You Need It Like . . .

. . . a Hole in the Head?



By Michael Colton

Washington Post Staff Writer

Sunday, May 31, 1998



Halvorson on his trepanation: "There was a warm feeling as my metabolism cranked up a bit." (M. Williamson/TWP)

WERNERSVILLE, Pa. Peter Halvorson's bald, freckled scalp glistens in the warm afternoon sun, and from certain angles you don't even notice the dent. It's just above his forehead, near where the hairline would be if Halvorson still had a hairline. The skin around the small indentation brightly reflects the sunlight, while the middle remains dark, in shadow. Peter Halvorson has a hole in his head. It's three-eighths of an inch wide, though it may have expanded slightly since 1972, when, in a small room in Holland, he used an injection of anesthetic, a scalpel, four drill bits and an electric power drill controlled by his foot to make the hole. He was suffering from depression and decided this would bring him happiness. Permanently. And on this day, Halvorson seems quite happy. Ignoring hordes of gnats, he circles the firs, pines and spruces on his 40-acre tree farm with his groundhog-chasing dogs, Duke and Dodger, and his friend Tom Wargo, who's a little envious of Halvorson. Wargo wants a hole in his head, too. He wants to undergo trepanation  an ancient procedure that involves geysers of blood and the removal of a chunk of one's skull. The skin heals, but it leaves a visible depression on one's dome. Most people find the very idea horrific, and doctors say you'd have to be nuts to do it. But Halvorson and Wargo appear entirely rational. Sane, you might even say. They talk about the procedure when they get together here to play volleyball or have cookouts. Wargo, 39, drinks beer and smokes cigarettes to unwind, but Halvorson, 51, sipping a soda, is naturally serene and affable. His voice rarely rises above a soft hum. Even faced with the acid wrath of Howard Stern while promoting trepanation on the radio last month, Halvorson was cool, collected, unfazed by insults. Wargo wishes he could be this way: "Bright, energetic, stable" is how he describes his friend. Halvorson, a diamond setter by trade, met Wargo nearly a decade ago, supplying jewelry to a shop Wargo ran. In this part of largely rural southeastern Pennsylvania, they found a common cause in trepanation. Halvorson, who advises against self-trepanation, is helping Wargo find a doctor who will open his skull. "Some people look at it as just drilling a hole in the head," says Wargo, who now runs an Internet service company. "I look at it as removing a piece of skull from the head to correct something that went wrong in nature." Halvorson expounds at length on his belief in the medical basis of the procedure  talking about pulsation, cerebral metabolism and something he calls "brainbloodvolume." Trepanation, or trephination, gave him more energy, more focus, more drive, he says. It supposedly returned to him the buoyancy he possessed as a child, though he has no objective proof. (Well, he says doctors told him his testosterone level approximates that of a man in his twenties.) He estimates there are several dozen others who agree with him  all with their own holes  scattered about the globe. And there are many others like Wargo who want to join the holier-than-thou club. Halvorson presides over the International Trepanation Advocacy Group, formed last fall to provide information on the Internet, and calling for medical research into a subject that even Halvorson admits is a little creepy. "The more I heard, the less enthusiastic I was about the idea," Halvorson says of his initial encounter with trepanation during his years as a yoga-practicing college dropout, traveling through Europe in the early '70s. But like other seekers of the era, who sought nirvana in gurus or drugs, he became convinced of a quick fix. Trepanation can hardly be called a trend. Halvorson is, as far as he knows, the only person in America to have performed the procedure for the purpose of enlightenment. (The others reside mainly in Europe, including  small world  a former teacher of President Clinton during his Oxford days.) It's an old idea, as are today's more fashionable and superficial expressions of primitivism  tattoos, body-piercing and scarification. At the intersection of age-old and New Age healing, trepanners think they've found a simple solution to modern problems  namely, how to combat the depression and lethargy that come packaged with adulthood. Like the trepanners of centuries past, Halvorson and the others are, in a manner of speaking, trying to let the demons out of their head. Being Made Hole Paul McCartney, in a 1986 interview in Musician magazine, recalls John Lennon asking him and his wife, Linda, "You fancy getting the trepanning done?" They didn't. This was about 30 years ago, when the Beatles and millions of other