I can imagine that deep, throaty laugh echoing down from Mount Olympus. “Immortality? That’s all? You got it. No problem.”
And true to Zeus’s word, Tithonus lived forever. No problem.
Although Tithonus couldn’t die, he nevertheless continued to age. Gradually he became frail, weak, and incoherent. In the end, he became an embarrassment to Eos, and she locked him away:
When hateful old age had utterly overcome him, and he could not move or lift his limbs, to her this seemed the wisest counsel; she laid him in a chamber, and shut the shining doors, and his voice flows on endlessly, and no strength now is his such as once there was in his limbs.
Lifesaving technology can revive a patient like Joe, at least in the short term. But it can’t make him young and healthy. Neither can it cure the other maladies that come with age. So we are left with many questions.
What happens when we test the boundaries of life? Do we get a miracle? Or is Zeus still up there somewhere, wondering why we humans never seem to learn?
Should we try to bring people like Joe or Michelle back to life just because there’s a very small chance that we might succeed? Will they thank us if we do?
Why does resurrection seem so easy? And how have we convinced ourselves that efforts to resuscitate someone should be automatic?
What does the future hold? And should we be excited or frightened? Or maybe both?
The answers to these questions aren’t easy, or simple. So don’t think of this as a self-help book. In fact, if you found it accidentally shelved in the self-help section, in between titles on sex and spirituality, just walk away. Now. The same advice holds if you found it filed under “Home Repair: Electrical.”
It’s precisely because these questions are difficult that the pursuit of answers has led me on a fascinating journey.
I’ll tell you about a device that saves people’s brains by cooling their noses, and about a bed that supposedly re-creates the heart’s natural circulation by shaking people like the Magic Fingers massage beds of the ’70s. I’ll also show you devices that will shock your heart back to life, and a drug that just might put people in a state of suspended animation.
I’ll introduce you to the people behind these inventions. We’ll meet a scientist who is convinced that lemurs—small, furry primates about the size of a plush dog toy—can teach humans to hibernate. We’ll meet a man who chops off people’s heads and freezes them, with a plan to thaw them in a thousand years or so. And I’ll introduce you to the drummer in a Journey tribute band who has made a career out of teaching CPR to kids.
We’ll also meet a few people who have benefited from the science of resuscitation. There’s a man who died a dozen times and who shocked himself back to life, a two-year-old girl who was brought back to life by her nine-year-old brother, and a mushroom farmer who survived a harrowing operation because his brain was put on ice.
We’ll also look at some of the hazards to this science. For instance, I’ll tell you about a woman whose “natural” death, without CPR, caused a national uproar. I’ll introduce you to paramedics who worry every day about whether bringing people back from the dead is the right thing to do. And we’ll meet a woman who blames herself because she didn’t do enough to save her husband’s life.
Although the science that makes resuscitation possible is amazing, its costs—financial, ethical, and emotional—can be enormous. As new breakthroughs continue to emerge, each of which will be more spectacular than the last, those costs are going to grow as well. So we’ll all need to think very, very carefully about when, and how, this science should be used to restore a life.
I can’t tell you whether you should embrace the science of resuscitation, and I can’t tell you whether you should let it bring you, or a family member, back to life. I can only suggest questions that we should all be asking about these advances that are blurring the line between life and death. For now, I can promise you a fascinating glimpse of what the future holds, and the sorts of choices we’re all going to need to make someday.
2
Why Amsterdam Used to Be a Good Place to Commit Suicide
Two guys and a dead woman walk into a bar . . .
The year is 1769. April 17, at 9:30 in the morning, to be precise. The place is Amsterdam. And Anne Wortman is lying facedown in the otherwise picturesque canal. She is quite dead.
Passersby stare. A few remove their hats out of respect. More than a few turn away.
Then Andrew de Raad and Jacob Toonbergen emerge from a side street and shoulder their way through the crowd. Respectably dressed in wool frock coats, waistcoats, and breeches, they could be merchants. But what are they doing here?
