1970: 27-year old Amanda Feilding put on a white robe, cut her hair away from her forehead and calmly drilled a hole through her skull. She had been searching for four years for a qualified surgeon who would agree to perform the procedure for her. It's hardly surprising that no one wanted to do it. Finally, she decided to trepan herself.

She used a dentist's electric drill, which was operated by a foot pedal. Practicing on an old skull before drilling into her own. Dark glasses were taped to her eyes in order to keep out the blood. An incision was made with a scalpel, and the drill dipped into water in order to cool it down. That day, she lost almost a liter of blood, and "it seemed to take an amazingly long time". Unbelievably enough, she was pleased with the result. She claims, "Over the next four hours I noticed myself rising up with a feeling of elation and relaxation. I went out and had steak for supper, then I went to a party."

Later, she joined the Dutch starter of the trepanation movement Bart Hughes and her companion Joseph Mellen in an effort to spread the "benefits". She ran for British parliment twice.. advocating trepanation as part of the National Health plan to be available to every adult who wanted it.

Need it be mentioned that Feilding, Mellen, and Hughes all experimented with LSD and other drugs in their search for "enlightenment"?

Trepanation.. Magic or Medicine?

Ever since archaeologists discovered signs of historical trepanation, there has been a debate over the purpose of these holes in skulls. Biological anthropologist John Verano of Tulane University in New Orleans asks, "Was it done for medical reasons or was it something primitive, done for illogical reasons?" For many people, it's easier to believe that these "primitive savages" did it to shoo out demons rather than as actual intelligent surgery.

Through ten years of investigation and skull sampling, Verano believes that the ancient techniques of trepanation were performed as life-saving operations to remove shattered bone and pooling blood from injured skulls.

Anthropologists have unearthed nearly a thousand trepanned skulls in the Andean region of Peru. Verano examined 650 of them, and by matching improvements in surgical procedures with increases in the survival rate of patients, he has shown a clear connection between head injuries and trepanation.

The most successful trepanneres were the Incas. History of trepanation began in AD 900, but by AD 1350, they had become so experienced that trepanation became almost a form of art. Verano describes, "In some cases the surgeons' skills were very impressive. They made nice round holes and there was good long-term healing. The Incas were doing better surgery than many later surgeons in Europe".

The Anti-Trepanation Conspiracy

Modern trepanation advocates have had a major problem in their advertising to others. There is no scientific proof that trepanation has any serious beneficial result, and the scientific community seems unimpressed by the procedure’s results. Surely this would stop a person from undergoing a potentially life-threatening elective operation… unless there was some sort of conspiracy behind it! Alas, several trepanation websites have pages or sections claiming that the medical community rejects trepanation as a legitimate medical procedure because of a massive conspiracy. As Trepanationguide.com says, “[Doctors] fear that to practice trepanation would demean their professional status.” ITAG repeats the mantra by saying, “[Doctors] can't deviate from the accepted standards without getting a lot of flak. There have been no studies on the effect of trepanation in humans conducted by universities or hospitals in the so-called western world.” This would seem perfectly logical, but we live in an age where countless medical treatments considered to be superstitious or just plain illogical are now being tested legitimately by the scientific community.

In the End - You're Psycho!

The onslaught of Peter Halvorson's website ITAG, the International Trepanning Advocacy Group, its message that trepanation, an unorthodox medical practice, truly has medical value, sparked controversy from doctors across the board. Whenever a novel procedure especially with inconclusive studies and research that claims it can benefit the patient in some way surfaces, people become skeptical of it. Ray Ybarra's testimony (see The Secret Life of ... Ray Ybarra) tries to mention some of the positive benefits of trepanation seemed to be reiterated throughout ITAG's website.

