Does life end inevitably or instead only because we don’t understand biology well enough yet? Today’s episode is about understanding what happens when your molecular cycles grind to a halt... and whether there's anything we can do to hit control-Z. Join Eagleman and his guest Dr. Zvonimir Vrselja to dive into the weird possibility of understanding cells well enough to reverse death.
From the point of view of biology, what is life and what is death and what is the line between them? Could you freeze your body to come back sometime in the future, and what does this have to do with Mary Shelley's Frankenstein or housefly or the poet John Dunn. Welcome to Inner Cosmos with me David Eagleman. I'm a neuroscientist and an author at Stanford and in these episodes we sail deeply into our three pound universe to understand why and how our lives look the way they do, and in this case, whether life is something that comes to an end inevitably or only because we don't understand the biology well enough yet. So today day's episode is about understanding what happens when your molecular cycles grind to a halt, and whether there's anything we can do to hit control z on that can death be reversed. A few months ago, my dog was lying on the floor and we were all gathered around her, and my kids were coming in and out, and everyone was crying because my dog was dying. She was fifteen and a half years old, which for a dog her size was quite old, and her body was shutting down and as I sat on the floor stroking her back, I was thinking about a poem by John Dunn that I had first read when I was a child, probably about ten years old. The poem is called Death Be Not Proud, and it really blew my young mind when I read it. It begins with these lines, death be not proud, though some have called thee mighty and dreadful, for thou art not so now. In this poem, one of his nineteen holy sonnets, Done gets right up in Death's face and he challenges Death's power and importance, and he tells death not to be proud because it is not as fearsome as it might seem. And the sonnet ends with the lines one short sleep past, we wake eternally, and death shall be no more death, thou shalt die so. Done ends the poem by spitting right in death's champagne glass, and he tells Death that he is going to die now. John Dunn wrote this poem through a religious lens. He was giving the interpretation of the victory of the soul over death. But I had a different interpretation. I was struck by this idea of defeating death. After all, biologists, we study life and each decade we know more and more about how it works, and the more we know about life, the more we can know about how to keep it going and possibly how to even reboot it. Now that sounds crazy, but we're going to unpack that carefully in this episode. There are many ways to look at what life is. I did an on stage conversation some years ago with a mystic named Saguru, and we discussed and debated a number of issues, but he said one thing that was phrased very simply, and it proved hard for me to forget. He said, the physical body is like a fruit, and when the person is gone, the person that you loved, all you have left now is the rind. There's nothing special about the body, the physical body, and I loved that description, but as a biologist, I wanted to dig deeper. And this is a problem I had actually started thinking about years earlier, because I once went to wash a dish in the sink and there was a tupperware in there with some water in it, and there was a house fly that had died in the tupperware. And I looked at the poor little lifeless fly, and a question struck me, What is the difference between the live fly and the dead fly. If you do a chemical analysis, it's exactly the same stuff. You have x number of carbon atoms in the quadrillions or ten to the eighteenth, and you have Y number of nitrogen atoms, and you have Z number of oxygen atoms, and so on. The weight of this little dead fly is exactly the same as a living fly. The chemical composition is the same, All the trillions of proteins are the same. Everything is the same between the living fly and the dead fly. The only different is the molecular momentum. All the cascades have come to a stop. All the crebs cycles and the action of the proteins around the DNA and the endoplasmic particulum, and all the step by step chemical reactions in the cell, they've all just come to a standstill. So what Saguru referred to as the fruit to the part we love and lament I interpret this as the ongoing cascades of the cellular processes. This leads to this leads to this, and as long as everything keeps going, then the fly is alive and it moves around. As soon as something breaks about these cycles, then everything just grinds to a halt. So this leads to the question what does it require to keep everything going for cells to stay alive? And the related question is if they stopped, would there be any way to you reboot the system to get the cycles going again. So when I read Dunn's poem as a kid, where he says that death shall die, I imagined that someday, in the very distant sci fi future, we might actually be able to make this true, to get cells going again that had come to a stop. But of course, when imagining this future as a kid, you imagine it as people in silver suits zipping around in the skies. So as I got older and studied biology and became more realistic about this, I realized, of course that we were all going to die after all. So given that perspective about how distantly in the future this would happen, you can imagine how surprised I was to see the speed at which this field is moving along. I suspect that I will die and perhaps the next few or several generations. But the idea of reversing deaths, at