Dan Snow's History Hit - The History of Head Transplants

Episode Date: June 7, 2021

The superpower rivalry of the Cold War had many different fronts, space, the rice paddy fields of south-east Asia and even the operating theatre. The desire to push the envelope of human ingenuity led Dr Robert J. White to conduct a series of successful head transplants on monkies during the 1970s with the eventual aim of performing the procedure on a human patient. Dr Brandy Schillace, the author of Mr Humble and Dr Butcher, is today's guest on the podcast and she tells the almost unbelievable story of how close we came to seeing human head transplants take place. 

Hi everybody, welcome to Dan Snow's History. Every so often a book comes across my desk, which blows my little mind. In fact, it happens quite a lot because there's wonderful historians out there and humans. We've provided a lot of mind-blowing material over the last few millennia, let me tell you, and none, none more so than this. This is a story of successful head transplants. I'm not joking. This has happened, not to a human, but to one of our near relatives. It's unbelievable. Dr. Brandy Scalacci is a brilliant historian. She writes about the history of medicine, where medicine and literature overlap. And she has written an astonishing new book. The central character of it being this guy, Dr. White, who basically discovered that you

could keep a human brain working by attaching the head in which that brain is to another body. I'm serious. It's unbelievable. You're going to struggle, struggle to maintain credulity as you listen to this podcast, but it is real. History, folks, all the most amazing stories are true. Don't have to go reading no fantasy novels. No TV shows about dystopian, semi-foodal societies that use dragons in combat here. No, no, no. You can get your mind blown by engaging with things that have actually happened. Speaking of mind-blowing things,

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if you use the code D-Day. D-D-A-Y. If you've ever wondered about using historyhit.tv, now my friends, now is the time to go and check it out. In the, though, here is Dr. Brandy Scalace. Brandy, thanks very much for coming on the podcast. Thank you for having me. This story is wild. I mean, it's just wild, dude. Talk to me about this guy, Robert White, because he's a transplant surgeon. He's like Nobel adjacent, but he's also like a crazy Frankenstein guy. Well, maybe that's what all Nobel adjacent scientists are, but tell me. Yes. So I think it's probably best if I give you my introduction to Dr. White, because I think that way it introduces you, but also tells you why I got involved in this

in the first place. I had written a book about death and dying. And in that book, I had been researching the concept of brain death. And I became friends with a neurosurgeon who also does trauma brain surgery. And he called me to his office one day and said, Oh, you need to come down. I have something I want to show you. So I do I go and he pulls out the shoebox. And it's battered. And I opened it up and inside is a notebook. And this notebook is from the 1950s, like an old MIT lab notebook. I'm flipping through it and there's pasted in notes and information and photographs and cramped writing and little flecks of dried blood. So it's a bloody notebook in a box. And I said, what is this? And he said, oh, and it's this sentence. That's the lab notebook of Dr. Robert White, nominated for a Nobel Prize, but he was

also the first person to perform a successful primate head transplant in 1970. And there's so much going on in that sentence that I just sat there for a minute being like, I have to process each clause kind of separately here. Head transplant, successful, 1970s, what is happening? And then the Nobel Prize part on top of that, because you're expecting he must have been run out of town on a rail. But no, he was friends with two popes. He set up the Vatican Council for Bioethics. He was nominated for a Nobel Prize for hypothermic treatments that we still use today in brain surgery and heart surgery. And he took the heads off of things. I mean, this is just really difficult to kind of grasp, you know? Talk me through that sentence a bit more. Was it a successful, like defined success? Like the animal

lived for like 10 seconds. Is that a thing? The animal actually, it lived for nine days. Yeah. The animal lived for nine days afterwards and would have probably lived longer if they had given it anti-rejection drugs. But I don't know if the body rejected the head or the head rejected the body, but it didn't survive beyond nine days. And this is a rhesus macaque. But it's easier for me to get you there if we start back a little further. This book begins in the 1950s with the first successful kidney transplant, because I think people don't realize how weird transplant really is. We're so used to it. Here in the United States, you tick off a box on your license application, and you just don't think about it anymore. And you may even know people. I know a liver transplant patient. It just seems like run-of-the-mill stuff. But this was

science fiction until the 50s. We couldn't do this. You couldn't have someone's heart beating in someone else's body. This just wasn't something you could do. Then in 1950s, they basically performed the first successful kidney transplant on identical twins. So you don't get the rejection. And this happens in Boston at the Peter Brigham Hospital. And that happens to be where Dr. White is in medical school. So he's there for this seminal moment where you have this transplant. They walk out of the hospital successful, alive. They go on to have lives. I think the patient lives for another eight years.

