>> host: mr. teresi nice to meet you. this book, "the undead," and you have written others about physics and the history of science and even a book on the brain, how did you come to write about organ transplantation and the in depth determination? >> guest: i wasn't drawn to organ translation at all. i was drawn to death and the reason that is i was watching carl fagin several years ago in the 1990s and he announced he

had this, his second or third own marrow transplant because of a cancerous disease he had and it did save his life. he had been saved by science. i said wow mock, he is going to die. i said why do you think? he looks bad and second this is the denial speech. she had cancer and she was since cancer support groups and this is the speech you get out of people who are pronounced terminal and they are in denial. it's a classic denial speech. the show finished and they announced this had been a rerun, the viet died or good been taped a couple of months earlier and the man who advance saved by science was dead. he said an interesting thing in the show, which was rose asked him what do you think death is? is at the light at the end of the table? he said no no, he stopped at that. he said that this along dreamless sleep according to shakespeare. i thought that can't possibly

be. sleep is kind of pleasant. you are breathing in your heart is reading and your narrow chemical processes are going on. it's invigorating. this is one of the greatest skeptics of our age and he thinks that he is just going to be sleeping and he is not sleeping. he is going to be gone. what i wanted to do was to try to find out what science says about death and what it was and i started with a simple question which is how do we know when we are dead? that ends up being the whole book because that's an impossible question. >> host: it's a very difficult question and i imagine particularly frustrating for someone whose whole professional life has been as a science writer and someone again it was written a book about topics like physics where at least physics used to be pretty straightforward and granted when you get into quantum theories it's more in certain but i

wanted to just start off before we get back to the great determination of death, which is the essence of the book, is a little bit more about you and your career. tell us about omni magazine magazine magazine and science digest and other places you have worked. >> guest: i have to say i've really never had a career. i'm a blue-collar guy who had a series of dates and followed whatever was happening and whoever would hire me and adding a new job whenever i was fired which was recently. i grew up in de soto where some strange magazines were created in the 30s, something called modern mechanics. their role these futuristic magazines that came out of the world's fair of that era, 1932 and during the depression when people were so depressed financially and emotionally and these magazines talked talk about this great future.

i was inspired by that and inspired by sputnik when the country went through a vast educational transformation where the country was looking for people who are good at math and might somehow beat the russians in space and i have the math scores but not the real talent for it. so i never knit did do science but when i got out of college i was offered a job at a science magazine and i took it. it's a wonderful thing to write about. >> host: you went from there to co-authoring a book which was a bestseller in 1993, right? >> guest: somewhere in there but i had a co-author. that was a bit of a -- host guy was going to ask you how did you come to collaborate with him and what was it like working with a nobel prize winner? >> guest: i was -- he was very funny. he was always a big draw at physics meetings because he was funny and i suggested we should

do a book together and we did. a very good man to work with and brilliant but in a really common man kind of way. >> host: you mention humor and in fact some other of the reviews of that book said it was the funniest book about physics ever written. >> host: that is not very high bar. >> host: it's a funny book about death. the review said well, what is the role of humor in your writing or the science writing in general? >> guest: i think for many people it should be a role. we were criticized for being funny. we brought down the field. i don't believe that. it's just a quirk of mine. i don't think science has to be funny or shouldn't be funny the way i happen to right. write. >> host: and it was just striking that both books, humor

was remarked upon in both of them. in writing this book, one of the themes that seems to pervade is it awakened in you or maybe reawakened it seems like a fair amount of anxiety about death. say a little bit about that. >> guest: the first things, i really didn't think this out. if you think about you it you can't really study death totally scientifically because scientists look at the empirical, mostly experiments, but death part of the definition of death is that it's irreversible and it's forever so in a person is dead they can't come back and tell you, it was like this. it's not like going to philadelphia. all come back and tell you about it. and if someone does come back, then they were not dead because that is part of the definition. so i should have thought that out. but what we reduced the sword of

netherlands, like nether worlds like rain death and persistent lot didn't syndrome. it was creepy. it was creepy reading about it and interviewing people about it. and so i started imagining myself in some of these states at times, waking up in the morning sort of terrified and trying to tell people i'm really alive in here, you know? like i was suffocating. i was very influenced by the book called the bell jar and the butterfly by john dominique debow be who had the locked in syndrome where you are totally conscience and you have your mental facilities but your brainstem is paralyzed. i had that book and i bought the book and it sat around three or four months before his brave enough to read it but it's really beautiful. that there was this incredible person inside this sort of shell

