Stiff

by Mary Roach

  White escorts me through the hospital corridors and stairways, past the neurosurgery department, up the stairs, to his old lab. He is seventy-six now, thinner than he was at the time of the operations, but elsewise little changed by age. His answers have the rote, patient air you expect from a man who has been asked the same questions a hundred times.

  “Here we are,” says White. NEUROLOGICAL RESEARCH LABORATORY, says a plaque beside the door, giving away nothing. To step inside is to step back into 1968, before labs went white and stainless. The counters are of a dull black stone, stained with white rings, and the cabinets and drawers are wood. It has been a while since anyone dusted, and ivy has grown over the one window. The fluorescent lights have those old covers that look like ice tray dividers.

  “This is where we shouted ‘Eureka!’ and danced around,” recalls White. There isn’t much room for dancing. It’s a small, cluttered, low-ceilinged room, with a couple of stools for the scientists, and a downsized veterinary operating table for the rhesus monkeys.

  And while White and his colleagues danced, what was going on inside the brain of that monkey? I ask him what he imagined it must have been like to find yourself, suddenly, reduced to your thoughts. I am, of course, not the first journalist to have asked this question. The legendary Oriana Fallaci* asked it of White’s neurophysiologist Leo Massopust, in a Look magazine interview in November 1967. “I suspect that without his senses he can think more quickly,” Dr. Massopust answered brightly. “What kind of thinking, I don’t know. I guess he’s primarily a memory, a repository for information stored when he had his flesh; he cannot develop further because he no longer has the nourishment of experience. Yet this, too, is a new experience.”

  White declines to sugar-coat. He mentions the isolation chamber studies of the 1970s, wherein subjects had no sensory input, nothing to hear, see, smell, feel, or taste. These people got as close as you can come, without White’s aid, to being brains in a box. “People [in these conditions] have gone literally crazy,” says White. “and it doesn’t take all that long.” Although insanity, too, is a new experience for most people, no one was likely to volunteer to become one of White’s isolated brains. And of course, White couldn’t force anyone to do it—though I imagine Oriana Fallaci came to mind. “Besides,” says White. “I would question the scientific applicability. What would justify it?”

  So what justified putting a rhesus monkey through it? It turns out the isolated brain experiments were simply a step on the way toward keeping entire heads alive on new bodies. By the time White appeared on the scene, early immunosuppressive drugs were available and many of the problems of tissue rejection were being resolved. If White and his team worked out the kinks with the brains and found they could be kept functioning, then they would move on to whole heads. First monkey heads, and then, they hoped, human ones.

  Our conversation has moved from White’s lab to a booth in a nearby Middle Eastern restaurant. My recommendation to you is that you never eat baba ganoush or, for that matter, any soft, glistening gray food item while carrying on a conversation involving monkey brains.

  White thinks of the operation not as a head transplant, but as a whole-body transplant. Think of it this way: Instead of getting one or two donated organs, a dying recipient gets the entire body of a brain-dead beating-heart cadaver. Unlike Guthrie and Demikhov with their multiheaded monsters, White would remove the body donor’s head and put the new one in its place. The logical recipient of this new body, as White envisions it, would be a quadriplegic. For one thing, White said, the life span of quadriplegics is typically reduced, their organs giving out more quickly than is normal. By putting them—their heads—onto new bodies, you would buy them a decade or two of life, without, in their case, much altering their quality of life. High-level quadriplegics are paralyzed from the neck down and require artificial respiration, but everything from the neck up works fine. Ditto the transplanted head. Because no neurosurgeon can yet reconnect severed spinal nerves, the person would still be a quadriplegic—but no longer one with a death sentence. “The head could hear, taste, see,” says White. “It could read, and hear music. And the neck can be instrumented just like Mr. Reeve’s is, to speak.”