Indeed, skeptics soon began to criticize the theory proposed on Halvorson's ITAG website. Numerous doctors openly derided Halvorson's conclusions, deeming they were premature or pseudoscience. Dr. William Landau, the head of neurology department at Washington University in St. Louis, commented in The Hole Story that "there is no scientific basis for this at all. It's quackery." The doctor worked with neurological department since the 1950s, and in all his experiences, repudiates the benefits of trepanation.

Another doctor also commented in the Hole Story. Dr. Robert Daroff's comments were quite direct and colloquial: "Horseshit...Absolute, unequivocal bullshit." Dr. Daroff too has an authoritative position in neurology. According to his biography, he is the Interim Vice Dean for Education and Academic Affairs, and Professor of Neurology, at the Case Western Reserve University School of Medicine. Perhaps, more impressive is that he is also is the president of the American Neurological Association and president of the American Headache Society and still used such blatant language to describe trepanation.

There are a few people would find trepanation as a miracle that cured a condition. For most however, it seems to be illogical or at most a placebo effect. In the end, the overwhelming criticism against trepanning may be the reason why trepanation is not as common as plastic surgery and the like.

Tools of the Trade

Though based on today's standards, the equipment used to perform trepanation seems to be simplistic and dated in regards to modern surgical tools. After some intricate surgeries we hear of today such as bypass surgery and laser eye treatments, one could barely believe that trepanation only takes a handful of equipment, most of which can be easily attained from a hardware store. With a drill (a power drill will do fine), drill bits, a scalpel, and a small brush are adequate to perform such a procedure. According to Amazon.com, the entire supplies listed would total about $100. Not bad considering that even surgery covered by insurance nowadays cost over $1000. It is no wonder then that some people took advantage of a really inexpensive procedure believed to improve the function of the brain.

Englishman Joseph Mellen was one such man performing this procedure on himself. In his book Bore Hole, he writes, "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!" Mellen used a mirror and bored a hole into his skull with a drill. The sensation depicted is hard to imagine, and the fact that he could bare the image of himself with a drill in his head in truly astonishing. Even more amazing is that Mellen must have performed one of the few self-surgeries in the history of the world that can be considered an absolute success.

Peter Halvorson's Story

In a small room in Holland in 1972, a man by the name of Peter Halvorson took a scalpel, four drill bits, and an electric power drill [which was controlled by his foot] to his head. For one reason or another, he hoped that this self-inflicted incision in his skull would alleviate his depression. Today, he carries a dent on his forehead that measures three-eighths of an inch wide.

Halvorson bolsters his pro-trepanation argument with various medical terms such as "pulsation", "cerebral metabolism", and "brainbloodvolume". Never mind that that last term was coined by a "Doctor" Hughes who coincidentally, also managed to fail his doctorate exams twice.

Halvorson also claims that this procedure gave him "more energy, more focus, more drive". Now, he presides over the International Trepanation Advocacy Group [ITAG] which vouches for further medical research into the supposed "benefits" of trepanation.

The Doctor Speaks for Himself

The famous interview of self-trepanner Dr. Bart Hughes, questioned by Joe Mellen, offers some interesting enlightenment of Hughes' mind.

According to Hughes, at age eleven, he had twenty-five girlfriends, fifty snakes, lizards, toads, frogs, newts, etc. By the time he was eighteen, he had three hundred and eighty-five of the said reptiles. First sign of a rather quirky individual?

Upon leaving school, Hughes started on his medical studies. As a child, he wanted to study biology. As he grew older, that idea narrowed down to a specialization in psychiatry and psychoanalysis. In 1962, he took the main part of the doctorate exam [psychiatry, neurology, and pharmacology] and passed. The second part, [obstetrics and surgery] he failed twice.

During this time of study, Hughes experimented with various drugs--mainly LSD. He recalls visions of devils, pigs, and chimpanzees; despite the fear that came with these visual distortions, he enjoyed the experience. Upon failing his doctorate exam, he took a vacation to Ibiza to experiment with pot. He claims that all the books he had read told him that pot was a non-toxic substance. Naturally, he smoked as much as he could. It is during these moments of "high" that he reached his "epiphany" that the key to permanent euphoria was a hole in his head.

