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Speaker 1: From the point of view of biology, what is life

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Speaker 1: and what is death and what is the line between them?

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Speaker 1: Could you freeze your body to come back sometime in

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Speaker 1: the future, and what does this have to do with

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Speaker 1: Mary Shelley's Frankenstein or housefly or the poet John Dunn.

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Speaker 1: Welcome to Inner Cosmos with me David Eagleman. I'm a

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Speaker 1: neuroscientist and an author at Stanford and in these episodes

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Speaker 1: we sail deeply into our three pound universe to understand

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Speaker 1: why and how our lives look the way they do,

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Speaker 1: and in this case, whether life is something that comes

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Speaker 1: to an end inevitably or only because we don't understand

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Speaker 1: the biology well enough yet. So today day's episode is

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Speaker 1: about understanding what happens when your molecular cycles grind to

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Speaker 1: a halt, and whether there's anything we can do to

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Speaker 1: hit control z on that can death be reversed. A

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Speaker 1: few months ago, my dog was lying on the floor

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Speaker 1: and we were all gathered around her, and my kids

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Speaker 1: were coming in and out, and everyone was crying because

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Speaker 1: my dog was dying. She was fifteen and a half

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Speaker 1: years old, which for a dog her size was quite old,

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Speaker 1: and her body was shutting down and as I sat

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Speaker 1: on the floor stroking her back, I was thinking about

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Speaker 1: a poem by John Dunn that I had first read

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Speaker 1: when I was a child, probably about ten years old.

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Speaker 1: The poem is called Death Be Not Proud, and it

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Speaker 1: really blew my young mind when I read it. It

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Speaker 1: begins with these lines, death be not proud, though some

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Speaker 1: have called thee mighty and dreadful, for thou art not

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Speaker 1: so now. In this poem, one of his nineteen holy sonnets,

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Speaker 1: Done gets right up in Death's face and he challenges

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Speaker 1: Death's power and importance, and he tells death not to

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Speaker 1: be proud because it is not as fearsome as it

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Speaker 1: might seem. And the sonnet ends with the lines one

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Speaker 1: short sleep past, we wake eternally, and death shall be

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Speaker 1: no more death, thou shalt die so. Done ends the

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Speaker 1: poem by spitting right in death's champagne glass, and he

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Speaker 1: tells Death that he is going to die now. John

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Speaker 1: Dunn wrote this poem through a religious lens. He was

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Speaker 1: giving the interpretation of the victory of the soul over death.

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Speaker 1: But I had a different interpretation. I was struck by

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Speaker 1: this idea of defeating death. After all, biologists, we study

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Speaker 1: life and each decade we know more and more about

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Speaker 1: how it works, and the more we know about life,

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Speaker 1: the more we can know about how to keep it

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Speaker 1: going and possibly how to even reboot it. Now that

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Speaker 1: sounds crazy, but we're going to unpack that carefully in

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Speaker 1: this episode. There are many ways to look at what

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Speaker 1: life is. I did an on stage conversation some years

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Speaker 1: ago with a mystic named Saguru, and we discussed and

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Speaker 1: debated a number of issues, but he said one thing

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Speaker 1: that was phrased very simply, and it proved hard for

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Speaker 1: me to forget. He said, the physical body is like

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Speaker 1: a fruit, and when the person is gone, the person

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Speaker 1: that you loved, all you have left now is the rind.

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Speaker 1: There's nothing special about the body, the physical body, and

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Speaker 1: I loved that description, but as a biologist, I wanted

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Speaker 1: to dig deeper. And this is a problem I had

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Speaker 1: actually started thinking about years earlier, because I once went

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Speaker 1: to wash a dish in the sink and there was

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Speaker 1: a tupperware in there with some water in it, and

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Speaker 1: there was a house fly that had died in the tupperware.

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Speaker 1: And I looked at the poor little lifeless fly, and

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Speaker 1: a question struck me, What is the difference between the

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Speaker 1: live fly and the dead fly. If you do a

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Speaker 1: chemical analysis, it's exactly the same stuff. You have x

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Speaker 1: number of carbon atoms in the quadrillions or ten to

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Speaker 1: the eighteenth, and you have Y number of nitrogen atoms,

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Speaker 1: and you have Z number of oxygen atoms, and so on.

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Speaker 1: The weight of this little dead fly is exactly the

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Speaker 1: same as a living fly. The chemical composition is the same,

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Speaker 1: All the trillions of proteins are the same. Everything is

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Speaker 1: the same between the living fly and the dead fly.

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Speaker 1: The only different is the molecular momentum. All the cascades

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Speaker 1: have come to a stop. All the crebs cycles and

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Speaker 1: the action of the proteins around the DNA and the

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Speaker 1: endoplasmic particulum, and all the step by step chemical reactions

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Speaker 1: in the cell, they've all just come to a standstill.

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Speaker 1: So what Saguru referred to as the fruit to the

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Speaker 1: part we love and lament I interpret this as the

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Speaker 1: ongoing cascades of the cellular processes. This leads to this

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Speaker 1: leads to this, and as long as everything keeps going,

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Speaker 1: then the fly is alive and it moves around. As

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Speaker 1: soon as something breaks about these cycles, then everything just

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Speaker 1: grinds to a halt. So this leads to the question

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Speaker 1: what does it require to keep everything going for cells

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Speaker 1: to stay alive? And the related question is if they stopped,

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Speaker 1: would there be any way to you reboot the system

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Speaker 1: to get the cycles going again. So when I read

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Speaker 1: Dunn's poem as a kid, where he says that death

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Speaker 1: shall die, I imagined that someday, in the very distant

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Speaker 1: sci fi future, we might actually be able to make

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Speaker 1: this true, to get cells going again that had come

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Speaker 1: to a stop. But of course, when imagining this future

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Speaker 1: as a kid, you imagine it as people in silver

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Speaker 1: suits zipping around in the skies. So as I got

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Speaker 1: older and studied biology and became more realistic about this,

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Speaker 1: I realized, of course that we were all going to

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Speaker 1: die after all. So given that perspective about how distantly

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Speaker 1: in the future this would happen, you can imagine how

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Speaker 1: surprised I was to see the speed at which this

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Speaker 1: field is moving along. I suspect that I will die

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Speaker 1: and perhaps the next few or several generations. But the

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Speaker 1: idea of reversing deaths, at least in some cases, is

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Speaker 1: not a subject constrained to the pens of poets. Anymore.

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Speaker 1: Over the past several years, you can find the beginnings

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Speaker 1: of this endeavor published in the top scientific journals. And

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Speaker 1: we're not talking about longevity in this episode. I'm going

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Speaker 1: to talk about that in the future episode. Instead, we're

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Speaker 1: talking about this completely wacky idea of reversing death, taking

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Speaker 1: an organism that has already died, and reversing back out

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Speaker 1: of that. Now, this sounds like something straight out of

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Speaker 1: Mary Shelley's novel Frankenstein, which, as you remember, tells the

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Speaker 1: story of a scientist named Victor Frankenstein who figures out

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Speaker 1: how to reanimate the dead. But the whole thing doesn't

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Speaker 1: turn out so well, and Frankenstein's monster ends up getting

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Speaker 1: rejected by mankind in general, and he regretfully murders people

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Speaker 1: to get revenge on his maker. But anyway, put that

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Speaker 1: interpretation aside for a moment while we talk about this,

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Speaker 1: because in the early twenty first century, we're now in

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Speaker 1: a more realistic position to assess what is possible and

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Speaker 1: to think deeply about the ethics. Now, it may sound

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Speaker 1: surprising that there's enough science now to even talk about

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Speaker 1: this topic, but hangtight, because we're about to see some

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Speaker 1: very strange stuff. First, this question of whether death could

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Speaker 1: be reversible has long been entertained, because sometimes people can

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Speaker 1: fall to the bottom of a lake and freeze to

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Speaker 1: death and lose all their function, and they are really

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Speaker 1: truly at a stop, and then sometimes they can be

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Speaker 1: brought to a hospital and revivified. For example, I remember

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Speaker 1: reading a story in two thousand about a young doctor

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Speaker 1: in Norway named Anna. She was a trainee surgeon who

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Speaker 1: was exactly my age, and she was skiing when she

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Speaker 1: fell through a rosen river and got trapped under the ice. Now,

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Speaker 1: her colleagues were there and they saw her, but they

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Speaker 1: couldn't get her out, and they struggled and struggled to

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Speaker 1: rescue her. But she ended up being under the ice

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Speaker 1: for forty minutes, and not surprisingly, her organs shut down

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Speaker 1: and she died. Her body temperature had fallen more than

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Speaker 1: twenty three degrees below normal. But Anna was eventually pulled

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Speaker 1: out from the ice and put on an air ambulance,

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Speaker 1: and she wasn't breathing when she got to the hospital.