of a body. >> host: yeah. i remember learning about that in medical school when we had a patient. it is frightening. >> guest: you had a patient? >> host: yeah, with that. >> guest: what was it like? >> host: you can't help imagine what this think would be like it sounds terrifying. back to you. you worked in a hospice for a bit. you don't continue to do that. was that part of the research for the book? >> guest: not really. i was always interested and it wasn't totally relevant to the book and i didn't see the relevance to the bug. it's just that i wanted to do it. hospice opened up a block and a half from the house so i went down there and they were happy to have me, because i was a man and most of the counselors are women. out of 60 counselors only two of us were mail.

i have always been interested in death and i wanted to see what people were like. >> host: what were they like? >> guest: they actually have the spirit shall counselor, a paid person who is not religious but spiritual and because you were not allowed to challenge anyone's religious beliefs. she made the comment once that for most people, they die if they live. and so, it was lovely being with these people but at the same time you could see whatever insecurities they had. they took them with them to the grave. if they were shy, they would be shy and if they were afraid of opposing authorities they would still be timid around the director. they could be bullied by staff in several ways and bullied at the volunteers in several ways. and so who you are is how you die is what i learned. there were moments. there were moments.

i did things i was not supposed to do. like you are not supposed to challenge people and i had this one patient, we called him best for lack of a better name and if was always complaining about his wife who had left him and was not coming to see him in hospice. he was gone every time. finally i said look, you don't have much time left. do you really want to go to the grave complaining about this woman? he said what do you suggest? i said i suggest you write a letter to her and i will help you. he said i don't know how to write it. you will dictated and you will think of all the great things about her and write them down. you can either send it or not funded but it might change her attitude if you told me all of these great things because i haven't heard anything great about her. we did and it took a couple of

weeks. we never finished it because she came back to him, magically. she appeared one day at hospice and became the devoted wife for the last few weeks of his life. i don't think there is anything going on, but later when he died, she found the letter that he had dictated to me among his belongings and called to say thank you very much because he had never express this to her in his lifetime. so it was against the rules but i thought it was kind of cool to do. >> host: it sounds very moving. now, denial of death, that is a big theme in this book. >> guest: yeah. >> host: tell me about it. you have a whole chapter, which i found so interesting about how the universal nightmare of courses being buried alive and

how so many cultures have different ways of trying to prevent that from happening by trying to, building and mechanisms to distinguish the living from the dead. over the millennia and across, over history and across cultures. tell us some of the more memorable examples. >> guest: only in the 18th century was death medicalized as they say where doctors became in charge of who is dead or who is was is a life. up then it was like, you are at doctor but your own people decided when your next of kin is dead. the egyptians for example, the quest was to find was there a singular organ that when it was gone, meant the whole organ was gone, the controlling organism of the body or was there a set

of particular behaviors that would tell you this person is definitely gone? egyptians for example had no use for the brain. when they made mommy say mummies they hollowed out the skull and threw it away. they were just like, what is it? they were much more concerned with the. the greeks would cut off a finger and that was a violent thing to do in a figure that would wake you up. the slavs and -- they would wash the body, make a lot of noise and on the third day they would sing slavic folk songs. if you don't stir from those you are dead and if they got no reaction after the singing, they would bury them. the pope has a very famous way of determining the dead and that is with the camera lingo which is a cardinal post. the pope handpicks this person and this person decides when the pope is dead.

he hits him three times in the head with a silver hammer and calls out his baptismal name three times, which is carryover from the rumors -- the romans. although even today the pope is an dead until he says he is dead. the doctors may pronounce death but he has the final say. it's a good system because one, he is someone close to the pope and two when he declares the pope dead, his job is over. he is not likely to declare death prematurely. the gold standard through the centuries, we really are convinced when this happens the guy is dead is putrefaction, when you smell to high heaven and the signal is the cell because the cell is the kind of an atom of life. when it implodes and gushes out, then you are probably dead and all your cells are dead. but if you quit -- kept

switching from a heart to the lungs to the brain and somewhere during the renaissance when we can see the brain come to a forefront as people people to determine in oregon. and i think one thing my book is going to because i'm not qualified is to figure out why this happened you need a interdisciplinary approach. i think therefore i am. it's shakespeare writing we are the crown of creation. we are the noblest of peace that man is somehow different from other animals. so we started to have a definition of death that was lower for humans because so much more was expected. brilliant minds and we are not dumb animals and in there for when her mind goes and when our brain goes then we are gone because then we become like another animal.

