By Andy Dworkin
Published April 25, 2006
PORTLAND, Ore. -- One day last year, a 33-year-old Oregon man picked up a nail gun and put it to his head.
Just what drove him isn't clear. Mental illness, personal problems and methamphetamine all probably played a role.
He fired. And fired again. And again. Twelve times.
Six nails clustered between his right eye and ear. The nailheads caught on the skull, the points pushing into the brain. He shot two nails below his right ear, four more through the left side of his face. At some point, he reloaded: Eight of the nails measured 1 1/2 inches, four had 2-inch shanks.
A day later, he went to a small Oregon hospital. He said he had a headache.
Doctors saw nothing strange at first. None of the nails protruded from the skin, and hair covered most of the wounds. Then they took X-rays.
Astounded, the doctors gave him a tetanus shot and put him on a helicopter to Oregon Health & Science University Hospital in Portland. There, surgeons peeled back his face and removed the nails with pliers and a high-speed drill. Doctors gave the man antibiotics and psychiatric treatment.
Twenty-five days later, he walked out of the hospital a little weak but physically healthy.
Doctors say he is the only person known to have survived after having so many foreign objects embedded in his head.
"At this point, he's made a full recovery," said Dr. G. Alexander West, the neurosurgeon who led the team that pulled out the nails. "This guy was blessed in some way. I mean, that's incredible really."
Because of medical privacy laws, doctors have not identified the man who put 12 finishing nails in his skull. The man declined to publicly discuss his story. But he gave doctors permission to write about the injury and surgery in the current Journal of Neurosurgery.
"This case represents the only known survivor of the largest number of foreign objects  ever purposefully penetrated into the skull," they wrote. The previous record was nine, from an attempted nail-gun suicide in Japan.
When he arrived at the hospital last April, the man told doctors that his head still ached, and it hurt when he moved his neck. The right side of his face drooped a little and he had trouble moving his jaw. He called the nail wounds an accident and got hostile when doctors asked just how the accident happened. A psychiatric test showed "poor judgment and insight."
Doctors prescribed antibiotics and started discussing how to take a dozen nails from a man's brain.
Even one nail in the brain can kill a person, West said. But while bullets can kill with sheer energy, with lower-speed nail guns "it's all location," he said.
X-rays showed how strangely lucky this man was. One nail, nearly fatal, went through the neck. "It just missed his brain stem," West said.
Surgeons cut from ear to ear, through the crown of his head, pulling the skin down to see the nailheads. They started with the nail judged least threatening, just below the right ear. With a bone drill, surgeons chipped away bone around the nail until they could grab the head. They pulled it out.
They kept on, drilling bone and pulling nails with pliers.
"Then," West said, "we got the psychologist involved."
West only recently heard the rest of the story, as he wrote the journal article on the surgery.
He phoned the man, who said he had been using meth when he wanted to kill himself.
The man also told West that, months after leaving the hospital, he again tried to kill himself. He wound up in court-ordered treatment. This time, the counseling and rehab took hold. The man said he had been drug-free for more than six months and was putting his life in order.
"It's a work in progress," West said. "You never know."
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