least in some cases, is not a subject constrained to the pens of poets. Anymore. Over the past several years, you can find the beginnings of this endeavor published in the top scientific journals. And we're not talking about longevity in this episode. I'm going to talk about that in the future episode. Instead, we're talking about this completely wacky idea of reversing death, taking an organism that has already died, and reversing back out of that. Now, this sounds like something straight out of Mary Shelley's novel Frankenstein, which, as you remember, tells the story of a scientist named Victor Frankenstein who figures out how to reanimate the dead. But the whole thing doesn't turn out so well, and Frankenstein's monster ends up getting rejected by mankind in general, and he regretfully murders people to get revenge on his maker. But anyway, put that interpretation aside for a moment while we talk about this, because in the early twenty first century, we're now in a more realistic position to assess what is possible and to think deeply about the ethics. Now, it may sound surprising that there's enough science now to even talk about this topic, but hangtight, because we're about to see some very strange stuff. First, this question of whether death could be reversible has long been entertained, because sometimes people can fall to the bottom of a lake and freeze to death and lose all their function, and they are really truly at a stop, and then sometimes they can be brought to a hospital and revivified. For example, I remember reading a story in two thousand about a young doctor in Norway named Anna. She was a trainee surgeon who was exactly my age, and she was skiing when she fell through a rosen river and got trapped under the ice. Now, her colleagues were there and they saw her, but they couldn't get her out, and they struggled and struggled to rescue her. But she ended up being under the ice for forty minutes, and not surprisingly, her organs shut down and she died. Her body temperature had fallen more than twenty three degrees below normal. But Anna was eventually pulled out from the ice and put on an air ambulance, and she wasn't breathing when she got to the hospital. Her blood circulation had stopped, her pupils were not responding to light, but the doctors put her on a heart and lung machine and re warmed her while the circulation was kept going. They used a machine that warmed her blood and oxygenated it and then put it back in her body, and things weren't easy. She spent sixty days in intensive care in the hospital, but five months after she was frozen to death, she was back to work as a doctor and she still skis now. You can find this case in the Lancet, which is a top medical journal in the field. So this stuff happens, and it happens more than you might think. I read another article in twenty sixteen about a guy walking home from a party and he slipped and hit his head and went unconscious and wasn't found until the next morning when his father was driving around looking for him and found him buried in the snow, frozen, no vital signs. They rushed him to the hospital. They pumped him full of warm, oxygenated blood, and it wasn't an easy recovery. But a year later, even though he's missing all his toes and pinkies from frostbite, he is indistinguishable from anyone else you might meet. Essentially, he was frozen in the same way that we might put meat in the freezer, so it doesn't go bad. But it's the same principle. Despite our sense of our beautiful essences, it's also the case that we are meat and we can be frozen and we can be thawed. Now, why can't you revivify any person who has died. Well, if things aren't frozen, then the biology decomposes, the cells break down. This is of course the same thing that happens if you leave a piece of meat on your counter instead of putting it in the freezer, and in the case of a person, that causes irreversible damage to the brain. But a frozen body doesn't decay, at least not rapidly. It stays intact because the molecules can't move around as much. Everything is held into place. So the observation that people could be frozen and unfrozen got scientists interested in the speculation of whether you could take a person who has just died and freeze them on purpose, with the idea of unfreezing them later. And this successfully started in the nineteen in seventies with freezing mouse embryos, and then that became a successful way to freeze human embryos. But keep in mind a human embryo is the size of a grain of salt, and so the challenges are a little less in successfully freezing and unfreezing those. But the question people have been asking is, could you actually freeze an entire adult body and unfreeze it later, Let's say, because they have cancer that we don't know how to cure. But maybe in seventy years the medical community will have no problem curing this. It'll be easy. Could you reanimate somebody in the same way that has been done on a much shorter timescale with the woman in the icy river or the man who fell into the snow bank. Well, in a previous episode, I mentioned a company in Arizona called Alcore, which strives to do exactly this. They are a cryogenics company, and upon your death, they will swoop in to perfuse your body with the right chemicals and get you to the facility in Arizona, and there they will lower you into a vat of liquid nitrogen. Now, do they know how to cure whatever your disease was, or, for that matter, do they even know how to unfreeze you successfully? No, But that's not the point. The point is that sometime in the distant future, our great grand descendants may know how to do this, and at that point they can unfreeze you and cure you of whatever ailment you have, presumably something