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.