[Note that this book was provided free to me by the publisher.]
Death isn’t what it used to be.
Mostly as a result of technological developments, we can increasingly see that the difference between life and death is not a stark one, but rather a series of steps. We don’t know much about the continuum, though, and interventions to stop death—or even bring people back from the early stages of death—are hots in the dark: sometimes they work, often they don’t. In this book, David Caserett looks at the history that has led us to the point where we can see the continuum between life and death—however murkily—as well as the ethical questions such a new vision raise.
Caserett traces the beginnings of resuscitation to eighteenth century Amsterdam and London, then jumps ahead to consider mostly the twentieth century, with occasional glances back in history. He is particularly interested in attempts to cool the body and slow the metabolism of the nearly- or recently-dead, which leads him to investigate studies of hibernation—hibernation accomplishing both things—and then taking on more futuristic subjects, including suspended animation and cryonautics—that is, the freezing of the body (or brain) of a recently deceased person in hopes that it can be unthawed, centuries hence, when the cure for whatever killed that person has been perfected. He then switches gears to the more prosaic, looking at the way CPR changed popular expectations for how people would react to someone collapsing—even if it didn’t always change the way people actually behaved—and considers how the spread of Automatic Defribillators in public spaces might further change what is expected of the Good Samaritan. The final chapter is a summing up, which also points to the ethical dilemmas he sees on the horizon.
The book, as a whole, is never equal to the sum of its parts: there is something missing (21 grams?) that prevents it from cohering and becoming truly alive. Part of the problem is that he never really addresses the issue he stated was most important to him at the beginning: the ethical questions posed by increasingly good—but still inconsistent—resuscitation methods. He starts the book with the tale of two resuscitation events, one which miraculously brought back a girl who had seemingly been dead for over an hour, another which revived a man but left him comatose and dependent upon costly machinery for almost three weeks, before he eventually passed away? What price resuscitation, then?, Casarett asks. But he offers no answer, only wanting us to know that there is this dilemma. But anyone interested enough to pick up this book probably already knows the thorny issue—it is part of our national discourse over healthcare, its costs, limits, and obligations. The problems have been pointed out again and again. Nothing in this book advances us toward any answers.
The other part of the problem is that the book is too glib—in tone, structure, and analysis. Casarett clearly is taking his cue from Mary Roach: there’s the title, which would fit into her corpus of writings (“Stiff,” “Spook,” “Gulp,” “Bonk”) and there’s the voice, too, which is light-hearted. At first, I was off-put by the constant joking, and the attribution of possible thoughts and motives to others, but eventually I was charmed enough and swept away. But the levity made it hard to take seriously the concerns the author was voicing—if it’s all a joke, who cares? The book flits from subject to subject, with only a few tenuous connections between them, and never really engages with material that would bring out the thorny issues the author says is his interest. Only at the end does the author suggest any possible problems with the science he has examined—otherwise, everything is just fine as it is done. The historical vignettes are Whiggish—not understood within the context of their time, but always measured against what we know now. Casarett puts his thumb on the scales, too, throwing off his analysis: when he wants to disparage cryonautics, he points out the thin research on which it is based and the profit-motive that drives it; but his stories about research of which he approves makes clear that it is also often very speculative, and has its own profit-motive—toward the end, he celebrates scientists becoming entrepreneurs—so what exactly is the difference between what he thinks to be good science and science fiction?
Casarett is at his best when his writing is not really concerned with these overarching issues—when he’s not trying to make a point—but just trying to tell a good story. And there are lots of good stories here—suggestions for further reading. His review of research into hibernation, for example, potted though it may be, is great fun. I enjoyed reading about Dutch attempts in the 18th century to resurrect drowned people—there was lots of tobacco smoke literally being blown up people’s asses, and how fun is that? Casarett explains scientific concepts very well, and a reader will certainly come away from the book with a better understanding of physiology and medicine. It makes for a light but entertaining beach read.
And, despite itself, the book is revealing—the parts adding up to a different sum than Casarett expected: the 21 grams are there, just not where the reader might think to look.
Ultimately, the book is not an argument about the ethical dilemmas associated with our new understanding of death. It is an argument about science in the modern world, what is good, what is bad, and how to trust it. The book is like an eighteenth century book of wonders, a catalog of all the amazing tricks scientists can do. The first three-quarters are meant to wow the reader, to show that we live in a world fundamentally transformed by science: so fundamentally that poor Ben Franklin’s axiom might need to be changed: maybe it’s just taxes that will be guaranteed in the future. Maybe science really is the new religion, doing the same miracles as Jesus.
But then the book pulls back—and even as it has convinced the reader to marvel at science, it worries about wonder. Suspended animation is too closely allied with science fiction—it is too popular, not rigorously scientific. And Cryonatuics is really a kind of charlatanism: it uses the same wonder-making sense of science to sell a bill of goods. Indeed, the general people may not do well with the gifts of science. The last chapter considers CPR, and the often visceral reluctance people feel to performing it. Science is, literally, wonderful—and only the wonders given by real scientists—like Casarett—are to be believed, or relied upon. Have trust in the institutions that exist, he is saying.
Viewed this way, his light tone makes sense. Shocked is about death—but it’s really a comedy. About how, despite a few problems, we really do live in the best of all possible worlds.