that was totally opaque or confusing for twenty first century minds, but easily curable with a twenty second century toolbox. Now here's something of interest. It turns out the first person to ever get frozen on purpose in this new field called cryogenics was born in what year, take a guess, eighteen ninety three, a guy named James Bedford who died in January of nineteen sixty seven from terminal cancer. He was the first person to do this. But did he die? Interesting question? I would say unresolved so far, because it's yet to be seen whether he can be rebooted nineteen sixty seven. So although this is science fiction y, it's not even that new. Now. Since that time, people have worked on the cryogenic technology to figure out how to make the freezing process better and better to prevent cell damage, because the problem is if you get an ice crystal during the freezing process, that will rupture the cell membrane and then the body that you hoped to revive is too damaged. Like when you stick a strawberry in the freezer to try to make it last longer. But once you unthought, it gets all mushy. That's the same thing that happens with any cells if they get ice crystals in it. So will Bedford's body be able to be reanimated? Who knows? And experts have different opinions about whether the bodies at the alcore facility will be reeve vivifiable. But the idea of cryogenics is straightforward in the sense that even if these first few hundred experiments fail, will surely get better and better at cryogenics in the future, and the hope is that someone fifty generations from now will know how to reverse the process. And before I go to the next step, I just want to say this idea about confronting death is not just about freezing and unfreezing. The deeper issues in biology have to do with how individual cells die. It turns out that cells can get injured by various things, let's say, a lack of blood flow or a chemical insult, and then they essentially blow up and die and cause a lot of inflammation. This is called necrosis. But in nineteen seventy two it was discovered that this isn't the way cells have to die. Cells can actually die on purpose, and this is known as a potosis. A potosis means that instead of a cell simply just falling apart, instead it implements a controlled process by which it folds up shop and cleanly commits suicide. Scientists came to understand that this is a very purposeful process, and over many years they showed how apotosis is actually the way that biological organisms structure themselves. For example, a human embryo has webbed fingers, in other words, little sheets of skin between the fingers of exactly the type that you would need for swimming. But in the case of our particular species, the cells making up that webbing. Those cells die off before the baby is born, such that we have independently moving fingers. But those cells between our fingers wouldn't die off if we were another mammal, say a bat, or a kangaroo, or a whale or a manatee. I'm actually going to put an X ray picture of a manatee fin on my website because it's so stunning how the bones inside their fin look just like a human hand. The bones look that way, but the difference is that the cells between their fingers, that webbing that doesn't die off, so what you get is a fin Anyway, apotosis is everywhere. Your body has about a trillion new cells developing every day, and so you need to kill off a similar number to keep the system from getting overrun. And this is all done with this very controlled process of cell death. And the scientists behind these discoveries Horbitz and Brenner and Sulstan. They won the Nobel Prize for this in two thousand and two. But it turns out since then biologists have discovered that necrosis and apotosis are not even the only game in town. We now know there are many flavors of program cell death, like what's called pyrotosis or ferrotosis or necrotosis. These are all different mechanisms that tip the balance between different cell fates, and people are working on drugs to block all these very specific flavors of cell death. It's no longer just the cell gets sick and falls apart, but it's much more sophisticated now and that gives the possibility to molecularly block the process. So now let zoom out to the big picture. There's an increasing amount known about how cells actually shut down, and we have proof of principle that systems can get going again even after they've stopped. And all this has led to the possibility that we might be able to take something like a dead brain or dead body and reboot it. Now this sounds so crazy, but the question I want to ask is are we actually going to have to wait fifty generations to see this happen? Or is it possible that things are moving so rapidly that there's some reason to think that we could take, say, a dead brain, a totally dead brain that's been dead for four hours, and get the whole factory running again. Well you'd agree that seems like a science fiction fantasy. But a colleague of mine recently published two papers in the journal Nature, and it seems we're already at the point, give or take, where we may be able to do something just about like that, at least in pigs. In the journals, this is cast in the paper as quote Cellular and molecular recovery in pigs, which I suspect doesn't sound that interesting to most people on the planet, and so it didn't get that much attention. But this is seriously big stuff. So I called up my colleague who wrote these recent papers, and I asked him, is cell death inevitable? Let's say when a person has a stroke and there's no blood going to the set. Well, we've always thought of that as being a really terrible scenario that inevitably leads to sell death. But is that the case?