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Speaker 1: Her blood circulation had stopped, her pupils were not responding

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Speaker 1: to light, but the doctors put her on a heart

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Speaker 1: and lung machine and re warmed her while the circulation

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Speaker 1: was kept going. They used a machine that warmed her

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Speaker 1: blood and oxygenated it and then put it back in

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Speaker 1: her body, and things weren't easy. She spent sixty days

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Speaker 1: in intensive care in the hospital, but five months after

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Speaker 1: she was frozen to death, she was back to work

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Speaker 1: as a doctor and she still skis now. You can

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Speaker 1: find this case in the Lancet, which is a top

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Speaker 1: medical journal in the field. So this stuff happens, and

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Speaker 1: it happens more than you might think. I read another

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Speaker 1: article in twenty sixteen about a guy walking home from

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Speaker 1: a party and he slipped and hit his head and

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Speaker 1: went unconscious and wasn't found until the next morning when

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Speaker 1: his father was driving around looking for him and found

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Speaker 1: him buried in the snow, frozen, no vital signs. They

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Speaker 1: rushed him to the hospital. They pumped him full of warm,

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Speaker 1: oxygenated blood, and it wasn't an easy recovery. But a

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Speaker 1: year later, even though he's missing all his toes and

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Speaker 1: pinkies from frostbite, he is indistinguishable from anyone else you

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Speaker 1: might meet. Essentially, he was frozen in the same way

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Speaker 1: that we might put meat in the freezer, so it

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Speaker 1: doesn't go bad. But it's the same principle. Despite our

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Speaker 1: sense of our beautiful essences, it's also the case that

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Speaker 1: we are meat and we can be frozen and we

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Speaker 1: can be thawed. Now, why can't you revivify any person

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Speaker 1: who has died. Well, if things aren't frozen, then the

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Speaker 1: biology decomposes, the cells break down. This is of course

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Speaker 1: the same thing that happens if you leave a piece

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Speaker 1: of meat on your counter instead of putting it in

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Speaker 1: the freezer, and in the case of a person, that

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Speaker 1: causes irreversible damage to the brain. But a frozen body

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Speaker 1: doesn't decay, at least not rapidly. It stays intact because

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Speaker 1: the molecules can't move around as much. Everything is held

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Speaker 1: into place. So the observation that people could be frozen

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Speaker 1: and unfrozen got scientists interested in the speculation of whether

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Speaker 1: you could take a person who has just died and

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Speaker 1: freeze them on purpose, with the idea of unfreezing them later.

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Speaker 1: And this successfully started in the nineteen in seventies with

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Speaker 1: freezing mouse embryos, and then that became a successful way

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Speaker 1: to freeze human embryos. But keep in mind a human

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Speaker 1: embryo is the size of a grain of salt, and

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Speaker 1: so the challenges are a little less in successfully freezing

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Speaker 1: and unfreezing those. But the question people have been asking is,

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Speaker 1: could you actually freeze an entire adult body and unfreeze

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Speaker 1: it later, Let's say, because they have cancer that we

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Speaker 1: don't know how to cure. But maybe in seventy years

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Speaker 1: the medical community will have no problem curing this. It'll

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Speaker 1: be easy. Could you reanimate somebody in the same way

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Speaker 1: that has been done on a much shorter timescale with

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Speaker 1: the woman in the icy river or the man who

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Speaker 1: fell into the snow bank. Well, in a previous episode,

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Speaker 1: I mentioned a company in Arizona called Alcore, which strives

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Speaker 1: to do exactly this. They are a cryogenics company, and

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Speaker 1: upon your death, they will swoop in to perfuse your

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Speaker 1: body with the right chemicals and get you to the

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Speaker 1: facility in Arizona, and there they will lower you into

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Speaker 1: a vat of liquid nitrogen. Now, do they know how

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Speaker 1: to cure whatever your disease was, or, for that matter,

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Speaker 1: do they even know how to unfreeze you successfully? No,

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Speaker 1: But that's not the point. The point is that sometime

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Speaker 1: in the distant future, our great grand descendants may know

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Speaker 1: how to do this, and at that point they can

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Speaker 1: unfreeze you and cure you of whatever ailment you have,

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Speaker 1: presumably something that was totally opaque or confusing for twenty

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Speaker 1: first century minds, but easily curable with a twenty second

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Speaker 1: century toolbox. Now here's something of interest. It turns out

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Speaker 1: the first person to ever get frozen on purpose in

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Speaker 1: this new field called cryogenics was born in what year,

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Speaker 1: take a guess, eighteen ninety three, a guy named James

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Speaker 1: Bedford who died in January of nineteen sixty seven from

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Speaker 1: terminal cancer. He was the first person to do this.

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Speaker 1: But did he die? Interesting question? I would say unresolved

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Speaker 1: so far, because it's yet to be seen whether he

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Speaker 1: can be rebooted nineteen sixty seven. So although this is

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Speaker 1: science fiction y, it's not even that new. Now. Since

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Speaker 1: that time, people have worked on the cryogenic technology to

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Speaker 1: figure out how to make the freezing process better and

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Speaker 1: better to prevent cell damage, because the problem is if

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Speaker 1: you get an ice crystal during the freezing process, that

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Speaker 1: will rupture the cell membrane and then the body that

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Speaker 1: you hoped to revive is too damaged. Like when you

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Speaker 1: stick a strawberry in the freezer to try to make

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Speaker 1: it last longer. But once you unthought, it gets all mushy.

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Speaker 1: That's the same thing that happens with any cells if

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Speaker 1: they get ice crystals in it. So will Bedford's body

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Speaker 1: be able to be reanimated? Who knows? And experts have

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Speaker 1: different opinions about whether the bodies at the alcore facility

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Speaker 1: will be reeve vivifiable. But the idea of cryogenics is

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Speaker 1: straightforward in the sense that even if these first few

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Speaker 1: hundred experiments fail, will surely get better and better at

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Speaker 1: cryogenics in the future, and the hope is that someone

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Speaker 1: fifty generations from now will know how to reverse the process.

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Speaker 1: And before I go to the next step, I just

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Speaker 1: want to say this idea about confronting death is not

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Speaker 1: just about freezing and unfreezing. The deeper issues in biology

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Speaker 1: have to do with how individual cells die. It turns

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Speaker 1: out that cells can get injured by various things, let's say,

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Speaker 1: a lack of blood flow or a chemical insult, and

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Speaker 1: then they essentially blow up and die and cause a

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Speaker 1: lot of inflammation. This is called necrosis. But in nineteen

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Speaker 1: seventy two it was discovered that this isn't the way

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Speaker 1: cells have to die. Cells can actually die on purpose,

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Speaker 1: and this is known as a potosis. A potosis means

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Speaker 1: that instead of a cell simply just falling apart, instead

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Speaker 1: it implements a controlled process by which it folds up

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Speaker 1: shop and cleanly commits suicide. Scientists came to understand that

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Speaker 1: this is a very purposeful process, and over many years

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Speaker 1: they showed how apotosis is actually the way that biological

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Speaker 1: organisms structure themselves. For example, a human embryo has webbed fingers,

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Speaker 1: in other words, little sheets of skin between the fingers

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Speaker 1: of exactly the type that you would need for swimming.

