I am a war correspondent for The Wall Street Journal who wrote a series on the U.S. government's use of lobotomies on veterans.

Thank you for writing a relatively unbiased article. Something like this would be extremely easy to sensationalize, but I thought you did a decent job of framing this procedure in the context of contemporary medical practice in the 40's and 50's. Its easy to look back with our current level of knowledge and say this was a terrible idea, but we have the benefit of hindsight and 60 years of biomedical research.

I saw in another comment you are need ideas for your next story. I think a good followup would be looking into how practices have changed, and what is currently being done to treat PTSD and other psychological disorders in both military and civilian medical facilities.

If you want to keep exploring strange military medicine, there were some pretty questionable practices that took place around the time of the Vietnam war. Persons who were drafted could take part in medical experiments that would effectively "exempt" them from the rest of their service. It is my understanding that there were several involving human nerve gas exposures. I used to work for the military doing traumatic brain injury research, and much of our work was based out of the Aberdeen Proving Grounds, where we used a VX class nerve agent called soman (a variant of sarin) as a model for closed head injury. On base, there was a water tower type structure with strange perforations on the side. The consensus amongst researchers at this facility was that these perforations were at one time fitted with gaskets that would seal around a persons neck, and they would be exposed to aerosolized nerve agent inside. At the time, it was assumed that the levels of exposure were [relatively] safe. However, new evidence suggests this may not be the case. There are still active ongoing government projects studying low level exposure might influence short and long term health. This sort of research does not typically find its way into mainstream scientific journals, and is much more commonly detailed in military briefs not released publicly (these can sometimes be obtained with a FOIA request). A brief summary of previous human studies can be found here

Wow. Thanks for letting me know about that. Mike

What is the most shocking fact you uncovered while working on this series?

It was probably the casual experiment done an Oregon VA hospital, where they took four mentally ill vets and gave them fake lobotomies to see if there was a placebo effect. There wasn't. So they the doctor went back and gave them real lobotomies.

I'd add one other shocking thing. The Roanoke VA hospital listed two vets lobotomized for "Psychosis, with psychotic personality (homosexuality)."

You are an honorable and compassionate and most brilliant human being.

And I thank you for your body of work!

Wow. I think I like this Reddit thing.

Do you feel there is a modern day equivalence? Isn't long term use of things like thorazine and lithium chemical lobotomizing?

Sorry. This question slipped by me.

I honestly don't feel qualified to give you an answer. I just don't know enough about the drugs to be able to say. Apologies.

I will say, though, that one of the prominent aspects of lobotomy is that it's irreversible. Once the neural fibers are cut, the impact is permanent.

Have any additional families impacted by this practice reached out to you since this series was published?

Several people have told me about relatives - uncles, grandfathers - who were lobotomized by the VA around WWII. We found solid evidence of roughly 2,000 VA lobotomies, but I suspect there were hundreds more out there.

What's the next big thing that you're looking for to investigate?

I wish I knew! Got any ideas???

What about the Eugenics program that continued well into the 70's in America. I know recently its coming to light in places like NC and VA. http://en.wikipedia.org/wiki/Eugenics_Board_of_North_Carolina

Thanks very much for pointing that out. Mike

Sorry, no question. I am just glad you did this ama so I know more about this interesting topic. Thank you.

Thank you for checking in.

MIke

Wall Street Journal print subscriber here ... I saw the articles, but did not read them. Too gruesome. How does this story apply to current day events? A lot of medical treatments were harsh back in the day, no? Doctors did not have treatment options yet were still faced with illnesses that had to be treated.

Many readers have suggested a connection to today's events: The country is again swamped by combat veterans struggling with the psychological aftermath of their service. We certainly have a far better understanding of PTSD and other such issues than we did in the 1940s. But many readers have asked aloud: What treatments are we using now that we'll consider barbaric in 50 years? Perhaps none. But...

Some aspects of the stories are indeed gruesome. The archival films of lobotomies being performed by Walter Freeman in story two are not for the faint of heart. Some viewers should skip those films. But I hope readers will understand that if we didn't provide detailed information about the operation and its impact, then we weren't really doing justice to the vets' experiences.

Fascinating topic - thanks for the AMA!

Did you have a group of people helping research the lobotomy series and how long does it take to ready something like this for publication?

Our incredible researcher, Jim Oberman, helped me track down the families, once I had found the names of lobotomized vets. And Juliette Arai at the National Archives is a wizard with the files. She helped steer me to boxes of records that might contain VA lobotomy files. But I did most of the research on my own. Start to finish the whole thing took about seven months.

Putting the online extravanganza together was very much a team effort at the WSJ. There were about 15 people involved in crafting the immersive online experience at www.wsj.com/lobotomyfiles For once in my career I really prefer to read the stories online, rather than on newsprint under my breakfast cereal.

Thanks for your answer. Was the VA cooperative in the whole story?

The VA really had no institutional memory of its lobotomy program. It's not that they didn't want to help; they just couldn't. The helpful records about the VA's lobotomy program were all in the National Archives.

The folks at the Tomah VA hospital were really helpful in our reporting on Roman Tritz (with Roman's permission, of course).

What's your favorite book or what have you been reading lately?

I've been reading Roald Dahl's memoir of his time in Africa and WWII. He's a charming writer.

Wolf Hall by Hilary Mantel is a fascinating historical novel about life in the court of Henry VIII (a hazardous place to be).

Is it immature to say that I love listening to my wife read the Harry Potter books to our kids?

Germans did Kamikaze attacks? Why isn't this better known?

It happened during the raid on Kaltenkirchen, one of the missions that Roman Tritz flew. According to Richard Muller, a military historian at the U.S. Air Force School of Advanced Air and Space Studies, towards the end of the war the Nazis recruited young pilots from among the Hitler Youth and gave them orders to ram Allied planes if they couldn't shoot them down. It was obviously motivated by desperation as the noose closed around Nazi Germany.

How long ago was the most recent one ?

Good question. Thorazine, the first antipsychotic drug, came on the market around 1954, and I suspect the VA quickly shifted from psychosurgery to drugs. But the records I've seen don't specify when lobotomy was officially abandoned. Roman Tritz - the 90-year-old subject of the first article in the www.wsj.com/lobotomyfiles series - had his operation in 1953. Dr. Walter Freeman, the subject of the second article, performed his last operations in 1967, but those were in civilian hospitals, not the VA.

I was just reading somewhere (maybe the New Yorker) that the original term for anti-psychotic drugs was "major tranquilizers." It's a wonder that so many people who need these drugs stop taking them after a while. Just from the original name, it doesn't sound like they do anything but mask the problem—and mask it largely only from the point of view of the outside world. Patients, reportedly, are caught in a fog. That's why so many can't stand taking them.

That's interesting. Thanks.

What are the best items to include in care packages sent to soldiers?

The war in Afghanistan is changing fast. Many units that would have been patrolling in the past - see my previous answer about staying alive - stick closer to their bases now and let the Afghans do the fighting. Most of the troops get what they need to stay comfortable these days. Candy is always popular. But perhaps what they'd most appreciate are cards telling them that those of us at home haven't forgotten that they're still there.

What are your thoughts on this new generation of veterans dealing with PTSD by continuing to serve in organizations like Team Rubicon (who put their skills to use in disaster relief) and The Mission Continues (who run veteran-led service projects across the US)? Do you think service as therapy can completely replace "medical" treatment from the VA?

I suspect that there is no one-size-fits-all solution to PTSD. What works for one vet might not for another. There are so many ideas out there - companion dogs, equine therapy, service - that complement medical and psychological therapies. One of the most important in my view - stay in close contact with your buddies. They're the ones who understand you the best. So don't let yourself get isolated.

What precautions do you take in a war zone to keep from getting blowed up?

I stick closely to the guys I'm embedded with. During some patrols, I literally walk in their footsteps. They're a lot smarter about staying alive than I am.

It doesn't always work.

http://online.wsj.com/news/articles/SB10001424052702304203604577394300669687414?mod=WSJ_TheHiddenCostofWar_LeftTopNews

Is it documented who consented?

VA policy was to seek consent from the families, assuming the vet himself wasn't considered competent to make that decision. I don't have comprehensive medical records to show how closely the agency stuck to its policy. But in certain cases where I do have documentation/interview information I've found that it was usually the parents who gave authorization to the VA to lobotomize the vet. In Roman's case, it was his father, with his mother witnessing the written authorization.

How do you feel about the negative sentiment against many news providers?

Wait a second... someone doesn't like us???

Uhhh....

Maybe they just haven't met us.

First, fantastic article. Thank you for doing some deep research and reporting on this.

A question on the design of the online version: I really like the new format of longform articles that use the scroll to include videos and full images. I think it's a new way to experience long articles. How did the new format change your vision of presenting this story?

