Cryonics, Nanotechnology and Transhumanism: Utopia Then and Now

Over the past few years there has been increasing friction between a subset of cryonicists, and people in the Transhumanist (TH) and Technological Singularity communities, most notably those who follow the capital N, Nanotechnology doctrine.[1, 2] Or perhaps more accurately, there has been an increasing amount of anger and discontent on the part of some in cryonics over the perceived effects these “alternate” approaches to and views of the future have had on the progress of cryonics. While I count myself in this camp of cryonicists, I think it’s important to put these issues into perspective, and to give a first-hand accounting of how n(N)anotechnology and TH first intersected with cryonics.

At left, the cover the first cryonics brochure to use the idea of nanotechnological cell repair as a rescue strategy for cryopatients. The brochure was sent out as a mass mailing (~10,000 copies) to special interest groups deemed of relevance in 1984.

It is important to understand that the nanotechnology folks didn’t come to cryonicists and hitch a ride on our star. Quite the reverse was the case. Eric Dexler was given a gift subscription to Cryonics magazine by someone, still unknown, well before the publication of Engines of Creation.[3] When he completed his draft of Engines, which was then called The Future by Design, he sent out copies of the manuscript to a large cross-section of people – including to us at Alcor. I can remember opening the package with dread; by that time we were starting to receive truly terrible manuscripts from Alcor members who believed that they had just written the first best selling cryonics novel. These manuscripts had to be read, and Hugh Hixon and I switched off on the duty of performing this uniformly onerous task.

At left, Eric Drexler, circa the 1980s.

It was my turn to read the next one, so as soon as I saw there was a manuscript in the envelope, I put my legs up on my desk and started reading, hoping to “get it over with” before too much of the day had escaped my grasp. I was probably 5 or 10 pages into the Velobound book, when I uttered an expletive-laced remark to the effect that this was a really, really important manuscript, and one that was going to transform cryonics, and probably the culture as a whole. After Hugh read it, he concurred with me.

At right, Brian Wowk, Ph.D.

Drexler was soliciting comments, and he got them – probably several hundred pages worth from Hugh, Jerry Leaf and I. And he listened to those comments – in fact, a robust correspondence began. I think that the ideas in Eric’s book, and to large extent the way he presented them were overwhelmingly positive, and that they were very good for cryonics, in the bargain. As just one small example, a young computer whiz kid, who was writing retail point-of-sale programs in Kenora, Canada, was recruited mostly on the basis of Drexler’s scenarios for nanotechnology and cell and tissue repair. His name, by the way, was Brian Wowk.  As an amusing aside, the brochure that recruited Brian to cryonics is reproduced at the end of this article; we thought it was cutting edge marketing at the time (hokey though it was, it was indeed cutting edge, in terms of content, if not artistic value).

At left, one of the first conceptualizations of what a nanoscale cell repair machine might look like. This drawing was made by Brian Wowk and appeared the article, “Cell Repair Technology,” Cryonics Magazine, July 1988; Alcor Foundation, pp. 7, 10. More sophisticated images were to follow (see below).

Engines and Drexler’s subsequent book Nanosystems,[4] explored one discrete, putative pathway to achieving nanoscale engineering, and to applying it to a wide variety of ends. That was and is a good thing, and both books were visionary and scientifically and technologically important, as well. Drexler never claimed that his road was the only road, and for the record, neither did we (Alcor). What was exciting and valuable about those books and the ideas they contained was that they opened the way to exploring the kinds of technology that would likely be required to rescue cryopatients. Even more valuably, they demonstrated that such technologies were, in general (and in principle) possible, and that they did not violate physical law. That was enormously important – in no small measure because they did so by providing a level of detail that was previously largely missing in cryonics. Yes, prior to this time Thomas Donaldson had explored biologically-based repair ideas[5] (as had I[6]), but these ideas were more nebulous and they lacked the necessary detail.

The idea of cell repair machines has now entered mainstream science and culture, as is apparent in the illustration above, by artist Svidinenko Yuriy in 2008 (http://www.nanotech-now.com/Art_Gallery/svidinenko-yuriy.htm).

If nanotechnology had stayed nanotechnology, instead of becoming Nanotechnology, then it would all have been to the good. By way of analogy, I’m not irrevocably wed to the idea of cryopreservation. I have no emotional investment in low temperatures and on the contrary, the need to maintain such an extreme and costly environment without any break or interruption, scares the hell out of me. I’d much prefer a preservation approach that has been validated over ~45 million years, such as the demonstrated preservation of cellular ultrastructure in glasses at ambient temperature, in the form plant and animal tissues preserved in amber.

Buthidae: Scorpiones in Dominican Amber ~25-40 Million Years Old [Poinar G and Poinar R.  The Quest for Life in Amber, Addison-Wesley, Reading, MA, 1994.]

 

 

 

Plant Cell Ultra-structure in Baltic Amber ~45 Million Years Old: Transmission electron micrographs of ultrathin cross-sections of the amber cypress tissue. (a) Section of a parenchyma cell with a chloroplast, the double membrane envelope (env), thylakoid membranes (th) and large plastoglobuli (pg), membranes of the endoplasmic reticulum (er), the golgi aparatus (g), the plasmalemma (pl) and part of a mitochondrion (m). (b) Crosssection of a mitochondrion with the outer envelope (env) and cristae (cr). (c) Cross-section of a double-bordered pit from a tracheid-like cell with fine structures of the primary and secondary cell walls. Size bars: (a) 500 nm; (b) 200 nm; (c) 1 mm.Cypress  [Proc. R. Soc. B272, 121–126 (2005)]

And if such an approach is ever developed, I’ll give it every consideration, with no ego or emotional attachment to cryopreservation.

At right, nanoscale “rod-logic” mechanical computer, as envisioned by Drexler.

Unfortunately, that’s not what happened vis a vis nanotechnology, and a clique of people emerged who were heavily emotionally invested in a 19th century mechanical approach to achieving a “technological singularity.” I know I never thought that rod logic computers would be the technology used to run teensy tiny mechanical robots that would repair cryopatients. Truth to tell, I have only vague ideas how repair will be carried out on severely injured patients, and the most credible of those involve information extraction and “off-board” virtual repair. And while I agree that the pace of technological advance is accelerating, I don’t believe in some utopian singularity, because I also know that these advances are not one-sided; they carry enormous costs and liabilities, which will to some degree offset their advantages.

