The Romeo Error

by Lyall Watson

  So there are three states of matter -- life, death, and goth -- but in biological terms it becomes realistic to deal with only two. Either matter is alive or it is goth. The distinction between the two is based on the presence or absence of a co-ordinating pattern or an organizer. Life can be said to exist as long as the most feeble remnant of this vortex persists in matter. When it finally disappears, in time or with isolation, then life is replaced by goth. If the matter itself should become dissipated, as a body would if it were caught in the middle of a thermonuclear explosion, then life as we know it would cease, but goth would not begin until the organizing field had also been destroyed.

  Some kinds of goth are identical to the condition of total biological breakdown that has been called absolute death. I like this term and find that it can be meaningfully applied, for instance, to a body that has been cremated, but it does not encompass those "zombic-like" cell conditions that fall within the definition of goth. The point that we usually call death has been more precisely defined as clinical death, and this, too, can be a useful concept, but it is such a flexible one that it seems more like an attenuation of the life force than a biological condition in its own right.

  Dead matter like a hair or claw, which serves an ordered function in a living organism, is alive. There might even be a case for including some magnets and crystals in this category. Dead matter such as fossil bones and spun cotton, which show none of the order or rhythm of life, are goth. An organism can be stripped down to its cellular components and still retain life, but when these isolated units lose their unique identities, the organization of life gives way to the disorganization of goth. The states of life and goth do overlap to some extent and lie along a continuum that ranges from the complexity of intelligence to the comparative simplicity of an independent molecule. Death is nothing more than a vernier which we slide along this scale in accordance with our current beliefs or the state of our technology. Death, as many philosophers have long suspected, is a state of mind.

  I am well aware that this notion is largely conjectural and owes more to extrapolation than to experimentation, but as a biologist I find myself faced with overwhelming contradictions in all the existing explanations of life and death. I dislike coining new words and new concepts just for the sake of doing so, but there is such a large gap between established theory and observable fact that some kind of new construct seems necessary and justified in this case.

  In my search for corroboration, I have been forced to look beyond the usual sources for clues that could help to put the problem back into evolutionary perspective. I have collected loose ends and odd threads from a variety of strange places and make no apology for their origins, because I intend in the following chapters to demonstrate that these can be woven together in a scientific way into a coherent pattern that begins to make some sense of the enigma of death.

  Chapter Two: DEATH regarded as a disease

  An adult human body contains roughly 60 million million cells, and every twenty-four hours it loses enough of them to fill a soup plate.

  Look closely at the flakes that shower constantly from the skin, and you see exquisitely wrought crystalline polygons whose surfaces form translucent pyramids of keratin. Look at one of the sixty hairs you shed each day, and see over a thousand cells arranged like circular shingles around a central fibrous core. Scrape a thin sliver from a fingernail, and you lose another ten thousand cells, stratified and compressed into a hard horny substance. On the outside of the body every touch, every breath of wind, takes its toll, and on the inside conditions are just as rigorous. Every day the entire lining of the mouth is washed down into the stomach and digested, and 70,000 million cells are scraped off the walls of the intestine by passing food. The rest of the daily quota are destroyed in chemical disasters as love, hate, anger, and worry all wear the body down.

  Laid end to end, the day's total harvest from one body would span the Atlantic, but in the average young adult there is no net loss or gain of cells because the body makes as many as it loses. A child is born with just 2 million million cells, and as it grows, these multiply in numbers about thirty times to bring the body weight up to the adult level. From maturity onward there is a constant drain. After the age of puberty, brain cells are never replaced, and each year after thirty we lose an average of 1 per cent of our neural network. The loss is progressive and continues with increasing age until a point is reached where the balance of life tips rapidly, and disorder and disorganization become more pronounced.

  Finally, a point is reached when we say that a particular organism has died, but how do we know exactly when this happens? Are there any criteria we can use to demonstrate that something special has taken place? Can we be sure?

  The United Nations Department of Vital Statistics defines death as "the permanent cessation of all vital functions." [285] Most authorities agree with this comprehensive definition, but there is considerable disagreement over how one should recognize the functions and what constitutes cessation.

  A British Consumer Publication on "What to Do When Someone Dies" suggests that the first thing to do is to check for breathing by holding a mirror to the mouth to see if it mists over, but even the earliest medical writings recognized this test as unreliable. [3] Advanced hatha-yoga students make nonsense of it with a technique called khechari mudra in which an adept thrusts the tip of his tongue into the nasal orifice at the back of the palate and sits with his mouth closed for hours, apparently unable to draw breath of any kind. [296] Tests on such a practitioner, kept in an airtight metal box in India, showed that he was able to reduce his oxygen consumption and carbon dioxide elimination to a minute level and survive under conditions that would certainly have been lethal for any normal person. [2] Other tests on Zen monks in Japan and on students of transcendental meditation in the United States show that they all produce an immediate decrease of about 20 per cent in oxygen consumption the moment meditation begins. [288] Presumably with practice these figures can be improved. Most of the textbooks on suspended animation refer to a certain Colonel Townsend who deliberately stopped breathing for so long in front of a panel of examining doctors in London that they certified him dead and all went home. He did it again the following day. [46]

