The Uncanny: An Examination of Re-Animation and Death
Grace Oei, MD, MA, Loma Linda University, Loma Linda, CA
In his famous essay “The Uncanny,” Sigmund Freud explored the eerie and unsettling nature of experiences that are simultaneously familiar and unfamiliar. An experience is uncanny when something familiar suddenly becomes strange or disturbing. It can elicit a robust emotional response. There is no other word or concept to describe the feeling I experienced when the hospital where I work performed its first organ procurement procedure using normothermic regional perfusion with controlled donation after circulatory death (NRP-cDCD).
In this presentation, I will first provide background information and pertinent details on organ donation after circulatory death (DCD), including which patients are candidates for DCD and how DCD is performed. I will then provide additional information on the differences between DCD and NRP-cDCD. For the purposes of this abstract, during NRP-cDCD, after death is declared, the transplant surgeons clamp the arteries that provide blood flow to the brain, cannulate the right atrium and the aorta, hook the cannulas to a pump, and pump donor blood through the body to re-perfuse all of the organs, except the brain, whose vessels have previously been clamped. The organs receive oxygenated blood and resume a semblance of function similar to before life-sustaining treatment was withdrawn. The heart, previously stilled, begins to beat again. After a period of re-perfusion, the organs are carefully removed from the patient, put into fluid that preserves their function, and transported to other hospitals where they are transplanted into other patients.
Using Freud’s theory of the uncanny, I will explore the emotions I felt when my once-alive then dead patient seemingly re-animated. In particular, I will examine Freud’s explanation of “surmounted primitive beliefs”. Primitive beliefs allow us, in our simple or naïve state, to believe in the possibility and the occurrence of unexplained events. Primitive beliefs are akin to magical thinking. As we learn more, the primitive belief is surmounted by new ways of thought, such as scientific theories and proposals. The primitive beliefs do not go away but are merely supplanted, allowing the uncanny to occur when an experience seems to support the old, discarded belief. The subjects of the most ensuring primitive beliefs tend to be existential ones – when life begins and when life ends. We have tried to supplant these primitive beliefs with other religious and scientific theories. The supplanted beliefs, though, may not be as robust as we imagine, especially when they allow the uncanny to slip through.
Religious beliefs surrounding death and rebirth occur in every religion. In the Christian tradition, I pose two areas of contradiction in how death is taught, which may allow the uncanny to slip through - the agony and pathos contrasted with the forgiveness Jesus displayed during his crucifixion and the deliberate pause Jesus implemented after hearing about Lazarus’s illness, which allowed Lazarus’s condition to progress to death. Perhaps the uncanny reveals that our religious beliefs are not so far from our primitive beliefs.
In this presentation, I will first provide background information and pertinent details on organ donation after circulatory death (DCD), including which patients are candidates for DCD and how DCD is performed. I will then provide additional information on the differences between DCD and NRP-cDCD. For the purposes of this abstract, during NRP-cDCD, after death is declared, the transplant surgeons clamp the arteries that provide blood flow to the brain, cannulate the right atrium and the aorta, hook the cannulas to a pump, and pump donor blood through the body to re-perfuse all of the organs, except the brain, whose vessels have previously been clamped. The organs receive oxygenated blood and resume a semblance of function similar to before life-sustaining treatment was withdrawn. The heart, previously stilled, begins to beat again. After a period of re-perfusion, the organs are carefully removed from the patient, put into fluid that preserves their function, and transported to other hospitals where they are transplanted into other patients.
Using Freud’s theory of the uncanny, I will explore the emotions I felt when my once-alive then dead patient seemingly re-animated. In particular, I will examine Freud’s explanation of “surmounted primitive beliefs”. Primitive beliefs allow us, in our simple or naïve state, to believe in the possibility and the occurrence of unexplained events. Primitive beliefs are akin to magical thinking. As we learn more, the primitive belief is surmounted by new ways of thought, such as scientific theories and proposals. The primitive beliefs do not go away but are merely supplanted, allowing the uncanny to occur when an experience seems to support the old, discarded belief. The subjects of the most ensuring primitive beliefs tend to be existential ones – when life begins and when life ends. We have tried to supplant these primitive beliefs with other religious and scientific theories. The supplanted beliefs, though, may not be as robust as we imagine, especially when they allow the uncanny to slip through.
Religious beliefs surrounding death and rebirth occur in every religion. In the Christian tradition, I pose two areas of contradiction in how death is taught, which may allow the uncanny to slip through - the agony and pathos contrasted with the forgiveness Jesus displayed during his crucifixion and the deliberate pause Jesus implemented after hearing about Lazarus’s illness, which allowed Lazarus’s condition to progress to death. Perhaps the uncanny reveals that our religious beliefs are not so far from our primitive beliefs.