“Hole in the Head: A Love Story” by Gary Fincke

Performed as far back as the Stone Age, trepanning is believed to be the world’s oldest surgery

            On the front page of USA Today, the national newspaper, was a picture of a small group of terrified subway passengers in New York City. They were scrambling after an explosion rocked one of the subway cars, filling it with smoke. The Effects of Fear, the headline read. The back of her head to the camera, my daughter was in the center of the photograph. “I was right behind this woman,” Shannon said, when I showed her the picture after we were seated in a restaurant the evening the picture appeared. “I’m wearing my black sweater and my hair was down that day. Like this?  See?”

            She turned, and I examined her hair, comparing it to the hair in the photograph as if I could match the DNA in each strand. “All I was thinking about was getting out of that crowd,” she said, and I thought of her keeping herself looking forward while the people around her glanced back as if they expected a larger explosion, poison gas, lethal spores, or the terrorists themselves looming out of the tunnel at the end of the Manhattan Bridge.

            It was October, twenty-one years ago, six weeks after the hijacked planes slammed into the World Trade Center towers. My daughter, despite her anxiety, had been riding the subway to the school where she was an art teacher less than a mile from Ground Zero. Ignoring her menu, she stared at the picture. “At first, I thought something might put a hole in the back of my head,” she said. “A piece of metal or something. It was all I could do to keep from crouching and covering my head. And then I just concentrated on not getting knocked down to the ground and trampled.”

            A hole in the head–the phrase my mother used nearly every day came hurtling back from nearly half a century before. “You need that like you need a hole in your head,” she repeated ten thousand times. She meant anything I wanted that cost too much, or if it came cheaply or for free, took up space. Soda cost money; water was free.  Comic books were trash waiting to pile up. A record player was expensive, and then think about all those records, what they cost, how to keep them. A baseball glove, a basketball—I could borrow one from a friend.

            My daughter tucked her hair back. “Go ahead and keep it,” I told her, and she slid the photograph into her purse. She slipped her hands through her hair again, dissatisfied with its arrangement, tugging it forward and then pulling it back again.

            “You don’t know what it’s like now in the city,” she said. “You hear a noise, you jump. You feel something, you flinch. I feel like that bread dough lady you told me about.” She smiled and pulled the picture back out and set it between us. The waiter arrived, and Shannon, distracted, said, “A glass of Chablis” without specifying further. “Remember?” she said to me, and I nodded.

            I had told that story to Shannon a year before, explaining how a woman, sitting in her overheated car in a supermarket parking lot, heard an explosion, felt something hit her skull, and then, reaching back, discovered a warm softness she believed was her exposed brain. She was certain she’d been shot, that she had to hold her brain to keep it from seeping out of the hole in her head. She pressed both hands to the back of her head, screaming until passers-by, uncertain, but alarmed, dialed 911 and summoned paramedics.

            Those men saw that she was holding canned bread dough against her skull, that a container of it had exploded in her hot car and splatted against the back of her head, flattening into a clot of hysteria. Carried off in the cars of nearby shoppers, that woman’s story was passed around dinner tables like salt. Laughing, I had told Shannon that pie-filling would be more apt for brains, the sweet ooze of crushed berries and corn starch swelling up through the fingers, no matter how heavily that woman would have pressed. “At least then all that stuff seeping away might have made her wonder why she was still thinking,” I’d said. “She would have started trying to figure out what part of her was sliding down her hands and over her wrists.”

“Short-term memory,” Shannon had said, although, sitting with her then, I thought there was no denying how lucky the woman who thought bread dough was her brains must have felt. She would have skipped past embarrassment to the great relief of safety. All she had to deal with was the silly name she’d given herself with public panic. What did it matter that her story would spread like a case bound over for court, that she had bungled the exam of common sense, holding her head as if she wasn’t already as good as dead?

I tried, once, to put a hole in my second-grade friend’s head with a buckeye on the end of a knotted shoestring. “I’ll break your head,” I shouted, swinging as hard as I could because he wouldn’t give back my rainbow-colored rubber ball. In a moment, that ball rolled free as he moaned and sagged, clutching his head just above the ear. As stunned as he was, I picked up my ball and ran two blocks to where we lived in three, second-story rented rooms. My father, after working night shift, was asleep, but my mother was alarmed by my panic. Before I confessed, my friend’s mother showed up with her son, alive and well.

