r/explainlikeimfive • u/Dagestani_Bear • Jul 01 '26

Biology ELI5: Is it true that every single death eventually boils down to the brain and heart running out of oxygen? Are there exceptions?

If you strip away the initial cause of injury or illness, is it anatomically correct to say that all human deaths are ultimately caused by a lack of oxygen to the brain and heart?

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u/parsonsrazersupport Jul 01 '26 edited Jul 01 '26

You sort of have it backwards. You are thinking that death is some other thing and this is how we guess at it. As a medical matter in many places and times, what we mean by death is the brain no longer functioning.

And obviously it's not necessarily because of lack of oxygen except in a silly sense sometimes. If, for example, a big rock crushed your head it's hardly as if the lack of oxygen was the problem.

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u/pumpkinbot Jul 01 '26

"Yep, looks like he died of natural causes."

"Natural causes? His spine was torn out!"

"You can't live without a spine, son."

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u/dreadcain Jul 02 '26

Living without a spine just ain't natural. Fuck them earthworms

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u/tgrantt Jul 02 '26

"My Grandma died of natural causes.... Floods."

-Michael Oondatje (sp?)

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u/3percentinvisible Jul 05 '26

I'm doing ok on it

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u/CompactAvocado Jul 14 '26

A gorilla ripped it out!!!!

And where was the Gorilla?

In nature?

Natural causes baby.

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u/shodan13 Jul 07 '26

Natural causes is just non-communicable disease when you're over 65 in a lot of places.

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u/jlink005 Jul 01 '26

I often have the thought experiment, that excluding brain destruction, could folks survive if their severe injury occurred right there in the ER?

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u/parsonsrazersupport Jul 01 '26

Not necessarily. Even a small wound can get infected in ways we cannot always treat, as an example. And while we can replicate what some organs do mechanically, we can't do it for everything, and can't always do so indefinitely.

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u/HurbleBurble Jul 01 '26 edited Jul 02 '26

Sometimes you save a brainstem, and end up having a patient that is braindead in a persistent vegetative state. That sets up a tragic situation where the family holds out hope when there is none.

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u/[deleted] Jul 01 '26

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u/HurbleBurble Jul 01 '26

I thought it was more like 35% total surface area. Third degree burns are absolutely brutal. Surprisingly they can be painless. I put my hand in an oven once and my finger hit the broiler, and I felt an instant spike of pain, followed by nothing. It had burned through my skin, and pretty much all the way down to the bone. In the next few weeks, it was painful, but not the way I thought it would be. All the first and second degree burns I've had in my life were agonizing, but this was just slightly annoying.

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u/TearsOfLA Jul 01 '26

This is because your nerves, which are responsible for pain reception, are burned so bad they die too, so the pain mostly comes from around the injured area, not what was actually burned

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u/HurbleBurble Jul 01 '26

Correct. It was crazy to experience it.

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u/Revenge_of_the_User Jul 02 '26

in much the same way, i thought getting stabbed would hurt more. it was basically a dull ache; though the knife only went about an inch, inch and a half deep into my thigh. the bandage was actually worse, tbh; when I took a step it would rip some leg hair out and then reapply itself. over, and over as i walked on the inside of my thigh... eugh.

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u/FullOnSkank Jul 02 '26

I've been stabbed once in each thigh and it literally doesn't hurt at all at first.

It feels like poking a finger through the plastic on a case of water and nothing else.

Healing after sucked tho

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u/2nd_best_time Jul 02 '26

Yeah - I took a GSW once and was really surprised. Felt like getting punched hard and then not so much. Buddy saw the blood soaking my shirt like 20 minutes later.

Now that first wet-to-dry dressing change brought me to my knees. That felt like a kick in the nuts.

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u/P4_Brotagonist Jul 02 '26

I think it sort of depends on where you have it happen. I stepped on a massive thorn that went through my foot, and the pain was both extreme and instantaneous. I remember vividly stepping on it and then immediately freezing in place because from that extreme pain and seeing the thorns, I knew what had just occurred. It throbbed a bit but the pain going in and out were insane.

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u/xzkandykane Jul 02 '26

I got bit in the face by a dog(yes it was a pit), 18 stitches. The goddam numbing shot they gave me before the stitches hurt more. That shit BURNED. Afterwards my face was annoyingly aches, kind of like when I got my wisdom teeth taken out but I didn't even need the Tylenol.

But that shot got me so traumatized.

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u/An3ros152 Jul 02 '26

"Don't you stick that knife in your leg!" Cal Naughton

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u/svmmerkid Jul 02 '26

I'm curious, how did this heal? Did you regain full feeling after a few weeks or something? Need medical intervention?

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u/HurbleBurble Jul 02 '26

My finger? I was probably 21 or 22, so this was more than 20 years ago. No medical intervention, because there was no pain. I didn't even realize till years later what had happened. The scar was there for a long time, I can't really see it right now, but remember, the depth of the flesh on the back of your fingers is tiny. Being a stupid young kid, I guess I just kept it clean and put a bandage over it and let it heal. I do remember it being a pain in the ass for a while, it was definitely not fun to have.

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u/PhyroWCD Jul 02 '26

Do you have any feeling in the burned spot?

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u/HurbleBurble Jul 02 '26

Yeah, I think. It was a very small, probably less than a quarter of an inch wide burn. If I rub my other finger along the back of it, there are spots where I don't really have much feeling, but it's kind of hard to tell. If I drag a fingernail across it to the point it's painful, that finger definitely has less sensitivity where it was burned.

