The Toothy Tale

 

गणेशःor Ganesha is a Sanskrit compound word joining the words Gana which means people and Esha means chief of the group or tribe. The elephant god's birthday falls on the 4^th day of the lunar cycle as he got his head transplanted and thus his birthday is celebrated from the Chaturthi and it took him few days to practice and exercise his full power hence his birthday celebration lasts upto 10 days.

 

Within infinite myths lies the Eternal Truth

Who sees it all?

Over the centuries the retelling of Ganesha’s elephant head transplant and one tooth story has been retold a hundred thousand times; here I am shaping up this time the story for the modern readers.

Going beyond the usual festival mood and devotional images, Ganesha elephant head on a human body shows a scientific aspect of thinking of ancient times of Bharat.

 

THE MOMENT: 

 It is said that an angry deed has its consequences like Lord Shiva after his wanderings returned to his home to find a seven year old boy guarding the main door. Shiva’s entrance to his own house was blocked by the boy who was carrying out his duty as his mother Parvati was taking her bath and she had asked him to guard the door and not allow anyone to enter. Ganesh till then had not been introduced to Shiva who happened to be his biological father. In the moment of anger Shiva lost his cool and cut the boy’s head off.

 

Hearing the commotion, Parvati comes out to witness a tragic scene. When Shiva comes to know of the reality he is remorse stricken. But then being Mahadev the Great God who now has to perform his Godship under the weeping, accusing eyes of the woman, wife and the mother squares up to  the challenge and performs a surgery. 

 

THE STORY: 

A living elephant head gets transplanted on a corpse. And then gradually as the head and body gets aligned, a new heart also gets transplanted thus giving life and making the Ekdant Ganesha alive. Who scribed the great epic Mahabharat in verse form. The Elephant God when called upon to undertake the task of writing the epic laid the rules to Ved Vyas the complier of the 4 Vedas. Ganesha had said You must narrate without a pause; This would ensure that what Vyas dictated was not adulterated by human prejudice. And Vyas said I will, provided you write nothing unless it makes sense to you. This would ensure that all that was written appealed to the divine.

 

THE SCIENCE: 

The very first time human head transplantation, which was surgically challenging and Ethically controversial in current times was done in 2017 by a team of Italian neurosurgeon names Sergio Canavero and the Chinese surgeon although this procedure has not been performed on a living human until now.

 

THE CHALLENGES: 

Head and body interventions on the recipient and donor. These include challenging surgical skills and demanding cooperation-coordination skills which depend on the multidisciplinary team of surgeons (neurosurgeons and neck, vascular, cardiothoracic, orthopedic, plastic surgeons) and the excellent preparation of the surgical protocol Sparing of phrenic nerves, recurrent laryngeal nerves, vagi, and cervical plexus is demanding and time-consuming, but very important postoperatively mainly for spontaneous respiration and phonation. Various vascular anastomoses, esophagus anastomosis, spinal cord reattachment and spinal cord fixation are demanding surgical steps which elevate the operation’s level of difficulty. Bleeding, infections, anastomotic leaks are common post-operative complications. Another crucial point that raises concern and needs to be studied and discussed is the exact cervical myelomere where the spinal cord is going to be transected.

Ischemia time Maintaining the blood flow to the recipient head and donor body can be achieved using various ways, on the background of hypothermia, up to the point of the reattachment of the vessels between the recipient and the donor. Extracorporeal circulation machine could be the first choice. However, several techniques such as the autocerebral hypothermic perfusion have been proposed in order to achieve profound hypothermia. Continuous cross-circulation between the recipient and the donor is being tested. Additionally, the level of hypothermia and the ideal temperature is still under discussion. It is true that one of the key elements for head transplantation is to decrease the temperature of the recipient’s head to a sufficiently low level that enables disconnecting and reconnecting it to the donor’s body under proper conditions, something which has been taken into serious consideration in the proposed protocol The other crucial factor is time. Nevertheless, the protocol is based on previous similar experiments and it is well designed, appearing promising enough to be implemented and be successful Interestingly, Li et al evaluated the longterm immune rejection and avoidance of ischemic events during the head transference phases and for those objectives they developed a bicephalic model of head transplantation.

Spinal fusion and spinal cord reattachment. A crucial point of discussion is the need for proper mechanical alignment of the severed axons. The surgeons would cut the spinal cords with an ultra sharp blade promising a “clean cut”, which will have a crucial role in the fusion of severed axons and in the spinal fusion in total. One way to enhance neuronal recovery is by installing an epidural spinal cord stimulating apparatus. Additionally, a pivotal role is attributed to the interneurons which are thought to promote functional recovery through the creation of interconnections between axons. Precision in the reattachment (alignment and proper distance of the reconnected spinal cords) could be perhaps the most important step for the outcome of the procedure.

Post-operative issues. After surgery, the patient will be monitored in the intensive care unit under ventilatory and circulatory support. The stability of the head and the spinal column is a major concern in order to reassure the successful spinal cord fusion. When possible, intensive rehabilitation for quadriplegia should be started. Another major issue is the presence of neurogenic shock due to the alteration in the function of the sympathetic nerves and of the vagus. Paralytic ileus and neurogenic bladder are possible postoperative complications. Long-term ventilatory support may be necessary due to the fact that function of the diaphragmatic muscle may be problematic for an uncertain period of time. After the initial phase, a spinal cord injury rehabilitation protocol should be performed, ideally in the specialized environment of spinal cord trauma unit. The possible presence of tracheotomy may cause problems in the rehabilitation and in the quality of life. Vocal cord function may present problems affecting communication and self esteem. Additionally, the onset of cord central pain is a possible postoperative complication because of the transection of the spinothalamic tract.

Thus as it takes quite a while to align a head in a new body, the old scriptures hence put a 10 day time frame for the festivity to seep into the minds of humans and devotees.

ॐ गं गणपतये नमः