure coma, which was when the procedure would be carried out. This new procedure became known as the
transorbital lobotomy A lobotomy () or leucotomy is a discredited form of neurosurgical treatment for psychiatric disorder or neurological disorder (e.g. epilepsy, depression) that involves severing connections in the brain's prefrontal cortex. The surgery causes ...
, also dubbed the "ice pick lobotomy" because the instrument used, an
orbitoclast An orbitoclast was a surgical instrument used for performing transorbital lobotomies. Because actual ice picks were used in initial experimentation and because of continued close resemblance to ice pick shafts, the procedure was dubbed "ice pi ...
, was very similar to a common ice pick. The new procedure also signaled the end of the professional relationship between Freeman and Watts. After performing the new procedure by himself on ten patients, Freeman finally revealed to Watts what he had been doing. Watts, unlike Freeman, was a trained neurosurgeon and adamantly believed lobotomy should be performed only by a proper surgeon. He insisted that Freeman cease performing operations alone, but it was to no avail and Watts soon left the practice that he had jointly established with Freeman. The 1950s saw the introduction of the first truly effective
antipsychotic Antipsychotics, previously known as neuroleptics and major tranquilizers, are a class of Psychiatric medication, psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), p ...
medications, notably
Thorazine Chlorpromazine (CPZ), marketed under the brand names Thorazine and Largactil among others, is an antipsychotic medication. It is primarily used to treat psychotic disorders such as schizophrenia. Other uses include the treatment of bipolar dis ...
. This, combined with a growing discomfort among the medical profession and general public regarding lobotomy, led to a sharp decline in the use of the procedure. In the intervening years, the theoretical basis of lobotomy has been largely discredited. Watts retired in 1969, but continued his association with The George Washington University Hospital until the late 1980s.


Personal life

Watts was born in 1904 in Lynchburg, Virginia. He had two children with wife Julia Harrison Watts. He died in 1994.


References

* * * * * {{DEFAULTSORT:Watts, James W. 1904 births 1994 deaths American neurosurgeons People from Lynchburg, Virginia University of Virginia School of Medicine alumni Virginia Military Institute alumni 20th-century American surgeons