To sum up, it isn’t the ideas of accelerating technological advance, nanotechnology, or any combination of these ideas per se that have been so pernicious; rather, it is the adoption of a utopian (all positive) framework which is socially enforced as the mandatory context in which these ideas must be viewed, that has been so destructive. That is certainly not Eric Drexler’s fault, and I would go so far as to argue that it was at least as much the responsibility of the cryonics organizations that systematically purged people who didn’t adhere to this party line for (among many reasons) the simple fact that failure to project this idealized and easily grasped view of the future was not good for sales. These ideas, presented in an inevitably utopian framework, do in fact get customers. And customers were exactly what every then (and now) extant cryonics organization wanted, and still want: not members, not people to join in the task at hand, but customers. Customers pay their money, get their goods and services, and that’s it, unless they come back as repeat business.

I think we can forget the “repeat business” element in cryonics, for the moment. So, what we now have are people who are increasingly showing up, no longer even alive, paying their ~ $45K, plopping into liquid nitrogen, and sitting there with the expectation that we are going to revive them. And, after all, why shouldn’t they do this, since it is what they are being sold.

For all practical purposes, there is no easily imaginable amount of money that would really cover the costs of a single person’s truly reliable cryopreservation and revival. From the start, cryonics societies were conceived of as mutual aid organizations. This was because of the open-ended and uncertain nature of the idea. Traveling to the future is most akin to signing on to a wagon train to the western United States in the 19th century. You paid your money, and then you worked your ass off. If you were lucky, you made it to California, to Salt Lake, or wherever else you were pioneering to, alive and in one piece.  In no way did “going west” imply buying a ticket on the Super Chief, or even on the stage coach.  That is where cryonics is right now; it is a pioneering undertaking, but more importantly it is an experimental procedure, and almost everyone seems to have lost track of that reality.

As to FM-2030 (left), I have a lot of sympathy with John La Valley’s article,[7] and I took one hell of a lot of heat for running it, as I was the editor of Cryonics magazine at the time. However, in so many ways FM was a special case, and I believe he deserves considerable forbearance from us – if for no other reason that he was, indeed, one of us.

I met FM for the first time in the early to mid-1980s, when he invited me to his apartment in Los Angeles to talk about how he could practically and immediately help cryonics. He started by signing up, and followed through by taking me to countless social functions to meet a lot of very influential (and very interesting people). I gained a lot of insight from those efforts.  He also relentlessly exhorted people to sign up, and to do it now, and he recruited at least 5 people to Alcor in the 1980s-90s, that I am personally aware of. He was also a good and decent man; someone who people in general liked – and there were not then, or now, many people promoting cryonics who fit that description.  He was a wildly overoptimistic man, but more importantly, he put his money and his actions where his mouth was, and that cannot be said for most of the others in the TH community.

Ray Kurzweil (right) is frustrating in many ways, but again, this is a man who has, on balance, made really important contributions to the broad set of issues that confront us. His discrete analysis of the historical trend of diverse technologies would make him invaluable as a stand-alone contribution.[8] That we don’t agree with his conclusions is a different matter, and shouldn’t be conflated with the overall intellectual worth of his contributions. Also, and this is very important, he has not in any way directly involved himself in cryonics, nor has he been critical of it, let alone someone who has ever even remotely attacked it. If he, or FM, had sought out leadership positions in cryonics, and then imposed their world view, my attitude would be very different. As it is, we as cryonicists invited both FM and Kurzweil to speak at our functions and to write for and about us. We were only too happy to accept their help (and indeed to solicit it) when we thought it to our advantage.  As a consequence, I’m unwilling to attack these men, or to devalue their very real contributions. Sure, we can and should be critical of ideas and approaches that we believe (or know) are damaging to cryonics. But it is very important to separate the men from their ideas, and our friends from our enemies. We have far too few the former, and far too many of the latter.

References

1.            Plus M: Editor’s Blog March 8, 2011: Is Transhuman Militance a Threat to H+? : http://hplusmagazine.com/2011/03/08/is-transhuman-militance-a-threat-to-h/. In: Humanity +.

2.            deWolf A: Cryonics and transhumanism: http://www.depressedmetabolism.com/2009/02/11/cryonics-and-transhumanism/. Depressed Metabolism February 11th, 2009

3.            Drexler K: Engines of Creation: http://e-drexler.com/p/06/00/EOC_Cover.html. New York: Bantam Doubleday Dell; 1986.

4.            Drexler K: Nanosystems: Molecular Machinery, Manufacturing, and Computation: http://e-drexler.com/d/06/00/Nanosystems/toc.html. New York: John Wiley & Sons 1992.

5.            Donaldson T: 24th Century Medicine: http://www.alcor.org/Library/html/24thcenturymedicine.html. Analog 1988, 108(9).

6.            Darwin M: The anabolocyte: a biological approach to repairing cryoinjury: http://www.nanomedicine.com/NMI/1.3.2.1.htm. Life Extension Magazine: A Journal of the Life Extension Sciences 1977, 1(July/August ).

7.            La Valley J: Are You A Transhuman? A short, irate book review: http://www.alcor.org/cryonics/cryonics9008.txt. Cryonics 1990 11 (121):41-43.

8.            Kurzweil R: The law of accelerating returns: http://www.kurzweilai.net/the-law-of-accelerating-returns. Kurzweil Accelerating Intelligence March 7, 2001.

1984 Alcor Brochure

Posted in Cryonics History, Cryonics Philosophy, Culture & Propaganda, Philosophy | 66 Comments

Cryonicists, Teach Your Children Well


By Mike Darwin

“You who are on the road
Must have a code that you can live by
And so become yourself
Because the past is just a good bye.

Teach your children well,
Their father’s hell did slowly go by,
And feed them on your dreams
The one they picked, the one you’ll know by.

Don’t you ever ask them why, if they told you, you would cry,
So just look at them and sigh and know they love you.

And you, of tender years,
Can’t know the fears that your elders grew by,
And so please help them with your youth,
They seek the truth so you and they won’t die.

Counter Melody To Above Verse:
Can you hear and do you care and
Cant you see we must be free to
Teach your children what you believe in.
Make a world that we can live in.”

-Crosby, Stills & Nash (slightly amended)

Recently, on the New Cryonet,  the questions were asked, “Does anyone know if Marce (Johnson) raised her children as cryonicists–or if they were introduced to it when they were older? I was wondering when her involvement started in relation to her children’s age and thought someone on this list may be able to answer.” I am forced to respond with, “Well, exactly how would you go about doing that? and, “What do you mean by “raised her (or your) children as cryonicists?”‘

Marcelon Johnson, circa 1979.

Most cryonicists, with or without children (and I speak with both knowledge and authority on this point), define raising their children as cryonicists variously as sitting down and telling them about cryonics,  or doing that and “leading by example,” by being signed up. And to that I respond, “Give me a fucking  break; are you serious???????”