I mean, this is quite a big deal. And Robert White thought to himself in this moment. He went straight to head. He went straight to head. He did. Wow. He did. He did not like do not pass go.

He basically thought, well, if we can transplant kidneys, right? He didn't think then, oh, we could also transplant hearts. That was what Christian Bernard thought in South Africa, the first person to do a heart transplant. Now, why it went, what if we just gave you all the organs at one time? So essentially, just give you the whole package still in skin and just move it over to where your head's at. And this is just an idea he had. And he claims that he had it as soon as he realized the successful surgery had happened by Joseph Murray, who also won a Nobel prize. And he thought, gosh,

we ought to be able to do more. So it's obviously not where I would have gone probably mentally. But what I discovered about Dr. White is leaps. That's what he does. Every single time you think the steps are like one, two, three, he's like one, seven, 19. And that's kind of how he ran not just his life, but his laboratory experiments as well. He was constantly breaking barriers in a way that I was both in awe of and slightly terrified by. Yeah. And today reading your book, are they ethical? Ah, well, so the thing about the 1950s, and I do want to say that though this book is the biography of Dr. Robert White, but it's also a biography of science coming to terms with itself over the last 50 years. It begins in the Cold War. And you have

to remember some of the strange things, you know, men who stare at goats, the United States government thought maybe the Russian government had figured out telekinesis. I mean, I know that sounds really weird to us now, but the atom bomb had just gone off and nobody thought that was possible either. So all sorts of things seemed possible. And when we found out about Sputnik launching, of course, the race begins. Everybody's like, we can't let them win. And then they did. They got up there before us. So there was an outer space race. There was simultaneously an inner space race. And a lot did, they got up there before us. So there was an outer space race, there was simultaneously an inner space race. And a lot of people don't know about that. And that's really

what the book is about. And White called himself an astronaut of the brain. There were literally people behind the Iron Curtain and in the United States competing over organ transplant, like who was going to be the first to do certain kinds of organ transplants, to do certain kinds of surgery. to do certain kinds of organ transplants, to do certain kinds of surgery. And they kept feeling like the Russians were winning, partly because of a film that came out in 1958. A Russian physiologist named Vladimir Demikhov trots onto the stage with a two-headed dog that has been surgically created. He has taken the head of one dog, put it on the body of another dog,

and both heads can pant and drink milk and look at you and all of this stuff. surgically created. He has taken the head of one dog, put it on the body of another dog, and both heads can pant and drink milk and look at you and all of this stuff. And this footage, this grainy black and white footage, hits the community in the United States like Robert White and Christian Barnard like a bomb. And Barnard was furious. He's like, no, if the Russians can do it, we can do it too. Again, you wouldn't normally think that your first response to a surgically altered dog would be like, let's try that. But Christian Barnard literally creates a two-headed dog in South Africa to prove that not just the Russians could do it. I bring this up because it means a lot of stuff that we might not think is ethical or that we might be surprised that the government would be willing to fund something like head transplants. But if the government at the time thought the Russians were winning, suddenly a whole lot of things become possible. And some ethical things are stretched, perhaps, because it's all about

making sure your ideology wins. So if you're in the Cold War era, there was a thought that if your science won, your ideology won too. In fact, Khrushchev, his comment, you know, we will bury you, that gets quoted a lot, he was actually referring to science. His point was, our science is going to win, and then we're going to win. And therefore, it wasn't just jockeying for position. It was considered to be of tantamount importance that we beat them at science. So again, today we look at this and go, he wanted to do what? He wanted to take heads off and transplant them. How could that possibly be something anyone would be interested in, much less fund? But in fact, he was given money to do this and he works throughout the 60s on brain isolation, which is sort of the first step, and then moves into transplanting a monkey's head onto another monkey's body in the 70s. In this new stance in this history, we are actually talking about head transplants. We are. It's crazy, I know. More after this.

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So it worked. It did. I read your book. I did not think it ever happened in my life. And I read your book, it blew my mind. I was like 42 years old before I realized that this was a thing that we had the power to do. So did they wire up the spine and everything? And could the monkey wiggle its fingers? No, they didn't. So to be honest, what White really was interested in proving is that brains could outlive bodies. Yeah, he didn't care about the spine. He didn't actually, no, not at that time. It was the

soul. It was the soul. It was. You have to understand too, this is happening in the context of we didn't really have a definition of brain death to begin with, right? Because typically, before respirating units, before there was artificial respiration, if you stopped breathing, you would die in short order. But once we began to artificially respirate people, your heart's part of the autonomic system. So if your brain is not operating, you're brain dead, your heart will still beat. So if we're putting oxygen into your lungs and it's oxygenating the blood, your body can keep living.

