Why it’s an Awfully Good Idea to Drill a Hole in your Head

by Timothy Chilman

email: timothychilman@yahoo.com

Trepanation is the practice of drilling a hole in the skull. The skull is pierced, but the underlying blood-vessels, meninges, and brain are left untouched. The word comes from the Greek “trypanon,” meaning “to bore,” which was the name of the tool the ancient Greeks used for the purpose. The Greeks were the first to use a drill-bore for the operation.

Medically, trepanation is known as a craniotomy, and other names for it are trephination, (erroneously) brain piercing, making a burr hole, and skull fucking. Alternative health practitioners claim that trepanation produces a high. One trepanee likened her new mental state to that produced by “acid mixed with some kind of opiate.” For those with limited experience of LSD and heroin, the feeling has also been described as that resulting from ten minutes of standing on one’s head, or sustained aerobic activity.

Trepanation has been around for a while. This painting was by Hieronymus Bosch (c.1488-1516).

Nowadays, trepanation is performed to evacuate hemorrhages, remove a blood clot from brain tissue, or relieve pressure caused by, for example, cerebral ulcers or trauma. In these cases, the bone is replaced. Boo! But trepanation has been with us since the Stone Age. John Verano, a professor of anthropology at Tulane University, remarked that trepanation is the oldest surgical procedure known to man. Others say it is the second oldest, with the honor going to circumcision.

The oldest trepanned skull was discovered in the Ukraine in 1966, and is between 8,020 and 7,620 years old, dating to the time that people first constructed buildings. Trepanation was practiced by the early Mesoamerican civilizations, the Greeks, the Romans, Indian, the Chinese, and the ancient Egyptians.

A trepanned skull from the Iron Age; bone growth shows that the patient survived the operation – http://en.wikipedia.org/wiki/Trepanning

At a gravesite south of Lima, 10,000 complete, well-preserved bodies were found of people from the Inca, pre-Inca Tallan, and Mochica cultures dating to as early as 2,000 BCE. About 6% had been trepanned. At one site, the proportion was more than a third. While different methods were employed, the most highly developed method used a ceremonial knife called a tumi, which was rubbed against the skull. The tumi is now the symbol of the Peruvian Academy of Surgery.

Coca was used by the ancients for pain relief.

Many skulls contained multiple holes, indicating that individuals definitely survived the procedure. Even if there is only one hole, new bone growth is shallower than the bone at the rim of a hole, allowing scientists to ascertain whether a person survived the operation. It is estimated that the survival rate exceeded 60 percent. By the 1400s in Europe, the number was 90.

Surgeons avoided those parts of the skull where cutting was more likely to result in bleeding, infection, or brain injury. While anesthesia and antibiotics were unavailable, medicinal plants were probably used. Coca and possibly maize beer could have been employed for pain relief. Balsam and saponins – plants with soap-like properties – could have been used to reduce the likelihood of infection. Valeria Andrushko of Southern Connecticut State University said “These people were skilled surgeons.”

In his classic text On Injuries of the Head, Hippocrates (460-370 BCE) made the first ever written reference to trepanation. He recommended it for the treatment of skull fractures sustained in battle where bone fragments had been pushed in and compressed the brain. Celsus and Galen speak of Roman surgeons of the first century CE performing trepanations with equipment similar to carpenters’ drills.

A trepanned skull form the Iron Age; bone growth shows that the patient survived the operation.

The holes in the earliest trepanned skulls found in Europe were made by scraping bone with sharp stones such as obsidian and flint. Later, drilling tools were used, and the late Medieval period witnessed the use of mechanical drilling instruments. Trepanation was still practiced in Europe as recently as 1850.

Brain surgery was often never the intention, and there is evidence that elaborate care was taken to avoid penetrating beyond the bone. Some anthropologists believe the procedure was used to treat headaches, epilepsy, hydrocephalus and mental disorders. These were attributed to the work of demons, which would exit through the hole. Others have suggested trepanation was ritualistic. Since the trepanned proportion of some populations was large, it has been suggested trepanation was a privilege granted to particular people. This was true in the case of the pharaohs, who were trepanned to make it easier for their souls to depart their bodies upon death.

In modern times, the procedure was popularized by Bart Huges (b. 1934), a veteran of medical school. He is sometimes referred to as “Dr. Bart Huges,” but never finished his studies. It is said variously that he wanted to be a psychiatrist but failed the obstetrics exam and that Amsterdam University authorities were none too impressed by his advocacy of marijuana usage.

In 1965, after years of using cannabis, LSD, and other drugs, Huges was smoking marijuana at a party on the isle of Ibiza. He saw another party guest standing on his head to maximize the intoxicating effects of the drug. Huges came to the realization that the level of one’s consciousness is proportionate to the volume of blood in the brain, which he calls brainbloodvolume.

A baby has 350 bones, but these fuze together so an adult has 206, and oxygen can no longer enter the skull. Worse still, standing upright pulls blood from the brain. Removing a piece of skull allows more blood to enter the brain, accelerating the delivery of oxygen and glucose to the brain cells and the removal of toxins. Huges reasoned that trepanation would allow an adult to feel the euphoria of a child on his or her way to a theme park.

