Available:*
Library | Call Number | Status |
|---|---|---|
Searching... Stayton Public Library | 610 TERESI | Searching... Unknown |
Searching... Monmouth Public Library | 610 Teresi, D. 2012 | Searching... Unknown |
Searching... Salem Main Library | 610 Teresi 2012 | Searching... Unknown |
Searching... Silver Falls Library | 610 TERESI | Searching... Unknown |
Bound With These Titles
On Order
Summary
Summary
Important and provocative, The Undead examines why even with the tools of advanced technology, what we think of as life and death, consciousness and nonconsciousness, is not exactly clear and how this problem has been further complicated by the business of organ harvesting.
Dick Teresi, a science writer with a dark sense of humor, manages to make this story entertaining, informative, and accessible as he shows how death determination has become more complicated than ever. Teresi introduces us to brain-death experts, hospice workers, undertakers, coma specialists and those who have recovered from coma, organ transplant surgeons and organ procurers, anesthesiologists who study pain in legally dead patients, doctors who have saved living patients from organ harvests, nurses who care for beating-heart cadavers, ICU doctors who feel subtly pressured to declare patients dead rather than save them, and many others. Much of what they have to say is shocking. Teresi also provides a brief history of how death has been determined from the times of the ancient Egyptians and the Incas through the twenty-first century. And he draws on the writings and theories of celebrated scientists, doctors, and researchers--Jacques-B#65533;nigne Winslow, Sherwin Nuland, Harvey Cushing, and Lynn Margulis, among others--to reveal how theories about dying and death have changed. With The Undead, Teresi makes us think twice about how the medical community decides when someone is dead.
Author Notes
Dick Teresi is the coauthor of The God Particle and the author of Lost Discoveries: The Ancient Roots of Modern Science, both selected as New York Times Book Review Notable Books. He has been the editor in chief of Science Digest, Longevity, VQ, and Omni, and has written for The New York Times, The Wall Street Journal, and The Atlantic, among other publications.
Reviews (6)
Publisher's Weekly Review
Suddenly, death doesn't seem so certain after all. In this brutally honest look at how doctors determine the moment of death, skeptical science writer and Omni magazine cofounder Teresi (The God Particle) relishes ripping into the 1968 Harvard team that formulated new criteria for determining death: "loss of personhood," or brain death. Doctors, Teresi says, can now "declare a person dead in less time than it takes to get a decent eye exam" by testing reflexes: "a flashlight in the eyes, ice water in the ears, and then an attempt to gasp for air" when the respirator is disconnected. Teresi interviews scientists who question the finality of brain death when the heart is still beating, and even the concept that personhood is located solely in the brain. More alarming, Teresi charges that the brain-death revolution is driven by the $20 billion-a-year organ transplant business. Teresi will scare readers to death with examples of how undependable brain-death criteria can be-one organ donor began to breathe spontaneously just as the surgeon removed his liver. But the more powerful effect of this scathing report should be the start of an uncomfortable but necessary conversation between doctors and potential organ donors. Agent: Janklow and Nesbit. (Mar.) (c) Copyright PWxyz, LLC. All rights reserved.
Booklist Review
*Starred Review* The Undead presents chilling, controversial, and, at times, comical commentary on physical death. The determination of death is fuzzier than you might imagine. There are cardiopulmonary death and brain-stem death, necrosis and apoptosis. There are those who straddle the divide between life and death beating-heart cadavers, individuals who've had near-death experiences, and even brain-dead pregnant women who carry fetuses to term. Physical signs of demise and clinical tests (EEG, apnea test, cerebral blood-flow studies) assist in establishing death, but the ultimate authority rests with medical opinion: You're dead when the doctor says you're dead. Teresi frets that physicians may be making moral judgments, not medical verdicts, when it comes to declarations of death. His other gripe involves the organ-transplantation industry (purportedly, a $20-billion-a-year business), which, understandably, revolves around recipients but arguably shortchanges donors and their next of kin. All sorts of experts on coma, animal euthanasia, and execution as well as undertakers, organ-transplant staff, neurologists, ethicists, and lawyers weigh in on the death debate. It is Miracle Max, a character in The Princess Bride, who sums things up best: There's a big difference between mostly dead and all dead. Mostly dead is slightly alive.--Miksanek, Tony Copyright 2010 Booklist
New York Review of Books Review