So brain death was this concept that the body could outlive the brain. And White wanted to show that the brain could outlive the body. And his reasoning was, he's trying to get at the same question, but sort of backwards or in reverse. When are you dead? We know what dead is. Medicine knows what dead is and it knows what alive is. But this ephemeral moment in between them, that's very difficult to judge. And obviously, if you're now doing transplant science and you want to harvest someone for their organs, you better be sure that they're dead. So that question is partly what White's interested in. So he's like, okay, can I show that a brain living outside of its body, that life is in the brain, that life equals brain.

And he starts that by basically carving a living brain out of a living creature and having it plugged up to EEG by itself, isolated, pink, naked. Is it still thinking? And that very first experiment, which to me is almost more mind-blowing, is he literally gets us a thinking brain outside of its body. And that's just hard to get your head around, not meaning that as a pun. That's full crazy scientist trope, every single cartoon, every single like Thundercats, you name it. I didn't realize actually. So the brain works. Yes. Yes, it does. So basically, this is partly how he came up with the perfusion, the therapeutic hypothermia, because the brain is greedy. It wants oxygen, so much oxygen. And if you

lose any oxygen, cells begin to die and brain death happens pretty quickly. So he realized if you cooled the brain down, it wasn't as greedy. So he uses hypercooling and then he begins to basically unplumb a monkey from its own vascular system until he just has the head. Now what he's doing is he's re-plumbing it with another monkey, a bigger monkey that's acting as a life support system. I know how strange and mad max this sounds, but it's like a living blood bag, essentially. This larger monkey beating just this head and he carves the body away. And this is disturbing. Trust me, I've toned it down in the book.

I had to watch footage of this and it's in color. So it's upsetting to see this happen. And then he opens the skull and he removes this living brain still flushed with blood and nutrients. And he sets it on this device that reminds me of sort of a lava lamp without the glass part. And blood is flushing through it. And there's EEG hooked up to it. And it's spiking over here on the graph paper. And it does look somewhat different, but doesn't look that different from what a living brain would look like if it were thinking. The biggest difference was that there's no sensory input, so the part of the brain that knows what you're hearing and seeing and smelling was not particularly active, but everything else was just ticking away in the three little lines on graph paper that you often see

in EEG. And it's not got a body. Wow. And what year was this? This was happening in the 60s, and he did hundreds of these things, something on the order of 300 frozen monkey heads in his lab. So when I was reading your book, I was thinking, is this like an orphaned branch of science? Or is it now a huge ongoing area of study and fascination for contemporary science? It's a hard question to answer because there's multiple moving parts in the types of surgeries that White was doing. Some of the things he was up to happen all the time. The perfusion technology, for instance. People still trying to figure out how to preserve the brain life when a body is

falling apart or is ill. Questions about how to stimulate and keep the body itself living. Because one of the problems of paralysis, this was more of a problem when White was operational than now, we've gotten better, is that if you are paralyzed, particularly if you're tetraplegics who can't move below your neck region, your organs begin to fail quite young usually. So yes, there's lots of research looking at all the same things White was looking at. But really, post-Cold War, there was a lot less interest in the head transplant because people wanted to know what would be the point? Why do you want all these monkeys? Why do you want to do these monkey head transplants? Surely, the only reason to do a monkey's head transplant would be if you were intending to do it on people.

And surely he wasn't intending to do it on people. But he was. Surely. But he was. He was perfecting the primate surgery because he wanted to perform a head transplant on people. And there is still some interest in that today. And there's a couple of scientists who are still looking at it. I got Jeff Bezos on the phone. He read your book and he wants to graft his head onto some 21-year-old stud. So the lesson from the history of science is when we do these things, we can't really undo

them. It may take a hundred years, but something is going to come of it. The trick I think is that we get to the scientific cans a lot quicker than we get to the scientific shoulds. And unfortunately, that means our science and our technology outstrips our ability to appreciate its consequences, but we have to live with the consequences. And so the whole point of having bioethics commissions and things is to try and get that out ahead. But it often doesn't work. For instance, going back to heart transplants, lots of debate around that at the time, because people weren't sure if we agreed about what death was, there was a real fear that minorities would be harvested and given to white people, particularly since the first one happens in South Africa. And the commission to