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Speaker 1: But in the case of our particular species, the cells

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Speaker 1: making up that webbing. Those cells die off before the

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Speaker 1: baby is born, such that we have independently moving fingers.

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Speaker 1: But those cells between our fingers wouldn't die off if

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Speaker 1: we were another mammal, say a bat, or a kangaroo,

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Speaker 1: or a whale or a manatee. I'm actually going to

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Speaker 1: put an X ray picture of a manatee fin on

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Speaker 1: my website because it's so stunning how the bones inside

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Speaker 1: their fin look just like a human hand. The bones

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Speaker 1: look that way, but the difference is that the cells

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Speaker 1: between their fingers, that webbing that doesn't die off, so

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Speaker 1: what you get is a fin Anyway, apotosis is everywhere.

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Speaker 1: Your body has about a trillion new cells developing every day,

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Speaker 1: and so you need to kill off a similar number

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Speaker 1: to keep the system from getting overrun. And this is

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Speaker 1: all done with this very controlled process of cell death.

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Speaker 1: And the scientists behind these discoveries Horbitz and Brenner and Sulstan.

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Speaker 1: They won the Nobel Prize for this in two thousand

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Speaker 1: and two. But it turns out since then biologists have

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Speaker 1: discovered that necrosis and apotosis are not even the only

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Speaker 1: game in town. We now know there are many flavors

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Speaker 1: of program cell death, like what's called pyrotosis or ferrotosis

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Speaker 1: or necrotosis. These are all different mechanisms that tip the

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Speaker 1: balance between different cell fates, and people are working on

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Speaker 1: drugs to block all these very specific flavors of cell death.

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Speaker 1: It's no longer just the cell gets sick and falls apart,

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Speaker 1: but it's much more sophisticated now and that gives the

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Speaker 1: possibility to molecularly block the process. So now let zoom

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Speaker 1: out to the big picture. There's an increasing amount known

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Speaker 1: about how cells actually shut down, and we have proof

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Speaker 1: of principle that systems can get going again even after

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Speaker 1: they've stopped. And all this has led to the possibility

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Speaker 1: that we might be able to take something like a

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Speaker 1: dead brain or dead body and reboot it. Now this

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Speaker 1: sounds so crazy, but the question I want to ask

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Speaker 1: is are we actually going to have to wait fifty

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Speaker 1: generations to see this happen? Or is it possible that

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Speaker 1: things are moving so rapidly that there's some reason to

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Speaker 1: think that we could take, say, a dead brain, a

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Speaker 1: totally dead brain that's been dead for four hours, and

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Speaker 1: get the whole factory running again. Well you'd agree that

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Speaker 1: seems like a science fiction fantasy. But a colleague of

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Speaker 1: mine recently published two papers in the journal Nature, and

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Speaker 1: it seems we're already at the point, give or take,

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Speaker 1: where we may be able to do something just about

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Speaker 1: like that, at least in pigs. In the journals, this

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Speaker 1: is cast in the paper as quote Cellular and molecular

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Speaker 1: recovery in pigs, which I suspect doesn't sound that interesting

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Speaker 1: to most people on the planet, and so it didn't

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Speaker 1: get that much attention. But this is seriously big stuff.

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Speaker 1: So I called up my colleague who wrote these recent papers,

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Speaker 1: and I asked him, is cell death inevitable? Let's say

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Speaker 1: when a person has a stroke and there's no blood

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Speaker 1: going to the set. Well, we've always thought of that

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Speaker 1: as being a really terrible scenario that inevitably leads to

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Speaker 1: sell death. But is that the case?

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Speaker 2: So we used to think that, and we had a

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Speaker 2: publication four years ago where we actually christened if sales

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Speaker 2: actually die after death after blood flow stops, and we

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Speaker 2: realized that actually death is a portracted process. It takes

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Speaker 2: a bit actually for sales to die, and if you

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Speaker 2: intervene properly, you can maybe reverse those processes.

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Speaker 1: That's Vanimir Russella. He's an mdphd originally from Croatia. He

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Speaker 1: did his postalk and became a research scientist at Yale

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Speaker 1: School of Medicine, and now he's spun off a company

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Speaker 1: around this called Becksore. So you mean the death of

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Speaker 1: an organism, let's say, of a person. You're saying it

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Speaker 1: doesn't happen all at once, but it takes time to die.

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Speaker 2: So yeah, yeah, So I think I just want to

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Speaker 2: be like a nuance here. There were instances that so

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Speaker 2: it is well known that For example, you can find

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Speaker 2: living cells in human specimens after hours of death, and

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Speaker 2: scientists have used like chunks of tissue to find like

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Speaker 2: living sales and record from them.

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Speaker 3: It was also observed.

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Speaker 2: That people who have died and were undercolt conditions that

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Speaker 2: they could be actually brought sort of The implication there

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Speaker 2: is that there are cells o functional. So there were

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Speaker 2: instances where this was a scene and recorded in the literature.

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Speaker 1: So let's just double click on that. So tell us

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Speaker 1: what you mean about people who were frozen and were recovered.

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Speaker 2: Give us an example, So on the macros kale, like right,

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Speaker 2: talking about the whole human, not about.

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Speaker 3: A single cell. It was observed that people.

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Speaker 2: Who have drowned their bodies would cool down as they

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Speaker 2: were drowning, that after a prolonged period of time, these

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Speaker 2: people could be resuscitated. So the time it was, you know,

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Speaker 2: we are not used as seeing like someone resuscitated after

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Speaker 2: that how long, Well, I don't know specifics, but just

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Speaker 2: to give you like a benchmark data point. Usually it

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Speaker 2: is assumed from the classical literature that four minutes after

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Speaker 2: blood flow stops, bodies cells just die.

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Speaker 3: So that was.

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Speaker 2: Always like a clinical data point, after which was really

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Speaker 2: difficult to bring people back with resuscitation.

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Speaker 1: Okay, so you started suspecting that maybe cells aren't as

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Speaker 1: fragile as we thought. So what did you do?

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Speaker 2: So yeah, so we have it's interesting storied up my

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Speaker 2: pi at the time. And then a Sistan received a

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Speaker 2: tissue specimens from abroad and they got stuck at customs

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Speaker 2: for a really long period of time. And so by

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Speaker 2: the time they came in the lab, you know, the

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Speaker 2: researchers were like thinking, oh.

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Speaker 3: You know, it's done, like the specimen is useless.

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Speaker 2: But they still made slice sculptures and after a week

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Speaker 2: they realized that they were living cells.

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Speaker 3: So that was the first observation that got the group like.

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Speaker 2: Thinking, and in our case in particular, we just wanted

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Speaker 2: to scale the whole approach, initially going from a small.

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Speaker 3: Slice to a whole inteked brain.

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Speaker 1: Right, So you said, hey, what if you could get

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Speaker 1: a brain of an organism that has died, could you

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Speaker 1: restore the function somehow? So what did you do to

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Speaker 1: try to tackle that problem?

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Speaker 3: So, you know, as one does, we started going to

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Speaker 3: a local slaughterhouse and we were procuring a tissue.

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Speaker 1: You were getting pig brains, right, pig reins.

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Speaker 2: Yes, so people don't. Luckily there we are like, people

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Speaker 2: don't eat the pig brains.

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Speaker 1: And this was the el right, yes, yes, yes, yes.

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Speaker 3: Yes, So we will go to the local slaughterhouse. You know,

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Speaker 3: they would do their job.

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Speaker 2: By the time when they are done, we would get

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Speaker 2: pig hits and so we'll bring them to the lab.

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Speaker 3: We would take the brain out, and.

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Speaker 2: Then we started developing this technology that could connect with

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Speaker 2: the vascular system of the brain and profuse a fluid

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Speaker 2: to sort of reboot the self functionality.

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Speaker 1: And how long had these pigs been dead?

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Speaker 3: On every g it was four hours, So from the

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Speaker 3: time of pig being killed in the slaughterhouse to the

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Speaker 3: time point where we started our profusion intervention, it was

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Speaker 3: usually four hours.

