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Comment by danohu | Hacker News Reader

Amanda Feilding, who this article is about, is a fascinating person. In the 70s she drilled a hole in her own skull ("trepanation"), then ran for political office to promote the benefits of that operation. She's now Countess of Wemyss and March, married to a similarly-trepanned Earl.

http://cabinetmagazine.org/issues/28/turner.php

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Trep-a-na-tion, eh? That's new. Let's have a look at the Wikipedia page then.....

https://en.wikipedia.org/wiki/Trepanning#/media/File:Peter_T...

Nope.

"ran for political office to promote the benefits of that operation"

As if there weren't enough reasons to be afraid of politicians!

'Fascinating' is not the adjective I would use to describe someone enamored with drilling holes through their skull.

Why, does the procedure not work?

It works insofar as you have a hole in your skull afterwards. Whether or not the evil spirits in your skull actually get out is disputed.

If you go just a bit further, the one who made you drill a hole in your skull does, though...

> Feilding wasn’t interested in performing the operation as an extreme form of body art, but because she believed it would have a life-changing effect on her. She hoped that a hole in her head would increase what she terms "cranial compliance," that alleviating the pressure in her skull would allow the heart to pump more blood to her brain, thereby giving her a new feeling of buoyancy. "If you don’t have that expansibility," she says of the prison of inflexible bone that most of us have for skulls, "then the heartbeat pushes against the brain cells, which isn’t very good."

She wasn't doing it to get rid of evil spirits.

> Archaeologists have speculated that the operation was performed as a religious rite, an initiation into the priestly caste, or as a treatment for demonic possession—symptoms we might now diagnose as epilepsy, psychosis, or migraine. A hole in the head served as a mouthpiece to the gods, it was thought, or as a window that would allow bad spirits to escape.

People might have done it for that reason previously but she wasn't.

Her reasoning as quoted is no more based in reality than theirs. Frankly, I would say it's worse, as the people who did this hundreds of years ago did not have the benefit of modern medicine to model why it is a bad idea in the first place.

Blood letting should have a similar effect no?

What makes you so sure your model of reality is more predictive than hers?

What testable predictions has she made?

This would have sounded crazy to me 6 months ago. However I had a friend who had a traumatic brain injury where the doctors had to remove a portion of their skull temporarily (a couple months) to releive pressure on the brain. The doctors told my friend that his brain function and parts of his personality may be different while parts of his skull was off, and sure enough it was. When they put his skull back together a couple months later his personality shifted. The stated reason the doctor gave had to do with differentials in blood pressure in the brain with and with out the skull entact. This was at a top hospital in San Francisco.

A traumatic brain injury that is severe enough to require removal of a portion of the skull to relieve pressure from swelling is a critical medical event that has nothing to do with an otherwise healthy individual drilling a hole through their skull. Blood does not 'press on the brain' in a negative way in normal function. Far from it- being supported from all sides by a bath of CSF is critical to proper function. Remove that support from an unexpected area, and problems are likely, as you saw with your friend. The only reason they do such a radical procedure is to prevent a swelling brain from squeezing itself out through the hole that connects the brain to the spinal cord, as that progresses rapidly to death.

https://en.m.wikipedia.org/wiki/Cerebrospinal_fluid

I hope your friend is recovering well, and I wish them the best of luck in recovery. Brain injuries are frightening and frustrating, but the brain is amazing in its plasticity, too.

[edit] for some reason, I can't reply to the comment below, so I'm posting my answer here, so you don't think I am ignoring your point. Personality change after TBIs is not a good thing. For a representative example: https://www.google.com/amp/s/www.psychologytoday.com/blog/pr...

You injected the word "problems" because it suited your argument... but OP used the words "different [..] personality"

>Personality change after TBIs is not a good thing.

Reminds me of a documentary I saw recently about snowboarder Kevin Pearce called The Crash Reel (2013) [1]. Kevin Pearce was changed by his TBI also but the one I came to think of when you said this was another person that was affected even worse from a TBI they got from a snowboarding accident.

[1]: http://www.imdb.com/title/tt2499076/

That looks like an interesting documentary. Thanks for the link.

this is prejudicial. Fielding didn't say anything about "evil spirits" nor was that her reason for performing the procedure. you're speaking from ignorance and displaying your own biases.

Her reasoning is nonsensical. It may not be 'evil spirits', but 'the heartbeat pushes on the brain cells, that's bad' is hardly more rational.

If she wants her opinion to be taken seriously, give us something testable instead of new age woo about feelings of buoyancy.

do you know for certain that it's irrational? there are some serious medical conditions caused by swelling of the brain (encephalitis, concussions, etc.) so it doesn't seem completely unfounded. her approach to it was unconventional and she failed to persuade other researchers to pursue the project. that doesn't mean she's crazy. her remarks about "feelings of buoyancy" were in response to a question about what kind of qualitative difference she felt. her answer was appropriate to the question as it was asked. what else do you expect from her?

it's very clear from your remarks that you are ideologically committed to this person being wrong because she offends your sensibilities for some reason. maybe do some introspection and think about why she offends your sensibilities. this seems like tribalism to me. you're reacting like "ewww dirty hippy" and dismissing her because of it.

I'm dismissing her because she has made no testable claims, and the medical conditions that do cause swelling of the brain are orthogonal to the brain in its healthy state. It does not follow that what is appropriate treatment for a pathology would have a similar effect on a non-swollen brain. This is, quite literally, one of the most common logical fallacies there is. By definition, that makes it an irrational belief.

https://en.wikipedia.org/wiki/Affirming_the_consequent

In addition, there are a vast number of medical cases involving cranial penetration in otherwise healthy adults. Some of them involve the skull only, with no underlying brain trauma. If trepanation has some sort of unsuspected, detectable benefit aside from placebo, it would have been noticed by now. Head trauma is not that uncommon.

If she wants to explore the potential benefits of trepanation and get it taken seriously, she needs to make testable claims. As she is going uphill against a mountain of pre-existing evidence that holes in the heads of healthy people are not good, she needs to have exceptional evidence, at that. That's how science and knowledge progression works.

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