So we used to think that, and we had a publication four years ago where we actually christened if sales actually die after death after blood flow stops, and we realized that actually death is a portracted process. It takes a bit actually for sales to die, and if you intervene properly, you can maybe reverse those processes.
That's Vanimir Russella. He's an mdphd originally from Croatia. He did his postalk and became a research scientist at Yale School of Medicine, and now he's spun off a company around this called Becksore. So you mean the death of an organism, let's say, of a person. You're saying it doesn't happen all at once, but it takes time to die.
So yeah, yeah, So I think I just want to be like a nuance here. There were instances that so it is well known that For example, you can find living cells in human specimens after hours of death, and scientists have used like chunks of tissue to find like living sales and record from them.
It was also observed.
That people who have died and were undercolt conditions that they could be actually brought sort of The implication there is that there are cells o functional. So there were instances where this was a scene and recorded in the literature.
So let's just double click on that. So tell us what you mean about people who were frozen and were recovered.
Give us an example, So on the macros kale, like right, talking about the whole human, not about.
A single cell. It was observed that people.
Who have drowned their bodies would cool down as they were drowning, that after a prolonged period of time, these people could be resuscitated. So the time it was, you know, we are not used as seeing like someone resuscitated after that how long, Well, I don't know specifics, but just to give you like a benchmark data point. Usually it is assumed from the classical literature that four minutes after blood flow stops, bodies cells just die.
So that was.
Always like a clinical data point, after which was really difficult to bring people back with resuscitation.
Okay, so you started suspecting that maybe cells aren't as fragile as we thought. So what did you do?
So yeah, so we have it's interesting storied up my pi at the time. And then a Sistan received a tissue specimens from abroad and they got stuck at customs for a really long period of time. And so by the time they came in the lab, you know, the researchers were like thinking, oh.
You know, it's done, like the specimen is useless.
But they still made slice sculptures and after a week they realized that they were living cells.
So that was the first observation that got the group like.
Thinking, and in our case in particular, we just wanted to scale the whole approach, initially going from a small.
Slice to a whole inteked brain.
Right, So you said, hey, what if you could get a brain of an organism that has died, could you restore the function somehow? So what did you do to try to tackle that problem?
So, you know, as one does, we started going to a local slaughterhouse and we were procuring a tissue.
You were getting pig brains, right, pig reins.
Yes, so people don't. Luckily there we are like, people don't eat the pig brains.
And this was the el right, yes, yes, yes, yes.
Yes, So we will go to the local slaughterhouse. You know, they would do their job.
By the time when they are done, we would get pig hits and so we'll bring them to the lab.
We would take the brain out, and.
Then we started developing this technology that could connect with the vascular system of the brain and profuse a fluid to sort of reboot the self functionality.
And how long had these pigs been dead?
On every g it was four hours, So from the time of pig being killed in the slaughterhouse to the time point where we started our profusion intervention, it was usually four hours.
So then what you did is you profused and tell us about profusion and what that means and what that looks like.
So there's a device, so you take the isolated brain, which is sort of front of you. You load the brain into this device and then the device pushes artificial blood or blood like fluid through the brain and it does it under controlled conditions. It has a bunch of drugs inside that counter certain cell processes. So the whole point is to try to reinstate homeosthetic environment or this like like normal environment in which cells are usually accustomed.
To be and so what did you find?
So we found that So this is an interesting equation. So first of all, we found that we could revert cell death. It was an interesting thing because at the time we were trying to define like what does it mean for a cell to be dead, like right, and how do you define cell death? So we found it cells that were considered dead they were actually still some adjective. And with our interventions we could restore or functionality and observed functions in those cells that we usually observe in cells that we sort of think or consider alive.
So were the cells completely restored or are there still things you need to do to get to the next level.
There is a lot more to do there.
What we have done we took a particular number of tests and we conducted those tests and so I can only speak about those.
They were pretty good broad tests that sort of speak on the state of these cells. So these same tests show that these cells performed in a similar way as normal cells.
And on top of it, with subsequent research data was done, we actually showed that it's clear that these cells go through stress of dying. So we've shown that we can stop it, and we even showed on the molecular scale that we can basically persuade sales like not to die and they can start to repair themselves and basically just say to them like, don't die, like they just want to live, you know.
