Reports of Lena Zavaroni's death, described as one of natural causes, is littered with failures and nebulous explanations about the treatment she received during the years leading up to her death. Many give mere justifications why the treatments did not work and emphasise the "huge problems faced in attempting to treat her illness."

The inquest heard that a friend of Ms Zavaroni wrote to the hospital to inquire about brain surgery in 1998. [1] Brian Simpson, the consultant neurosurgeon who carried out the operation at the University Hospital of Wales said that he had been satisfied that all the requirements of the 1983 Mental Health Act [2] had been strictly adhered to in that all other possible treatments had been given before having to resort to brain surgery.

It's described as keyhole surgery to partially interrupt the nerve pathways that control emotions. Interestingly, however, the hospital were quick to stress that it was not a lobotomy, nor was it an operation for anorexia, for which there is no known cure. The relationship between illness and operation is not clear.

Mr Simpson, said that a brain scan had confirmed that the operation had been successful. He also stated that Ms Zavaroni had only mild confusion afterwards (a normal side effect) and that it had cleared up quite quickly. he further stated that, "She seemed surprisingly cheerful". However, a few days later her condition worsened and she lost 20 per cent of her body weight, taking her down to three-and-a-half stone.

On September 29th Ms Zavaroni contracted bronchial pneumonia and her condition deteriorated she subsequently died on the evening of 1 October. Mr Simpson said he was surprised by her sudden weight loss and the infection. "By that stage she was getting better."

Mr Simpson's claim that the operation had been successful reminds me of that famous quote by Ernest Hemmingway after receiving numerous treatments of ECT, "it was a brilliant cure, but we lost the patient. [3]" Mr Hemmingway committed suicide just two days after leaving the famous Mayo psychiatric clinic.

Recording his verdict, Dr Addicott said Ms Zavaroni had understood the risks of surgery and still wished to proceed. "There is no distinct and definite connection with the operation. In conclusion I would say it was natural causes."

Lena had suffered from the eating disorder anorexia nervosa and depressive illness for over 20 years, she had been prescribed numerous drugs, had undergone ECT (Electro Convulsive Therapy) and a brain operation none of which had been effective in curing her condition. Yet she died of "natural causes."

The Guardian gave a more poignant and pragmatic version[4] that questions the psychiatric practices that were carried out on Ms Zavaroni and delved into its questionable background history. Below is a summary of the article.

It began by citing the 1975 release of One Flew Over the Cuckoo's Nest which dealt a severe blow to the reputation of the psychiatric profession as the treatments it showcased were seen as relics of a cruder and crueller age of medicine highlighting clumsy tools and being abused by pitiless staff to suppress free will and individuality.

British doctors supervise 1,300 ECT treatments each week. Most of these patients are women and many are treated without their consent.

Lena Zavaroni died after receiving "pioneering surgery namely, "a leucotomy" and "stereotactic surgery", both of these terms for what is essentially a lobotomy. This involved surgeons opening up the skull and destroying parts of the frontal lobe of the brain by hacking through the fibres which attach it to the rest of the brain.

Psychosurgery has probably been around for more than 40,000 years. However, it was only in the last years of the 19th century that it acquired a scientific gloss. In 1894, a Swiss surgeon experimented by selectively destroying parts of the frontal lobes of several patients in a bid to help control their psychotic symptoms.

Two American surgeons developed a quick and easy version which could be performed in just a few minutes under local anaesthetic. With one slight hammer blow of an ice-pick instrument through the front of the skull followed by a rapid sideways movement the fibres to the frontal lobe are severed. In the 40s and 50s, an estimated 50,000 patients were given lobotomies worldwide.

It soon became apparent that the side effects were, to put it mildly, undesirable. Lobotomies were grossly abused. They were unnecessary and many people suffered very severe personality damage.

But in fact, the operation has quietly survived the bad publicity. Today, in what proponents call "neurosurgery", the holes cut in the skull are much smaller, and carefully targeted sections of the nerve fibres are burnt out. There are several versions of the operation, involving different parts of the lobe and different methods of cauterising the brain tissue, but the procedure is still essentially a lobotomy.

Yesterday it was confirmed that 35-year-old Lena Zavaroni, who weighed little more than three stone when she died, was being treated for chronic depression, not anorexia. In the UK this surgery is only used – as a last resort – in cases of severe depression or obsessive compulsive disorder.

Keith Matthews is professor of psychiatry at the Ninewells Hospital in Dundee said, "Our patients… have usually been exposed to just about every treatment available with nil impact. The surgery… remains highly controversial, largely because no one really understands how the brain works or why such procedures sometimes do seem to help.

These doctors are undoubtedly well-meaning. But the simple truth is that this surgery destroys parts of an organ doctors are still struggling to understand. Mind, the mental health charity, wants the surgery banned. "It's irreversible and there's no evidence that it works," says a spokeswoman. "We can't find any justification for carrying on its use."

— © Citizens Commission on Human Rights (5 October 1999)

(Unfortunately the Citizens Commission on Human Rights has removed their article on Lena Zavaroni) which is why I have decided to add the full article here.

Robcamstone