Huges trepanned himself, an activity requiring local anesthetic, a hypodermic needle, a scalpel, an electric drill, and 45 minutes. He said the procedure left him feeling like he was 14. He wrote a book called Trepanation: The Cure For Psychosis.

John Lennon discussed trepanation with Bart Huges, and suggested it to Paul McCartney.

John Lennon discussed trepanation with Huges. Huges told him he would not benefit because in 10 percent of adults, the intracranial seams of children never heal, leaving such people with increased metabolism and heightened awareness. Huges believed this was patently the case with Lennon because he was so creative. In a 1986 interview with Musician magazine, Paul McCartney recalled that Lennon asked him and his wife, Linda, if they wanted to be trepanned. The answer was negative.

In his early 20s, Peter Halvorson plumbed the depths of depression. He says, “The door slammed shut on me.” Psychotherapy and medication were no help. He dropped out of the University of Cincinnati in 1968. He met Huges, learned of the brainbloodvolume theory and in 1972 in a small room in Amsterdam he trepanned himself with a foot-operated electric drill. The hole was 0.3 inches, small enough to not cause meningitis but sufficiently large that the bone did not heal itself. The hole is located above his forehead, where the hairline would be if he had one. The skin healed, but a noticable depression remains, although it cannot be seen from certain angles. Halvorson says trepanation gave him more “energy, focus and drive”. While this cannot be measured objectively, he declares that doctors have told him his level of testosterone is that of a man in his twenties.

Halvorson believes the medical industry conspires to withhold the benefits of trepanation: “Trepanation restores you to a youthful state where you’re happy and upbeat, and that diverts attention away from Prozac and protracted psychotherapy.”

In Utah in 2001, Halvorson pleaded guilty to practicing medicine without a license after drilling holes in the skull of Heather Perry of Gloucester, England, to relieve her depression and chronic fatigue. Perry reported “definite improvement” in her condition, but Halvorson still received three years’ probation.

Halvorson established the International Trepanation Advocacy Group (ITAG) in 1997. It has its headquarters in Wemersville, Pennsylvania and provides trepanation advice over the internet and advocates medical research into the subject. Halvorson admits the subject is somewhat creepy. People associated with ITAG include Lord James Neidpath, a former professor at Oxford who taught the future US president Bill Clinton.

Howard Stern, who interviewed Peter Halvorson on the radio.

Halvorson was interviewed by a highly skeptical Howard Stern, who called him “insane” and trepanation “a cry for help”. Despite this, Halvorson retained his composure and later said, “Actually, it was a lot of fun.” Afterward, Stern told him, “Come back with more people with holes in their heads.” The ITAG website (www.trepan.com) received 15,000 hits in the two hours following the program.

ITAG instituted a study, where fifteen volunteers were trepanned by a competent surgeon. For legal reasons, surgery took place in Monterrey in Mexico. All surgeries were successful, and the volunteers were happy with the results. MRI methods employed were unable to detect changes to blood flow, with blame placed on the observational methods.

In 2005, an internationally recognized and much-published professor of cerebral circulation investigated trepanation for ITAG. Hospital studies were conducted into fifteen subjects who were undergoing minor operations where the skull was opened. In each case, the hole was not sealed until several months after surgery. Measurements of cerebral circulation were made before the operation, immediately after and then some months later when the skull was closed. Blood flow was significantly less before the operation then after it, and the level returned to its original state after the skull was closed.

A larger study supported by ITAG monitored changes in blood flow in the brain over many decades of life. This study has resulted in eight scientific publications in international journals and shows that trepanation restores blood flows to the levels of youth.

ITAG offers trepanation by a surgeon who is board-certified in the United States, Mexico, Spain and France. The cost is $2,400-$3,600, excluding travel and accommodation.

Yuri Moskalenko is the president of the Sechenov Institute of Evolutionary Physiology and Biochemistry at the Russian Academy of Sciences in St Petersburg and is studying trepanation with researchers at the Beckley Foundation in Oxford. He studied 15 people who had undergone trepanation after head injuries, finding that cranial compliance was approximately 20 percent higher than the average. Cranial compliance measures the degree to which brain fluids (cerebro-spinal fluid and blood) are able to move around within the cranium. He estimates that a 1.6 inch hole increases cerebral blood flow by between eight and ten percent. As a result, trepanation might lead to “significant” improvement in the mental functions of anyone beyond their mid-40s, when cranial compliance diminishes. Moskalenko believes Alzheimer’s could be treated in this way.

Does anybody disagree? A man who trepanned himself in 2000 told an interviewer that he had “come to the frustrating conclusion that the trepanation has had no lasting effect… It does not do what many hope it will.”

Self-trepanation is not recommended.

The man had covered the walls of his room with plastic sheeting, and combined drilling with rinsing of the incision with sterile saline solution. The procedure took approximately three-and-a-half hours. Self trepanation is not recommended, because scalp incisions bleed profusely, and blood is likely to obscure the field of vision. Three friends were present, but took no part in the operation for legal reasons.