These two good citizens of Amsterdam tumble down the slippery stone steps and grasp Ms. Wortman roughly by her arms and feet. They drag her up and over the canal’s edge, laying her down on the cobblestones. Then they look carefully for signs of life.
Breathing? Nope.
Heartbeat? Afraid not.
Movement of limbs? Opening of eyes? Twitching of fingers? All negative.
Alas, it is becoming increasingly clear that our brave duo has encountered someone who has succeeded in expiring.
Given this information, most Good Samaritans in the eighteenth century—and I’m guessing that’s upward of 99.9 percent—would simply have walked away. They’d shrug, check their pocket watches, and remember they have tickets to Christoph Gluck’s new opera, Alceste.
But not these Good Samaritans. Oh, no.
These men view the victim’s departure from the world of the living not as the end of their efforts but rather as the beginning. This, they’re thinking, is a challenge.
First, they drape her over a log and roll her back and forth for about fifteen minutes in an attempt to remove some water from her lungs. As they hoped, water emerges. But Anne Wortman fails to wake up.
So the two impromptu paramedics hoist the dead woman. The crowd, perhaps sensing that things are about to get interesting, lends a hand. Soon the dead woman and her rescuers are surrounded by a scrum of bystanders who, for reasons that are not immediately clear, all seem to want to help transport a corpse.
Minutes later the throng arrives at a nearby tavern. The late Ms. Wortman is carried up the stairs, where she is deposited on a bed.
Then the apothecary arrives. Mr. Bernard Donfalaar, it seems, is an old hand at this resuscitation business, and he immediately takes charge. Poor Ms. Wortman is “cold and stiff, without either respiration or pulse. . . .” Admittedly it’s not an auspicious beginning. Yet Donfalaar is undeterred.
Under his direction, the inn’s servants undress Ms. Wortman and place her before the fire, between two blankets. Next, Mr. Donfalaar begins to rub Ms. Wortman’s body with ammonia and spirit of rosemary. He does so assiduously, paying particular attention to “the spine of the back, muscles of the neck, the whole head and temples, and particularly the loins.” He also puts a bottle of boiling water on her feet.
Under his direction, Mr. Donfalaar’s assistants remove a knife from its sheath and cut off the sheath’s tip, creating a flattened hollow tube. They then use this jerry-rigged device to blow tobacco smoke into Ms. Wortman’s rectum. One can only assume that Ms. Wortman herself is still a corpse at this point, and thus is more or less indifferent to the liberties being taken with her person.
Somewhere in this flurry of activity, Mr. Donfalaar takes a step that is even more unusual, and which no doubt causes bystanders to gasp in astonishment. He places a handkerchief over the mouth of the dead woman, bends over, and exhales. There is, alas, no immediate salutary effect from this maneuver. Nevertheless, he repeats this process several times. The crowd is breathless.
Unfortunately, so is Ms. Wortman. Things are looking very grim indeed, and the good Mr. Donfalaar’s reputation appears to be hanging in the balance.
Finally, perhaps despairing of the possibility of returnin
g this dead woman to the bosom of her family, Mr. Donfalaar brandishes his pièce de résistance. This is the device that will haul her back among the living. This is the newest technology in the new science of resuscitation.
Mr. Donfalaar brandishes . . . a feather.
You can just hear the knowing murmurs circulating in the crowded tavern.
“Told you so.”
“Yup, knew they’d have to pull out the feather eventually.”
Mr. Donfalaar opens the dead woman’s mouth and inserts the feather. Farther. Farther. As far back as he can get. Then he tickles the back of the dead woman’s throat.
This is when Ms. Wortman seems to decide that enough is enough. Willing, perhaps, to endure a wide range of indignities, this was beyond anything she’d bargained for. And so, overwhelmed by these ministrations and the kind intentions that inspired them, Ms. Wortman decides that this is an excellent time to rejoin the living.
Admittedly, she does this with something less than perfect grace, choking and coughing and vomiting up copious amounts of brackish canal water. Her rescuers, delighted by this turn of events, ply her with Jenever, a Dutch version of gin made with malt liquor. She responds to this overture—not surprisingly—with more choking, coughing, and heaving.
