Reaching Down the Rabbit Hole: Extraordinary Journeys into the Human Brain

by Allan H. Ropper

we did the caloric reflex: squirting ice water into one ear, then the other. This provides a potent stimulus to eye movements through a hardwired circuit in the brainstem, if it’s functioning at all. “Nada.” Now the moment of truth, the apnea test. Will he breathe? “How do you like to do it, Dr. Ropper?” “Preoxygenate him.” The person must have an apnea test. Then you can prove to yourself that the whole brain, including the brainstem, is gone. Just remember, when you take a patient off a ventilator, either for an apnea test or after a declaration of death, make sure that family members are out of sight, and forewarn the nurses. Many brain dead patients, once the ventilator is removed, exhibit the so-called Lazarus sign, where their arms spontaneously contract and their hands come up to their chest as though they’re grasping for the endotracheal tube. It’s creepy no matter how many times you’ve seen it.