In a forthcoming book, “Final Exam: A Surgeon’s Reflections on Mortality,” Dr. Pauline W. Chen writes about the many operations she performed on brain-dead patients for the purpose of procuring, or “harvesting,” their organs for transplantation. “They all,” she writes, “seemed remarkably alive.”
This past fall, the prestigious journal Science published a report on a young woman who, after a devastating car accident, was declared vegetative. For five months, she showed no signs of awareness whatsoever. Scientists, though, decided to put her in a Functional Magnetic Resonance Imaging scanner, a machine that tracks blood flow to different parts of the brain and that was only developed a few years ago. When they asked her to imagine things like playing tennis and walking through her home, the scan lit up with telltale patterns of language, movement and navigation indistinguishable from those produced by the brains of healthy, conscious people. The report’s authors, while stressing that the patient may still be classified as “unconscious,” conclude nonetheless that she has a “rich mental life.”
Ten years earlier, a patient like the young woman would have been assumed, for all practical intents, to be – effectively, if perhaps not legally – lifeless. Only the development of a new diagnostic technology has now rendered her more obviously alive. It’s hard not to wonder what technologies might one day yet be developed – or what aspects of consciousness might forever elude scientific instrumentation.
The acronym DCD might be mistaken for some new medium of music reproduction but in fact refers to “donation after cardiac death” – the procurement of organs from people whose hearts have stopped, even if their brains may still be functioning. Such procedures have taken place in many countries, despite the fact that the cessation of heartbeat is not necessarily irreversible. Even some patients whose hearts did not respond to cardiac resuscitation, it is well documented, have “come back to life” – in one case after the lapse of a full seven minutes, certainly sufficient time to harvest a vital organ or two.