Thursday 11 April 2013

Bacterial Buddies, the Gut Brain, and Organ Transplants

The New Scientist had a very interesting article on the Gut Brain recently.  The same sort of cells that make up the brain – the neurons - can also be found throughout the rest of the body, the spinal cord being an obvious example.  What is less well known is that the human gut contains 500 million neurons – about as much as a cat brain.  This Gut Brain operates largely independently of the Head Brain, and I suspect is by far the older.  90% of signals go from the Gut Brain to the Head Brain.  When the connection to the Head Brain is severed, the Gut Brain can continue its work independently.  It plays an important part in repairing tissues and bones, and the signals it sends to the Head Brain have a strong impact on moods and desires.

I am not going into details, because they are technical and can easily be found elsewhere.  The important point is, in my opinion, that a person is a lot more complicated than we think.  We are not just a computer-like brain lording it over a car-like body.  Rather, the Head Brain is simply the biggest conglomerate of neurons in the body.  There are subsidiary centres in the guts and in the spine, and smaller outlets can be found throughout the body.  Including all our organs …

A further complication is that, as maintained in a previous post, there are trillions of bacteria and other micro organisms in our bodies, mainly in the gut but also everywhere else.  Most of them are not ‘foreign bodies’ who can be dismissed as free-loaders or aliens – they are in a symbiotic relationship with the rest of our body-cells and contribute to its success or failure.  Indeed, I think it makes little sense to view them as separate from the rest of our body-cells.  They are a part of us, just like all the other cells that make up the cosmos that is our body.

A body is a supremely integrated mechanism, where all parts constantly interact with each other.  Any change will affect the entire system, even if this is not always immediately obvious.  Just as a change in diet will affect mood, sleep patterns, skin texture, concentration, etc, so will a change in mood affect sleep pattern, desire for particular foods, etc.  To focus on one aspect of the body/person to the exclusion of all others may be a convenient approach to a particular problem, but will ultimately fail because of its reductionist nature.

Personally I find it absolutely amazing how all the different bits of me, cells and neurons and bacteria and other assorted micro organisms work together so well, despite all having their own unique individual life-goals and objectives.  They are like the citizens in a state, all working together for the common good. 

In light of this it strikes me as ridiculous to decree that when the Head Brain no longer functions everyone else, all the bacteria and other micro organisms, not to mention the various subsidiary brains and organs, can just be cut out and implanted in another, equally complex, human body.  These are not spare parts, to use in any way a medical team sees fit.  It is all very well for the Head Brain to sign up as an organ donor, but s/he is donating something that is not hers/his to give. 

It seems much more dignified, and kind, to let them all adjust to the new situation after Head Brain has died.  There may be a period of mourning, of letting go, and then some micro organisms will also die and others will leave the body and join another one, when they are ready and as they see fit.

Lastly, the argument I keep hearing is that it is selfish not to donate one’s organs to save or improve someone else’s life.  Well, and what about donating one’s money?  If it is silly to love one's body even unto death, surely it is much sillier to love one's material possessions?  

PS  I appended this post with the following Reader's reply to a newspaper article, which I found very moving:

'Everyone and every situation, is different... For some, it helps them through the pain, for others it does not...

Until you have actually been in a "survivors" shoes, no one can really understand all that is involved, both emotionally and physically. As opposed to what the article is talking about, the one who has died, or is dying, is NOT the real issue (in my opinion) with orgran donations.

Twelve years ago, my late wife and I were either organ donors, or had discussed it and knew that both of us wanted it done. It sounded like a great and honorable thing to do. We knew nothing about the actual process involved...

One evening, my wife suddenly, with no warning, suffered a massive stroke / burst anurism (sp). Rescue came and we were transported to the closest hospital within ten to fifteen minutes. They were unable to do anything for her, other than to "keep her alive" and transported her to a major trama center by life-flight. I was driven by a friend.

An hour later, we made it to the hospital and were told she had a 1% chance of survival... Essentially, none. She and I had never discussed "percentages", or who and or what makes that decision. While waiting for our daughters to make it to the hospital (one was on her honeymoon), I was approaced by the "organ harvest team leader". Since my wife and I had discussed this, I said yes... What do I need to do...

I was presented with 17 pages of documents I had to sign and "pressure" on the time... Every minute / hour eliminated the possibility of anyone using more and more organs. I simply "HAD" to wait for my daughters to arrive, so they could say good-bye. The machines kept her body "alive".

The "process" that would be involved was "scary"... The Dr. said there was only the slightest of chances for survival... but they can never say, no chance. We would not know, for sure, until her heart and breathing actually stopped, after turning off the machines. BUT... if you are doing organ donation, they do NOT turn off the machines, until all the needed organs are removed. A big "empty" question-mark hit me, like a ton of bricks.

If we go with the organ donation, we will never know if "we" killed her, or if she had already (actually) died. Given everythng going on, at that moment, none of us could say "yes"... We "had" to know if she was going to make it, or not.

"I" turned off the machines at 8:17 in the morning... Her daughters stayed for awhile, I stayed throughout. It took 23 minutes for her breathing and heart to stop... I stayed, holding her hand, talking to her, for the longest 23 minutes of my life.

Within 5 minutes, the "organ harvest team leader" was back with me to discuss tissue transplants, since they can not use organs, after the patient has officially died. Again, I discussed it with our daughters and we said yes... up to the moment they explained that it would take up to a week to accomplish and there would be no funeral, etc. until afterwards.

It was simply impossible for anyone to agree to, at that time. None of us, not myself, our daughters, my father, her sister, or cousins, etc. knew any of this, knew what was involved, or how it would feel to those of us, left behind. To all of us, right, or wrong, the funeral was important, the laying to rest, essential for saying good-bye.

Today... I am married again. My current wife and I have discussed all this and I "may" react differently, this time, should a similar situation come up. At least we have "said" we would.

So... Until you have been there, until you are sitting there, holding your wife, or husband, who you have loved dearly for 12 years, in your arms, as they slowly pass away, please do not get all "preachy" towards me about what is the right, or wrong thing to do, with their body. Until you do so, you will have no idea how you will feel, at that moment.'


Judging by other comments this experience is neither unique, nor universal.  But it shows the disrespect we have developed for death and the dieing person.