Canavero is once more in the “head”lines. This time, at least, I saw it coming. He emailed me a sort of press-release for his latest article, where he claims to have moved on from head transplant. Not very far, though. Now he will transplant brains. In case you need it, some history on this weird little story:

In 2013, an unusual paper appeared in Surgical Neurology International, a peer-reviewed medical journal based in the United States. The piece had been written by a surgeon named Sergio Canavero, of the Turin Advanced Neuromodulation Group in Italy, and it boasted an unusual title: HEAVEN, or the “head anastomosis [connection] venture.” It suggested a radical surgery protocol, with “two teams, working in concert, would make deep incisions around each patient’s neck, carefully separating all the anatomical structures to expose the carotid and vertebral arteries, jugular veins and spine.” Then, one patient’s head would be transplanted onto another patient’s body.

It sounds unreal. And to be fair, the TEDx talk Canavero gave not long after was flagged by the organization. It nonetheless earned him half a million views, as well as epithets; critics called him “delusional,” a “James Bond villain,” and of course “Dr. Frankenstein.” The 52-year-old Italian surgeon stepped onto the stage with a shaved head, turtleneck and jeans, like a surgical Steve Jobs. “All the experts know is wrong,” he announced. “Sit tight, I’m about to give you one hell of a ride.”

Canavero ranges from promises of spinal fusing to the thinly veiled suggestion that billionaires in Russia could live forever (oh my). He swaggers with unmistakable bravado, proudly asserts his authorship of a book on “female seduction,” doesn’t eat beef, practices jujitsu and likes to talk about his six-pack, (among other things). But he also successfully introduced cortical brain stimulation for Parkinson’s (a process by which motor nerves are magnetically stimulated deep in the brain), has written textbooks on dysfunction of the central nervous system, and has over 100 peer reviewed publications. And he’s convinced that head transplant will work. Mostly because it’s already been done—in primates, by Dr. White (subject of my last book).

If you’re new to this head transplant stuff, it happened in 1971, in a small Brain Research Lab in Cleveland, Ohio. A portly, balding neurosurgeon in black frame glasses (and smoking a pipe all the while) transplanted the head of one monkey onto the body of another. And it lived. It woke in its new body, recognized the doctors, and tried to bite one of them. In fact, the very words Canavero uses to describe the surgery in his own paper come from one published by the lead surgeon, Robert White, and his team. There were diagrams, plans, protocol, and even film: this is how you take a head off. This is how you put it back on.

The whole thing leaves a LOT of questions unanswered, and the monkeys lived for only 9 days. Which means the head was alive, but was the monkey technically alive? Where in this strange composite of brain and body, mind and self, do “we” live? I titled it after White’s two nicknames in life: Mr. Humble and Dr. Butcher. Like Canavero, he was sometimes called Frankenstein, too. (It happened to be one of White’s favorite books.)

But let’s face facts. This isn’t exactly a practical surgery. You can’t reconnect the spinal cord. No matter what, the subject would not be able to use the new body. But Canavero has always waived that sort of thing to one side.

His first goal was to reattach a head using a Polyethylene Glycol “brain glue” electrical stimulus to (supposedly) help establish communication across the severed spinal cord. This has not yet been proven effective, but even without it, re-attachment would be more labored than in White’s monkey surgeries: as all muscle tissues and nerves would have to be reknit together. White hadn’t bothered; it didn’t matter much without the spinal cord to direct nerve impulses. And even Canavero doesn’t expect the nerves and muscles to work again straight away. The body must be tethered to life support until signs of motor recovery appear.

Every few years, however, he suggests they are on the verge of this breakthrough. Here cometh the next. Imagine me, blythely checking my inbox and not recognizing Sergio’s address; I face-planted into two gruesome looking photographs and the following announcement:

WHOLE BRAIN TRANSPLANTATION AND REJUVENATION FEASIBLE US AND ITALIAN SCIENTISTS SAY

The failure of drug, cellular and genetic approaches as “fountains of youth” – as pursued by multiple companies- casts a pall on future prospects of extending human life by restoring the aged body to youthful levels.

Now, two scientists - Prof Jean Hebert, Department of Neuroscience and Genetics, Albert Einstein College of Medicine, New York and Prof Sergio Canavero, HEAVEN/GEMINI Collaborative Group - propose a radical approach that promises radical rejuvenation. Whole Brain Transplantation (WBT)– widely considered technically impossible- is now reported to be surgically feasible, after an initial round of animal and cadaveric experiments.

