Empty-Headed Quick Fixes

Last month ABC News.com reported the death of former British child singing star Lena Zavaroni. According to the report, at the time of her death, Zavaroni, 35, weighed less than 60 pounds. But anorexia nervosa did not kill her. She died of complications following brain surgery.

Zavaroni’s fame began at age 9 on Opportunity Knocks, a nationally televised talent show, according to ABC. She sang for presidents, queens, and luminaries, but her meteoric rise soon came to a screeching halt.

The genesis of her anorexia is a familiar story. When she started to develop, her handlers commented on her weight, and by age 13, according to ABC, she was anorexic.

According to the report, Zavaroni had a procedure called a leukotomy, an operation in which connective fibers are cut, severing the connection between two different areas of the brain. She died four weeks later from an infection brought on by the procedure.

ABC cites Paul Hamburg, associate director of the Eating Disorders Unit at Massachusetts General Hospital, who notes that there is no clinical data showing that leukotomy is an effective treatment for anorexia. Then why did Zavaroni undergo the procedure?

The report suggests she was so desperate for a cure that she was willing to try anything. When people get desperate, they get reckless. And then bad things usually happen.

That point was graphically demonstrated on a recent episode of the ABC television show “20/20”. The program’s lead segment reported on a small group of twentysomethings who wanted to have holes drilled in their heads, a procedure called trephination.

Tulane University’s John Verano explained that trephination is “probably the oldest form of surgery” with a history stretching back to the Incas who used it to cut away parts of a damaged skull. But the young people on this program were all physically healthy. And they planned to perform the operation on themselves without any medical supervision.

Some wanted to “increase their consciousness.” Others were searching for a cure for life’s problems. “Mary” was desperately seeking relief from suicidal depression.

The group had rented a farmhouse in a remote location where the procedure was to be performed. The organizer of this insane event was Peter Halvorson, who had drilled a hole in his head in 1972, and whose website, according to “20/20,” has received tens of thousands of hits.

In the farmhouse basement, “Heather” began to trephan herself using what “20/20” correspondent Chris Cuomo described as “an overgrown corkscrew.” But the online transcript does not capture the horror of what happened next.

The video footage shows a lot of blood and Halvorson clumsily trying to assist the young woman. “The hand tool isn’t penetrating the skull correctly, and they don’t have the right instrument to draw back the scalp,” observes Cuomo.

While this ghastly scene was unfolding, the landlord and other local citizenry suddenly appeared and kicked the group out of the house. According to Cuomo, they were concerned about “trouble” coming from these goings-on. “Heather” finished the procedure at another location, where she began to leak brain fluid.

All medical experts interviewed by “20/20” agreed that trephination is extremely dangerous and confers no medical benefits. Columbia Presbyterian’s Dr. Michael Sisti, who has performed thousands of brain surgeries, called it an “assault.” Sisti said that the chances of improving your lifestyle from trephination are “zero,” and none of his patients reported heightened consciousness after surgery.

These stories recall medieval times when the line between torture chambers and medicine was often blurred. It is also reminiscent of lobotomy, which is discussed in a thoughtful piece at MSNBC.com by Dr. Glenn McGee of the University of Pennsylvania’s Center for Bioethics.

McGee notes that lobotomy was a popular method for controlling fear, anxiety, and violent criminal behavior in the 1950’s. The procedure involved drilling the brain’s frontal lobes. Because it resulted in numerous deaths and injuries, lobotomy was quickly abandoned when drug therapy became widely available.

So how does one prevent desperation? The ABCNews story on Zavaroni suggests an answer: most people feel desperate before they have exhausted all options, such as switching doctors or making adjustments in their relationships. Numerous articles on this topic page have indicated that the best treatment for anorexia is a multifaceted approach involving psychotherapy, medically supervised drug treatment, good nutrition, and social support. No, Virginia, there is no magic bullet— especially when it comes to eating disorders.

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