Saturday, April 22, 2006

Trepidating Trepanations

In one of my usual stupors, I was imagining a thriller like plot which went like this:

<plot>
Our main character is a stereotypical middle-aged doctor with amateur interests in subjects likeTrepanation alternative medicine, ancient healing, cults, etc. Today, he is responding to a trauma emergency. Even from afar, the good doctor immediately recognizes the case at hand. His medical friends from various hospitals from all over the city have described this bizzare case to him: In the middle of the day, a man, or rarely, a woman, with a shaven head and a bloody spot on the top of his head will be rushed in. What's more bizzare was that, on the bloody spot , or the "Holey-C" as his friends had nicknamed it, was a 'C' shaped incision on the scalp that's been sutured shut. The doctors had found that there was a circular piece of skull bone "missing", as in "removed", underneath the Holey-C. What's more bizzare was that the victims were consious not only when they arrived at the hospital but also were reportedly kept consicous by the perpetrators as they ground away his skull bone.

The victims describe being jumped on by a gang of seemingly old men in business suit at around noon. The perps, having bound and gaged the victims, had clamped a bench vice onto a desk and clamped their victim's head on it. After shaving the head and applying a local anesthetic, they had scalpelled off a piece of the scalp to make the C-shaped hole and then used what sounded like a dremel to remove the skull bone piece. Then they saw bright lights being used on their skull bones.
All the doctors were well aware of the procedure performed on the victims. The question was 'by whom' and 'what ever the hell for'. It was 'Trepanation', supposedly one of the earliest surgical procedure performed by man. It's still performed on rare occasions, and only as a last resort, on head trauma patients to relieve of cranium pressure on the brain. There are early accounts of trepanation done on normal healthy adults too. It was either done by shamans to dispel evil spirits from the head, or by an eccentric few to open a "third-eye" to gain a sort of everlasting high.

The Good Doctor (GD) knew the latter kind of people only too well. Almost a decade ago, when he had just started work in this hospital, an unconscious young man was admitted by his girl friend. The young lady was apparently trepaning her lover at home which is, surprisingly, a quite common occurance since doctors refuse to trepan anyone not in need of one. The team of doctors were surprised he was still alive considering how close the 'trepan' had come to his brain. The GD was thinking how ironic it was that the brain cannot feel pain, cold or any other sensation even though it is the seat of all sensations. Pain, as is said, is a necessary evil. It sets our priorities right. For example, when you sip on a glass of very hot coffee, it is pain that tells you not to burn your tongue cells in your hurry to drink the coffee. So, in the absence of pain sensing nerves on the brain, there's no way of telling when, for example, a trepan is cutting the brain cells or just the meninges. You will become aware of any damage to the brain only after sufficient damage was done to induce visible changes like unconciousness, stroke or coma. Obviously, nature didn't anticipate that any animal would, in its right mind, find the fun in putting a chink in their brain's armor. The doctors fixed the guy up but, as they say, there's one born every minute.

Our GD later on has the hunch that the "bright light" described by the victims was some ultra compact strong source of a focussed radiation to make sure that the skull bone doesn't fuse/grow with any replacement skull piece the doctors are sure to try to introduce into the "third eye". The hole supposedly helps displace the Cerebrospinal fluid, the brain nourishing fluid, from the brain ventricles and replace it with plain old blood. This is called restoring the "brain blood volume". Protagonists claim that it makes them feel "young at heart" again, cures depression, betters their awareness of their surroundings (hence "third eye"), brings back creativity and all things gay. It is not scientifically proved that trepanation does what it's claimed to do or if it's just a placebo.

The GD's knowledge of trepanation includes knowing that some protagonists of the "third eye" think that the doctors are part of a world wide conspiracy to deny people of their own "third-eye". Following some trails, the GD was able to pick up the fact that all the victims were either child prodigies or not-so-renown artists who have lost their heyday. The hi-tech cult seems hell-bent on proving trepanation's effectivness and proving the medical world wrong. The GD does some more sleuting and exposes the cult. End of story.
</plot>


Feel free to run with the story on your own. Do try to send me a copy if you do :)
Some trepanation links:
Mother of All Holeys (MOAH)[link]
People with Holes in ther Heads [link]
An article on trepanation (Plot character inpired from this one)[link]