So you take a pig brain that's been dead for four hours and you perfuse this this solution through it. It's like blood, but it doesn't have cells in it. It has lots of meds and the proper kind of molecules in it. You push that through and then you can measure things about the cells and see that it's like they're cooking along. They're doing their thing that cells normally do.
Absolutely.
So the point is like, you know, you just go to like meet school biology and it's you know, you see if oxygen is going in, you see if glucose is going in, so you're expecting CO two to come out, so you know that's happening, and then you compare those results.
I'm simplifying this, but you know, conceptually it works.
You can provide stimuli or for example, drugs because you know, like you can take a drug, which we have done actually, so we would take a drug that works in humans, it's well known, and we would see if it's exerting the same effect in these restored cells.
And it worked.
So these cells can also be like stimulated and you can observe how they respond. You can compare those responses and learn about the brain, you know.
And so you have been doing this in pig brains since the first paper you did was in twenty nineteen or yes, okay, so you've been doing it in pig brains since then. What is the road that you see two human brains?
So this is a new type of research, and we were pretty lucky from day one to have ANIH and other institutions Yale including involved in helping us put the guidelines and think about like where this research should go and how it should be conducted. So what we have done we really wanted to build like a ground up approach, and so we wanted to show that these interventions are opening new spaces, and so we went to do it in the smart way. So that said going to humans and what it really means, you know, think about like restoring cells and their function, like you can think about clinical applications of the technology like SOAK is the first thing that comes to one mind.
So it will take a bit more time to get there.
Because we need to really understand, like deeply what's going on on the cellular level.
But this is one approach.
Another approach that we have taken was in collaboration with a transplant team here at Yale. So we actually wanted to see if we could deploy our technology in dead pigs.
Essentially and see if we could restore like kidneys or liver for transplant.
Because if this works in the clinical sense, then there is a chance to readically expand organ pool or organ donations.
Oh incredible. And when it comes to restoring the brain, when you think down the road, you think ten twenty years in the future, what are the ethical questions here?
Well they are big. So the first thing is clearly, are we sort of rebooting this brain like big where it was. I'm really particular how I speak about these things, So I talk about sales, I don't actually talk about brain function. The reason is because we are making sure that we are not rebooting global network or EG. But one could go in that phase. So that is definitely something that can be explored.
So now you can think about all the ethical implications that our eyes with this technology.
So you said you're being careful not to reboot the function of the brain. Correct me if I'm wrong, But you're not actually sure when or why that would happen. It's just that in the experience you've done so far, the electrical signaling, the global functioning the brain wasn't restored in the pigs, but we don't know why that's the case, and it could happen with another few molecules or whatever of the right flavor.
Absolutely, so there is research already showing thatta done in the pace that this could be done. And also in our case, it is basically the design of the experiments. Our experiments we were actively suppressing or we were avoiding that situation because even without the network being rewooted, we still have an extremely valuable tool to understand how the brain works and functions. So in the future, the question has definitely been the technology, as you said, been the technology is matured and we actually know exactly every single thing that goes into it and what happens, then the question is like what should be done next?
And so what do you think about that, what are your thoughts on the ethics of you know, somebody has found drowned at the bottom of a lake and it's four hours later and you say, hey, I've got a solution here to bring this person back.
Oh yeah, so definitely not now, and technologically and our understanding, we're just not there yet, and there's a lot of research that has to be done. I think it also been comes an interesting.
Question like assuming that the technology is capable of doing such a feit, you know, you have a question from you like should you do this?
Like should you go and save this person? I'm a trained physician, so that's the goal. You know, you want to go and save someone. So this should become just another tool that allows us to do our job. So, but it needs to be it really needs to be researched over time and show that there is value and potential for this outcome.
So let's imagine forty seven years from now where it's really been researched and it really works well and you know exactly the solution to profuse into the brain to restore the function. So, first of all, what's your guest about how many hours let's say you find somebody who has passed away ten hours ago. Is that too late?
That's a difficult question to answer.
We do know that their process is still ongoing then after death, but I don't believe that you can sum certain processes that hip on it those time points to the whole human being. So I don't see that happening. I think there is definitely like a time limit, you know, if you think about the current practice now, which is in minutes. So basically, whatever V do, we would be a huge feit really difficult.
Absolutely, So I just want to press one more time on this issue about what are the ethical questions that come up for you. So let's imagine forty seven years from now, the technology works great, and the question is, Okay, somebody has passed away, how do we decide about restoring them, whether it's the right thing to do when when it's not.