  In 1971, White achieved the unthinkable. He cut the head off one monkey and connected it to the base of the neck of a second, decapitated monkey. The operation lasted eight hours and required numerous assistants, each having been given detailed instructions, including where to stand and what to say. White went up to the operating room for weeks beforehand and marked off everyone’s position on the floor with chalk circles and arrows, like a football coach. The first step was to give the monkeys tracheotomies and hook them up to respirators, for their windpipes were about to severed. Next White pared the two monkey’s necks down to just the spine and the main blood vessels—the two carotid arteries carrying blood to the brain and the two jugular veins bringing it back to the heart. Then he whittled down the bone on the top of the body donor’s neck and capped it with a metal plate, and did the same thing on the bottom of the head. (After the vessels were reconnected, the two plates were screwed together.) Then, using long, flexible tubing, he brought the circulation of the donor body over to supply its new head and sutured the vessels. Finally, the head was cut off from the blood supply of its old body.

  This is, of course, grossly simplified. I make it sound as though the whole thing could be done with a jackknife and a sewing kit. For more details, I would direct you to the July 1971 issue of Surgery, which contains White’s paper on the procedure, complete with pen-and-ink illustrations. My favorite illustration shows a monkey body with a faint, ghostly head above its shoulders, indicating where its head had until recently been located, and a jaunty arrow arcing across the drawing toward the space above a second monkey body, where the first monkey’s head is now situated. The drawing lends a tidy, businesslike neutrality to what must have been a chaotic and exceptionally gruesome operation, much the way airplane emergency exit cards give an orderly, workaday air to the interiors of crashing planes. White filmed the operation but wouldn’t, despite protracted begging and wheedling, show me the film. He said it was too bloody.

  That’s not what would have gotten to me. What would have gotten to me was the look on the monkey’s face when the anesthesia wore off and it realized what had just taken place. White described this moment in the aforementioned paper. “Cephalic Exchange Transplantation in the Monkey”: “Each cephalon [head] gave evidence of the external environment…. The eyes tracked the movement of individuals and objects brought into their visual fields, and the cephalons remained basically pugnacious in their attitudes, as demonstrated by their biting if orally stimulated.” When White placed food in their mouths, they chewed it and attempted to swallow it—a bit of a dirty trick, given that the esophagus hadn’t been reconnected and was now a dead end. The monkeys lived anywhere from six hours to three days, most of them dying from rejection issues or from bleeding. (In order to prevent clotting in the anastomosed arteries, the animals were on anticoagulants, which created their own problems.)

  I asked White whether any humans had ever stepped forward to volunteer their heads. He mentioned a wealthy, elderly quadriplegic in Cleveland who had made it clear that should the body transplant surgery be perfected when his time draws near, he’s game to give it a whirl. “Perfected” being the key word. The trouble with human subjects is that no one wants to go first. No one wants to be a practice head.

  If someone did agree to it, would White do it?

  “Of course. I see no reason why it wouldn’t be successful with a man.” White doesn’t think the United States will be the likely site of the first human head transplant, owing to the amount of bureaucracy and institutional resistance faced by inventors of radical new procedures. “You’re dealing with an operation that is totally revolutionary. People can’t make up their minds whether it’s a total body transplant or a head transplant, a brain or even a soul transplant. There’s another issue
too. People will say, ‘Look at all the people’s lives you could save with the organs in one body, and you want to give that body to just one person. And he’s paralyzed.’”

  There are other countries, countries with less meddlesome regulating bodies, that would love to have White come over and make history swapping heads. “I could do it in Kiev tomorrow. And they’re even more interested in Germany and England. And the Dominican Republic. They want me to do it. Italy would like me to do it. But where’s the money?” Even in the United States, cost stands in the way: As White points out, “Who’s going to fund the research when the operation is so expensive and would only benefit a small number of patients?”

  Let’s say someone did fund the research, and that White’s procedures were streamlined and proved viable. Could there come a day when people whose bodies are succumbing to fatal diseases will simply get a new body and add decades to their lives—albeit, to quote White, as a head on a pillow? There could. Not only that, but with progress in repairing damaged spinal cords, surgeons may one day be able to reattach spinal nerves, meaning these heads could get up off their pillows and begin to move and control their new bodies. There’s no reason to think it couldn’t one day happen.

  And few reasons to think it will. Insurance companies are unlikely to ever cover such an expensive operation, which would put this particular form of life extension out of reach of anyone but the very rich. Is it a sensible use of medical resources to keep terminally ill and extravagantly wealthy people alive? Shouldn’t we, as a culture, encourage a saner, more accepting attitude toward death? White doesn’t profess to have the last word on the matter. But he’d still like to do it.

