file://rtd.com/pub/zines/skeptic/01.2.harris-society-for-dead http://www.rtd.com/~lippard/
file://rtd.com/pub/zines/skeptic/01.2.harris-society-for-dead
http://www.rtd.com/~lippard/01.2.harris-dead.html
From _Skeptic_ vol. 1, no. 2, Summer 1992, pp. 24-31.
The following article is copyright (c) 1992 by the Skeptics Society,
2761 N. Marengo Ave., Altadena, CA 91001, (818) 794-3119. Permission
has been granted for noncommercial electronic circulation of this
articles in its entirety, including this notice. For information about
a special Internet introductory subscription rate, see the file
subscription-rates or contact Jim Lippard (lippard@rtd.com).
THE SOCIETY FOR THE RECOVERY OF PERSONS APPARENTLY DEAD
By Steven B. Harris, Ph.D.
The history of technological innovation is the history of the tortuous
paths which advances often take to acceptance. It might seem at first,
from the many well-known instances of simultaneous discoveries, that it
is the nature of important ideas to spring up newly everywhere,
independently, as soon as the world is ripe for them. But this is only
the view at first glance. In actuality, the "synchronicity" of discovery
usually turns out to be a late phenomenon, one that follows a prodrome
in which the "new" idea in question has long been around in some form or
another, but steadfastly has been ignored.
How long can an important idea be ignored? The model steam engine was
demonstrated by Hero of Alexandria in the first century A.D., sixteen
centuries before people started thinking along these lines again. Gregor
Mendel published the basic principles of genetics in 1866, and was
ignored until 1900. Oswald Avery published strong evidence that DNA was
the principle of heredity in 1944, but no one really believed it until
the time of Watson and Crick almost a decade later. The time varies,
depending on circumstance.
Delayed acceptance of discovery happens in all areas of science, of
course, but it always happens in the field of medicine with great
poignancy, since there the human costs of dropping the technological
ball are usually great. We may consider, for instance, the numbers of
lives which might have been saved if not for the following delays:
- Leeuwenhoek invented the microscope in 1668 and saw animal cells
and protozoa with it--but unfortunately for humanity, doctors weren't
interested in that kind of thing in 1668, and wouldn't be for another
couple of centuries. In the meantime they missed out on the germ theory
of infectious disease; thus, as late as 1850, when good Doctor
Semmelweiss tried to get his Hungarian colleagues to curb the incidence
of fatal "childbed fever" by washing their hands between dissecting
diseased cadavers and examining patients, his colleagues responded by
hounding him out of his job. Meanwhile diseases continued to spread on
the hands of well-meaning doctors.
- Several explorers like Sir Richard Hawkins independently discovered
the antiscorbutic properties of oranges and limes in the 18th century,
and James Lind in 1754 even published the results of a controlled
experiment in which he showed that citrus was superior to other folk
methods for the curing of scurvy. The world, however, was not ready for
the discovery, and sailors continued to suffer and die from this quite
treatable nutritional disease for more than half a century after Lind's
demonstration. Scurvy was also rampant among the troops of both North
and South during the American Civil War, though the means was available
to prevent it, and as late as 1912 the famous explorer Robert Falcon
Scott died on his way back from the South Pole, probably as the result
of scurvy.
- An investigator before the First World War discovered the curative
powers of _penicillium_ mold extracts on infected animals, but could not
interest his colleagues, although he published the work. It remained for
Alexander Fleming, ignorant of the earlier work, to rediscover the
antibacterial effect of _penicillium_ in a laboratory accident in 1928.
- Alexis Carrel, the French-American scientist who won the Nobel
Prize in 1902 for techniques of suturing blood vessels, demonstrated in
1910 that a saphenous vein graft between aorta and main coronary artery
in animals could bypass a blockage there, and speculated that the
technique might be useful in the treatment of angina. Although Carrel
(with aviator Charles Lindbergh) later went on to develop the heart-lung
machines that would make such surgery possible, the medical community
contented itself for the next half-century with ineffective treatments
for severe coronary heart disease, and it was not until 1967 that the
saphenous-graft coronary bypass operation was employed on humans.
