杏吧原创

THERE鈥橲 a story doing the rounds about Sergio Canavero. One day, as a 9-year-old, he sought refuge from playground bullies in the pages of a superhero comic. 鈥淚 myself have surgically rejoined severed neurolinkages,鈥� declares Dr Strange, in the November 1976 issue of Marvel Team-Up. The brilliant but egotistical fictional surgeon continues: 鈥淭he nerve endings have been fused 鈥� the healing process begun.鈥� The young Canavero was captivated. Four decades on, he announced plans for the world鈥檚 first human head transplant鈥�

If this story sounds a little too neat to be true, that鈥檚 because it probably is. The Italian neurosurgeon, who describes himself as a 鈥渂ig comics nut鈥�, says he didn鈥檛 read that issue until adulthood. He claims the publication that reported the comic as inspiration for his work was mistaken.

Whatever the true picture, Canavero does not flinch at comparisons with fictional characters. Quite the opposite, he encourages them. He sees a lot of himself in Peter Parker 鈥� aka Spider-Man 鈥� who, as a nerdy student, was bullied by classmates and shunned by girls. After dismissing the Marvel Team-Up story, he sends me PDFs of the relevant comic frames, along with a screen grab of a doctor discussing fusing severed spinal cords from the 2016 film Dr Strange. Canavero says he was the inspiration for that scene. 鈥淚 have good ties with Hollywood and I can tell you for a fact that line came out of my book.鈥�

Since 2013 Canavero has been promoting the idea that head transplants 鈥� better understood as body transplants 鈥� are feasible, and should be offered to people with conditions involving muscular and nerve degeneration, for example. The response, in the West in particular, has ranged from disbelief and opposition to the questioning of his motives and scientific credibility.

鈥楻eady to roll鈥�

Unperturbed, two years ago Canavero agreed to help set up a team to carry out the procedure in China, working with Xiao-Ping Ren, an orthopaedic surgeon at Harbin Medical University who helped with one of the first hand transplants, in 1999. At the time of writing, Canavero claims several papers supporting the feasibility of human head transplantation will soon be published, that an operation could go ahead by the end of this year and that a 鈥済ame-changing鈥� announcement is imminent in China.

鈥淭he team in China is ready to roll,鈥� says Canavero, who worked as a neurosurgeon at Turin University Hospital in Italy until 2015. 鈥淎ll the preclinical and clinical studies have been conducted successfully.鈥� Much of this work will not be published, he says, but insists that what will be published 鈥渨ill be more than enough to show where China stands鈥�. The precise date of a transplant attempt depends on finding a donor of the right height, build and complexion, he says. 鈥淭he problem now is only organisational.鈥�

Canavero calls his proposed procedure the head anastomosis venture, or HEAVEN. He says it would begin by cooling the donor body and recipient鈥檚 head to delay tissue death. The heads would be detached and the donor body attached to the recipient鈥檚 head. Polyethylene glycol (PEG) would help fuse the cords by encouraging the fat in adjoining cells to mesh together. Stimulation from implanted electrodes would help to strengthen nerve connections. That鈥檚 the plan, anyway.

Canavero doesn鈥檛 agree with mainstream medical thinking that movement below the neck depends primarily on bundles of long-range nerve fibres in the spinal cord. Inspired by research dating back to the first half of the 20th century, he believes a person undergoing a head transplant could regain close to full movement after those nerves have been severed, thanks to the regeneration and fusing of short-range nerve fibres that are part of an additional, interconnected network of cells in the spinal cord called propriospinal neurons. Think of a fire brigade passing buckets of water along a line if their main hose has been severed.

C-Yoon Kim of Konkuk University in Seoul, South Korea, is part of Canavero鈥檚 group and has led animal experiments that use PEG to encourage regrowth of severed spinal cords. In a , Kim claimed that five of eight mice whose spinal cords were severed and treated with PEG regained some movement after four weeks, while none of the mice in the control group did. This year, Ren鈥檚 team reported a similar experiment, claiming that five of nine PEG-treated mice 鈥溾��. And in a widely criticised experiment in 2016, Kim鈥檚 team at the neck regained 90 per cent of its motor function within three weeks, with the aid of PEG. Critics pointed out there was no control in the study and no data proving the degree of damage to the dog鈥檚 spinal cord.