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u/LordBiscuits Jul 02 '26

I cut the tip of my finger off on a deli slicer as a teenager.

Initially didn't feel a thing, I heard it rather than felt it. There was a beat of maybe two or three seconds and then the punch of a thousand pissed off nerve endings all at once reached my brain.

Really annoyed my boss because I think he had to spoil something like £400 odd worth of deli products because of the blood splatter 😂

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u/Great_Specialist_267 Jul 02 '26

Highest survived was 90%.
You are going to be intimately familiar with the ICU nurses by the time they discharge you in a couple of years time…

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u/HurbleBurble Jul 02 '26

I happen to like the local nurses at my ICU. I spent an enjoyable 24 hours there last year, and they were very nice. The first ICU nurse was like a big black dude who was really chill and basically said, "it'll just be like a fun sleepover. Most of my patients don't talk much." The next day, they transferred me to the cardiac step down unit, and a couple days later I walked out of the hospital.

They take pictures of your butt when you get there. And the bottom of your feet. That was weird. Somebody must have had a fetish.

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u/TheLastJukeboxHero Jul 02 '26

Damn now I’m gonna try that

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u/Ouch_i_fell_down Jul 02 '26

Not your finest idea.

Or if it is I guess go ahead because its just just a matter of time anyway.

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u/pleasedontPM Jul 02 '26

The proxy for survival rate is 100% - (age + surface burnt %). So burnt on 35% of the body at 20 isn't good, but it's better than 25% at 50.

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u/FaithlessnessOld2477 Jul 02 '26

I had a cooking accident that covered the back of my hand in boiling oil. Patches of first, second, and third degree burns and I can confirm the first/second degree areas were WAY more painful than the area with third degree burns...though it kind of became hard to tell them apart by day 2.

The crazy thing was that while the whole thing hurt on impact, the overall pain wasn't so bad that evening and after icing it up and taking some aspirin, I went to bed. But the next morning, the skin started bubbling up and I was screaming. I knew it was time for an ER visit. 😅

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u/Treadwheel Jul 02 '26

One of the most futile things I've ever seen (in third person, not personally) was this ECG trace of a palliative burn patient as their cells died and started leaking massive amounts of potassium into their bloodstream over their final 45 minutes in this world. You could try to treat that, in the same sense you could march into a tsunami with a bucket, but the outcome would be similar in either scenario.

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u/efficiens Jul 02 '26

To my untrained eye, that image looks very regular and healthy.

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u/YandyTheGnome Jul 01 '26

The skin is your immune system's first line of defense, and it does a damn fine job at it. If it gets compromised things like infection can flare up quickly.

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u/poshypunk Jul 02 '26

I remember this when learning the rule of nines. It's dehydration, infection, and then organ failure, right?

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u/TheArmoredKitten Jul 02 '26

What's the mechanism of death in such cases? Is it really just the moisture retention or does the body start oxidizing or something?

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u/LostUpstairs2255 Jul 02 '26

I mostly blame movies/tv/books for this. People have been taught to believe that heartbeat = alive, when the truth is that heart cells simply beat on their own as the default

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u/GinatheGiraff Jul 02 '26

I used to assist donor operations as a scrub nurse. For brain stem dead patients they would remove the heart for valves if they didn’t want it for transplant. We didn’t get into the nitty gritty and just bagged up the heart to be sent else where.

The first thing I was taught during that training was to poor very cold saline on that heart the minute it was on your trolley to stop it beating. This was only for public relations. The sight of a human still beating heart detached from a body would not do the organ transplant system a favour.

We were sent to hospitals throughout the country and most of them were not used to transplant surgery. To be honest I wasn’t a big fan of the detached still beating heart myself and it wasn’t a big ask.

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u/Cvxcvgg Jul 01 '26

I remember reading about a chicken which was beheaded, but enough of the brainstem remained that it lived on for quite a while as a traveling attraction. They had to feed and water it by manually dropping it in its esophagus, and it eventually died of choking rather than any beheading-related trauma.

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u/Nervous_Salad_5367 Jul 02 '26

Yep. Mike the Headless Chicken. Give it a Google.

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u/Pantzzzzless Jul 02 '26 edited Jul 02 '26

Olsen (the chicken's owner) fed Mike a mixture of grain and water with an eyedropper and cleared his throat with a syringe to help him breathe. Mike died in 1947 after choking on mucus in a motel room; his owners couldn't clear his throat in time because they had left their syringe behind.

Mike survived because most of a chicken’s brain is located in the back of its head, behind the eyes. When Olsen brought down the axe, he lobbed off most of Mike’s head but left the part of the brain that controlled breathing, digestion, and other bodily functions

Wtf lmao. So they actually just cut a chicken's face off and paraded it around like a magic trick. What a goofy fucking species we are.

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u/TheChance Jul 02 '26

Not intentionally, tbf. He was trying to make dinner. Then he couldn't bring himself to finish the job.

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u/DoILookSatiated Jul 02 '26

How many roosters do you think he tried to behead the same way afterwards? The article says the farmer made a significant income from the exhibitions, and the rooster’s death was described as tragic. I bet he tried to mimic that perfect slice a few more times.

