They subsequently signed to producer Rick Rubin's American Recordings, releasing their major label debut, The War of Art, two years later on August 28, 2001. Trepanation refers to a form of surgery in which a hole is drilled or scraped into the skull, thus exposing the dura mater in order to treat health problems related to intracranial diseases, though in the modern era it is used only to treat epidural and subdural hematomas.
The debut album contains the earliest recordings of AHC, where they formulate their industrial metal sound (which they continued to do so on later albums). This is American Head Charge's only album with Peter Harmon on drums. After he left, keyboardist Chris Emery became the new drummer of the band, and roadie Justin Fowler replaced Emery on keyboards.
Tracks marked with a (*) means they also appear on the band's major label debut, The War of Art (although in different incarnations). Tracks marked with a (^) means they also appear on the band's 2007 DVD/CD Can't Stop the Machine. On the inside booklet, in the customary acknowledgments section, the band collectively declare: "No Thanks To: any Minneapolis local music publications (you know who you are...) that have ignored and/or continue to ignore the hardcore/industrial/rapcore scene. Take your Replacements memories and shove them up your collective asses."