for examples with brain death no one ever talks about the brain death of a dog. the brain is considered unimportant in dogs and it's not really scientific to say theirs is one species that is different. it's what we believe perhaps but its scientific. that is what we have come to today. we have a lower standard for death in the history of man with brain death. >> host: in some ways the most intense. another conundrum is as you now when one person becomes a body. >> guest: yeah and what i found and you mentioned i covered physics, it's true i never heard particle physicist talking about their feelings. i feel that this is a proton. no one ever says that. they have test for it and they are physical test. i feel that was an electron. no and the medical profession

talks very openly about its feelings. we feel that these reflexes and movements and brain dead people when they're being harvested for their organ we feel that is not pain. be feel that is not important as opposed to other sciences where is well we did a pet scan on this person and while they were flailing around we showed no chemical or biochemical activity in the brain. we are not doing that so we are just going on people's feelings. >> host: will get into that a little late that is actually a very controversial aspect of the book. we will certainly get to that. i wanted to move into technology because as you know, new technology is probably in all areas but especially medicine, takes concepts and practices that seem to be settled and in the case of organ donation and

death determination. i understand that was really are overarching interest in the organs are secondary but death technology happens to be the ventilator. >> guest: yes, yes, yes and it starts with william harvey, the english doctor who chartered the circulatory system. he was wondering about what is the pentacle organ and he chopped off the head of a rooster. he had his own ventilator which was a -- and he stuck it in the windpipe and pushed air into the rooster's lungs. it revived the rooster. he could keep this rooster live without it. in 1903, cushing, an american surgeon, thought is a person with fatal brain damage, are they alive or dead?

he gave his patients artificial respiration, old-fashioned, push on the back, elbows up artificial respiration and he was able to keep the patient alive for 23 days this way. the heart continued to. >> while he gave them artificial restoration and in the 1950's there was a polio epidemic. the iron lung is basically a proto- ventilator. it's a better ventilator than the ventilator we had later. there were entire floors of hospitals devoted to iron lung's and kids who would otherwise die without them. the ventilator we know today is less bulky mechanism that came about and we had all those people. at that time, not today but at that time they were crowded at the icu's so this pushed a group

of people to form the harvard addicott -- ad hoc committee on the brain-dead. you came up with this new definition of debt. >> host: we will come back to that as well but right now who are the undead, the title of your book. >> guest: who are the undead? it? it would include the brain-dead and people in it resistant vegetative state and it would include some minimally conscious people and it would include those that are having a near-death experience. those are the people i looked into that get as close to death as you can get without dying and of course brain-dead people have not gotten the rules of their data and that is where we disagree. >> host: how do they make that determination? >> guest: which one? brain death? the original harvard paper in

1960's that there should be no reflexes and no movements and breathing, whether person could breathe on his own would be decided by an apnea test. is called the apnea test which the ventilator is turned off and the patient can breathe on his own. if he can't come he's, he's dead and then you repeat all of the test anywhere from two hours to 12 hours later. the clinical side of the test, looking for reflexes and movement, icewater in ears for a reaction, touching the cornea with a q-tip, putting a flashlight and turning the head sideways looking for dolls eyes to see if the eyes will follow it. if you are alive it takes a while for your eyes to adjust to the movement but if they are dolls eyes it means they go directly sideways when you move the head sideways. is a very short exam.

