The Birth & Death of Autotrepanation
I sat at dinner with them once, Linda and me came over and we sat at dinner, and John said, “You fancy getting the trepanning thing done?” I said, “Well, what is it?” He said, “Well, you kind of have a hole bored in your skull and uh, you know, it relieves the pressure.” And I said, “Well, look—” We’re sitting at dinner and this is seriously being offered, as a serious – it wasn’t a joke! — Paul McCartney, 1986
In November 1962, Bart Hughes was using his head- filled with some combination of mescaline, marijuana, and LSD on a vacation in Spain- when he had a sudden realization that being upside-down got you high.
This was not enough for Hughes, who, as the adage goes, had just enough knowledge to be dangerous- a Dutch citizen, he had recently finished medical school at the University of Amsterdam but would never receive his degree after failing an oral exam multiple times, whether to actual failure or other controversies. He would not be stopped in his mission, his everyman’s dream – to become permanently high. He would accomplish this by drilling a hole in his own head.
Nothing new is under the sun, and Hughes’ idea had ancient originations. Trepanning (from Greek trupanon, meaning “auger”) is a practice in which a hole is drilled into a living patient’s skull. The oldest known trepanned skull is dated back to 6500 B.C. They can be differentiated from holes made in dead people’s skulls because bone spurs and other signs of structural healing can be seen on the wound. The reasoning behind the practice is at best murky. Our best guesses are that patients who had suffered head injuries (think cavemen smashing each other with clubs) would likely function better after having bits of bone cleared from the wound. Trepanations of some kind could also relieve pressure from hematomas or other blood-pooling or clotting in the head- it’s possible that ancient and medieval subjects suffering from headaches, seizures, and other illnesses after receiving a skull fracture could find some relief from undergoing trepanation. (The removal of pieces of skull for operations is medically known as a craniotomy- but the bone is replaced back in the head as soon as possible- making it very boring to write about.)
As with all good ancient practices, they did not have the vocabulary of the Enlightenment to talk about these things, so trepanation took on mystical reasonings. With the relief of reduced skull pressure or removed bone fractures also came the idea that drilling a hole released evil spirits that were trapped in the head, giving them a way to escape and no longer possess the patient. The bits of bone were also used as charms to ward away evil spirits after being removed.
The thing about drilling a hole in someone’s head is that their brain is in there. Patients survived trepanning because the brain has a membrane around it called the dura mater, which you can think of like a big water balloon that wraps around all the important stuff and protects it. This is part of the blood/brain barrier that is often mentioned, and it is so good at its job that it can even be safely be exposed to the atmosphere. Cross the dura mater and you are now directly touching- and destroying- the brain tissue. The intentional destruction of brain matter by piercing the dura mater is better known by a Nobel Prize-winning name: lobotomy.
In an interview Hughes mentions that the theory of trepanation has a long history, acknowledging the old practices already discussed and also mentioning “the painting and writing of Hieronymus Bosch.” The specific painting is Cutting the Stone, made by Bosch just around mid-1490s, depicting a surgeon wearing a funnel hat operating on a patient, as a monk and a woman with a book on her head observe. There are a couple of very Dutch jokes hidden in the painting: the flower bulb on the table is a kind of visual pun on “stone.” The bit of bone removed during a trepanation was referred to as the “stone of madness,” thought to be the source of the illness the patient was experiencing, and the Dutch kei can mean either “stone” or “bulb.” The consternated patient is Lubbert Das, who is a common fool-type character is Dutch literature, with the inscription reading “Master cut the stone out, fast. / My name is Lubbert Das.”
Art analysts have claimed that Mr. Das is not the only fool depicted- that the funnel cap and book-balancing woman also represent caricatures of popular Dutch images. Additionally, Foucault in the History of Madness states: “Bosch’s famous doctor is far more insane than the patient he is attempting to cure, and his false knowledge does nothing more than reveal the worst excesses of a madness apparent to all but himself.”
Try as I might, I could not find any writing by Bosch regarding trepanation, though I can’t entirely doubt Hughes’ claim as he had the resources of the University of Amsterdam at his disposal. But to say the least, Bosch does not seem to present a ringing endorsement.
This is all just to say that trepanation is by no means a risk-free procedure. This did not discourage Bart Hughes.
Fast-forward from Bosch and rewind from the present moment- Hughes begins taking LSD in 1958 as a subject in psychiatric experiments(!) for the University Hospital of Amsterdam. He then proceeded to dabble with pot (even naming his daughter Maria Juana, a move that did not make him popular in the medical community) before eventually finding mescaline and the most powerful of all of these, standing on your head.