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Speaker 1: So then what you did is you profused and tell

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Speaker 1: us about profusion and what that means and what that

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Speaker 1: looks like.

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Speaker 2: So there's a device, so you take the isolated brain,

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Speaker 2: which is sort of front of you. You load the

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Speaker 2: brain into this device and then the device pushes artificial

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Speaker 2: blood or blood like fluid through the brain and it

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Speaker 2: does it under controlled conditions. It has a bunch of

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Speaker 2: drugs inside that counter certain cell processes. So the whole

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Speaker 2: point is to try to reinstate homeosthetic environment or this

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Speaker 2: like like normal environment in which cells are usually accustomed.

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Speaker 1: To be and so what did you find?

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Speaker 2: So we found that So this is an interesting equation.

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Speaker 2: So first of all, we found that we could revert

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Speaker 2: cell death. It was an interesting thing because at the

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Speaker 2: time we were trying to define like what does it

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Speaker 2: mean for a cell to be dead, like right, and

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Speaker 2: how do you define cell death? So we found it

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Speaker 2: cells that were considered dead they were actually still some adjective.

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Speaker 2: And with our interventions we could restore or functionality and

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Speaker 2: observed functions in those cells that we usually observe in

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Speaker 2: cells that we sort of think or consider alive.

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Speaker 1: So were the cells completely restored or are there still

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Speaker 1: things you need to do to get to the next level.

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Speaker 3: There is a lot more to do there.

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Speaker 2: What we have done we took a particular number of

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Speaker 2: tests and we conducted those tests and so I can

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Speaker 2: only speak about those.

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Speaker 3: They were pretty good broad tests that sort of speak

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Speaker 3: on the state of these cells. So these same tests

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Speaker 3: show that these cells performed in a similar way as

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Speaker 3: normal cells.

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Speaker 2: And on top of it, with subsequent research data was done,

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Speaker 2: we actually showed that it's clear that these cells go

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Speaker 2: through stress of dying. So we've shown that we can

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Speaker 2: stop it, and we even showed on the molecular scale

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Speaker 2: that we can basically persuade sales like not to die

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Speaker 2: and they can start to repair themselves and basically just

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Speaker 2: say to them like, don't die, like they just want

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Speaker 2: to live, you know.

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Speaker 1: So you take a pig brain that's been dead for

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Speaker 1: four hours and you perfuse this this solution through it.

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Speaker 1: It's like blood, but it doesn't have cells in it.

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Speaker 1: It has lots of meds and the proper kind of

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Speaker 1: molecules in it. You push that through and then you

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Speaker 1: can measure things about the cells and see that it's

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Speaker 1: like they're cooking along. They're doing their thing that cells

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Speaker 1: normally do.

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Speaker 3: Absolutely.

437
00:27:28,720 --> 00:27:30,919
Speaker 2: So the point is like, you know, you just go

438
00:27:31,040 --> 00:27:34,639
Speaker 2: to like meet school biology and it's you know, you

439
00:27:34,760 --> 00:27:37,080
Speaker 2: see if oxygen is going in, you see if glucose

440
00:27:37,200 --> 00:27:40,640
Speaker 2: is going in, so you're expecting CO two to come out,

441
00:27:40,760 --> 00:27:44,280
Speaker 2: so you know that's happening, and then you compare those results.

442
00:27:44,359 --> 00:27:48,119
Speaker 3: I'm simplifying this, but you know, conceptually it works.

443
00:27:48,520 --> 00:27:51,840
Speaker 2: You can provide stimuli or for example, drugs because you know,

444
00:27:52,040 --> 00:27:54,320
Speaker 2: like you can take a drug, which we have done actually,

445
00:27:54,320 --> 00:27:56,360
Speaker 2: so we would take a drug that works in humans,

446
00:27:56,720 --> 00:27:59,040
Speaker 2: it's well known, and we would see if it's exerting

447
00:27:59,080 --> 00:28:01,760
Speaker 2: the same effect in these restored cells.

448
00:28:02,119 --> 00:28:02,800
Speaker 3: And it worked.

449
00:28:02,840 --> 00:28:05,240
Speaker 2: So these cells can also be like stimulated and you

450
00:28:05,240 --> 00:28:08,679
Speaker 2: can observe how they respond. You can compare those responses

451
00:28:08,680 --> 00:28:10,359
Speaker 2: and learn about the brain, you know.

452
00:28:11,240 --> 00:28:14,640
Speaker 1: And so you have been doing this in pig brains

453
00:28:14,680 --> 00:28:18,160
Speaker 1: since the first paper you did was in twenty nineteen

454
00:28:18,440 --> 00:28:20,960
Speaker 1: or yes, okay, so you've been doing it in pig

455
00:28:21,000 --> 00:28:25,000
Speaker 1: brains since then. What is the road that you see

456
00:28:25,119 --> 00:28:26,920
Speaker 1: two human brains?

457
00:28:27,600 --> 00:28:32,080
Speaker 2: So this is a new type of research, and we

458
00:28:32,080 --> 00:28:35,359
Speaker 2: were pretty lucky from day one to have ANIH and

459
00:28:35,440 --> 00:28:39,920
Speaker 2: other institutions Yale including involved in helping us put the

460
00:28:39,960 --> 00:28:42,800
Speaker 2: guidelines and think about like where this research should go

461
00:28:42,880 --> 00:28:45,760
Speaker 2: and how it should be conducted. So what we have

462
00:28:45,840 --> 00:28:48,640
Speaker 2: done we really wanted to build like a ground up approach,

463
00:28:49,120 --> 00:28:52,240
Speaker 2: and so we wanted to show that these interventions are

464
00:28:52,440 --> 00:28:55,240
Speaker 2: opening new spaces, and so we went to do it

465
00:28:55,280 --> 00:28:58,360
Speaker 2: in the smart way. So that said going to humans

466
00:28:58,360 --> 00:29:00,680
Speaker 2: and what it really means, you know, think about like

467
00:29:00,920 --> 00:29:04,040
Speaker 2: restoring cells and their function, like you can think about

468
00:29:04,040 --> 00:29:07,440
Speaker 2: clinical applications of the technology like SOAK is the first

469
00:29:07,440 --> 00:29:08,640
Speaker 2: thing that comes to one mind.

470
00:29:09,480 --> 00:29:11,920
Speaker 3: So it will take a bit more time to get there.

471
00:29:12,040 --> 00:29:14,600
Speaker 2: Because we need to really understand, like deeply what's going

472
00:29:14,640 --> 00:29:16,280
Speaker 2: on on the cellular level.

473
00:29:16,320 --> 00:29:17,680
Speaker 3: But this is one approach.

474
00:29:17,760 --> 00:29:21,080
Speaker 2: Another approach that we have taken was in collaboration with

475
00:29:21,200 --> 00:29:25,400
Speaker 2: a transplant team here at Yale. So we actually wanted

476
00:29:25,440 --> 00:29:28,680
Speaker 2: to see if we could deploy our technology in dead pigs.

477
00:29:28,800 --> 00:29:32,320
Speaker 3: Essentially and see if we could restore like kidneys or

478
00:29:32,400 --> 00:29:34,040
Speaker 3: liver for transplant.

479
00:29:34,120 --> 00:29:38,560
Speaker 2: Because if this works in the clinical sense, then there

480
00:29:38,600 --> 00:29:42,840
Speaker 2: is a chance to readically expand organ pool or organ donations.

481
00:29:43,320 --> 00:29:47,200
Speaker 1: Oh incredible. And when it comes to restoring the brain,

482
00:29:47,680 --> 00:29:50,640
Speaker 1: when you think down the road, you think ten twenty

483
00:29:50,680 --> 00:29:53,160
Speaker 1: years in the future, what are the ethical questions here?