  The second traditional sign of clinical death is cessation of the pulse. Here again the picture is complicated by those who have learned conscious control over normally unconscious processes. A French cardiologist who went to India with a portable electrocardiograph found several subjects who could stop their hearts on demand. [287] Even rats can be taught by instrumental training techniques to control their heart rate. [184] In one test series seven rats actually resisted the strong automatic signals which the body sends out when something dangerous is going on, and kept their hearts stopped for so long that they died. [63] I have personally seen a skilled fakir in a New Delhi hospital, also while attached to an electrocardiograph, stop his heart altogether for twelve minutes. On this occasion, a stimulus to the vagus nerve, which carries instructions from the hind brain to the heart, seemed to be produced by what the yogis call the valsalva technique, which involves building up increased pressure in the chest by inhaling deeply and bending sharply forward. The fact that modern medicine has not simplified the problem of death diagnosis is nicely demonstrated by low-temperature surgical techniques in which a heart is prevented from functioning throughout an entire operation. Any nineteenth-century surgeon wandering into such an operating room today would without hesitation certify the patient dead.

  Abnormally low body temperature is also said to be a sure sign of clinical death, but one of the problems with this indicator is that there is little agreement about what the "normal" level should be. In Britain it is 98.4° F., while in the United States it is 98.6° F. Europeans agree with the Americans, but they of course record it as 37° C. Our temperatures are below "normal" when we wake up and above this hypothetical average when we go to sleep. Babies have a much higher temperature and old people have a lower
one, while women gain a whole degree during ovulation. Alter exercise, athletes can simultaneously register 41° C. rectally and 34° C. on the sweat-cooled skin. A cold bath may reduce temperature to 32° C., and old people in cold rooms have been rescued when their temperatures had fallen as low as 24° C. Police pathologists claim that the body temperature falls by almost a degree with each hour after clinical death, and they calculate the time elapsed since murder was done by the formula 10(37 - rectal temperature)/8. [70] This is said to work well up to twelve hours, but thereafter a more subtle table based on a percentage method is brought into use. [74]

  The problem with temperature as a sign of clinical death is that sudden death from lightning or from an internal injury may not result in much change for several hours, while attacks of asthma quickly bring about deathlike temperatures in living people. Other anomalous possibilities are that the temperature rises immediately after due to cholera, tetanus, and smallpox and that all bodies generate so much heat during decomposition that they soon attain normal temperature anyway. Drug-induced suspended animation, as Friar Laurence assured Juliet when he gave her the potion, produces deep sleep in which "no warmth or breath shall testify thou liv'st." A young Swedish boy rescued from a snowdrift recovered completely from a temperature of 17° C., which, according to the police formula, would normally indicate that he had been dead for twenty-five hours. Many animals survive even lower body temperatures during natural hibernation (the hedgehog stabilizes at about 6° C.), and now artificial hibernation is becoming possible for humans. [252] As mentioned before, in hypothermic surgery it is common to stop circulation for an hour by reducing the body temperature to 15° C., and in Japan brain surgery is done at the hedgehog level of 6° C. In 1967 James Bedford of California, had his body permanently frozen at liquid nitrogen's temperature of -196° C., and since that time at least ten others have followed him into deep freeze under the auspices of cryonics societies, whose motto is "Never say die." [205] These bodies in limbo in their cold cocoons pose awesome problems for both biology and the law.

  Some medico-legal experts emphasize the changes that take place in the eye at clinical death. The kindly doctor who closes the staring eyes of the corpse has become a cinema cliche, but the eyelids become equally tractable in deep sleep, apoplexy, asphyxia, drunkenness, poisoning, and after certain injuries to the head. The other classic test of shining a light into the eye has equally little merit because the iris muscles, like many others in the body, remain active and will continue to contract for several hours following certified clinical death. Forensic medical experts claim that the pupil dilates at death and then partly contracts about twenty hours later. Some credence is also given to color changes in that it is said that all eyes become greenish brown some time after death. This may well be true because the iris pigment, melanin, is the same in all eyes; in brown eyes it is merely nearer the surface and in blue eyes obscured by overlaying tissue. It also seems to be true that the cornea becomes dry and hazy and that ten to twelve hours following clinical death the eyeballs become sunken and flaccid.

  When blood comes to a standstill, the red cells settle under the influence of gravity, leaving behind a clear serum that shows through the skin as a pallor, but of course only in light-skinned people. All the blood also tends to sink down to fill the capillaries in the lowest parts of the body and produces a dark staining there that is invaluable to detectives, because it can show whether or not a body has been moved. These stains cannot, however, be used as definitive signs of death, because the only way to distinguish them from predeath bruising, which shows more blood in the surrounding tissues, is by making an incision. [70] The fact that a few hours after clinical death the blood begins to clot led to a belief that it was possible to test for death by making a pinprick and looking for liquid. But the blood is prevented from clotting during life by a chemical that is produced in cells lining the vessels, and these continue to function slowly following death, so that even several days after clotting begins, the blood may once again become completely fluid.

