What makes us alive? Moreover, what makes us dead?

When it comes to death, science is part of the problem as well as part of the solution. Deepening our understanding of the body’s processes and learning how to keep them going longer has complicated and obfuscated the end of life.

There’s a claustrophobic moment in the new film of Stephen Hawking’s life when he describes his wife being given the option to let him die. It was 1985 and A Brief History of Time was a still-unpublished manuscript. Hawking had been hospitalised with pneumonia. He was placed on a life-support machine and put into a drug-induced coma. The doctors asked Jane Hawking if she wanted them to turn off the machine.
 
We can all be glad she said no, otherwise the planet would have been much the poorer for the past 28 years. Nonetheless, the shadow of death hangs over the whole film. One day – and it may not be many years away – Hawking will be no more. His declaration in September that assisted suicide should be possible without fear of prosecution suggests he might be squaring up to the idea.
 
Death seems to be the one thing that sets human beings apart: we are aware, unlike most (if not all) other animals, of our impending demise. Worse – as Jane Hawking knows too well – in this technological age, we have to make fine decisions about death. And here the advance of science seems to offer more hindrance than help.
 
Death is not what it was. Until half a century ago if you couldn’t breathe, you would soon be officially dead. Then someone invented the ventilator. Is a body that needs a machine to operate its lungs still alive? For sure, we now say.
 
It’s no longer the case that the heart has any jurisdiction over whether you’re dead. Remember the Bolton Wanderers footballer Fabrice Muamba? His heart stopped for 78 minutes but then defibrillation got it started again. It’s a testimony to our scientific resourcefulness that we have learned how to choreograph the pulses of electrical current that will kick-start a long-immobile heart. Nonetheless, this, too, has complicated the notion of being “alive”.
 
Even what has been termed “brain death” is not enough. A lack of electrical activity inside your skull is not a sign that your brain cells are all dead. It takes up to eight hours to start dying and you can lose a lot of them before significant damage ensues. What’s more, damage to some cells makes permanent loss of consciousness inevitable. But damage to some others isn’t much of a problem.
 
Perhaps the most extreme technological management of death is among those who have paid to have their bodies frozen. Their hope is that future technologies will be able to defrost them and repair the damage that freezing cells full of water inevitably causes. This is not the last refuge of the frightened fool: plenty of our finest minds, including the MIT professor of artificial intelligence Marvin Minsky, have signed up to be cryo-preserved.
 
So, when it comes to death, science is part of the problem as well as part of the solution. Deepening our understanding of the body’s processes and learning how to keep them going longer has complicated and obfuscated the end of life. That’s why a few researchers have suggested that doctors are no longer qualified to make life-and-death decisions. Robert Veatch, a medical ethicist at Georgetown University, goes further: he thinks you should be allowed to come up with your own definition of death and inscribe it in a living will for others to respect.
 
It would certainly be nice to have a say – especially when you can see it coming. Long live Stephen Hawking. As long as he wants, that is.
Science has complicated death. Image: Getty

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 30 September 2013 issue of the New Statesman, The Tory Game of Thrones

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The answer to the antibiotics crisis might be inside your nose

The medical weapons we have equipped ourselves with are losing their power. But scientists scent an answer. 

They say there’s a hero in everyone. It turns out that actually, it resides within only about ten percent of us. Staphylococcus lugdunensis may be the species of bacteria that we arguably don’t deserve, but it is the one that we need.

Recently, experts have cautioned that we may be on the cusp of a post-antibiotic era. In fact, less than a month ago, the US Centres for Disease Control and Prevention released a report on a woman who died from a "pan-resistant" disease – one that survived the use of all available antibiotics. Back in 1945, the discoverer of penicillin, Alexander Fleming, warned during his Nobel Prize acceptance speech against the misuse of antibiotics. More recently, Britain's Chief Medical Officer Professor Dame Sally Davies has referred to anti-microbial resistance as “the greatest future threat to our civilisation”.

However, hope has appeared in the form of "lugdunin", a compound secreted by a species of bacteria found in a rather unlikely location – the human nose.

Governments and health campaigners alike may be assisted by a discovery by researchers at the University of Tubingen in Germany. According to a study published in Nature, the researchers had been studying Staphylococcus aureus. This is the bacteria which is responsible for so-called "superbug": MRSA. A strain of MRSA bacteria is not particularly virulent, but crucially, it is not susceptible to common antibiotics. This means that MRSA spreads quickly from crowded locations where residents have weaker immune systems, such as hospitals, before becoming endemic in the wider local community. In the UK, MRSA is a factor in hundreds of deaths a year. 

The researchers in question were investigating why S. aureus is not present in the noses of some people. They discovered that another bacteria, S. lugdunensis, was especially effective at wiping out its opposition, even MRSA. The researchers named the compound created and released by the S. lugdunensis "lugdunin".

In the animal testing stage, the researchers observed that the presence of lugdunin was successful in radically reducing and sometimes purging the infection. The researchers subsequently collected nasal swabs from 187 hospital patients, and found S. aureus on roughly a third of the swabs, and S. lugdunensis on up to 10 per cent of them. In accordance with previous results, samples that contained both species saw an 80 per cent decrease of the S. aureus population, in comparison to those without lugdunin.

Most notably, the in vitro (laboratory) testing phase provided evidence that the new discovery is also useful in eliminating other kinds of superbugs, none of which seemed to develop resistance to the new compound. The authors of the study hypothesised that lugdunin had evolved  “for the purpose of bacterial elimination in the human organism, implying that it is optimised for efficacy and tolerance at its physiological site of action". How it works, though, is not fully understood. 

The discovery of lugdunin as a potential new treatment is a breakthrough on its own. But that is not the end of the story. It holds implications for “a new concept of finding antibiotics”, according to Andreas Peschel, one of the bacteriologists behind the discovery.

The development of antibiotics has drastically slowed in recent years. In the last 50 years, only two new classes of this category of medication have been released to the market. This is due to the fact almost all antibiotics in use are derived from soil bacteria. By contrast, the new findings record the first occurrence of a strain of bacteria that exists within human bodies. Some researchers now suggest that the more hostile the environment to bacterial growth, the more likely it may be for novel antibiotics to be found. This could open up a new list of potential areas in which antibiotic research may be carried out.

When it comes to beating MRSA, there is hope that lugdunin will be our next great weapon. Peschel and his fellow collaborators are in talks with various companies about developing a medical treatment that uses lugdunin.

Meanwhile, in September 2016, the United Nations committed itself to opposing the spread of antibiotic resistance. Of the many points to which the UN signatories have agreed, possibly the most significant is their commitment to “encourage innovative ways to develop new antibiotics”. 

The initiative has the scope to achieve a lot, or dissolve into box ticking exercise. The discovery of lugdunin may well be the spark that drives it forward. Nothing to sniff about that. 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman