James W. Watts
Encyclopedia
James Winston Watts was a neurosurgeon, born in Lynchburg, Virginia
Lynchburg, Virginia
Lynchburg is an independent city in the Commonwealth of Virginia. The population was 75,568 as of 2010. Located in the foothills of the Blue Ridge Mountains along the banks of the James River, Lynchburg is known as the "City of Seven Hills" or "The Hill City." Lynchburg was the only major city in...

 and a graduate of the Virginia Military Institute
Virginia Military Institute
The Virginia Military Institute , located in Lexington, Virginia, is the oldest state-supported military college and one of six senior military colleges in the United States. Unlike any other military college in the United States—and in keeping with its founding principles—all VMI students are...

 and the University of Virginia School of Medicine
University of Virginia School of Medicine
The University of Virginia School of Medicine is a medical school located in Charlottesville, Virginia, United States. The tenth medical school to open in the United States, it has been part of the University of Virginia since the University's establishment in 1819 by Thomas Jefferson...

. Watts is noteworthy for his professional partnership with the neurologist and psychiatrist Walter Freeman. The two became advocates and prolific practitioners of psychosurgery
Psychosurgery
Psychosurgery, also called neurosurgery for mental disorder , is the neurosurgical treatment of mental disorder. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under the Swiss psychiatrist Gottlieb Burckhardt...

, specifically the lobotomy
Lobotomy
Lobotomy "; τομή – tomē: "cut/slice") is a neurosurgical procedure, a form of psychosurgery, also known as a leukotomy or leucotomy . It consists of cutting the connections to and from the prefrontal cortex, the anterior part of the frontal lobes of the brain...

. Watts is known for carrying out the lobotomy of Rose Marie Kennedy under the supervision of Freeman.

Career

After completing medical school in 1928, Watts worked as a research fellow at Yale
Yale University
Yale University is a private, Ivy League university located in New Haven, Connecticut, United States. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States...

 before joining the faculty of the Department of Neurosurgery and Neurological Surgery at The George Washington University Hospital
George Washington University
The George Washington University is a private, coeducational comprehensive university located in Washington, D.C. in the United States...

 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 technique pioneered by the Portuguese neurologist António Egas Moniz
Egas Moniz
António Caetano de Abreu Freire Egas Moniz , known as Egas Moniz , was a Portuguese neurologist and the developer of cerebral angiography...

. In the procedure developed by Moniz, the "white matter
White matter
White matter is one of the two components of the central nervous system and consists mostly of myelinated axons. White matter tissue of the freshly cut brain appears pinkish white to the naked eye because myelin is composed largely of lipid tissue veined with capillaries. Its white color is due to...

" in the frontal lobe
Frontal lobe
The frontal lobe is an area in the brain of humans and other mammals, located at the front of each cerebral hemisphere and positioned anterior to the parietal lobe and superior and anterior to the temporal lobes...

s was severed using a leucotome
Leucotome
A leucotome or McKenzie Leucotome is a surgical instrument used for performing leucotomies, lobotomies and other forms of psychosurgery.Invented by Canadian neurosurgeon Dr. Kenneth G...

, 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
Amarro Fiamberti
Amarro Fiamberti was an Italian psychiatrist who first performed a transorbital lobotomy in 1937...

, 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. This new procedure became known as the transorbital lobotomy, also dubbed the "ice pick lobotomy" because the instrument used, an orbitoclast
Orbitoclast
An orbitoclast is a surgical instrument used for performing transorbital lobotomies. It was invented by Dr. Walter Freeman in 1948 to replace the unique form of leucotome used up until that point for the transorbital lobotomy procedure. This instrument is an ice pick with some gradation marks...

, 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 only be performed 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
Antipsychotic
An antipsychotic is a tranquilizing psychiatric medication primarily used to manage psychosis , particularly in schizophrenia and bipolar disorder. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s...

 medications, notably Thorazine. 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.
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