>> Dr. Terry Simpson: Right now, I am standing in the Surgeons Hall Museum

in Edinburgh. It's one of the oldest

surgical museums in the world, filled with

skulls, saws and surgical tools that tell

the stories of medicine's slow,

stumbling progress. And today, we're going to talk about

one of the oldest and sometimes the most horrifying

ideas in medicine and surgery. That the best way to

treat mental illness was to drill a hole in

your head.

I'm Dr. Terry Simpson, your chief medical

explanationist, on site at the

Surgeons Hall Museum in Edinburgh.

And this is Fork U Fork

University, where we unpack the weird,

wild and too often wrong history

of food, medicine and surgery. And we look at

how bad ideas never really die.

They just rebrand.

Let's start today with trepanation, the

practice of drilling or scraping a hole in the

skull. It's one of the oldest known

surgeries in human history. And here at the

Surgeons Hall Museum in Edinburgh, you can

see the actual ancient skulls with neat

round holes carved into them. Some of these

skulls show clear signs of healing,

meaning the patients survived, some of them

for a long time. But why did they do it?

That's the part we don't know.

Maybe they did it to relieve pressure from a head injury.

Maybe they thought they were letting out evil spirits.

Maybe, just maybe, they figured out by

observation that people sometimes got better

when they drilled. Were they scientists

or shamans, healers or hopeful butchers?

Sadly, that data is lost. But we

do have some disturbing data today. We

do drill holes in the skull, but we do it for some really

good reasons. If someone has increased

intracranial pressure after trauma, meaning high

pressure in their brain, we drill a hole. Or

sometimes if they have a subdural hematoma or a brain

bleed, we drill a hole to remove the clot, to relieve

the pressure on the brain. So you don't have stroke like symptoms or

lose second grade. And in some severe

brain injuries, we even remove a portion of the

skull to let the brain swell without

compression. So trepanation as a

technique isn't the problem. The problem

was a lack of understanding about why it works sometimes

and not others. And before we did the

research, we made things up,

meaning we saw it work once and assumed it was always

the answer. We saw a survivor and declared it

a cure. It's the oldest mistake in

medicine and one we and the

public keep repeating. Fast

forward to the 20th century. Take Dr.

Henry Cotton, a psychiatrist who believed that mental

illness came from hidden infections in the body. So what

did he do? He had his surgeons remove teeth,

tonsils, gallbladders and pieces of colon to

cure psychosis. Many of his patients

died and the rest didn't improve. But he

was celebrated in medical journals. He ran a major

institution, he lectured. He wasn't a

fringe player. He was medicine's main stage.

And that's the real horror. Even

when evidence showed that his surgeries caused harm, his

reputation protected him. Because confidence

often beats data. Hello,

Gary Brecke and Paul Saladino.

Today we don't drill holes in the skull to release

spirits. But we still try to hack the brain

with products that offer less harm but just

as little proof. One of the biggest fears in

America today is dementia. So why do people

turn to things like lion mane's mushroom? Because

it promises to regrow brain cells, boost memory and

prevent Alzheimer's. Some lab studies are

promising, but real clinic evidence, almost

none and has never been repleted.

Still, it is a booming industry.

A $50 a bottle, memory gummies, mushroom

coffee, neurotropics. Meanwhile, two real

diets, the mind and Mediterranean diets, can

reduce dementia risk by almost half.

But eating well doesn't make anybody rich.

We chase the shiny pill and ignore the

olive oil. Let's look at orthopedic

surgery. Some surgeons offer

platelet derived growth factor for injections. They

spin your blood, pull out the platelets and inject them

back. The idea, boost healing,

help your recovery. The evidence,

weak or absent from most uses. And I should know because

I helped publish one of the first studies showing

platelet derived factor helped with

patients with diabetic wounds. That was valid,

but now it's used from everything from tennis elbow to torn

knees to post op shoulders with no proof

but high building codes because that is not

covered by insurance. So it is

a tax on your health care from the

orthopedic surgeon to you that

you pay for. Because the orthopedic surgeon, the

person that you have your confidence in, says this

will help you heal better and recover faster. And

you're just giving your orthopedic surgeon an extra 2000 bucks

to feel good and get a band aid. It's

trepanation with better lighting and

sterile gloves. As I walk through this

museum, one thing is clear. We've always

meant well. But meaning well isn't

enough. Progress in medicine and surgery

means being willing to say we're wrong.

It means asking, does this actually help people?

Science moves forward when we replace story with

evidence. That goes for trepening and

lion's mane mushroom.

This episode was written and recorded by me, Dr. Terri

Simpson, standing right here in the halls of the Royal College of

Surgeons in Edinburgh. You can find references and

more@yourdoctorsorders.com and

forku.com and while I am a board

certified surgeon, I am not your

physician. If you're tempted by PRP Brain

Mushrooms or the next TikTok Brain Booster,

talk to a real doctor and a registered

dietitian. Not to your chiropractor, not

the shaman in Luaman, and not the guy who

drilled a hole in your head for clarity.

This episode was produced by Simpler Media and the man with

more wisdom than any mushroom Evotera.

Have a good week.

Hey Evo, if a wellness influencer told you

mental clarity comes from drilling a hole in your skull,

would you try that? Or do you think a good

IPA would serve just as well?

>> Speaker B: Aye, right. Craft beer might be just the thing

for you, but you're up there in the Scottish

Highlands, so I'd be thinking there, Dr.

Simpson, that a nice single malt might be more what

you're looking for. I can't tell if that's Scottish

or pirate. Anyhow.