He tried in vain for two years to find a doctor who would perform the operation on him, and in the end, took a drill to his own head. Surgery complete, he began to preach his ideology and now enourages every adult to consider drilling a hole in his or her head.

Is this man a true prophet of alternative medicine? Or his he simply a deluded man whose mind was further exacerbated by the use of drugs? Decide for yourselves.

The Secret to the Life of ... Ray Ybarra

Scandals have always intrigued someone in this world. Consider that every absurd infomercial on television have at least one customer. Likewise, people like our friend Ray Ybarra belong to this elite group of gullible people.

Ray Ybarra, a resident of Anthony, New Mexico (near El Paso, TX), had a severe case on insomnia, a case of horrible nightmares, and overall lack of pleasure in his life. He turned to trepanation as a treatment for his problems. He wrote on the ITAG's website:
"I can, however, attest to some heavy-duty insomnia for the last 20+ yrs. My interest in trepanation is not so much what it can do for my insomnia, but about the fabulous other things I've heard it can do."

The man writes about the myths he heard about trepanation, myths that he accepted to be true. He claimed it could reverse the effects on insomnia and eliminate his nightmares. According to WebMD, insomnia is a difficulty falling asleep or staying asleep. The website suggested that the cause may be from other prevalent conditions depression and anxiety. Likewise, simple lifestyle changes such as the amount of time devoted to sleep or increasing activity during the day can also solve the problem. If worse comes to worse, there are clinically proven prescription drugs to induce sleep. Notice however, trepanation is not exactly one of those suggested treatments.

Mind all the effective treatments of insomnia, Ray Ybarra chose trepanation because of myths he heard from the ITAG website. He recalls that trepanning himself would "maybe even [cause] some mystic qualities [to] arise from what lies dormant in the tightly sealed vastness of my brain (just a little drama there folks). I do remember back to the age of fourteen and to the dreams I had then as a kid. I always thought nothing could stop me. I still believe that I'm unstoppable and in all honesty my life has been telling me something else. So I want to be trepanned to regain my youthful vitality and optimism." His intent is very charming, an excellent plot for a movie- a 40-year-old man trying to regain his childhood. Unfortunately, this is not a movie nor will it ever be because it is downright obscure.

Ybarra concludes his short testimony by desperately calling out to the internet community for two more volunteers for the procedure. The clinic in Mexico only schedules trepanations for groups of four or more.

More Confusion about Cerebrospinal Fluid

The Frequently Asked Question page of the International Trepanation Advocacy group has even more to say on the topic of the relation of changes in cerebrospinal fluid to mental wellness. Their explanation leaves much to be explained. Essentially, ITAG claims that as a person ages, cerebrospinal fluid (which they refer to as “brain water” on this web site) circulates less, resulting in decreased brain function. One paragraph in particular discusses “excess, stagnant, toxic brain water” as the reason why trepanation is an effective medical procedure. Every one of these words is somewhat misleading. There is no such thing as excess CSF in the average individual. To make a case otherwise, ITAG refers to a study about the draining of CSF in Alzheimer’s sufferers. This study however, was run by the company making the device, and concluded that there was no firm evidence that there was any change from the control group. Additionally, CSF is not stagnant at all; the body circulates new CSF several times a day!
What does all this have to do with increased well-being? There is no evidence to support ITAG’s theories. In fact, the author of the FAQ page even states, “I haven't had much luck in getting the doctors I know to think beyond endorphins to the lowering of the CSF volume as being the root of [a mental high].” This makes the reader wonder why the author of the article, who has no medical school experience, should know more about the topic than multiple doctors.