To the historian, some medical fields seem more plagued with delays
in the acceptance of new ideas than others (the medical study of
infectious disease has been prominent in this dubious regard, as noted),
and the above examples are sad enough. Still, there is possibly one
field of medicine which is at least the equal of infectious disease in
its record of ignoring proven lifesaving strategies for the longest
time, and that is the area to which we will turn for the remainder of
this essay. The medical field in question is that of resuscitation,
which is the art of restoring clinically dead people to life. It will be
of no surprise that many of the issues related to it which have been
debated in history are also familiar to cryonicists. For example: when
exactly is a person "dead," and how do you tell?
Cryonicists looking into the history of resuscitation may find
themselves reading with a sense of deja vu. We've seen these
controversies already, and we'll see them again. Perhaps we can profit
by exploring them further.
Resuscitation
Historically, the art of resuscitation turns out to be old. The idea of
resuscitating a seemingly dead person by more or less physical means
occurs in the Hebrew scriptures. Both I Kings 17 and II Kings 4 contain
descriptive elements of resuscitation by chest compression. In II Kings,
Elisha also places his mouth on the child's mouth. Clearly there is
something more than mystical prayers and incantations going on. Perhaps
the oral traditions which were later codified into these tales once
contained descriptions of one or more real resuscitative events.
By a few millennia later, things were better defined. Italian
writings of the 15th century indicated that midwives had, even then,
long been using mouth-to-mouth breathing techniques to resuscitate
newborns who did not spontaneously breathe. These techniques were soon
to be imitated in the mechanical experiments of the Enlightenment.
Paracelsus (1493-1541), an alchemist and perhaps the greatest physician
of his age, was said to have attempted the resuscitation of a corpse
using bellows, a trick he perhaps picked up from Arabic medical
writings. And Andreas Vesalius (1514-1564), the father of modern
anatomy, reported successfully using bellows to resuscitate asphyxiated
dogs.
Bellows may not always have been available, but physicians eventually
learned (possibly again from laymen) that simple mouth-to-mouth
resuscitation sometimes worked on recently asphyxiated adults just as it
did on newborns. By the 1740s, several cases of successful mouth-to-
mouth resuscitation had been reported, the most famous of which was
Tossach's 1744 report of the resuscitation of a clinically dead coal
miner who had been suddenly overcome after descending into a burned-out
mine. By the 1760s, in the wake of such reports, a number of groups
advocating the resuscitation of drowned persons had sprung up in Europe.
The thinking at this time in many places was strikingly modern. Here, by
way of example, is a quote from a 1766 governmental edict from Zurich:
. . . Experience has shown that the drowned who are considered dead and
that lay for some time under water have often been restored again and
kept alive by proper maneuvers. From which one rightly concludes that
life has not been completely suspended in the drowned, but that there is
hope to save them from death if, as soon as they are withdrawn from the
water, prompt and careful help is administered.
The Swiss may have been their usual regulation-happy selves about the
subject, but in the rest of the Western world resuscitation was being
pushed typically by entirely private societies (voluntary clubs). In
1774, a society was founded in London to promulgate the idea of
attempting to resuscitate the dead in some circumstances. Called, after
a bit of experimentation, the _Society for the Recovery of Persons
Apparently Drowned_, it quickly evolved into the _Humane Society_ (and
still later, with official patronage and funding, the _Royal Humane
Society_).
The _Humane Society_ advocated techniques which were highly advanced.
Three months after the society's founding, as an example, a society
member had the opportunity to minister to a 3-year-old child named
Catherine Sophie Greenhill, who had fallen from an upper story window
onto flagstones, and been pronounced dead. The society member, an
apothecary named Squires, was on the scene within twenty minutes, and
history records that he proceeded to give the clinically dead child
several shocks through the chest with a portable electrostatic
generator. This treatment caused her to regain pulse and respiration,
and she eventually (after a time in coma) recovered fully.
[This story and other direct quotations, unless otherwise noted, are
taken from _The History Of Anesthesia_, Richard S. Atkinson and Thomas
V. Boulton, eds., International Congress and Symposium Series, #134,
Parthenon Publishing Group, NJ, (Parthenon).]
The resuscitation of little Catherine Greenhill was probably the first
successful cardiac defibrillation of a human being, and it followed
earlier suggestions by American scientist Benjamin Franklin and others
that electricity might possibly be used to "revivify" the human body.
