Oops me heads fallen orff, missus!

Your future perhaps? Not mine.

In Mary Shelley's book 'Frankenstein', Dr Frankenstein (for it is he) created a patchwork monster by sewing together various parts from human cadavers. As I recall the monster was animated by a burst of electricity. For those of pedantic disposition: the monster was never called 'Frankenstein'. As a point of fact, the abomination was called, Nigel; I've digressed.

Today, modern medical surgeons can transplant most organs of the body with varying degrees of success. However, one body part remains firmly fixed- the head. To date, no one has tried to transplant the head from one individual to another. Although it is true a few Islamic extremists have managed to master the first part of the procedure. From a technical perspective, the successful transfer of a head from a donor body to a recipient body is plagued with apparent insurmountable biological and surgical problems. More of this later. Consequently, the medical world has reacted with disbelief and astonishment to a recent announcement by an Italian neurosurgeon, Dr Sergio Mugumbo (sorry, that should read Dr Cavaero ), in which he stated that human head transplants will be possible within the next 24 months. Also, he is personally willing to lead an extensive team of surgeons, technicians and nurses in performing the first 'head transplant'. To be fair, the procedure is strictly a body transplant, but 'head transplant' grabs headlines and therefore beloved and preferred by science journalists.

Removing a head from a dead person and reattaching it to a live person is technically  demanding, especially as you want the recipient to continue to remain a live person. First, you must obtain a suitable donor. A team of doctors need to be present at the time of death. It requires a special type of person to tolerate, and be surrounded by, a team of 'grave diggers'. One hopes that a coma intervenes/supervenes. At the time of death,  hypothermia will be required to maintain biological integrity. And this needs to be done with astonishing alacrity. Hopefully, the cells will be maintained and kept vital over the extended time demanded by the procedure. Some form of artificial circulation is a must and oxygenation is desirable. It is estimated that a team of 150 will be necessary and the surgery will take about 36 hours to complete. The recipient body will need to be similarly treated and the core temperature should be maintained at 12 degrees C. The brain is a sensitive organ and four minutes without oxygen, at body temperature, will result in irreversible brain damage. Reattaching the head is no mean feat (no shit). The relatively easy part will be the connection of the musculature and blood vessels. The major challenge will be the splicing of the donor and recipient spinal cord. In order to stimulate inter-neural connections, chemical or electrical treatment is contemplated.  Without nerve connectivity the patient will remain a tetraplegic. The patient will be placed in an induced coma for at least 4 weeks. This is essential to ensure the cord knits and the head is not subject to disruptive movements. Twitching and convolutions/convulsions are not to be allowed.

Even if the operation is successful and the patient regains motor function to the limbs, grave complications remain. Rejection of the head, mediated by the immune system of the donor, and vice versa, is almost certain unless the patient undergoes constant and lifelong immunosuppressive therapy. This is not a perfect solution and organ damage may still result. As the organ in question is the brain, brain damage and loss of intellectual function is a real possibility.

Who would benefit? Believe it or not, quite a few patients have volunteered for the procedure. Out of the hundreds of applicants, a Russian, Valery Spiridonov has been given the dubious honour of being the first, potential, head transplant patient. Valery suffers from a rare and ultimate fatal muscle wasting disease and suspects he has no other option to extend his life.

Is it really possible? Most neurosurgeons consider the procedure beyond contemporary medical and surgical competence and envisage success to be virtually nonexistent. There are also concerns about Dr Cavaero's motivation for performing such a dangerous and controversial procedure. Many doubt that this is about advancing medical science but more about gaining fame and notoriety for the surgeon. Surely, if it is possible to perform head transplants with all its attendant difficulties, then repair of existing spinal lesions without removing the head should be eminently possible? Although patients with extensive cancer and body wasting diseases would remain legitimate candidates, perhaps? It is highly doubtful that any medical ethics committee in the West would countenance such a procedure. This does not deter Dr Cavaero. He is more than willing to perform the procedure in a country where ethical considerations are not a concern (China). And then there is the cost. It is estimated that the procedure, in total, will cost at least US$10,000,000. This raises the pertinent question: who will really benefit?  The good doctor does not conceal his ultimate objective- he wants to produce an immortal. Imagine your body exchanged for a younger model every 20 years, or so; interesting, no doubt. But surely the head, and especially the brain, will eventually degenerate unless the brain cells are continually rejuvenated? Perhaps a technology available for the usual suspects: rich, old, white men?  A brave new world indeed. I’m hoping that I’ll be dead before this transpires.          

The first bit is always easy.