The Cost of Cure: Psychosurgery and Its Discontents in Suddenly Last Summer
Lobotomy, Cannibalism, Conniving Millionaires, Doctors, and More
Suddenly Last Summer depicts the early stages of a cautionary enthusiasm in the psychiatric community for lobotomy as a way to treat mental illness. The film, set in 1937, was released in 1959, two years after Tennessee Williams wrote the play on which it is based. The stellar cast included Elizabeth Taylor (Catherine), Katherine Hepburn (Viola), and Montgomery Clift (Dr. Cukrowicz). This is a powerful film, that according to a critic, covered “unwholesome things as homosexuality, rape, insanity” (Scott, 1959). Time period films present another layer of complexity because they are products of the time in which they were made, but they strive to depict another time.
In previous posts we argued that first, there was initial enthusiasm for lobotomy and then an eagerness to deploy this surgical intervention as a therapeutic tool for an ever-growing series of conditions (1945-1954). Finally, the release of chemical alternatives resulted in the operation's fall from grace. Thus, being set in the 1930s, we would expect the film to depict a context where lobotomies are growing in popularity, but are still treated as an experimental procedure, with surgeons venturing into potential new uses. These surgeons have some knowledge about possible side effects.
It is important to note that the film was written in the late 1950’s, when awareness about lobotomy side effects would have been known and yet when the operation was still seen as a legitimate treatment of last resort. This is evident in the plot, since both the doctor and other characters recognized the value of the operation, but treated it with caution.
Plot summary
The young and beautiful Catherine Holly is committed to a mental institution by her aunt, the wealthy and influential Violet Venable. She had experienced a mental breakdown after witnessing the mysterious and violent death of her cousin, Sebastian, during a holiday to Europe. After struggling at one institution, Catherine is transferred to Lions View State Hospital. Later, Miss Venable reached out to Dr. John Cukrowicz, the leading surgeon in the field of psychosurgery, to operate and cure Catherine. It is unclear whether Mrs Venable wants Catherine lobotomized to help her, or to prevent her from speaking about Sebastian’s death.
Cukrowicz's situation is precarious. He works for Lions View State Hospital, which lacked funding to sustain his research and was overcrowded. Therefore, gaining Miss Venable’s support would ensure much-needed financial support. Upon meeting with Ms. Venable, Cukrowicz noticed her obsession with her late son, to the point of hinting at a nearly incestuous relationship. Also, he becomes aware of the possibility that Mrs. Venable is more concerned with protecting her son’s reputation and legacy, as opposed to healing her niece’s trauma.
Conditioned by the hospital’s dire financial situation, Dr. Cukrowicz agreed to consider Catherine as a potential patient for lobotomy. The doctor is a fascinating character because he is reluctant to operate despite being portrayed as one of the best psychosurgeons. He was aware of lobotomy’s experimental nature and its possible irreversible consequences. Thus, he agreed to treat Catherine with different methods, leaving lobotomy as an option. His approach and investigation revealed that Catherine, while indeed suffering from some form of trauma and illness, does not need lobotomy. Instead, he used talk therapy and hypnosis. His belief is that she has blocked memories which are causing her psychological problems. This echoes Freudian ideas that psychosis results from repressed memories and ideas. This is likely a little anachronistic, as Neo-Freudian approaches that saw anxiety as the root of mental problems started to gain prominence after the Second World War (Harrington, Mind Fixers, 2019).
Near the film’s end, the truth is revealed in Mrs Venable’s garden. Catherine unveiled that Sebastian was killed and eaten by a mob of locals, who went into a rage after weeks of suffering his constant manipulation, predation, and exploitation of young boys. The truth overwhelmed Mrs Venable, who, in a fit of delusion, misidentified the doctor as her dead son. At the time, film critics raved about this scene. For example, “instead of the banal flashback, Jack Hildyard’s camera has ingeniously kept Miss Taylor’s face, close up,” which would otherwise be “with vignettes she is describing” (Bower, 1960). And with this scene, the movie ends. Catherine was saved from lobotomy, Violet lost her mind, the hospital secured the funds, and Sebastian was exposed as a predator and manipulator.
Lobotomy as a solution
When lobotomy was introduced, many were enthusiastic about its potential to treat otherwise incurable patients. The operation was seen as a valuable solution to a social problem, and heralded as a revolutionary method to cure several illnesses. By 1948, lobotomies had been used to treat “worries, persecution complexes, suicidal impulses, obsessions, and nervous tensions” (NYT 13, 1949). Dr. Walter Freeman introduced the procedure in the US and ardently campaigned for its wide use. He introduced a new technique, accessing the brain through the eye socket, which allowed the operation to be an outpatient procedure. Not all surgeons were as keen on the operation as Freeman.
Dr. Cukrowicz clearly embodied a cautious approach to using lobotomy. The film made clear he was a top surgeon specializing in psychosurgery, which he calls a “delicate operation.” Yet, his reluctance to operate stemmed from the experimental nature of the operation, the potential side effects, and the lack of certainty it would help. Rather than pushing for lobotomies, he saw them as a last resort, only to be used “for unapproachable and helpless.” Further, he stated that lobotomy carried a “great deal of risk.” It is worth noting that Dr. Cukrowicz performed psychosurgery on the operating room, and from behind the patient’s skull, which suggests he used the prefrontal approach rather than Freeman’s transorbital lobotomy (introduced in 1946).
When Tenessee Williams wrote the play, there was much more knowledge about lobotomy’s side effects. By 1950, newspapers, like the New York Times, featured articles detailing these effects. That same year, Laurence wrote about them and concluded that at “best, these individuals become childish, dull, apathetic, with little capacity for any emotional experience, pleasurable or otherwise” (Laurence, 1950). From the start, some patients had adverse side effects such as reduction in their emotional range and memory loss.