Trepanning in Antiquity

"Of these modes of fracture, the following require trepanning: the contusion, whether the bone be laid bare or not; and the fissure, whether apparent or not. And if, when an indentation (hedra) by a weapon takes place in a bone it be attended with fracture and contusion, and even if contusion alone, without fracture, be combined with the indentation, it requires trepanning. A bone depressed from position rarely requires trepanning; and those which are most pressed and broken require trepanning the least; neither does an indentation (hedra) without fracture and contusion require trepanning; nor does a notch, provided it is large and wide; for a notch and a hedra are the same."

Above is an excerpt from Hippocrates’s medical journal, "On the Injuries of the Head", detailing the procedure in treating an injury to the head. Dated at approximately 400 BC, the entire document describes the cranium, as Hippocrates called the head, its structure, inner workings, and susceptibility to injury. It is no surprise however that the Greek culture was intrigued by trepanation, a relatively ancient procedure well before the Greeks. Many Stone Age civilizations have already performed the surgery on their people all for different reasons, whether medicinal or ritual.

Back in classical times, the trepanation was used as a treatment to a head injury. Hippocrates is very specific on the injury, one from a club. And such injury would require trepanning, even if the skull was not fractured. As long as there is a noticeable indentation n the head then the victim should have a trepanation. Likewise Hippocrates logs a certain number of situations that are not severe enough to be treated in this manner. An indentation, also called a hedra, does not necessary have to be treated by trepanning. Another important discernment that Hippocrates points out is that the skull has strong points and weak points. Depending on the location of the injury to the skull and the size of the area, trepanation may or may not be necessary. Though today trepanation seems absurd and unreasonable, the practice was quite catholic in its usage to treat head wounds.

Trepanation as a Cure for Mental Disorders

According to ITAG, trepanation restores the brainbloodvolume (always written as one word and abbreviated as BBV) of the subject back to childhood levels. This, according to “experts” allows the Freudian ego to return to the state at which it was originally “installed.” The return of BBV to childhood levels then can help those suffering from depression or even schizophrenia. Mr. Haverson, the director of ITAG concludes that trepanation would have a beneficial effect on anybody, but psychotics would see the largest difference.

Not surprisingly, Mr. Haverson arrives at his conclusion because of a few misunderstandings. Trepanation advocates measure brainbloodvolume (the amount of blood in the brain’s capillaries) by the amount of cerebrospinal fluid (CSF) pushed out of the brain. This is where Mr. Haverson’s confusion begins. CSF does not regulate the amount of blood in the capillaries; it cushions the brain and spinal cord inside their respective bony shells. The relationship between CSF and mental disorders is not one of the cerebrospinal fluid volume or pressure. Doctors often take CSF samples in order to diagnose neurological problems, but the samples are used to determine the concentrations of cells, glucose and protein. These tests are also generally used to diagnose infections, not chemical imbalances like depression. True, there have been studies, linking chemical changes in CSF to autism. But even in this case, trepanation would still prove unhelpful, because a hole in the head could not change the cerebrospinal fluid’s chemical composition. That, of course, does not include a possible chemical change brought on by a trepanation-related infection.

The Stone Operation

A 16th century painting by Hieronymous Bosch titled “The Stone Operation” lends some insight into the cultural significance of trepanation. In it, a gray-haired man is strapped to a chair, with a practitioner of trepanation making an incision and removing something from a hole in the man’s skull. The surgeon has a funnel on his head, which symbolizes a gap in wisdom. The doctor seems to be removing what is either a stone or a tulip, which both represent ignorance. The caption of this painting has been translated as “Master, dig out the stones of folly, my name is ‘castrated daschund’”.

Another way to interpret this painting claims that trepanation did not actually exist, but rather, that it was a result of medical and spiritual folklore. In this case, the funnel symbolizes lack of knowledge in the medical community and the “outdated” belief in religion. The object being removed is now a lotus, which symbolizes the human spirit. Putting all these together gives “an elderly man involuntarily tied to the chair while the medical and religious figures collude to take away his spirit."