Yeah, so this is a really complex question.
There are bodies that deal with the definition of death, and one thing in particular there which is interesting is a distinction between something that's reversible and something that's permanent. And I think it is going to be really interesting to understand like which one is which, because there are instances where you know, brain can get completely destroyed and then you can die because your brain was destroyed, like right, So there's no point in doing that is a permanent death by itself. So if you go to a cardiac arrest, if your heart stops, so then actually your brain is going to die because your heart has stopped, like right. So there are instances where it makes sense from the clinical point of view to intervene in the future, like assuming that this technology is effective.
Okay, great, and I assume that there will be bodies of philosophers and so on who get involved with this question about when is it the right thing to do? When does it make sense?
Absolutely so yeah, So we hit with both publications, we hit commentary work actually on this particular topic.
And I think it's really interesting to see how the field is developing now and how people are thinking now with these new technologies that are coming to a right, including ours and others. If you just think about now, like I think last week or this week actually what was done with transplants and other things.
Here's a question for you. So you, as a scientist and a physician, you're very careful about saying, you know, if this works and this doesn't work yet, and so on. But what is your guests in a century from now. Let's say, do you feel like this is a dead on winner, this is definitely going to work, or do you feel there are some problems that are insurmountable.
I'm positive that this is going to work. I think we are going to it. I think we're developing new tools now. I think our ideas about what death is is changing. In particular, I'm referring to cells here, but we can build a death like we can do like a ground up approach.
We can really develop new approaches and therapist I'm confident that this is a field that is going to advance in the future.
Let me just double click on that. What do you mean by we're having a new understanding of what death is?
Well?
As I said, you know, I went to med school like recently, I still would like to think that I'm young, although it's starting to show.
I was thought that once there's blood laws, that sales just die like after a couple of minutes.
And you know, there have been like instances where people have observed it in their work. But it's not this reasoning or under tending that the death is a process it's not ubiquitous, it's not widespread, and so you know, taking data into account first and then start to do research.
On these things. I think that's going to lead to new tools and new developments.
Just to give you like a simple example, we had a so in in the team, we would always have our electrophysiologists. So these are people who take slices of tissue like right, and they record electrical properties from cells from neurons. I remember one instance, we had a slide, a really bad run, and sales were, like, you know, they were not doing well.
This was early on, and this new person came and so he's looking at the cells in there around which is usually a bad thing because they go from like a triangle to like a rounding and so because so he just goes like, oh, these cells are dead, because he's accustomed to thinking that these cells are dead and they're useless, like.
Right, and so you know, so after a whole day of work, we go like, maybe you should think about these cells and maybe they're not dead yet, maybe they can be saved.
And so it's interesting, you know, from our point of view.
He was new to the whole team, and so it's really interesting like his perception of like one thing and ours. It's basically like it's the glass like half full or half empty situation.
And have you been able to show that you can take those bloated cells and reverse the processes?
So absolutely, so this was the first So going back to who were doing like initial research, that was the first observation that we made. So because I trained in radiology and so you know, you do an MRI in the brain, like you know sort of like how the signal is going to change based on the fake that sales are becoming round or bloated. And so you know, if we're looking these slices, like these cells and we're seeing that they're not round, they're starting to regain their their shape like right, And that was the first thing we observed with the technology.
So that's why, oh incredible, wow, what was that like for you the first time you saw that reversal?
The whole was really you know now with like a benefit of the hindside, Like just for us, we started in a closet like Atale University, we cleared out the closet and we just started doing stuff there and it went from like basic stuff because because people think that when they think about research. They have these like grand ideas of like you know, scientists and like fight codes like doing some capitalists.
This was such a completely opposite thing. And so you know, you go through these motions daily twenty four to seven. You're grinding, and you finally you start to see stuff.
And then the first thing, like like the genuine first thing is confusion because you see something.
And you're like, well, this doesn't like go you know, it's.
It's sort of go against the grain, right, So it's like like what do I do now? And so it's like a confusion and excitement because you want to be sure that that you don't fool yourself, like that's the biggest mistaked.
You know, you can make. But you know, it was really funny, you know, the whole thing. Yeah, it was really fun.
Wow, did you realize at that moment what you were on the verge of because then you published paper. You know, you've had really terrific publications that you've put out about you know, the pig brain and the cellular functions. Did you did you realize when you were first seeing that what this was going to lead to?
