Madness Read online

  ‘I myself would leave all three coverings – don’t they have lovely names, the dura, the arachnoid, and the pia? – I’d leave them all intact. There are many reasons for this, not least among them being the fact that within the dura run the venous channels that drain the blood from the brain into the jugular.

  ‘Now,’ he went on, ‘we’ve got the upper half of your skull off so that the top of the brain, wrapped in its outer covering, is exposed. The next step is the really tricky one: to release the whole package so that it can be lifted cleanly away, leaving the stubs of the four supply arteries and the two veins hanging underneath ready to be re-connected to the machine. This is an immensely lengthy and complicated business involving the delicate chipping away of much bone, the severing of many nerves, and the cutting and tying of numerous blood vessels. The only way I could do it with any hope of success would be by taking a rongeur and slowly biting off the rest of your skull, peeling it off downwards like an orange until the sides and underneath of the brain covering are fully exposed. The problems involved are highly technical and I won’t go into them, but I feel fairly sure that the work can be done. It’s simply a question of surgical skill and patience. And don’t forget that I’d have plenty of time, as much as I wanted, because the artificial heart would be continually pumping away alongside the operating-table, keeping the brain alive.

  ‘Now, let’s assume that I’ve succeeded in peeling off your skull and removing everything else that surrounds the sides of the brain. That leaves it connected to the body only at the base, mainly by the spinal column and by the two large veins and the four arteries that are supplying it with blood. So what next?

  ‘I would sever the spinal column just above the first cervical vertebra, taking great care not to harm the two vertebral arteries which are in that area. But you must remember that the dura or outer covering is open at this place to receive the spinal column, so I’d have to close this opening by sewing the edges of the dura together. There’d be no problem there.

  ‘At this point, I would be ready for the final move. To one side, on a table, I’d have a basin of a special shape, and this would be filled with what we call Ringer’s Solution. That is a special kind of fluid we use for irrigation in neurosurgery. I would now cut the brain completely loose by severing the supply arteries and the veins. Then I would simply pick it up in my hands and transfer it to the basin. This would be the only other time during the whole proceeding when the blood flow would be cut off; but once it was in the basin, it wouldn’t take a moment to re-connect the stubs of the arteries and veins to the artificial heart.

  ‘So there you are,’ Landy said. ‘Your brain is now in the basin, and still alive, and there isn’t any reason why it shouldn’t stay alive for a very long time, years and years perhaps, provided we looked after the blood and the machine.’

  ‘But would it function?’

  ‘My dear William, how should I know? I can’t even tell you whether it would ever regain consciousness.’

  ‘And if it did?’

  ‘There now! That would be fascinating!’

  ‘Would it?’ I said, and I must admit I had my doubts.

  ‘Of course it would! Lying there with all your thinking processes working beautifully, and your memory as well …’

  ‘And not being able to see or feel or smell or hear or talk,’ I said.

  ‘Ah!’ he cried. ‘I knew I’d forgotten something! I never told you about the eye. Listen. I am going to try to leave one of your optic nerves intact, as well as the eye itself. The optic nerve is a little thing about the thickness of a clinical thermometer and about two inches in length as it stretches between the brain and the eye. The beauty of it is that it’s not really a nerve at all. It’s an outpouching of the brain itself, and the dura or brain covering extends along it and is attached to the eyeball. The back of the eye is therefore in very close contact with the brain, and cerebrospinal fluid flows right up to it.

  ‘All this suits my purpose very well, and makes it reasonable to suppose that I could succeed in preserving one of your eyes. I’ve already constructed a small plastic case to contain the eyeball, instead of your own socket, and when the brain is in the basin, submerged in Ringer’s Solution, the eyeball in its case will float on the surface of the liquid.’

  ‘Staring at the ceiling,’ I said.

  ‘I suppose so, yes. I’m afraid there wouldn’t be any muscles there to move it around. But it might be sort of fun to lie there so quietly and comfortably peering out at the world from your basin.’

  ‘Hilarious,’ I said. ‘How about leaving me an ear as well?’

  ‘I’d rather not try an ear this time.’

  ‘I want an ear,’ I said. ‘I insist upon an ear.’

  ‘No.’

  ‘I want to listen to Bach.’

  ‘You don’t understand how difficult it would be,’ Landy said gently. ‘The hearing apparatus – the cochlea, as it’s called – is a far more delicate mechanism than the eye. What’s more, it is encased in bone. So is a part of the auditory nerve that connects it with the brain. I couldn’t possibly chisel the whole thing out intact.’

  ‘Couldn’t you leave it encased in the bone and bring the bone to the basin?’

  ‘No,’ he said firmly. ‘This thing is complicated enough already. And anyway, if the eye works, it doesn’t matter all that much about your hearing. We can always hold up messages for you to read. You really must leave me to decide what is possible and what isn’t.’

  ‘I haven’t yet said that I’m going to do it.’

  ‘I know, William, I know.’

  ‘I’m not sure I fancy the idea very much.’

  ‘Would you rather be dead, altogether?’

  ‘Perhaps I would. I don’t know yet. I wouldn’t be able to talk, would I?’

  ‘Of course not.’

  ‘Then how would I communicate with you? How would you know that I’m conscious?’

  ‘It would be easy for us to know whether or not you regain consciousness,’ Landy said. ‘The ordinary electroencephalograph could tell us that. We’d attach the electrodes directly to the frontal lobes of your brain, there in the basin.’

  ‘And you could actually tell?’

  ‘Oh, definitely. Any hospital could do that part of it.’

  ‘But I couldn’t communicate with you.’

  ‘As a matter of fact,’ Landy said, ‘I believe you could. There’s a man up in London called Wertheimer who’s doing some interesting work on the subject of thought communication, and I’ve been in touch with him. You know, don’t you, that the thinking brain throws off electrical and chemical discharges? And that these discharges go out in the form of waves, rather like radio waves?’

  ‘I know a bit about it,’ I said.

  ‘Well, Wertheimer has constructed an apparatus somewhat similar to the encephalograph, though far more sensitive, and he maintains that within certain narrow limits it can help him to interpret the actual things that a brain is thinking. It produces a kind of graph which is apparently decipherable into words or thoughts. Would you like me to ask Wertheimer to come and see you?’

  ‘No,’ I said. Landy was already taking it for granted that I was going to go through with this business, and I resented his attitude. Go away now and leave me alone,’ I told him. ‘You won’t get anywhere by trying to rush me.’

  He stood up at once and crossed to the door.

  ‘One question,’ I said.

  He paused with a hand on the doorknob. ‘Yes, William?’

  ‘Simply this. Do you yourself honestly believe that when my brain is in that basin, my mind will be able to function exactly as it is doing at present? Do you believe that I will be able to think and reason as I can now? And will the power of memory remain?’

  ‘I don’t see why not,’ he answered. ‘It’s the same brain. It’s alive. It’s undamaged. In fact, it’s completely untouched. We haven’t even opened the dura. The big difference, of course, would be that we’ve sev