Cheating Death by Sanjay Gupta

Author:Sanjay Gupta
Language: eng
Format: mobi, epub
Tags: HEA000000
ISBN: 9780446558761
Publisher: Grand Central Publishing
Published: 2009-10-12T10:00:00+00:00

CHAPTER FIVE

What Lies Beneath

No event is so terribly well adapted to inspire the supremeness of bodily and of mental distress, as is burial before death… . What I have now to tell is of my own actual knowledge—of my own positive and personal experience.

—Edgar Allan Poe, “The Premature Burial”

DR. MARK RAGUCCI was so far gone, his doctors thought he’d never come back. For nearly two months after a surgery that went badly awry, Ragucci was completely unresponsive, dead to the world in his hospital bed. “They said I had irreparable brain damage from having no oxygen to my brain,” he recalls. “They said I showed no response to stimuli. That means they could shine a light in my eyes, poke me with a needle, whatever, it wouldn’t register. I was a vegetable.” 1

For two months he lay in a darkened room while his mother, father, and wife kept vigil, all waiting for a miracle. The head of the unit, a physician with an elite medical education and more than a decade of experience in one of the country’s top hospitals, told them to forget it. So did two other doctors with the combined weight of half a century of medical experience. The doctors in the crisp white coats, the medical literature on which they relied, all gave his family the same simple message: pull the plug. 2

Up to this point, we’ve been talking about death as stoppage of the heart. That’s been the meaning of death almost as long as humans have been around. But in an American hospital today, that’s not what doctors mean by death: They’re talking about whether the brain can function in a meaningful way, about whether consciousness is irretrievably lost. They’re talking about brain death. And here, the line between life and death is shifting just as much, if not more, as it is for the doctors who try and keep our hearts beating and the blood pumping through our veins.

You won’t find a better example than Ragucci. His doctors might have given up, but he can tell the story today because one doctor didn’t—and because something inside Ragucci was able to bounce back, something that gave him the strength to cheat death: brain death.

The concept of brain death first gained popularity among a small group of surgeons in the 1950s. They were transplant surgeons, intent on taking body parts from a patient with no hope of survival and giving them to one who might be saved. Through the 1950s and most of the 1960s, these surgeons made tremendous technical advances toward the removal and implantation of kidneys, hearts, and livers in animals. But except for the use of a single kidney—which could be removed without killing the donor—they were forbidden from trying human transplants. No hospital would allow a body part to be removed from an organ donor until the patient’s heart stopped beating on its own. Any doctor who defied these guidelines might be prosecuted for murder. Of course, once the heart stops,

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