The frontal lobe is the part of the brain that makes us human. It is the seat of reason, planning, judgment, impulse control, and the quiet voice that stops us from doing the foolish things we very much want to do. It is, in essence, the brain’s civilising department—the one that tells you not to send that angry text, not to eat the fourth gulab jamun (or, in my case, the tenth), and not to tell your boss what you really think of him.
A few months ago, in walked Mr Mehta, a 58-year-old Gujarati businessman with a paunch that entered the room one second before he did and a smile that tried to apologise for it. He arrived with his wife, Kusum, a tiny woman with sharp eyes and sharper commentary, the sort who noticed that the framed certificates on my wall were two millimetres off-centre.
“Doctor,” she said before he could sit down, “my husband has become… how to say… unfiltered.” Ashok nodded meekly. Lately, he had started saying things that should never be said out loud. At dinner parties, he announced who had gained weight. At family gatherings, he commented on who had lost hair. At a funeral, he once asked the wife of the deceased why she was dressed in a simple white sari.
“I don’t know why I say these things,” he told me. “They just escape my mouth!” Kusum folded her arms: “Doctor, he has become Google with no privacy settings.” The MRI showed a tumour sitting squarely on his left frontal lobe—the area responsible for tact, judgment, and inhibition. Medically, this explained everything. Socially, it had already caused three family WhatsApp groups to fall silent.
“So, he’s not rude?” she asked. “No,” I said, “his tumour is.” She nodded, as if finally understanding the laws of the universe. We decided to operate. The morning of surgery, Ashok said, “Doctor, please be careful; that’s the part of my brain that has kept me married for 32 years.” I was confused if he wanted out or wanted to stay.
The frontal lobe, when exposed during surgery, looks both powerful and fragile, a pale landscape of grooves and ridges that contains our best selves and our worst impulses. As I navigated my way to the tumour, I thought of how casually surgeons once approached this region.
This was the era captured in One Flew Over the Cuckoo’s Nest, when frontal lobotomies were advertised as cures for everything from depression to ‘difficult behaviour’. The tragedy was, that worked mostly by dimming people into obedience. The procedure made lives quieter, not better.
This chapter in medical history also produced Egas Moniz, the Portuguese neurologist who won the 1949 Nobel Prize for pioneering the lobotomy—a fact that still makes neurologists and psychiatrists stare at the ceiling in disbelief. He genuinely believed he was saving people; what he didn’t realise was that he was also accidentally removing their personality settings. In hindsight, awarding a Nobel Prize for lobotomy feels a bit like applauding someone for fixing a leaky tap by shutting off the entire water supply. A creative solution, but one with catastrophic consequences. Thankfully, we have learned since then. Today, the frontal lobe is treated with reverence, not enthusiasm.
The tumour came out cleanly. The next morning, Ashok was noticeably calmer. Kusum tested him immediately. “Do you think my hair looks messy today?” she asked. He paused. He thought. “No. You look fine.” She burst into tears. “Doctor,” she whispered later, “he’s back!”
Frontal lobe patients often teach me more about the brain than textbooks. They remind me that personality isn’t a philosophical abstraction, it is anatomy. It’s fibres and synapses and circuits firing in impossible harmony. One small lesion can turn a diplomat into a stand-up comedian; fixing it can return him to himself.
At his follow-up, Ashok told me proudly, “Doctor, I’m filtering my thoughts now.”
Kusum added, “Not all of them, but enough to keep our friends.”
The frontal lobe is the brain’s editor—the one that trims reckless sentences, reins in impulsive ideas, and stops us from hitting ‘send’ on all the things we would regret. When it falters, life becomes unscripted. When it recovers, so do we.
So, the next time you stop yourself from saying something unfiltered or unwise, thank your frontal lobe. And if you don’t, get an MRI. Except if you are a Parsi.
The author is consultant neurosurgeon at Wockhardt Hospital, Mumbai.
mazdaturel@gmail.com Instagram@mazdaturel