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Date:    2015 Feb 15 10:43
From:    dentin
Subject: GCS followup
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Once my mother stabilized enough to get a proper MRI, we were able to
understand the full extent of the brain damage.  Over the course of the
week, she slipped back from a GCS number of 7 to 6, then 5, then 4.  We
decided to suspend life support, and respect her DNR (do not resuscitate)
order.  Her body officially died less than two hours later.

Determining the exact point at which she died depends a lot on your
definition.  By the standards of modern technology, she died within seconds
of the initial impact - there was no medical technology available which
could have saved her life (except for cryogenic freezing, which we won't
discuss here.)

By the modern legal definition of death, she officially died when her heart
stopped, a week later.

By the medical standards of a century or two from now, she probably didn't
really die until some time after her heart stopped.  Molecular scanning and
reconstruction is pretty much the only technology that would have worked
that late, and it's a technology that will be available in that time frame
barring true global disasters.

If you take away anything from this, take away the fact that 'death' is a
very fluid concept.  Doctors routinely work on people who are quite 'dead'
by the standard definition of the heart not beating, and even ordinary CPR
is all about bringing someone back to life after their heart has stopped. 
When does death occur exactly?  Is it at the point where they can't be
saved?  Is it when the heart stops?  Is it when the brain is damaged beyond
repair?  These are tough and interesting questions which are worth thinking
about.

As an aside, I'm somewhat disappointed that more people don't sign up for
cryonics.  It probably wouldn't have saved my mother, but it would have
given her a much, much better chance than she has now.  She's been cremated
as per her wishes, so she's not just dead, but she's truly, permanently
dead.  IMHO there's only a few percent chance she could have been recovered
from cryofreeze, but a few percent is infinity times better than her
current level of zero percent.


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