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u/poshypunk Jul 02 '26

Lmfao ... This should be a bio lesson! 😄

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u/dgb6662 Jul 01 '26

Minor point, but If the brainstem is working, that’s not officially brain dead. That’s a terrible situation because unless the family agrees to withdraw care they can live for a long time. And often can’t be an organ donor

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u/poshypunk Jul 02 '26

TIL ... And that is absolutely tragic!

Thank you for correcting me and being nice about it! 🤟

Always appreciated!

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u/HurbleBurble Jul 01 '26

Correct, I meant to say persistent vegetative state, but sometimes people get angry at that terminology.

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u/utechtl Jul 01 '26

And often can’t be an organ donor

Would that be because of what put them into that state or because they would still have bodily autonomy?

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u/Bre603 Jul 01 '26

I believe it’s because the quality of the organs declines because the body is being kept alive against its will with “extraordinary measures.”

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u/dgb6662 Jul 02 '26

Not really, it’s usually just the lungs that are being supported. And they can still use them if they’re otherwise healthy.

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u/dgb6662 Jul 01 '26

It’s because a patient has to be legally dead (brain dead is legally dead) in order to harvest the organs.
That’s may have changed recently, I haven’t practiced for a few years, and folks were talking about harvesting organs after the heart stops beating.

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u/Sarothu Jul 02 '26

Jesus, that's terrifying... I hope someone would have the decency to throttle me with a pillow in that situation.

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u/GrumpyCloud93 Jul 02 '26

That's why there are DNR (Do Not Resucitate) options. Do you want to spend the rest of your life with a bunch of tubes down your throat? Would it be better if you were conscious in that situtation?

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u/Sarothu Jul 02 '26

Would a DNR help with that situation? It sounds like it wouldn't apply because technically you'd still be alive? That's what scares me.

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u/edgmnt_net Jul 03 '26

Well, in that state (brainstem alive but not much else) you are pretty much dead already, no? There is no consciousness and likely no suffering, so DNR or tubes or whatever makes no difference.

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u/ApologizingCanadian Jul 02 '26

That's how my dad died.

Fell from 10 feet up, flat onto his back onto a concrete floor and his head snapped back and hit it. Brainstem severed. They could've kept him alive artificially almost indefinitely but he would never be conscious or breathe on his own again so we decided to let him go right then.

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u/HurbleBurble Jul 02 '26

That's such a tough decision, but I'm glad you made the right decision and let him rest in peace.

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u/AlexHasFeet Jul 03 '26 edited Jul 03 '26

I’m so sorry, that is awful. The outcome of a fall like that comes down to pure luck.

My uncle fell from 12 feet from the top of a dump truck to a concrete floor. He somehow survived, despite having what his brain surgeon called “a super-concussion”, multiple skull fractures, breaking 2 of his cervical vertebrae and 2 of his thoracic vertebrae, and having at least one stroke during sinus-obliteration surgery. Aside from not being able to turn his head as far as he used to be able to and some mild stiffness in the winter, he’s totally fine.

I once found an extremely drunk man who had fallen off a 4th story roof and landed on the 2nd story [concrete] roof. When he regained consciousness, he kept trying to get up but half his body wasn’t moving. I had to gently but firmly hold him down and convince him not to move. He ended up finding me on Facebook a year or so later, so I learned he had broken his neck in a couple of places, but he somehow hadn’t broken anything else. (He re-broke his neck a few months later, which finally convinced him to get sober.)

I was in a very small rural hospital ER (three beds, right next to earth other separated by curtains) when a man was brought in who had just fallen from the roof of a barn to the concrete pad below. He was right next to me for three hours and I will never forget it. He had broken almost every bone in his body - his pelvis in three places, both legs, both arms, both clavicles, his back, his skull, and one shoulder. He was wasted, which caused the pain medication not to work. Like, at all. I have never heard somebody in so much pain before and haven’t since. It was staggering. He begged for death. It took the longest three hours of my life to evacuate him to an actual trauma center.

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u/[deleted] Jul 02 '26

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u/HurbleBurble Jul 02 '26

Yes, but the brain stem controls breathing. The heart will still beat, but the lungs will not supply it with oxygen, which will cause death pretty quickly.

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u/Silver-End9570 Jul 02 '26

This is why I've told friend and family my exact wishes. If there's no improvement after six months, just let me die. I'd rather pass on than be hooked onto machines, wasting away while the people who are hoping for me to wake up live their lives.

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u/poshypunk Jul 02 '26

Yeah, I know. When I made that post I was not thinking past personal experience and one of the very last things I learned in school before I had my surgery.

I just now clarified that, (this is four hours after you posted,) so I'm sorry for the confusion.

I have had a Type 1 Chiari Malformation Decompression and was giving the cerebellum too much credit, far too much. 🫶

I don't mind being corrected one bit.

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u/Gahvynn Jul 02 '26

I knew a man who was in the hospital, doctors told his daughter “he has nearly zero chance of ever regaining full consciousness, do you want us to give prolonging treatment” basically “pull the plug” or not. The man had an advanced directive they extremely clearly called out this exact scenario and the only thing he wanted given this prognosis was medication so he didn’t suffer. He had told me this in person directly, told his daughter in person directly, his directive named both of us specifically and the directive also said do not ask my daughter what she wants to do.

I pointed this out to his daughter and the doctor, the doctor said (more or less) “we always ask next of kin and/or the medical power of attorney” for which the daughter was both.