I don’t have Dr. Canavero’s permission, so won’t share those particular photos. He has a few more in his editorial here, where he admits that modern science disagrees with his premise. Namely, brain transplant won’t work because:

You can’t extract the brain proper from the dura mater, given the intimate relationship between the brain’s venous and cerebrospinal fluid (CSF) outflow and the dural cranial sinuses
You can’t resuture the internal carotid and vertebral arteries (ICAs/VAs) and the internal jugular veins (IJV) once the brain is laid on the donor’s skull base
We don’t have the technology to functionally reconnect the 12 pairs of cranial nerves

Now, Dr. White solved a few of the venous problems—big air quotes around “solved. He painstakingly replaced the bloodflow from the monkey’s body with that of another monkey. But for isolated brains, White never intended putting them back in bodies. He let them live outside skulls, for the purpose of study, until they shut down. (One exception—he put a brain in a dog’s neck, attached to the arteries. It did quite well in there, apparnetly).

Canavero, on the other hand, wants to put the whole brain in a whole new body. It’s his solution to aging, by the way, by “moving an old brain into a young […] body,” in the hopes that all that youthfulness will transfer to the brain itself. (Partly, this is true—or at least White agreed that young blood and hormones would affect the older brain.) But Canavero has a solution for the aging brain, too. Not in the essay, but in his email to me, he suggested that we should “progressively [add] young engineered tissue while neurosurgically removing old tissue over time,” that is, just take out old bits and let neuroplasticity do the rest. (The old “if you replace all the planks of the ship is it still the same ship” problem remains…)

Actually, there are some other hurdles. Where are we to get these new bodies? Canavero writes in the paper that it would be best to use a "nonsentient clone." Yes. A clone. I have a bunch to say about THAT too, incidentally, as I also research cloning… (technically, it’s not impossible to clone a person, but getting an adult-sized non-sentient one is beyond both our ethics and our tech, I’m afraid. Also, maybe watch The Island.)

But for argument’s sake, let’s assume we have sci-fi answers to the body issue. There are other no-nos. Brains are not just sloshing about up there. They are connected to everything (blood vessels and nerves). You CAN get a brain out still ‘alive’ but you can’t just stick it back in and expect the connections to come back online. THEY DON’T. Canavero’s solution would be to transplant the brain while still inside the dural sac, the thick membrane that surrounds the brain and spinal cord, and to quickly revascularize via sutureless vascular anastomosis. That still doesn’t fix severed nerves. For that, Canavero wants to use neural fusion. What is that? Well, it relies on so-called fusogens, like—yup: PolyEthylene Glycol (PEG). He claims:

Within minutes, successful PEG-fusion restores gross anatomical and electrophysiological continuity across severed nerves. At 6 weeks, many fused axons are morphologically similar to intact axons.

Again. It’s more complicated than that. The only real successes I’ve encountered with PEG relate to helping semi-paralysed dogs recover motion (but the nerves are damaged, not severed). Canavero supplied several cited works where fusogens have in fact re-connected nerves. They are all written or co-written by, well, Sergio Canavero. I have yet to see an external research group come to the same sanguine conclusions. And that’s why I didn’t actually follow up and write about this before. I honestly didn’t think anyone would. But he’d made it into an IFLScience piece (you can read that here). It ends with a quote by Sergio, "With appropriate funding, a long-held dream may finally come true”—and the editorial note: “That dream being a nightmarish future where clones are grown in a brain-dead state, only to have their brains scooped out when their original decides they are getting on a bit.”

You might be wondering why Sergio sends me emails. He has read my book; I only know this because he sent a note to a neurologist we both know saying he was surprised “a woman” wrote it. Maybe he was trying to impress? Or perhaps he hoped I’d possibly write about his new ideas, as I do some science journalism for WIRED, SciAm. I declined. And yet here we are. I mean, as soon as it popped up in headlines, everyone and their second cousins sent me links accompanied by DID U SEE THIS?

For what it’s worth, my take-away is this: No, no, nope. Not for the sci-fi horror reasons of the quote above (though, hey, valid). But because to perform a single surgery would be so unbelievably expensive (not to menion the billions necessary to create system/apparatus/research to support it’s viability in the first place) that the only people who would benefit would be billionairs like Elon Musk or Jeff Bezos. We CANNOT do a brain transplant now, and we had better never spend so much on a procedure that would benefit so few people. How about socialized medicine, free healthcare, and accessibility to all first?

Then again, Canavero did get head transplant (and himself) in the news again. Which may have been the point. In which case—well-played, Sergio. Well-played.

[Image with permission from the Dr. White Archive]

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