A normal part of human cognitive development, and a very important one, is to learn to lie. Children who do not learn to deceive, and to do so cleverly, have something wrong with their brains, and they fail to be able function either intellectually or socially (you can find a long list of articles detailing the importance of lying and deceit in normal mental and social development here: http://www.eric.ed.gov/ERICWebPortal/search/simpleSearch.jsp;jsessionid=vUf4k+jE9YQVr7sWdgKHPw__.ericsrv003?_pageLabel=ERICSearchResult&_urlType=action&newSearch=true&ERICExtSearch_Related_0=EJ402886).

Stealing is also an extension, of or an actualization of lying and deceit. If this seems evil or bad, just imagine the life a person who cannot or will not lie by omission, or by the use of “white lies,” to avoid hurting others?!?! On a deeper level, the skill of lying is a prerequisite for fantasizing, and thus for creating “alternative versions” of reality – the very essence of storytelling and creativity – to be able construct a reality you want, rather than the one that exists. That’s the up-side of deceit.

The down-sides are appallingly obvious to (most) adults, and parents are uniformly horrified when their little “innocent” tells a whopper, or deliberately tries to mislead them at the tender age of 2 or 3. Some truly stupid parents will respond to this behavior by gently admonishing their little darling that, “It isn’t nice to lie, and we mustn’t do that.” And if such is the response to subsequent lies and acts of deciet, the end product is a monster. As it turns out, molding moral behavior requires intense hard work using a variety of tools: reasoning, explanation, reward, punishment, and emotional manipulation.

All of these tools have to be used in the face of biologically programmed and imperative behaviors of this kind. Parents who tell their kids not be promiscuous, and then hand them a box of condoms or pills are idiots – if they expect responsible behavior to result from a such a perfunctory and meager exercise. And those who expect to get results solely. or even mostly, by the expedient of leading by example, are even greater idiots. For one thing, most of the real, hard work of leading by example is necessarily invisible, because your kids don’t get to see you wrestling with the temptation to bed the babe who is flirting with you at work, or to forego a late night trip to the casino, or for that matter, generally not indulge yourself in any other “vice” or behavior that is at odds  with your core values – and there are many such behaviors and vices – and we most of us wrestle with them often, if not daily.

Ooops, I just did it, I used that word “values,” and I then compounded that sin by adding the adjective “core” to it. Babies are born with urges, drives and needs – cravings for things that, to a great extent, are inventoried under the “physiological” heading of Maslow’s Hierarchy of Needs: http://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs Everything on the pyramid that builds on those basic drives is, to a greater or lesser degree, moderated and determined by inculcation; not by sweet reason alone, but by sweet reason coupled to a host of other powerful, behavior modifying tools.

I was raised as Roman Catholic in the 1950s and 1960s and the principal “high order” intellectual instructional tool used to accomplish that end in young children was the 1941 revision of the Baltimore Catechism http://www.catholicity.com/baltimore-catechism/ This is the opening of Lesson One:

“1. Who made us?

God made us.

In the beginning, God created heaven and earth. (Genesis 1:1)

2. Who is God?

God is the Supreme Being, infinitely perfect, who made all things and keeps them in existence.

In him we live and move and have our being. (Acts 17:28)

3. Why did God make us?

God made us to show forth His goodness and to share with us His everlasting happiness in heaven.

Eye has not seen nor ear heard, nor has it entered into the heart of man, what things God has prepared for those who love him. (I Corinthians 2:9)

4. What must we do to gain the happiness of heaven?

To gain the happiness of heaven we must know, love, and serve God in this world.

Lay not up to yourselves treasures on earth; where the rust and moth consume and where thieves break through and steal. But lay up to yourselves treasures in heaven; where neither the rust nor moth doth consume, and where thieves do not break through nor steal. (Matthew 6:19-20)

5. From whom do we learn to know, love, and serve God?

We learn to know, love, and serve God from Jesus Christ, the Son of God, who teaches us through the Catholic Church.

I have come a light into the world that whoever believes in Me may not remain in darkness. (John 12:46)

6. Where do we find the chief truths taught by Jesus Christ through the Catholic Church?

We find the chief truths taught by Jesus Christ through the Catholic Church in the Apostles’ Creed.

He that heareth you heareth me; and he that despiseth you despiseth me; and he that despiseth me despiseth him that sent me. (Luke 10:16)

7. Say the Apostles’ Creed.

I believe in God, the Father Almighty, Creator of heaven and earth; and in Jesus Christ, His only Son, Our Lord; who was conceived by the Holy Ghost, born of the Virgin Mary, suffered under Pontius Pilate, was crucified, died and was buried. He descended into hell; the third day He arose again from the dead; He ascended into heaven, sitteth at the right hand of God, the Father Almighty; from thence He shall come to judge the living and the dead. I believe in the Holy Ghost, the Holy Catholic Church, the communion of Saints, the forgiveness of sins, the resurrection of the body, and life everlasting. Amen.”

A nice spot for pleasant outdoor lunch and to reflect on the comparative viability of ideologies; the Cathedral of Christ the Saviour (Храм Христа Спасителя) on the bank of the Moskva River, a few blocks west of the Kremlin.

Get the picture? Beyond that, my behavior as a Catholic was reinforced in countless ways, and I do mean countless. The words I used when in distress were the Catholic-prescribed words of prayer and comfort, and the words I used when frustrated or angry were, in fact, words, that shamed and reminded me that I had violated, or been untrue to my faith, and thus to my fundamental morality: “thou shalt not take the name of the Lord thy God in vain.” A few years ago, I tried to explain this to a Russian Oligarch and a Russian Intellectual as we lunched on an expansive plaza adjoining the magnificently restored Greek Orthodox Cathedral of Christ the Saviour (Храм Христа Спасителя) in Moscow. They were incredulous, and found it all very amusing. Well, laugh they did, but alas, Soviet Communism is now almost 20 years gone, and the Catholic Church, of which the Greek Orthodox Church is a part, is till here and prospering after 2,000 years. Especially ironic, and a point I declined (deceived) to mention, is that the 24 carat gold clad onion domes of the cathedral, in whose figurative shadow we dined, had just been re-gilded at their expense, using Russian Federation tax dollars!

