This document discusses the history and potential future of neurosurgery being available to more people. It describes trephination procedures that were historically performed to treat skull fractures and injuries. It suggests that opening the skull through self-trephination may allow one to return to a childlike state of consciousness. The document then outlines indications and procedures for burr hole evacuation to drain blood from an extradural hematoma as a potential emergency treatment option in areas where neurosurgery availability is delayed. It acknowledges the need for prospective studies but presents preliminary mortality and outcome data supporting potential benefits over doing nothing in some cases.