  Another symptom that comes and goes is rigor mortis. This is caused by muscle fibers stiffening when one of the large energy-bearing molecules in the cells changes its form. The process starts in the intestines and then progresses to the heart, the diaphragm, and the muscles of the face. It is usually first noticed in the eyelid after one hour, in the jaw after three or four hours, and in a rigidity of all the long muscles of the body after about twelve hours. Thirty-six hours later the muscles relax again, but this timetable can easily be confused by a number of factors. Rigor mortis can be delayed by stress or fright leaving a high concentration of adrenaline in the blood at the moment of death, and it can be overcome artificially by using force. If a limb in rigor is made to bend, the stiffness does not reappear. It can also appear earlier than usual in cases following severe exhaustion, or even instantaneously as a cadaveric spasm in cases of sudden death. This rare condition is sometimes confused with severe attacks of tetanus.

  The latest advances in medical technology have stretched the definition of clinical death to allow it to cover states once considered irreversible. The Laboratory of Experimental Physiology of Resuscitation in Moscow now describes clinical death as "a state during which all external signs of life (consciousness, reflexes, respiration and cardiac activity) are absent, but the organism as a whole is not yet dead; the metabolic processes of its tissues still proceed, and under definite conditions it is possible to restore all its functions." [87] Under normal conditions an organism in this state would probably not recover, but with therapeutic intervention resuscitation is possible at all times until the brain cortex has become irreparably damaged. After that point, it is still possible to restore activity in individual organs like the heart and lungs, but not to bring the whole organism back to independent life. Experimental work in this area suggests that at normal temperatures five or six minutes is the maximum period of inactivity that the brain can tolerate and still recover all its functions. So death is now being pinpointed with electroencephalographs as the moment this period has elapsed in the least stable of all tissues in the body. This would seem to be the most precise method of death determination yet devised, but the Russian workers warn that the six-minute maximum is still not fixed with any degree of certainty. They say that "from a practical standpoint it is impossible to determine exactly the end of the state of clinical death for each individual organism, and one has to resort to data based on averages.

  It is obvious that no symptom on its own can be taken as a sure indication of clinical death. Most authorities have long been aware of this, and all stress the fact that there is only one reliable sign -- putrefaction. When bacteria and fungi begin to proliferate in the intestines, they produce a discoloration on the abdomen which starts as gray spots that gradually turn to green and produce a foul smell. Not even this, however, is foolproof, because certain diseases of the skin produce markings exactly like these signs of final decay.

  A standard text on postmortem appearances sums up the problem by pointing out that there are three possible causes of death. [220] These are asphyxia, or respiratory failure (produced by choking, strangulation, paralysis, etc.); syncope, or circulatory failure (brought on by shock, hemorrhage, heart disease, etc.); and coma, or nervous failure (caused by brain injury, poisons, drugs, etc.). In not one of the three causes are there any characteristic external signs of any real use in diagnosis.

  All the latest advances in medicine and technology do not seem to have helped much. In 1890 one concerned doctor produced a paper on the problems of determining real from apparent death and listed 418 references. [88] Today the list would have to be even longer, but there is still no sign of unanimity on the subject. All our new devices for sustenance and resuscitation have made the distinction between life and death even less clear; and despite the sophistication of our equipment, we still make mistakes. On November 3, 1967, a severely injured United States soldier was taken to the best military hospital in Sou
th Vietnam, where efforts to resuscitate him were abandoned after forty-five minutes. The doctors and the electrocardiograph and the electroencephalograph all said that he was dead, but four hours later he recovered in the mortuary and today he draws a combat pension back home in Illinois. [174] A comment made in 1821 is still very apposite: "If we are aware of what indicates life, which everyone may be supposed to know, though perhaps no one can say that he truly and clearly understands what constitutes it, we at once arrive at the discrimination of death. It is the cessation of the phenomena with which we are so familiar -- the phenomena of life." [254]

  It is now clearly recognized that there are degrees of death and that clinical death (the cessation of the vital functions) occurs some time before absolute death (which is marked by the breakdown of the cells producing those functions). Hair and nails continue to grow, the liver goes on making glucose, and cells can be taken from the body and successfully cultured more than seventy-two hours after clinical death. Our new state of goth does not begin until the cells have undergone sufficient chemical damage or physical isolation to separate them from their source of organization. The first organs to experience absolute cellular death seem to be the most specialized ones like the brain and the eye. Transplant surgeons realize this and demand more and more specialized equipment to keep certain organs alive and functional for transference to other patients. Of course this equipment is only brought into action when it is obvious that the donor must die anyway, but with each technical advance and with the addition of each new life-prolonging device, more patients are being saved who would normally have died.