484
00:29:53,880 --> 00:29:58,920
Speaker 3: Well they are big. So the first thing is clearly,

485
00:29:59,360 --> 00:30:03,080
Speaker 3: are we sort of rebooting this brain like big where

486
00:30:03,080 --> 00:30:06,760
Speaker 3: it was. I'm really particular how I speak about these things,

487
00:30:06,760 --> 00:30:09,360
Speaker 3: So I talk about sales, I don't actually talk about

488
00:30:09,400 --> 00:30:13,560
Speaker 3: brain function. The reason is because we are making sure

489
00:30:13,600 --> 00:30:18,120
Speaker 3: that we are not rebooting global network or EG. But

490
00:30:18,280 --> 00:30:21,720
Speaker 3: one could go in that phase. So that is definitely

491
00:30:21,920 --> 00:30:23,320
Speaker 3: something that can be explored.

492
00:30:23,360 --> 00:30:26,240
Speaker 2: So now you can think about all the ethical implications

493
00:30:26,280 --> 00:30:29,400
Speaker 2: that our eyes with this technology.

494
00:30:29,800 --> 00:30:33,240
Speaker 1: So you said you're being careful not to reboot the

495
00:30:33,440 --> 00:30:35,960
Speaker 1: function of the brain. Correct me if I'm wrong, But

496
00:30:36,000 --> 00:30:39,000
Speaker 1: you're not actually sure when or why that would happen.

497
00:30:39,120 --> 00:30:41,000
Speaker 1: It's just that in the experience you've done so far,

498
00:30:41,480 --> 00:30:45,120
Speaker 1: the electrical signaling, the global functioning the brain wasn't restored

499
00:30:45,200 --> 00:30:47,880
Speaker 1: in the pigs, but we don't know why that's the case,

500
00:30:47,920 --> 00:30:51,520
Speaker 1: and it could happen with another few molecules or whatever

501
00:30:51,560 --> 00:30:52,440
Speaker 1: of the right flavor.

502
00:30:53,280 --> 00:30:57,880
Speaker 2: Absolutely, so there is research already showing thatta done in

503
00:30:57,920 --> 00:31:01,280
Speaker 2: the pace that this could be done. And also in

504
00:31:01,320 --> 00:31:05,120
Speaker 2: our case, it is basically the design of the experiments.

505
00:31:05,240 --> 00:31:09,480
Speaker 2: Our experiments we were actively suppressing or we were avoiding

506
00:31:09,840 --> 00:31:15,920
Speaker 2: that situation because even without the network being rewooted, we

507
00:31:16,080 --> 00:31:19,479
Speaker 2: still have an extremely valuable tool to understand how the

508
00:31:19,480 --> 00:31:23,200
Speaker 2: brain works and functions. So in the future, the question

509
00:31:23,400 --> 00:31:25,440
Speaker 2: has definitely been the technology, as you said, been the

510
00:31:25,480 --> 00:31:29,880
Speaker 2: technology is matured and we actually know exactly every single

511
00:31:29,880 --> 00:31:32,240
Speaker 2: thing that goes into it and what happens, then the

512
00:31:32,320 --> 00:31:34,000
Speaker 2: question is like what should be done next?

513
00:31:34,520 --> 00:31:35,960
Speaker 1: And so what do you think about that, what are

514
00:31:36,000 --> 00:31:39,440
Speaker 1: your thoughts on the ethics of you know, somebody has

515
00:31:39,480 --> 00:31:42,720
Speaker 1: found drowned at the bottom of a lake and it's

516
00:31:43,080 --> 00:31:46,000
Speaker 1: four hours later and you say, hey, I've got a

517
00:31:46,000 --> 00:31:47,960
Speaker 1: solution here to bring this person back.

518
00:31:48,520 --> 00:31:54,360
Speaker 4: Oh yeah, so definitely not now, and technologically and our understanding,

519
00:31:54,840 --> 00:31:56,880
Speaker 4: we're just not there yet, and there's a lot of

520
00:31:56,920 --> 00:31:59,760
Speaker 4: research that has to be done. I think it also

521
00:31:59,840 --> 00:32:01,600
Speaker 4: been comes an interesting.

522
00:32:01,240 --> 00:32:05,520
Speaker 2: Question like assuming that the technology is capable of doing

523
00:32:05,680 --> 00:32:08,960
Speaker 2: such a feit, you know, you have a question from

524
00:32:09,080 --> 00:32:10,600
Speaker 2: you like should you do this?

525
00:32:11,080 --> 00:32:13,720
Speaker 3: Like should you go and save this person? I'm a

526
00:32:13,760 --> 00:32:16,760
Speaker 3: trained physician, so that's the goal. You know, you want

527
00:32:16,800 --> 00:32:19,080
Speaker 3: to go and save someone. So this should become just

528
00:32:19,160 --> 00:32:22,640
Speaker 3: another tool that allows us to do our job. So,

529
00:32:22,840 --> 00:32:25,720
Speaker 3: but it needs to be it really needs to be

530
00:32:26,040 --> 00:32:29,160
Speaker 3: researched over time and show that there is value and

531
00:32:29,280 --> 00:32:31,040
Speaker 3: potential for this outcome.

532
00:32:31,200 --> 00:32:35,320
Speaker 1: So let's imagine forty seven years from now where it's

533
00:32:35,360 --> 00:32:37,840
Speaker 1: really been researched and it really works well and you

534
00:32:37,880 --> 00:32:40,800
Speaker 1: know exactly the solution to profuse into the brain to

535
00:32:40,920 --> 00:32:45,120
Speaker 1: restore the function. So, first of all, what's your guest

536
00:32:45,160 --> 00:32:49,360
Speaker 1: about how many hours let's say you find somebody who

537
00:32:49,360 --> 00:32:52,840
Speaker 1: has passed away ten hours ago. Is that too late?

538
00:32:53,440 --> 00:32:56,480
Speaker 3: That's a difficult question to answer.

539
00:32:56,800 --> 00:32:59,760
Speaker 2: We do know that their process is still ongoing then

540
00:33:00,400 --> 00:33:03,600
Speaker 2: after death, but I don't believe that you can sum

541
00:33:03,960 --> 00:33:07,640
Speaker 2: certain processes that hip on it those time points to

542
00:33:07,680 --> 00:33:11,520
Speaker 2: the whole human being. So I don't see that happening.

543
00:33:11,560 --> 00:33:15,520
Speaker 2: I think there is definitely like a time limit, you know,

544
00:33:15,560 --> 00:33:18,480
Speaker 2: if you think about the current practice now, which is

545
00:33:18,520 --> 00:33:21,680
Speaker 2: in minutes. So basically, whatever V do, we would be

546
00:33:21,680 --> 00:33:24,760
Speaker 2: a huge feit really difficult.

547
00:33:25,000 --> 00:33:27,000
Speaker 1: Absolutely, So I just want to press one more time

548
00:33:27,040 --> 00:33:30,000
Speaker 1: on this issue about what are the ethical questions that

549
00:33:30,160 --> 00:33:32,720
Speaker 1: come up for you. So let's imagine forty seven years

550
00:33:32,720 --> 00:33:37,400
Speaker 1: from now, the technology works great, and the question is, Okay,

551
00:33:37,680 --> 00:33:42,160
Speaker 1: somebody has passed away, how do we decide about restoring them,

552
00:33:42,640 --> 00:33:44,920
Speaker 1: whether it's the right thing to do when when it's not.

553
00:33:45,640 --> 00:33:49,560
Speaker 3: Yeah, so this is a really complex question.

554
00:33:50,360 --> 00:33:53,480
Speaker 2: There are bodies that deal with the definition of death,

555
00:33:53,520 --> 00:33:56,920
Speaker 2: and one thing in particular there which is interesting is

556
00:33:57,480 --> 00:34:02,400
Speaker 2: a distinction between something that's reversible and something that's permanent.

557
00:34:02,520 --> 00:34:04,440
Speaker 2: And I think it is going to be really interesting

558
00:34:04,480 --> 00:34:08,120
Speaker 2: to understand like which one is which, because there are

559
00:34:08,160 --> 00:34:12,200
Speaker 2: instances where you know, brain can get completely destroyed and

560
00:34:12,239 --> 00:34:15,200
Speaker 2: then you can die because your brain was destroyed, like right,

561
00:34:15,560 --> 00:34:19,480
Speaker 2: So there's no point in doing that is a permanent

562
00:34:19,520 --> 00:34:24,200
Speaker 2: death by itself. So if you go to a cardiac arrest,

563
00:34:24,320 --> 00:34:27,600
Speaker 2: if your heart stops, so then actually your brain is

564
00:34:28,239 --> 00:34:30,839
Speaker 2: going to die because your heart has stopped, like right.

