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You sure he's dead? Detail from Rembrandt's "The Anatomy Lesson of Dr Nicholaes Tulp" (1632)
You sure he's dead? Detail from Rembrandt's "The Anatomy Lesson of Dr Nicholaes Tulp" (1632)

Review: Science

Dead re-reckoning Add to ...

When I first began reading Dick Teresi’s new book, The Undead, with its lengthy subtitle, I thought: Great, death buffs will love this. It’s got everything: the history of death, medical ethics, hot-button topics such as organ transplants, a section on near-death experiences, with the long tunnel and the blinding white light, intriguing chapter headings – Death is Here to Stay, The New Undead, Netherworlds, Postmodern Death – and even a tip of the hat to religion.

U.S. author Dick Teresi, I thought, might well be doing for death what Canada’s Margaret Visser did for wheat ( Much Depends Upon Dinner), rendering a commonplace subject immediately spellbinding.

Death, certainly, is commonplace enough, though Ernest Becker revealed the scope of our denial of this irrefutable fact of life in his groundbreaking The Denial of Death, a book Teresi refers to early in his own. “Of all things that move man,” Becker wrote, “one of the principal ones is the terror of death.”

Adding insult to injury, we have now, according to Teresi, a new terror to deal with: being undead. He’s not referring to fantasy here, vampires or zombies, but something much more sinister.

Teresi, a medical journalist extraordinaire, is the author of Discoveries: The Ancient Roots of Modern Science, former editor of Science Digest and Omni, and writer for such publications as The Wall Street Journal and The Atlantic, and he does render his subject gripping à la Visser, and magnificently so – but not in the sense I was expecting.

His book isn’t so much cultural anthropology as between-your-eyes, “just the facts ma’am” reporting, an approach used by the best investigative journalists. Teresi lets the evidence speak for itself. The simple question he asks is: “When exactly is a person dead?”

Prepare to have your assumptions shattered.

What Teresi found in answer to his question, or rather, the many answers he found, has enormous implications for the medical and legal professions as well as the organ harvesting business, now a $20-billion industry in the United States.

Teresi says he “thought he had chosen a simple topic. Who is alive? Who is dead? I assumed that science had the answers. Instead, I found that bad science was being used to obfuscate the distinction between the living and the dead, while good science, which was finding that life is far more persistent in humans than we had imagined, is being ignored.”

It turns out that those in the “death-defining business” are frequently altering their criteria for what constitutes a dead person; definitions change with the decades, and even now, can change from one jurisdiction to another, brain death being in current ascension as final criteria.

The list of conditions mimicking death has become, Teresi notes, shockingly long. Drug intoxication and hypothermia, for example, are often misdiagnosed as brain death. And then there are these: “They pee, they have heart attacks and bedsores. They have babies. They may even feel pain. They are ‘mostly dead’. Meet the beating-heart cadavers.”

Much of the book covers “a kind of dead zone,” the large grey area between aliveness and irreversible death, that is inhabited by the beating-heart cadavers, and others: those in locked-in syndrome, conscious but unable to communicate; those in persistent vegetative states who show minimal evidence of life; those stroke victims in a coma who can be saved, but who, Teresi writes, “can just as easily be pronounced dead by our own criteria.”

It is these unfortunates who primarily concern Teresi, because they are in danger of becoming candidates for organ harvesting.

Not surprisingly, political correctness governs much of our behaviour around organ donation, which is promoted as a way to “give meaning” to death, something selfless and even heroic that benefits others.

But there is one important group that is crucial to the endeavour and pretty much ignored (and unpaid): the donors. “No one,” Teresi says, “speaks for the donors.”

Teresi does. He suggests, in part, that the reason for enlarging the criteria for who is dead is that the organ harvesters have a stake in the matter. Think of dead bodies as inventory. Think of $20-billion.

Jerry Seinfeld, in a quote used by Teresi, nicely sums up the confusion around who is or isn’t dead: “The proof that we don’t understand death is we give dead people a pillow.”

M.A.C. Farrant’s new book is The Strange Truth About Us.

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