Maybe the Baltimore Catechism sickens you, and all the other “liberal minded people” who believe reason reigns supreme in instructing the young in moral, or if you prefer (and I don’t) “purely ethical” behavior? If so, and you have children, or you influence how children are raised, you are in for a sorry, sorry time of it. Trying to modify the sexual urge in an adolescent with reason alone, is like trying to stop a bulldozer with a toothpick (and usually, the same can be said for adults, as well). If that is your position, it’s unfortunate, because that is the kind of approach, albeit not the kind of content, that is required to input any moral system into a developing human being when such a moral system is at odds with that present in his culture, as a whole.

Pay special attention to the last part of the last sentence above, because it is a goodly part of the take home message of this piece. Most  children who receive lousy moral instruction and control at home will, in fact, grow up to be reasonably functional human beings. That is so because what they don’t get at home, they will get from their peers and their environment. In general, bad behavior has wicked social consequences, and the result is that people, absent programmed values and morals from parents, will nonetheless be programmed by the morals and values of the culture they develop in. Of course, the catch is, this culture is, from a cryonics perspective, morally bankrupt, and often actively evil.

Additionally, most people who obtain their values and morals in this way function in a fog. If you actually sit them down and ask them specific questions about what they should do in specific situations, they aren’t usually “wrong,” they are clueless. They simply stumble around, give an inane and meaningless answer, giggle, or just morosely say, “How should I know?” The last answer, BTW, is, in fact the correct one! How could they possibly know, since they have no clearly defined set of values?

Did Marce Johnson raise her kids as cryonicists? Sure she did, by most cryonicists’ definitions. Marce was a Unitarian who believed reason and intellectual freedom were the most important values she could give to her children, not respect for the values and moral decisions of others, and not a deep and abiding respect for the sanctity of life and the imperative to preserve it at all costs. No, those were “optional” things that you got to pick and choose in life. The result was 8 spineless, immoral brats, regardless of their current age.

How effective is conventional religious instruction/inculcation in shaping the religious affiliation of children in adulthood in the current highly secular and highly ideologically  competitive environment? The numbers, according a recent Pew Forum Report (http://religions.pewforum.org/reports) are:

“More than one-quarter of American adults (28%) have left the faith in which they were raised in favor of another religion – or no religion at all. If change in affiliation from one type of Protestantism to another is included, 44% of adults have either switched religious affiliation, moved from being unaffiliated with any religion to being affiliated with a particular faith, or dropped any connection to a specific religious tradition altogether.”

And what about Catholics? How well does the Baltimore Catechism hold up? Well, that’s not an easy question to answer, because it got revised, and Catholicism in general was radically re-morphed after Vatican II (1962-1965). Catholicism got more liberal and less “rigid,” and that may explain why that while the percentage of Roman Catholics in the US population has remained constant since ~1970, the number leaving the church has increased astronomically. To again quote the Pew study:

“Another example of the dynamism of the American religious scene is the experience of the Catholic Church. Other surveys – such as the General Social Surveys, conducted by the National Opinion Research Center at the University of Chicago since 1972 – find that the Catholic share of the U.S. adult population has held fairly steady in recent decades at around 25%. What this apparent stability obscures, however, is the large number of people who have left the Catholic Church. Approximately one-third of the survey respondents who say they were raised Catholic no longer describe themselves as Catholic. This means that roughly 10% of all Americans are former Catholics. These losses, however, have been partly offset by the number of people who have changed their affiliation to Catholicism (2.6% of the adult population) but more importantly by the disproportionately high number of Catholics among immigrants to the U.S. The result is that the overall percentage of the population that identifies as Catholic has remained fairly stable.”

So, the best anyone can hope for, even if they employ a highly ordered and well established approach to raising their children to adhere to a particular ideology, or religious belief, is somewhere in the range of 30-40%! And keep in mind that that doesn’t imply ADHERENCE, nor does it imply ADHERENCE IN THE FACE OF DURESS. Most Christians, Muslims, Unitarians, Hindus, Sikhs or Communists.. really aren’t very good at practicing what they preach (and for this, we can be thankful) and most would turn on a dime and recant if a gun was held to their head and they were told to choose their values over their lives. Arguably, that’s how it should be as long as your values diverge from, and fail to support, the imperative of your personal survival (the “physiological” and “safety” categories of needs that are near the base of Maslow’s hierarchy will hold sway in a pinch). Finally, it isn’t simple, even when the values you hold do support your personal survival, because the world is a complicated place, and things are rarely black or white. Here, I need have recourse to examples that bear directly upon values and morals driven choices in cryonics.

Currently, there is no moral or ethical code in cryonics – none (See the end for definitions of these terms as used herein). There really aren’t even any clearly defined values, and here is a practical example: A cryonics patient, or cryonics patients, are under attack, and you are the responsible cryonics organization’s CEO, or an Officer or Director. What are the limits of your responsibility and what are your obligations; to yourself and to the patient(s)? If the authorities come to you and say that you will either give over the patient(s), or they’ll strip you of your livelihood (i.e., take your medical or law license away, get your employer to discharge you…) is it permissible for you to hand over the patient(s)? What if they threaten your family, and/or other uninvolved, and completely “innocent” people? Is it OK, then? What if they threaten to imprison you, and even put the death penalty on the table, or they offer to spare some patients (those that may matter most to you, personally) if you just given them the one(s) they want? These are not hypothetical questions – they actually happened to me, and to the other Alcor Directors in the opening months of 1987.

Let me frame the question a bit differently, in order to show you just how dangerous having no defined values and no accompanying morals is. Suppose that the state comes to you and says, “We will shut you down unless you give us control over your patients.” What is the right thing to do? What principles or values will you use to guide you in making such a decision? The answer is NONE. We aren’t even “making it up as we go,” because that would imply that we keep a record our actions, and refer to these decisions as precedents. In fact, we don’t even do this!

And this situation isn’t hypothetical either, because when the Cemetery Board came down on the Cryonics Institute (CI) , CI, and thus the American Cryonics Society (ACS), decided to surrender control of their patients to the state. Now, it is the laws and jurists of the state of Michigan that determine the conditions under which a patient can be removed from a cryostat at CI, and be relocated elsewhere, not the CEO or the Board of either CI, or ACS. If you want to understand the practical implications of this, you can go to http://www.bhsj.org/forms/disinterment%20and%20reinterment.pdf and to http://law.onecle.com/michigan/333-health/mcl-333-2853.html and read what you find there. It isn’t pretty.

A consequence of this is that anyone who steps into a position of leadership in cryonics does so with no rudder to guide them, and no set of standards to which they can be held accountable, or conversely, to which they can turn to defend themselves against unreasonable expectations, or worse, unreasonable charges of misconduct. In particular, the man who steps into the Presidency of Alcor is a man who has entered a country with no laws, but which is nevertheless populated by judges and jurors – each of whom will decide his fate on unknown, unknowable, shifting, and all too often completely arbitrary grounds. The Directors, who are for all intents and purposes anonymous, never suffer the consequences of this grotesque situation (unless they err by becoming visible in their personal decision making, or are otherwise conspicuous), even as they select victim after victim for the rack and the chopping block.