  Interestingly, White, a devout Catholic, is a member of the Pontifical Academy of Sciences, some seventy-eight well-known scientific minds (and their bodies) who fly to Vatican City every two years to keep the Pope up to date on scientific matters of special interest to the church: stem cell research, cloning, euthanasia, even life on other planets. In one sense, this is an odd place for White, given that Catholicism preaches that the soul occupies the whole body, not just the brain. The subject came up during one of White’s meetings with the Holy Father. “I said to him, ‘Well, Your Holiness, I seriously have to consider that the human spirit or soul is physically located in the brain.’ The Pope looked very strained and did not answer.” White stops and looks down at his coffee mug, as though perhaps regretting his candor that day.

  “The Pope always looks a little strained,” I point out helpfully. “I mean, with his health and all.” I wonder aloud whether the Pope might be a good candidate for total body transplant. “God knows the Vatican’s got the money….” White throws me a look. The look says it might not be a good idea to tell White about my collection of news photographs of the Pope having trouble with his vestments. It says I’m a petit bouchon fécal.

  White would very much like to see the church change its definition of death from “the moment the soul leaves the body” to “the moment the soul leaves the brain,” especially given that Catholicism accepts both the concept of brain death and the practice of organ transplantation. But the Holy See, like White’s transplanted monkey heads, has remained pugnacious in its attitude.

  No matter how far the science of whole body transplantation advances, White or anyone else who chooses to cut the head off a beating-heart cadaver and screw a different one onto it faces a significant hurdle in the form of donor consent. A single organ removed from a body becomes impersonal, identity-neutral. The humanitarian benefits of its donation outweigh the emotional discomfort surrounding its removal—for most of us, anyway. Body transplants are another story. Will people or their families ever give an entire, intact body away to improve the health of a stranger?

  They might. It has happened before. Though these particular curative dead bodies never found their way to the operating room. They were more of an apothecary item: topically applied, distilled into a tincture, swallowed or eaten. Whole human bodies—as well as bits and pieces of them—were for centuries a mainstay in the pharmacopoeias of Europe and Asia. Some people actually volunteered for the job. If elderly men in twelfth-century Arabia were willing to donate themselves to become “human mummy confection” (see recipe, next chapter), then it’s not hard to imagine that a man might volunteer to be someone else’s transplanted body. Okay, it’s maybe a little hard.

  10

  EAT ME

  Medicinal cannibalism and the case of the human dumplings

  In the grand bazaars of twelfth-century Arabia, it was occasionally possible, if you knew where to look and you had a lot of cash and a tote bag you didn’t care about, to procure an item known as mellified man. The verb “to mellify” comes from the Latin for honey, mel. Mellified man was dead human remains steeped in honey. Its other name was “human mummy confection,” though this is misleading, for, unlike other honey-steeped Middle Eastern confections, this one did not get served for dessert. One administered it topically and, I am sorry to say, orally as medicine.

  The preparation represented an extraordinary effort, both on the part of the confectioners and, more notably, on the part of the ingredients:

  …In Arabia there are men 70 to 80 years old who are willing to give their bodies to save others. The subject does not eat food, he only bathes and partakes of honey. After a month he only excretes honey (the urine and feces are entirely honey) and death follows. His fellow men place him in a stone coffin full of honey in which he macerates. The date is put upon the coffin giving the year and month. After a hundred years the seals are removed. A confection is formed which is used for the treatment of broken and wounded limbs. A small amount taken internally will immediately cure the complaint.

  The above recipe appears in the Chinese Materia Medica, a 1597 compendium of medicinal plants and animals compiled by the great naturalist Li Shih-chen. Li is careful to point out that he does not know for certain whether the mellified man story is true. This is less comforting than it sounds, for it means that when Li Shih-chen does not make a point of questioning the veracity of a Materia Medica entry, he feels certain that it is true. This tells us that the following were almost certainly used as medicine in sixteenth-century China: human dandruff (“best taken from a fat man”), human knee dirt, human ear wax, human perspiration, old drumskins (“ashed and applied to the penis for difficult urination”), “the juice squeezed out of pig’s feces,” and “dirt from the proximal end of a donkey’s tail.”

