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    換頭術

    作者: 阮一峰

    1、

    我讀過一本醫學暢銷書《最好的告別》,作者是美國醫生葛文德。

    他的一個觀點,令我印象深刻。他說,醫學的進步改變了人們對于死亡的看法。人們不再把死亡當作不可避免的自然結果,而是歸因于某種技術失敗。某個治療步驟出錯了,或者技術還不夠好,所以病人死了。

    越來越多的人相信,死亡的原因是技術缺陷,而不是預料之中的事。死亡證明書的診斷結論,不會寫死于老年,總是寫著某種最終的近似原因——例如呼吸衰竭,或者心搏停止。

    既然死亡是技術失敗,而技術問題總可以用更好的技術解決,所以人們逐漸形成一種觀念:衰老和死亡只有在反常的情況下才會發生,正常情況下是可以治療和延遲的。

    新聞媒體經常炫耀某個97歲的老人跑馬拉松的故事,仿佛類似事例不是生物學奇跡,而是對所有人的合理期待。然后呢?當我們的身體不能滿足這種幻覺時,我們就覺得好像需要為此感到慚愧 。

    2、

    我一直無法忘懷這個觀點,技術是否可以阻止死亡?如果技術變得無比先進,人類是否真能將死亡推遲得足夠久,活到200歲呢?

    我越來越覺得,這是很有可能的。未來人類的壽命也許非常長,遠超過自然的生理極限。

    延長壽命的關鍵是什么?我認為主要就是一點:克服器官老化和衰竭,方法就是器官移植。目前,器官移植的成功率正變得越來越高,越來越多的器官可以移植。肺癌就換肺,肝癌就換肝,冠心病就換心,都有辦法救回來。

    臺北市長柯文哲曾經是臺大醫院的外科權威,在一次演講中,講過兩個他親手處理的病例。一個女孩九天沒有心跳,全靠體外循環維持生命,最后還是撐到心臟移植,活了過來;另一個病例更厲害,心臟由于嚴重的細菌感染都爛了,只好拿掉,沒心臟撐了16天,心臟移植以后也活了下來。

    隨著手術技術的成熟、抗排異藥物的完善、人造器官的出現,可以想象,未來的器官移植終將像拔牙那樣簡單易行、安全可靠。

    3、

    目前為止,只有一個器官,從來沒有人嘗試過移植,那就是腦袋。

    醫學上,死亡的定義就是腦死亡。也就是說,如果大腦死了,就算身體的其他部分還活著(心臟還在跳動),這個人也是死了。反過來說,如果其他部分壞死了,但是大腦還有意識,那么這個人就是還活著。

    大部分人死的時候,大腦的功能其實都是好的,思維依然敏捷,就是身體的其他部分不行了,導致大腦養分供不上,于是先陷入昏迷,然后再死亡。

    如果頭部移植可以成功,那么人的壽命就會有本質的提高。軀干不行了,腦袋就移植到另一個軀干上,于是就可以接著活。

    4、

    頭部移植的難度無疑是極高的,血管和神經都要正確連接。一個人的大腦如何指揮另一具身體,沒有人知道能不能實現。但是,技術是那么地不可思議,我覺得沒有理由懷疑可能性,未來是一定可以做到頭部移植。

    事實上,1970年就有人嘗試,一只猴子的腦袋移植到另一只猴子身上。手術后猴子活了三天,被認為實驗成功。

    迄今為止,人的頭部移植還沒有實驗過。有一位意大利神經科醫生 Sergio Canavero 宣稱2017年底前,就要完成第一例頭部移植手術。他還宣稱,已經在一條狗身上實驗成功,將脊髓神經跟大腦連接起來,讓這條癱瘓的狗重新恢復了行動能力。

    他還找到了一位俄國志愿者,此人患有退化性疾病,不能行走,不能照料自己,類似英國物理學家霍金的情況,因此愿意割下自己的腦袋,讓醫生安裝在另一具軀體上。

    Canavero 醫生聲稱,手術的第一步將是冰凍大腦和身體,阻止腦細胞死亡。然后切開脖子,將關鍵的動脈和靜脈將連接到管子上。在進行移植之前將切斷患者的脊椎。當肌肉和血液供給成功連接之后,病人將昏迷一個月時間來限制新移植頭顱的活動,同時將通過電刺激讓脊椎新連接得到強化。這位野心勃勃的醫生相信,物理療法將讓接受頭部移植手術的病人在一年內下床走路。

    醫學界普遍不相信這個實驗,認為這不過是另一場偽科學的鬧劇。但是,沒有一個科學家說,頭部移植是絕對不可能的。

    5、

    展望未來,幾乎可以肯定,人類將不再是純自然的產物,很可能一部分器官和肢體是自然的,另一部分是人工合成材料。這既是為了替換壞掉的器官,也可能是為了追求更強的功能,比如安裝電動的碳纖維假肢,老年人就可以健步如飛,登高山如履平地。

    美國發明家、《奇點迫近》的作者、谷歌公司工程總監雷蒙德·庫茲維爾(Raymond Kurzweil)說過一句著名的話。

    “雖然我像別人一樣熱愛自己的身體,但是如果我能依靠硅基材料活上200歲,我會毫不猶豫地放棄肉體。”

    未來,器官移植和換頭術一旦成熟,人的壽命可能會翻倍增加。那時,只要保住腦袋就可以了,其他部分就不太重要了,因為可以換。動畫《Futurama》里面,人甚至連軀體都不需要了,就是一個頭安裝在底座上那樣活著。

    到了那個地步,人與機器就將合為一體:機器給了人更長的壽命,人給了機器靈魂。

    最后生成于 2018-7-9 08:15:49

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