If you want to “raise your children as cryonicists,” you must necessarily first create a system of values, moral and ethics (in that order), and then generate and use the tools required to communicate and enforce adherence to them in a world that is hostile to cryonics, and to its values and goals. Fail to do that, and you will very likely fail not only to “raise your children as cryonicists,” but to raise them at all.” Be assured however, that others will do that for you.

Definitions:

Moral  =   Webster’s Dictionary defines “moral” as: Relating to,  dealing with,  or capable of making the distinction between right or wrong conduct  –   Principles, standards habits with respect to right or wrong in conduct.

Values  =   Webster’s Dictionary defines “values” as:  The social principles, goals or standards held or accepted by an individual, a class, a society, etc.

Right  =   Webster’s Dictionary defines “right” as:  In accordance with fact, reason, justice, law, and morality;  correct in thought and action;  Synonyms for right include:   correct, honest, ethical, just, true, accurate,  precise,  suitable, fitting, appropriate, proper.

Wrong  =   Webster’s Dictionary defines “right” as:  Contrary to fact or reason, crooked, twisted, immoral, improper;   Synonyms for wrong include:  dishonest, mistaken , criminal, unethical,  sinful,  unsuitable,  inappropriate improper, incorrect, injurious, harmful, damaging, unjust.

Ethics  =  A reason based, cumulative system of decision making based upon values and values.  Ethics are built upon one or a few basic principles and require that we be thorough, honest, and comprehensive in making statements about right and wrong.  Ethics is about building the kind of world we want to live in and developing a consistent process by which to achieve this.  Ethics are an advanced expression of morality.

 

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You be the Judge: Understanding and Evaluating the Quality of Human Cryopreservations from Cryonics Organization Literature and Case Report Data, Part 4

Medical Records, Medical History and the Necessity for Highly Skilled Cryonics-Based Medical Evaluation and Judgment

“The physician must be able to tell the antecedents, know the present, and foretell the future–must mediate these things, and have two special objects in view with regard to diseases, mainly to do good or to do no harm.”[119]

-Hippocrates Of The Epidemics

By Mike Darwin

Figure 9: Hippocrates of Kos, the father of rational medicine.

In the past two decades I have had the frustrating experience of having no fewer than four Officers, Directors or Presidents of currently extant cryonics organizations dismiss the need to gather and thoroughly analyze the medical records and the medical histories of cryopatients. Two cryonics organization Presidents have informed me that these materials are not only hard to gather, but in addition, are of little or no use to the patient, since future medical diagnostic and treatment modalities will render such information superfluous at best, and misleading at worst. As a consequence, it has been deemed not merely annoying and futile to gather this information (let alone analyze it), but also a needless and costly burden on the cryonics organization, and one which is presumably best avoided.

My purpose here, from the beginning, will be not only to refute this erroneous position, but to demonstrate, largely by example from long previously published case reports, the criticality of the patient’s medical condition prior to as well as at the time he presents for cryonics care, to the quality of the cryopreservation he will subsequently receive. In addition, I wish to demonstrate that the routine acquisition and interpretation patient medical records is not just of great utility to the patient for whom it is done, it stands to benefit all patients who come later, by enriching the knowledge and experience base in the practice of cryonics as a scientific-technological discipline.

Example 1: Pre-cryopreservation Disease May Alter Critical Anatomy

The first example I am going to use to demonstrate the criticality of the patient’s medical history (Hx) and complete medical record to optimizing cryopreservation and avoiding delay took place on 12 Feb 1985. Since the involved family member discussed in this case is now in cryopreservation, it is possible to discuss the case with greater frankness than was possible when it was first reported. The patient was a 68-year-old woman (Alcor Life Extension Foundation patient A-1068) who was terminally ill with recurrent, disseminated lymphoma. The husband was not only supportive of cryonics; he was a long-time cryonicist himself. Hospital cooperation was excellent and cardiopulmonary support (CPS) was initiated within ~1-2 min of cardiorespiratory arrest and pronouncement. The patient was transported from the hospital to a nearby mortuary without any interruption in CPS and a right femoral cut-down was undertaken (with CPS still underway) to allow for femoral arterial and venous cannulation to permit femoral-femoral cardiopulmonary bypass (CPB) and total body washout.  I will now quote directly from the case report as it appeared in Cryonics magazine in April of 1985:

“The patient’s right groin was prepared for surgery by swabbing with Betadine solution and draping with sterile towels and a fenestrated drape. The anatomical position of the right femoral artery and vein were located by reference to the pubic tubercle and the anterior superior iliac spine. An incision with a #10 scalpel blade was made at the midpoint between these two structures, beginning at the inguinal ligament and running parallel to the longitudinal axis of the leg for approximately 5 cm.

The femoral artery was promptly identified and an 18 fr. arterial cannula, USCI type 1860, introduced through an arteriotomy and secured with silk ties. Despite extensive dissection which consumed nearly an hour, the right femoral vein could not be located. It was later discovered from the patient’s medical records (which were unavailable at the time of transport) that the patient had a history of thrombophlebitis with a venogram done in December, 1975 demonstrating extreme deep vein thrombosis of the right leg, including the entire right femoral vein.

Owing to lack of success identifying the right femoral vein, the left groin was prepared for surgery and the left femoral vein was promptly raised and cannulated with a 32 fr. venous cannula, USCI type 1967.” http://www.cryonics.com/Library/html/casereport8504.html

The delay, due to our inability to find a non-existent femoral vessel under very difficult field conditions (the wound rapidly filled with blood-tinged interstitial fluid), occurred because the patient was massively edematous due to hepatorenal syndrome (liver and kidney failure) and fluid resuscitation (~20 L of IV crystalloid), compounded by the necessity to make a contralateral wound and raise the left femoral vein, was approximately ~ 30-45 minutes. While the patient was receiving closed chest CPS, such support (using the conventional CPR technique available at the time) was only marginally effective, and was further compromised by the presence of fulminating pulmonary edema, which greatly reduced the ability of the lungs to provide gas exchange.

