Twenty-nine-year-old Anna Elisabeth Johansson Bagenholm was skiing with friends when she took a spill that sent her through the ice of a frozen stream. Only her skis, still above the ice, kept her from being swept away. The swift current held her so firmly, her friends couldn’t wrench her free. Eighty minutes passed before rescue teams pulled her from the water. By then, Bagenholm had no pulse. She was not breathing. Her body temperature was 56 degrees.
That was in 1999. Today, she’s a physician, with no signs of the ordeal she went through.
“Shocked: Adventures in Bringing Back the Recently Dead,” sounds like it will be an exploration of defibrillation, that magical moment in every TV medical drama in which a heart is electrocuted back to life. But David Casarett’s book could just as easily be called “Frozen,” or at least “Chilled,” given the role low temperature plays in the quest to prolong life.
Casarett provides an often surprising journey through revivification’s history and its future, and Anna Bagenholm’s story is just one of several eye-opening examples of how life can be prolonged. The physician and researcher at the University of Pennsylvania Perelman School of Medicine treats with admirable seriousness the scientific possibilities even in the most outlandish schemes. For instance, in the 18th century, both the Netherlands and Great Britain had societies devoted to the reanimation of drowning victims. Among the methods these societies tried was tickling the back of the throat with a feather, throwing the apparently dead body across the back of a horse for a trot, and, quite literally, blowing smoke up its behind. Casarett explains why these things didn’t work — or occasionally did — and even had himself tied to the back of the horse to see if a trot acts as a rough cardiopulmonary resuscitation. It doesn’t.
He is just as analytical about the scientific questions facing the optimistic folks who pay to have their bodies — or heads — frozen after death in hopes for a future cure for what ails them. Although he’s serious about the science, he can’t help making fun, saying some of the people who intend to be frozen are “utterly and completely bonkers.”
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But there is a great deal of practical science here as well, including research into the kind of low temperatures that allowed dramatic recoveries like Bagenholm’s. The body’s response to low temperature is already making its way into medicine. Casarett interviews Thomas, a mushroom farmer who lives outside Philadelphia. Thomas’ heart was stopped for more than 30 minutes during surgery to repair his aorta, the major artery that comes out of the heart and curves into the abdomen. Normally, a heart-bypass machine takes over for the heart when it’s shut down for repairs. But Thomas’ damage was too severe. His aorta ballooned abnormally where it came out of the heart, and the lower portion was shredding. To repair it, surgeons first lowered Thomas’ body temperature to about 64-68 degrees, which decreased the demands of his cells for oxygen. Then they stopped the heart. Although procedures like this are rare, low-temperature medicine could have more widespread use if it could be rapidly deployed to slow someone’s metabolism after a heart attack or stroke, buying valuable time for physicians to find the right treatment.
The physiology of hibernating animals may reveal something about slowing human metabolism. Casarett explores basic research into the hibernation of 13-lined ground squirrels and lemurs. He also visits a lab in which mice are put into a hibernation-like state with a single injection. Mice normally don’t hibernate.
As fascinating as much of this is, Casarett seems to doubt its ability to keep reader attention and compensates with frequent leaden jokes, inapt metaphors and unnecessary analogies. Only a few writers can make science — especially the icky parts — funny the way Mary Roach did in last year’s “Gulp.” Casarett is no Mary Roach. It’s not that he’s never funny. He’s just not as funny as he thinks he is. Too often, in pursuit of a laugh, are too many paragraphs that add too little information, such as more than a page in which a wood frog is depicted as a monster. I’m not sure why. His analogies often interrupt clear explanations and add mystery where none was. A heart is compared to a 1978 MG convertible. Maybe, but I know less about ’78 MGs than I do about hearts. A potential drug is like a No. 12 hopper — a trout fishing fly. Why this is important, I can’t say.
The best science writers strike a balance between engaging their readers and maintaining clarity. Casarett writes clearly, and then muddies it up with distractions. In the middle of a very nice, clear explanation of a complicated process called the allosteric reaction, he throws in an analogy invoking characters from “The Hobbit.” Not only was it unnecessary, the analogy was actually a bit misleading.
In the final chapter, Casarett drops most of the effortful tap dancing, and it’s a relief. The chapter explores CPR and defibrillation, and Casarett tells stories about familiar medical procedures that most of us think we understand — like what happens when someone’s chest is pressed over and over. It’s not what you think. He also explores some of the moral and ethical problems that arise when CPR or defibrillation rescues people already in dire health.
As a tour guide through the world of resuscitation, Casarett has the makings of the best. He goes to a middle school classroom to learn CPR. He travels with paramedics as they make their rounds. He even interviews a man in central Ohio who keeps 13-lined squirrels as pets. Now, if he’d just stop clowning around, he’d be perfect.
Jenni Laidman is a frequent Printers Row Journal contributor.
“Shocked”
David Casarett, M.D., Current, 260 pages, $27.95