I you know, like if you still understand like where these can go and there's always like something, you know, like if you look at something and you like, oh, like these capabilities are like new, you know, like these implications are huge and it's still ongoing and potential.
So that was Vonimir Russella. And it's clear that as a community, our biological insights are opening up big new questions for us. Now this really complicates things from a clinical and legal perspective. Death is usually defined as the cessation of biological functions. Traditionally this had to do with the stopping of the breath and the stopping of the pulse, but even that started to get complicated by the nineteen fifties because people had invented ventilators so it didn't necessarily matter if you stopped breathing, and people invented defibrillators so they could get your heart going again, so that no longer made sense to define death that way. And in nineteen sixty eight Harvard Medical School got together to put together a definition of brain death and they said, look, if you are in a coma that's irreversible, then we'll say you're dead. And different places took on different versions of this until nineteen eighty when the United States came up with a Uniform Determination of Death Act and they said, look, you're dead if you've had an irreversible cessation of blood flow and breathing, or an irreversible cessation of the function of your brain. But the interesting thing is how interventions could play a role here, because the key word that needs to come under scrutiny is reversible. What do we do, How do we redefine death when many problems are no longer going to be irreversible. Now, I want to be clear, there's still a long way to go with the science. The work is underway in pigs, but no one's even talking about humans at this point, in part because the ethical questions are something we can't even wrap our heads around. But the thing I want to point out is that this is now a question. It is a scientific problem being studied in the labs and published in the top journals. It'll be a long while before you hear about this past the walls of the lab, but it's coming. So consider this in the context of recent history. When Mary Shelley wrote her novel Frankenstein that was just over two hundred years ago, it was cast as a warning against the dangers of playing God. But it's fascinating to see how the concept of playing god evolved. After all, you can imagine a time when someone might have said, Hey, if you crack open someone's chest and operate on their heart, you're playing God. Or if you take out someone's heart entirely and replace it with an artificial, pulseless blood pump, you are playing God. Or what about doing an open head surgery to cut out a brain tumor playing god? Or injecting someone with a medication that reverses at the level of invisibly small molecules whatever process in their body is making them sick. You can imagine any moment in history where someone would have looked at this and said, you're messing with the body and playing the role of a deity. But when we look at the long arc of human understanding of science, we see this is the natural direction of things. As we come to understand that the heart is just a pump, we can fix it or replace it. Once we understand what a tumor is a cell that keep dividing out of control, we can learn how to open the skull and control the bleeding of the brain tissue, and the whole issue of tumor removal becomes routine. Once we know how molecular cascades work, then we put them in the textbooks of high school students, and we find drugs that interact with those cascades, and we don't think twice about this stuff. We don't think about it as deity playing, just that someone is hurt or sick and needs our help, and that this is some operation or medication that we now understand that we didn't used to. So John Dunn, who died in sixteen thirty one, coming up on four hundred years ago, could have never imagined that when he penned the poem death Be not Proud, that we'd actually be talking about the end of death as just a molecular puzzle about which we say not now, but at some point, okay, we got it. Just block these pathways by which die or commit suicide, and then these cells stay alive and the whole system just keeps on trucking. And he could never imagined that we'd even be talking about rebooting a system that has already ground to a halt. Now. Mary Shelley died in the mid nineteenth century, two centuries after done, and most of us will see the mid twenty first century, two centuries after Mary Shelley, and it looks likely that we, or our children or our near term descendants will be the first to see Shelley's ethical questions get tackled. Should we revivify a system that's come to a halt under what circumstances? What will be the consequences for society as a community will come to address Shelley's questions not as a science fiction fantasy, but as a basic challenge of passing the right legislation and determining how hospital ethics committees should make their decay decisions about reversing death. And there might be whole groups of people that are your friends and neighbors and work colleagues, and some of them will have ground to a halt. At some point they're revivified, just as you currently have friends and neighbors and colleagues who were under anesthesia and woke up, or they had a heart attack and had their heart defibrillated, or they were in a coma for weeks and regained consciousness. And at some point we'll all live in this new world where we have to address whole new fields of question marks. Because as John Dunn predicted death will have died. Go to eagleman dot com slash podcast for more information and to find further reading. Send me an email at podcasts at eagleman dot com with questions or discussions, and I'll be making sporadic episodes in which I address those until next time. I'm David Eagleman, and this is Inner Cosmos