Figure 10: Femoral-femoral cardiopulmonary bypass (CBP) requires the placement of a long, large caliber cannula through the femoral vein (A&B) and into the inferior vena cava, preferably threaded up to the level of the right atrium (C). If the femoral vein has been obliterated, sclerosed, or is otherwise too small to accommodate the venous cannula (E), then either the contralateral femoral vein must be used, or venous drainage may be accomplished by cannulation of the internal jugular vein in the neck (not shown).When the femoral vein is destroyed as a result of disease or trauma, it is ‘replaced’ by a network of smaller caliber collateral vessels which serve to provide venous return from the leg to the heart (D). These vessels are often tortuous, are not of sufficient diameter to accommodate the venous cannula, and do not provide a straight, large diameter path to the inferior vena cava. In the case of patient A-1086 the arterial cannula in place in the right groin was used for perfusion (E) and the venous return cannula was placed in the left femoral vein.

The patient’s husband was, at his and the patient’s request, present during the entire procedure, and he was able to inform us, as we struggled futilely to identify the right femoral vein in the massively edematous tissue, that his wife had suffered severe deep vein thrombophlebitis of the right leg, six years earlier, in 1975. This was, in fact, the reason for our inability to identify and raise the right femoral vein; it no longer existed. Our only choices in this situation were either to cut-down, raise and cannulate the femoral vein in the opposite leg, or to cannulate the internal jugular vein in the neck. Because we needed to maintain the patency of the jugular veins for drainage during CPA perfusion, we chose to surgerize the contralateral leg and cannulate the opposing femoral vein to accomplish venous drainage for CPB.

When the patient’s body was subsequently autopsied (she was a neuropatient) we found a narrow band of tissue tightly adherent to the fascia of the femoral sheath, which was all that remained of the femoral vein. What made this incident particularly difficult for all involved, was that both Jerry Leaf and I had repeatedly made efforts in the months preceding the patient’s arrest to obtain her medical records – efforts which were unsuccessful. The patient’s husband was a highly intelligent man, and he immediately understood the implications of his inaction in obtaining the patient’s medical records prior to her cryopreservation. His wife had suffered an additional ischemic insult that was completely avoidable and we missed the last plane back to Alcor by less than hour, exposing the patient to ~ 8 hours of additional cold ischemic injury as a consequence.

Example 2: Pre-Cryopreservation Pathology may Preclude or Delay Adequate Cryoprotective Agent Equilibration in the Brain without Effective Intervention

In clinical medicine, the patient’s medical history is defined as a written summary of past and present medical conditions which may contain clues bearing on their health; past, present, and future. The medical history is thus an account of all medical events and problems a person has experienced (including psychiatric illness), and it is especially helpful when a differential diagnosis is needed. By contrast, the patient’s medical record is a chronological written account of a patient’s examination and treatment that includes the patient’s medical history and complaints, the physician’s physical findings, the results of diagnostic tests (including copies of any medical imaging performed), procedures, medications and therapeutic interventions. In short, the patient’s medical record ideally contains not only all of the conclusions and summaries of a patient’s illnesses, preventative care and treatment, but also all of the raw data upon which those actions and conclusions were based.

Figure 11: The anatomy of a heartbeat. The heart’s pacemaker is the sinoatrial (SA) node, which sends impulses to the atria and to the atrioventricular (AV) node,  from which they are relayed to the ventricles. The signal from SA node (1) is seen as the P-wave on the ECG, at right. This signal results in the contraction of the atria, and within milliseconds it reaches the AV node (2), which in turn signals the rest of the cardiac conduction system to initiate ventricular contraction (3, 4, 5). The QRS complex of the ECG reflects the rapid depolarization and contraction of the right and left ventricles. Since the ventricular muscle mass is large, the amplitude of the electrical signal generated is on the ECG is corresponding large, as well.

For example, a cardiologist in 1998 may have correctly concluded, based upon a 12-lead electrocardiogram (ECG), that a patient suffered a serious myocardial infarction (MI) of the posterior wall of the left ventricle, with evidence of a previous infarction of the left anterior descending coronary artery. However, at that time, sophisticated algorithms for analysis of the ECG were not in common use that would, for instance, allow for evaluation of subtle variations in R-R regularity of the ECG following an MI.[120, 121] While the elapsed time (interval) between R waves in the ECG appears superficially regular, careful analysis reveals that it is in fact variable, and obeys the laws of chaos theory.[122] Children show complexity and fractal correlation properties of the R-R interval time series comparable to those of young adults, whereas healthy older people demonstrate R-R interval dynamics showing higher regularity and altered fractal scaling that are consistent with a loss of complex variability.[123]

Figure 12: Loss of chaotic variability and accompanying increase of the R-R interval is a sign of damage to the cardiac conduction system which is prognostic of a markedly increased risk of sudden cardiac arrest (SCA).Simplification of the fractal complexity of the R-R interval occurs in normal aging, independent of frank cardiac disease, and may be responsible for some of the increased risk of SCA associated even with so-called “healthy aging.” Loss of R-R interval fractal complexity in the presence of cardiac disease, or during the agonal process in slowly dying patients, is prognostic of increased risk of cardiac arrest, or impending cardiac arrest in the agonal patient.

This phenomenon is very pronounced in patients who have suffered MIs, or other cardiac damage that destroys or degrades the robustness (complexity) of the system of nerves that conducts the contractile impulses to the various parts of the heart (the cardiac conduction system). As the conduction system is pruned down by age and/or disease, there are fewer and fewer signal pathways for the Q-wave, the impulse that initiates heart beat, to travel through and to reach the myocardium. Thus, paradoxically, the more uniform the R-R interval becomes and the less chaotic variation it exhibits, the greater the patient’s chances of experiencing sudden cardiac arrest.[120] [A good summary of this phenomenon and its prognostic utility in heart disease is http://circ.ahajournals.org/cgi/reprint/101/1/47] The take home messages here are that the data are only as good as the theory and technology for interpreting them, and that a physician’s summary of raw data, no matter his competence, will, in many instances, be incomplete and sometimes inaccurate, or in any event, lacking the context necessary to yield the maximum benefit for the cryonics patient.

The following case illustrates not only the importance of gathering and evaluating the patient’s medical records, but also the importance of being able to meaningfully interpret the medical history and medical records data in the context of cryonics. I will open this particular analysis by quoting from the case report of Alcor patient A-2063:

“The initial contact for this March 2004 case began at 12:15 (MST), with Hugh Hixon taking the emergency call. A non-member was in the hospital and dying. The gentleman was suffering from terminal cancer and had a subdural hematoma, the result of recent brain surgery. He was suffering from sepsis and pneumonia when Alcor received the call…”

Among the myriad deficiencies in this case report is that virtually no details are given about the patient’s medical Hx, including the patient’s age, sex, weight, race, fat cover, body surface area, underlying medical condition, and so on. However, in this case, because the date and place of medico-legal death are given, it is possible to infer who this patient was, and thus determine that he was a 36 year old, Caucasian male who suffered from acute myelogenous leukemia and whose proximate cause of cardiac arrest was sepsis and thrombocytopenia (inadequate number of circulating blood platelets) following a bone marrow transplant. The thrombocytopenia thus explains the intracranial bleed in the form of a subdural hematoma.