And so it proved able to do in certain circumstances. In 1788, a silver
medal was awarded to _Humane Society_ member Charles Kite, who was by
this time not only advocating the resuscitation of victims in cardiac
arrest with bellows and both oropharyngeal and nasolaryngeal intubation,
but had also developed his own electrostatic revivifying machine which
used Leyden jar capacitors in a way exactly analogous to the DC
capacitative countershock of the modern cardiac defibrillator. (I must
confess that to my mind all of these contraptions are as fantastic as
the devices in a _Flintstones_ cartoon, yet they actually existed. A
time-traveling physician from the present could not have put together a
better resuscitation kit, given the technology of the time.)
Dark Clouds
However amazing its progress was, the enlightened state of the late 18th
century as regards resuscitation was not to last. From the very first,
dark images from the human psyche began to gather in resistance to the
new ideas. Technology never intervenes in a major way into the
borderland between life and death without creating major anxieties and
social backlash. Resuscitation had its problems.
To begin with, as the modern reader may guess, the 18th-century
discovery that "death" was not a sure and objective state, did not
exactly sit well in the public mind. Our historical friend Charles Kite
was of the opinion that not even putrefaction was a sure sign of
permanent death, since it might also be due to advanced scurvy(!).
However conservative this view might have been for Kite and his medical
agenda, the public had its own concerns. If one could be mistaken for
dead when one was in fact resuscitatable, what else did that imply?
The answer, of course, is that it implied that you could be buried
alive. Not long after the first word-of-mouth reports of adult
resuscitations began surfacing in the 1730s, the French author Jacques
Benigne Winslow published a book descriptively titled _The Uncertainty
of the Signs of Death and the Danger of Precipitate Interments and
Dissections_. Now the real problem with the difficulty of defining
_death_ in a technical age was out of the bag: _What if you got the
diagnosis wrong?_
The result of this realization was a psychological terror perhaps
made familiar to the reader by some of the works of Edgar Allan Poe. But
Poe, popularizing the problem for early 19th-century America, was late
to the controversy. In 18th-century Europe the fear of premature burial
and dissection was not just the preoccupation of macabre writers; whole
classes of people were affected, albeit in different ways. Upper-class
persons took to fitting coffins and crypts with special signaling
devices which could be used to alert the outside world in case the
occupant should inexplicably revive. The lower classes had their own
special problems, too, since anatomical dissection (long a part of the
punishment for heinous crimes because it denied the malefactor an intact
bodily identity or a grave) had now taken on a special meaning. Here, as
example, is what Ruth Richardson says of the dissection of criminals in
her treatise _Death, Dissection, and the Destitute_, describing an
incident in the 1820s in which one dissecting anatomist at Carlisle was
killed, and another severely wounded, by the friends of an executed man:
. . . Although this was of course an extreme reaction, it was
certainly the case that hanging the corpse in chains on a gibbet was
popularly regarded as preferable to dissection. What later incredulous
commentators seem to have missed or misunderstood was that in eighteenth
and early nineteenth century popular belief, not only were the
anatomists agents of the law, but they could be the agents of death.
Genuine cases were known of incomplete hangings, in which the 'dead'
were brought back to life, and plans for celebrated corpse-rescues
centered on the possibility that the noose had not fully done its work.
Folktales circulated about famous criminals revived by friends, and
these ideas were fostered by the publicity which Humane Society
resuscitations attracted after apparent drownings. Increased control
over the body of the condemned rendered rescue and revival virtually
impossible.
