Painkiller: Did Arthur Sackler really perform lobotomies?

In Netflix’s Painkiller, a fictionalized retelling, the show only briefly touches on Arthur Sackler’s history as a practicing physician. But whether it was in the script or it’s just Clark Gregg’s interpretation of the material, the show makes it seem like Sackler was sort of…gleeful over conducting such barbaric medical practices.

There is a graphic scene depicting a prefrontal lobotomy in the first episode, and Gregg wears a smug smile before hammering into his patient’s orbital bone. Painkiller’s fictional version of Arthur Sackler is motivated to create Thorazine, what the show-version of the character calls “a lobotomy in a bottle,” to “keep a customer for life” rather than the one-time deal you get with a lobotomy, but that isn’t the entire story.

Patrick Radden Keefe’s book Empire of Pain provides a slightly more altruistic motivation behind Arthur’s pivot to pharmaceuticals in real life.

Did Arthur Sackler really conduct lobotomies?

In 1952, after completing his schooling, Arthur started working at the Creedmoor Psychiatric Center, even convincing his brothers Raymond and Mortimer to join him. Procedures we now consider barbaric, like electroshock (though it does have its defenders, even today) and lobotomies, were commonplace back then. During that era, patients were regularly given both procedures to treat mental illnesses, even depression.

On page 31 of Keefe’s book, the writer says that Sackler hated performing electroshock therapy but was forced to do it repeatedly.

"“Among them, the brothers conducted the procedure thousands of times, an experience they came to find demoralizing. They were disgusted by the limitations of their own medical knowledge—at the idea that there was no more humane therapy that they could offer (Keefe 32).”"

Lobotomies were “coming into vogue” around the same time because they were so “quick and efficient” to perform, despite often leaving patients incapacitated or with a significant reduction in their emotional responses.

"“The procedure was irreversible, rendering people pliable by turning them into zombies (Keefe 32).”"

Believing these techniques to be too gruesome and invasive, Arthur, Raymond, and Mortimer became determined to find a better way to treat mental illness. Of course, later, the Sacklers would pivot fully toward the marketing and sales of pharmaceuticals. Still, their initial motivations were a little less American Horror Story: Asylum than Painkiller depicts.

They started experimenting, first on rabbits and later on human test subjects. Arthur began working with the pharmaceutical company Pfizer and helped them shift from chemical manufacturing to prescription drugs.

From there, Arthur would go on to help popularize drugs like Valium and Betadine. He essentially created the framework that pharmaceutical companies, including Purdue Pharma, would go on to use to make millions in profits off of these drugs.

In Painkiller, Richard Sackler was inspired by his uncle’s strategies to create the marketing tactics that would popularize OxyContin, eventually triggering the opioid crisis and turning the Sackler family into billionaires.