The case report continues as follows (emphasis mine):

Neuro-perfusion was begun at 09:00, after the head was removed and placed inside the cephalon enclosure. We saw good flow from the left side, but the right jugular showed little venous return. Flow eventually picked up somewhat, but the reason for the obstruction was not determined. Less than twenty minutes later, we noted some swelling of the brain. We attempted to moderate the swelling by slowing perfusion and allowing more time for the cryoprotectant to equilibrate across the hemispheres. The left hemisphere reached terminal concentrations at 15:00, but the right hemisphere had only obtained 59.4% of the concentration needed to vitrify. We continued the neuro perfusion for another five hours before stopping because of toxicity concerns, lowered uptake curves, and staff exhaustion. Final uptake concentration on the left jugular side was 117% of the concentration necessary to vitrify, and the concentration on the right had climbed to 74%. This was the longest neuro-perfusion we’ve ever done.

Figure 13: At the top are images of a human brain in the presence of a right subdural hematoma. At left is the brain at autopsy (after fixation and sectioning) showing compression of the right hemisphere and the relative collapse of the right cerebral ventricle and at right is a CT scan with false color (red) showing the appearance of a typical subdural bleed prior to craniotomy to evacuate the accumulated clotted and fluid blood overlying the brain. The rest of the Figure shows the procedure used for surgical management of a subdural hematoma; beginning with an incision in the skin (1) to expose the cranial vault over the area of the hematoma, after which the bone is cut and temporarily removed to expose the dura mater, the fibrous, tough membrane that covers the cerebral hemispheres (2). The dura is then incised and reflected to allow the surgeon to evacuate the hematoma; a process that is usually carried out by gentle suction and saline irrigation of the affected area of the cortical surface (3). Any evident bleeding vessels are clipped and cauterized, the bone flap is replaced and secured in position with metal staples or stainless steel sutures, and the skin flap is reapproximated and (typically) closed with metal staples (4).

It is of great importance to note that two physicians were either in consultation, or directly involved in this patient’s care; one of them a Board Certified neurosurgeon. This is both noteworthy and remarkable, when consideration is given to the sentences highlighted in red in the excerpt from the case report, quoted above. We are also told that, “Burr hole drilling was started within five minutes, after shaving the head and disinfecting the scalp, and was completed by 07:29.” While we are not told which side of the patient’s brain the subdural bleed was on, but we are told, “We saw good flow from the left side, but the right jugular showed little venous return. Flow eventually picked up somewhat, but the reason for the obstruction was not determined.” and that likely answers the question for us (the right hemisphere).

A quick glance at Figure 13, above, should also go a long way towards explaining why the “right jugular showed little venous return” at the start of cryoprotective perfusion, and also why cerebral edema developed in this patient. The brain receives ~ 1/3 rd of the resting cardiac output and the internal jugular venous drainage from an isolated cephalon will consist mostly of return from the cerebral hemisphere it drains. A patient presenting for cryopreservation with this medical Hx should be re-imaged during the agonal period and must, before the start of CPA perfusion, have the craniotomy re-opened to ensure there has been no subdural rebleed, accumulation of serosanguineous fluid, or pre-existing cerebral edema that could compromise CPA equilibration in the brain. In this case, none of these things were done.

The case report further notes that, “The left hemisphere reached terminal concentrations at 15:00, but the right hemisphere had only obtained 59.4% of the concentration needed to vitrify. We continued the neuro perfusion for another five hours before stopping because of toxicity concerns, lowered uptake curves, and staff exhaustion. Final uptake concentration on the left jugular side was 117% of the concentration necessary to vitrify, and the concentration on the right had climbed to 74%. This was the longest neuro-perfusion we’ve ever done.”  If we do the math, that works out to this patient being exposed to ~ 1-8 M cryoprotectant solution for 11 hours, presumably at a temperature of somewhere between +5 to -3oC, the temperatures Alcor has reportedly used in the past to equilibrate patients with the vitrification solutions B2C and M-22, which it licenses from 21st Century Medicine.

Figure 14: The graph at top shows a 191 minute (3 hr, 11 min) cryoprotective perfusion for the vitrification of Alcor Life Extension Foundation neuropatient A-1097,carried out at the in January of 2006. The vitrification solution employed was M-22, however no patient temperatures during cryoprotectant loading are given in the case report. The graph below shows a 255 minute (4 hr, 15 min) cryoprotective loading of Alcor neuropatient A-2024 with a vitrification solution carried out in April of 2005. The solution used and the temperatures it was perfused at were not disclosed in the case report.

The graphs in Figure 14, above, show typical CPA loading times and curves for two Alcor neuropatients. Frustratingly, neither the graphs or the case reports provide patient temperature data during CPA loading, nor do they provide graphic or tabular data that would allow determination of the mean arterial pressure (MAP) over the course of CPA perfusion.  No graphic data for CPA perfusion were given in the case report for A-2036, however, to appreciate the difference in exposure time it is only necessary to multiple 11 hours x 60 minutes to understand that this patient’s CPA perfusion went for 666 minutes; 475 minutes longer than that of patient A-1097 and 411 minutes longer than for that of patient A-2024.

Why did this happen? The answer to that question is present in the patient’s medical Hx, and would have been glaringly evident in the CT and/or MRI scans that no doubt comprised part of the patient’s most recent medical record; principally that he had a large compressive mass of fluid or clotted blood overlying some portion of his right cerebral hemisphere. There are two inevitable and easily foreseeable consequences of this in the context of cryoprotective perfusion. The first is that the clot or fluid mass is not vascularized; it is not permeated by countless capillaries, as is normal brain tissue, with many square centimeters of surface area across which mass transport of CPAs and water can occur. In other words, it is largely ‘dead space’ from which mass exchange can occur only at the surfaces that abut circulated tissues. The second is that such a mass, if it is compressing the brain that underlies it, will reduce or altogether stop flow in the affected cerebral hemisphere. And since cryoprotectant solution is not blood, and does not contain platelets or any other hemostatic agent, any perfusate that leaks from torn or leaking bridging veins on the dura mater, as well as from the pia mater covering the brain, will continue to accumulate in the subdural space, further increasing the intracranial pressure.

