For fantasy books popular with young readers, the His Dark Materials trilogy by Philip Pullman delves into some unsettling topics, like the destruction of souls and the bleakness of the afterlife. It is also in those pages where I first read about trepanning: the act of drilling or cutting a hole in a person’s skull. In the books, the Tartars people practice trepanation to let the magical “dust” into their brains.

His Dark Materials (known better as the Golden Compass series in the States) shifts back and forth from two versions of Oxford, England: one that we recognize and another where people’s souls appear as animals and polar bears wear armor. Familiar with the Pitt Rivers Museum in Oxford, Pullman likely drew some inspiration from the collection’s trepanned skulls, and even had his main character, Lyra, encounter the odd exhibit as a plot point. The museum also has a case of trepanning tools, including a set from Algeria acquired in the early 20th century and fragments of bone from an operation.


While the trepanning in His Dark Materials was done for religious reasons, the oldest form of surgery has had various goals. Sometimes it was to relieve brain pressure or to stop headaches, other times to let evil spirits escape, often on people with mental disorders. Despite being a grotesque and extreme procedure, it was widespread across the Americas, Oceania, and Europe and studies of trepanned skulls show it had a high survival rate. Prehistoric patients had their skulls broken open with stones, later there were medieval saws, and finally metal medical instruments. In most cases, the people having their scalps stretched back and brains exposed were completely awake and unanesthesized. Trepanning is still practiced in some areas of the world, and by intrepid individuals with electric drills and presumably a few evil spirits to let out.

In addition to the Pitt Rivers Museum, there are other places on Atlas Obscura that hold trepanned skulls. Perhaps visiting them will inspire you to write your own fantasy epic on the extremes people will go to for the sake of enlightenment, even if it’s the literal opening of your mind.


  St. Leonard’s Church - Hythe, England

  A house of bones — but nobody is quite sure whom they belong to.

  The church’s ossuary has trepanned skulls among its thousands of
  bones. (Read more)


  Mütter Museum- Philadelphia, Pennsylvania

  America’s most famous museum of medical oddities

  The museum of medical curiosities and history has a collection of
  trepanned skulls on display, with the slash marks from surgical
  instruments still visible. (Read more)


  Wellcome Collection & Library- London, England

  Curios of Pharmacist and Collector Henry Wellcome

  Along with trepanned skulls, the collection holds historical images of
  trepanning. (Read more)


  International Museum of Surgical Science- Chicago, Illinois

  Museum dedicated to Surgical Science, and its assorted arts

  Skulls with violent-looking gouged holes are on display. (Read more)


  Warren Anatomical Museum- Boston, Massachusetts

  A Boston medical museum featuring the skull of famous medical case
  Phineas Gage

 In addition to the historic trepanned skulls, the skull of the iron rod  victim Phineas Gage could count as a trepanation of sorts. (Read more)