As a medical student in the 1970s, Henry Marsh took a job as a psychiatric nursing auxiliary in a mental hospital, on what he describes as "the end-stage ward where the burnt-out cases went to die". There he saw first-hand the devastating effects of lobotomy. "It was painfully apparent to me that there was no proper follow up of these patients at all," he says. "The patients who were the worst, most apathetic, sort of ruined patients were the ones who had been lobectomised."