David McRaney  |  Journalist

Drive-Through Enlightenment

This is the general idea: Drill a small hole into your skull and you’ll become more than human.

Provide an expansion window causing the brain's capillaries to expand and you’ll transcend, well, everything.

This expansion will allow a greater volume of blood, thanks to the released pressure within the skull, to flow in and around the brain. Once the hole has been cut, the blood volume supposedly increases while the cerebrospinal volume decreases, a state advocates claim increases contact between capillaries and the brain, resulting in a more efficient mind.

Like late night infomercials touting pills promising to make an individual skinny and beautiful with no exercise, trepanation, the removal of a small medallion of skull bone, seems to offer a quick and easy path toward transcending the flesh, a cure-all for the individual seeking drive-through enlightenment.

Believers say once trepanned, an individual feels an increase of energy, well-being and intellect. The idea is rooted in the fact that at a certain point in childhood, the skull permanently seals, and the brain's pulsation levels and metabolism of youth change to those of an adult.

Though some may think there is a definitive purpose to the human skull sealing itself off, most trepanners would agree this is an undesirable state.

A trepanned individual supposedly feels childlike and dynamic because they’ve returned the form of the child.

It is important to note trepanation is not synonymous with lobotomy, a purely medical procedure affecting the brain itself. Trepanning does not involve any direct contact with brain matter or the meninges surrounding it. Only the skull is affected by the trepanner's drill, and all side effects of this procedure can only be attributed to the supposed release of pressure inside the skull. No actual brain surgery is taking place in the case of trepanation.

The human mind is a complicated thing to own, manage, and maintain. As a generator of thoughts and likely seat of consciousness, the brain is one of the last mysterious universe of theories and conjecture left to science. Only the brain, and its yet to be understood connection to self and thought, can produce this much lamentation among neurologists and psychologists, biologists and physicists, philosophers and theologians, washed out hippies and heads of state.

There is a certain portion of human society who believes the right kind of home surgery could enhance the mysterious electro-chemical process that has produced literature, art, genocide, global warming and Gallagher. With so many opportunities for betterment, it seems only natural people will eventually seek to enhance the three-pound universes in their skulls.

This is why there are nice people, people with nice houses and college degrees, who are willingly having holes drilled into their skull, in what amounts to back alley operating rooms, based on a handful of evidence suggesting this procedure will result in their enhanced mental functioning.

The practice of trepanation, also called trephination or trepanning, may date back as far as 12,000 years. Evidence suggests the practice was used as a sound treatment for people who had suffered severe head trauma and were in danger of dying from internal bleeding. Over 2,000 skulls from around the world have been discovered with evidence of ancient trepanning, and a great deal of those come from Peru where blunt force trauma to the skull was a common result of combat.

The Peruvian skulls, dating back 2,400 years, show a survival rate of around 70 percent, and it is theorized the early Peruvians also used a variety of techniques and pharmaceuticals that are as yet undetermined.

What is unclear is exactly how these ancient people came to realize boring a hole into the skull of someone bleeding internally would relieve pressure there and save his or her life.

Researchers point out trepanning was likely to have been used to treat mental illnesses, headaches and epilepsy. The Kisii tribe in Kenya still performs trepanation to relieve chronic headaches and severe head injuries, though they look to such operations as a last resort. Based on the archaeological evidence, most people survived the procedure, but many did eventually die from some sort of infection.

The seductive notion this is an ancient forgotten procedure only a select few understand is one of the most important canons of the modern trepanner. As noted by a recent article in Paediatric and Perinatal Epidemiology, trepanation is considered the oldest surgical procedure for which there is objective evidence. The act has been practiced on every continent as far back as the Neolithic Age, when primitive people used to scrape away at the skull with instruments of flint.

The purpose of trepanation among ancient cultures may have been to allow demons or similar beings to escape from the skulls of those who were plagued by mental disorders, and judging from the growth patterns around the holes in ancient trepanned skulls, those people who did undergo this procedure not only survived, but underwent several trepanations afterward, possible lending credit to the benefits of such a practice.

For those who look to the widespread and prolific nature of the procedure for thousands of years as an indicator of its viability, it may behoove them to consider the popularity of lobotomy in the early part of the twentieth century.

Walter Freeman and James Watts introduced frontal lobe lobotomy in 1936 as a way of calming down schizophrenics and making them normal. Many methods became popular, but the one preferred by Freeman was stirring the brain via an ice pick hammered in through the eye socket.

By 1949, over 5,000 lobotomies were performed a year and Moniz, the doctor responsible for inventing the practice, won the Nobel Prize in Medicine for inventing a technique which, only few years later, would be considered unnecessary and barbaric.

Trepanation doesn’t even have the slightest backing of the scientific and medical community as frontal lobotomy, a surgical procedure now obsolete, once had.

The predominant argument for the benefits of trepanation come from those who believe what they are doing has documented medical and scientific benefits.

Another aspect of this predicament, known as the placebo effect, must also be taken into account. The placebo effect is a powerful psychological reaction to the promise of a result; if a person thinks something is going to make them feel a certain way, they often do. Until recently, is was not known exactly what was happening in the brain when a person experienced the placebo effect, but in a recent study at the University of Michigan and at Princeton, researchers have used brain imaging on students who believed they were getting a pain reducing cream after receiving electric shocks.

After applying the cream, many of the subjects reported the pain was being relieved. Though the cream was just a placebo, their thalamus, somatosensory cortex, and other parts of the cerebral cortex showed decreases in activity, just as if they had received a drug that would affect those pain-sensing areas.

