How to Perform a Head Transplant

Just because you shouldn't do something doesn't mean you can't.

Abandoned military hospital in Beelitz, Germany (Sebastian Niedlich / Flickr)

"Honey? What are you doing down there?"

Clattering at the foot of the shadowy staircase stops abruptly, replaced by the sound of someone trying not to make a sound.

"Oh boy, don't even tell me you're working on those human head-body chimera plans again."

After a long moment, a solitary cough echoes off the basement floor.


Many of us know this scene all too well -- torn between home life and the professional demands of experimental surgical fusion of human body parts. Perhaps no one would be more familiar than those close to Dr. Robert White in the 1970s. The Harvard-trained neurosurgeon famously devoted much of his career to what he called a head transplant. In 1970, he "succeeded" in carrying one out, on a monkey.

I qualify succeeded because, while that's the way it was publicized, the monkey chimera remained paralyzed from the neck down. Despite having a machine do his breathing for him, he died after eight days ... only a number of hours of which he was conscious.

The surgeons basically connected the blood vessels, but not the money part: the spinal cord.

"R's head, previously fixed in a Mayfield three-pin fixation ring, will literally hang from the stand during transference, joined by long Velcro straps. The suspension apparatus allows surgeons to reconnect the head in comfort."

So, big whoop, right? Wasn't there a story about a kid in your neighborhood who put the head of one animal onto the body of another and got it to stay alive for a little while? But this scene was more agonizing than anecdotal or whimsical, as Case Western neurosurgeon Jerry Silver remembers it: "When the head would wake up, the facial expressions looked like terrible pain and confusion and anxiety in the animal. ... It was just awful. I don't think it should ever be done again."

White was convinced, though, that his work with cephalosomatic linkage surgery in the monkey was pretty much proof that it was "fully accomplishable in the human sphere." By 1999 he said it was "now possible to consider adapting the head-transplant technique to humans."

People called him a genius. Gave him honorary degrees. People also call(ed) him crazy.

Screen Shot 2013-07-03 at 4.01.39 PM.png

White's autocerebral hypothermic perfusion in place, 1978 (White, Mayo Clinic Proceedings)

Jump forward to 2013, when last month Italian surgeon Sergio Canavero said that we have at last figured out that issue of connecting the spinal cord. The head transplant is now feasible, said Canavero, and he has a project called HEAVEN that's going to do it.

HEAVEN stands for Head Anastomosis Venture, which is a poor choice of acronyms in an industry constantly sidestepping God-complex accusations. Maybe it's like, ironic in a super self-aware way. That would be unique among the pages of the journal Surgical Neurology International, though, where Canavero dives deep into the specifics of how HEAVEN will work. So deep that we arrive at the existential.

For example, is it a head transplant? Technically it would be a body transplant. Identity remains with the brain. Doesn't it? If the chimera were to have sex and bear a child, though, it would have the genetic identity of the parent's body, not its head.

In Thomas Mann's 1959 novel The Transposed Heads, which is based on a traditional Indian folk tale, the two male protagonists behead themselves, and their heads are magically reattached, but to the other's body. One man's wife, Sita, subsequently has difficulty knowing which to take as her husband: the head or the heart.

Canavero does convey only the most benevolent of intentions, writing of the potential to use head transplants in patients with "horrible conditions without a hint of hope of improvement [that] cannot be relegated to the dark corner of medicine." He mentions tetraplegic patients, those with multi-organ failure, or intractable cancer that involves much of the body but not the head. The first patient to undergo head transplantation, though, "should be someone, probably young, suffering from a condition leaving the brain and mind intact while devastating the body, for instance, but by no means exclusively, progressive muscular dystrophies or even several genetic and metabolic disorders of youth."

Silver remains a non-believer. Earlier this year his team successfully fixed the spinal cords of rats that had them completely severed. Others have done it for dogs and pigs. When Danielle Elliot at CBS asked Silver about Canavero's proclamation that all of this could be done in humans, though, he laughed. "It's light years away from what they're talking about." Silver's experiments involved a clean cut to the spinal cord, and nothing but the spinal cord, and not involving a second animal. He told CBS, "To sever a head and even contemplate the possibility of gluing axons back properly across the lesion to their neighbors is pure and utter fantasy in my opinion ... Just to do the experiments is unethical."

Presented by

James Hamblin, MD, is a senior editor at The Atlantic. He writes the health column for the monthly magazine and hosts the video series If Our Bodies Could Talk.

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