i just noted that from the time of the transcript we had, there is the apnea test. originally the harvard committee said there should be confirmatory test because these tests only test the brainstem, the stalk at the base of the brain. it does not test the cortex which most of us think of as our brain. is where we think and where we feel and where we feel pain and where we feel pleasure and where we see things and hear things. so they should take an eeg of the patient to see if there any are any brainwaves. that is the terminator. these tests decrease, not increasing as more technology has been developed that has not been used. for example, had scans were used in england. pbs versus a vegetative state

person to see if they're really unconscious. this brainstem unlike the rain that person is working. >> host: like terri schiavo? >> guest:? >> guest: yes, probably not the -- but she probably was not there from what the autopsy was telling us. the brainstem is functioning to breathe on your own but the rest of the brain is gone and you have no consciousness. it's estimated there are something like 100,000 people in pbs in this country alone and the tests for pbs were devised in the 1970s by man named fred he said you don't need to allergy and you don't need equipment. a lot of it had to do with the examination of the eyes and reflexes. when they put pet scans on these people in england, that doctor

named adrian owen, he found 43% of them are unconscious. these are people we have judged the unconscious and some of them have been in this thing for four years. he devised ways of communicating with them through hand busters. for years the families of these patients have said you know, our son or my husband or whatever seems very aware when people he likes come into the room. he lightens up and if there is a doctor he likes or doctor he doesn't like he can you can tell from his expression. this had all been pooh-poohed. they saw the patient more than he did. with this technology they found were conscious and another thing is conscious mri. it's ongoing lack of film almost and that can be -- detect consciousness but we are not using this technology to ferret

out the people who are not really brain-dead. >> host: my impression is that minimally conscious state is certainly different from the persistent vegetative state. but you have taken that distinction into account. >> guest: oh yeah. it's much less closer to death in pbs. >> host: and people often come out of that and that is my understanding of where an mri has been used where people are asked, imagine yourself rained dead enders activity. this has introduced, technology introducing a holt and other wrinkle into these determinations. >> guest: you should know that this technology is not used for brain death. >> host: it's to test brain

death -- >> guest: they were going back to ged's. that is very important point and i know it said a lot in the book. several things you mentioned, this is too important to be left to the physicians, this determination. if i'm understanding you correctly, what kind of a -- do you feel would be more appropriate? >> guest: well i think it was phil brock who said you are on an airplane and the captain comes over the intercom and says we have an emergency and is there a doctor on the plane? he never here is there a writer on the plane? the wing is on fire and we go back to our drink. i don't have any practical advice about what to do about it. you know i am not a wonk.

and a plan i would come up with would be so fatally flawed it would be worthless so i don't know what to do about it except to simply point out for most of human history, people have not lifted up left it up to the doctors. what we have got now, since 1981 there was a law passed, uniform determination of death and it is now law and all 50 states. what it says is there are two forms of death, regular old heart and lung death and there is brain-dead and they are both legitimate and there is only one kind of person who decides who is dead and that is a doctor. and that doctor cannot he faulted. he cannot be arrested or judged criminally for saying someone who is alive is actually dead and he cannot be sued civilly in court.

not only have doctors totally taken over this area but they have no responsibility either. >> host: they have responsibility, that is for sure. within the last two years in california, a surgeon who was examined for potentially prematurely taking organs from a patient who might not have been fully dead. august do you wrote this book before that. >> guest: was he arrested? >> host: he was investigated that people take it very seriously because that is the point. >> guest: was the patient declared dead? >> host: yes, well this was a case of circulatory death for obtaining organs and actually can you say more about the general requirements for

obtaining organs or at least the official ones? ii know you are skeptical that these are often met, these congressional requirements. >> guest: well, we have what is called the dead donor rule which is universal as you know. there are live donors but those -- that is the only organ we get from live donors. if you have two kidneys you can get along without one. everything else comes with a dead donor in there are two kinds of dead donors. one is the brain-dead that we have spoken of and beginning in the last 15 years we start taking organs more often from those who died unconventionally, heart and lung and some doctors think that is even scarier than the brain-dead because you have to wait for the person's heart to stop. then immediately transplanted before it spoils it.

there is a very short time window and all sorts of gimmicks are used such as -- sort of like a blood pressure cuff are put around the donor to keep the blood pressure going after the heart stops, to keep the organs artificially perfused. sometimes chemicals are injected and in waiting for a man to have a heart attack, a man or a woman to have a heart attack, and what happened in the world world, he tried to resuscitate them. they don't try and in some ways it's called the two-minute drill because after the heart stops you wait two minutes and then the harvest. some people wake -- wait three minutes and some people wait five minutes but in any case

many hearts have started long after five minutes. >> host: but the family is to give permission, correct? >> guest: well, yes and no. it's an interesting point. that is the debate. with the new laws where you are checking it off as a donor on your driver's license, that is theoretically binding in all 50 states and the next of kin can say no we don't want this to happen. that doctors can still do it. they don't like to get the family puts in an objection. they worry about it and they try to quell the families fears but if you are used to the brain-dead type of donor and that is what you are thinking up when you are thinking at all, when you check off that box, are you thinking that you're going to go through this new process of what is called a nonmedia and heart cadaver where they are waiting for your heart to stop for the harvest you.

