The research for my Master of Science degree involved obtaining rat spinal cords immediately after having decapitated the live rat with a guillotine (One reason for pursuing microbiology for the Ph.D.). The first time I ever decapitated a rat, I was stunned at what I beheld as I cut away the spine and looked into the animal’s cavity.
There before me the intestines were still moving, the heart still beating somewhat, muscles were twitching. All of this in an animal that had been decapitated a moment or two before. By any common understanding, this was a dead animal, yet its body retained so much intrinsic life. It was an experience that played itself out dozens of times during that research, and caused me to begin to question the concept of “Brain Death”.
How could the organs of a “dead” animal retain so much life? The answer is relatively simple, and requires a little (painless) biological explanation.
Cells run on electrical energy. The oxygen we breathe is carried to every cell in the body, where it aids the cell in extracting energy in the form of electrons from glucose, and storing them in a three-pack of rechargeable molecular batteries called ATP (adenosine triphosphate). So long as oxygen and glucose are available to the cells (from the surrounding blood vessels), the ATP gets recharged and helps cells to perform their functions.
When the oxygen runs out, death quickly follows. As the old beer ad said, “When you’re out of Bud, you’re out of beer.” The same holds true for oxygen.
The concept of “death” then depends on what level at which we wish to draw the line. Certainly at the instant the rat’s head is struck from the body, the brain is not dead, though its ability to coordinate bodily functions is immediately eliminated by the act of decapitation. However, that brain still contains oxygenated blood, as do the other organs. Thus, while bodily coordinate function is gone, intrinsic function within the brain is not, just as the other organs retain their intrinsic function.
To suggest that the human brain as an organ is dead, and then rush in to harvest the other organs which remain perfused with oxygen, is an absurdity. More and more stories are coming to light (as will be seen in Part II) of people who were declared brain dead, and who made a recovery when family refused to pull the plug.
Biologically speaking, if the other organs are sufficiently perfused with oxygen and retain their intrinsic function, it’s a safe bet to assume that the brain also retains sufficient oxygen and intrinsic function. The truth is that the brain is the final frontier of the human body, and we know relatively little about its ability to direct its own recovery and healing.
If the brain is truly dead, then it is oxygen-depleted, and ATP production has ground to a halt. That is the definition of death, when the cell runs out of energy. When the brain finds itself in that circumstance, the rest of the body is essentially there as well, making organ harvest pretty much impossible.
A severely impaired brain may not be “dead” at all (Terri Schiavo).
Next time we’ll look at Terri Schiavo as well as others who survived the diagnosis of brain death and lived to tell about it. We’ll see the withering forces brought to bear on frightened and confused family members at their most vulnerable moment.
that’s quite a way to recover from a cold……..
I haven’t read the article yet but I plan to – just a head’s up, Dr. Nadal Terry’s last name is spelled incorrectly (Schiavo)
Thank you for writing this, I just saw a story on LifeSite news about a woman who woke up from a coma and who doctors wrote off as brain dead.😦
I have a question for you Dr. Nadal that might be more pertinent in Part II.
It seems in many accounts that I have read a person remains in comatose state – sometimes referred to as brain dead or PVS UNTIL they are removed from the respirator.
I can’t help but wonder if somehow being on the respirator at some point becomes a hindrance to becoming conscious again or if the trauma of coming off a respirator somehow stimulates the brain in a way that helps the person awaken?
You obviously haven’t had to deal with a loved one on life support. Where I agree with your premise, how long do you propose waiting on a “brain dead” person to come back to full consciousness with all their mental faculties intact? A day? A month? A year? Ten Years? What quality of life are you suggesting? Every situation is different and all the facts need to be addresses in every case. The idea that you are suggesting a grieving family prolong a desperate, helpless situation is absurd. I hope you don’t have to go through that.
Joe,
I’ve walked this road. If the brain is dead, the rest of the body dies too. I’m addressing an entire industry built on railroading patients and families. Quality of life and being declared brain dead are two very different realities. Read Part II tomorrow.
Joe have you read about how organs are harvested?
The patients are paralyzed and drugged. This is done not for the patient’s benefit but for the staff doing the harvesting. People groan, moan and move around. Heart rates increase etc.
In other words these people are living human beings. They are not dead and on some level they are feeling what is happening to them.
It’s quite obvious that we don’t know enough about the brain and how it heals from trauma.
Locked in syndrome is another condition that is just now being researched more thoroughly. People who have recovered from being locked-in say that they can understand everything around them but are unable to respond in any way at all.
Imagine being in this condition and hearing your family discuss that they will be donating your organs? How horrifying must that be?
Neuroscientist Adrian Owen is researching patients who are brain dead and he has found that if a “brain dead” person is given a specific task such as to imagine themselves say, playing hockey, specific part of the brain ligthts up in scans. This suggests that the person can hear, can comprehend the command and can respond in the only way they can – with their living brain.
I, too, like Joe, am very interested in Gerard’s discussion of brain death and quality of life issues from scientific and Catholic theological standpints. I remember the Karen Ann Quinlan case from my childhood as being a catalyst for such issues.
My older sister had been treated for a recurrent, life-threatening condition that brought her to death several times over a period of a year and a half. After each event (at least four), she was hospitalized for weeks, including several days or longer in ICU, in four different hospitals, undergoing tests that were alway inconclusive.
At the time of her death, Sis had been hospitalized at one of the top-rated hospitals in the US (not in the state where my family lives) for several weeks. On her birthday 10 years ago, while in the ICU, she had a severe brain hemorrhage, likely from medication for complications that arose. After testing, she was declared either brain-dead, or a least in a permanent vegetative state. (I cannot ask my parents which it was, as they both died last year. I’ll have to ask my other sister if she remembers.) I don’t think my parents were asked about donating her organs; even if they had been, I am certain they would have said, “No.”
I remember my mother saying that when she looked at my sister, she knew that Sis was “gone.” They chose to have her taken off life support the day after her birthday, prior to which, they had arranged for and were present for her Annointing of the Sick, a Mass said at Sis’ bed (for which I think a nurse or two kindly joined them), during which the priest ensured that the Host touched Sis’ lips, which he told my parents counted as her having received the Eucharist (something I didn’t know but which I am sure a priest reading this can confirm or deny). After that, my parents left, and Sis was taken off life support, a few minutes after which she died.
Honestly, although I agreed with my parents’ choice, I was floored that they made it. I had always assumed that given such a situation, they would have hung onto denial/hope for days, weeks, even months. For me, their decision indicated they knew for themselves, and not only based on medical opinion, that Sis’ consciousness – Sis herself – was gone for good and that she would not have wanted to linger.
CY, despite these tests, they do not conclusively prove that a person is brain dead. We don’t really know. All we know is that the person isn’t responding on measurable levels.
Secondly, the tests done at hospitals vary from one place to the next and are applied differently. There appears to be no set protocol or if there is it is not applied in a regular way from hospital to hospital nor country to country.
To my mind if a person has a beating heart, circulation, and normal blood pressure , temperature and respiration, they are not dead.
I’ve walked the end-of-life road as well, but, as I often say, making an issue personal doesn’t prove anything.
Please keep writing. Your descriptions/explanations are enlightening. Thanks.