Sixteen-month-old Jaxon Taylor of New South Wales, Australia was recently internally decapitated after a major car accident severed his upper vertebrae. Upon airlift to a Brisbane hospital where spinal surgeon Dr. Geoff Askin led a rigorous six-hour operation, Jaxon was put in a coma while a part of his ribs was used to graft together his head and spine. With astonishingly quick recovery, Jaxon is now alive and kicking. It is no wonder that the world has deemed this a “miracle surgery.”
To what extent, then, can the human head and brain handle decapitation? Can we—dare we ask—successfully stitch a head not onto the same body, but another? Italian neurosurgeon Sergio Canavero believes so, and he plans on leading such an operation by December 2017. Chinese doctor Ren Xiaoping, having already performed a thousand head transplants on mice already, has partnered with him. The question that remains is, are they out of their minds?
How It’s Going to Work
As described in Canavero’s two recently published papers, the thirty-six-hour, $15 million surgical operation will transplant the head of a patient with degenerated muscles, organs, and nerves onto the healthy body of a brain-dead donor. Keeping the head and body alive during the procedure will require cooling below 20°C. Next, Canavero asserts, an ultra-thin blade will cleanly cut both spinal cords, before injections of a special glue-like substance known as polyethylene glycol (PEG) help fuse the patient’s head to the new spine. As the patient remains in a three- to four-week coma, regular electrical stimulation to the spine will induce nerve fiber reconnectivity and maintain neuromuscular cell function. So when the patient finally awakes, with a little physiotherapy, he will be able to operate the new, healthy body—much like putting someone new in the driver’s seat or placing a new musical conductor in front of an orchestra.
By comparing neuronal bundles to spaghetti at the American Academy of Neurological and Orthopaedic Surgeons’ annual meeting, Canavero stated simply, “You cut the spaghetto, you apply PEG, and boom. The world will never be the same again,” he declared confidently at a TED Talk. But is that all it takes?
By far the most critical procedure in his outline is the severing and fusion of the spinal cord. Canavero explains that a wrecked spinal cord will not reconnect, but a cleanly sliced spine will allow for neural connectivity upon attachment. However, as many experts have argued, Canavero has yet to take into account the prevention of glial scarring, the body’s protective response to direct central nervous system trauma that involves groups of immune cells rushing to heal the injury site. Glial scars secrete inhibitory chemicals to obstruct total recovery, thus posing an obstacle to Canavero’s expectation for axonal repair.
Also, there is uncertainty that the surgical attachment of spinal cord and brain will result in successful neural rewiring. PEG and stem cell therapy have been shown to prompt nerve repair and regrowth in isolated cell populations and in rats with spinal injury, but even the animal models are far from ready for human application. According to some experts, this plan essentially means we can transplant whole central nervous systems, which is impossible as of yet. To take into account the possibility of transplant rejection, a large amount of immunosuppressive medications would also have to be administered to prevent the body’s immune system from immediately attacking the head.
If Canavero fails, incomplete spinal fusion would result in paralysis and potentially fatal consequences for the chosen volunteer, Russian computer scientist Valery Spiridonov. Spiridonov, afflicted with the muscle-degenerative Werdnig Hoffman disease, remains optimistic though and believes this transplant to be his only hope of “get[ting] rid of the limits which I have today.”
Yet if we just assume, despite all the technical intricacies, that this operation is doable, does this mean we should do it?
To many, the “self” exists in the brain, so it is the identity of the head that is the identity of the whole being. In the words of a recent article, we are not stitching a new head onto someone’s body—we’re stitching a new body to someone’s head. From what we currently understand, the body plays a vital role in the composition of the human self. When, or if, Spiridonov wakes up from his coma, his brain must be able to adjust to an entirely different brain to body to soul network. Whether identity crises will arise or induce psychological chaos has yet to be determined. And we aren’t even entirely sure whether it will be Spiridonov or his body donor who awakes post-operation. This is certainly some tricky ethical deliberation, but Canavero dismisses it (once again) with another bold stand: there is no self.
So is Canavero in way over his head? We’ll find out soon enough.