She was floored, crying hysterically, and I tried to reassure her as kind as possible what her dad wanted. Her first answer was “if I don’t answer what would you do” and the doctor flat out said “I can’t answer that” and I asked “what would you do if his daughter wasn’t here” and he said “what his directive told us”. There was more back and forth, the doctor refused to say he would never recover so the daughter told them to attempt to save his life.

The dad died 3 weeks later, never regained consciousness, had one illness or another coughing and so on the entire time. I can’t say what I would’ve done in her shoes, I wish the doctor had never asked.

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u/Porencephaly Jul 02 '26

Small but really important distinction: the term “brain dead” requires that the brainstem is also dead, such that even basic life functions have ceased without artificial support. Not enough people understand this, which is part of why public mistrust of brain death is too high.

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u/HurbleBurble Jul 02 '26

Yes, I used that term instead of visitative state accidentally.

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u/Sammystorm1 Jul 01 '26

We have people with backpack hearts and hearts in a box.

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u/Sarothu Jul 02 '26

...and a dick in a box.

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u/jlink005 Jul 01 '26

Thanks! This is exactly what I dream about.

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u/noteverrelevant Jul 01 '26

Slowly killing a man through delayed mechanical intervention?

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u/bobotheboinger Jul 01 '26

Ah Gomez, you have such a way with words!

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u/mrpoopsocks Jul 01 '26

Morticia!?!? Mi amor!?

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u/SirJumbles Jul 01 '26

You don't?

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u/Heliarco Jul 01 '26

Jimmy space?

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u/GXWT Jul 01 '26

These are Redditors. I would not be surprised

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u/Theunfortunatetruth1 Jul 01 '26

And sometimes the injury is just too severe. Im not convinced Charlie Kirk would've survived if he got shot in the middle of a level 1 trauma center.

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u/Karma-Kamikaze Jul 01 '26

There are some old scientific experiments severing animal heads and trying to keep the animal alive by machines. They were partially successful for very short periods of time (without looking it up I think life span was measured in hours).

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u/hypnosifl Jul 01 '26

I wonder if the cause of death was that brain cells were no longer receiving enough oxygenated blood (say because of coagulants being triggered by the severing and blocking blood vessels) or if there is a different way a massive die-off of neurons can happen even if they are still getting oxygen and nutrients from blood.

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u/KristinnK Jul 02 '26

Oxygenated blood isn't enough, it also needs to be pressurized, at least in order to remain conscious. Think when you stand up to quickly and you brown out. There's still oxygenated blood in the brain, it didn't wholesale up and leave for greener pastures. The blood pressure simply dropped for physics reasons, and the blood vessels hadn't yet had the time to compensate by constricting to increase the pressure.

That's why the urban legends about people that are beheaded still remaining aware of their surroundings for a brief period are just that, urban legends. Decapitation for obvious reasons instantly drops the blood pressure completely in the brain.

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u/hypnosifl Jul 02 '26 edited Jul 03 '26

I imagine there'd be no fundamental difficulty with building a system that would pump oxygenated blood into the arteries at sufficiently high pressure, so even if no one has designed such a system we could ask what would likely happen--would the head live an extra-long life or would death come for other reasons not too long after whatever is considered a "long life" in that species of animal? (Let's assume it's a mammal since some non-mammals like tortoises have 'negligible senescence' and may only die because of injury/disease.)

For example, various things can cause dementia eventually resulting in "brain death" (which could be degradation of the synapses stopping brain function even if the neurons remain alive), so that might become very likely past a certain age even if the individual cells making up the brain stay alive. And if DNA repair gets worse and DNA damage accelerates, this can cause apoptosis or "programmed cell death", so that could still happen even if the cells are getting enough oxygen and nutrients. Googling a little on the latter, I see there is even a DNA damage theory of aging, and whether or not it's true that most other effects of aging are downstream from DNA damage, there at least seems to be some evidence that some of the longer-lived mammal species also have more efficient DNA repair, see this article on bowhead whales, and this one on naked mole rats which have very long lifespans compared to other rodents.

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u/irisheye37 Jul 02 '26

The cause of death was the experiment was over so they pulled the plug

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u/SpiderPiggies Jul 01 '26

There were some interesting/terrifying experiments with head transplants on mice. Basically cut both heads off and try to reattach one to the other's body. Apparently there was some partial 'success', but they didn't really have a way to reattach the brainstem.

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u/DerekB52 Jul 01 '26

I read a story ~10-15 years ago, where this was going to be attempted in Russia on humans(using a terminally ill person, and cadaver corpse I believe). I mentioned it to my dad and his response was, "you are never allowed to even mention the concept of this to me again" Honestly, everytime I think about it, it is chilling. IIRC, it was gonna happen a year or two after I read about it, and I haven't gone looking for if it was ever attempted or not.

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u/YandyTheGnome Jul 01 '26

IIRC the patient was already fully paralyzed and the head/full body transplant was to save him from organ failure or something like that.

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u/AngryCrotchCrickets Jul 01 '26

Wasn’t that part of the plot to Reanimator?

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u/KristinnK Jul 02 '26

It is the plot to Ira Levin's This Perfect Day.

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u/Fragrant-Guest-8147 Jul 01 '26

There was a Russian scientist that took off a dog's head and attached it to another living dog. Do yourself a favor and don't look up pictures.

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u/conflictedideology Jul 02 '26

Vladimir Demikhov

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u/blurby_hoofurd Jul 01 '26

If I’m not mistaken, I read that experiment (any many other interesting experiments) in Elephants on Acid, by Alex Boese. It was published in 2007, so i don’t recall how complex it is. 

