Like a Hole in the Head

Some lonely night we can get together
And I’m gonna tie your wrists with leather
And drill a tiny hole into your head ~Andrew Bird

Trepanning is one of the oldest forms of surgery and, frankly, one of the more bizarre. It’s essentially the boring of a hole into a person’s skull. The hows and whys differ depending on time and culture, but the fact remains that people have been drilling holes into their skulls for thousands and thousands of years.

The practice has assaulted me from three different directions this week. The first was in Andrew Bird’s Fake Palindromes, quoted above (and, incidentally, one of my very favorite songs), which was stuck in my head for a few days. The second was in The Subtle Knife (I have been re-reading the series for the hell of it), where trepanned skulls make an appearance in an Oxford museum, where Lyra comments on the amount of Dust concentrated around these strange skulls. The third was in the television series Dead Like Me, which I’ve been watching lately. One of the reapers in the program, Mason, died after drilling a hole in his head in the 60s.

…As an aside, he’s also gorgeous:

I've got a thing for lanky Brits, I guess.

And so, with The Drain spending this last week circling around trepanning, I decided we may as well discuss it here.

As always, my galleons, you are so lucky.


The word trepanning comes from the Greek trupanon, meaning “borer.” Which is an apt name, considering trepanning is simply the cutting, drilling, or scraping of a hole into the skull. The process first surfaced in the Neolithic Age, almost 12,000 years ago. The practice was widespread, with trepanned skulls found in Europe, South America, and parts of Africa. In a group of 120 skulls found in France dating from around 6500 B.C., 40 of them were trepanned. While most trepanned skulls belonged to males, there have been examples of women and children who also underwent the procedure.

Considering the dangers of the procedure (accidental lobotomies, meningitis, death), the most amazing thing about these skulls is the evidence that many of those who underwent the procedure actually survived. Many of these skulls show that the skull began to heal and form new bone, meaning the patient survived. In fact, many came back for additional holes.

But why?

Of course, we have no records of exactly why these prehistoric people decided to go about drilling holes into their skulls. Prevailing theories are that the holes were to release evil spirits, cure headaches, or even cure brain diseases and insanity.

Whatever the reason, the practice continued through the ages. In Ancient Rome and Egypt, the bone bits gathered from trephination were used to make potions to cure several diseases. The skull discs (rondelles) were gathered in many cultures to use as amulets and charms. Hell, Hippocrates himself wrote detailed instructions on how to perform trepanning for medical reasons. Each session took 30-60 minutes (with no anesthetic), and scientists believe roughly 70% survived.

Trepanning didn’t fall out of favor until well into the 18th century. In fact, Prince Phillip of Orange was actually trepanned a whopping 17 times by his physician. However, with the onset of the Christian era, trepanning all but disappeared.


While some African cultures still practice trephination the old-fashioned way, we only use it for a few instances in modern medicine. Trepanning (called a craniotomy if the bit of skull is replaced and a craniectomy if it is removed) is used to treat epidural and subdermal hemotomas. These types of brain injuries are serious and involve heavy bleeding within the cranial cavity, leading to an increase in intercranial pressure. Trepanning helps relieve that pressure and to help monitor it.


That’s basically the extent of trephination’s actual, medical usefulness, but that doesn’t stop people from thinking drilling a hole in their head will do all manner of exciting things to them.

Fucking pseudoscience bullshit.

Much as I usually loathe these sorts of people, however, I find myself more amused by some of them than others. Particularly the ones who believe the addition of a hole in the skull will lead them to the ultimate high.

I shit you not, dear galleons. Forget drugs- give me a drill, and I’ll show you enlightenment.

Bart Huges was the leader of modern trephination folk theory (and a huge druggie- he even named his daughter Maria Juana). A Dutch research librarian and medical school drop-out (apparently, he wanted to be a psychiatrist but failed the obstetrics exam), he created this concept called brainbloodvolume (…yes, it’s supposed to be all one word like that) which trephination impacts.

Okay, so what the balls is this “brainbloodvolume” nonsense? Huges’ first flickers of insight came when he was told he could get high by standing on his head. Using this (and a bit of mescaline), he eventually surmised that, by permanently relieving the pressure in his head, he could increase brain blood flow (or brainbloodvolume) and gain a permanent, natural high. According to Huges, when we’re babies with soft, squishy headparts, our brains are allowed plenty of room to breathe and grow. But, as we get older, we get all locked up in our bony prisons. With trepanning, we can get back some of that freedom. Return to a freer, child-like state of consciousness.

And so, using an electric drill, a scalpel, and a needle to administer a local anesthetic, Huges took 45 minutes and drilled a hole in his head. And how did he feel after? ” I feel as I felt before the age of fourteen,” he said.

Huges’ ideas have developed a small following, and the most prominent members would be Joey Messen and Amanda Feilding, Countess of Wemyss. Feilding spent four years, without success, trying to find a doctor who would perform trephination on her. Finally, she decided to do it herself. With a dental drill. Messen filmed the procedure. Following this, Feilding twice ran for Parliament on a pro-trephination platform (she wanted the procedure to be offered free by the National Health Service).

Mellen also wanted to undergo trephination, and was equally unlucky in finding a surgeon to perform the procedure. So, he and Feilding tried it on him. Twice. Unsuccessfully. In fact, they were so unsuccessful that the second attempt landed him in the hospital, where doctors severely reprimanded him and sent him in for psychiatric evaluation.

Of course, the moment he got home, he decided to try again. In his book, Bore Hole, written about his attempts at trephination, he describes that third try:

After some time there was an ominous sounding schlurp and the sound of bubbling. I drew the trepan out and the gurgling continued. It sounded like air bubbles running under the skull as they were pressed out. I looked at the trepan and there was a bit of bone in it. At last!

…The things people will do to get high.

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