  The medicinal use of mummified—though not usually mellified—humans is well documented in chemistry books of sixteenth-, seventeenth-, and eighteenth-century Europe, but nowhere outside Arabia were the corpses volunteers. The most sought-after mummies were said to be those of caravan members overcome by sandstorms in the Libyan desert. “This sudden suffocation doth concentrate the spirits in all the parts by reason of the fear and sudden surprisal which seizes on the travellers,” wrote Nicolas Le Fèvre, author of A Compleat Body of Chymistry. (Sudden death also lessened the likelihood that the body was diseased.) Others claimed the mummy’s medicinal properties derived from Dead Sea bitumen, a pitchlike substance which the Egyptians were thought, at the time, to have used as an embalming agent.

  Needless to say, the real deal out of Libya was scarce. Le Fèvre offered a recipe for home-brewed mummy elixir using the remains of “a young, lusty man” (other writers further specified that the youth be a redhead). The requisite surprisal was to have been supplied by suffocation, hanging, or impalement. A recipe was provided for drying, smoking, and blending (one to three grains of mummy in a mixture of viper’s flesh and spirit of wine) the flesh, but Le Fèvre offered no hint of how or where to procure it, short of suffocating or impaling the young carrot-top oneself.

  There was for a time a trade in fake mummies being sold by Jews in Alexandria. They had apparently started out selling authentic mummies raided from crypts, prompting the author C. J. S. Thompson in The Mystery and Art of the Apothecary to observe that “the Jew even
tually had his revenge on his ancient oppressors.” When stocks of real mummies wore thin, the traders began concocting fakes. Pierre Pomet, private druggist to King Louis XIV, wrote in the 1737 edition of A Compleat History of Druggs that his colleague Guy de la Fontaine had traveled to Alexandria to “have ocular demonstration of what he had heard so much of” and found, in one man’s shop, all manner of diseased and decayed bodies being doctored with pitch, wrapped in bandages, and dried in ovens. So common was this black market trade that pharmaceutical authorities like Pomet offered tips for prospective mummy shoppers: “Choose what is of a fine shining black, not full of bones and dirt, of good smell and which being burnt does not stink of pitch.” A. C. Wootton, in his 1910 Chronicles of Pharmacy, writes that celebrated French surgeon and author Ambroise Paré claimed ersatz mummy was being made right in Paris, from desiccated corpses stolen from the gibbets under cover of night. Paré hastened to add that he never prescribed it. From what I can tell he was in the minority. Pomet wrote that he stocked it in his apothecary (though he averred that “its greatest use is for catching fish”). C. J. S. Thompson, whose book was published in 1929, claimed that human mummy could still be found at that time in the drug-bazaars of the Near East.

  Mummy elixir was a rather striking example of the cure being worse than the complaint. Though it was prescribed for conditions ranging from palsy to vertigo, by far its most common use was as a treatment for contusions and preventing coagulation of blood: People were swallowing decayed human cadaver for the treatment of bruises. Seventeenth-century druggist Johann Becher, quoted in Wootton, maintained that it was “very beneficial in flatulency” (which, if he meant as a causative agent, I do not doubt). Other examples of human-sourced pharmaceuticals surely causing more distress than they relieved include strips of cadaver skin tied around the calves to prevent cramping, “old liquified placenta” to “quieten a patient whose hair stands up without cause” (I’m quoting Li Shih-chen on this one and the next). “clear liquid feces” for worms (“the smell will induce insects to crawl out of any of the body orifices and relieve irritation”), fresh blood injected into the face for eczema (popular in France at the time Thompson was writing), gallstone for hiccoughs, tartar of human teeth for wasp bite, tincture of human navel for sore throat, and the spittle of a woman applied to the eyes for ophthalmia. (The ancient Romans, Jews, and Chinese were all saliva enthusiasts, though as far as I can tell you couldn’t use your own. Treatments would specify the type of spittle required: woman spittle, newborn man-child spittle, even Imperial Saliva, Roman emperors apparently contributing to a community spittoon for the welfare of the people. Most physicians delivered the substance by eyedropper, or prescribed it as a sort of tincture, although in Li Shih-chen’s day, for cases of “nightmare due to attack by devils,” the unfortunate sufferer was treated by “quietly spitting into the face.”)