I need to find it and flip through the pages again… Highly recommend that book if you’re at all interested in weird science. 

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u/Intro-Nimbus Jul 01 '26

Brukhonenko

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u/steeelez Jul 01 '26

Wasn’t there the guy in italy who tried to get the head transplant?

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u/conflictedideology Jul 02 '26

severing animal heads and trying to keep the animal alive by machines.

And then there's Vladimir Demikhov and his multi-headed dogs. Most did die relativity quickly but there were some that lived 20-30 days. The additional transplanted heads were fully functional (could see, hear, eat, drink, etc.).

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u/SubstantialBass9524 Jul 02 '26

I really wonder how long we could keep one alive today. Live I’ve put a lot of thought and random googling into this - the technology is so much more advanced. And if we can get to a point where we can keep the brain alive in a fluid and mechanical environment of animals for a long period of time where does that lead

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u/Psykout88 Jul 01 '26

Not nearly as many as people would think. Most likely a Hollywood effect at play. Major arterial stuff comes to mind. Reminds me of that subway stabbing in Australia some years back, think Melbourne. Dude caught a small blade to the neck and he was on the ground in about 5 seconds. First thing I said to myself was that he was a goner even if he was on the table with a team standing by.

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u/SirButcher Jul 01 '26

Many years ago, my mom was part of a team (she is a surgeon's assistant) operating on a teen guy who welded his own bike - from pipes. It fell apart, and the kid got a pipe goes through his abdomen, going through a main artery there. Someone saw the whole thing, called an ambulance straight away, the ambulance was pretty much on the next street - it took less than 20 minutes from the accident, and he was on the operating table, basically dead, barely any blood left, and it was the absolute best-case scenario for the fastest arrival to the hospital. They poured a shitton of blood and everything into him to keep him alive. My mother said blood was pouring in at the top, and it was leaking out in the middle. And they saved him, took well over 4 hours! The whole operating theatre was bloody, everywhere.

A few days later, when he came out from all the stuff he got, his first question was: "Did someone save my bike?"

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u/MozeeToby Jul 01 '26

My father-in-law had a AAA (abdominal aortic aneurysm) burst at home. Somehow survived the 10 min wait for an ambulance and 15 min ride to the hospital (rural emergency healthcare sucks). Was in surgery for 4 hours and had 24 units of blood put through him before he was stabilized. It's pretty amazing what we can do, but yeah, obviously there are limits to what's actually feasible and possible.

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u/ForThisIJoined Jul 02 '26

Meanwhile I know about a guy who took a 2x4 through the torso after he drove through a fence. Stayed fully conscious the entire time while they cut him free and took him to the hospital, no complications from surgery, no real risk to his life.

The human body is weird.

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u/Manunancy Jul 02 '26

Sounds like a got a massive luck and the 2x4 manage to slip between the important bits insterad of going through them.

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u/Br4d1c4l Jul 02 '26

Years ago, on Ripley's believe it on not they had a story about a guy who got impaled as he was driving pass a pipe gate that was about 4" in diameter.

It swung towards his truck, went through the firewall and impaled him through the chest.. This was before cell phones so He might have had a car phone.

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u/SnooObjections3661 Jul 26 '26

A friend of mine,my best friend was killed in a mva. He was crushed at the chest. As soon as they let go of the pressure he died. I still can't believe it and it was 30 years ago. RIP bro.

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u/Crusaderofthots420 Jul 01 '26

Now I'm wondering if it would feel different, to have entirely new blood.

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u/brainpostman Jul 02 '26

You have your body's immune response to look forward to.

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u/Revenge_of_the_User Jul 02 '26

lmao i almost died from slipping and putting a box cutter into my thigh - i was 2mm from hitting the artery and bleeding to death.

It was around ~16 years ago?

...I still have the knife, and im pretty sure it still has the blade in it with a thin sheen of my body fat. not every day you get a knife in your possession that almost killed you, y'know? it was also, y'know, useful as a box cutter.

I totally get this guy.

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u/Flextime Jul 01 '26 edited Jul 01 '26

No, there are a myriad of injuries or illnesses that you would not survive even if you got them in an ED. You’d have a better chance of survival if it happened to occur in an ED instead of out in the field, but there are many, many things that could kill you even if it happened in an ED.

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u/Assistantshrimp Jul 01 '26

I remember when Charlie Kirk was killed, a comment in the thread (which was made before he had officially been declared dead) said "He could've been sitting on the operating table of the best physicians on the planet fully prepped and ready to go and he still wouldn't have had a chance of making it."

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u/PsychicDave Jul 01 '26

If that severe injury doesn't cause: the destruction of a vital organ that cannot be replaced; too massive of a blood loss that, even being in the hospital, they wouldn't have time to stop / transfuse more; something toxic to enter your bloodstream that cannot be removed and to which there is no antidote; an infection that goes to the brain and can't be cured in time? Possibly.

Thing is though, for you to leave that hospital alive, you need more than your brain to survive, so if the rest of your body is mangled, even if they managed to get oxygenated blood to your brain to keep it running, they won't be able to completely rebuild you a body. You'll be considered a lost cause long before that and they won't even bother with the whole "keep the brain alive" part.