Practitioners of kundalini yoga speak of opening the third eye, giving a person access to a higher level of consciousness. The margin of error separating a third eye from a lobotomy, however, is alarmingly small. The potential effects are drastic and even life-threatening: epilepsy, generalized encephalitis, permanent injury, stroke, death from infection, and brain abscesses. Many surgeons say the brainbloodvolume theory is impossible. There’s Dr. William Landau, a neurologist in St Louis (“It’s quackery”), Dr. Robert Daroff, professor of neurology at University Hospitals of Cleveland (“a crackpot notion… dangerous”), and Ayub Ommaya, professor of neurosurgery at George Washington University and the former chief of neurosurgery at the National Institutes of Health (“nonsense”).

Dr. Bruce Kaufman, an associate professor of neurological surgery at Washington University School of Medicine, said neurosurgeons experimented with a similar therapeutic procedure where holes were made in the skull to treat slit ventrical syndrome, but that it didn’t work and the idea was abandoned. Louis Sokoloff, Chief of the Laboratory of Cerebral Metabolism at the US National Institute of Mental Health, said brain function diminishes with age and increased blood flow would not reverse the process.

But it still sounds like such fun.


“Ancient Trepanation.” The Epoch Times. 27 July 2008. 15 February 2011. <http://www.theepochtimes.com/n2/content/view/1138/.>
“Trepanation.” RationalWiki. 14 February 2011. 14 February 2011. <http://rationalwiki.org/wiki/Trepanation.>
“An illustrated history of trepanation.” Scienceblogs.com. 24 February 2008. 14 February 2011. <http://scienceblogs.com/neurophilosophy/2008/01/an_illustrated_history_of_trep.php.>
“How many bones does a 10 year old child have?” Answers.com. 14 February 2011. 14 February 2011. <http://wiki.answers.com/Q/How_many_bones_does_a_10_year_old_child_have.>
“Introduction to trepanation.” www.trepanationguide.com. 14 February 2011.14 February 2011. ><www.trepanationguide.com.>
“Self-Trepanation.” 17 August 2008. 14 February 2011.
“Trepanation.” Encyclopedia Dramatica. 15 February 2011. 15 February 2011. <http://encyclopediadramatica.com/Trepanation.>
“Trepanation.” MedLibrary.org. 15 February 2011. 15 February 2011. <http://medlibrary.org/medwiki/Trepanation.>
“Trepanation.” meinah.tripod.com. 20 July 1998. 15 February 2011. <http://meinah.tripod.com/MI/trepanation.html.>.
“Trepanation.” Realization.org. 15 February 2011. 15 February 2011. <http://www.realization.org/page/topics/trepanation.htm.>
“Trephinning in pre-Columbian Mesoamerica.” Www.fact-index.com. 14 February 2011. 14 February 2011. <http://www.fact-index.com/t/tr/trephinning_in_pre_columbian_mesoamerica.html.>
Bjerg, Greg. “The Hole Story on Trepanation.” Damn Interesting. 7 February 2006. 14 February 2011. <http://www.damninteresting.com/the-hole-story-on-trepanation.>
Bowen, Jon. “The hole story.” Salon.com. 29 April 1999. 15 February 2011. <http://www.salon.com/health/feature/1999/04/29/trepanation/print.html.>
Carroll, Robert T.. Trepanation. 15 February 2011. 15 February 2011. <http://www.skepdic.com/trepanation.html.>
Colton, Michael. “You Need It Like… a Hole in the Head?.” 31 May 1998. 14 February 2011.<http://www.washingtonpost.com/wp-srv/style/features/trepan.htm.>
Frey, Rebecca J.. “Trepanation.” 1 January 2005. 15 February 2011. <http://www.healthline.com/galecontent/trepanation.>
Frey, Rebecca J.. “Trepanation.” 1 January 2005. 15 February 2011. <http://www.healthline.com/galecontent/trepanation/3.>
Frood, Arran. “Like a hole in the head: The return of trepanation.” 17 June 2009. 15 February 2011. <http://www.newscientist.com/article/mg20227121.400-like-a-hole-in-the-head-the-return-of-trepanation.html.>
Halverson, Peter. “ITG: International Trepanation Advisory Group.” 15 February 2011. 15 February 2011. <http://www.trepan.com/.>
Norris, Scott. “Inca Skull Surgeons Were ‘Highly Skilled,’ Study Finds.” National Geographic. 12 May 2008. 14 February 2011. <http://news.nationalgeographic.com/news/2008/05/080512-inca-skulls_2.html.>
Norris, Scott. “Inca Skull Surgeons Were ‘Highly Skilled,’ Study Finds.” National Geographic. 12 May 2008. 14 February 2011. <http://news.nationalgeographic.com/news/2008/05/080512-inca-skulls.html.>
Pescovitz, David. “Trepanation for dementia.” 18 June 2009. 15 February 2011. <http://boingboing.net/2009/06/18/trepanation-for-deme.html.>
Schimelpfening, Nancy. “Could Trepanation Actually Help Depression?.” 28 August 2008. 14 February 2011. <http://depression.about.com/cs/treatments/a/trepanation.htm.>