determine brain death happens after the first two heart transplants. So the idea is you want that stuff to precede, but so often our ethics are like running to catch up with what science has already accomplished. And so when White realizes that a brain outlives its body, he said, in the operating room, have I come to the place where I can transplant the human soul? So you know, the whole time, his questions are much bigger than can I study this brain in isolation? His questions are, can I give a head a new body? Can I give a thinking organ, which to White was not just the life, but also the soul, the animating principle, the personality? Can I give that a brand new body? And he loved to use Stephen Hawking as an example, where he was like, isn't he worth preserving? Why don't we give him a new body that will help him out? And yes, you'd still be paralyzed. that will help him out. And yes, you'd still be paralyzed. But then again, many people already are. The human patient White wanted to help was already a tetraplegic patient. And he had agreed to potentially be the guinea pig because his organs were failing. And guess what? If you're

a tetraplegic patient in the 80s, it's very difficult to get on a waiting list for organs. They don't think you're a good candidate. So to him, Craig Vitavis was his name. He's like, my life's worth saving. My life is just as important as an able-bodied person's. Why can't I get a new body? And so I constantly came to this place in the book of going, oh, Dr. White is being strange and crazy, and you shouldn't do that. And that's too Frankenstein. And at the same time, realizing that some of our conceptions about what is and isn't worth doing with bodies probably is ableist, and he was helping people who were paralyzed, but yet felt that their lives were just as meaningful. And so suddenly, the head slash body transplant, White's rhetorically quite savvy, he calls it a head transplants when it's monkeys and a body transplant when it's humans. But just to get to grapple with that and realizing there really

are constantly two sides to even these seemingly fringe scientific experiments. So tell us why White was not allowed to perform that body transplant. Well, if you want to do a body transplant, you need four things. You need a willing patient. And you'd think that would be the hardest thing to get. But White already had that. So he had one. You also need a body donor. Because remember, if you're going to take someone's body and give it to another head,

that body still has to have a beating heart. It still has to have its organs. We're all back to this concept of brain death. Are you dead enough to have your body harvested? So you would need a donor body. Now White, he worked at a trauma hospital. And in fact, there was lots of motorcycle accidents and things of that nature. He didn't actually have a difficult time getting a body donor either. So he's someone who has body donor ready, who has a patient ready. Two other things you need are money and permission. And even though the federal government might have been quite happy to put money towards some of his

projects earlier on, things had changed in the last 50 years. We'd been through the civil rights movement, the animal rights movement. They're the ones who called him Dr. Butcher, actually. We'd started to see the consequences of some of the science and things that were done in the 40s and 50s. And we started to go, wow, look at the dangers. There's still cancers where the atom bombs were dropped. Suddenly, we're getting these reckonings. And you have a population that's far more aware of what science is doing. Like these things are not happening behind closed doors. And suddenly things that you might have been able to do, and the government might have been willing to do, and the government might have been willing to fund, because we're talking $7, $8 million to do a surgery like this,

isn't there. And hospitals have to give you permission to do it. And they're not super willing to be involved either. I mean, think of how difficult it was to get permission to do the first face transplant. So PR is a big deal. So he didn't get those last two things, the money and the permission. And it wasn't for lack of trying. He actually went back to Russia to see if he could perform the surgery there. Well, that's a twist in the tale, isn't it? It is just such an extraordinary book. I urge everybody to go out and buy it immediately.

Brandy, thank you so much for coming on the podcast and talking about this. Oh, I really appreciate being here. Oh, and I should say, the book is launching soon in the UK, and I'm actually going to do a launch on June 10th at the Old Operating Theatre. That's what's so cool. So in the best museum space in the UK, Brandy will be there doing a launch.

Yeah, on June 10th. That'd be awesome. Thank you very much. Thank you. I feel we have the history on our shoulders. All the traditions of ours, our school history, our songs, this part of the history of our country, all were gone and finished. Hope you enjoyed the podcast.

Just before you go, bit of a favour to ask. I totally understand if you don't want to become a subscriber or pay me any cash money. Makes sense. But if you could just do me a favour, it's for free. Go to iTunes or wherever you get your podcasts me a favour, it's for free. Go to iTunes or wherever you get your podcast. If you give it a five-star rating and give it an absolutely glowing review,

purge yourself, give it a glowing review, I'd really appreciate that. It's tough weather, the law of the jungle out there, and I need all the fire support I can get. So that will boost it up the charts. It's so tiresome, but if you could do it, I'd be very, very grateful. Thank you. you could do it i'd be very very grateful thank you