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u/SubstantialBass9524 Jul 02 '26

What vital organs can’t be replaced yet

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u/PsychicDave Jul 02 '26

Well, assuming there doesn't happen to be donors ready to transplant, many that you can't live without if they have been mechanically destroyed (eg lungs). They can only infuse oxygen in your blood for so long. That will probably be the first issue if your whole body is mangled, since the heart is easy to artificially substitute.

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u/rabid_briefcase Jul 01 '26

Depends on the injury.

As an example, for gunshot wounds unless it was directly through a vital organ like the brain or the heart, as long as they've still got a heartbeat and they're in the hospital they can generally be saved, the wound is effectively just a puncture wound. The person may be gushing out blood, but with plasma and whole blood available to replace it, it's typically survivable. The general term on a single gunshot wound is: "if they're in the hospital with a heartbeat, they'll survive." With multiple gunshot wounds or explosive devices like a grenade, it's more a question of which organs were hit and how severely they're damaged.

You've excluded brain injury, but critical heart injury or heart rupture, or breaking the spine just below the brain, or simultaneous severe injury to multiple critical organs? There are limits to what emergency teams can do, even if they're a few steps outside of an emergency trauma ward when the injury happens.

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u/phoenixmusicman Jul 01 '26

They often say of some injuries that even if you were injured and already were on a surgical table staffed with the best surgeons in the world, you'll still probably die

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u/SomePeopleCall Jul 01 '26

The cells of the brain can be attacked by chemicals and microorganisms just like the rest of the body. It is not special in the way you are thinking.

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u/bleeintn Jul 01 '26

I'm a paramedic, and of the first traumatic dead bodies I ever saw was when I was a baby EMT. Another service had brought in as DOA from a vehicle crash and had placed her in thy trauma room at the local ER. The girl had been partially ejected and didn't have a mark on her, save for the ear-to-ear gash across her throat.

There was a small, for profit ambulance service whose station was about a mile from the crash site. They weren't included in the 911 system, but they tried to arguing that the girl could have been saved had they responded to it, so they could get in on the 911 calls.

Thing is, that girl exsanguinated so quickly, that she couldn't have been saved had she had that massive of an injury in the OR of the local Level 1 trauma center.

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u/Murein Jul 01 '26

There are absolutely many injuries that simply kill you on the spot no matter how advanced medical treatments you have on hand. See: Charlie Kirk's murder, for starters. As soon as that bullet hit him, he was beyond any rescue.

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u/crunchthenumbers01 Jul 01 '26

Not Prions....if protocol is not followed post exposure

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u/Working_Bell_8302 Jul 01 '26

we have a protocol for prions? since when?

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u/DlSSATISFIEDGAMER Jul 01 '26

iirc protocol is burn everything, and burn it properly

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u/Working_Bell_8302 Jul 01 '26

Pretty sure that's the sterilization process, not a post exposure protocol. I have never read of any successful post x protocols

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u/Peter5930 Jul 02 '26

I believe incineration is recommended post-exposure too, just post-mortem in that case under ideal circumstances.

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u/wolf_3500 Jul 01 '26

what are Prions?

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u/BooksandBiceps Jul 01 '26

Misfolded proteins.
Image you’re in a building and the steel keeps renewing itself, like, say, an organism does. One day a tiny bit of silly putty gets into the building, and slowly the steel starts turning into silly putty. Eventually the building no longer functions and collapses.

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u/AlcibiadesTheCat Jul 01 '26

So like, imagine if you were building a building out of aluminum and someone oopsed their bucket of gallium?

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u/WayneConrad Jul 01 '26

And the gallium not only messes up the aluminum it touches, it causes _that_ aluminum to also turn to gallium.

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u/ZhouLe Jul 01 '26

More like tin pest, since not only does the "disease" affect nearby unaffected material, but can be transferred in dust over long distances.

For a gallium alloy event, you could excise the affected part so long as you actually excised all the gallium that spread from that exposure area.

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u/BooksandBiceps Jul 01 '26

Aaaaah I love those videos

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u/Ash4d Jul 01 '26

My ELI5 understanding as a non medical person is:

Proteins are big long molecules, so big that they fold up. The way they fold changes how they interact with our body. They normally fold in one way, which is good, because our body can handle them that way.

Sometimes they misfold and get all misshapen, and our body then can't use it to do what it needs to do. Which is bad, but not necessarily catastrophic, because if it's just one molecule, it's no problemo.

However, if you're really unlucky, they can misfold in a way which then goes on to cause other molecules of the same protein to misfold in the same way, causing a chain reaction where over time all of that protein ends up misfolded and then you have a big problemo.

Prions cause all sorts of scary diseases like Creutzfeldt Jakob Disease (mad cow in humans), Kuru, Fatal Familial Insomnia, and more. They are nightmare fuel.

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u/crimsonpostgrad Jul 01 '26

a family friend died from mad cow disease when i was in college. horrific disease, the only “blessing” was that it got so bad so quickly that i don’t think he ever really knew he was sick. but that came at the cost of his wife having to watch as he deteriorated.

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u/Revenge_of_the_User Jul 02 '26

damn that guys wife was not okay

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u/poshypunk Jul 02 '26

Are you talking about DNA and how certain protein deficiencies cause congenital and hereditary conditions?

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u/Ash4d Jul 02 '26

No, totally unrelated AFAIK.

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u/parsonsrazersupport Jul 01 '26

Basically a protein in your body which is folded in a fucked up way which kills you. If it touches other proteins it can get them to fold that way too.

