Sunday, January 23, 2011

Brain Death versus Cardiac/Respiratory Death – Part 2

In the previous post, we asked the following question. "If the term lev does indeed mean mind and also the anatomical heart, there must be some connection between the two. What is it? Why is it that in lashon hakodesh the mind shares the same term with the anatomical heart?"

My Rabbaim explain as follows. The mind has two distinct elements. The first element encompasses pure intellect. Mankind is capable of acquiring facts and is capable of assessing these facts within the parameters of reason and rationality. The second element is the emoting quality of the mind. Mankind can relate to these facts on a personal level. They have the ability to shape his personality and can even become instinctual to him on a subconscious level. Human emotion is what gives the intellect relevance. In Judaism, i.e. in Tanach, the mind is always treated as a composite of these two elements. The purpose of the intellect is not just the amassing of information; rather, it is the internalization of the information which ultimately counts the most. The pasuk says, "v’yadata hayom, vahasheivosa el livavecha" you must know, and you must internalize in your mind. Hashava el haleiv is the ultimate goal of the intellect. We cannot satisfy ourselves with yedias ha’sechel alone; we must internalize the awareness of Hashem until it becomes a part of our personalities, until it becomes yedias haleiv, the "knowledge" of the emotions. We must feel the presence of Hashem, not just know it in an abstract way.

Anyone who possesses a beating heart knows that the heart participates in the emotions. It beats faster when an emotion is experienced and sometimes even physically hurts when experiencing negative emotions. People can even get heart attacks chs’v from negative emotions. The heart is inextricably tied to human emotions and plays a fundamental role in their functioning.

In the May 2004 edition of the science magazine Discover, the editors reviewed a fascinating book by essayist Charles Siebert. Here’s a snippet.

"…a recognition that the heart is no mere pump, as some physicians still insist, but a sophisticated participant in the regulation of emotion. The heart has a mind of its own: It secretes its own brainlike hormones and actively partakes in a dialogue among the internal organs—a dialogue on which cardiac researchers are only beginning to eavesdrop. The heart likewise undergoes all manner of organic change inflicted on it by the tempestuous brain and its neurochemicals. As one doctor explains, people do suffer heartbreak, literally.

Consider the fate of William Schroeder, the second—and longest-surviving—recipient, in 1984, of the Jarvik-7 artificial heart. As a pump, the Jarvik-7 was a resounding success, keeping Schroeder alive for an unprecedented 620 days. The patient’s mental state was another matter. Schroeder was weepy and deeply despondent. (Barney Clark, the first Jarvik-7 recipient, expressed a wish to die or be killed.) The blood still circulated, but something vital—some emotionally charged communication between heart and mind had been lost. What is it like, Siebert asks, to watch your favorite sports team rally yet not feel your pulse quicken? To see a loved one yet not feel your heart leap? "When someone’s heart is no longer working in concert with those feelings, does he feel that and cry more?" Affirming all myths, the heart truly is a seat of human emotion. The Jarvik-7, in contrast, was deaf to the song of human experience; built to invigorate its patient, it instead alienated him, supplying Schroeder with everything but the will to live. He had the look, Siebert writes, "of a man who has lost his heart."

Now, I don’t know how much of Siebert’s depiction is attributable to his attempt to humanize the heart but the magazine certainly takes his book seriously. Furthermore, Rav Avigdor Miller already discussed scientific connections between the heart and the emotions in the seventies, long before this book came out!

So, the upshot of all this is that although emotions are no doubt generated by the mind which is nested in the brain, the heart plays an indispensible role in the functioning of the emotions and thus the term for mind in lashon hakodesh is "lev".

4 comments:

  1. R. Coffer.

    To take this back to R. Slifkin's postings:

    R. Slifkin has a theory, into which you are poking a hole. That's all fine and good.

    Do you have a theory as to why the existence or non existence of life should be measured by hearbeat/breathing, and not by brain wave? Might it have anything to do with common beliefs in the day of Chazal about physiology, and/or the technology of their day?

    Even according to your essay, the heart's connection to the essential "self" is secondary to that of the brain.

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  2. Nachum,

    Do you have a theory as to why the existence or non existence of life should be measured by hearbeat/breathing, and not by brain wave?

    No, not really. Well, maybe yes. But that’s not the point. The issue is, I don’t need a theory. Just like I don’t need a theory as to why shaatnez is assur. The way the poskim relate to the gemara in Yoma, the cardio/pulmonary criteria is immutable. It seems it is a kabbala b’yadam akin to a halacha l’moshe mi’sinai. As such, theories are irrelevant. But even if it would be ok to theorize, Rabbi Slifkin’s theory is based on a false premise so his theory is out. As far as my “theory”, I would venture to guess that perhaps as soon as the heart and breathing cease irreversibly, this is an indication that the nefesh has left the body permanently. I can’t think of anything else that would make sense to my tiny little ant mind but as I said I don’t need a theory.

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  3. R. Coffer.

    It seems it is a kabbala b’yadam akin to a halacha l’moshe mi’sinai.

    What is the basis for your judgment that it is the above, and not based on Chazal's understanding of physiology and/or technical limitations in ascertaining brain death?

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  4. Nachum -

    What is the basis for your judgment that it is the above, and not based on Chazal's understanding of physiology and/or technical limitations in ascertaining brain death?

    Our Messorah. If you study the Rishonim and Acharonim, you will notice that they never reject a halacha merely because scientific knowledge changes. In order to change a halacha, the Rishonim always employ some kind of facility such as nishtanu hativim or the like. Otherwise, it is automatically assumed that the halacha is immutable despite the disparity in the science. A prime example is the permissibility of killing lice on Shabbos.

    As far as our particular sugya, I paraphrased the words of the Chasam Sofer in Yoreh Deah Chelek Beis teshuva #338.

    For an excellent treatment of modern day poskim and gedoley yisrael’s views on this matter, see Rabbi Slifkin’s book Sacred Monsters pages 356-367. Also, please feel free to peruse my most recent post on this matter.

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