Dangerous and unethical


headtrans

Sergio Canavero wants to transplant a head, and he has a volunteer. Canavero thinks he can carry out this operation, although he has no successes in preliminary animal testing, and just wants to jump right in with a human with a debilitating disease.

Do not trust this guy. He makes a number of claims here that are transparently false, and glibly glides past major problems.

  • I am not at all fond of people who misrepresent the field. He claims that the common dogma is that motor activity is driven entirely by the brain, and that the spinal cord is a ‘slave’ to higher levels…and that this is false, enabling his operation. Neuroscientists have used the decerebrate cat model since the 1950s; this is not novel. It is misleading to suggest that cutting the spinal cord is OK because spinal motoneurons can take over the job.

  • The secret to his success, he claims, is that he will cut the spinal cord with a very sharp knife, which is less damaging than traumatic spinal cord injury. There is a grain of truth to that, but he is minimizing the damage that will be done. Slice through long fibers, and you’ve still destroyed long distance connections. He doesn’t say anything about scarring; apparently, polyethylene glycol is magic and will allow the cut ends to fuse neatly.

  • He harps on the fact that you can get some restoration of function if you can only get “10 to 20 percent” of the fibers in the motor pathway restored. Can he even do that? Evidence not shown. Is that really adequate? You could easily argue that it’s better than 0%…but your patient won’t be dancing afterwards.

  • While pretending that getting a small percentage of the motor fibers reconnected is sufficient (while not showing that he can even do that), he completely ignores the importance of sensory reconnection. Even in his best fantasy, you end up with a head grafted onto a numb body with no proprioception, controlled by a few restored connections that activate motor programs in the spinal cord. Now that’s a creepy nightmare.

  • What about the autonomic nervous system? Does that even count to this guy with a knife and a mad glitter in his eye?

His prospective patient is a doomed young man with Werdnig-Hoffman disease, a terrible heritable degenerative disease that causes progressive cell death in populations of motoneurons in the spinal cord and brainstem (exactly how high up is Canavero planning to cut?). It’s a generally terrible disease, with its victims having normal intelligence and awareness, but losing control of their body starting at a very young age — I cannot fault the volunteer for hoping for rescue from his condition.

But I can fault Canavero for exploiting him and lying to him. This procedure will not work. If it was a good procedure, show me a dog that has undergone it, walking across the stage with a transplanted body. Try it with monkeys first. But he can’t: the result would be, at best, a shambling horror, an animal driven mad with pain and terror, crippled and whimpering, and a poor advertisement for his experiment. And most likely what he’d have is a collection of corpses that suffered briefly before expiring.

I can also fault the media for promoting this charlatan. TEDx should be ashamed. At least most of the print media are treating this as a circus freakshow.

I don’t think this operation will occur, fortunately. Canavero claims to need over $7 million to cover the costs, and a team of 150 doctors and nurses to carry out an intricate surgery that will take 36 hours to execute. He’s going to have to find 150 medical professionals with no sense of ethics at all, who are willing to risk their careers carrying out an elaborate act of slow torture and murder.

I find it hard to believe that anyone is taking Canavero at all seriously.

Comments

  1. Kevin Anthoney says

    If you cut through a trunk telephone cable and then just rewired everything randomly, it’d all still work, right?

  2. Akira MacKenzie says

    Fine! Then you find a home for all the severed human heads I’ve got stored in my freezer!

  3. John Pieret says

    Maybe Canavero can prove how serious he is by volunteering to undergo the procedure himself.

  4. marcoli says

    Yikes. Highly unethical indeed. Following the failed attempt he would of course be arrested for murder.

  5. magistramarla says

    Strangely, I just went through a spinal surgery, so I know a bit about how it feels when the brain, spine and nerves aren’t talking to each other. I had numbness and spasms in my legs and feet and couldn’t walk without help. I haven’t been able to drive for two years.
    I had three discs that were compressed and degenerating, squeezing off some major conduits for nerves in my spine.
    The way that I understand it, my brain wasn’t able to communicate with those nerves in my lower body because the conduit was closed off.
    I had the surgery Monday. The surgeons said that it was a painstaking job carefully freeing up those nerves. I now have three big pins in my back holding those discs apart.
    It was like turning on a light switch! The next day I was walking with no pain and the numbness, spasms and contracted muscles were gone. It seems that my brain, spine and nerves can all talk together again!
    After this experience, the idea of severing those nerves that all need each other to communicate and successfully doing such a transplant doesn’t seem possible, Of course, who knows what will be possible in the future?
    I’m sure that my surgery didn’t seem possible to surgeons a century ago.
    I’m headed home today with nothing but a prescription for Ibuprophen 800. All communications in my system are a go now!