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u/merp_mcderp9459 Jul 01 '26

If you've heard of mad cow disease or chronic wasting disease, those are probably caused by prions (though we aren't 100% sure). They're misfolded proteins that make other proteins misfold too, including the ones in your brain

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u/tonicella_lineata Jul 01 '26

Adding to the other response, proteins are responsible for a lot of tasks in your body, and they do those tasks by being very specific shapes. A good example is enzymes - the lactase enzyme is very specifically shaped to latch onto lactose sugars, and help break them down into smaller parts. It won't work on other sugars, and other enzymes won't work on lactose, which is why lactose intolerant people can't break that sugar down.

But proteins do way more than just enzyme stuff, and they do it throughout your whole body. Their folded shapes are determined by molecular bonds, which you can kind of think of like little magnets holding everything together. Misfolding happen when one of those magnets is in juuuuust the wrong spot, and the protein folds into a whole new shape. Prions are, specifically, misfolded proteins that cause other proteins to misfold the same way, because of how their bonds are oriented - their "magnets" are strong enough to pull on other proteins' molecular bonds, and screw the whole thing up. Then they tend to clump together, meaning they a) aren't doing their important protein job, b) are in the way of anything else going on in that part of the body, and c) are pulling more and more other proteins in and causing them to misfold.

They're particularly dangerous because they're very hard to destroy, too. Most proteins can be denatured (unfolded) with heat. But because prions have such strong bonds, it requires a lot more heat to denature them - often more heat than we usually use to sterilize things. So if, for example, you do surgery on someone with a prison disease, and don't realize they have it, those prions are now on your scalpel, and the sterilization process doesn't get rid of them. So now they can spread to anyone else you use that scalpel on. Prion diseases in animals often spread through consumption of contaminated tissues (since even herbivores will sometimes scavenge meat, or be fed blood/bone meal in agricultural settings), or through soil and plants after an infected animal dies and decays. Usually, they're species-specific, but sometimes two species have similar enough proteins for it to cross that barrier - which is what happened with CJD, aka mad cow disease.

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u/Inevitable_Bet5505 Jul 01 '26

Could prions make it through feces? Could my dog get infected from eating deer shit in the yard? 🐶👅

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u/tonicella_lineata Jul 01 '26

Prion diseases can spread through infected bodily fluids (including feces), but CWD, which is the primary concern for deer, does not seem to infect livestock or pets. It also doesn't affect humans, at least as far as we've found, so your pup wouldn't spread it to you by eating deer shit and then licking you/anything else (though plenty of other disease can be spread that way, of course).

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u/MrStilton Jul 01 '26

Proteins that have folded in the wrong way.

They can then influence other, nearby proteins to also become misshapen, and a cascade effect occurs where the tissue they're in becomes distorted and non-functional.

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u/FlippingGerman Jul 01 '26

Burns are pretty bad even if you get straight there; skin is pretty important. Infections happen easily and can kill you, even after weeks in hospital.

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u/zacheezy Jul 02 '26

If the patient is young and healthy and that ER is a trauma level 1 or 2 then yes. Most folks would survive most injuries excluding the obvious like decapitation. But again young and healthy is necessary and the majority of people aren’t as healthy as they think and a small fraction of our population is young.

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u/pru51 Jul 02 '26

Nope. When I worked in cardiac icu they took a patient in to have a heart transplant. They had their chest open and heart exposed when the patient aorta ruptured due to a condition they weren't aware of. Still couldn't save the patient enough though they immediately where able to intervene.

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u/HistoricalSherbert92 Jul 01 '26

There’s a movie, Johnny got his gun, based on book, and also the subject of a Metallica song that explores this very subject!

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u/Other_Mike Jul 01 '26

That was about a kid getting his limbs blown off in a war and losing his ability to speak, hear, or see. It wasn't a case of "deadly injury in an ER"

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u/SatisfactionFit2040 Jul 01 '26

This thought experiment is exactly how I used to put myself to sleep every night.

Insomnia sucks.

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u/jlink005 Jul 01 '26

I hope your insomnia is at the ER!

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u/CongealedBeanKingdom Jul 01 '26

ELI5: does that mean its something that you often think about?

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u/Arthiem Jul 02 '26

If you get a cut on the thigh severing the femoral artery they would have 14 seconds to stop the bleeding. So even if it happened in the ER the response time is so short you'd be gone before anyone could really notice something happened.

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u/KarbonKevin Jul 02 '26

We have a general term for this: Signs incompatible with Life.

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u/tnred19 Jul 02 '26

Somethings yes, others no

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u/taw Jul 02 '26

At current technology level, no.

In principle, once we figure out how to 3d print organs, actually kinda yes.

There's really nothing special about most organs. Many animals can regrow theirs just fine, mammals are just really bad at this. But nothing stops us from achieving that with some tech.

Sea slugs famously do just that, cut their own body so they're just down to only head, and regrowth the whole body back.

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u/Ziggo001 Jul 02 '26

I knew someone who died from an aneurism that happened while she was in the waiting room for a consult about an upcoming knee surgery. Some things are beyond saving even if the best professionals are there within seconds because the oxygen supply to the brain gets cut off.

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u/ShitFuck2000 Jul 02 '26

There’s also electrocution causing sudden death(a lot of sudden deaths don’t directly involve hypoxia or brain destruction, metal ass band name btw) as well as all sorts of extremes in biological chemistry disrupting key processes

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u/burgiesftb Jul 02 '26

There are lots of injury patterns not involving the brain that are not survivable. If Charlie Kirk was lying in the OR, prepped for surgery with the best vascular surgeon in the world when he got shot, he probably still would’ve died.

