CMDA's The Point

If I Only Had A Heart…

November 16, 2021
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by David Prentice, PhD

In the classic tale The Wonderful Wizard of Oz by L. Frank Baum, perhaps most recognized by the 1939 movie version starring Judy Garland, young Dorothy Gale from Kansas and her dog Toto are transported via tornado to the strange Land of Oz and undertake a journey to see the Wizard of Oz in hopes he can return them to their Kansas home. Along her path on the Yellow Brick Road, Dorothy acquires three traveling companions who also have requests they hope the Wizard will grant, to give them each something they seem to lack: a brain, a heart and courage. The group’s progress and attempts to win the favor of the Wizard are hindered and harassed repeatedly by the Wicked Witch of the West and her minions, including incessant taunts about their shortcomings as well as a dire warning for Dorothy: “I’ll get you, my pretty—and your little dog, too!”

Near the end of the story, the Wizard bestows on members of the group a gift. However, the gift was not the characteristic they originally sought, but rather a recognition that they already possessed those attributes which they were told they lacked. And for Dorothy, the realization she had a home that she valued.

There is in some sense a certain parallel with the journey of a human being during embryological development, including harassment and science denial by various naysayers, especially in the context of current court cases related to abortion.

A Heart?

Some abortion providers have contended that the human embryo at six weeks gestation has no heart, no blood circulating and no accompanying heartbeat, and that what is detected by ultrasound at that age is electrical activity from cells that will become the heart. Some have also questioned whether the doctors who made such statements slept through medical embryology. Certainly, it’s a poor worker who understands neither the subject of their work nor the function of their tools.

The heart is the embryo’s first functioning organ, with the first heartbeats occurring approximately day 22-23 after fertilization (the sixth week of gestation in pregnancy), followed by active fetal blood circulation by the end of the sixth week. The heart forms very early in embryogenesis because the embryo’s survival requires circulation of oxygen-carrying blood, a fact that is validated by all embryology textbooks. Passive oxygen diffusion at that age is insufficient to support metabolism and life, so the fetal heart beats and circulates blood to provide oxygen and nutrients to the developing human. Without a heartbeat, we die; this is true of all humans from the sixth week onward.

Initially, the embryonic heart rate is, on average, 110 beats per minute, and it increases to approximately 170 beats per minute at nine to 10 weeks. At six weeks, the heartbeat can be detected via a transvaginal ultrasound. Doppler ultrasonography measures the movement of the beating heart. The same type of instrument is used to measure blood flow through the carotid arteries of adults. Electrocardiography measures the electrical activity of heart cells. Ultrasonography does not measure electrical activity, as it detects changes in frequency of pulses of high-frequency sound reflected off solid objects. This is the same principle used by a radar gun to bounce radar pulses off your car and detect its speed and movement; a radar gun is not measuring the electrical activity of your car’s battery.

At six weeks, the embryo’s heart is beating rhythmically to pump blood throughout the tiny body, and the heart can be easily identified and its image captured. At that age, is it exactly the same as an adult heart? Of course not, there is still more growth, development and remodeling to come, even up to and after birth, but the early human embryo has a functioning heart.

A Brain?

The human brain begins to form early in development. The brain and spinal cord form from a structure called the neural tube, with formation beginning around six weeks gestation. Very soon after this, more specific brain regions (forebrain, midbrain, hindbrain) form and further specialization of brain regions commences.

By the end of the seventh week, the developing human brain has identifiable right and left cerebral hemispheres. The human brain continues its development throughout gestation. During the first half of gestation, new neurons are formed at a rate of up to 250,000 neurons per minute. Human brain development continues even for years after birth; final maturation of the brain cortex does not occur until about 25 years of age. Yes, the early human embryo has a brain.

Courage?

Some define courage as strength even when faced with uncertainty or imminent pain. The developing human being certainly faces uncertainty. Starting as a single-celled organism who becomes an organized, interacting community of over 30 trillion cells, growing and forming a multitude of specialized organs and tissues in mere weeks, the complexity of the developmental pathway can seem miraculous at times.

Moreover, facing that uncertainty implies developing conscious awareness. Modern science has shown that the organs have developed and neural connections are present by 15 weeks. The technological and medical advances in human embryology have made it possible to directly observe fetal behavior. Studies now demonstrate that fetuses as young as 12 weeks show conscious awareness of their environment, sensory discrimination, sociality and even planning of intentional physical movements and interactions.