>> host: i believe they need to interview the family before they do that is my impression. >> guest: legal experts in the field think maybe they don't. that is the debate. did they really have to do that exist that might cut down on the number of organs they get. this is really not gerald. it is what christian bernard -- >> host: that was before 1958. >> guest: it was in 67 with the first heart transplant in and the problem there was that, think her name was darnell, i think denise ann darnell. she was a donor and her heart would not stop. they had a recipient waiting in the heart just kept beating. barnhardt's rather years later said they injected some potassium to temporarily stop

the heart so they could declare her dead and remove the heart. and put it in someone else. that is illegal today. it's not part of standard practice today. you have two different teams. you have to have a separate team that declares death and a separate team that does transplant. >> host: that is one of the people who are reluctant to sign the owner -- organ donor card, that is one of the reasons. the doctors are going to try to save me if they know i'm a donor. >> guest: is actually the opposite because they want you healthy. you may get the best care in your life if they think you're a donor and that is another controversy. can you give these patients drugs that are only meant to keep their organs healthy but have no benefit to the patient? in other words are you already treating them before you declare brain death or are you treating them as a patient? of course after you have been declared dead, you will get

referred treatment because frankly, people are violent chick leah life in my opinion and the opinion of many people because they hook them back up to the ventilator and their heart continues to beat. they can get infections. their system will fight the infection. they have heart attacks and they can be resuscitated. you will see crash carts going down hallways to resuscitate a dead person. the language in the journal is very interesting because one of them warns people, the nurses taking care of what they call beating heart cadavers and brain-dead waiting for harvest, they say be careful because diabetes is -- diabetes insipidus is one of the competitions of death. usually when people die you don't worry about competitions,

and there was a 2008 white paper report from a bioethics that said that some dead people are less healthy than others. to me death should be minor it. there shouldn't be healthy dead people and less healthy dead people. they should all just be dead. >> host: that is, when a person is declared brain dead, just to go over this, the cortes you said is the consciousness, the engine of consciousness and perception and pain and what makes us as human, recognizably human to think and feel and then there's the brainstem which controls the breathing and other basic functions and those reflexes. as you said those are tested in

brain death determination, but they can be, like an eeg for example. do you still believe they should be used? i? i am under the oppression -- impression they should so be used. >> guest: it is prone to artifact meaning artificial waves. there is a lot of equipment in the hospital that may be picking that up. but, you have the other results too where you see an almost flat or in wait for the person is alive. they put them on living people and 10%, with flat brainwave. it's not a good test. airwaves in the interior of the brain that is not going to be picked up so it's not a very good test but we have run test. the thing is that the reason they don't do eeg's is because the clinical part of the harvard

criteria, the water in the air and a flashlight and the reflex and then the apnea test, those are called the clinical tests. they were based on no patience at all. they looked at no patience and they cited no medical papers, no scientific papers. they just found this out to meet this criteria. so there were two groups after that in the late sixties and 70s that decided to look at actual patients who had passed the clinical definition of death to see if they were truly dead by doing autopsies etc. and they found that doing autopsies on the brain-dead, the clinical criteria, many of them, their brains had not been so destructive. they did not look bad at all and when they put eegs on some of

them a remarkable number of i nordby but five out of nine in one case, five out of nine still had an eeg before they died and another was less scary, 17 out of 503 had rain waves after they were declared rain did. but it should be zero. >> host: actually you are making in the point and one that i wonder market and a little obscure in the book because i came away from the book and also that article you wrote in "the wall street journal" which was that an eeg was abandoned. irresponsibly. actually i have, just want to elaborate a tiny bit on what you just said about the fact that you can get false positives and