I guess it was kind of a mutually reinforcing process during the story's development. As I was researching, I found all of this fascinating material: photos of Roman's plane bombing Hamburg, a VA take-home guide given to the parents/spouse of newly lobotomized vets, 1945 newsreel footage of the liberation of the POW camp where Leonard Kingcade was held by the Japanese, etc., etc., etc. We wanted a format that would let readers see that primary source material for themselves.

At the same time, the WSJ, like other newspapers, is trying to find new ways to display important stories online, in order to give readers a more immersive experience.

Our online team in NY spent months hand-crafting the format that you at our website. I was amazed at what they could do.

I skimmed your article and found it very enlightening...

Ever since I can remember hearing about lobotomy's, it's always been an extremely negative thing, in every single way. Performed by quack doctors that drive around in a van across the US, searching for people unlucky enough to have family around them thinking that this will be a miracle cure... Or being forced upon ' unruly ' patients that people wouldn't want to deal with...

I've thought about it a lot myself, and the only answers I ever came up with were for repeat-criminals that are guilty of the crimes I CONSIDER unforgivable... ( Mostly pedophilia and serial killers )... And the only reason I'd lobotomize them is because I don't think that the death sentence is severe enough and this would be a punishment that would last them a life time... ( And yes, I also realize this would just create a strain on society since they wouldn't be able to take care of themselves, but I'm vindictive and immature, so I'd be up for that )

My question is... Do you think that there would ever be a case where performing a lobotomy on someone is a positive thing to do? ( By positive, I mean for them, not society... )

Interesting question. I spoke to a couple of families who felt like the lobotomies were a net positive for their vets. The operation often took away the unrelenting anguish and violence, even if it left the patients faded reflections of their former selves.

Did you form an opinion on whether or not the patients would have suffered from tough mental health issues regardless of their war service?

In my view it really shouldn't matter but at least the VA was there to try and help them. In my experience with a mentally ill son, you really have to fall into certain "buckets" in order to get services. If you fall outside a bucket, or if you don't like the service offered, it all falls back on the families which if they can't provide support becomes a very ugly situation.

It was really hard to tell, even when I had complete medical records, whether the lobotomized vets were mentally ill because of their wartime service or coincidental to it. Schizophrenia - to take one example of a common diagnosis - tends to hit men at a fairly young age. So does military service. Would they have been schizophrenic absent the stresses of combat? I wish I knew for sure, but I have to believe that it would vary from case to case.

What are some questions you'd like us to ask? Is there anything you'd love to talk about but can't until someone asks you the right question?

One issue that fascinates me, though I know very little about it: Was there tension between the WWII vets and the returning Vietnam vets over PTSD-related issues? Were there arguments over whose war was tougher? Whether PTSD was real?

I don't now the answer. I'm just curious.

What is the most important thing your experiences in Afghanistan and Irag taught you? Did the experiences you had change you in any way?

I've covered the wars from a fairly narrow perspective. I write about U.S. troops and their experiences. (We have far more qualified people writing about Afghan politics and society, as well as the larger strategic issues.) So I've been immersed in the lives of soldiers and their families. What strikes me is how concentrated the costs of war are on those who fight it and those who wait for them to come home. As a nation, we've come a long way since the Vietnam War. People really do distinguish between the war and the warrior. The public, in my view, provides a warm and grateful welcome home for returning troops. But that will inevitably fade with time, while military families continue to feel the impact for years and years. Especially in the case of Gold Star families, for whom the wounds are always fresh.

As for the second question... I don't know. I don't feel like I have any PTSD from the experiences I've had. I do spend a fair amount of time thinking about guys I know who have been killed, and families they left behind.

What was the first war, or combat zone, that you reported on? What was the most shocking difference between that experience and normal life that you didn't expect?

In the early 90s I was working for The Associated Press out of Madrid and was sent to cover civil wars in Angola and Somalia. Both were fascinating experiences, but I was stunned by the chaos of Somalia. No rules, true anarchy. We didn't go anywhere without a driver, a fixer and two gunmen. One AK pointing out of a window on each side.

Considering the files you uncovered hadn't been disturbed in years, and that the VA itself didn't even know of its past lobotomy practices, how did you stumble upon this story?

I spoke to a woman whose uncle had been lobotomized by the VA after the war. She had a few 1940s medical journal articles about the practice. She suspected that if it happened to her uncle, it probably happened to many others. She was absolutely right.

What is a normal work day for you in Iraq or Afghanistan?

Usually I'm embedded with a unit and I just do what they do. Patrols, raids... or just sitting around waiting for something to happen.