This study shows instead of blocking the pain, placebos affect how the brain interprets the signal. Researchers suggest doctors be positive when administering drugs to patients. If a patient receives a good treatment and positive expectations of how the medication will affect them beforehand, then the medication or procedure will be more effective.

The implications of the placebo effect in trepanation could thus be inferred as having a tremendous role in the overall effect an individual believes it has on his or her mind. If people who are receiving trepanation are repeatedly told about the positive effects of the procedure, and they want it to work, then it is feasible the placebo effect could be a major factor, if not the only factor, in the reported sense of well-being and more acute thought processes.

The resurgence of trepanation in modern times can most likely be attributed to immediate access of pseudoscientific information on the internet and the diligent campaigning of a certain Bart Huges.

In the 1960’s, Bart Huges, who had no medical training and worked as a librarian, claimed blood brain volume could be significantly and permanently increased by trepanation, and a state of constant bliss with accelerated thought would be achieved via the greater flow of blood into the skull.

In 1962, Huges trepanned himself and began proselytizing to the world of the benefits he had reaped from his research and subsequent operation, eventually receiving enough publicity to have John Lennon announce he was considering getting trepanned.

One of his many converts at the time was Peter Halvorson, a jeweler from Pennsylvania, who met Huges in the Netherlands and underwent the surgery. Thanks to his reintroduction of the process in 1997 via the website www.trepan.com, Halvorson has brought back the subversive crusade for trepanation, and the number of people giving it a try is increasing.

According to Robert Heary, the vice president of the American Association of Neurological Surgeons, the assertions of trepanners is “bullshit,” and the arguments of all these advocates should be proven before the procedure is given any further medical consideration.

Trepanners hold themselves up as the kind of people without fear or reservation, willing to do whatever it takes to reach a higher level of mind.

It seems the type of person interested in this kind of thing would have had to tried alternatives like meditation, psychotherapy and mind altering drugs before resorting to trepanation. Scientists often point to biofeedback, meditation, and enriched mental environments, all of which can positively alter the brain.

The brain is thought to be quite plastic, and can be remodeled at any time without drugs or surgery. In fact, neuroscience has been turned on its ear in recent years by all the research revealing how an adult brain can form new synapses and even new neurons.

If a person is placed in a complex environment and given plenty of mental exercise, the brain will create complicated synaptic connections that give rise to enhanced memory and motor coordination. The intriguing aspect of plasticity is not only are new synapses formed, but the brain also develops more astrocytes, the brain cells that connect neurons to capillaries and clean away debris, and new blood vessels to these growing areas of the brain.

Simply exerting a person’s mind can enhance both blood flow and mental acuteness.  It seems trepanners are simply uninterested in this information, and are in some ways at the end of their rope and desperate for anything to change their lives. Despite its drastic and invasive nature, trepanation can be seen in this light as a lazy and naďve approach to mental health.

The most damaging evidence against trepanation comes from a recent study by neurosurgeons in India and Turkey. They sought to discover whether or not blood flow to the brain improved in head trauma patients who underwent cranioplasty.

Cranioplasty is a procedure in which a person who is missing a part of their skull due to injury has it replaced, often by a prosthetic, and the skull itself may be reshaped to appear normal.

According to the results, once the skull was put back together and sealed, cerebral blood flow increased. Though none of the patients in the study completely recovered, most of them reported a drastically improved mental state after the procedure.

One proposed explanation for this increase in blood flow and mental functioning was the cerebral hemodynamics, the balance of blood pressure and cerebrospinal fluid, had been restored. Craniectomy, removal of part of the skull, results in diminished pressure and blood flow. This information has huge implications for those who suggest cutting a hole in the head will make a person smarter, happier and more aware of their surroundings. Clearly, neuroscience disagrees with this proposition, and the evidence offered by the cranioplasty study disputes the claims of trepanation. The final conclusion of the cranioplasty study stated, “Neurological improvement after cranioplasty can be explained by improvement of cerebral hemodynamics,” a statement that goes against the basic tenet of the modern trepanner.

Perhaps the only way to truly know what is happening with trepanners would be to put them under an MRI during the procedure, but this is highly unlikely. Trepanation has a foothold in that area of human exploration where science is not willing to waste its time.

People who are convinced neuroscience and modern medicine have it all wrong will continue to seek out people willing to knock a hole in there head. These individuals neglect to realize consciousness might just be a singularity in the universe, or a happy accident of evolution.

Maybe when the conditions are just right and the nervous system of an animal develops in just a certain way, a being that has a strange hyper-connected mass of neurons in their head somehow generates a mind, whatever that is. An animal, possessing such a strange consequence of natural selection, living amongst other animals that do not possess such an anomaly, would likely develop many ways to manage such a burden.

In humanity’s case, there is religion, spirituality, science, politics and philosophy, all of which have progressed with the understanding of what it means to be unique, to have a consciousness, to be human. Throughout Homo Sapiens’ incredible history, people have stumbled time and again in an attempt to wrestle with the combination of animal and intellect.

Medicine has floundered until the last few hundred years, and in that time the concept of the brain and the mind has shifted all around the scientific community. Unfortunately, psuedoscience has trickled down into the community at large, and many unsubstantiated claims are bouncing around.

As the knowledge of humankind increases, the methods of treatment naturally follow. Not long ago cocaine was an ingredient in children’s toothache medicine, schizophrenics were routinely lobotomized, and nicotine filled enemas were all the rage.

Trepanners attempt to rewrite science in order to have it match their beliefs. Yet, they shun those who have devoted their life to the study of the brain if they oppose their ideals. This is a dangerous standpoint to have academically, even more dangerous when at the business end of bone drill headed for the forehead.