She then converted the carriage house into a cozy one-bedroom home where she now lived with Edward. She dedicated her time to caring for lobotomy patients whose lives she had once believed they had saved. It still pained her to remember her hopeful past. To see the horrific reality of all the good she thought she and Robert had done. But she deserved that pain. She wanted to live with it for the rest of her life.
And yet, as Ruth heard shrieks of joy from Frank and Margaret’s children, as they ran up to their ankles in and out of the icy-cold water; as she looked at Susie and Meg, still happily in love; and as she held hands with Edward, feeling his unfailing, unconditional support, her heart felt fuller than it had in as long as she could remember.
She thought of all the plans she and Harry had made on that beach. Even if her life hadn’t taken the path she expected, somehow, she had still ended up in her favorite place surrounded by people she loved. People she would devote the rest of her life to protecting.
She now understood what she wished she had known decades before, when Harry was alive: for some maladies, there is simply no cure. Sometimes, the best you can do for someone is to stand beside them, appreciate their strength, and acknowledge their pain.
In the end, this was Harry’s legacy. She hoped that was enough.
AUTHOR’S NOTE
The first question I was asked by almost every early reader of The Lobotomist’s Wife was: “How in the world did you come up with this?” The truth is it was an accident. Before I started writing this book, my expertise in mental health treatment was limited to the fact that my mother and stepfather are practicing therapists, and my knowledge of lobotomy started and ended with One Flew Over the Cuckoo’s Nest.
I am an avid reader of fiction in general and historical fiction in particular, but when I drive, I listen to nonfiction. A few years ago, Audible recommended a book called Get Well Soon: History’s Worst Plagues and the Heroes Who Fought Them by Jennifer Wright. It was a bit of an oddball choice for me, but I was a history major in college, and it was well reviewed, so I gave it a try. （Side note: great book, funny, smart, and eerily relevant in our postpandemic world.） Anyway, the book is largely about the biggies like the Black Death and leprosy, but Wright also includes a chapter about lobotomy, specifically Walter Freeman II （1895–1972）， the doctor who brought the treatment to the US and eventually invented the quickie “ice pick” version. I was stunned to learn that not only did the use of lobotomy peak in the middle of the twentieth century, but also that more than half of those lobotomized were women—Rosemary Kennedy being one of the most notable.
Wright describes Freeman as a charismatic proselytizer who traveled the country lobotomizing thousands. She tells of an incident where, while on the road, he went to a man’s motel room to sedate him because the man hadn’t shown up for his court-ordered lobotomy, and Freeman decided to perform one on the spot. （I fictionalized this moment into the Sam Orenbluth scene.） This was a man who sounded, to me, one beat shy of a serial killer. I was horrified and fascinated.
At the time, I was working on my first novel, a contemporary fiction about a woman who feels trapped and unhappy in her suburban life. I couldn’t get this sick lobotomist out of my head and started to think: What if you were this same woman in the early 1950s, the small window of time when lobotomy was the “miracle cure”？ Or, what if you had an actual illness like postpartum depression that wasn’t yet considered an illness and were unlucky enough to cross paths with a maniacal lobotomist? From here, The Lobotomist’s Wife was born.
Initially I intended for this to be Margaret’s story. But when a writer friend asked me whether Freeman was married, I became fascinated by the kind of woman who could stand by a man doing this to so many. My research revealed that Freeman’s actual wife, Marjorie Franklin, was an economics professor and purportedly an alcoholic. She and Freeman had four children but a strained relationship that included many affairs （on Freeman’s part）， much time apart, and the tragic loss of a child. This wasn’t the story I wanted to tell. So, I invented Ruth Emeraldine, a strong woman singularly devoted to a career in mental health in an era when women often needed men to truly succeed. There were real women who blazed trails in this field, one of the most notable being Dorothea Dix, who made her name as an advocate for the mentally ill a generation before Ruth was born, but Ruth is entirely from my imagination. I did my best to make her lifestyle and the places she frequents historically accurate—for example, the sign she carries at the suffragist march in 1917 is from a photo in the Mount Holyoke archives—but the idea that the lobotomist had a wife who was an American heiress, who worked as his partner and advocate in the popularization of lobotomy, and was ultimately the reason for his downfall, is fiction.