false negatives and that is the reason why they were abandoned. >> guest: i didn't see them saying that. they are saying that now. they are saying that after-the-fact that they said that in 1969 to 1972. we are getting dead people, you know and they were saying because because some of these tests, the test must be wrong. and they just threw it out. they didn't add something. you should add something. if you think the eeg is wrong than what you going to do to confirm that the upper brain is dead? and the decision was to do nothing. >> host: well, that actually, i guess that gets to the american academy of neurology and now, one of the questions i had was that 1968 was obviously decades ago and now brain death

determination is done somewhat differently as you say and the eeg is not part of it because there are so many situations. for example you can beyond medication that will give you what is called a flat line sometimes or even hypothermia, those kinds of things. >> guest: you could pass all the clinical tests for brain death also. >> host: and many other reasons and i got this from a textbook. the point is you know there are other reasons why someone could haven't eeg that is active or inactive. but 1968, much has happened and new technologies have come on line and the american academy of neurology really sets the standards for brain death determination and has issued guidelines in 1995 in 2010. i wonder if you could talk about

this mention in the book? >> guest: they are hardly different. as you say, there has been a lot of technology added since 1958, and the writers of that article were saying as new technology comes along, we hope it will be adopted. we are testing the cerebral cortex. so you tell me how much of that technology has been adopted. the aan? host of the american academy of neurologist. >> guest: first of all they are neurologist and the adjusting thing is the harvard community had -- not one, they were mostly neurologist, a couple of transplant people including joseph murray who won the nobel prize, and they came out and said brain death is exactly the same as heart and lung death but

they had no cardiologists to tell them that. they didn't let any cardiologists on the committee nor did they have any pulmonologist. they had no one who is an expert of either heart or lung to say oh yeses exactly the same because i don't think they believe that. they set up rigorous tests that they have now been a handing. the new test which is sort of -- it's rearranging deaths on the titanic. >> host: this academy of neurology, we can take it out of the round of the abstract and take it into the ultimate empirical dimension, which is has any patient who has ever been declared brain dead by the american academy of neurology standards, which are similar to what you have mentioned, without the eeg, have any of them ever

weighed in and it is 2010 report, they actually come is called evidence-based guidelines, an update on determining brain death. and the objective of this report specifically was to update your 1995 guidelines for several questions but the one that is relevant now are patients who filled the clinical criteria for brain death did they ever recover their logical functions and they did not look at the literature for over 13 years and they were finding it was no. to me that would be kind of the ultimate empirical test. >> guest: how are they going to recover when you take their organs out? >> host: this is brain death. this is brain death criteria. >> guest: but who are found brain-dead? >> host: he doesn't have to be -- not everyone certainly. you know and the conversion

rate, the what the conversion rate refers to is yeah, and you know correctly that people die by -- >> guest: are the same 1%? >> host: not all of those bequeathed their organs. the families are, depending on whether they know the person's wishes, are often likely not to donate. but i just bring that up as another perspective. >> guest: this has been said every year since 1968 that no one has ever survived brain death. this has been set every year. >> host: i am more reassured that we are saying it in 2010. >> guest: have you read shuman's report? they would quickly go to cardiopulmonary death, correct? that is a very. >> host: it depends how they

are managed in the hospital. .. >> guest: you go directly to your heart-stopping. >> host: okay, there's variation in time -- >> guest: variation? twenty years. >> host: what about the quality of life? just noting that was not something, and some of the folks who reviewed the book noticed, i mean, i know you can't cover everything in a book, i

appreciate that, but what about the quality of life? even if you are brain dead and you survive, let's say, 20 years on a respirator, i mean, that's an ethical question, again, about when one disconnects that. but, um, there is a quality of life dimension, and that's something that wondered if you had comments on it because it's not that much in the book. >> guest: there's nothing. i don't think there's anything on it. it wasn't my concern. i was trying to answer this question, when is a person dead. not should they be kept alive forever. i wasn't making any moral judgments on whether they should be kept alive forever. i don't think i would want to be. >> host: yeah. >> guest: but could they? is this really death? i mean, the quality, you know, i think -- i have a wife who's a freelance writer, and i think most people would say i would rather be unplugged than have your life and the insecurity of