As far as imminent pain, the scientific evidence indicates that a human fetus can indeed experience pain much earlier than previously believed. When the science is objectively reviewed, “Overall, the evidence, and a balanced reading of that evidence, points toward an immediate and unreflective pain experience mediated by the developing function of the nervous system from as early as 12 weeks.” It is definitely time to reconsider any previous suppositions about fetal pain experience and consciousness. A developing human being certainly does show courage.

A Home?

It should be self-evident that the developing human being has a home: the womb. This protective, nurturing environment provides a valued home during the nine months of gestation. But the obvious value of this home goes beyond the usual assumptions and benefits both mom and the developing human. A new scientific review paper details how cells exchanged between mom and baby across the womb during pregnancy create a lifelong bond between a mother and her child right down to the cellular level, a bond that contributes to the survival of both individuals.

If I only had a heart, I could see the value in letting a young human develop her own heart, brain and courage, completing the journey in what should be the safest of homes. For a view of the entire journey of the developing human being, see the Voyage of Life.

David Prentice, PhD

About David Prentice, PhD

David A. Prentice is Vice President and Research Director for the Charlotte Lozier Institute. He is also Adjunct Professor of Molecular Genetics at the John Paul II Institute, The Catholic University of America and was a Founding Advisory Board Member for the Midwest Stem Cell Therapy Center, a unique comprehensive stem cell center in Kansas that he was instrumental in creating. In 2020, he was appointed by the Secretary of HHS to the federal Human Fetal Tissue Ethics Advisory Board. Dr. Prentice has over 40 years’ experience as a scientific researcher and professor, including previous service as senior fellow for life sciences at the Family Research Council, Professor of Life Sciences at Indiana State University, and Adjunct Professor of Medical and Molecular Genetics, Indiana University School of Medicine. He established Stem Cell Research Facts, an educational website providing scientific facts and patient-centered videos about adult stem cells, and is a founding member of Do No Harm: The Coalition of Americans for Research Ethics, and an advisory board member for the Center for Bioethics and Human Dignity. He has provided scientific advice for numerous medical professionals, legislators, policymakers and organizations at the state, federal, and international levels. Dr. Prentice received his Ph.D. in biochemistry from the University of Kansas, and was at Los Alamos National Laboratory and the University of Texas Medical School-Houston before joining Indiana State University where in addition to his research and teaching, he served as Acting Associate Dean of Arts and Sciences and Assistant Chair of Life Sciences. He was recognized with the University’s Caleb Mills Distinguished Teaching Award and Faculty Distinguished Service Award. He has taught courses ranging from non-majors biology to advanced and graduate courses including developmental biology, embryology, cell and tissue culture, history of biology, science and politics, pathophysiology, medical genetics, and medical biochemistry. Several of his courses were also taught on-line. He received the 2007 Walter C. Randall Award in Biomedical Ethics from the American Physiological Society, given for promoting the honor and integrity of biomedical science through example and mentoring in the classroom and laboratory. Dr. Prentice’s research interests encompass various aspects of cell growth control, cell and developmental biology; one major focus is adult stem cells. He has reviewed for various professional publications including The Journal of the American Medical Association. He is an internationally-recognized expert on stem cell research, cell biology and bioethics, and has provided scientific lectures and policy briefings in 40 states and 21 countries, including testimony before the U.S. Congress and numerous state legislatures, the U.S. National Academy of Sciences, the President’s Council on Bioethics, European Parliament, British Parliament, Canadian Parliament, Australian Parliament, German Bundestag, French Senate, Swedish Parliament, the United Nations, and the Vatican. He was selected by President George W. Bush’s U.S. President’s Council on Bioethics to write the comprehensive review of adult stem cell research for the Council’s 2004 publication “Monitoring Stem Cell Research.” Dr. Prentice has published numerous scientific and bioethics articles, including a recent review of stem cell science and adult stem cell treatments published in Circulation Research. He has also published numerous commentaries and op-eds, and travels nationally and internationally to give frequent invited lectures regarding stem cell research, fetal tissue research, gene editing, cloning, embryology, cell culture and vaccines, bioethics, and public policy. He has been interviewed in virtually all major electronic and print media outlets, including CNN, ABC, NBC, CBS, Fox, CSPAN, Reuters, AP, NPR, USA Today, BBC, The Washington Post, The Los Angeles Times, and The New York Times.

1 Comments

  1. Soozi Scheller on December 5, 2021 at 11:31 am

    Thank you, I like the Kansas connection plus the allusion fits: brain heart, courage home!