Afterward, my mother lectured me, but she didn’t need to. I had been terrified. A few weeks earlier I’d watched a movie that showed the battle between David and Goliath. I knew what small objects could do to the skull if flung with enough force. My friend had dropped to his knees and held his head. Not as dramatic as Goliath toppling like a redwood, but close enough for a second grader in Etna, Pennsylvania.

“Why would you want to kill your friend?” my mother said, and I vowed never to feel that way again, keeping that promise for a few weeks until another rage made me use my fists, one improvement, at least, in my behavior.

What accounts for anger so terrible that otherwise ordinary people believe they want to kill somebody?  My daughter and I didn’t speak directly about the World Trade Center, but that evening, over dinner, we were less surprised that a woman could believe rage had found her in a supermarket parking lot. That she had been shot in the head by a stranger.

A story I didn’t share with my daughter that night was about a boy whose parents had drilled holes in their heads before he was born. The father had attempted to bore the hole himself with an ancient, hand-held drill and bit. He’d fainted. No surprise, but he tried it again, managed to chip out a sliver of bone, enough that doctors told him a hole in his head like that would kill him if he made it larger or deeper. He disregarded their advice, opened his skull at a different place and believed he had found a kind of tranquility as soon as his brain was exposed to light and air. He described overhearing his brain, what sounded like air bubbles running under his skull.

The boy’s mother filmed her drilling. By then it had been seen by thousands of people who watched her cut her hair, examine herself, then bring the bit to her skull.  She leans toward the lens; she reaches the moment of spurting blood, her brain exposed, and smiles.

Despite that smile, they’re haven’t been many converts to the therapeutic benefits of a hole in the head. I looked again at my daughter’s head in the photograph and then at her. Turned away from the camera, in the foreground, she seemed to be “the very next victim.” Of course, there’s the photographer who’s closer to the imagined danger, but I’d watched enough “killer point of view” movies to have thought of the camera as stalker.

And I’d thought of that boy, old enough to get by without a baby sitter, left alone for an evening. He could watch his mother’s film like pornography. And watching, could he keep his hands from moving to his head? From moving slowly along his scalp and pinpointing the spot where her drill entered?  Whenever his parents came home they could check how that film lay in its drawer, and seeing it shifted, they could shiver within themselves, recalling those last moments between sealed and unsealed.

            My mother had more than thrift behind her hole-in-the-head warnings. Our minds, she said, contain the angels we can be. There were spirits inside us that needed to be nurtured, and she pressed her thumbs, once, to my temples until I heard my heart push blood to my brain. “Hear that?” she said. Unable to speak, I nodded, terrified by what seemed to be spoken by that liquid choir.

            Not long after, the summer I turned eleven, I watched a neighbor boy a few years older than I was lift a rock and pitch it at the back of the head of another older boy, opening a gash in his scalp. Moments before, my neighbor had been prone, his face in the dirt, saying “I give” ten times to satisfy the boy who had just thrashed him.

            “Unhhh” that boy moaned, dropping to his knees as the rock thrower ran, beginning near-sprint in the direction of his house. The boy on his knees clutched the back of his head with one hand while he held himself steady with the other. He had a hole in his head, what I thought just then, looking through his spread fingers at the bloody patch of scalp. “I can walk,” he said, but he couldn’t, sagging at once, then sitting on a lawn a few unsteady steps from where the fight had taken place. A woman none of us knew rushed outside, disappeared, then reappeared with a cloth she pressed to his head. 

“My God,” she said, “you’re lucky you aren’t dead,” and I agreed, though I didn’t say a word about who had struck him with the rock, doing my part to keep his identity secret.

There’s more, of course, to the fascination with and fear of a hole in the head than anecdotes of childish violence and peculiar behavior. A student, recently, told me about how her younger brother had received a hole in his head, this one opened by an expert neurosurgeon in order to extract a brain tumor. Attention getting, for sure, but what made her story indelible was her mentioning that her brother had been given a video of his surgery. “First, my brother watched it,” she said. “Eventually, everybody in the family watched it except my mother.”

