Where's the rest of me?

The prospect of "full-body transplants" offers some weird new twists on the old mind-body problem.

Published June 29, 1998 7:00PM (EDT)

After the surgery, the rhesus monkeys became "pugnacious," recalls Dr. Robert J. White, professor of neurosurgery at Case Western Reserve University School of Medicine in Cleveland.

Well, who could blame them? The animals had gone to sleep as complete beings and had woken up paralyzed and insensate from the neck down. Their heads were attached by clamps and sutures to new bodies over which they had no control. They could only see, hear, smell, taste -- and bite. According to White, if your finger came anywhere close to their mouths, you could easily lose it. The monkeys survived in this disembodied state for up to two weeks. And Frankenstein's monster thought he had it bad!

Although the experiments were done in the '60s and '70s, White says that the time is now right to offer what he calls a "full-body transplant" to humans. He has been featured on ABC News and in the New York Times discussing the possibility. With present technology, nerves could not be reconnected, so a new body wouldn't offer feeling or movement; but it could prolong the lives of quadriplegics, most of whom presently die of organ rather than brain failure.

White is not just some mad scientist with crazy ideas. The monkey research was originally published in the prestigious journals Science and Nature. In addition to his post at Case Western, he is director of neurosurgery and the Brain Research Laboratory at MetroHealth Medical Center in Cleveland.

"Christopher Reeve, Steven Hawking, these people are sustained by their hearts and other organs, but they can't move, they can't feel," he says. "Right now, they are the equivalent of a head. And Mr. Hawking's body might fail, it might become susceptible to infections, which could kill him. The issue comes up, is he entitled to a transplant? We say it's OK for a liver, why not a whole body?"

Like many medical techniques that start being used for the sickest and most desperate patients, this one has frightening implications. For example, eventually some scientists believe they will be able to reconnect the nerves and offer feeling and motion.

Could full-body transplants become a macabre fountain of youth, offering people a chance at near immortality as they continually replace old bodies with new, younger ones? Will headless bodies be cloned as replacements, or would people need other sources of donors? Could this offer a bizarre new way to get a sex change? And what does it say about identity, humanity and the soul?

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Tia Powell, assistant professor of psychiatry at Columbia University and an expert on medical ethics, does not believe that such transplants are inherently unethical.

"Ever since 'Frankenstein' was written, which captured the questions of the modern era -- what are the ends of science, where is it taking us? -- these questions come up. They came up with egg donation, with cloning, and we never do answer them," she says. "One response is to say that technology in itself doesn't have a moral cast. It can be used morally or immorally. If you transplant Christopher Reeve's head onto another body, it might work well; people might say, 'Well, that's great.' If it's Bill Gates or some evil wealthy person who has more money than God and who is unable to deal with death and buys the body of a pauper ... It isn't the science that changes, it's whether or not we approve of the people or their goals."

Other ethicists are more queasy. Tom Murray, the current director of the Center for Biomedical Ethics at Case Western Reserve, says, "Thirty-three years ago, we didn't have the understanding about primates that we do now; I won't criticize it 33 years ago. But now there would be some very hard questions, and it's not clear that the study would pass muster today."

James Nelson, professor of philosophy at the University of Tennessee, agrees. He explains that many people like to believe there's a clear line separating us from other species, but that line is remarkably hard to pin down.

"We think there's a magic moral bubble around members of our own species," he says, "and that it is wrong to treat humans as ends to some other goal. But why humans alone? Because we have complex intelligence, deep emotional and social connections, high-level communicative abilities? This isn't true for all human beings. What about the severely retarded? What about babies?"

Nelson believes that whatever the monkeys felt, "It must have been terrifying," and adds: "If he had taken mentally handicapped human orphans and done this, it wouldn't be a creepy-making interesting experiment, but it would be Nazi-like and we would drag him away in chains."

Nelson is intrigued, however, by the intellectual issues inherent in the possibility of body transplantation. "The questions it raises about immortality and identity are interesting," he says. "In 'The Iliad' and 'The Odyssey,' the gods' lives were trivial and dull. It was the mortals who had lives where things mattered. Our way of valuing and thinking about life is not unaffected by the fact that we are mortal beings."

Of course, body transplants couldn't help you if you got Alzheimer's or brain disease -- or if your head got crushed in some accident. But they could remarkably reduce death from many causes.

"If you extend life by three, four, five times our current span, one would have cause to wonder how is that related to our [actual] mortality?" asks Nelson. "Is that really our future, or is it the future of some other being that replaces us? One could imagine, even now in my mid-40s, my childhood memories seem almost like they happened to another person. What kind of sense of connection would I have to them if I was 200 years old? And if I'd switched bodies -- are we really extending life or are we dying and being resurrected in some sense?"

He adds, "You might be being slowly effaced by someone who is not you."

Nelson cites a "thought experiment" published by Stanford philosopher John Perry in which a philosopher has an accident that destroys her body but not her head, and is offered the chance to have her brain transplanted into another body. She claims that even if she woke up after the operation and said, "Hey, it's me, my boyfriend's name is Jack, etc.," we wouldn't necessarily be able to believe her -- because who we are is determined by both our bodies and our brains, and that identity would be unable to survive the transplant.

In his book "Descartes' Error," neurosurgeon Antonio Damasio also explores these questions -- concluding, along with Perry, that without a particular body a self cannot really exist. Damasio's argument is that our emotions are intimately linked with bodily sensations; even intellectual decisions, according to Damasio, at some point rely on emotion. We are embodied creatures, shaped by evolution to experience the world through our senses -- and our identities lie not just in what we feel, but in how we feel it via our unique bodies.

The technical capability required to wire one head to another body so that the head could have control and sensation is also far from trivial. There are literally billions of nerves involved, and as White concedes, "They aren't color-coded." It's also conceivable that individual differences might actually make such connections impossible, because people's bodies might be wired in completely unique ways.

Talking to the philosophers and ethicists, reading the consciousness books and inquiries related to this research and thinking about the possibilities can be dizzying. Despite the potential for extending life, the prospect of switching bodies is one many are likely to find revolting. If the price of longer life is this great, both in discomfort and in animal suffering, perhaps it's not worth paying. The alternative is almost literally becoming a vampire -- relying on the death of others for one's own immortality.

White himself is a devout Catholic who has 10 children and has advised the pope on bioethics issues. He has little time for animal-rights concerns, believing that "God gave us dominion over the animals."

He says, "I think there's a soul and a spirit in the Judeo-Christian sense" -- one that is unique to human beings. When pressed about whether the soul could be trapped and prevented from going to heaven, hell or some other afterlife if a brain were kept alive outside the body, he said simply, "At some point, it just comes down to faith."

A frustrating answer from a neurosurgeon! And it begs the big questions: If we did succeed in achieving bodily immortality, would that be the end of the idea of the soul? If we could switch bodies, would we really know what it's like to walk in someone else's shoes -- or would we simply become some odd combination of us and them, unable to relate to either?

By Maia Szalavitz

Maia Szalavitz is the author of the forthcoming book "Tough Love America: How the 'Troubled Teen' Industry Cons Parents and Hurts Kids" (Riverhead, 2005). She has also written for the New York Times, Elle, Redbook and other publications.

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