Ren and Canavero also published a paper in the journal Surgery, in which they claimed to have carried out a monkey head transplant, described as successful on the basis of 鈥溾��. 鈥淭here鈥檚 not such a big difference between animals and humans 鈥� the basic functions, physiology and the possibility of recovery are the same,鈥� says Kim. 鈥淚 believe we will succeed in the human operation in the near future.鈥�

Many scientists refuse to comment on the record about Canavero鈥檚 work, often because they have serious doubts about the published papers. Most who have commented say a successful human head transplant is far from feasible. 鈥淭here is no way that I know of, that has been published, that would allow fusion of the spinal cord,鈥� says Jos茅 Oberholzer, director of the Charles O. Stickler Transplant Center at the University of Virginia, Charlottesville. 鈥淭he rest, including reconnecting the blood vessels and the airways, is theoretically possible but very challenging, and carries major risks of complications from leaks and immune system rejection.鈥�

Others have used words such as 鈥渃harlatan鈥� and 鈥渟elf-promoter鈥�. Canavero dismisses his critics as too short-sighted to share his vision. 鈥淭he history of science is full of people being called nuts and then going on to prove their point,鈥� he says. 鈥淭he academe tried to destroy me, they tried everything to stop me, to slander me, but they failed. It鈥檚 no problem: I practice ju-jitsu and the mindset is let your enemy come to you, and then exploit his momentum to bring him to the ground.鈥�

Canavero claims the media has failed to report his work properly. And in his efforts to seek favourable coverage he tries tactics more often employed by spin doctors. For example, he offers me early 鈥渆xclusive鈥� early access to as-yet unpublished papers if I interview specified people, avoid others who have criticised his work, show him my article in advance and we agree 鈥渕utually acceptable鈥� terms. I politely refuse his offer.

Canavero, now 52, does not want to talk about his early years, but the few details he does give me could help explain why he self-identifies as an outsider. He describes growing up as an only child in a poor neighbourhood of Turin in a 鈥渄ifficult family situation鈥�. He says he was bullied by classmates because he was bright, which made him resentful. 鈥淚鈥檓 a loner, I鈥檓 a maverick,鈥� he says. 鈥淚 believe the initial suffering when I was a child had a lot to do with it.鈥�

When I ask Canavero about what motivates him, he does not mention helping patients. 鈥淭he goal is to understand the nature of consciousness and to answer the basic question of what happens when we die. I believe consciousness is not generated in the brain, which merely acts as a filter.鈥�

鈥淚 believe consciousness is not generated in the brain, which is merely a filter鈥�

Canavero believes the mind and body are separate and that so-called near-death experiences support this view. He wants to show that those who dismiss these reports as hallucinations are wrong.

鈥淢y idea is to generate near-death experiences,鈥� he says. 鈥淲hen you detach a head or a brain, the brain is cooled so there is no electrical activity and no blood flow, that brain is clinically dead. Patients will tell us about their near-death experiences and we will know for a fact that they could not have been generated by the dying brain.鈥� That will change how we consider ourselves as human creatures, he says. 鈥淭hat will trigger the greatest revolution ever. That is the final goal, the real goal.鈥�

鈥淥f course, there is another goal,鈥� he continues, 鈥渨hich is life extension鈥�. The book Canavero says inspired Hollywood鈥檚 scriptwriters is his 2014 work Head Transplantation and the Quest for Immortality, in which he predicted the transfer of human brains to artificial bodies 鈥減ossibly by 2025鈥�. He also claims to be assembling a team to perform a human brain transplant, and that this procedure will happen within three years.

Many believe the chances are remote that Canavero鈥檚 aspirations will become reality any time soon. 鈥淭he complexity of what he is proposing is enormous,鈥� says neurophysiologist Peter Ellaway, an emeritus professor at Imperial College London. 鈥淚 think his aims are almost in the realm of science fiction. In my opinion this will never happen.鈥�

Others fear indirect downsides to Canavero鈥檚 actions, even if no head transplant is ever attempted. 鈥淏eing a transplant donor is one of the very few purely altruistic things a human can do,鈥� says Oberholzer. 鈥淲hen someone wants to be the hero by putting on this audacious show, people may be put off donating their organs or bodies if they think doctors are going to do something crazy like this.鈥�

Superheroes aren鈥檛 the only fictional characters Canavero likens himself to. Victor Frankenstein is another. When I confess I haven鈥檛 read Mary Shelley鈥檚 Frankenstein, he emails me quotes from the novel. Such as: 鈥淲hence, I often asked myself, did the principle of life proceed? [鈥�] I was surprised, that among so many men of genius who had directed their inquiries towards the same science, that I alone should be reserved to discover so astonishing a secret.鈥�

Dr Strange-meets-Victor Frankenstein, with a dash of Spider-Man, might make for an entertaining science fiction character. And Canavero certainly loves to entertain, playing on his renegade scientist image. 鈥淎re you sitting tight?鈥� he asks, in full showman mode, at the start of a recording of his . 鈥淚鈥檓 about to give you one hell of a ride.鈥� He smiles at his audience鈥檚 nervous laughter. But fast-forward to today, with the scene shifting from the stage to the operating theatre, and the Canavero carnival risks turning into a horror show. With real-life patients at stake, no one鈥檚 laughing any more.

This article appeared in print under the headline 鈥淒r Strange meets Dr Frankenstein鈥