Her behaviors, everyone realizes, are not usually observed in a dead person. This realization is cause for rejoicing. And rejoice they do.
One advantage of carrying out resuscitations in a tavern is that the ingredients for a celebratory party are mercifully close at hand. Conversely, if things don’t turn out well, solace is nearby as well. Either way, those pragmatic Dutch seemed to have had their bases covered.
Now, though, the recently dead Ms. Wortman probably begins to wonder why she is in a strange bed. The fact that she is as naked as a jaybird has probably also begun to penetrate her consciousness, perhaps providing some cause for uneasiness. If she is paying attention, the crowd of onlookers surrounding her has probably also been brought to her attention, further confusing matters in her already-addled, formerly deceased mind. Given all of this, I would not be at all surprised if she begins to at least entertain the idea of returning to being dead.
But she does not. In fact, Ms. Wortman is none the worse for wear. “By these prudent methods,” we’re assured, “[Donfalaar] had the satisfaction to see her entirely recovered in less than a fortnight.” Entirely recovered, that is, except for a newly acquired fear of feathers that she will find herself unable to explain.
Welcome to the strange new science of resuscitation.
THE AMSTERDAM SOCIETY IN FAVOUR OF DROWNED PERSONS
The small stone bridge that connects the two sides of Egelantiersgracht like the horizontal bar of the letter H is at the picturesque heart of the most picturesque Jordaan neighborhood of the already quite picturesque city of Amsterdam.
It’s a cloudless spring morning and I’m standing by the bridge’s railing, surrounded by a veritable United Nations of tourists photographically recording the scenery from every conceivable angle. One couple has focused on a bright red door whose lintel is wreathed with a manicured arch of white roses, and a serious-looking woman in a Yankees baseball cap is in digital rapture over the basketful of tulips attached to an old sturdy bicycle tethered to the canal railing. A crowd of Italian kids feverishly snaps pictures of one another.
I’m painfully aware that I seem to be the only tourist in this beautiful city who is not amassing a digital record of everything in view. Instead, what I’m looking for here in Amsterdam is something that isn’t visible in the shops and cafés and tall, lean, row homes that line the canals. What I’m looking for is a bit of history.
I approach the woman in the Yankees cap and mention casually that we’re standing in the city where the first successful attempts at cardiopulmonary resuscitation took place.
Her expression suggests that she wasn’t aware of this fact. Her expression also suggests that this information isn’t rocking her world.
Undeterred, I press on.
Back in 1767, two years before the Anne Wortman incident, a band of concerned Dutch citizens formed the Society in Favour of Drowned Persons here in Amsterdam. Most of the biggest advances in medicine in the past hundred years—anesthesia, surgery, artificial hearts, and of course resuscitation—started right here, I tell her.
But it seems she isn’t impressed. With a final look at her beloved bicycle, she’s gone. I wander on too, through the sparse traffic to the north side of Egelantiersgracht, then head east toward the center of town. Crossing canal after canal, and looking down into the murky water that seethes between bridge pilings, I begin to get a new respect for those daring souls in the Society who decided that a body floating down there amid the trash might be brought back to life.
Unfortunately, there’s little written history about that group or its founders. All we know is that at some point in the 1760s, a small group of merchants, government clerks, and clergy became concerned about the number of their fellow citizens who were drowning in the city’s canals.
They met, they debated, and they made lists. Most important, they tried to figure out how best to revive someone who was “apparently dead.” Along the way, they kept copious notes of rescues like that of poor Ms. Wortman. We know about her story, and the stories of dozens of people like her, because a British physician named Thomas Cogan who went to medical school in Holland took the time to translate the Society’s notes into English.
Some of the rescues he describes were successful. Some others not so much. And yet those feisty Dutch persevered. In their mission to revive the dead, they undertook various experiments. They discussed, they learned, and they tried again. And again. And again.
