Mr. Humble & Dr. Butcher is a new book by Brandy Schillace, a historian of medicine that tells the story of Dr Robert White, a neuroscientist who performed the world’s first successful head transplant in the 1970s.
Dr Robert White was a friend to two popes and a founder of the Vatican’s Commission on Bioethics. He developed lifesaving neurosurgical techniques still used in hospitals today and was nominated for the Nobel Prize. But like Dr Jekyll before him, Dr White had another identity. In his lab, he was waging a battle against the limits of science, and against mortality itself—working to perfect a surgery that would allow the soul to live on after the human body had died. Sky HISTORY spoke to Brandy Schillace over Zoom about the life and work of Dr Robert White, a modern-day Frankenstein who believed he was doing God’s very own work.
Sky HISTORY: What drew you to writing about Dr White as a subject?
Brandy Schillace: It's a great origin story actually. I wrote a book called Death’s Summer Coat, and it's a cross-cultural, historical look at death and dying and how we can arrive at modern grief. During that time I met and spoke with a neurologist who did a lot with brain trauma because I was looking at brain death and how we understand that. So, fast forward a few years, I get a phone call, and he says, 'I've got something in my office I really think you need to see'. So I head down there and I go to his office, he pulls out a shoebox which I wasn't really expecting. He sets it on the desk and he pushes it towards me, and I make some a ridiculous comment like 'Oh there's not a brain in there?'. And he says, 'Not exactly....'.
So I opened this box and inside there’s one of those MIT lab notebooks with the graph paper. It's got cramped handwriting and pasted in notes, and little flecks of brownish coloured stuff, which, Michael, the neurologists who invited me down, tells me is dried mouse blood from brain isolation experiments. I’m like, 'What is this thing?'. Michael tells me, that's this is the lab notebook of Dr Robert White. The first person to do a successful head transplant... And there's so much involved in that sentence. 'Wait, I'm sorry successful what?' And that was my first introduction.
Why isn't Dr Robert White and his work more well-known?
He was in the news a lot at the time, in Time Magazine and Scientific American, but we have forgotten about him and I think it's because it's just so strange. Science and medicine don't always want to remember the more peculiar fringey bits of things.
He was nominated for a Nobel Prize for brain perfusion, for hyper cooling the brain, which helps if you're having a massive heart attack, to keep your brain cells from dying. So he did all those things: he saved people's lives; he was a good Catholic (he had ten children); he invented surgeries and he took the heads off of things. It's just these two aspects of his personality, how could you not want to write about someone like that?
What sort of man was Dr White?
The title of the book is Mr Humble and Dr Butcher and I just need to say that these are nicknames that he gave himself. He had a big personality. It was very tongue in cheek because he was not humble. I spoke to a neurologist friend of mine and he said that brain surgeons tend to be that way. They need to believe that they’re the best every time and you want them to because they got their hands in your brain.
What was the historical context surrounding Dr White’s neurological research?
He's at the Peter Bent Brigham Hospital in Boston when the very first kidney transplant happens. Until then, organ transplant is science fiction.
This is the 50s, in the early part of the Cold War and the US government wasn't sure what the Soviet Union was capable of. They even thought they could telekinetically control missiles. The atom bomb had just gone off, and no one thought that kind of thing was possible either.
There's a lot that people are grappling with scientifically and the worst thing in the world would be to be beaten by the Soviet Union at this time. This is the whole purpose of the space race which also inaugurated an inner space race of medical science. And so Dr White is becoming a doctor in the middle of this moment where there's funding available for beating the Russians at science.
In 1958 Russia releases a video showing that they have surgically created a two-headed dog. They've taken a dog's head and transplanted it onto the body of another dog. This gets people really nervous. People start worrying whether the Soviets had figured out a way to thwart death. If their science wins, does their ideology? And what we can do to stop it?
That's the context in which he begins looking at brain death, brain life and whether or not a brain can outlive its body (the answer turns out to be yes) and what does that mean about where life begins and ends.
All of these questions are happening in the 50s 60s, leading up to his actual work on head transplant in the 70s.
Why was the development of organ transplants so revolutionary in medical science?
If you take out your kidney you have another kidney, so we're good there. But if you want to transplant a heart, it still has to be beating in order to be transplanted. But if your heart is still beating, are you still alive, or are you not alive?