young people were searching for ways to heighten perception by doing drugs  or "psychovitamins," as one trepanned woman refers to LSD, marijuana and the like. Some of them claimed to have found a "permanent high" through trepanation, more subtle than drugs, more gratifying and less dangerous. (Halvorson, for one, hasn't done drugs in years.) The procedure itself, though, predates the '60s by about seven millenniums. The word "trepan" comes from the Greek trypanon, meaning "a borer." According to John Verano, a professor of anthropology at Tulane University, trepanation is considered the oldest surgical practice, still performed medically worldwide and ceremonially by some African tribes today. Recently, a trepanned skull found in France was estimated to be about 7,000 years old. "In Europe in particular, there has long been an association of trepanation with the liberation of evil spirits  that comes from ideas in medieval Europe," says Verano, one of the country's foremost scholars on the subject. Medieval painters such as Hieronymous Bosch depicted trepanation  though Bosch's "The Operation for the Stone (The Cure of Folly)" seemed to be the artist's commentary on quackery. Trepanned skulls are frequently excavated by archaeologists, and many have several holes  often several centimeters wide  indicating that the trepanation was successful and the patient survived. Superstition was not the only reason for trepanations; it was also performed to relieve pressure on the brain caused by injuries. Hippocrates endorsed trepanations for light head wounds. Some experts also believe that the procedure was intended to cure ailments from headaches to epilepsy to insanity. Medical trepanations are still done today, to relieve pressure on the brain, but the bone is usually replaced. The father of the modern trepanation movement is a Dutch librarian named Bart Huges, considered a genius by his followers and featured in a new documentary, "A Hole in the Head." He came close to being Dr. Bart Huges, he says in the film, but Amsterdam University refused to give him his medical degree because of his advocacy of marijuana use. Huges still lives in Amsterdam and works as a research librarian, but he is phoneless, according to Joe Mellen, a friend and fellow trepanned person. "He doesn't like communicating," says Mellen. "He's had enough of silly reporters writing silly articles about trepanning." Fueled by experiments with LSD and other drugs, Huges concluded in 1962 that consciousness is related to the volume of blood in the brain, or what he called "brainbloodvolume." Hoping to increase his brain pulsation and blood volume, he trepanned himself and preached the benefits to others around Europe. He wrote a book: "Trepanation: The Cure for Psychosis." According to Huges, gravity and age conspire to rob adults of the creativity and energy that a child possesses. A baby's skull has a fontanel  the "soft spot"  that allows the brain to pulsate with great amplitude. One can actually see the fontanel rising and falling with the heartbeat. By adulthood, a person's skull has hardened, and the brain is denied an elastic surface in which to expand. Pulsation decreases, and as we grow, gravity saps more blood from the head. Trepanation, the theory goes, reverses this loss of blood volume and provides a feeling like one gets from standing on one's head for 10 minutes, or from sustained aerobic activity. (Or, as Tom Wargo believes and hopes, like the feeling one gets after a couple of beers: "You're not drunk, but you feel relaxed and notice things better.") In 1965 in Ibiza, off the coast of Spain, Huges met Mellen, now a London publisher and art dealer, who subsequently made several bloody, botched attempts to open his own skull. Mellen had dropped out of Oxford and forsaken a stockbroking path, and was drifting around Europe, writing poetry and reading Aldous Huxley's "Doors of Perception." He traded cigarettes and whiskey for marijuana and mescaline, searching for better ways of escape from his biological shackles. "I thought that life as an adult was rather flat, dull and uphill," he says. In short, Mellen wanted to expand his mind, and Huges showed him a way to do it literally. Huges and Mellen delivered their offbeat ideas to the swinging circles in '60s London; they spoke to a skeptical press, initiated a small but determined movement and helped launch some uniquely hippie artwork. Julie Felix, a popular folk singer, recorded some songs Mellen had written, including "Brainbloodvolume" and "The Great Brain Robbery." Heathcote Williams wrote an award-winning, gibberish-filled play, "AC/DC," that climaxed with a trepanation: "Clean up all your bad vibrations. Letting the spirits out of the hole, that was the Greek version of it. . . . Eight orifices in your head now. Get you responding to undiscovered electromagnetic