It was popularly understood that the surgeon's official function and
interest in a murderer's corpse was not to revive, but rather to destroy
it. Dissection was a very final process. It denied hope of survival -
even the survival of identity after death[!]. Above all, it threw into
relief the collaborative role of the medical profession in the actual
execution of death. The Carlisle surgeons bore the brunt of the
resentment and frustration felt by the dead man's friends, for in their
eyes the doctors had murdered him more surely than the hangman's
rope. (The denial of the body of the heinous criminal to the family has
had a long history in law, and we see it historically employed in
capital crimes which particularly outraged the public, even in
relatively recent times. For instance, after execution in 1865 the
bodies of the four Lincoln assassination conspirators were immediately
buried in Army equipment boxes a few feet from the gallows in the prison
yard in Washington's Old Penitentiary, the same institution where the
body of John Wilkes Booth had been secretly buried a month earlier. In
1901, after anarchist Leon Czolgosz was electrocuted for the
assassination of President McKinley, his body was dissolved in acid in
the prison basement. One cannot read such accounts without a deeper
appreciation for the psychological power of the freshly dead body in an
era when resuscitation was still somewhat magic. Even as late as 1946,
after the ten members of the Nazi high command were hanged at Nuremburg,
the Surgeon General of the United States himself was turned down when he
asked that the brains be removed, preserved, and sent to Washington for
study. Instead, the bodies were cremated immediately at Dachau and the
ashes secretly scattered, with the specific intent that nothing remain.
One may read into official penal policy in all these cases a more or
less unconscious desire to destroy what was perceived as the continuing
identity of persons already pronounced dead.)
By the end of the first quarter of the 19th century, when the riot
over the dissection of the hanged man at Carlisle took place, things had
reached a fever pitch. With scientific resuscitation, technology had
intruded into the macabre. The horrific potential of the new
electromechanical resuscitative technology had its influence on Mary
Shelley, who in 1818 had first set out to write a ghost story, but
instead ended up producing a cautionary tale of the technological
resuscitation of a soulless corpse by a medical experimenter. Given the
spirit of the times, the story touched a public nerve as though with one
of the new electrical machines, and Frankenstein's monster was an
instant sensation.
And then something strange happened. Shortly after the publication of
Shelley's famous story, the new medicine began to go out of favor, and
the science of resuscitation began to suffer on both the technical and
mythological fronts. It happened for several reasons.
It is the propensity of all social movements to go too far. The
_Humane Society_'s problem was that, when it came to complicated
biology, the late 18th century did not possess the experimental
expertise necessary to separate the wheat from the chaff. Thus, within a
few years after its founding, the _Humane Society_ had gone from mouth-
to-mouth resuscitation to the more impressive use of bellows. Following
a number of instances of lung rupture with the bellows, however, these
complicated and difficult-to-use devices were discarded early in the
19th century. Mouth-to-mouth resuscitation, unfortunately, was not
reinstituted at that time, partly because of the new discovery of life-
giving oxygen and the finding that expired air contained less of it
(nobody bothered to find out if the difference was significant). For the
next century and a quarter, therefore, resuscitative techniques centered
around chest massage and armlift techniques, and mouth-to-mouth
breathing did not return until the middle of the twentieth century.
Emergency electrical defibrillation fared no better. The new
phenomenon of electricity had been transformed early-on into a quack
cure by the practice of "galvanism" (passing mild shocks through the
body in an attempt to cure disease), and its reputation accordingly
tarnished. Later, and perhaps even more devastatingly, the charming new
electricity was transmuted into a powerful and dangerous force by the
giant transformers of Westinghouse (maligned from the first for their
deadliness, in a PR campaign by rival industrialist-inventor Thomas
Edison) and by the newfangled American electric chair. Technologies as
well as people suffer from social stigmas. Mary Shelley had originally
not specified the method of the revivification of her monster, but by
1930, in the new electrified America, Frankenstein's monster came into
the movies electrically charged. The upshot of all these social
transformations was that therapeutic electric shock, so full of promise
in the 1790s, did not again come into its own for lifesaving purposes
(or even for psychiatric purposes, for that matter) until about the same
time resuscitative breathing was being reassessed, in the late 1950s.
Other resuscitative techniques like chest/cardiac compression had
been used sporadically since the late 19th century as well, but they too
did not see acceptance until the late 1950s, when almost inexplicably
all of the "modern" techniques came together approximately
simultaneously in what we know as "cardiopulmonary resuscitation" (CPR).
The world, apparently, was not ready until the Space Age for any of
these techniques, and simply rejected them when brilliant and well-
meaning scientists invented them too early.
Some General
Observations On History
What are we to make of all this? Is there anything to be learned? In
looking at the history of resuscitation and medicine we might ask if
there are any observations to be made about it which might apply as well
to the medicine of today and tomorrow.