Before long Hughes had a method to his madness: he hypothesized that a combination of head-standing and psychedelic drugs gave him such an excellent high because it increased what he called “brainbloodvolume” – that more blood in the head meant that more glucose and oxygen were supplied to the brain, giving the upside-down man a high that reflected they way people should feel all the time. His term for this was “Homo Sapiens Correctus,” the corrected man. This was also the name of his holy text: an eight-foot long scroll with explanations surrounding thirteen illustrations, explaining how manipulation of bloodbrainvolume and glucose could- and would- send man to an enlightened state.
Besides his drug-induced epiphany Hughes also pointed to the fontanelle, a gap in the skull of infants that eventually fuse to form a solid single piece of skull later in development. Connecting this to his theories, he claimed that after the skull fused into one solid piece, man sunk into a kind of fugue state that deprived him of the joy and mental activity found in childhood – a state of mind that increasing brainbloodvolume via drugs or trepanation could return to an adult. Hughes credited this great evil to the twin demons of gravity and evolution. A standing man brought less blood to his head versus an animal on all fours. The argument goes that reduced brainbloodvolume gave rise to the ego and speech centers necessary for civilization – but Hughes was not satisfied with civilization – he wished for all of his brain to be lit up by the rejuvenating powers of blood and LSD. He didn’t use the words I’m about to, but he eventually settled on trepanation as a way to correct God’s mistake.
Hughes sought for two years after his realization to find someone to perform a trepanation on him, to no avail. Finally he acquired, likely from some medical practice, a dentist’s drill, a surgical knife, local anesthetic, and some acid, and on January 6th 1965 drilled a hole in his head. Apocryphally, the operation took forty-five minutes, but cleaning the blood from the walls and ceiling took four hours.
Finally Hughes was ready to show the world his achievement. He arranged for a public “happening,” and, in what may have been Holland’s first Joker moment, unwound foot after foot of bandages from his head with “HA HA HA” written on them in psychedelic colors. Seven days later he was held against his will at the University Hospital for three weeks after requesting an X-ray to prove to himself he had broken through his skull. After a battery of psychological tests could find nothing wrong with him, Bart Hughes- and his skull and his scroll- were unleashed upon the world.
Finding himself pushed out of the Dutch medical community and seeking new disciples to understand the power of “brainbloodvolume,” Hughes sought the largest collection of open-minded individuals he could find – which was, at that time, on the Spanish island of Ibiza.
Enter our next player Joseph Mellen, born 1939 into an upper crust of British nobility, attending both Eton and Oxford University, and being somewhat unbelievably on the same university boxing team as Kris Kristofferson. Mellen comes perilously close to completing certifications to join his father’s London stockbroking firm but drops out at the last minute, estranging himself from his family and joining the new up-and-coming British counterculture. Starting in 1963 Mellen began imbibing some combination of pot and speed daily (he references Kinortine, which was a French non-prescription variety). On one occasion in ‘64 he took mescaline from a friend and was instantly hooked, writing:
“Now that I had been up there I knew that there was where I wanted to stay. At the height of the trip I had looked in the mirror and seen the faces of all the members of my family look back at me in turn where my face should have been. Having assumed for some time that I must have some problem (I mean everyone has some problem, don’t they?), I asked myself what it was. The answer was that I had no problem on mescaline. I have felt that whatever needed doing I could do quite easily. The only problem was to get more mescaline.”
Bouncing around Paris, London and Spain in an attempt to start a writing career, he finally found himself in Ibiza in ‘65, making a living from smoking marijuana in movie backgrounds as an extra and occasional accountant work for millionaire country and yacht clubs, which was just enough to cover his food, weed, and woman expenses. He then fortuitously met Hughes and politely asked to have one LSD trip with him to compare it to his mescaline experience.
Their meeting and subsequent joint trip- fueled by sugar cubes and lemons- was the true beginning of the “brainbloodvolume” movement. Bart Hughes was Jesus Christ and Joe Mellen, John the Baptist. Through 1965 a truly unbelievable amount of acid was to be found in Ibiza and Hughes’ recommendation was to take Vitamin C supplements and a pound of sugar per acid trip to ensure that enough glucose was reaching the brain cells “activated” by the LSD. (I have one 12-oz root beer here in front of me, made with pure cane sugar- it would take eleven to get one pound of sugar into my body.)
Of course, every “flip out” and “freak out” on the island was now chalked up to the misunderstanding of “sugarlack” and “brainbloodvolume,” as Mellen soon helped Hughes translate his eight-foot-long scroll into English. Near the end of the year Mellen was perennially finding himself low on money and in the unpleasant company of Acid-King David, aka David Jove, who would later set up the infamous Rolling Stones Redland Bust for the UK government. In any case, Jove became tired of Mellen’s proselytizing and Mellen also thought that he might find more intelligent people in London to receive the word of “Homo Sapiens Correctus” – and so with a little money from the Acid-King, he found himself back with the British.
