Friday, 6 February 2015

Erasing Death

Dr. Sam Parnia’s book 'Erasing Death' is about recent advances in resuscitation science. When somebody suffers cardiac arrest and the heart stops; brain devoid of oxygen, also closes its shop within seconds. In that case, there is no heart beat, no respiration, no pulse or blood pressure and no neural activity. That person is dead in traditional sense. But as we have all seen in the movies and on the TV, if CPR (cardiopulmonary resuscitation) or artificial respiration and chest compression are applied within minutes, then that person can be brought back to life.

It all started in 18th century Amsterdam, Holland when it was discovered that blowing air into lungs can save people drowning in city canals. But the science of resuscitation truly progressed in the 20th century. In 1960’s and 70’s, electrical shocks to restart the heart (through defibrillator) and administration of certain drugs to boost the blood pressure were added to the repertoire. Hypothermia treatment was included later when it was realized that people who die in cold climate can be revived many hours afterwards. Lower body temperature seemed to preserve cells. ECMO (Extracorporeal Membrane Oxygenation) which is a type of heart-lung bypass device is being successfully used in Japan and South Korea with above 70% revival rates. Post resuscitation treatment and care also proved to be of vital importance in preventing irreversible brain and organ damage.

Now, medical science recognizes that death is not an event but a process. There is a grey zone after death that permits the reversal of this process. This grey area is extending further and further whenever there is advancement in resuscitation techniques. It is also crucial to understand that the original cause of death must be fixed quickly during or after resuscitation otherwise that person will die a second time after a few hours or days of revival. For example, if a person is dying of cancer then his or her recovery doesn't matter as underlying cause of death can not be fixed at present.

Dr. Sam Parnia’s book also deals with the question of near death experiences or NDE’s. Around 10% of people who are revived through resuscitation, report seeing some kind of tunnel or light, reviewing of past life, meeting dead relatives and out of body experiences. These experiences have been dismissed by the majority of scientists as hallucinations. However, Dr. Parnia believes that these may be pointing towards some undiscovered country that lies beyond the present limits of science. He was also part of the AWARE Study during 2008-2012. In this study, several hospitals in USA and Europe were monitored to improve resuscitation efforts and to conduct objective interviews of persons claiming NDE’s. In a number of emergency rooms and cardiac care units, pictures were placed high over the shelves that can only be viewed from above. This was specifically aimed at out of body experiences. It was reasoned that if such claims are for real then those persons should be able to describe those images. In reality, it was found out that out of body experiences are very rare. Only two persons claimed such experiences during the study and no definitive answers were found. So jury is still out on that matter. 
A recent development in this field is EPR (Emergency Preservation and Resuscitation) treatment which was reported in several journals last year. It is in initial stages for trauma patients at a few places in the US. It works by lowering the patient’s body temperature and replacing blood with cold saline solution. By applying EPR, patient will go into a state of suspended animation. Once the damage to the body is repaired, blood will be pumped back and person can be brought back to life. A possible application of this technique could be longer space voyages of future. It would be much more economical and efficient besides psychological reasons to send astronauts in the state of suspended animation and revive them years or decades later. 

All these developments raises several moral and ethical dilemmas. Lines between life and death are being blurred. Are we playing God and interfering with the course of nature? The answer would vary from person to person based on personal beliefs and convictions. But humans started to alter the course of nature when first person was cured through herbs and plants or was given some kind of first aid treatment. Other living being don’t do that. Science of medicine evolved over centuries and new discoveries were made. Modern medicine and surgery techniques, state of art diagnostics, mass vaccinations and organ transplants are extending human lifespan and delaying death all over the world. 3D organ printing is now at initial stages and nanobots are getting ready to roam human body. Humans would keep on adopting such measures to extent life because nature allows us to do that.

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