Is This A Good Idea? Having your head transplanted onto another body?

August 10, 2009

For a moment, pause in your admiration of those recently released photos of Vladimir Putin, shirtless and engaged in various manly outdoor pursuits, and ponder this: How is it that at age 56, the Russian prime minister has the rippling deltoids, biceps and latissimus dorsi muscles of a much younger man? As busy as Putin is pulling strings above Russian President Dmitry Medvedev, suppressing political dissent and consolidating power, it’s hard to imagine that he has much time for exercising with Russian kettlebells or practicing throws while studying his own popular Let’s Learn Judo With Vladimir Putin instructional DVD. All the same, the sight of the ex-KGB man’s eerily preternatural musculature from the neck down—juxtaposed incongruously with that early Rudy Giuliani-style comb-over and increasingly wrinkly jowls—makes me wonder if the real explanation may lie in the grisly annals of old-school Soviet medical experimentation. What if Putin has had his head transplanted onto a younger body?

Having such a head transplant—or actually, from your point of view, a rest-of-the-body transplant—would have fairly obvious benefits. Why go to the trouble of Photoshopping the wrinkles from your Facebook portrait, traveling to an offshore rejuvenation clinic for human growth hormone therapy, or having yourself frozen at a cryonics lab, when you can just discard your worn cartilage, shrinking musculature and increasingly gunk-lined arteries and upgrade to a newer, better-equipped, higher-powered replacement? It’s not just an alternative to succession planning for aging authoritarian leaders, either. Aging action movie stars wouldn’t have to be demoted to straight-to-DVD status, just because they were getting a little too paunchy to be plausible heroes on the big screen. No longer would professional athletes find themselves reduced to doing weight-loss cuisine commercials or auctioning off their memorabilia, just because their knees were too creaky for the football field. Recently divorced dentists wouldn’t have to dig into their retirement accounts to buy flashy sports cars and Viagra prescriptions.

There’s one inconvenient ethical catch to getting a rest-of-body transplant: You need a set of healthy young muscles, bones and organs to have your head implanted upon. Until scientists develop the ability to clone a replacement body from your own cells, you’ll have to find a body donor who either has had a catastrophic brain injury from which he won’t recover or is, well, astonishingly generous. If you already find the global black market in transplantable kidneys distasteful, imagine how you’ll feel when gangsters in the developing world start offering complete, still-fresh physiques for sale (though thankfully, at least, eBay’s policy against selling human remains prevent them from doing it on that Web site).

Pop culture has its share of head-transplanting references, especially if you infer a slightly different meaning to the lyrics of the 1958 Paul Anka hit “Put Your Head on My Shoulder". One of the creepiest is the life-is-cheap dystopia of Ira Rosemary’s Baby Levin’s 1970 science-fiction thriller, This Perfect Day, in which a fictional despot strives for immortality by having his noggin sewn onto a succession of younger bodies. There’s also the classic 1972 horror-exploitation flick The Thing With Two Heads, in which Ray Milland portrays a white bigot who has his head grafted onto the body of an African-American biker (played by ex-NFL player and Bobby Kennedy pal Rosey Grier). More recently, in 2008’s The X-Files: I Want to Believe, ex-FBI Agent Fox Mulder (David Duchovny) stumbles upon a malevolent Eastern European surgical team holed up in a West Virginia compound, just as it is about to engage in an illicit head-replacement.

But in this case, actual science preceded the fiction. The first researcher to attempt a head swap was American physiologist Charles Claude Guthrie, who put a dog’s head on a new body back in 1908, though the unfortunate subject only lived for a day. (Some suggest that his head transplantation stunt turned off the Nobel Prize committee, which snubbed Guthrie in favor of his colleague and collaborator Alexis Carrel when it recognized contributions to vascular surgery in 1912.) Half a century later, Soviet researcher Vladimir Demikhov proudly displayed a German shepherd dog named Pirat who had a second, smaller but apparently fully functioning puppy head, shoulders and paws affixed to his shoulder. When a United Press International reporter visited the researcher and his “Surgical Sputnik” in 1959, she observed:

Sometimes the puppy will playfully bite the ear of the big dog and Pirat will shake his head, but he never has tried to scratch or kick off the extra head. The puppy licked its paws and washed its face like a cat. When I patted big Pirat, the puppy head became drowsy in the sunshine and dozed off; the two heads sleep and wake independently.