In Man in the Dark, a film released in 1953, we saw a lobotomized criminal with severe memory loss. In the real world, these side effects were appreciated by some of the families and caregivers of those who were lobotomized (Raz, p. 72-74). Freeman simply did not care if his patients lost their ability to “maintain complex positions” (Raz, p. 131). He assessed his success by determining whether patients could “return to a useful life” (as cited in Raz, p. 20). It is thus conceivable that a lobotomy would erase Catherine’s anxiety regarding Sebastian’s death.
The alleged potential for lobotomy, as portrayed in the film, is evident as the hospital administrator pushed for the construction of a psychosurgery wing. In the time where the movie is set, such surgeries required operating rooms, were expensive and resource intensive. This would change with Freeman’s transorbital lobotomy.. Dr. Cukrowicz seemed to think lobotomies do leave patients without “anxiety”, even if there is a “strong possibility that the patient will always be limited.” Some surgeons knew that this was a risk, but the side effects of lobotomy were not widely known or discussed until later. For some, these side effects were even welcomed because they rendered unmanageable patients docile.
Side Effects & Eagerness to Abuse Lobotomy
During their first meeting, Mrs. Venable applauded Dr Cukrowicz work, even if she is quite ignorant about it. She claimed to have been fascinated by the article he wrote in the paper, quoting, “the sharp knife in the mind that kills the devil in the soul”, to which Dr. Cuckrowicz admits he got too carried away. Recognizing that he may have been too enthusiastic about the uses of lobotomy. This enthusiastic coverage of lobotomy by the press is concordant with our examination of articles mentioning lobotomies during the time the film is supposed to take place.
The film hints that Mrs Venable wanted Catherine lobotomized to protect Sebastian’s legacy. She is willing to donate money to build a psychosurgery ward to get it done, which suggests a belief in lobotomy as both a valid therapeutic tool and one that risks maiming patients. She raved about Sebastian, thus demonstrating how important his legacy is to her. She claimed that “madness is the most horrible doom there is in this world” in a bid to convince Dr. Cukrowicz to operate on Catherine. A newspaper critic commented that she was “deadly afraid” of “learning the truth” (Bower, 1960). In this review, Bower claimed that Mrs Venable sought a lobotomy hoping that it would “erase the truth forever from the girl’s mind, so that it can bever be known” (Bower, 1960). It is thus likely that the dispersion of knowledge about lobomy’s side effects gave Williams the appropriate context to craft this story.
In turn, Dr. Hockstader, chief doctor at the Lions View State Hospital, is much more concerned with lobotomies as a means to position the hospital as the nationwide standard. One could argue that his position is much more selfish than Dr. Cukrowicz, and is fueled by his ambition. In multiple scenes, he is characterized with a big personality and flair in his language, bragging about the hospital’s prestige, pushing Dr. Cukrowicz to perform the lobotomy on Catherine (regardless of the effects) to secure the funds, and even open a Psychosurgery dedicated building. This is an early, but powerful indictment of psychiatry and medicine, suggesting that they are willing to operate even when there is no clear need to do so. The role of patronage and abusing medical interventions is an interesting ethical question which the movie raises but does not explore in depth.
Conclusions
Suddenly Last Summer presents the early stages of a novel psychosurgery and its application for dealing with mental illnesses. It also exposes the risks and motivations behind the use of technology to solve social issues. While the film presented lobotomy as a valuable resource, as would have been the case for the early days of psychosurgery, Dr. Cukrowicz displayed clear reservations due to the potential side effects. This is probably not an accurate representation of a leading doctor in the field during the 1930s, as the concern for the grave side effects of lobotomies did not gain much relevance until two decades later. Thus, through the character of Dr. Cukrowicz, the film explores a cautious approach to psychosurgery, treating it as a last resort.
In contrast, characters like Mrs. Venable and Dr. Hockstader reveal how lobotomy could be exploited for personal or institutional gain, prioritizing legacy or prestige over patient welfare. Interestingly, Dr. Cukrowicz problematized some common definitions related to mental health. At one point, after Catherine is described as insane, he insists, “insane is a meaningless word.” We have also discussed the power that labels can have on our perception of the world. This shows early concerns about the abuse of power, the role of money in medicine, and how interventions originally designed to cure could also be used nefariously.
By exploring the tensions between psychosurgery and the characters motives, the film captures the optimism and ethical dilemmas surrounding lobotomy during its rise, offering a powerful commentary on the human cost of adopting technological solutions to deal with social problems.
Sources
Bower, Helen. 1960. Brilliant Performances Help Tell Horror Tale. Detroit Free Press, February 4, 1960, p.16.
Harrington, A. (2019). Mind fixers: psychiatry's troubled search for the biology of mental illness. First edition. New York, W.W. Norton & Company.
Scott, John L. 1959. Last Summer, Bizarre, Morbid But Powerful. Los Angeles Times, December 24, 1959, p.14.
Raz, M. 2013. The Lobotomy Letters: The Making of American Psychosurgery. University of Rochester Press.
Intriguing. I’m not an avid viewer of classic films, but I’ll try to check this out.
Lobotomy has almost always been portrayed in cinema as either a tool of the antagonist or a deus ex machina, rarely leading to a positive outcome. At best, it exists in a moral grey area, as seen in Shutter Island. Hollywood has done a remarkable job of cementing its reputation as a sinister and ethically dubious procedure—one that, at its peak, likely destroyed countless lives rather than improved them. Its really hard to argue with an image of strapping someone down tight and sticking needles in their heads from all sorts of weird angle, it tend to leave a vivid mark on the audience.