The first thing we notice is that there seem to be some themes in
medical history which occur again and again. Important medical
discoveries, like important philosophical discoveries, seem quite likely
to be made by outsiders. In some cases, the "outsiders" in medicine have
been doctors working outside the traditional groves of academe, and in
others, the important medical discoveries have not been made by doctors
at all. Leeuwenhoek, for instance, was a haberdasher, Pasteur a chemist,
Fleming a bacteriologist. Recall that mouth-to-mouth resuscitation was
the secret of midwives, and passed to medicine quite late. The original
_Humane Society_, though founded by a doctor, was less a professional
medical group than a group of ordinary and somewhat evangelistic
citizens who (in exactly the manner of cryonicists) had banded together
for humanitarian reasons and out of fear of being buried alive. A
second observation which can be made about the history of medicine and
technology in general is that discoveries depend for acceptance upon a
very complex social milieu which may have little to do with technology.
A technological advance will not be accepted in a world which is not
ready for it socially. The idea of using a steam engine to replace human
muscle, for example, will not catch on in a world where human muscle
power, because of slavery, is cheap. Conversely, a device like the
cotton gin, which replaces delicate work with muscle work, will
instantly be accepted in such a world.
For an analogous example of this phenomenon from medicine, we might
consider the history of anesthesia. As we know from their writings,
Muslim physicians practiced various forms of anesthesia during surgery
back as far as the 8th century A.D. In Christendom, conversely, where
the idea of redemptive suffering held sway, anesthesia took much longer
to catch on. Thus, the anesthetic properties of nitrous oxide had been
widely and publicly noted by Sir Humphrey Davy as early as 1798, yet it
was not until the 1840s that an obscure general practitioner from
Georgia and a couple of part-time dentists (remember our observation
about outsiders) began to try out inhaled anesthetics for surgical
purposes. Even at that, there was an ecclesiastical outcry when Queen
Victoria requested chloroform for childbirth, soon after the first
anesthetic demonstration in America. One prominent cleric complained
that "travail and pain" in childbirth had been ordained by God in the
Bible, and that therefore anesthesia was against the will of God.
(Others pointed out Genesis 2:21 where Adam is put to sleep as the rib
is taken for Eve. Scriptural wars can be quite inventive.)
What then held up full cardiopulmonary resuscitation until the late
1950s, even though the world had discovered all of its essential
features before 1900? We can only speculate, but the answer may lie in
the fundamental change in the way which people began to relate to and
trust technology between 1900 and 1950 - a social change which is as
profound as any generation of humans has ever had to cope with. (See
Frederick Lewis Allen's book _The Big Change: America from 1900 to
1950_.) Mythmaking, as ever, played a role. If technology first crept
into our nightmares with Frankenstein, it later (redemptively) crept
into our heroic myths and won some measure of acceptance. Thus, if the
new 20th-century technology of aviation was capable of creating a new
kind of hero like Charles Lindbergh, the public was also willing to let
him have a technological shot at Death with his new artificial heart
machine. In any case, the mantle of Dr. Frankenstein had by the middle
of the 20th century passed to the physicists and their atom bombs, and
medicine for the time being, was at last back in the heroic mode. This
situation continued until the development of the modern ICU and "life
support," at which time doctors and medical technology began taking
criticism once again.
Cryonics
In the context of some of the foregoing observations, it is interesting
to consider cryonics as an unaccepted technical idea. The study of
history always offers perspective. Thus, if we cryonicists shudder with
dread over the idea of a "premature" burial, or the idea of a viable
person being destroyed by the autopsy knife, we may be a bit chastened
to find that this conflict is already two centuries old, and not over
concerns invented entirely by us.
As a practical matter, it might first be well to remind ourselves of
the sources of danger in these situations. It takes only a change in
point of view to regard a person in full cardiac arrest as being in a
desperate and life-threatening situation for not just a few minutes, but
(perhaps) days. This, in turn, may change the whole tenor of the game,
for having a loved one in a desperate situation can engender the most
desperate acts. Historically, as we have seen, violence has been
committed over the question of dissecting a relative who might be
viable, and as we have also seen, this very situation is a prime area of
potential conflict between cryonicists and society. (We have seen
cryonicists taken into custody over this question, though fortunately,
not yet for long.) All of this should re-emphasize the need to do
tremendous amounts of prior legal preparation, if we are not eventually
to be faced with the otherwise inevitable situation in which a
cryonicist is charged with the assault of a coroner or pathologist.