HOW dead would you like to be before your organs are harvested for donation? According to Dick Teresi in "The Undead," "pretty dead" is good enough for transplant surgeons. "If you wait for everything to be a hundred percent," a physician tells him, "you'd never have organ donation." In days of yore, the absence of a heartbeat was the gold standard for determining death, but even that wasn't foolproof. "People declared dead come back to life with some frequency," Teresi writes. They recover from drowning, coma, asphyxia and lightning strikes. Rigor mortis doesn't always occur in the dead, and it can occur in the living. Even experienced practitioners could misdiagnose stiffness or coldness, a lack of breath or pulse. An 18th-century Frenchman recorded "more than 150 pages of accounts of premature burial and mistaken death" between ancient times and the mid-1700s. To avoid such errors, Greeks cut off a finger; Romans called out the dead's name; Slavs rubbed bodies with warm water for an hour; Hebrews considered putrefaction the only fail-safe indicator. As science learned more about suspended animation and hibernation in other creatures, the dying were given another chance - subjected to smelling salts, electric shock, sharp pricks to the fingers, yanks to legs and the application of caustic chemicals to the skin, to see if it blistered. And so it went for 5,000 years, with the criteria for death becoming ever more stringent. Then, in 1968, 13 men on a Harvard University committee devised a protocol that privileged a "loss of personhood" over cardiopulmonary death, allowing doctors "to declare a person dead in less time than it takes to get a decent eye exam." Teresi lays the turnabout to the invention of ventilators and advances in organ transplants. By declaring patients with beating hearts brain-dead following two rounds of tests with a Q-tip, a flashlight, ice water, a rubber hammer and the removal of the ventilator, doctors created a vast pool of potential organ donors. The bar for being dead had dropped, and the bar for being considered alive had risen. Adopted in 1981, the Uniform Determination of Death Act states that in order to pronounce brain death, "the entire brain must cease to function, irreversibly." But the act is silent on how this function is measured (in one study, 65 percent of physicians and nurses couldn't identify the established criteria for brain death). Most physicians look at the brain stem, which controls heart and lung functions, but not the cortex, which coordinates consciousness. Teresi reports on an apparently unconscious patient who "could have been calculating the cross section of the bottom quark using Heisenberg's matrices, and no amount of ice water squirted into her ear would have detected it." The patient was unplugged, her organs harvested. The Harvard criteria assume that the brain-dead will quickly move to conventional heart-lung death. But Teresi learns that the brain-dead can maintain a long list of bodily functions, including some sexual responses, stress responses to surgery and the ability to gestate a fetus. After making a case that brain death is easily misdiagnosed and that death can be a construct of convenience, Teresi next places his body between the transplant team and patients who exist in a sort of "death lite" netherworld, with a nonresponsive cortex but a functioning brain stem. And now things get really creepy. A tiny minority of patients in minimally conscious or persistent vegetative states have been known to sit up and speak. And one "locked in" patient (with a brain stem irreparably damaged but a healthy cortex) even wrote a best-selling book about his condition, "The Diving Bell and the Butterfly." But the onus is on patients to prove they are aware or in pain. "We would all sleep better at night if we could believe that patients in unendurable situations were unaware, but that does not make it so," Teresi writes. Off they go to be harvested, despite the potential for surgeons to be distracted by their "screaming during organ retrieval." This is strong stuff, and Teresi - the author of "Lost Discoveries" and the former editor of Science Digest and Omni - never backs off. He circles, probes and pokes. He needles physicians and bioethicists, and he provokes organ banks by agreeing to donate only if he can be guaranteed an anesthetic during the procedure. (When the organizations refuse, he considers commissioning two operations: the organ donation and then a face-lift. "I'd get my anesthetic, and I'd hold the face-lift.") Teresi consorts with death in many places: mortuaries, execution chambers, hospices, intensive-care units and a meeting room filled with people who've had near-death experiences. But he steers a wide berth around two important groups: grateful organ recipients and those who tend the persistently vegetative for years on end. If I'm reading Teresi right, no one who shows any sign of consciousness, and hasn't clearly indicated he or she wants to die, should be unplugged. Where there's life, there's hope. But he gives extremely short shrift to quality-of-life issues. And while a resuscitated donor headed for the transplant table may receive "the best medical care of his life," a vast majority of acutely ill patients on chronic ventilation units don't improve. Their skin gradually breaks down, and their circulatory and renal systems are propped up until an infection finishes them off. Teresi prides himself on his just-the-facts approach, but he hasn't told the entire story. Like the author, I don't want to suffer when my organs are harvested, nor do I want them harvested if I can consciously make use of them myself. This disturbing, often hilarious book raises many critical questions about deadness. But it doesn't, by a long shot, answer them. Elizabeth Royte's books include "Garbage Land" and, most recently, "Bottlemania."