American brain surgeon and researcher Robert J. White—a scientist so esteemed that when he toured Soviet medical facilities in the 1960s, he was afforded the privilege of handling Lenin’s preserved brain — one-upped Demikhov in the early 1970s by decapitating two rhesus monkeys and then surgically implanting the head of monkey A onto the body of monkey B. As White noted in a 2007 interview with the Cleveland weekly Free Times, the monkey mashup not only regained consciousness but tried to bite members of the medical team. It went on to live for several hours with the help of mechanical life support. The transplant wasn’t truly functional; White’s team didn’t try to connect Monkey B’s spinal cord to Monkey A’s brain, since nerve endings can’t just be sutured together like blood vessels. Ergo, the head was unable to control the body. "We only wanted to show that it could be done,” White explained to Free Times.

That inability to rewire a transplanted head to the nervous system has put the kibosh on human head transplants. But Science Daily reported last week that scientists at the University of California-San Diego School of Medicine have been able to regenerate axons—the portion of nerve cells that transmits signals to other cells—and guide them to re-form connections disrupted by a spinal cord injury, by using a hormone called neurotrophin-3. That breakthrough may someday help enable paralyzed people to regain the use of their bodies, but I’m wondering if it might also open the door to eventually forging new connections between a spinal cord and a transplanted head. Another solution might be to wire the donor body with some sort of prosthetic transmitting system, which would pick up signals in the brain and route them around the cut in the spinal cord. As I noted in a previous blog, University of Pittsburgh researchers already have devised a system that enables a monkey to manipulate a robotic arm with its thoughts.

So what do you think? Should researchers strive to develop a method for transplanting heads onto other bodies? Or, to rephrase legendary University of Texas football coach Darrell Royal, should we only dance with the carcasses that brung us? Express your opinion below.

Bacteria-sized medical robots inside our bodies?

April 24, 2009

What if doctors could inject robots the size of microorganisms into our bloodstreams and send them to attack individual cancer cells, remove plaque deposits from the walls of our arteries, fix damaged kidneys, deliver drug treatments and perform various bodily repairs from the inside on a scale too tiny for regular-sized human surgeons to attempt?

Keep reading...there's more!

Controlling Machines With Your Thoughts?

April 03, 2009

What if you were able to make machines do things simply by thinking about the action that you want to happen? Imagine being able to adjust the air conditioning in your house without leaving your couch, simply by pondering your perception that the room is too warm for your taste, or being able to type without touching the keyboard. Or being able to order your personal Honda ASIMO robot to go into the kitchen and fetch you a nice cold bottle of Black Forest Berry Honest Tea, without even lifting a finger to press a button.

Keep reading...there's more!

Exercise in a Pill?

August 29, 2008

Before we get into a new drug’s seemingly miraculous ability to provide the same benefits as strenuous exertion, here’s why it is so potentially important. When I saw this headline in Google news, I had to do a double-take to make sure that it wasn’t from The Onion, the satirical Web site whose faux-journalistic parodies occasionally are plagiarized by reporters in other countries and run as actual news. But no, this story is from Reuters, and apparently it’s dead serious:   

ALL U.S. ADULTS COULD BE OVERWEIGHT IN 40 YEARS   

Ouch. The study in question, published in the latest issue of the scientific journal Obesity, uses data gathered over the past four decades to project the expansion of American waistlines into the future. And it’s not a pretty picture. By 2030, if present trends continue, 86.3 percent of American adults will be overweight, with a body mass index of 25 or greater, and 51.1 percent will be obese, with BMIs above 30. If the pattern persists through 2048, all American adults will be carrying a significant excess of pounds, something scientists would not have believed to be possible.

"Genetically and physiologically, it should be impossible" for all U.S. adults to become overweight, said Dr. Lan Liang of the federal government's Agency for Healthcare Research and Quality, one of the researchers on the study.

However, she told Reuters Health, the data suggest that if the trends of the past 30 years persist, "that is the direction we're going."

I’m avoiding the temptation to make a gratuitous Jabba the Hutt joke here, because the trend described by this study is a potential health catastrophe of staggering proportions. Indeed, the researchers predict that the cost of treating health problems associated with excess weight could double each decade, so that by 2030 we could be spending nearly a trillion dollars a year, or nearly a fifth of total U.S. healthcare expenditures, to cope with what essentially is a preventable condition.

So what’s an increasingly corpulent nation to do? Giving up cheese fries and venti lattes will help, but cutting caloric intake drastically only works up to a point, because our bodies kick into starvation-fighting mode and become super-efficient at preserving those stores of fat, often at the expense of consuming muscle. A less-drastic balanced diet, combined with plenty of exercise, is the conventional wisdom. The problem with that solution: A lot of people don’t particularly care for getting all breathless and sweaty.

But what if you could get the benefits of exercise simply from taking a pill?

Placebo Surgery?

