These days, you could find at least a dozen guys wearing penis rings who are eager to drill holes in your head. In Walter Freeman's day, it was more of a novelty.

Of course, the holes in this case were surgical rather than cosmetic. From the 1930s through the '60s, Freeman championed lobotomy in the U.S. as an ideal treatment for incurable mental illness. As author Jack El-Hai details in his recent biography, The Lobotomist: A Maverick Medical Genius and His Tragic Quest To Rid the World of Mental Illness (John Wiley & Sons), Freeman became either lobotomy's poster boy or whipping boy, depending on one's opinion of the procedure.

The penis ring, the most bizarre of the mementos Freeman obsessively kept, is evidence of the traits often cited in favor of the latter view: Freeman's vanity, recklessness and showmanship. After cutting the ring off of a patient, Freeman refused to return it. He had it repaired and engraved with his family crest, and wore it on a gold chain for decades thereafter. Via telephone from his home in Minneapolis, El-Hai explained, "He wanted to remember the role that he played with that patient. He could pull out that ring whenever he wanted to and handle it, and be back there. I think it stroked his ego."

Freeman's ego required plenty of stroking. "This was a man who needed a lot of people telling him that he was innovative and a great doctor," says El-Hai. "He sought out that attention. In the book I quote him saying that he'd rather be seen as wrong than seen as boring. He wanted to entertain and be in the spotlight."

Nov. 18 will mark the 110th anniversary of Freeman's birth, and if he were alive today he would likely still be arguing in favor of lobotomy. Belligerent adherence to a bad idea may ring familiar to Philly ears, with good reason: Freeman was the third generation of a Philadelphia medical dynasty. Though his own practice would be centered in Washington, Freeman was raised in Rittenhouse Square.

"One of the things that growing up in Philadelphia did for him," according to El-Hai, "was to show him that there were two courses that he could take in medicine." Freeman's grandfather, William Williams Keen, achieved a significant degree of fame: first American surgeon to remove a primary brain tumor, America's first colostomy, president of the American Medical Association, etc. Due to a malignant growth, he removed a section of President Grover Cleveland's jawbone, which today is part of the Mütter Museum's collection.

The second course was that of his father, Walter Jackson Freeman, whom the son "looked down upon as a medical drudge," explains El-Hai. "He put in the hours but never attended medical conferences, didn't publish anything and really didn't make medicine a part of his life, even though he made it his career. I think Freeman saw lobotomy as his ticket to becoming the kind of innovator and recognized physician that his grandfather had been."

The difference being that W.W. Keen never felt the intense desire for notoriety that consumed his grandson. Freeman's P.T. Barnum tendencies led to a cloudy view of medical ethics and a reckless disregard for sterilization techniques during surgery. This last led to a break with his most important collaborator, James W. Watts, a surgeon whose understated qualities made him the perfect contrast to Freeman.

Freeman abandoned the traditional lobotomy technique, which involved drilling holes through the skull, for transorbital lobotomy, where an icepick-like tool (Freeman in fact used an actual icepick on several occasions) is inserted through the eye socket. Now that no incision needed to be made, Freeman took to performing the procedure himself, in his office, sans mask or gloves. During one demonstration, he performed the operation on both sides of a patient's brain at one time. According to El-Hai, Freeman "had a blind spot as to how other people saw him and another blind spot about ethics. To Freeman, doing a lobotomy with two icepicks at the same time was not a show of recklessness, it was a show of fluency and energy."

The Lobotomist is valuable for the many myths that it dispels, not least that of the zombified patient, a la One Flew Over the Cuckoo's Nest. But it was the central character, a brilliant and skilled doctor who somehow allied himself to a brutal and ultimately fruitless procedure, that drove Jack El-Hai forward in his research. "I came to think of him as a tragic figure. Not so much a monster but as somebody like King Lear, whose misunderstandings of himself cause him to make some big mistakes and to, in fact, bring down the procedure that he wanted to champion."