How do we know someone is dead enough to take their organs? This becomes a huge problem. If your heart's still beating, but your brain is completely offline, are you dead? Is your personality gone? Are you gone?
This was never a problem before artificial respiration. Because you need your brain to be online to breathe. If your brain stopped working, you just died of suffocation shortly afterwards but now we can keep bodies alive but are they alive?
These were the questions people were asking at the time so White decides to ask the question from the other side.
People were asking whether a lack of EEG [recorded brain signals], a complete flatline, is death? But what White was asking was whether the presence of EEG - even if you have nothing else - life? So he sets about doing an experiment where he takes the brain out of something while it's still alive, and keeps the brain alive outside of his body, and tests it for EEG signals.
How did this brain isolation experiment lead to his interest in performing a head transplant?
To prove his original point, that the EEG signal is not just reflex or just some ghost in the machine, he does the same surgery again but without taking the brain out of the head.
He's got a monkey's body supporting – with blood and everything - this head from the other monkey. And he waits for it to wake up, and it does. It comes out of anaesthesia, and it looks around, and it tries to bite Dr White.
Dr White keeps it alive for about nine days. They’ve sown it at that point to the other body so there are not just tubes connecting them anymore, but it is completely paralysed. It's just a head on a body-like support system.
This was him proving that the brain equalled life and as a Catholic, the brain equalled the soul. So the absence of EEG equals death, and you could use those bodies for transplants.
How did he reconcile his religious beliefs with his research?
White was friends with two different Popes and I don't even know how you become friends with one Pope but he knows Paul VI and he becomes quite close with Pope John Paul II. He helps John Paul II second establish the Vatican Council for bioethics. I think some of the harder things to reconcile is how somebody who starts a commission for bioethics has 300 monkey heads frozen in his freezer or thereabouts,
As a matter of fact, he felt that his medical work was his God-given mission. He felt that God was behind him. He felt that religion and medicine and science were completely the same thing. He didn't see any conflict at all, which is surprising The brain is the repository of the human soul, and our job is to keep the brain alive because that's tantamount to saving souls. He believes that souls are fourth dimensional. There's the three-dimensional brain, and a soul bisects it somehow in this fourth dimension, but it is not shrunken if the brain is shrunken. You can take half the brain but you still have a whole soul.
How was his research received at the time? Are people still interested in it?
At the time that he did the head transplant with the monkeys, it was lauded. People were really excited about it. It revealed so much about the circulatory system and neurological systems and how you can cool brains to allow more complicated surgeries. But these days, if you talk about head transplants, you sound like you're not an OK person. You sound like you've got some problems, and that you're like Dr Frankenstein.
What explains this shift in attitudes?
Times have changed. This book covers, 50 years of history of medical breakthroughs that also covers the civil rights movements in the United States, the rise of animal rights movements in both the UK and the United States, the space race the fall of the Soviet Union. All of these things are happening simultaneously to these medical breakthroughs and Dr White doesn't really change much but the world around him is radically altering.
Has anyone followed in Dr White’s footsteps in terms of his research?
It is being pursued, but the doctors who are interested in it, are not leaders and they’re not well respected in their field. One doctor ended up losing his position at his own university. The community of medicine looks down upon it.
Another example of this is Joseph Murray who performs the first kidney transplant and who nominates White for a Nobel Prize. In his letter to White, he says, maybe, let's not talk about the monkey head transplant.
Something that was deeply important to Dr White was clearly an impediment to getting a Nobel Prize, so much so that Joseph Murray warned him not to talk about it.
What did you enjoy most about writing the book?
I figured out where he went and I went to these places too. I went down into basements and I saw the surgical tools that were used to make the two-headed dog and I saw the machines that were used to keep the monkeys alive and I saw the chair that they put the monkeys in to serve as body donors. The chair was named Frankenstein by the way.
Everything I discovered was weirder than the rumours. Every time I'd find out one thing, it would be way stranger than I thought it would be. For instance, he's friends with the Pope, no he's actually friends with two. They created a two-headed dog: no there were 9 two-headed dogs running around. Everything was bigger and stranger and connected in weird ways to what we still do every day.
Truth is stranger than fiction and in Mr. Humble & Dr. Butcher, Brandy Schillace shows us just how strange science can be.
Mr. Humble & Dr. Butcher is available in all good book shops.