On Trephination (or, Pierce Your Skull, You’ll Feel Better)

When I’m upset, stressed, anxious, or hung over, it goes right to my head. It’s as though there’s a tightness in my skull, like my brain wants to expand outwards in a fleshy mushroom cloud. My more pleasant fantasies involve some sort of pressure gauge with a knob I can use to vent my aching head. My less pleasant ones involve a chisel.

Trephination (or trepanation), the act of surgically piercing the skull, is an age-old practice. Its origins are sinister, dating back to the time when humans thought negative emotions and intense headaches were caused by supernatural entities. The skull was pierced to get at and free these spirits and demons, thus relieving the suffered of immoral urges. But these skull breaches were usually more akin to what we now think of as a lobotomy.


But like many formerly taboo practices, trephination was re-examined in the 20th Century. An eccentric Dutch medical student named Bart Huges claimed that humanity’s evolution into upright-walking beings caused blood flow to the brain to be significantly altered, halting the flow of enough blood into the brain for humans to attain true enlightenment. He discussed how the soft spot on the child’s skull allowed for improved blood flow within the cerebellum, but that once it sealed over it suffocated membranes, thus throwing off our “brainbloodvolume.”

Huges wanted to free his mind by creating a hole in his skull that allowed for improved bloodflow. No doctor would do it, so he got an electric drill and some anesthetic and did it himself. The result? Instantaneous relief. Of course, Huges was then committed by those who considered boring a hole in your skull to be a little, well, old-fashioned.


Huges’s concept of brainbloodvolume was not abandoned when he was sent to the nuthouse. There now exists ITAG, the International Trepanation Advocacy Group, which seeks to educate the everyday person about boring a hole through their skull. According to the group’s homepage, “The supposition here at ITAG has been that every advantage should be available to anyone choosing to retain and improve their mental functions through their life span and thus assure their fullest participation in this one certain life, for their own well being and for the well being of the entire world population.”

There’s a distinct attractiveness to trephination. The idea of one’s mind being literally fettered, and better able to function when given a porthole through which to pulsate, feels pretty organic, the kind of thing most people can agree on. If only your brain had just a little more space—a walk-in closet of sorts—then you could sort out all of this infuriating knowledge you seem stuck with like some cat you bought with a cheating love. Of course, there are risks involved—infection, disease, and of course any mishaps that may occur if one handles the goods too carelessly—but that could be said about any cosmetic procedure, and at least this one also promises enlightenment of a sort.

Here’s my worry: I take the plunge, get the punch, and nothing happens. I’m still frustrated and anxious, only now sometimes I have to spray water into the hole in my skull to keep my brain from drying out. What does it mean? Is my brain just so damaged at this point that being given a vent would in no way affect it? Or worse, maybe my life sucks, and all this enlightenement and ease I suddenly feel does is make me even more acutely aware that I’m an asshole and burden on those I love. Because drilling a hole in your skull is a pretty dramatic way to improve your life, and if you do it for nothing and everyone else feels amazing once they’re punctured, it’s got to be you, right?


That said, if you’re already entertaining the idea of trephination as a way to alleviate your psychic pain, then you’re probably already past the point of worrying about minor regrets. No great leap forward in life is achieved without risk, and a sense of existential ease is a damn fine reward for a small if life-changing puncture wound.

So here’s my vow: if a respectable surgeon, using the proper tools, begins performing trephinations in a safe medical facility, and I can afford the procedure (one doubts it would be covered by Aetna), I will undergo trephination. I know all those qualifiers really baby-proofs that vow, but if getting heavily tattooed has taught me anything, it’s that you don’t alter your body without doing it your way.

We’ll see if medical standards change in a few years. In the meantime, I’ll rely on booze and weed for holes in my head.


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