it. and yet i've decided that i would go on and not unplug myself. i can't make those decisions. what i was trying to say, is this death? i mean, as soon as you go through puberty, you could say, well, you're an a slippery slope to death. as soon as you're born. not is this life worth it or not worth it, i'm just saying, is this person dead or is this person not dead, and i don't really see where brain dead people are dead. now, the president's council wants to push it a ten further. they -- a step further. they want to harvest the 100,000-plus people who are in persistent vegetative state. they don't think their lives are worth living either, and they want to harvest those people. >> host: my gosh, not president bush's council, dr. leon kass and pellegrino. they're, as you said, they felt that neurological standards were valid. it's a hundred-page report, and i'm sure you know it well although you must have finished the book before -- that

wasn't -- >> guest: what year is this? >> host: 2008. >> guest: yes. >> host: the president's council. >> guest: no, i read that. now, in that, if you read that carefully, they suggest that the persistent vegetative state person could be harvested. >> host: the way i read it was they were trying to almost adjudicate between people who thought the threshold was too high and those that thought it was too low, those who thought maybe somebody like an individual, you know, that's very debatable, there's no question about that, that that might be appropriate candidates and others who felt, in fact, that we might even return to the cardiovascular standard. so they really had to adjudicate a lot of -- and be most of the people on that commission were not, were bioethicists and folks not directly involved with transplantation which is a little different from -- >> host: but they did say -- >> guest: they talked about the debate, for sure.

>> guest: no, they made recommendations on how you would harvest a pvs patient. they said that we don't want to freak out the transplant surgeons, the retrieval surgeons because these people's eyes would be open and they would be breathing. so we really have to give these donors sedatives so as not to upset the doctors. i'll find you the reference, but that's true. >> host: let's move on to you. i notice that we're moving along -- >> guest: oh, okay. >> host: we only have about ten minutes. so, now, you mentioned in the here you have diabetes. >> guest: yeah. >> host: and that's, as you know, one of the bigger risk factors for, ultimately, developing renal failure. i'm not saying you will, but statistically over half, about half of all folks who, ultimately, need kidneys in this country, it's because of renal -- excuse me, diabetes. if you did need, if you did need a kidney, what would you do? would you opt for dialysis or

accept a deceased kidney? have you thought about that? >> guest: probably just fold my cards. i mean, i'm 66. if i were 30 -- >> host: look at you. you're feisty as can be. >> guest: i mean, i'm 66. i've outlived my evolutionary usefulness by double. i just, you know, we just live in a society that is so entitled. i don't believe i'm entitled to more years. i've had a good life. this is good. >> host: okay. okay. um, you had, actually, you have a nice few pages in here about, um, not so much the pitfalls of avoiding death, but of that time you have between now and death. and there were things that, um, that you thought one should do or at least you should do. can you talk a little bit about that? >> guest: yeah. um, well, yeah. [laughter]

i had some mundane examples. this sounds pretty silly, but we waste so much time in our lives. and i just sort of, like, don't want to waste any more time. like, i don't go to weddings. [laughter] you know, they don't work out. and whether they work out or not, i realize it's probably not dependent on my attendance or non-attendance. i had this funny conversation with my roofer, you know, when i was 60, i put a new roof on, and he said do you want 30-year shingles, for a few dollars more i can get you 40-year shingles. i said, well, that would be odd, i can choose for the shingles that will last 15 years after i'm dead or 25 years after i'm dead, why would i possibly care? he said, that's a funny way to think about it. i said, no, it's perfectly reasonable. so it's changed my way of thinking that things are temporal. i don't want to waste the time.

i don't want to do things i don't want to do. i want to get things done that i haven't done. there's just -- people's worries now just amuse me. and, you know, i've -- i'm in a position, i'm 66, i'm living on borrowed time. i've avoided the pitfalls of life. just have a good time. >> guest: sounds like this was a therapeutic exercise for you. you start out so anxious about death, and now it sounds like you're more philosophical and distanced. >> guest: well, people say i seem more relaxed. i explain to them, it's was i'm going to die. you haven't talked about your kidney. >> host: because this is about you. >> guest: i thought they brought you in here because you had -- >> host: oh. that got me interested in this topic, and i'm very concerned about the shortage -- >> guest: but you had a live donor. that's very different. >> host: and those are the

