Being a former brain surgery patient, I remain fascinated by the subject. Ancient brain surgery proved to be almost too much for even me, however!  On a recent peregrination to San Diego, I happened to notice while scanning the “What to Do in San Diego” listing for the week that the San Diego Museum of Man was hosting an exhibit entitled “Skull Stories: The Art of Ancient Surgery.” Well, needless to say, this piqued my interest.  Trephination is form of brain surgery that was first practiced in very early times.  This exhibit dealt that that rudimentary brain surgery.

We viewed this exhibition on Saturday at the Museum, located in beautiful Balboa Park in downtown San Diego. Balboa Park was built for the Panama-California Exposition (1915-16) and the California-Pacific Exposition (1935-36). The grounds and these beautiful Spanish-Colonial buildings remained, forming the basis for what now makes up Balboa Park and the world famous San Diego Zoo.

The park was bustling with all sorts of activity in each of its venues. The Spreckels Organ Pavilion had an all-day Latin American dance exhibition. The Japanese tea garden next door was doing a booming business. The world-famous “Body Worlds” exhibit was currently in the city for a run. It was a beautiful sunny day and it seemed most of the city was outdoors enjoying it.

It is believed that cranial trephination first began in the Neolithic area at least 7000 years ago. The word “trephination” comes from Greek and means auger or borer. Trephination refers to an opening made by a circular saw of any type. Cranial trephination, as practiced in earliest times, was performed with primitive tools and techniques, yet it remains one of the most fascinating practices today.

The practice and procedure developed for various reasons: to cure sickness or injuries, or as a supernatural healing method. Ancient people apparently believed that it would cure ailments such as epileptic seizures, migraines, and mental disorders. Some peoples practiced it as a method to release evil spirits from an individual. Additionally, some individuals actually kept the bone that was trephined and wore it as a talisman or charm to keep evil spirits away!

The highest concentration of trephination practice appears to have taken place in Peru and Bolivia, although there is evidence it was also done in Europe, Asia, New Zealand, some PacificIslands and North America.

The “surgery” consisted of removing a piece of the skull by drilling a number of small holes in the skull or by scraping the skull with blades (or in earliest times before metal, made with a sharp-edged flint scraper or knife.) A circular or rectangular groove was made and then cut deeper and deeper until penetration of the dura mater was accomplished. (After you cut through the skull, there are three layers of “covering” protecting your brain: the dura mater, the pia mater, and the arachnoid. The dura mater is a tough, leathery covering immediately after entry into the skull itself. Once the surgeon has cut through all three of these layers, he or she is faced with the grayish-pink jello-like ooze that we call the brain.)

You can imagine some primitive “surgeon” scraping or (some several hundred or thousands of years later), “drilling” with some crude equipment into the human brain for reasons that today remain largely a mystery. Unless the patient was lucky enough to live in South America and had access to some coca leaves, there was no anesthesia; all surgery was done while the patient was fully conscious.

Drilled holes were usually roughly circular. Knife ones were usually more square. A few skulls have up to five holes, the longest of which measures two inches across.

Although the operation was performed on men, women and children, it was most often performed on adult males. Surprisingly, most patients had impressive recovery rates. As many as 2/3 of the skulls showed various degrees of healing. Considering the risks involved with brain surgery today (shock, brain swelling, infection), these are remarkable statistics.

It is hard to understand or believe that in this day and age trephination is still practiced in parts of Africa and South America. There is a man in Africa who had endured a large number of trephinations but he could only recall between 5 and 30 of them. A very large portion of his skullcap was entirely missing!

Incredibly enough, there are some fairly recent stories of people who have attempted to perform trephining on themselves. In the 1970s, Philadelphia jeweler Peter Halvorson made a T-shaped incision in his scalp, secured a power drill to his ceiling and commenced to drill his own skull! He reported it took several drill bits. I’ll leave this account right there….pretty grisly.

The second individual, an award-winning independent filmmaker named Eli Kabillio has produced a documentary, “A Hole in the Head.” There were some reports he was attempting to have PBS or HBO broadcast it, but apparently no takers yet.

Some call this thing the “ultimate in body piercing.” (As one who has a very large “piercing” across the back of my head, I just don’t understand this one at all. I’ll stick with my pierced earrings.)

If this sort of thing might interest you, this is a fascinating little exhibit at the Museum of Man in Balboa Park. Be forewarned, however, there are quite a few skulls in the exhibit, many of which have been breached in various fashion and the whole (pardon the pun) exhibit can be a little overwhelming at times.