Richard Matthews DC, DACNB

On the sixteenth of December 1960 a twelve-year-old boy was put on a table in a San Jose hospital, given electric shocks until he was unconscious, and had an ice pick hammered through the thin bone above each eye and swept from side to side through the front of his brain, because his stepmother had told the doctor he was defiant. The doctor's fee was two hundred dollars. Howard Dully was a big, clumsy, daydreaming boy whose mother had died when he was five, and his father had married a woman called Lou who could not stand him. She took him to six psychiatrists. All six told her the problem was not the boy. The seventh was Walter Freeman, who had performed more lobotomies than any man alive, who drove between state hospitals in a van he called the lobotomobile doing them by the dozen in an afternoon, with no gloves and no surgical training, and who had once done twenty-five in a day. Freeman's notes on Howard, which Howard did not read for forty-four years, record the symptoms. He objects to going to bed. He turns the lights on when there is broad daylight. He does not react to love or to punishment. He has a savage streak. On that evidence, and Lou's signature, and two hundred dollars, Freeman wrote that the boy would benefit from a transorbital lobotomy and did it four days later. Howard remembers the table. He remembers waking with two black eyes and a fever and no idea what had been done to him, because nobody told him, then or ever. His father never spoke of it. Lou put him into a state institution the following year, and the boy with the holes in his brain spent the next forty years in and out of asylums, juvenile halls, a jail, halfway houses and the street, drinking, drifting, never quite able to say why he was the way he was, with a photograph that existed somewhere of a doctor in a suit standing over a child with a steel spike in each eye socket. At fifty-six, driving a school bus, he went to find out. He found his file in Freeman's archive at a university in Washington, in the doctor's own handwriting, and read for the first time what his stepmother had said and what the doctor had agreed to. He went to see his father, who was eighty, and asked him why he had let it happen, and his father said he had been bullied into it. Howard told the story on the radio in 2005 and five million people listened to a man weep over a piece of paper. Walter Freeman was not a quack. He was a professor of neurology, the man who had brought the lobotomy to America, and the operation had won its inventor the Nobel Prize for Medicine in 1949. The journals published him. The hospitals booked him. The newspapers called it a miracle. He did it to three and a half thousand people, nineteen of them children, and he kept doing it until 1967, when a patient died on the table and the hospital took his privileges away, and he spent his last years driving the country in the van looking up his old patients to prove it had worked. That is what settled science looked like from inside, to a twelve-year-old. A mother's complaint, an expert's confidence, a procedure with a prize behind it, two hundred dollars, and a lifetime nobody could give back. The same institutions now tell you what your child should eat, in the same voice, with the same certainty, and the leaflet has a logo on it. Howard Dully is in his seventies and still cannot say what was taken. Nobody ever apologised.

The most successful drug advert in history said Lipitor cuts the risk of heart attack by 36%, and the truth was in the footnote. What the headline said: - 36% fewer heart attacks What the asterisk said: - On the sugar pill, 3 people in 100 had a heart attack - On Lipitor, 2 people in 100 had a heart attack Both statements describe the same trial. 3 down to 2 is a drop of about a third. It is also a difference of 1 person. What that means for the 100: - 1 avoided a heart attack - 2 had one anyway - 97 were never going to have one - 100 took the tablet every day for over three years - 100 were exposed to the side effects Nobody sat in a surgery was ever told "this will help 1 in 100 of you." They were told 36%, by a doctor who had been told 36%, by a rep who was paid on it. Lipitor went on to sell well over $100 billion. That asterisk is the most expensive piece of punctuation ever printed.