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The Undead: Organ Harvesting, the Ice-Water Test, Beating-Heart Cadavers--How Medicine Is Blurring the Line Between Life and Death [Hardcover]

Dick Teresi

Price: 16.02 & FREE Delivery in the UK. Details
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Book Description

13 Mar 2012

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-Bénigne 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.

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Customer Reviews

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Most Helpful Customer Reviews on Amazon.com (beta)
Amazon.com: 2.6 out of 5 stars  72 reviews
42 of 46 people found the following review helpful
4.0 out of 5 stars Calls attention to some serious issues 18 April 2012
By A. Press - Published on Amazon.com
I've just read the entire book, unlike many of the negative reviewers.
Nowhere does Mr. Teresi claim that the people involved in this field aren't compassionate or sensitive (with a few exceptions). He does, however, cite enough published acientific work to support his thesis that decisions are made based on false or untested assumptions. He also claims that those who are in the position of declaring people dead are often misinformed or careless about the proper procedures. Studies in other areas have shown that doctors believe they are following protocol much more often than they actually are, with unfortunate results. If those who work in the field are convinced otherwise let them show studies that contradict this.
This book is well written, although I did occasionally feel that he as being sensationalist. Mr. Teresi also bases some claims on facilitated communication, a method whose scientific merit is highly questionable. Still, the studies cited to support his claims demand an informed response, not the emotional pleas of caregivers, transplant recipients and others who feel that the good of transplants supercedes any of the legitimate issues raised in tis book.
26 of 29 people found the following review helpful
5.0 out of 5 stars Ignore the hysteria; this book matters 22 April 2012
By Clammy - Published on Amazon.com
Format:Hardcover|Verified Purchase
This bracing book manages to entertain, even amuse, while exploring the disturbingly interconnected, undeniably fascinating subjects of death, near death, "brain death," coma, consciousness, paralysis, pain and organ donation. Early on, lost count of OMG moments. It's is a game changer, or should be, raising as it does the possibility that organ harvesting has occurred when or in ways it should not have. (Brought to mind the spectre of executed convicts later proved innocent by DNA evidence.) As if Teresi hasn't already made a case for extreme caution in declaring "brain death," he saves for the end the shocking financial incentives that underlie this widening corner of the medical-industrial complex. The sassy style masks a deadly serious message -- one that clearly has rattled many fellow "reviewers"; their panicky protests seem inadvertently to support the book's thesis rather than undermine it. How Teresi executed this book without invoking "Oy'm not dead yet" from Month Python, or Ishiguro's "Never Let Me Go" is a little mystifying, but perhaps admirable...
17 of 18 people found the following review helpful
4.0 out of 5 stars Now that I have read the book... 11 Jun 2012
By MikeF - Published on Amazon.com
Format:Hardcover|Verified Purchase
I am about to purchase this book after listening to the author discuss it on NPR. I will post a review on the book AFTER reading it.

In the interim, however, I find it intriguing that though the book was published on March 13, on that very same date it had already received 16 critical one-star Amazon ratings. By March 16 (just 3 days later), there were an additional 14 one-star Amazon ratings - totaling 30. All this before the book could have possibly even been delivered to (much less read by) any of these "reviewers."

So what operation orchestrated that smear?

After reading the book, I may indeed conclude it stinks. Or I may appreciate the author's research and cautions. Or something in between. I won't know until I read and evaluate its content. (I'm giving it an initial 3 stars simply because Amazon reviews require a star selection in order to post. My stars rating may go up or down after reading it.)

We all have our biases. I do as well. At least read the material before you take shots at it rather than simply regurgitating the opinions of others telling you what you should write. Sheesh!

Ok, it's 4 weeks later, and now having actually READ the book, here are my thoughts:

First, I have bumped up my overall opinion from an original "non-committal" of 3 stars to 4 stars. I wouldn't say this was a great read, but a pretty informationally compelling one - especially if you are or lean toward becoming an organ donor at death.

(As a side note, this book is nothing about donating organs while you are alive, such as donating one of your two kidneys for someone you match up with.)

Though some will criticize the book because it appears to go in directions that aren't specifically related to organ donating, the author's apparent goal is to provide an overall perspective first on death itself. What exactly is death, and when exactly does it occur in human beings? These are not just philosophical questions. They matter when YOU (a donor) are lying on the table to have your organs extracted.

So the time he spends discussing death from an evolutionary perspective, a overview of historical perspectives on death (i.e. what constitutes death, when it occurs) and even a chapter on near-death experiences - which on the surface may seem "out there" - makes evident his intent to bring into perspective the critical issues of when a person is really dead, and how the medical community can tell.