Right then, I had nothing but empathy for her mother, but that young woman kept talking. “Finally, a few months after the surgery, he told my mother he’d sent it to her phone. ‘You don’t have to watch,’ he said, ‘but now you have it.’”

            My student told her story calmly. She could tell from how attentive I was that I believed this was the seed for an essay that belonged in her senior portfolio. “My mother, when she heard that news, allowed him to pick up her phone. My brother explained that the video was only four minutes and thirty-nine seconds. He told her, ‘You can’t even tell it’s me because it’s so close up and starts after they have my skull open.’”

            What there are no words for, I thought. “What did she see when she gave in?” I said.

“A small part of the operation. When there are yellow specks coming out, the bits of the tumor. My mother kept touching the scar on the back of his head where his hair won’t grow. The tumor was benign. My brother wanted to keep some of the tumor, but they wouldn’t allow it.”

That friend I struck with a buckeye nearly seventy years ago died, in his fifties, from a brain tumor that was malignant. Although it seemed absurd, the thought occurred to me that the small early trauma might have seeded something. By then I’d had my share of minor head trauma. I had been hit in the head with a golf ball struck errantly by a member of our foursome. Disoriented, I finished the last two holes of the round. The next winter, I slipped and fell on an icy sidewalk, slamming my head in a way that shouted concussion. Neither of those incidents opened a physical hole in my head, but those moments of vulnerability were reminders that whatever literally opens us is often only a lottery result away.

            When my daughter was three, sitting on a stool at the dinner table, she began to rock. The stool tilted back, then teetered forward, then back, and toward the table again, a sensation Shannon squealed at with delight. Sitting across from her, I managed one “stop” and one “no” before, as I pushed myself up and toward her, the stool toppled backwards and she was flung toward the raised stone fireplace that projected out like an old-fashioned hearth where the kitchen, dining room, and living room met.

            I lunged, too late, and then I saw that she’d miraculously missed splitting the back of her head open by less than an inch. Stunned, she stared up at me, her skull intact. That stool and another like it went into a storage closet. When dinner was served, she sat on two telephone books stacked on a chair whose center of gravity kept her safe.

            For weeks, that spot a finger’s width from the right angle of stone forced my eyes down as I passed. Ten years later, a student of mine, the editor of the university’s literary magazine that I advised, fell on a flight of stone stairs, her head snapping back to the edge of a step with enough force to kill her. A while later, after her parents were summoned for a campus-wide memorial service, I stood beside her mother in the President’s huge house clutching a crystal flute of wine while she let me tell her stories stuffed with praise and promise. The room sparkled with embellishment’s light, that girl’s mother listening while looking at me as if I were folding a flag like a soldier, endowing the unbearable.

My daughter, the night I showed her the USA Today photo, ordered a second glass of wine with her meal; we ate with the photograph between us. Who in that crowd of October, 2001 commuters carried a camera?  And who, caught in what seemed to be an escape from terrorists, would begin to snap pictures with it, exposing his own head to the possibilities of shrapnel?

            There was more to the story. The panic that day had been fermented by the phrase “for police activity,” how the voice on the subway speakers described the reason for the cars coming to a full, unscheduled stop on the Manhattan Bridge. For an hour or more my daughter and the other passengers had fretted. Shannon was seated in the next to last car, and when the subway lurched forward toward the tunnel entrance to Manhattan, the sudden, unexpected explosion in the last car seemed so terribly close that panic had been instantaneous.

For eight days, my daughter refused the subway. She carpooled; she sacrificed and took a cab. And then, resigned to necessity, she boarded the subway again.

That night, as we ate, I thought of “police activity” and how that phrase would sound if you were inside a subway car on a bridge, the doors locked, the train not moving not long after terrorists had taken down the Trade Centers and the lives of thousands. She saw me eyeing the pieces of meat she had left on her plate. She lifted one with her fork and examined it as if she intended to show me what inedible means. “It’s a filet,” I said. “There’s no fat.”

