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Only in the Emergency Department at Massachusetts General Hospital, after the doctors started swarming, and one told her she needed surgery now, did M. learn what had happened. She had scratched through her skull during the night—and all the way into her brain.

Really? I am having a hard time imagining a fingernail winning against bone. Could anyone provide more detail?

this surprised me a bit as well.. it seems like:

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi...

is likely the case, and it makes some sense if she's incessantly scratching the same area over a year.. (I didn't buy the pdf, but the abstract explains it)

> this surprised me a bit as well

Surprised isn't the word. That freaked me out totally. I was I hadn't read this article.