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This book is full of scary details like, “The majority of healthcare professionals can not accurately list the criteria for brain death,” and “Sixty-five percent of brain-death exams are done incorrectly,” and “Organ transplantation is a $20-billion per year business.”  Details that if you’re a non-naive, semi-informed, slightly pessimistic but likes to consider themselves more of a realistic healthcare professional, leave you feeling like this:


People are idiots.  We know this.

I was semi disappointed because, 1) I thought this book was written by a doctor (I was disappointed when I found it was written by Dick Teresi, who calls himself a “science writer”), and 2) I thought it would be less bias.  The man obviously thinks organ donation and the healthcare system overall is full of crooks and money hungry cats, which — it is.  However, throughout the entire book he insists he isn’t bias — he gushes with self-righteousness, defending himself against imaginary judgement, insisting that he’s only “doing his job by telling the truth.”  You may have more in common with doctors than you think, Mr. Teresi.

I do appreciate his humor and sarcasm, though.  I think his book is full of interesting facts (even if it gets redundant) and overall, I do agree with him that it’s f*cking scary that our healthcare system can not accurately determine what brain death really is.  Is it lack of cortical function?  Or brain stem function?  Or both?  Is it a lack of a heartbeat?  Is it lack of consciousness?  How do you define consciousness?  Why is there not a universal, brain-death criteria that must be met before doctors declare brain death?  Brain death criteria varies across hospitals, doctors and states, which means as you cross borders, you could go from dead, to alive, to dead again — uhh… what?!


A pulse and respiration can be so faint you don’t catch them with the human eye.  You can have a pulse with no breathing or vice versa.  A brain scan shows no cortical activity but the brain stem is intact and functioning.  As the author says, dying has never been easy.  From the beginning of time physicians have struggled with determining death (burying someone alive was common) and to this day we still struggle with the same question.  Now that our bodies are hooked up to artificial lungs and hearts, death has become even more elusive.

He then went on to quote a physician who said the only true way to determine death is to leave the body in a room for 1 week — if decomposition begins, then they’re dead.  “They” meaning, the human “soul” we came to know as that person.  The microscopic cells are still alive, still morphing, dissolving, evolving — some scientists believe this constitutes as everlasting life.  A comforting idea.

Can you imagine a hospital set up with that system in place?  The machines are unplugged, family members gaze toward the door as their loved one is rolled out, down the elevator to the 2nd floor (morgues are in the basement after all), ID badge scanned and into the “Sleeping Room.”  Concrete walls, comfortable lighting and temperature control (after all, they may be alive), the nurse transfers the body from a gurney to a padded mat on the floor, next to dozens of others who may or may not snap out of their seemingly dead state.  

A body in the corner looks painfully bloated.  Is that foam seeping out of the ears?  The nurse motions toward it, “I think that he’s gone for sure.”  The morgue is notified.  Two days later another body is checked on — warm skin, breathing, pulse but unconscious.  Not dead.  Perhaps a coma or vegetative state.  Good to know.  Now, we can move him back to the floor, very certain that this one is quite alive.


What fun.