Much of his discussion revolves around contemporary views of brain death, tests done to confirm death, and a number of factors demonstrating how conclusively UNreliable these can be.

I suspect most people would be at least relatively comfortable - if not enthusiastic - about donating their organs at the point of death so long as we have medical assurance that there is no risk of either consciousness or sensation of pain while in a vegetative state when while brain dead. This book calls those two assurances into question in a disconcertingly significant number of documented cases - and thus by extrapolation, you're made to wonder about one's own prospective experience when it comes time to donate organs at death.

For me, one of the main drawbacks of the book is that the author neither offers his opinion or even his personal intentions in how/if he would make his own body available for organ donation at death. (I have actually heard him state his intent during an interview, but it is not included in the book. So I'm not repeating his verbal comment here for two reasons: First, my feedback is about his book, not his interview. And secondly, since it was a radio interview, I wasn't able to determine if his comments were serious or more tongue-in-cheek.) But an author's personal conclusions can be very helpful, especially when the reasons for those conclusions are spelled out clearly - even if I don't agree with him.

For those who plan to donate their organs and are content assuming that all will go well at death (i.e. you'll really, truly be dead and therefore won't know what's going on with your body or feel a thing), this is probably not the book for you. The odds are in your favor, anyway.

If, on the other hand, you wish to at least chew on the possibility that medical errors concerning death, consciousness (in circumstances when all appearances would seem to INDICATE death), pain after "death," and that maybe - just maybe - there can be significant financial incentives to declare death too quickly when viable organs for donation are at risk of not surviving a more thorough death analysis, then this book is a worthwhile read.

After doing so, you may blow off many of the author's concerns as unlikely, or conversely they may give you pause for thought concerning your plans for the use of your own body at death. Either way, you owe yourself a knowledgeable decision.

As for a number of previous Amazon "reviews" of this book where many individuals clearly hadn't read a word of the book (couldn't have even had it in hand at the time of their comments), that just demonstrates a fundamental lack of integrity and an agenda that for them clearly supersedes informative research which more thoughtful people may see as helpful. I find such "reviews" reprehensible - even if they were to agree 100% with my own conclusions.

If you read the book and hate it, say so. If you think the author is spot on, say so. But as I said in my initial feedback 4 weeks ago, at least be honest and read it before commenting.
8 of 8 people found the following review helpful
4.0 out of 5 stars A good counterargument to the current organ-harvesting philosophy 9 Jan 2013
By Bonnie Buratti - Published on Amazon.com
Teresi offers a counter argument to the "harvesting and transplant above all else" ethic that has taken hold in the medical community. Disturbing examples of recovery from what appeared to be near-dead people, combined with our ignorance about when death occurs, cry out for putting a brake on the whole organ-harvesting enterprise. (On a personal note, a friend's 19-year old child was on life support for 9 days and fully recovered). The friction between the rights of the dying patient and their families, and those waiting for transplants - sometimes with their own lives in the balance, is vividly portrayed. The book argues that the pendulum has swung far too much in the direction of harvesting. Teresi also deals with the lack of dignity in the whole process. The cadaver is not a person but an object, a commodity, to the medical community.

I like Teresi's point of view that science is uncertain about a lot of what we think we know. Doctors and brain scientists don't really know what is going on with people in vegetative states, comas, or on life support.

The book is not especially well-written: there is a lot of narrative ribbing, personal asides, disorganization, and redundancy. But his point-of-view is well-formed.
8 of 8 people found the following review helpful
5.0 out of 5 stars unusual and original 22 Aug 2012
By Adam B. Ritchie Jr. - Published on Amazon.com
Format:Hardcover|Verified Purchase
I have noticed that among the gentry not every Richard can be called Dick. This is an unusual case in which Dick is the writer and Richard a mere resident of Amherst, MA. I was glad to see the book appear because I had wondered what new forms of hanky panky had emerged in the world of organ donation. The first clue that it was business as usual was when an elderly Chinese man handed me a pamphlet on Fisherman's Wharf in San Francisco describing a thriving organ-harvesting industry in the Peoples' Republic of China. But evidence is easy to refute. Some familiarity with human nature would lead one to posit that the demand for organs and the need to harvest them while the patient was still alive if he/she could be deemed brain dead might lead to what the author calls philosophical rather than medical determinations on just who is brain dead and who is not. The spectrum of criteria for admission is likely broad. Oh she can no longer wear a bikini and walk along the beach. Oh he has forgotten how to integrate in the complex plane. Finally I really liked the number of one and two stars the author drew from reviewers. That means he has something unusual and original to say.
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