  6. says

    Knowing what disease the potential victim of the scam is suffering from just made me sad. It seems to me that if the cell death extends to his brain stem, and the surgery starts high on the neck, even if by some miracle it succeeded with 100% connection, the results would still be the same in the long run: The motoneurons above the point of incision would still die off.

    And if we’re having trouble finding ways to reconnect severed spinal cords, what chance would anyone have of cleanly cutting out someone’s brainstem and replacing it? IIRC, the brainstem extends pretty deep into the rest of the brain.

    Suddenly, I’m wondering if this guy referred to “Spock’s Brain” as his reference material.

  7. twas brillig (stevem) says

    Wouldn’t a paraplegic’s spinal reparation be a demonstrable proof-of-concept precursor to a full head transplant? As in, can’t he first demonstrate his skills by rewiring a person who broke their back and nicked their spinal cord, resulting in loss of leg control and/or arms, fingers, etc.
    Has he done such a demo, to reassure all us skeptics? I’ll just wait a little longer for such a demo. Like all other vaporware, I’m sure the answer will be “demo, next year”, then next year, “demo next year”. rinse and repeat perpetually. Do. Not. Allow. Him. To. Go. Full. Speed. At. First. Demo. First.

  8. Dr Marcus Hill Ph.D. (arguing from his own authority) says

    Given the limited movement control, lack of proprioception and lack of autonomic system connection, wouldn’t it be more efficient to transplant the head to a mechanical body fitted with artificial pulmonary and cardiac systems (and nutrition, dyalisis etc for survival over days rather than hours)? With supplementary processing units in the cybrenetics, you could actually gain better control of movement via sensors attached either to the spine or around the skull to detect control signals. Make the cut below the larynx and you could retain speech. OK, it may sound a bit familiar, but you could easily use a non-humanoid chassis (far easier than walking). You’d probably need regular blood products (or some biological systems retained to refresh them), but, unlikely as it sounds, I think this idea is at least on a par feasibility-wise with Canavero’s.

  9. komarov says

    Re: John Pieret, #6

    He could donate his body to the volunteer and then wait in the freezer until another spare turns up. According to his own theories he’d be helping someone in need who can’t wait for very long and demonstrate confidence in his own ideas by making himself patient #2.

    P.S.: “The future is now”? A heading like that screams for a live demonstration. He should have hired someone to do the talking for him while surgeons swapped his head with Aunt Agatha live on stage. Far more impressive. (Disclaimer: I haven’t watched the talk because by and large TED talks are a waste of time these days. So if that actually did happen, I apologise and wish Auntie all the best.)

  10. bojac6 says

    I once had a series of medical issues put me in the hospital. When I was released, I was fine for a day and then it all went to crap. For a week and a half, I could not stand, any sort of elevation of my head resulted in vomiting, I could not focus on anything for longer than a few seconds, headaches were extreme, and random pain shot through my body. A close friend was taking care of me and tells me that when she was taking me to the hospital again, I had trouble getting shoes and socks on because I could not figure out the order of operations. Like I’d put a shoe on and then try to slip the sock on under it. I don’t remember much of this time, except that I thought I was dying and may have tried to kill myself if I had been mentally capable of figuring out how without moving.
    Turned out it all happened because a lumbar puncture didn’t heal right and I had leaked a bit of spinal fluid so the pressure on my spinal column and brain wasn’t regulating appropriately. They did a quick procedure that sounded fairly routine where they pump blood into my spinal sheathing, which increases the pressure in the column, forcing more into the head, and gives you time to generate more. I was mobile in 5 minutes, walking in 20 and eating everything I could find within an hour.
    That was a pressure problem in the spine. A simple matter of just a tiny bit of fluid. I can’t even imagine how cutting it would go. I understand somebody’s desperation to walk, or be pain free, and I wish them success. But I how it does not happen and nobody experiences that level of pain.

  11. says

    It’s not inconceivable that something like this may eventually be possible. It’s not even unreasonable to try some experimentation with existing technology. However, to jump directly to a full transplant on a human subject is beyond irresponsible.

    This sounds like a doctor so obsessed with getting his name in the history books that he’s willing to gamble a desperate patient’s life on the off-chance that this wil work out.