565
00:34:31,320 --> 00:34:34,000
Speaker 2: So there are instances where it makes sense from the

566
00:34:34,000 --> 00:34:36,920
Speaker 2: clinical point of view to intervene in the future, like

567
00:34:37,080 --> 00:34:40,600
Speaker 2: assuming that this technology is effective.

568
00:34:40,400 --> 00:34:43,719
Speaker 1: Okay, great, and I assume that there will be bodies

569
00:34:43,760 --> 00:34:46,560
Speaker 1: of philosophers and so on who get involved with this

570
00:34:46,719 --> 00:34:48,759
Speaker 1: question about when is it the right thing to do?

571
00:34:49,200 --> 00:34:50,080
Speaker 1: When does it make sense?

572
00:34:50,440 --> 00:34:54,640
Speaker 2: Absolutely so yeah, So we hit with both publications, we

573
00:34:54,760 --> 00:34:59,040
Speaker 2: hit commentary work actually on this particular topic.

574
00:34:59,160 --> 00:35:01,319
Speaker 3: And I think it's really interesting to see how the

575
00:35:01,360 --> 00:35:05,239
Speaker 3: field is developing now and how people are thinking now

576
00:35:05,280 --> 00:35:07,680
Speaker 3: with these new technologies that are coming to a right,

577
00:35:07,840 --> 00:35:11,279
Speaker 3: including ours and others. If you just think about now,

578
00:35:11,320 --> 00:35:14,160
Speaker 3: like I think last week or this week actually what

579
00:35:14,320 --> 00:35:30,520
Speaker 3: was done with transplants and other things.

580
00:35:33,320 --> 00:35:36,719
Speaker 1: Here's a question for you. So you, as a scientist

581
00:35:36,760 --> 00:35:39,920
Speaker 1: and a physician, you're very careful about saying, you know,

582
00:35:40,000 --> 00:35:42,799
Speaker 1: if this works and this doesn't work yet, and so on.

583
00:35:43,120 --> 00:35:46,879
Speaker 1: But what is your guests in a century from now.

584
00:35:47,000 --> 00:35:50,479
Speaker 1: Let's say, do you feel like this is a dead

585
00:35:50,560 --> 00:35:53,080
Speaker 1: on winner, this is definitely going to work, or do

586
00:35:53,080 --> 00:35:55,680
Speaker 1: you feel there are some problems that are insurmountable.

587
00:35:56,440 --> 00:35:59,319
Speaker 3: I'm positive that this is going to work. I think

588
00:35:59,400 --> 00:36:02,640
Speaker 3: we are going to it. I think we're developing new

589
00:36:02,680 --> 00:36:06,280
Speaker 3: tools now. I think our ideas about what death is

590
00:36:06,280 --> 00:36:10,080
Speaker 3: is changing. In particular, I'm referring to cells here, but

591
00:36:10,200 --> 00:36:11,799
Speaker 3: we can build a death like we can do like

592
00:36:11,800 --> 00:36:12,840
Speaker 3: a ground up approach.

593
00:36:12,880 --> 00:36:17,480
Speaker 2: We can really develop new approaches and therapist I'm confident

594
00:36:17,520 --> 00:36:20,280
Speaker 2: that this is a field that is going to advance

595
00:36:20,400 --> 00:36:21,120
Speaker 2: in the future.

596
00:36:22,000 --> 00:36:23,440
Speaker 1: Let me just double click on that. What do you

597
00:36:23,480 --> 00:36:26,360
Speaker 1: mean by we're having a new understanding of what death is?

598
00:36:27,320 --> 00:36:27,520
Speaker 3: Well?

599
00:36:28,800 --> 00:36:31,520
Speaker 2: As I said, you know, I went to med school

600
00:36:31,520 --> 00:36:34,520
Speaker 2: like recently, I still would like to think that I'm young,

601
00:36:35,160 --> 00:36:36,560
Speaker 2: although it's starting to show.

602
00:36:37,160 --> 00:36:40,880
Speaker 3: I was thought that once there's blood laws, that sales

603
00:36:41,000 --> 00:36:44,200
Speaker 3: just die like after a couple of minutes.

604
00:36:44,320 --> 00:36:47,000
Speaker 2: And you know, there have been like instances where people

605
00:36:47,000 --> 00:36:50,000
Speaker 2: have observed it in their work. But it's not this

606
00:36:50,520 --> 00:36:54,520
Speaker 2: reasoning or under tending that the death is a process

607
00:36:54,640 --> 00:36:59,040
Speaker 2: it's not ubiquitous, it's not widespread, and so you know,

608
00:36:59,400 --> 00:37:03,280
Speaker 2: taking data into account first and then start to do research.

609
00:37:02,960 --> 00:37:05,600
Speaker 3: On these things. I think that's going to lead to

610
00:37:05,680 --> 00:37:07,480
Speaker 3: new tools and new developments.

611
00:37:07,520 --> 00:37:10,799
Speaker 2: Just to give you like a simple example, we had

612
00:37:10,840 --> 00:37:14,080
Speaker 2: a so in in the team, we would always have

613
00:37:14,160 --> 00:37:18,520
Speaker 2: our electrophysiologists. So these are people who take slices of

614
00:37:18,560 --> 00:37:22,880
Speaker 2: tissue like right, and they record electrical properties from cells

615
00:37:22,920 --> 00:37:27,400
Speaker 2: from neurons. I remember one instance, we had a slide,

616
00:37:27,840 --> 00:37:30,160
Speaker 2: a really bad run, and sales were, like, you know,

617
00:37:30,280 --> 00:37:31,560
Speaker 2: they were not doing well.

618
00:37:31,960 --> 00:37:35,640
Speaker 3: This was early on, and this new person came and

619
00:37:35,680 --> 00:37:38,120
Speaker 3: so he's looking at the cells in there around which

620
00:37:38,160 --> 00:37:39,960
Speaker 3: is usually a bad thing because they go from like

621
00:37:40,000 --> 00:37:43,319
Speaker 3: a triangle to like a rounding and so because so

622
00:37:43,360 --> 00:37:46,200
Speaker 3: he just goes like, oh, these cells are dead, because

623
00:37:46,239 --> 00:37:49,279
Speaker 3: he's accustomed to thinking that these cells are dead and

624
00:37:49,320 --> 00:37:50,239
Speaker 3: they're useless, like.

625
00:37:50,239 --> 00:37:53,239
Speaker 2: Right, and so you know, so after a whole day

626
00:37:53,239 --> 00:37:55,520
Speaker 2: of work, we go like, maybe you should think about

627
00:37:55,520 --> 00:37:58,680
Speaker 2: these cells and maybe they're not dead yet, maybe they

628
00:37:58,680 --> 00:37:59,400
Speaker 2: can be saved.

629
00:37:59,400 --> 00:38:01,960
Speaker 3: And so it's interesting, you know, from our point of view.

630
00:38:03,239 --> 00:38:05,480
Speaker 2: He was new to the whole team, and so it's

631
00:38:05,520 --> 00:38:09,680
Speaker 2: really interesting like his perception of like one thing and ours.

632
00:38:09,760 --> 00:38:12,239
Speaker 2: It's basically like it's the glass like half full or

633
00:38:12,280 --> 00:38:14,160
Speaker 2: half empty situation.

634
00:38:14,960 --> 00:38:16,920
Speaker 1: And have you been able to show that you can

635
00:38:16,960 --> 00:38:20,600
Speaker 1: take those bloated cells and reverse the processes?

