The Straight Dope on Death
What death is, and what it is not.
Death is unsurvivable. It is the end of living. And yet, we all know someone who claims to have died and come back to life. A latter-day Lazarus. Perhaps you yourself are one such resurrected person/zombie. And popular culture is full of stories wherein one claims to have died, gone to heaven, had brunch with Jesus, and returned to tell the tale, all in the three minutes between when their heart started fibrillating and paramedics zapped it back into rhythm.
So let’s get this straight.
Diagnosing death has changed in recent years, so one can’t be blamed for associating cardiac arrest with death. Physicians of the bygone era declared death when the heart and lungs had ceased functioning. It wasn’t until the 1960s that the advent of modern technology enlightened us.
As vital as the heart is, these days we can live without it.
Stan Larkin lived without a heart for eighteen months. When he was in his early twenties, he collapsed during a game of basketball after succumbing to arrhythmogenic dysplasia — a genetic heart disease causing deformity in the heart muscles that prevents the heart from effectively pumping blood. When Stan’s heart failed, surgeons swapped it out with a machine. He lived a relatively normal life with a device in his backpack circulating his blood. For 555 days. He then received a heart transplant and is living happily ever after.
This machine, the SynCardia, is an artificial heart. It is meant to keep humans alive between when their heart stops working and when they can procure an organic replacement. But this bridge can be a long one, and the SynCardia has proven effective in sustaining long-term life. A 61-year-old man in Turkey has been living with one of these synthetic hearts for four-and-a-half years and counting.
Thus, when one’s heart stops beating, one is not dead. One is likely experiencing some kind of cardiac arrest, which may lead to death if the heart is not restarted or replaced. The same can be said for the lungs. Not breathing does not equal death, although it can certainly cause it. The same is true — that the organ can stop working without causing death — of every organ except one: the brain. Despite a non-beating heart, or non-breathing lungs, or a non-functioning liver, the brain can still function. One can still think, one can still be. But not for long.
If the flow of blood and oxygen to the brain stops, the brain begins to die in about six minutes, with coma and catastrophic brain damage occurring after about ten. After fifteen minutes, death is imminent.
When the brain stops, life stops. The brain is the central organ of the nervous system, is the seat of our consciousness, and, fundamentally, is who we are. It relies on vital organs to supply it with clean blood and oxygen (and other chemicals). And without those, the brain will incur irreparable damage. Unlike the heart, the brain cannot be resuscitated.
Under normal circumstances, the brain hums with electricity as nearly 100 billion neurons send signals around the brain and throughout the body. Physicians can monitor the brain’s electrical activity using an electroencephalogram (often shortened to “EEG”). This machine can determine when any given brain has ceased all electrical activity; at which point one is proclaimed dead.
So, we now have an answer for Confucius, who asked: “If we don’t know life, how can we know death?” With an EEG, Confucius. An EEG.
When the lights go out in the brain, all the billions of brain bits march into the darkness. Cell corruption and biological disintegration of neurons is irreversible. Dr. Victor Frankenstein achieved mild success in resuscitating a brain, but he experienced mixed results.
Admittedly, there is a bit of controversy among physicians on how to define death. One camp takes a holistic approach to determine whether there has been an “irreversible breakdown in the functioning of the human organism as a whole.” The other “refers to neurological death, namely, that the person has lost the capacity for consciousness secondary to irreversible brain (or brainstem) injury.”
For the most part, this is a distinction without a difference. If one meets the definition of one of these deaths, the other is impending. But this bilateral approach is reflected in the law.
One’s death has a myriad of legal implications. As a result, the law needs a uniform, coherent definition of death. In the 1980s, most states adopted some version of a heavy-metal-named law called the Uniform Determination of Death Act. The Utah version (Utah Code section 26–34–2) states:
(1) An individual is dead if the individual has sustained either: (a) irreversible cessation of circulatory and respiratory functions; or (b) irreversible cessation of all functions of the entire brain, including the brain stem.
(2) A determination of death shall be made in accordance with accepted medical standards.
Now before you say, “see! Told you I died when my heart stopped beating that one time when I was getting my tonsils out!” take note of the word “irreversible.” The irreversible cessation of the heart and lungs will starve the brain of oxygen and life will end. If your heart and lungs ever irreversibly ceased functioning, either your brain stopped functioning and you died, or you are RoboCop.
See, RoboCop, formerly known as Officer Alex Murphy, was gunned down in the crime-ridden streets of Detroit. His heart and lungs were irreparably destroyed, but his brain was preserved. After he was equipped with a cybernetic body, he was back to fighting crime like the good ol’ days. (You may also recognize this plot from Ghost in the Shell.)
Although science fiction, one can see how these plots are conceivable because the brain is the command center of our consciousness and the cradle of everything we know and are. Save the brain, save the person. The plot wouldn’t really work if Officer Murphy’s brain was blown to smithereens, but they were able to recover his heart and put that in a machine. Without a brain, we do not exist.
So although one’s heart or other vital organs may fail while the brain continues to operate (with, say, the help of a SynCardia heart), when one’s brain leads the charge into death, once ceases to exist despite the fact that the other vital organs may be harvested to save the lives (i.e., brains) of others. Even though our heart can go on beating when wired into a new body, we remain dead.
“Death is the wish of some, the relief of many, and the end of all.” -Seneca
And, as a point of clarification, brain death is different than a persistent vegetative state, although they are often confused. When one says that a person is “brain dead” what they usually mean is that the person is in a wakeful unconscious state. The vegetative brain may be damaged to the point of an absence of all cognitive functions, but it is not dead. As long as the life sustaining areas of the brain are operational, one cannot be considered dead, even if the areas of the brain responsible for thought and consciousness are irreparably non-functioning.
Death, then, is the cessation of all brain activity. At least when it comes to us animals. Death may be tougher to define when it comes to plants, fungi, or non-eukaryotic life like bacteria and archaea. But in all instances, there’s no coming back. Death is the end, and it only happens once. If you are alive, you have not died.
Having died, one is dead.
That said, if you have died and now exist as a non-dead entity like a ghost, spirit, zombie, angel, specter, incubus, demon, or frankenstein-esque monster, please call CNN (1–404–827–1500), NPR (1–202–513–2000) or the New York Times (1–800–698–4637). Let us begin scientific studies about the so-called afterlife, learn about a new life-from (that presumably wouldn’t be carbon based), and revolutionize our thinking on bad-mouthing the dead.
So stop hanging out in that dilapidated, dusty old Victorian, and become the most famous person to have ever lived. Then died… and then lived?
