The Brains Behind 'Poor Things'

Is there a scientific basis for Bella Baxter’s brain transplant in the 2024 film 'Poor Things'? 

Having burst through the patchwork skin and mechanical bolsters of her predecessor, Bella Baxter breathes new life into the rotting body of Frankenstein’s Creature. A curious and lively woman, revived from death by a brain transplant from the growing baby in her womb, she explores her own humanity in the film Poor Things. While the concept of brain transplantation is mostly rooted in works of science fiction and horror, a history of research into the treatment of neurological disease over the years suggests a brain transplant may not be out of reach.

Illustration: Magdalena Yiacoumi

1970 saw the bizarre completion of the first mammalian brain transplant — that of a rhesus monkey — by Dr Robert White at Cleveland Metropolitan General Hospital in Ohio. Following surgery, the primate retained its vision, hearing, and sense of smell, but was immobile from the neck down due to the surgical limitations that came with rejoining the nerves in the spine. 

If such a procedure were carried out in humans, neurosurgeon Sergio Canavero notes that it would require a large team of highly skilled physicians to monitor body temperature, oxygen levels, and other vital signs. During transplantation, the donor and recipient must be subjected to a temperature of 10 degrees Celsius — positively arctic when compared to the toasty 37 degrees Celsius preferred by internal organs — to slow down all body processes. Following the transfer of the head to a pre-owned torso, the membranes of the newly acquainted spinal cords would need to be sealed together with special surgical glue and mechanically stabilised by modern-day answers to the bolts that held Frankenstein’s Creature together. Such a procedure, however, poses a high level of risk and extensive ethical concerns, increasing the attraction towards alternative stem cell therapies.

Pluripotent stem cells are unspecialised, self-renewing cells that act as a source of regeneration in various tissues. They can give rise to almost any cell in the human body and possess a wide range of therapeutic and research-based applications. Recent clinical trials have shown that the injection of neural stem cells into the brains of stroke victims can improve previously limited movement in the upper limbs. 

Although stem cells can be cultured in a laboratory, when grown in the absence of a body — isolated from a diverse neighbourhood of tissues and organ systems — they lack the environmental ‘nurture’ which so crucially complements their genetic ‘nature’. As a result, lab-grown stem cells differ from their body-native partners in ways that make their study less representative of the whole neurological picture. 

To overcome this, a 2021 study from the Centre for Brain and Disease Research — at Flanders Institute for Biotechnology in Belgium — showed that mice could be genetically altered to express a human form of the gene CSF1, an important factor in the survival of human microglia (immune cells of the brain). By doing so, human microglial organoids (lab-cultured ‘mini-brains’), can then be integrated into living mice models. This method can be used to insert and study human cell lines plagued by the genetic components of Alzheimer’s disease or Parkinson’s disease within a functioning nervous system — something that is not ethically feasible in humans. However, such mice are less Frankensteinian and more chimeric — involving a dramatic crossing of the lines between species — which in itself is morally problematic. 

Although whole brain transplantation remains in the realm of science fiction, neural stem cell research offers a promising new chapter for the treatment of various neurological disorders. While much of Poor Things’ medical content is grounded in fantasy, it offers a story of self-discovery and exploration which echoes the endeavours of scientific progress, as well as the curiosity of human beings. Regardless, Bella Baxter has firmly settled into her skin, an embodiment of the inherently human desire to be free, and free from suffering.