When it comes to freaky sideshow acts, no other trick seems to furrow brows and turn stomachs as effectively as the human blockhead. Even the name itself can seem quite jarring: the human blockhead? But what else would you call someone who hammers nails into their skull? Obviously this does not sound like something a smart person would do.

As stated, the human blockhead trick entails the pushing or hammering of long objects into the nose. Long nails are the most commonly used, but other insert-able items include corkscrews, awls, drills, and knives.

Although it may appear to be an illusion, the act involves no sort of trickery. The nails really are being driven into the head. The only part of the act that is an illusion is caused by the ignorance of human anatomy. Since our noses lie vertically upon our faces, there is a common misconception among people that the nasal cavity goes up, when in reality it goes straight back. It is this misconception that makes it appear as though the nails are going straight through bone (or skull), when in actuality they are being pushed carefully through the nasal cavity.

The trick is said to be invented in the 1920s by Coney Island magician and sideshow performer Melvin Burkhart. A professional sword-swallower, fire-eater, knife-thrower, and lightweight boxer, Burkhart came up with the idea of the blockhead after breaking his nose in a boxing tournament. While being treated by doctors, Burkhart became fascinated by the scalpels, picks, and other medical instruments doctors had inserted into his nose to remove the broken bone fragments. Burkhart’s epiphany came when he realized if the doctors could put those instruments into his nose, then he could probably put other things into his nose too.

Once recovered Burkhart quit boxing and immediately incorporated the blockhead trick into his sideshow master of ceremonies gig. Burkhart soon rose to fame and eventually worked with notable circuses and troupes such as Ringling Bros. Barnum & Bailey and Ripley’s Believe it or Not. When asked by spectators how the trick is performed, Burkhart often jokingly replied with the ambiguous, “I use a false nose.” Since coming up with the trick, Burkhart has taught it to hundreds of others throughout his lifetime of performing, touring from the early 1930s until retirement in 1989. Unfortunately in November of 2001 Burkhart died of a stroke.

Even though it may look bizarre, the human blockhead trick makes perfect sense once you know the basics of the anatomy of the head. The human skull is comprised of 22 bones that are sutured together, and contains several holes and spaces throughout, such as the eye sockets and sinuses. The nose is made of mostly cartilage and connective tissue, with skin on the outside, and a mucous and hair layer on the inside, to detect, trap, and protect the body from inhaling irritants such as dirt, dust, dander, viruses, and any other foreign invaders.

The nasal cavity itself is a lot larger than it seems. Rather than traveling upward as it appears from the outside, the cavity actually extends straight back. The dimensions of the cavity lie with its ceiling just below where the nose meets the eyes, and its floor approximately level with the openings for the nostrils. The walls of the nasal cavity undulate producing grooves called conchae, which provide extra surface area to help hold in moisture. When a blockhead performer pushes a nail straight back into the nasal cavity, they usually apply a slight downward pressure onto the nail to drag it against the cavity floor, in an effort to ensure an easy pass through to the back of the throat, and avoid getting caught on any conchae. The area where the nail ends is a hollow space that widens at the back of the nose and hits the throat, and is known as the nasopharynx.

Obviously since none of us have the exact same appearance or anatomy, some performers may have to alter their approach when it comes to performing blockhead. Performers with a low nose may have to move the nasal tip out of the way in order to get the nail through, causing somewhat of a pig-nosed snout. However, most blockhead performers would say maneuvering through the nose is the easy part. It’s the trying not to sneeze part that’s the hardest…and most dangerous.

Sneezing is an involuntary reflex, just like the knee-jerk when the doctor taps your leg with his hammer. Involuntary reflexes are automatic reactions, meaning they do not require thought. They are the body’s response to an outside stimulus, in an effort to protect itself. Like all other reflexes, sneezing follows the reflex arc of the receptor, sensory neuron, integration center, motor neuron, and effector.

When the nerve endings (receptors) in the nose detect irritants, an impulse (sensory neuron) quickly travels to the sneezing center of the brain stem (integration center), which in turn sends instructions (motor neuron) along the facial nerves that lead to the lungs and diaphragm, causing the eyes to water, the diaphragm to contract, and the person to take a deep breath (effector). What follows is an abrupt contraction of the chest muscles to forcefully and rapidly expel the air from the lungs via the nose and mouth (aka sneeze). This is the body’s way of trying to rid of potentially infective and harmful particles that enter the nasal cavity, a basic defense mechanism against bacteria and viruses.

Ignoring this defense mechanism is the most difficult aspect of blockheading. Performers learn to suppress this automatic and natural response by desensitizing the area through frequent practice. This conditioning involves repeatedly stimulating the nasal cavity in a controlled fashion, while trying to ignore the tickling sensation it causes.

Most human blockhead performers have a preference for which nostril they use, either because that nostril already has a naturally lessened sensitivity to sneezing, or because they trained that nostril to be less sensitive. Mastering complete sneeze suppression is a very difficult task, and even though some blockhead performers condition and practice for many years, occasionally it may just not be possible to hold that sneeze back. Here lies the real danger of the human blockhead.

Sneezing while performing blockhead could cause the inserted object to enter into the skull base, perforate the septum, or head into a sinus. Since a sneeze begins with a sharp inhalation of air, the object could potentially be pulled in deeper, piercing the back of the throat or causing damage to the soft tissue lining. The actual sudden expulsion of air and whipping of the head at the culmination of sneezing could cause the object to tear through various nasal structures as it is suddenly and erratically launched out of the nose. In addition to sneezing, performers also must always ensure their inserted objects are clean, to avoid any potential sinus or throat infection.

Amateur blockhead performers start with smaller and softer objects before working their way up to sharp nails. While beginners usually start with a q-tip, more advanced performers have been known to go beyond just nails, inserting everything from fireworks, to lit fire-eating torches, to even automatic drills.

In fact the blockhead trick has spawned several other similar performance acts. In the year 2000 blockhead performer Ryan Stock created a variation known as the “human meathead,” in which he inserts a hook into his nose and coming out of his mouth, and hangs up to 70 lbs of weight on it. Other variations of “mental floss” or “skull floss” involve similar acts of items such as balloons, condoms, and noodles going through the nose and out the mouth.

If you ever witness a blockhead performance you’ll notice most performers hammer the nails in. The hammering, though totally unnecessary, adds to the charm of the trick. For it is the sound effects produced from the hammer hitting the nail head, and the suffering and strenuous facial expressions the performer puts on, that create the illusion of hammering through bone. In reality, the nails could simply be slid into place.

Obviously inserting nails into your nose and fighting the urge to sneeze can feel weird and uncomfortable. But as long as people continue their reactions of dread, disgust, and disbelief, performers will continue shoving things up their shnozzes.