In November 1941 the richest man in America drove his twenty-three-year-old daughter to a hospital in Washington without telling her mother, had two surgeons drill holes in her skull and cut into the front of her brain while she sang God Bless America to them, and when the singing stopped she had a mental age of two and the family did not speak her name for twenty years. Rosemary Kennedy was the third child and the first girl, and she was slow. A nurse at the birth had held Rose Kennedy's legs together for two hours while they waited for the doctor, and the baby had been starved of air. She learned to read and write, but late, and in a family where the boys were being bred for the presidency and the girls for the right marriage, she was the one who could not keep up, the one who had to be coached and watched and given the simpler part in the photograph. She was also, by every account, the prettiest of them, and when the family went to London in 1938 she was presented at court in a white dress and curtsied to the King without a mistake. Then she was twenty-one, and the trouble started. Moods. Rages. Slipping out of the convent school at night and coming back in the morning and not saying where. The nuns said she might be meeting men. For Joseph Kennedy, who was managing his sons towards the White House and could not have a daughter who might get pregnant or get talked about, that was the end of it. He had read about a new operation. Walter Freeman had promised the newspapers it calmed the agitated, and Joe Kennedy had never in his life been told that a thing he could pay for would not work. Rosemary was given a mild sedative and kept awake. Freeman and his surgeon, James Watts, opened the skull on both sides and Watts pushed a blade into the frontal lobes and swept, while Freeman asked her to recite the Lord's Prayer and sing, and count backwards, so they would know how far to go. They went until she was incoherent. Then they stopped. She came out of it unable to walk or speak. Years of therapy got her a few words and a limp. Joe moved her to a private hospital in New York and then to a convent school in Wisconsin, told the family she was teaching the retarded in the Midwest, and never went to see her. Rose, her mother, was not told what had been done until long after, and did not visit for twenty years. The brothers and sisters, including the one who became President, were told she was away. When Joe had his stroke in 1961 and could no longer manage the story, Eunice went to Wisconsin and found a woman of forty-three who did not know her, and came home and started the Special Olympics. Rosemary lived to eighty-six, in the convent, and died in 2005 with her surviving sisters at the bed. The brother who became President had signed the first federal mental health law in 1963, and the family has said she was the reason. Freeman kept operating for another twenty-six years. His notes on Rosemary have never been released. That is what the expert's confidence looks like when it meets a powerful man with an inconvenient child. The science was published. The father was certain. The daughter sang to the surgeon until she could not. Every institution that has ever decided it knows what is wrong with you and how to tidy it has the same two ingredients in the room, and the person on the table is still the only one who pays.

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.