Death isn’t what it used to be.
Mostly as a result of technological developments, we can increasingly see that the difference between life and death is not a stark one, but rather a series of steps. We don’t know much about the continuum, though, and interventions to stop death—or even bring people back from the early stages of death—are hots in the dark: sometimes they work, often they don’t. In this book, David Caserett looks at the history that has led us to the point where we can see the continuum between life and death—however murkily—as well as the ethical questions such a new vision raise.
Caserett traces the beginnings of resuscitation to eighteenth century Amsterdam and London, then jumps ahead to consider mostly the twentieth century, with occasional glances back in history. He is particularly interested in attempts to cool the body and slow the metabolism of the nearly- or recently-dead, which leads him to investigate studies of hibernation—hibernation accomplishing both things—and then taking on more futuristic subjects, including suspended animation and cryonautics—that is, the freezing of the body (or brain) of a recently deceased person in hopes that it can be unthawed, centuries hence, when the cure for whatever killed that person has been perfected. He then switches gears to the more prosaic, looking at the way CPR changed popular expectations for how people would react to someone collapsing—even if it didn’t always change the way people actually behaved—and considers how the spread of Automatic Defribillators in public spaces might further change what is expected of the Good Samaritan. The final chapter is a summing up, which also points to the ethical dilemmas he sees on the horizon.
The book, as a whole, is never equal to the sum of its parts: there is something missing (21 grams?) that prevents it from cohering and becoming truly alive. Part of the problem is that he never really addresses the issue he stated was most important to him at the beginning: the ethical questions posed by increasingly good—but still inconsistent—resuscitation methods. He starts the book with the tale of two resuscitation events, one which miraculously brought back a girl who had seemingly been dead for over an hour, another which revived a man but left him comatose and dependent upon costly machinery for almost three weeks, before he eventually passed away? What price resuscitation, then?, Casarett asks. But he offers no answer, only wanting us to know that there is this dilemma. But anyone interested enough to pick up this book probably already knows the thorny issue—it is part of our national discourse over healthcare, its costs, limits, and obligations. The problems have been pointed out again and again. Nothing in this book advances us toward any answers.
The other part of the problem is that the book is too glib—in tone, structure, and analysis. Casarett clearly is taking his cue from Mary Roach: there’s the title, which would fit into her corpus of writings (“Stiff,” “Spook,” “Gulp,” “Bonk”) and there’s the voice, too, which is light-hearted. At first, I was off-put by the constant joking, and the attribution of possible thoughts and motives to others, but eventually I was charmed enough and swept away. But the levity made it hard to take seriously the concerns the author was voicing—if it’s all a joke, who cares? The book flits from subject to subject, with only a few tenuous connections between them, and never really engages with material that would bring out the thorny issues the author says is his interest. Only at the end does the author suggest any possible problems with the science he has examined—otherwise, everything is just fine as it is done. The historical vignettes are Whiggish—not understood within the context of their time, but always measured against what we know now. Casarett puts his thumb on the scales, too, throwing off his analysis: when he wants to disparage cryonautics, he points out the thin research on which it is based and the profit-motive that drives it; but his stories about research of which he approves makes clear that it is also often very speculative, and has its own profit-motive—toward the end, he celebrates scientists becoming entrepreneurs—so what exactly is the difference between what he thinks to be good science and science fiction?
Casarett is at his best when his writing is not really concerned with these overarching issues—when he’s not trying to make a point—but just trying to tell a good story. And there are lots of good stories here—suggestions for further reading. His review of research into hibernation, for example, potted though it may be, is great fun. I enjoyed reading about Dutch attempts in the 18th century to resurrect drowned people—there was lots of tobacco smoke literally being blown up people’s asses, and how fun is that? Casarett explains scientific concepts very well, and a reader will certainly come away from the book with a better understanding of physiology and medicine. It makes for a light but entertaining beach read.
And, despite itself, the book is revealing—the parts adding up to a different sum than Casarett expected: the 21 grams are there, just not where the reader might think to look.
Ultimately, the book is not an argument about the ethical dilemmas associated with our new understanding of death. It is an argument about science in the modern world, what is good, what is bad, and how to trust it. The book is like an eighteenth century book of wonders, a catalog of all the amazing tricks scientists can do. The first three-quarters are meant to wow the reader, to show that we live in a world fundamentally transformed by science: so fundamentally that poor Ben Franklin’s axiom might need to be changed: maybe it’s just taxes that will be guaranteed in the future. Maybe science really is the new religion, doing the same miracles as Jesus.
But then the book pulls back—and even as it has convinced the reader to marvel at science, it worries about wonder. Suspended animation is too closely allied with science fiction—it is too popular, not rigorously scientific. And Cryonatuics is really a kind of charlatanism: it uses the same wonder-making sense of science to sell a bill of goods. Indeed, the general people may not do well with the gifts of science. The last chapter considers CPR, and the often visceral reluctance people feel to performing it. Science is, literally, wonderful—and only the wonders given by real scientists—like Casarett—are to be believed, or relied upon. Have trust in the institutions that exist, he is saying.
Viewed this way, his light tone makes sense. Shocked is about death—but it’s really a comedy. About how, despite a few problems, we really do live in the best of all possible worlds.
