Evidence of 8,500-Year-Old Head Surgery Excavated at Çatalhöyük

During ongoing excavations at the 9,000-year-old extinct Anatolian city of Çatalhöyük in central Turkey, a team of archaeologists discovered something remarkable. While examining the skeleton of a young man recovered from a collective ancient burial, the archaeologists found a small hole drilled in this individual’s skull, showing that he’d undergone a radical surgical procedure known as trepanation.

First developed during the Neolithic Period (10,000 to 4,500 BC), this type of surgery was used to drain fluids or relieve pressure on the brain. Trepanation was popular in many Neolithic societies in different parts of the world, and was recommended by ancient healers as a form of treatment for a broad range of injuries and brain conditions, including headaches, concussions and even mental health disorders.

Archaeologists analyzing skeletal remains found at Çatalhöyük found evidence of trepanation surgery. (Anadolu Agency)

Ancient City of Çatalhöyük Reveals its Trepanation Secrets

Under the leadership of Anadolu University archaeologist Dr. Ali Umut Türkcan, a large team of researchers from several Turkish institutions have been busy performing excavations in residential areas of Çatalhöyük since 2020. 

In 2022 the researchers unearthed a new residential area on one of the settlement’s sloping areas. Inside one house they uncovered a grave beneath the floor that contained seven skeletons. There was nothing especially remarkable about this, as it was customary practice in ancient Çatalhöyük to bury the dead under their previous residences, or under the homes of their loved ones.

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But upon further examination, the researchers found a most unusual feature on the skull of one skeleton, which was eventually identified as having belonged to a young male aged between 18 and 19 who lived about 8,500 years ago. This was a small, round opening that was so neatly cut that it was clear it had not been created by an accidental head trauma.

“A round bone piece, approximately 2.5 centimeters [1 inches] in diameter, was removed from the side of the skull with a properly opened circular section,” Dr. Handan Üstündağ, an archaeologist from Trakya University, told an interviewer from the Turkish news agency AA. “During this time, we encountered many incision marks showing that they scraped the scalp. We think that this was a trepanation performed for therapeutic purposes.”

Dr. Üstündağ explained that trepanation had already been in use for quite some time in ancient Anatolia before it was used by the people of Çatalhöyük. “The example we found in Çatalhöyük is one of the oldest,” Dr. Üstündağ said, before noting that “examples of practices that are at least 1,000 years older than Çatalhöyük were found in the excavations of Aşıklı Höyük, located near Kızılkaya village in Aksaray, and Çayönü Mound, in Ergani district of Diyarbakır.”

Nevertheless, this find was still incredibly significant, as it represents the first clear example of trepanation discovered in Çatalhöyük. “Our finding shows that people who lived 8,500 years ago tried to treat diseases, relieve the pain or suffering of their relatives, and prevent deaths,” Dr. Üstündağ stated.

Unfortunately, this treatment doesn’t seem to have done the man much good, perhaps because it was applied too late. “There is no indication that the individual was alive after the operation in question,” Dr. Üstündağ confirmed. “Because there was no sign of healing in the bone tissue. When this operation was performed, this person was either about to die or had already passed away."

Model representation of Çatalhöyük in Turkey, at the Museum for Prehistory in Thuringia. (Wolfgang Sauber / CC BY-SA 4.0)

The Amazing Story of Çatalhöyük, Turkey’s Most Legendary Ancient City

The densely populated Çatalhöyük represented one of Anatolia’s earliest experiments in city building and urban living. The buried ruins of this UNESCO World Heritage site are located on the Konya Plain in Turkey’s Central Anatolian Plateau, not far from the modern city of Konya.

The latest estimates are that Çatalhöyük was occupied for at least 1,300 years, from 7,500 to 6,400 BC, which in Anatolia spans the Late Neolithic through the very earliest Chalcolithic or Copper Age periods. The settlement as a whole covered an impressive 34 acres (14 hectares), and includes an eastern mound that was occupied during the Neolithic and a western mound that housed city residents in the later Chalcolithic.

While this proto-city may have been home to as many as 10,000 residents during its Neolithic Period heyday, its architecture and design style bear little resemblance to modern cities of any size. Çatalhöyük was comprised entirely of private mudbrick homes and other multipurpose domestic buildings, which were relatively uniform in height.

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These structures were packed so closely together that they created a honeycomb-like physical profile, as if they were one large structure with many conjoined parts. Homes were either directly connected to each other or accessible from one to another by ladders, and there was actually no room for footpaths or streets at the ground level. 

All the evidence suggests that the people of Çatalhöyük were united by an egalitarian outlook, which rejected differences in status based on gender or wealth. Important tools and supplies were shared equally, and communal gatherings would have been frequent and would have included feasts prepared by community members using community-owned hearths or ovens.

With no physical boundaries separating homes people could have visited their neighbors easily, either by hopping from roof to roof (the rooftops in Çatalhöyük were flat and used as patios) or by crawling down ladders to enter other residence via side doorways. It is likely that family groups lived side by side, helping to preserve a sense of kinship that would last for generations. They also buried their deceased beneath their homes, maintaining those familial bonds even after death.

The residents of Çatalhöyük were deeply unified by their culture and religion. They decorated the walls of their mudbrick buildings with vivid murals, which included images of domestic, agricultural or hunting scenes in some instances and more stylized portrayals of animals or human-like figures that likely had spiritual significance in others. They also carved or molded striking figurines from minerals or clay, in the likenesses of humans or gods (female deities were portrayed far more frequently than male deities, which once fueled speculation that Çatalhöyük was governed as a matriarchal society).

Archaeologists sorting skeletal remains found at Çatalhöyük. (Anadolu Agency)

The Lost Art of Trepanation, a Neolithic Medical Innovation

As the discovery of the adolescent skull with the trepanation hole shows, the people of Çatalhöyük also practiced medicine, demonstrating yet another characteristic associated with true societal development. It is not known whether there were Anatolian doctors or surgeons who specialized in applying such complicated procedures, or if a more generalized knowledge of medicine qualified a larger number of people to perform this type of delicate surgery.

It seems likely there would have been a few specialists trained to administer such an invasive and risky form of treatment. But given the egalitarian nature of the society of Çatalhöyük and its apparent rejection of social classes, it’s conceivable that medical expertise was shared just as broadly as the city’s tools and culture.

Trepanation might sound like a primitive procedure. But this most ancient form of surgery was actually used for thousands of years, starting in the Neolithic period (10,000 to 4,500 BC) and continuing on in various places up through the seventh century AD (at least).

It seems obvious that the practice of trepanation wouldn’t have been used for as long as it was unless it showed some effectiveness as a form of treatment. In fact, trepanation represents a less developed version of a modern medical procedure known as a craniotomy, in which a section of skull is surgically cut and then temporarily extracted to relieve pressure or remove excess fluid from the brain.

While it apparently could be used to treat many troubling conditions, trepanation carried a clear risk of death, and likely would have been used only as a last resort. One young man who lived in Çatalhöyük in 6,500 BC did not survive the procedure, but it is probable that many other Anatolians did and even showed signs of recovery from their conditions, which would explain why the practice of trepanation remained popular in ancient Anatolia for thousands of years.

Top image: Archaeologists excavating skeletal remains at Çatalhöyük in Turkey. Source: Anadolu Agency

By Nathan Falde