A Neurosurgeon’s Perspective on Brain Death

Yesterday I wrote on Dr.Richard Niles and posted an entire chapter from his book The Death of the Brain, with permission from his son. The late Dr. Richard Nilges, retired from neurosurgery at age 64, something he states he had not planned to do. He was 80 when he contributed to the book Beyond Brain Death.

Committed as I was to the seriously injured or a very sick patient under my care, whether he or she was brain dead or not, I had to literally fight the transplant teams.

One case he recalled was when a transplant team was called to the community hospital without his knowledge and before he was ready to call brain death on an unconscious patient who had been in a motor cycle accident. He dismissed the transplant coordinator and his “team.” He continued to treat the young man’s brain swelling and he walked out of the hospital and returned to college.

Dr. Nilges talks about the slippery slope we have grown into with organ transplants.  He grew weary of being at loggerheads with his patient’s needs and the transplant teams.  To preserve a suitable kidney for transplantation the transplant technicians would demand that he order intravenous fluid overload. Knowing that more fluid would overload the brain swelling of an already injured brain he would refuse, knowing it would cause further injury.

Dr. Nilges commitment was to his patient and not a faceless patient on a waiting list.

The real challenge came to him when he started to see the media spewing transplant propaganda and families beginning to demand that he “put their love one’s out of suffering”, knowing full well his unconscious patients were not suffering or brain dead. Therefore he left his beloved field of neurosurgery. He increasingly saw advocates of transplanting were never satisfied and began to whittle away the Harvard Criteria, and stopped using EEG’s that still showed brain activity.

Transplant coordinators made sweeping claims to neurosurgeons all over the country that transplant surgery was the highest point of modern surgery. Yet he knew the benefit simply did not fit the facts.

He felt the supreme contempt for the human condition had developed, from man a little lower than the angels, that we had slipped to man, dying but not yet dead, the “heart beating donor”, source of spare parts for the fortunate.

I am thankful that Dr. Richard Nilges words live on in the book, Beyond Brain Death.