No, this is not a post about the afterlife. Rather, I want to talk about what happens when your body dies. Hospitals generally call the time of death after a person cannot be resuciated and their heart stops beating. But the brain can function for a number of minutes after the heart stops. The person is not likely concious during this time, but are they still alive?
I've honestly been thinking about this all semester, thanks to my physiology class. I started thinking about ways in which people committ suicide: overdose of drugs, bullet to the heart or brain, etc. And it made me wonder if the person really dies when their heart stops. Obviously people are still considered alive even if their higher brain is not functioning (braindead individuals), but the brain is what makes us humans.
You may be wondering why I'm going on about this now. Well, being the science geek that I am, I came across an article that discusses this very concept. Scientists have found that the cells in the body do not die from lack of oxygen. Meaning, when the heart stops and 5 minutes pass, the cells are all still alive, even when the person is declared dead. Pretty serious discovery, hmm?
What's more is that it turns out the cells die (via a preprogramed mechanism) when they are reintroduced to oxygen (after 5 minutes without). So it's not the lack of oxygen after a heart attack that kills someone. It's the resucitation afterwards. Which basically means that the protocol in the ER for treating people who code is pretty much killing them:
When someone collapses on the street of cardiac arrest, if he's lucky he will receive immediate CPR, maintaining circulation until he can be revived in the hospital. But the rest will have gone 10 or 15 minutes or more without a heartbeat by the time they reach the emergency department. And then what happens? "We give them oxygen," Becker says. "We jolt the heart with the paddles, we pump in epinephrine to force it to beat, so it's taking up more oxygen." Blood-starved heart muscle is suddenly flooded with oxygen, precisely the situation that leads to cell death.
According to the article, a study done to slowly reintroduce oxygen has an 80% success rate, compared to only a 15% success rate over traditional resucitation practices. This, of course, has huge implications, and could result in saving huge numbers of lives, especially with cardiovasular disease being high on the list for causes of death here in the US. Who knows what further research into this area could demonstrate.
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Awesome post, that's all I have to say, keep up the great work!
-Alexa
I'd just like to celebrate that 4 people have voted and I still have a 5.0 rating. Thanks much :-D
~C
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Execellent Post! It's something to think about. My mom died on the OR table and was brought back. How conscious she was of what was going on...I'm not sure, but she said she knew what was going on.
"A prime part of the history of our Constitution...is the story of the extension of constitutional rights and protections to people once ignored or excluded." ~US Supreme Court Justice Ruth Bader Ginsburg
I went and read the article that you linked here and that really is facinating. It alters our entire concept of death. In those next couple of hours, before your cells die, what has died? How has it been determined that this person is no longer alive? Nothing has left. At least not physically (and I'm not going to go into the spiritual debate at the moment) so how are they dead? If this new development turns out to truly be a life saving adjustment then we may have to revise our entire perception of what death is and when it happens.
JD
Wow. Need I say more? This could bring up some serious issues
This is a very surprising discovery. It makes me wonder about how many people were actually harmed by traditional resuscitation and it also makes me wonder about what doctors are going to do in the future to accomodate these new findings into their practices.
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You must be the change you wish to see in the world -- Mahatma Ghandi
Honest disagreement is often a good sign of progress. --Mahatma Gandhi
That's quite the discovery they've made; it will be interesting to see where they go with it and how they work around the whole 'killer oxygen' problem.
As for death, it's not quite what you said. Technically one can be said to come back from the dead if his heart stops and then is revived. I read an interview with Pantera's Phil Anselmo where he claimed that he's died three times; the first was when he was born and the hospital equipment keeping him a live went dead for a short while, and I think the others were due to drugs.
"CONSERVATIVE, n.
A statesman who is enamored of existing evils, as distinguished from the Liberal, who wishes to replace them with others."
- Ambrose Bierce, "The Devil's Dictionary"
As for death, it's not quite what you said. Technically one can be said to come back from the dead if his heart stops and then is revived.