fields. . . . Your brain's got an erection." Mellen's own trepanation experience was messy, to put it mildly, as recounted in his book "Bore Hole." He began with a hand trepan, like a corkscrew with a ring of teeth. After making an incision (and fortified by a dose of LSD), he was unable to drive the spike into his bone by himself; he described it as "like trying to uncork a bottle from the inside." Several attempts followed and finally, weeks later, Mellen succeeded with an electric surgical drill. Adrenaline in the anesthetic helped minimize blood loss, but it still gushed forth when he finally broke through the bone. He started to notice effects a few hours later. "It's not really a 'high,' " he says now from London. "You feel more energy, and less self-consciousness." His companion, Amanda Feilding  a former lover of Huges as well  performed her own trepanation soon after. Mellen filmed it. The result, "Heartbeat in the Brain," is both captivating and nauseating. Wearing a blood-spattered white robe, she cuts open her head and drills a hole, then wraps her dome in a bandage and dabs the blood off her face while she stares wide-eyed into a mirror with an eerie, beautiful smile. The film, intercut with flying scenes of Feilding's pet pigeon, Birdie, is extremely difficult to find, but it counts director Bernardo Bertolucci as one of its fans. Feilding, another Oxford dropout, was drawn to trepanation from the study of comparative religion. "It was all fairly unsatisfactory," she says from her farm in Gloucestershire, England. "I never found the explanations I was looking for." After four years of trying to find a doctor to trepan her, she decided she would do it to herself while also making an artistic statement. "I was trained as a sculptor, so I thought, 'I spend all my time making holes in objects, I might as well make one in my own head.' " Like Mellen, she first noticed a change about four hours later. Wearing a bandage and turban, she had gone to "a fancy-dress party for some journalist," and experienced "a lifting upwards, like the tide coming in, and at the same time a feeling of relaxation and silence in the head, a peace, a stopping of that voice in the head. "You remain the same personality, with the same hangups, character defects, et cetera, et cetera," she says. "But we all have our neurotic bag we carry around. I think trepanation, by increasing the brainbloodvolume, it lessens that bag." Under the banner of "Trepanation for the National Health," Feilding ran for Parliament in the late '70s. She didn't expect to win (she didn't), but in two elections, she convinced 188 voters that professional trepanation should be available to anyone who wants it. Feilding and Mellen eventually split up, but they had two sons together, ages 13 and 19. Neither has an interest in getting trepanned. "They are slightly embarrassed by the whole thing," says Feilding. "They think, 'God, why can't we have an ordinary mom?' " Mellen married recently, and his wife, Jenny, says she decided to undergo the procedure after noticing her husband's youthful vitality. (Mellen is 58; she is 32.) The surgery was performed by a friend, and she described the result in a 1995 article for the London Independent: "It was as though for years I'd been a puppet with my head hung down, and now the puppeteer had taken hold of my head string and was gently pulling it up again." Feilding also married after her breakup with Mellen, to Lord James Neidpath, a real estate agent and former professor at Oxford, where he taught international relations to a "reasonable guy" named Bill Clinton. Neidpath is not as effusive about trepanation as Feilding; he decided to get a hole in his skull simply because, he says, "my wife had been trepanned already, and she spoke very highly of it." The couple traveled to Cairo two years ago to find a surgeon willing to cut open Neidpath's head, for about $2,000. Within a few hours Neidpath says he felt the effects. "It seemed to be very beneficial." Going With the Flow Peter Halvorson is a busy man, with his jewelry business, his farm and his Web site. The depression that plagued him in his twenties is gone  it left shortly after the drill touched bone. "I dropped out of college, yet I made it because of my energy and enthusiasm," he says. "It's as if the resources of life are always there, like fruit to pick." He drifted after dropping out of the University of Cincinnati in 1968, ending up a disciple of Bart Huges in Amsterdam. Huges recommended he find a doctor to do the operation. Halvorson couldn't find one, but learned the procedure from a plastic surgeon sympathetic to the cause. He made sure to use a drill that would stop cutting once it hit membrane, so he could avoid damaging his brain. "I could hear a gurgling, and I could feel the shifting of volume in the brain water," he says of the moment