‘No one wakes up from brain death,’ Kenyan doctors say even if the heart keeps beating
When a person is declared brain-dead, there is no coming back not even with machines keeping the heart beating. That’s the firm and sobering view from Kenyan doctors working in intensive care units.
“Brain death is irreversible,” said Dr George Biketi, a general practitioner. “I have never seen someone declared brain-dead survive. Not one.”
Dr Biketi explained that brain death happens when all brain activity stops completely and forever often due to a lack of oxygen or severe head trauma. “The most common causes are accidents, gunshot wounds, or internal bleeding in the brain,” he said.
Even if the heart is still pumping, the person is medically and legally considered dead. Machines may help for a while, but they don’t change the outcome.
No pain response, no reflexes, no breath
Neurosurgeon Dr Lee Ogutha was just as direct.
“Survival without brain function is impossible,” he told The Standard. “A brain-dead person may appear alive because a ventilator is keeping the heart and lungs going. But the brain especially the brain stem is no longer working.”
Doctors use a strict checklist before declaring brain death. The patient shows no reaction to deep pain. Their pupils don’t respond to light. Basic reflexes in the brain stem like blinking, gagging, or breathing on their own are gone.
In such cases, the body begins to shut down. Without ventilator support, the heart stops within minutes.
“If we unplug the machines, the patient dies,” said Dr Ogutha. “That’s the truth families have to face.”
A painful decision for families
Once brain death is confirmed, families are often asked to consider signing a Do Not Resuscitate (DNR) order. This means doctors will not try to restart a failing heart or use further medical intervention.
But that is not the same as mercy killing or euthanasia, which is illegal in Kenya.
“DNR allows a natural death,” said Dr Ogutha. “We are not ending a life. We are just not prolonging the dying process with machines.”
A DNR is usually discussed in the ICU with a team of doctors and nurses. It’s meant to spare families long emotional suffering and financial hardship.
“It’s one of the hardest conversations we have,” Dr Biketi admitted.
Can brain-dead patients donate organs?
In countries like the United States or the UK, a person who is brain-dead may become an organ donor. Organs like the heart, liver, kidneys, and corneas can still be healthy for transplant as long as the donor had previously consented.
That remains rare in Kenya, where organ donation laws are less developed.
Still, doctors here say it’s time to open a broader conversation. “We need to talk about what brain death really means,” said Ogutha. “Too many people think it’s a coma or a deep sleep. It’s not. It’s death.”
Unanswered questions in Boniface Kariuki’s case
Dr Biketi and Dr Ogutha did not comment on the recent case of Boniface Kariuki a man allegedly shot on the streets of Nairobi and reportedly undergoing surgery. Details remain unclear. No official confirmation has been released about his brain function or the nature of the operation.
Dr Ogutha only noted: “Brain surgery is complex. Survival depends on where and how bad the injury is.”