  12. twas brillig (stevem) says

    Interesting…. verrry interrrrestingk……. now… do a demo on that cat over there, show us! No people, till cats first! got it? good. show us your feline survivor ;-|

  13. mjmiller says

    “First, I have to find someone who has a bunch of human torsos stored in their freezer…”

    You want a torso? I can get you a torso, believe me. There are ways, Dude. You don’t wanna know about it, believe me…

  14. Thumper: Who Presents Boxes Which Are Not Opened says

    Magistramarla #9

    Hey, congratulations :)

  15. borax says

    Fuck Canavero. He is just as corrupt and exploitative as a psychic surgeon using sleight of hand to pull a tumor (chicken guts) out a person without using a scalpel. Also fuck TED for giving this asshole a platform. I’ve provided care for many people dealing with spinal cord injuries over the past 12 years and assholes like this guy brings out the angry nurse in me.

  16. grumpyoldfart says

    Canavero is probably trying to reserve himself a place in history. He knows he will never succeed with the operation (nor even be allowed to attempt it) but some time in the far distant future, doctors will be in a position to give it a try. And when interested parties check back on the history of the subject they will discover that Sergio Canavero came up with the idea way back in the 21st Century. He is hoping their reaction will be Never forget Sergio Canavero, the most forward thinking doctor since Hippocrates.

  17. says

    I want to say this is a parody or something: no one could be such an archetypical mad scientist in real life. You can almost hear him cackling, “The fools! I will show them what I can do. I will show them all!”

    Good luck getting this past an IRB.

  18. Amphiox says

    And if we’re having trouble finding ways to reconnect severed spinal cords, what chance would anyone have of cleanly cutting out someone’s brainstem and replacing it? IIRC, the brainstem extends pretty deep into the rest of the brain.

    Disconnection of the brain stem leads to hear instantaneous death. Pretty much all the essential life sustaining systems are controlled from the brain stem (like breathing, heart rate, the reticular activating system that wakes you up and “turns on” consciousness, all the cranial nerves except smell and parts of vision, etc)

    So if one cannot reconnect and restore function within a few minutes, the patient dies. Even with infinite protection of future technology, it would require some kind of nanotechnology “backup” system that could instantly take over all those functions while the neutrons are regenerating and reconnecting, or genetic engineering to make future humans with a redundant backup brain stem in their esophagus or something.

    That, or magic….

  19. george gonzalez says

    If Dr. McCoy could do it in ST TOS, even in the third season, after receiving wisdom from the brain-probe helmet, with Spock’s Brain, why not this guy? Oh, no helmet.

  20. grasshopper says

    If asked to participate , I think medical professionals should demyrrh, or else they could create Frankincense’s monster.

  21. says

    “He’s going to have to find 150 medical professionals with no sense of ethics at all, who are willing to risk their careers carrying out an elaborate act of slow torture and murder. I find it hard to believe that anyone is taking Canavero at all seriously.”

    You haven’t met the doctors I have, apparently. Ethics is one thing: rationality is another. In my experience, they’re no less susceptible to wishful thinking and bullshit than anyone else. Especially when there’s money on the line.

  22. mildlymagnificent says

    Hell’s teeth.

    I checked in with our neurologist recently to see if there were any treatments that might delay or repair my degenerating long nerves (it’s genetic) affecting my hands, legs and feet. We had a bit of a discussion about various medications, surgeries and therapies which work with variable, very variable, success rates in several conditions. He mentioned the eagerly awaited improvements that look to be coming in a decade or so in repairing spinal injuries. Nothing very wonderful in the make-things-work-better-in-sensory-perception is in the offing – neither in surgery nor medication.

    I simply cannot see how you can do this – at all – given our lack of experience in reconnecting injured spines so far. Show me some cats, dogs, monkeys where this has been successful and then we’ll talk some more.

  23. carlie says

    My guess is that finding a hospital willing to have that operation carried out in their surgery, with all of the potential lawsuit opportunities, will be even more difficult than finding all of the surgical assistants he needs.

    And yay magistramarla!

  24. says

    Even if you can re-connect severed nerves, I think there’s another major difficulty: How do you know which nerves to connect to which? You can’t just connect them up in an ad-hoc way, because sensory-motor nerves each have their specific functions. Each nerve in the head must be connected to the specific corresponding nerve in the body, or else you’ll get seriously messed up.

    Imagine what would happen if the doctor connected your axons wrong. You might try to move your finger, but you end up moving your toe instead. You might try to bend your waist, but you end up twisting your knee. It wouldn’t feel like that was your body at all. You’d feel like some evil demon was jerking you around.

    http://space-hippo.net/why-not-head-transplant/