he broke through the bone. "There was a warm feeling as my metabolism cranked up a bit." Halvorson is fond of talking about biology, but much of what he says is conjecture and opinion, even as he whips out medical journals and neurological textbooks and skulls borrowed from a Philadelphia museum to make his points. In 10 percent of adults, he believes, the intracranial seams that we all have as children do not heal. Those people, who have natural openings in their skulls, already have an increased metabolism and the increased awareness that trepanned people possess. John Lennon was in this 10 percent, he believes, so a trepanation would have been redundant. Doctors, too. "I consider the medical profession an old boys' club of people with positive pulse pressure, because they have the energy required to get through an extensive education," Halvorson says. "Their metabolism is active beyond the norm." Halvorson's wife died in March, a victim of multiple sclerosis. He had asked her doctor to trepan her, but the physician refused. Halvorson, extrapolating from Huges's theory, believed a trepanation would have increased her blood volume, giving "her brain cells a chance to heal." The response of the medical and scientific community to these theories is succinct. "This is nonsense," says Ayub Ommaya, a professor of neurosurgery at George Washington University and the former chief of neurosurgery at the National Institutes of Health. The risks of the procedure  including blood clots, brain injuries and infections leading to meningitis or death  far outweigh any unproven benefits, he says. According to several doctors and scientists, blood flow  not blood volume  is related to brain function. The removal of bone from the skull might help increase blood flow in a diseased or damaged brain, but in a normal brain, a trepanation would do nothing. "There is no reason to believe drilling a hole in the head will increase blood flow to the brain," says J. Bob Blacklock, an associate professor of neurosurgery at Baylor College of Medicine in Houston. But even if increased blood flow were attainable, brain function would not increase, says Louis Sokoloff, the chief of the Laboratory of Cerebral Metabolism at the National Institute of Mental Health. Brain function decreases with age, he says, and an increase in metabolism as a result of increased blood flow, even if that were possible, would not reverse the process. "It's like a broken clock," he says. "Moving the pendulum back and forth doesn't make it keep time any better." If the trepanned folks do feel changes, says Ommaya, it is probably the result of a placebo effect. "Anything given with a powerful message might work for someone eager to believe in it," he says. So the holes in the heads might make them feel good after all  but not for the reason they think. He Knows the Drill Facing a skeptical medical community, those who want to be trepanned have to search elsewhere. Few are willing to try self-trepanation, as Huges, Mellen, Feilding and Halvorson did long ago. "I always discourage people from getting trepanned, because it's such a headache," says Feilding, with inadvertent irony. The producers of "A Hole in the Head" plan a sequel, "Another Hole in the Head," which would follow four wannabe trepanners, including Tom Wargo, from pre- to post-operation. Halvorson says "it's no more exacting a procedure than having a tooth pulled." Last month Halvorson and Wargo appeared on Howard Stern's radio program, perhaps the media outlet where they would be ensured the most ridicule. Halvorson tried to explain complicated biological processes, but Stern called him "insane" and said, "I thought Jews for Jesus was a cry for help, but this one's really out there." Still, they accomplished their goal: Their Web site (http://www.trepan.com) received 15,000 hits in the two hours after the program aired. Wargo is dead set on, even desperate for, trepanation. "Even if I could gain 10 percent higher awareness I'd do it," he says. "It will happen. There is no doubt in my mind." His wife doesn't seem as enthusiastic. So far he has not discussed it with his 14-year-old son. Unlike many of the other trepanned people, Wargo says he was never a frequent drug user. ("I'm a wimp when it comes to that.") He's a working man, trained as a machinist, and his interest stems not from a hippie zeal for mind expansion, but from a simple yearning for greater satisfaction in life. Like everyone else, he has good days and bad days. "Wouldn't it be great to move the whole scale up?" he asks. In 1979, Wargo had a waterskiing accident that caused the loss and subsequent reattachment of his left leg. "I went through a living hell for quite a few months," he says. Doctors pronounced him dead, twice. He's not afraid of a little hole in the head. "Trepanation," he says with a shrug, "is nothing."





