BREAKING INTO THE BRAIN

A journey into the vault holding our greatest mystery

- ALLAN HAMILTON, M.D.

As a brain surgeon, I have made my living for more than three decades by “breaking and entering” into patients’ skulls, much like a bank robber. In fact, the skull is anatomically referred to as the cranial vault. As with any good bank heist, there are two important rules. First, know where the money is. Second, get in and out as fast as you can. No alarms. And no one gets hurt.

How and where you open the cranial vault is critical. There needs to be an exact correspondence between where you create the opening in the skull—the so-called craniotomy—and the anatomical structures beneath, for which you want to gain access. You need to know exactly where the money lies. And gaining access—getting through the skull—is no easy task. The human skull can withstand more than 500 pounds of weight on it before cracking. That’s like balancing two full-size refrigerators on it. And its walls are remarkably dense. To gain entry into the skull, you need quite a drill. Not one you might pick up at the Home Depot. This industrial-strength, pneumatic drill is powered by hundreds of pounds of pressurized nitrogen, with the working end made of an inner ring of fluted stainless-steel teeth that spins inside a larger outer drill bit with even sharper, larger teeth. It can remove a quarter-size plug of incredibly dense bone in two or three seconds.