May 09, 2008

A pal of mine, medical journalist Kent Steinriede of Outpatient Surgery Magazine, recently tipped me off to the strange phenomenon of sham or placebo surgery, in which medical researchers perform what essentially are fake operations on a portion of the patients in a clinical trial, in order to test the efficacy of a particular surgical procedure.

Here’s an example of how sham surgery works. A few years back, researchers from the U.S. Department of Veterans Affairs and Baylor College of Medicine wanted to find out whether arthroscopic surgery, then a common treatment for osteoarthritis of the knee, really did patients any good. A Baylor press release explains how they went about answering the question:

In the study, 180 patients with knee pain were randomized into three groups. One group received debridement, in which worn, torn, or loose cartilage is cut away and removed with the aid of a pencil-thin viewing tube called an arthroscope. The second group underwent arthroscopic lavage, in which the bad cartilage is flushed out. The third group underwent simulated arthroscopic surgery; small incisions were made, but no instruments were inserted and no cartilage removed.

It should be mentioned that when potential subjects for the study were informed beforehand that they might be receiving sham surgery that would have no effect on their condition instead of an actual arthroscopy, 56 percent — more than half — still agreed to participate. But the results were even more startling:

During two years of follow-up, patients in all three groups reported moderate improvements in pain and ability to function. However, neither of the intervention groups reported less pain or better function than the placebo group. Indeed, the placebo patients reported better outcomes than the debridement patients at certain points during follow-up. Throughout the two years, the patients were unaware of whether they had received real or placebo surgery.

This was particularly significant, because previous studies conducted without a sham group had reported that the majority of arthroscopy patients got relief from knee pain. The V.A.-Baylor study showed that it may not have been the surgery that caused their improvement, but rather the Subject Expectancy Effect  — i.e., if a patient thinks that a treatment will work, he or she has a better outcome than a patient who doesn’t really believe it will help.

The effect was even more startingly apparent in a University of Denver study published in 2004 on the effectiveness of transplantation of human embryonic dopamine neurons into the brains of persons with advanced Parkinson's disease. Half the patients were given the transplants, while the others received a phony operation in which small holes were drilled into their skulls for realism. Those who got the real operation experienced measurable improvements in movement, while those who got the sham surgery didn’t. Nevertheless, a year later, patients who believed that they had received a transplant reported a better quality of life than those who believed that they hadn’t gotten one, regardless of whether or not they actually had. Moreover, doctors treating the patients — who didn’t know which of them had the real transplants — reported more improvement in those who believed they’d received the treatment. As Science Daily reported:

One patient, for example, reported that she had not been physically active for several years before surgery, but in the year following surgery she resumed hiking and ice skating. When the double blind was lifted, she was surprised to find that she had received the sham surgery.

You may ask: How could that possibly be? How could patients experience results from a fake operation that doesn’t actually do anything? Are they simply being fooled into thinking that they feel better? Perhaps not. University of Michigan researchers have found that after patients were told that a fake medicine would alleviate their jaw discomfort,  it apparently caused their bodies to produce endorphins, a chemical that reduces pain. As this BBC News story details:

Their brain scans also showed that they had more endorphin activity after simply being told they were about to get the "medicine."

The most pronounced effects were seen in four parts of the brain known to be involved in processing and responding to pain, namely the left dorsolateral prefrontal cortex, the pregenual rostral right anterior cingulate, the right anterior insular cortex and the left nucleus accumbens.

Furthermore, activity in the dorsolateral prefrontal cortex was associated with the expectation of pain relief.

Activation of the other brain areas was associated with relief of the intensity of pain, how unpleasant it was and how the individuals felt emotionally during the pain.

This leads me to an extremely bizarre — but nevertheless intriguing — thought: If fake surgery actually helps study subjects, what about using it to treat ordinary patients, particularly ones for whom no other effective treatment seems to be available? To medical ethicists — some of whom object to the use of sham treatments even in clinical trials — this would be total heresy.  On the other hand, as I was surprised to learn, many doctors already occasionally engage in therapeutic deception. According to the American Medical Association AMedNews.com, a recent survey of 231 physicians revealed that nearly half had treated their patients with placebos, and 8 percent had used such fakery more than 10 times in the past year. (Only 4 percent of the doctors had bothered to inform patients that they might be receiving the proverbial sugar pill, despite a 2006 AMA report that condemned the use of placebos without patient consent as a breach of trust.)

So, what do you think? Should doctors use fake operations to tap into the placebo effect and try to help consenting patients who might not see improvement through conventional treatment? Or would sham surgery for therapeutic purposes be utterly wrong? Express your opinion below.