Of course, the question of viability holds another danger specially
for cryonicists, over and above our potential conflict with government.
If a man in the throes of grief is capable of killing on behalf of a
potentially viable "deanimated" loved one, then the refusal of "last-
minute" cases (no matter the circumstances) places cryonics
organizations in a potentially explosive confrontation with the public
as well. Here, _cryonicists_ are the potential targets. We have seen
cases in the news where distraught relatives have killed ER physicians
in the midst of grief and misplaced anger. Might not then the same
violent action be directed at representatives of a cryonics organization
which was in the position of being (technically) able to rescue a viable
person, but (for necessary financial reasons) refused to do so? If
history is not to be repeated, it is clear that security concerns are
going to have to be paramount for cryonicists in the future.
What about wider concerns? Here, too, the past has something to
teach, this time about groups of concerned people who began as outsiders
to established medicine, yet later prevailed. Although the cry of "They
laughed at the Wright brothers, too!" has long been the defense of
crackpots, even a cursory examination of the history of medicine shows
that the initial non-acceptance of any important new idea by that
profession is almost de rigueur. Thus, although the mere fact of medical
non-acceptance does not prove the cryonicists' cause, at the same time
cryonicists certainly do not necessarily need to suffer embarrassment on
that score. The long view of things is helpful. At present, it seems
likely that cryonicists play the role of the midwives of old, practicing
their own peculiar lifesaving ministrations in parallel with medicine.
Medicine's recognition of cryonics, like its belated recognition of
resuscitation, will come.
When? Unfortunately, history is not prophecy. The answer from the
foregoing discussion, if there is one, is that it will come when society
is ready for it. We know that humans are not naturally very good
scientists (our brains weren't developed for that), and very primitive
needs and fears drive both acceptance and rejection of new technologies.
As we've noted, the fear of premature burial stimulated a series of
electrical defibrillation experiments in the late 18th and early 19th
centuries, all of which then were suppressed for more than a century
partly because the idea of shocking people back to life had in turn been
killed by a single well-placed monster myth. Human beings and their
societies run on good stories, not scientific reports. Similarly,
American society of the 1960s, gearing up for a holy war on cancer and
heart disease and intoxicated with the Salk-myth of the all-powerful
medical researcher, was not ready for cryonics. By the late 1980s,
however, when it had begun to become apparent that heart disease and
cancer (not to mention aging) were a lot more intractable than polio,
there existed in this society at least a subculture that was now ready
to listen to another idea for cheating death.
And so here we are. From a strictly technical view, cryonics as we
know it might have been practiced 70 or 80 years ago. Technically we
might have been ready for it, but culturally we were not. What is more
(let's face it), American society _as a whole_ is _still_ not ready to
listen to the idea of radically extended lifespans. The good news,
however, is that with the publication of a number of popular gerontology
books in the last decade, things are changing slowly. The social milieu
(not to mention the age of the population) is changing, and scientific
immortalists are getting ready for another try at the hearts of the
public. As has been argued in previous essays, this change will require
yet another set of new myths (hero stories) to counter Frankenstein's
monster, just as our out-of-body experience stories now let us, as a
society, deal with the ambiguity of complex resuscitations from clinical
death (see the film _Flatliners_). In the case of cryonics, the new
myths will come, too. We can only hope for all our sakes that this
necessary process doesn't take as long as it sometimes has in the past.
Steve Harris is currently a Post Doctoral Scholar at the UCLA Department
of Pathology. A graduate of the University of Utah Medical School, Dr.
Harris has published medical research papers as well as numerous
articles on both the medical and humanistic aspects of cryonic
suspension. Dr. Harris has also done considerable research on why
dietary restriction retards the aging process, and is currently involved
in a long-term research project on the nutrition of the inhabitants of
Biosphere II, the self-contained ecosystem in the Arizona desert in
which one of Harris's major professors is currently living and doing
research.
E-Mail Fredric L. Rice / The Skeptic Tank