The Society made strident recommendations regarding effectiveness. And they disseminated those recommendations widely in the form of pamphlets distributed to “hospitals and public charities, coffee houses, taverns, &c.” Here we see formal endorsements of many of the techniques that were inflicted on Ms. Wortman.
For instance, inflating the intestines was felt to be a good thing to do. Specifically: “To blow into the intestines through a tobacco-pipe, a pair of bellows, or the sheath of a knife, cutting off the lower point.” Time is of the essence. “The sooner this operation is performed with force and assiduity,” the Society’s pamphlet says, “the more useful it will prove.” Better still, the Society suggests that rather than inflating the intestines with mere air, try “the warm irritating fumes of tobacco.”
The same document offers other suggestions, including the use of “strong frictions all over the body, particularly down the spine of the back of the neck to the rump.” Spirits of ammonia were popular too. Sprinkling a victim with salt was thought to be salutary, as was rubbing with a cloth steeped in brandy. One has to wonder at the culinary spectacle this creates—pulling a dead person out of the water, tenderizing, marinating, and sprinkling him with salt.
The foregoing list might seem to indicate that the Society had a naive credulity regarding any treatments that might conceivably bring a dead person back to life. I mean, if smoke blown into the rectum makes the cut, then the selection process can’t be very stringent. Was there anything that the Society didn’t consider worth a try?
Indeed there was. It was particularly critical of the technique of rolling a victim over a barrel or log, one of the many ministrations to which our young Ms. Wortman was subjected. The Society points out repeatedly in its meeting notes that this method could lead to internal injury and death. Its case studies are full of gruesome accounts of victims who, after being so rolled, proceeded to void blood “from above and below” until they died. Really died.
Alas, though, this rolling technique had so thoroughly worked its way into the minds of the populace of Amsterdam that the Society had difficulty curbing its use. “Yet in vain is it condemned by persons better instructed,” the Society laments. “The populace will not easily re
nounce prejudices supported by long custom.” Despite its best efforts, the Society found it impossible to prevent well-meaning rescuers from reaching for a barrel at the first sight of a dead person.
On the other hand, in what has to be its finest moment, the Society seems to have hit a home run. It also recommended an odd procedure that is not formally named. In fact, it is not described in much detail at all, but you’ll get the gist: “Let one of the assistants, applying his mouth to that of the drowned, closing the nostrils with one hand, and pressing the left breast with the other, blow with force, and endeavor to inflate the lungs.” So: mouth-to-mouth resuscitation was promoted all the way back in the eighteenth century.
And the Society was bullish about its benefits. “We believe,” the manual opines, “that, from the beginning, this might be as efficacious as blowing up the fundament [rectum].” Indeed. And much more pleasant, one can only assume, for everyone involved.
The Society even offered a suggestion that the American Red Cross has, alas, not taken up. With typical Dutch caution, the Society advised placing a handkerchief over the victim’s mouth. When placing your lips onto lips that have been immersed in a canal for who knows how long, and when those lips are connected to a body that is quite possibly not just “apparently dead,” but really dead, I’d say a handkerchief—at least—is a very good idea.
Finally, if all else fails, you could tickle the back of the victim’s throat with a feather. This is my own personal favorite, the technique that onlookers might have said did the trick in the case of Ms. Wortman, but I deeply regret that the science behind it has since proven to be nonexistent, as we’ll see.
Actually, to be fair, there is at least a bit of hard science behind most of the Society’s recommendations. Some methods, in fact, have been repurposed and used in different ways more than a century and a half later. But more about that later.
The Society was also methodical in measuring its outcomes. In the first two years of the Society’s existence, in fact, it claimed to have saved more than 150 people who were “apparently dead.” Unfortunately, we’ll never know how many of those “victims” were really dead, or even apparently dead. One can imagine that a society eager to demonstrate its impact might be tempted to count a few questionable cases as victories. So during those heady first years when members of the Society were on the hunt for victims to rescue, it probably wasn’t a good idea to take a nap in public, unless you wanted to wake up with a very uncomfortable tickle in your throat.
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