636
00:38:21,560 --> 00:38:25,040
Speaker 2: So absolutely, so this was the first So going back

637
00:38:25,080 --> 00:38:27,200
Speaker 2: to who were doing like initial research, that was the

638
00:38:27,239 --> 00:38:30,520
Speaker 2: first observation that we made. So because I trained in

639
00:38:30,640 --> 00:38:34,120
Speaker 2: radiology and so you know, you do an MRI in

640
00:38:34,200 --> 00:38:36,319
Speaker 2: the brain, like you know sort of like how the

641
00:38:36,360 --> 00:38:39,480
Speaker 2: signal is going to change based on the fake that

642
00:38:39,600 --> 00:38:42,960
Speaker 2: sales are becoming round or bloated. And so you know,

643
00:38:42,960 --> 00:38:46,040
Speaker 2: if we're looking these slices, like these cells and we're

644
00:38:46,080 --> 00:38:48,520
Speaker 2: seeing that they're not round, they're starting to regain their

645
00:38:49,080 --> 00:38:51,120
Speaker 2: their shape like right, And that was the first thing

646
00:38:51,160 --> 00:38:52,360
Speaker 2: we observed with the technology.

647
00:38:52,360 --> 00:38:56,319
Speaker 1: So that's why, oh incredible, wow, what was that like

648
00:38:56,360 --> 00:38:58,640
Speaker 1: for you the first time you saw that reversal?

649
00:38:59,560 --> 00:39:02,239
Speaker 2: The whole was really you know now with like a

650
00:39:02,320 --> 00:39:05,640
Speaker 2: benefit of the hindside, Like just for us, we started

651
00:39:05,680 --> 00:39:08,960
Speaker 2: in a closet like Atale University, we cleared out the

652
00:39:09,040 --> 00:39:12,520
Speaker 2: closet and we just started doing stuff there and it

653
00:39:12,640 --> 00:39:16,640
Speaker 2: went from like basic stuff because because people think that

654
00:39:17,200 --> 00:39:20,160
Speaker 2: when they think about research. They have these like grand

655
00:39:20,200 --> 00:39:23,000
Speaker 2: ideas of like you know, scientists and like fight codes

656
00:39:23,040 --> 00:39:24,239
Speaker 2: like doing some capitalists.

657
00:39:24,680 --> 00:39:29,840
Speaker 3: This was such a completely opposite thing. And so you know,

658
00:39:30,160 --> 00:39:33,640
Speaker 3: you go through these motions daily twenty four to seven.

659
00:39:33,719 --> 00:39:36,160
Speaker 3: You're grinding, and you finally you start to see stuff.

660
00:39:36,880 --> 00:39:39,359
Speaker 2: And then the first thing, like like the genuine first

661
00:39:39,400 --> 00:39:41,880
Speaker 2: thing is confusion because you see something.

662
00:39:41,520 --> 00:39:44,840
Speaker 3: And you're like, well, this doesn't like go you know, it's.

663
00:39:44,840 --> 00:39:47,480
Speaker 2: It's sort of go against the grain, right, So it's

664
00:39:47,560 --> 00:39:50,200
Speaker 2: like like what do I do now? And so it's

665
00:39:50,239 --> 00:39:52,719
Speaker 2: like a confusion and excitement because you want to be

666
00:39:52,760 --> 00:39:54,880
Speaker 2: sure that that you don't fool yourself, like that's the

667
00:39:54,880 --> 00:39:56,200
Speaker 2: biggest mistaked.

668
00:39:55,840 --> 00:39:57,960
Speaker 3: You know, you can make. But you know, it was

669
00:39:58,000 --> 00:40:00,440
Speaker 3: really funny, you know, the whole thing. Yeah, it was

670
00:40:00,480 --> 00:40:01,080
Speaker 3: really fun.

671
00:40:01,320 --> 00:40:04,160
Speaker 1: Wow, did you realize at that moment what you were

672
00:40:04,160 --> 00:40:06,960
Speaker 1: on the verge of because then you published paper. You know,

673
00:40:07,000 --> 00:40:10,960
Speaker 1: you've had really terrific publications that you've put out about

674
00:40:11,080 --> 00:40:14,239
Speaker 1: you know, the pig brain and the cellular functions. Did

675
00:40:14,280 --> 00:40:16,160
Speaker 1: you did you realize when you were first seeing that

676
00:40:16,200 --> 00:40:17,160
Speaker 1: what this was going to lead to?

677
00:40:17,480 --> 00:40:21,480
Speaker 2: I you know, like if you still understand like where

678
00:40:21,480 --> 00:40:24,200
Speaker 2: these can go and there's always like something, you know,

679
00:40:24,520 --> 00:40:26,000
Speaker 2: like if you look at something and you like, oh,

680
00:40:26,080 --> 00:40:28,560
Speaker 2: like these capabilities are like new, you know, like these

681
00:40:28,600 --> 00:40:31,960
Speaker 2: implications are huge and it's still ongoing and potential.

682
00:40:35,880 --> 00:40:39,839
Speaker 1: So that was Vonimir Russella. And it's clear that as

683
00:40:39,840 --> 00:40:44,000
Speaker 1: a community, our biological insights are opening up big new

684
00:40:44,080 --> 00:40:47,719
Speaker 1: questions for us. Now this really complicates things from a

685
00:40:47,800 --> 00:40:52,799
Speaker 1: clinical and legal perspective. Death is usually defined as the

686
00:40:52,880 --> 00:40:56,719
Speaker 1: cessation of biological functions. Traditionally this had to do with

687
00:40:56,840 --> 00:40:59,840
Speaker 1: the stopping of the breath and the stopping of the pulse,

688
00:41:00,400 --> 00:41:03,360
Speaker 1: but even that started to get complicated by the nineteen

689
00:41:03,440 --> 00:41:08,680
Speaker 1: fifties because people had invented ventilators so it didn't necessarily

690
00:41:08,719 --> 00:41:13,200
Speaker 1: matter if you stopped breathing, and people invented defibrillators so

691
00:41:13,239 --> 00:41:16,120
Speaker 1: they could get your heart going again, so that no

692
00:41:16,239 --> 00:41:19,239
Speaker 1: longer made sense to define death that way. And in

693
00:41:19,320 --> 00:41:22,200
Speaker 1: nineteen sixty eight Harvard Medical School got together to put

694
00:41:22,200 --> 00:41:25,080
Speaker 1: together a definition of brain death and they said, look,

695
00:41:25,400 --> 00:41:28,359
Speaker 1: if you are in a coma that's irreversible, then we'll

696
00:41:28,360 --> 00:41:32,640
Speaker 1: say you're dead. And different places took on different versions

697
00:41:32,680 --> 00:41:35,719
Speaker 1: of this until nineteen eighty when the United States came

698
00:41:35,760 --> 00:41:39,719
Speaker 1: up with a Uniform Determination of Death Act and they said, look,

699
00:41:40,400 --> 00:41:44,800
Speaker 1: you're dead if you've had an irreversible cessation of blood

700
00:41:44,800 --> 00:41:49,600
Speaker 1: flow and breathing, or an irreversible cessation of the function

701
00:41:49,760 --> 00:41:54,120
Speaker 1: of your brain. But the interesting thing is how interventions

702
00:41:54,160 --> 00:41:57,080
Speaker 1: could play a role here, because the key word that

703
00:41:57,160 --> 00:42:02,399
Speaker 1: needs to come under scrutiny is reversible. What do we do,

704
00:42:02,440 --> 00:42:07,040
Speaker 1: How do we redefine death when many problems are no

705
00:42:07,120 --> 00:42:11,600
Speaker 1: longer going to be irreversible. Now, I want to be clear,

706
00:42:11,640 --> 00:42:13,680
Speaker 1: there's still a long way to go with the science.

707
00:42:13,719 --> 00:42:16,759
Speaker 1: The work is underway in pigs, but no one's even

708
00:42:16,800 --> 00:42:19,920
Speaker 1: talking about humans at this point, in part because the

709
00:42:20,040 --> 00:42:24,120
Speaker 1: ethical questions are something we can't even wrap our heads around.

710
00:42:25,160 --> 00:42:27,560
Speaker 1: But the thing I want to point out is that

711
00:42:27,680 --> 00:42:31,600
Speaker 1: this is now a question. It is a scientific problem

712
00:42:31,640 --> 00:42:35,000
Speaker 1: being studied in the labs and published in the top journals.