donors i'd like to see more of. >> guest: are you close to your donor? >> host: i'm much closer to her now than i was. we weren't even that close. she came from a third party. >> guest: really? >> host: it really leaves you speechless with gratitude. it was an amazing thing she did. >> guest: what was her reason for doing it? >> host: she's a fine -- >> guest: she knew you, right? >> host: she had an impulse. she did know me. and i am more than happy to talk with you about this after because i've become very passionate about increasing living donation. i even think we might compensate people for their organs, but that's a whole other issue. what i want to know from you is you've written a supercontroversial book. i don't believe your others have been this controversial, right? >> guest: my previous one about nonwhite science was. that got me a lot -- >> host: nonwhite? >> guest: well, it was nonwestern, and that usually means nonwhite. the debt we owe to ancient,

nonwestern cultures. that got a lot of -- yeah. you know, who weren't necessarily white, you know? >> host: when did you write that book? >> guest: ten years ago. >> host: so it's been a whole decade without a lot of controversy then. >> guest: well, right. but, yeah, i got a lot of hate mail on that. >> host: and you've been getting a lot of pushback. >> guest: a lot of hate mail, yeah. i prefer hate mail. it sounds more dramatic, don't you think? [laughter] but, you know, we live for that, right? i mean, if you're a journalist, you live for that. we can't do anything positive for the world, as i mentioned, but we can upset people. >> host: stimulate questions -- >> guest: that's another way of putting it. >> host: and doubt. healthy and still healthy keptism. it's also -- for a science writer, that's very important. what's next for you? >> guest: you know what? you know, i want to do a big book about puppies and kittens. [laughter] and how adorable they are. and see if i get as much hate mail on that. you know, i'd like to stay out

of the, stay out of the vortex for a while. >> host: so, mr. teresi, it's very interesting to talk to you about the book whose full title is requested the undead: organ harvesting, the ice water test, heart-beating cadavers, how medicine is blurring the line between life and left. a very controversial topic and someone who's taken it on a little out of passion. thank you. >> guest: nice meeting you. >> that was "after words," booktv's signature program in which authors of the latest nonfiction books are interviewed by journalists, public policymakers, legislators and others familiar with their material. "after words" airs every weekend on booktv at 10 p.m. on

saturday, 12 and 9 p.m. on sunday and 12 a.m. on monday. you can also watch "after words" online. go to booktv.org and click on after words in the booktv and series list on the upper right side of the page. >> the idea that climate change, um -- when the greens use that phrase, what they want you to think is subliminally man-made climate change. and this is where we do dispute it, those of us on my side of the argument. um, catastrophic, man-made climate change, if you look at the intergovernmental panel on climate change's reports over the last 20 years, um, the ipcc has grown increasingly shrill in its prognostications about

manmade climate doom. but in that period no convincing evidence has been produced to show that human influence on climate is so significant or dangerous that we are all going to fry. on the contrary, global warming actually stopped or flattened out, um, you know, over ten years ago now, um, we are entering a period of cooling, and i think we need to remember that if you look at human history and look at what man has done in times of cooling as opposed to in times of warming, society, civilization flourishes in times of warming. we are designed for warm

weather. it's not that we can't cope in colder climates. we're very adaptable, you know? we've got igloos and stuff like that. but, you know, i was telling you earlier, i'd like to live in california. there's a reason i'd like to live in california. it's not the political climate, it's the weather climate. it's nice and warm. we are drawn to warmer weather. warm weather solves two of our main problems; how to heat ourselves and how to feed ourselves. in periods of warmth, you can grow things like wheat at higher latitudes, so you can help feed the world. so the first part of my book, "watermelons," covers the science of climate change. but i'm not a scientist. and this isn't the part that really, really interests me about this whole debate. it's where these ideas come from. it's the sociopolitics of climate change, if you like.

if science is flawed, how come so many people believe in it? and i think one reason is that i think there is built into our dna this innate catastropheism. i think every generation believes that somehow it will be the last, that it will be the one that so, so shapes the world that it will destroy it through its, through its own evil. and if you look at, look at religions through the ages, what it is about, what they're all about in one way or another is atoning for sins to try and appease the gods, you know? the aztecs dealt with this by sacrificing people and sucking blood out of their hearts, their