Lyric discussion by Quisquilloso 

Cover art for Fake Palindromes lyrics by Andrew Bird

In Trepanation, he talks about singles ads being used as a sort of shortcut to getting to know someone. At the end he talks about the Trepanation Singles Club of America, for people who want to "meet nice people with cranial holes/and touch upon the truth that lies inside." So there trepanation seems more of a grisly over-the-top metaphor for 'artificial' (for lack of a better word) ways of socializing, ways of looking into someone's head bypassing traditional interaction. In this song it certainly has a more sinister feeling, what with monsters, death kits, etc.