            She shrugged and offered the fork. She’d ordered from the part of the menu my mother always forbade—lobster tail, filet mignon, veal stuffed with crabmeat—the list of expensive meals we need like a hole in the head. I ran the piece through the rich sauce that had begun to congeal on her plate, brought it to my mouth, and began to chew.

            She turned toward the waiter, choosing that moment to signal for the check so she wouldn’t have to watch me. Her hair tossed slightly against the back of her head. I rubbed a second piece through the sauce and savored it. And then a third, smearing her plate.

Months after that dinner with my daughter, I discovered that many archaeologists believe trepanning is the world’s oldest surgery.  Performed as far back as the Stone Age, the operation, essentially, means drilling a hole through the skull in the long-ago expectation that it would relieve some sort of malignant pressure or give access to shards of bone or tapeworms that need to be removed after battle or invasion. Hundreds of ancient skulls have been discovered with circular, measured holes. What headache would drive their owners to sit for the drill?  What needed to be freed? Who, surviving, would come back for more?

It must have worked for more than a few people because hundreds of skulls have been discovered with circular, measured holes.  And those who know how to read such things, examining the bone for signs of healing, have concluded that many of the skulls sat atop the bodies of people who outlived their surgeries by years.

Most likely, the news of success would entice more people to sit still for the drill.  But what pain would drive someone to submitting?  Imagine volunteering for that primitive drill. As soon as I try, I want to scream, “You need that operation like a hole in the head,” marveling with my mother that anyone would give themselves up to such risk.  And yet, in one extraordinary circumstance, an ancient Peruvian man underwent and survived seven trepanations, every one of the seven holes in his skull showing signs of healing. 

More than fifty years ago, a first-year high school teacher, I grabbed and shoved a tenth-grade boy into a wall so hard that his head thunked against the high school’s yellow cinderblock for the sin of making fun of my name. I’d risked my job to prove something in front of a few dozen teenagers, and, as it turned out, I did, praised by the principal for being assertive, my classes more obedient for a week or two, or merely warier. But I made a pledge to reason and kept that vow of “Never again” with thousands of other peoples’ children.

            Despite my mother’s warnings, I succumbed to every one of those items I needed like a hole in the head. I acquired stacks of comic books, swallowed gallons of soda and later, equal amounts of beer. I bought a stereo and then a larger one and finally one that included speakers enormous enough to be called “marriage killers” by the salesman who wrote up the invoice.

            And through it all, I managed to keep my skull and my children’s skulls intact.  They, in time, have purchased tens of thousands of dollars of frivolous things. Along the way, my daughter continued to endure New York City, the dangers and expenses of which she needed like a hole in the head. She kept her teaching job in lower Manhattan, commuting by subway for another year to a building where she had cared for children who, on the first day of school, became eyewitnesses, from the classroom windows, to the World Trade Center cataclysm. 

The films of those events are as indelible as the one of the Kennedy assassination, the President, while I still lived in my mother’s house, receiving a hole in his head for reasons other than love of trivial pleasures. My daughter will be forever like one of those people who stood along the Dallas parade route watching the limousine speed by and trying to make sense of things.

And then like those people returning to work regardless of who was President, my daughter boarded a subway that took her back to work until, one day, it stalled, then lurched forward, then produced an explosion that spread panic enough to produce a scene photographed and reproduced as a newspaper’s lead story about national news.

            That night, after I’d paid for dinner, we walked outside the restaurant, the wind’s velocity serving notice that a promised cold front was nearly there. Shannon’s hair swept sideways and then up as she bent to the car door, and I turned my head as if the base of her skull were her bared breasts. “It’s a blue moon,” I said, nodding toward where the clouds had peeled apart, and she said “What?” without looking.

            I had a chance to explain about how it was the second full moon of the month. About how likely such an occurrence was. She straightened again and turned toward me when I asked her which version of the song she liked best. After she shook her head, I said, “Elvis, The Marcels, Billie Holiday, Nat King Cole,” using, before I hugged her, what all of my stereos, regardless of their size, had somehow comforted me.

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