The clinical definition of death is when your heart stops and you stop breathing. But the point is that your body doesn't die when your heart stops. Your brain is still functioning for at least a short time. However, the death certificate is never signed if a person is revived. Thus, legally, the person never died.
According to Wikipedia (death-medical-definition), most physicians determine the time of death to be when the brain has no more electrical activities. People that are 'brain dead' I assume don't fit into this category, because part of their brain is still functioning.
But that wasn't exactly what I was getting at. Especially based on what scientists have just found, it doesn't make sense to say that death occurs when the heart stops beating. All the cells in the body are still alive. It's like someone who gets dunked into freezing cold water... they go into a sort of suspended animation where they don't die, but all their organ systems sort of shut down.
I could, of course, get into the whole religious aspect of this... when does your soul leave your body and all that, but that starts to get into dangerous grounds.
At the end of the day, though, we don't really know what death means, and this study just proves that even more.
~C
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Now, let's step away from the death part, and think about the
mind when it is dying. If you are giving five to ten of live, what would you be thinking? Is it impossible to think when you coming close to death? I personally wonder more about how we react to death than daeth itself.
Another very interesting point. I imagine if your heart has stopped, you're gonna be unconcious really quickly. So are you thinking during that? Hmmm...
~C
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amazing. I also always wondered about death..
It reminds me of the pyramid system of organism structure. Cell, tissue, organ, organ system, organism. It's great to know this new truth is realized.
mediatrix
As a physician I would just like to pull you up on one point, if I may, since there seems to be a lot of misunderstanding about what constitutes brain death. You say 'Obviously people are still considered alive even if their higher brain is not functioning...' Yes, this is the case even when a person has such severe brain damage resulting in coma that he/she will never (or is deemed highly unlikely to) regain any consciousness, but that person nevertheless still has brain stem function and can breathe on his/her own.
You then equate such a brain-injured person with someone who is brain dead. A diagnosis of brain death is reached when there is irrevesible and profound coma - along with the permanent loss of brain stem function. Thus in the brain dead person, not only consciouness but also the ability to breathe has been permanently lost. A diagnosis of brain death cannot be made unless there is a medical history of a serious event that can lead to brain death, and causes of loss of higher brain and brain stem function that are reversible have been excluded. A brain dead person's other organs only remain alive because a ventilator (breathing machine) is supplying oxygen and removing carbon dioxide. Obviously it is pointless supplying breathing to one who is beyond any help so that the diagnosis of brain death needs to be made in order for the ventilator to be switched off.
Sometimes someone who has died in this way has given permission beforehand that should he/she become brain dead his/her organs may be given to another person i.e. used for transplantation.
Yes, this is the case even when a person has such severe brain damage resulting in coma that he/she will never (or is deemed highly unlikely to) regain any consciousness, but that person nevertheless still has brain stem function and can breathe on his/her own.
Hence the 'higher brain is not functioning'.
Thus in the brain dead person, not only consciouness but also the ability to breathe has been permanently lost.
Okey. Sorry for my mistake.
If I may ask, where'd you go to medical school, and how long ago?
~C
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mediatrix
I qualified in 1968 from Birmingham Medical School in the United Kingdom. I was involved in transplantation for 20 years but now am concerned with medical ethics.
It is very important to appreciate the difference between brain death, which includes loss of brain stem function - and severe brain damage, which does not. Patients in the (unfelicitously termed) permanent vegetative state (unfelicitous because people never lose their status as persons and become vegetables no matter how ill and brain damaged they are - it is a derogatory term) still have brain stem function (and therefore can breathe).
There are those who would suggest that it is acceptable to use such severely brain damaged individuals (those in a state of coma considered to be permanent) as organ donors. While it is not right to go to great lengths giving medical treatment to someone whose prognosis is so poor, it is certainly morally indefensible deliberately to cause the death of such a person and exploit him/her for organs.
It is important that there is no confusion in the public mind about the difference between brain death and the 'persistent vegetative'. i.e. permanent coma, state - and other states of severe brain damage where, unlike the permanent coma state, there is some degree of consciousness and interaction with the environment.