Mellen wasted no time once back in the isles, encountering the extremely suspicious figure of Micheal Hollingshead, who had “an apparently inexhaustible supply of acid,” and began redistributing the translated Homo Correctus scroll along with LSD and sugar. The main operation was out of the short-lived “World Psychedelic Center” on Pont Street, in the modern-day borough of Kensington and Chelsea. I say “short-lived” because at this time, either undercover police technology was very new, or Mellen and co. were extremely naïve, because some young men showed up to the flat, asked if there were any drugs, were immediately pointed to them, and in turn placed everyone there under arrest.
After being harassed by police (for marijuana possession) and some coordinated British press attacks against the group, things were looking very sour again for Mellen around 1966. But two important things happened near August of that year – Bart Hughes began a relationship with a young woman named Amanda Fielding and whisked her off to Amsterdam, and Mellen decided it was finally time to trepan himself.
Hughes’ self-trepanation story makes it sound as simple as trimming your nails or getting a haircut- largely, I suspect, because Hughes was prone to self-fictionalizing and preaching as equally as he was devoted to the cause of brainbloodvolume. Mellen’s description of the process is much more like a Three Stooges sketch, with him playing one Stooge and his brain and skull the other two.
His first attempt was with a hand trepanner, something used since medieval times, with a kind of corkscrew-like apparatus and round teeth for biting into the skull. This of course failed horribly. The device can’t be torqued properly when using it on yourself, and Mellen was unable to inject any local anesthetic and was high on LSD- he famously described it as “trying to uncork a bottle from the inside.” Soon Amanda Fielding returned to the country and assisted on the second attempt (Hughes was now barred from entering the United Kingdom). With this assistance Mellen was able to make much more headway. . . until he fainted from blood loss. His third attempt would have to wait as he now had to serve jail time for the aforementioned marijuana bust.
Finally, Mellen and Fielding were able to give it a third go around January of 1967. By this time they had also formed a romantic relationship, apart from Hughes (dating tip: try not to get banned from the country your girlfriend is traveling to). Using the hand trepanner, Mellen was finally able to extract a bit of bone from his head and hear a gurgling sound- his pulse- indicating that his dura mater was exposed to the outside world. He had done it.
Or had he? After further inspection he realized the teeth of the hand trepanner had gone in at an angle and instead of a nice hole straight to the brain he had wound up with an off-kilter cross-section of skull, leaving one side of the hole much deeper than the other. Mellen would not finally have a successful self-trepan until 1970, when he and Fielding had moved to Morocco. Fielding would follow him soon after.
Fielding served an essential role for the new movement of brainbloodvolume: rich single woman. Her back-to-back relationships with Hughes and Mellen put her in a unique position to see the father and son of the trepanation movement, and self-possessed Fielding – she tried to hitchhike to Sri Lanka at 16 to track down her Buddhist monk godfather – would not be left out of the movement.
Her self-trepanation was unique in that she filmed the entire process as a documentary film called “Heartbeat in the Brain”. It very clearly shows Fielding making a hole in the middle of her forehead with a dentists’ drill, interspersed with shots of her pet pigeon Birdie. Mellen personally set the soundtrack with Thelonius Monk, Fats Waller, and a Mozart string quartet. It was first screened at the Institute of Contemporary Arts in London and, when shown in New York in ‘78, it caused numerous audience members to faint right out of their seats.
In what is an enormous personal frustration, the full documentary is not publicly available anywhere. You can catch snatches of it in the 1989 film “A Hole in the Head”, which makes it clear that “Heartbeat in the Brain” holds nothing back as far as the price of the blood needed to get a hole going in your skull.
Fielding went on to run for Parliament twice unsuccessfully on the platform of “Trepanation for the National Health,” a program through which the NHS would offer trepanation to anyone who wanted one. She mothered two children with Melling and they amicably separated around the ‘90s. Fielding later founded the Beckley Foundation – a research and policy group dedicated to learning more about the positive effects of psychedelics and cannabis and promoting those causes to various governments and drug-makers. Interestingly, and despite her many glowing reviews of the operation, you will not find a single word on trepanation anywhere on their website, not even on her biography.