Choice Review
This is a hard-hitting, strongly worded expose of the deep hypocrisy in parts of the medical profession, embodied in the notorious Harvard criteria for so-called brain death. Today, the emphasis is on evidence-based medical practice. However, when collective evidence is applied to the determination of clinical death based on cortical activity but not brain stem functions, the criteria fail. Author/journalist Teresi aptly identifies the real rationale for blurring the line between total lack of competent cardiopulmonary activity (death) and the gray zone that presumes that loss of cerebral cortical function inevitably leads to heart stoppage, viz, the effort to obtain transplantable organs. These endeavors for defining death are sold to the public as laudatory medical advances, ignoring the principle that there is a cost to everything. Many of these practices resulted in revocation of medical licenses and criminal charges of homicide not that long ago. Ironically, this may occur again because just as this book appears, scientific advances show the possibility of creating artificial organs from special cultivation of stem cells. Teresi does not comment on the negative effects of after-death fluid perfusion to maintain organs in preparation for harvest, which often confounds autopsy findings. Overall, a thought-provoking look at a serious medical/ethical issue. Summing Up: Recommended. All levels/libraries. D. R. Shanklin Marine Biological Laboratory
Kirkus Review
Lost Discoveries: The Ancient Roots of Modern Science--From the Babylonians to the Maya, 2002, etc.) claims that the rights of organ donors are being violated by the medical profession. "In 2010," writes the author, "there were an estimated 28,144 transplant operations in the United States"--with 111,530 candidates on the waiting lists as of June 2011. His stated purpose is to call attention to what he sees as a subtle shift in medical emphasis from saving lives to declaring patients dead prematurely in order to preserve their organs for the lucrative organ-transplant business. Like a real-life version of Robin Cook's medical thriller Coma, Teresi paints a grisly picture of organ harvesting and raises uncomfortable questions: Is the donor actually dead rather than at the point of death? Might he or she be revived given time and proper medical attention? Might the donor feel pain during the process of organ extraction even though seemingly brain dead? Citing reports of out-of-body experiences, the locked-in syndrome portrayed in The Diving Bell and the Butterfly and evidence that comatose patients who are apparently unresponsive are sometimes fully aware of conversations held in their presence, Teresi expresses skepticism about the medical definition of brain death. The author searches out experts, including, among others, "undertakers, cell biologists, coma specialists (and those who have recovered from coma), organ transplant surgeons," in an effort to penetrate the boundaries between life and death. "The unborn, fetuses, have plenty of political clout," he writes. "No one speaks for donors," and the press has abdicated its responsibility for investigative journalism. However, some of Teresi's writing verges on sensationalism--e.g., his lurid account of modern executions. A provocative, if one-sided, examination of important ethical issues and the still-unresolved question of what constitutes death.]] Copyright Kirkus Reviews, used with permission.
Library Journal Review
Few if any of the numerous recent books on end-of-life care combine humor, learning, and insight as Teresi (Lost Discoveries: The Ancient Roots of Modern Science) does here. By exploring how death has been determined from ancient times through modern Western medicine, he shows that some tests for death are not always foolproof. He argues that the possibility of organ donation has changed how we define death and shows the sometimes forceful recruitment tactics of procurement agencies. While the book discusses how the 1968 Ad Hoc Committee of Harvard Medical School influentially defined brain death, several other works have covered it in more depth. Teresi also includes sometimes moving personal stories of friends who struggled with end-of-life issues, putting a human face on the debates. VERDICT By combining learning and humor in an accessible format, this book is a good introduction to the medical, biological, and social conditions related to end-of-life care. Teresi will make you laugh, groan, and question what you think you know. An accessible but illuminating introduction to current questions in end-of-life care. [See Prepub Alert, 9/11/11.]-A.W. Klink, Duke Univ., Durham, NC (c) Copyright 2012. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Table of Contents
| Acknowledgments | p. vii |
| Prologue | p. ix |
| 1 Death Is Here to Stay | p. 3 |
| 2 A History of Death | p. 50 |
| 3 The Brain-Death Revolution | p. 89 |
| 4 The New Undead | p. 141 |
| 5 Netherworlds | p. 170 |
| 6 The Near-Death Experience | p. 198 |
| 7 Postmodern Death | p. 224 |
| 8 The Moment of Death and the Search for Self | p. 26 |
| Notes | p. 293 |
| Selected Bibliography | p. 331 |
| Index | p. 335 |