713
00:42:35,600 --> 00:42:38,440
Speaker 1: It'll be a long while before you hear about this

714
00:42:38,600 --> 00:42:42,440
Speaker 1: past the walls of the lab, but it's coming. So

715
00:42:42,520 --> 00:42:46,920
Speaker 1: consider this in the context of recent history. When Mary

716
00:42:47,000 --> 00:42:50,200
Speaker 1: Shelley wrote her novel Frankenstein that was just over two

717
00:42:50,280 --> 00:42:53,600
Speaker 1: hundred years ago, it was cast as a warning against

718
00:42:53,680 --> 00:42:57,720
Speaker 1: the dangers of playing God. But it's fascinating to see

719
00:42:58,040 --> 00:43:01,960
Speaker 1: how the concept of playing god evolved. After all, you

720
00:43:01,960 --> 00:43:05,239
Speaker 1: can imagine a time when someone might have said, Hey,

721
00:43:05,320 --> 00:43:08,399
Speaker 1: if you crack open someone's chest and operate on their heart,

722
00:43:08,600 --> 00:43:11,799
Speaker 1: you're playing God. Or if you take out someone's heart

723
00:43:11,920 --> 00:43:15,840
Speaker 1: entirely and replace it with an artificial, pulseless blood pump,

724
00:43:16,080 --> 00:43:18,719
Speaker 1: you are playing God. Or what about doing an open

725
00:43:18,800 --> 00:43:21,760
Speaker 1: head surgery to cut out a brain tumor playing god?

726
00:43:22,160 --> 00:43:26,920
Speaker 1: Or injecting someone with a medication that reverses at the

727
00:43:27,000 --> 00:43:31,520
Speaker 1: level of invisibly small molecules whatever process in their body

728
00:43:31,640 --> 00:43:35,480
Speaker 1: is making them sick. You can imagine any moment in

729
00:43:35,640 --> 00:43:37,880
Speaker 1: history where someone would have looked at this and said,

730
00:43:38,360 --> 00:43:41,160
Speaker 1: you're messing with the body and playing the role of

731
00:43:41,200 --> 00:43:44,759
Speaker 1: a deity. But when we look at the long arc

732
00:43:44,880 --> 00:43:48,759
Speaker 1: of human understanding of science, we see this is the

733
00:43:48,880 --> 00:43:52,200
Speaker 1: natural direction of things. As we come to understand that

734
00:43:52,239 --> 00:43:54,840
Speaker 1: the heart is just a pump, we can fix it

735
00:43:54,920 --> 00:43:58,839
Speaker 1: or replace it. Once we understand what a tumor is

736
00:43:59,160 --> 00:44:02,040
Speaker 1: a cell that keep dividing out of control, we can

737
00:44:02,120 --> 00:44:05,000
Speaker 1: learn how to open the skull and control the bleeding

738
00:44:05,040 --> 00:44:07,920
Speaker 1: of the brain tissue, and the whole issue of tumor

739
00:44:07,960 --> 00:44:13,479
Speaker 1: removal becomes routine. Once we know how molecular cascades work,

740
00:44:13,560 --> 00:44:16,640
Speaker 1: then we put them in the textbooks of high school students,

741
00:44:16,880 --> 00:44:20,600
Speaker 1: and we find drugs that interact with those cascades, and

742
00:44:20,640 --> 00:44:22,799
Speaker 1: we don't think twice about this stuff. We don't think

743
00:44:22,840 --> 00:44:27,040
Speaker 1: about it as deity playing, just that someone is hurt

744
00:44:27,120 --> 00:44:29,960
Speaker 1: or sick and needs our help, and that this is

745
00:44:30,200 --> 00:44:34,600
Speaker 1: some operation or medication that we now understand that we

746
00:44:34,680 --> 00:44:38,840
Speaker 1: didn't used to. So John Dunn, who died in sixteen

747
00:44:38,880 --> 00:44:42,439
Speaker 1: thirty one, coming up on four hundred years ago, could

748
00:44:42,480 --> 00:44:46,399
Speaker 1: have never imagined that when he penned the poem death

749
00:44:46,480 --> 00:44:49,839
Speaker 1: Be not Proud, that we'd actually be talking about the

750
00:44:50,080 --> 00:44:54,600
Speaker 1: end of death as just a molecular puzzle about which

751
00:44:54,640 --> 00:44:57,520
Speaker 1: we say not now, but at some point, okay, we

752
00:44:57,560 --> 00:45:00,600
Speaker 1: got it. Just block these pathways by which die or

753
00:45:00,600 --> 00:45:04,600
Speaker 1: commit suicide, and then these cells stay alive and the

754
00:45:04,680 --> 00:45:08,560
Speaker 1: whole system just keeps on trucking. And he could never

755
00:45:08,760 --> 00:45:12,640
Speaker 1: imagined that we'd even be talking about rebooting a system

756
00:45:13,000 --> 00:45:17,640
Speaker 1: that has already ground to a halt. Now. Mary Shelley

757
00:45:17,760 --> 00:45:21,000
Speaker 1: died in the mid nineteenth century, two centuries after done,

758
00:45:21,600 --> 00:45:24,520
Speaker 1: and most of us will see the mid twenty first century,

759
00:45:24,640 --> 00:45:28,960
Speaker 1: two centuries after Mary Shelley, and it looks likely that we,

760
00:45:29,360 --> 00:45:32,239
Speaker 1: or our children or our near term descendants will be

761
00:45:32,320 --> 00:45:37,800
Speaker 1: the first to see Shelley's ethical questions get tackled. Should

762
00:45:37,880 --> 00:45:42,000
Speaker 1: we revivify a system that's come to a halt under

763
00:45:42,000 --> 00:45:47,160
Speaker 1: what circumstances? What will be the consequences for society as

764
00:45:47,160 --> 00:45:50,440
Speaker 1: a community will come to address Shelley's questions not as

765
00:45:50,480 --> 00:45:54,239
Speaker 1: a science fiction fantasy, but as a basic challenge of

766
00:45:54,280 --> 00:45:58,719
Speaker 1: passing the right legislation and determining how hospital ethics committees

767
00:45:59,040 --> 00:46:02,640
Speaker 1: should make their decay decisions about reversing death. And there

768
00:46:02,719 --> 00:46:05,280
Speaker 1: might be whole groups of people that are your friends

769
00:46:05,280 --> 00:46:08,680
Speaker 1: and neighbors and work colleagues, and some of them will

770
00:46:08,719 --> 00:46:11,720
Speaker 1: have ground to a halt. At some point they're revivified,

771
00:46:12,080 --> 00:46:14,960
Speaker 1: just as you currently have friends and neighbors and colleagues

772
00:46:15,000 --> 00:46:17,839
Speaker 1: who were under anesthesia and woke up, or they had

773
00:46:17,840 --> 00:46:20,600
Speaker 1: a heart attack and had their heart defibrillated, or they

774
00:46:20,600 --> 00:46:24,319
Speaker 1: were in a coma for weeks and regained consciousness. And

775
00:46:24,400 --> 00:46:27,640
Speaker 1: at some point we'll all live in this new world

776
00:46:27,920 --> 00:46:32,200
Speaker 1: where we have to address whole new fields of question marks.

777
00:46:32,960 --> 00:46:41,600
Speaker 1: Because as John Dunn predicted death will have died. Go

778
00:46:41,640 --> 00:46:44,719
Speaker 1: to eagleman dot com slash podcast for more information and

779
00:46:44,760 --> 00:46:48,960
Speaker 1: to find further reading. Send me an email at podcasts

780
00:46:48,960 --> 00:46:52,040
Speaker 1: at eagleman dot com with questions or discussions, and I'll

781
00:46:52,040 --> 00:46:58,840
Speaker 1: be making sporadic episodes in which I address those until

782
00:46:58,840 --> 00:47:02,880
Speaker 1: next time. I'm David Eagleman, and this is Inner Cosmos