There is only one other known self-trepanner I can find – Peter Halvorson, who sought out Hughes directly and performed the operation in a Holland hotel room in 1972. He was part of a new group Hughes had formed – new, separatist brainbloodbelievers – after Hughes was back in his native country. After being denied entrance to Great Britain and Fielding’s elopement with Mellen, he became more and more isolated – to even talk about the “mechanisms” with him, you had to do “homework,” as Joe Mellen described it, which involved writing out the contents of the Homo Correctus scroll ten times while saying the words out loud. You then had to present this work while on your hands and knees and your head below your chest (ostensibly to beat gravity and get more blood in your head, but I’m sure it was not coincidental that you came prostrate before Hughes to win his affection). A reptile fanatic, Hughes spent time caring for his lizard collection and spending some time in and out of an asylum before he finally got steady employment at the Tropenmuseum in Amsterdam.
Halvorson gave a brief interview with The Washington Post in 1998, advocating for the positive power of trepanning, along with a young fellow he had taken in that hoped to get trepanned soon – from my understanding, most surgeons willing to perform trepanations could be found in Egypt or Mexico. He also ran the “International Trepanation Advocacy Group,” which hoped to connect candidates to surgeons and espouse the positive benefits of the operation, and was the administrator of www.trepan.com, which has been defunct since November 2018.
Through this personal crisis Hughes estranged himself from most of his former circle of hippies and acidheads and split up with his wife Barbara Mohr (but, it seems, remained in contact with dear Maria Juana). Barbara would go on to have a relationship with the extremely amorous Dutch poet Simon Vinkenoog and Hughes found a young disciple in Eveline van Dijk, an artist with a knack for the psychedelic illustrations that were slowly going out of style near the ‘80s. Altogether they co-wrote four comics, all regarding Hughes’ theories on the benefits of trepanation, so we only need one for an example: “Arnold Slak & de Slow Sisters op weg,” made in 1978. In it a family of snails living in “Slowland” find that their lives are much more comfortable after they smash holes in their shells for some breathing room. It is difficult to tell who exactly “Arnold Slak” is marketed to – the cute animal style seems to suggest a younger audience, but as far as I can tell, trepanation is never directly mentioned in the comics, meaning a more educated mind would have to make the metaphorical leap between shell-smashing and airing out the brain.
Evidently, the comics did not merit a new wave of believers, as the four were made in a very tight grouping of time between ‘78 and ‘80. Hughes and Van Dijk married in 1980 but Hughes maintained his isolationist attitude toward the world, succumbing to eventual alcoholism and a death by heart failure in 2004.
The other self-trepanners are all still with us, with Joe Mellen a ripe, happy, gray-headed 83 in September of this year.
Now, even when there were active trepanation advocates, all advice tended toward getting someone else to do it for you – either a foreign medical professional, a wayward medical student, or a very (very) trusted friend. Even though the trepanning website had been up until recently I was not able to find very many testimonials of additional trepanation-receivers, either DIY or through more official channels. And I feel this is for a good reason. The medical community today is under worldwide scrutiny – there are very few “isolationist” areas of the world left, and in how many of those places would you trust someone to take a drill to your skull? There aren’t any “quacks” with surgical equipment around either: all the scams are institutionalized now (see: Theranos, COVID et al.) Moreover, I find it very likely that some reliable doctor was drummed out of their profession or at the very least faced legal trouble for performing such operations, which is why mum’s been the word for at least since the 1990s.
The most recent detailed source for a homemade trepanation can be found here, beneath a slog of dead links and third-page results. And, I am forced to say, for my sake and from the entire APOCALYPSE CONFIDENTIAL legal team, DO NOT DRILL A HOLE IN ANYONE’S HEAD.
Trepanation was born of and killed by LSD. Bart Hughes’ ideas were radical (a one-time operation is like permanent mescaline! Doctors hate him!) but were ultimately destroyed by converging factors of the ‘70s – his own theories and practice, British government attitudes, and the cheap and easy acid hippies had before the crackdown on psychedelics began. Why risk a dangerous operation when you could get the same effect tripping with all your friends? And – although Hughes was an avowed atheist – his religious fervor and rigidity surrounding Homo Sapiens Correctus was noticeable, and worked against him in the end.
All my information was obtained from sources online and Joe Mellen’s excellent book, Bore Hole, reprinted by Strange Attractor Press in 2015. Yet still my analysis has speculation, unintended gaps, and areas of contention- I don’t speak Dutch, am somewhat ignorant about early Dutch countercultures, many primary sources maybe could’ve been had in a year’s time but not nearly soon enough to enjoy a timely publication. But this is the art of history- gingerly touching a live wire with a hum, transcribing the music of the wind blowing ‘cross empty beer bottles, picking up phones listening to dial tones for hours. Scrape enough of these moments from the black incinerator of time, from the shredder of history, and you have – a story. Today’s is simply the story of a man who wanted a little more out of his head.
— Will’s Bible verse of the day: “Whoever digs a hole and scoops it out falls into the pit they have made.” – Psalm 7:15