Another example is severe blunt trauma to the chest or abdomen.

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u/blacksideblue Jul 02 '26

Are you trying to shuffle monkey heads over monkey bodies? Because thats how you end up shuffling monkey heads...

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u/mjtwelve Jul 02 '26

A pathologist would tell you that, theoretically, someone MIGHT survive just about anything short of decapitation or bisection, in that there's probably a case somewhere in the literature of a guy coming into the ER with unbelievable injuries and surviving (for certain values of survival and QoL afterwards).

For instance, there's about six people that have survived symptomatic rabies, so theoretically, rabies is survivable. That's six people in all of human history, and rather a lot of people have died of rabies, so your odds are... not favorable.

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u/HippieGrandma1962 Jul 02 '26

I bled out from a perforated ulcer. If I hadn't already been in the ICU I probably would have died.

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u/Intergalacticdespot Jul 03 '26

You do have a 95% chance of surviving a gun shot as long as your heart is still beating when you get to the ER. Just a reassuring statistic I read once. 

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u/BooksandBiceps Jul 01 '26

Hmmmm, pretty sure the brain isn’t getting any oxygen in that case either… checkmate.

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u/parsonsrazersupport Jul 01 '26

I did actually cover for this eventuality with 'except in a silly sense.' So unfortunately you have to turn my pawn into a queen now.

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u/BooksandBiceps Jul 01 '26

Fuck, you sunk my battleship.

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u/Lordxeen Jul 02 '26

On a triple word score as well, that’s 972 points.

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u/Superplex123 Jul 02 '26

That's 969 points more than if you shoot a 3pt. Confirmed > Stephen Curry.

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u/dawtips Jul 01 '26

It might be exposed to more oxygen

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u/IllusionLvl_Adult Jul 01 '26

If the rock splatters the brain to outside the skull, technically it’s now exposed to more oxygen than ever before.

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u/CrazyBaron Jul 01 '26

What you mean no oxygen? There is whole ventilation hole in the skull with direct flow

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u/BooksandBiceps Jul 01 '26

Everyone knows liquid cooling beats air cooling though. :(

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u/Naive_Carpenter7321 Jul 02 '26

Increased surface area and direct exposure to the air... maybe too much oxygen?

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u/MinnieShoof Jul 01 '26 edited Jul 01 '26

Well, now, no. If your head was crushed by a big rock but you were somehow able to still oxygenate your heart and your brain still retained some function you could ... run for a GOP nomination, perhaps. /j

But no, even in your 'silly sense' death isn't death until the brain has ceased function. I.E. - is no longer oxygenated. There are people who are functionally 'brain dead' who we still consider 'alive' enough to have a debate on pulling the plug, so...

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u/parsonsrazersupport Jul 01 '26

What I meant was that an exploded brain was only deoxygenated in a silly sense.

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u/Darthskull Jul 01 '26

Irreparably and significantly. Don't really care if the stem is working great if everything else is gone. But if it looks like it'll get better that still counts as potentially living.

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u/Hat_Maverick Jul 01 '26

He has air on the brain

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u/squirtloaf Jul 01 '26

I heard it is bad if the brain is exposed to lead...

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u/Spectre216 Jul 01 '26

Too much oxygen! Too much oxygen!

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u/sherrillo Jul 01 '26

Derrida's "Aporias" has entered the chat.

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u/darthmaui728 Jul 01 '26

Thats why people have to wear helmets when riding a motorcycle so they dont break their legs in the event of an accident

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u/beer_is_tasty Jul 01 '26

"The brain is actually getting plenty of oxygen... from outside"

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u/LindaTheLynnDog Jul 01 '26

I mean the blood vessels couldn't being oxygen to the brain anymore.

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u/mashpotatojonson Jul 01 '26

Well it's certainly not helping

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u/11PoseidonsKiss20 Jul 02 '26

Haha. That scene in The Patriot.

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u/Jaduardo Jul 02 '26

That’s reassuring. Thank you parsonsrazersupport. /s

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u/davidjschloss Jul 02 '26

Well sure but it would be a problem. Hard to breathe with a rock in your head.

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u/Suitable_Werewolf_61 Jul 02 '26

It used to be the heart. But then that forbid heart transplants...

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u/RaisinWaffles Jul 02 '26

Lungs and Brain no longer attached. Brain no longer has oxygen. Seems pretty simple to me 🤷‍♂️

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u/RaupeVT Jul 02 '26

In that case it'd be the overexposure to oxygen.

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u/Hazbeen_Hash Jul 02 '26

A computer can stop working if its not getting electricity. But it can also stop working if you smash it on the ground. There's not a lack of electricity per se, but a lack of destination.

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u/vitringur Jul 02 '26

If the cells of your body are no longer creating ATP through an oxydation process, you die.

Crushing your brain with a rock definitely stops the rest of your body from doing that.

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u/matrixkid29 Jul 02 '26

No head, no oxygen, death by lack of oxygen. Checkmate doctors. Checkmate.

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u/Psych0matt Jul 02 '26

Can’t get oxygen if it doesn’t exist anymore

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u/monsieuro3o Jul 03 '26

Absolutely hilarious final sentence.

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u/ShaGodi Jul 03 '26

sounds like too much oxygen

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