In fact, this patient was fortunate that he experienced any cerebral perfusion, because such massive unilateral failure of perfusion of one hemisphere in the presence of a closed cranium is often associated with failure of global brain perfusion, due to elevation of the intracranial pressure to 40–50 mm Hg, which is the range of pressures at which cerebral perfusion, even with severe compensatory hypertension (~250-300 mm Hg), fails.[124, 125] The CPA perfusion pressures used on A-2036 are also not given in the case report, and the patient’s intracranial pressure was either not monitored, or not reported, if it was.

Figure 15: The temperature controlled neuro-cryoprotective perfusion enclosure used by the Alcor Life Extension Foundation. The cephalon is held in position using a standard surgical head fixation halo, with the stump of the neck being positioned over a polycarbonate plastic tray  (venous sump, green arrow) that serves as the reservoir to collect venous drainage from the stump of the neck (right angle blue arrow) and return it to the extracorporeal circuit.

The proper management of this patient would have been to re-open the craniotomy prior to CPA perfusion and to leave it open for the duration of perfusion.[126-128] This would have eliminated the need for a burr hole (and the associated loss of time experienced in creating it) on the affected side, and it would have allowed for free drainage of any leaking perfusate into the venous sump of the neuroenclosure, where it would have been picked up along with the rest of the venous drainage from the jugulars (and the stump of the patient’s neck), been filtered, and then have been returned to the extracorporeal circuit (Figure 15). In addition, the large opening in the skull would have functioned as a decompressive craniotomy, allowing the ischemia-injured brain to swell during CPA perfusion, without the danger of it raising the intracranial pressure (in the closed cranial vault), thus compromising perfusion to the left hemisphere of the brain, as well.

Why didn’t the “cryonics” physicians, one of them a skilled neurosurgeon, who were attending/consulting for this patient, undertake or suggest this course of action? Many answers to this question are possible, some of them decidedly unflattering, however the most likely reasons are as follows:

1) They do not understand the basic principles and practice of human cryopreservation. They very likely did not give consideration to both why and how CPA perfusion works. Unless the physician understands that effective cryoprotection for vitrification can only be achieved by substituting ~ 60% of the water in the patient’s brain tissue with cryoprotectant molecules (that are on average 1/3rd to ½ the molecular weight of glucose!), and which can only be equilibrated via a patent brain tissue capillary bed, the presence of a compressive mass of non-vascular fluid will have no importance to them.

Figure 16: The Bentley Autotransfuser, which made its debut in 1970, allowed emergency medicine physicians and trauma surgeons to recover hemorrhaged blood and rapidly return it to the patient, thus preventing death from exsanguination, and often the need for extensive homologous blood transfusion, as well.

2) In a clinical setting it is essential to secure hemostasis in a surgical wound – any surgical wound – before concluding surgery. Otherwise, the patient will bleed to death, or the wound will become engorged with a pressurized mass of blood (a hematoma) and will subsequently dehisce, or otherwise fail to heal properly. Conventional neurosurgeons do not have the luxury of leaving an open head wound to bleed freely into a catch basin, whereupon the contents are filtered and returned to the venous circulation. However, patients undergoing cryopreservation do have that option, and so do anticoagulated patients undergoing open heart surgery. In the latter case, the blood seeping from and into the sternotomy wound is collected via cardiotomy suction, filtered, and returned to the patient’s circulation. Taking a leaf from the cardiothoracic surgeons, trauma surgeons adapted the cardiotomy suction system in the 1970s and developed auto-transfusion systems (Figure 16) to allow for rapid recovery, reprocessing and reinfusion of a patient’s own shed blood until hemostasis could be secured.[129, 130]

3) They have not been instructed and mentored to care for the cryonics patient as they would any living human being whose medical care they undertook. It is not a precondition that physicians, or other medical professionals (or even volunteers) involved in delivering care to cryopatients, be card carrying (or tag wearing) cryonicists, but it is essential that they understand and share the values of cryonicists, and that they both understand and agree to provide the same level and quality of care that they render to any of their ‘conventional’ medical patients. This knowledge and consent can only be had by a carefully structured course of learning, which actively selects for those men and women capable of such behavior, and which filters out and rejects those who are not. In this respect, such a program of ‘cryomedical residency’ is no different than any other in medicine, in the professions, or in the trades (where the apprenticeship system is used to the same end).

Figure 17: Typical CT images of non-traumatic subdural hematomas (left and center) similar in nature to those frequently seen in spontaneous intracranial bleeds due to thrombocytopenia. The red arrows denote the area of the bleeds, the orange arrows the distortion of the contralateral cerebral ventricles. The green arrow on the image at right shows an air-fluid interface in the left fronto-parietal subdural hematoma cavity with fluid level from burr hole drainage causing mass effect compression the adjacent lateral ventricle (this image was from a case of subdural hematoma secondary to traumatic brain injury). Rebound of the compressed cerebral cortex to normal volume following craniotomy may take several days, providing the patient survives.

Figure 18: The operating rooms of every cryonics facility the author has had responsibility for over the course of his career all featured an x-ray view box (red arrows) to allow for intra-operative viewing and evaluation of diagnostic electromagnetic patient images. The operating rooms of all currently operational cryonics facilities lack this feature; this has been the case since they were first put into operation. Alcor Foundation, 1989 (A), BioPreservation/PW Biomedical, 1992 (B), BioPreservation, 1993 (C), BioPreservation/21st Century Medicine, 1999 (D).

The bottom line is that patient A-2036 suffered ~5-7 hours of unnecessary and undoubtedly injurious cryoprotective perfusion (and the associated additional cold ischemia) when a procedure as simple as removing freshly placed staples, and opening an already created surgical wound, would have very likely reduced or eliminated the problem. This happened primarily because of a lack of the ability to meaningfully interpret the patient’s medical history and current medical condition, and possibly to a lesser extent, because the patient’s medical records, and the medical images that were no doubt present in them, were not reviewed at any point prior to undertaking the patient’s cryonics care. It would be hard to imagine that any thoughtful consideration of an image, such as any one of those shown in Figure 17, above, undertaken in the operating room where CPA perfusion was to take place (before the procedure began) on an inexpensive x-ray viewing box (Figure 18) would not have lead to at least some consideration (and thus understanding of the likely consequences of) lesions of this size and location by anyone with any material degree of medical sophistication, coupled with the barest knowledge of the mechanics of cryoprotective perfusion.

Example 3: Pre-Cryopreservation Disease Often Critically Alters Physiology

Figure 19: Femoral-femoral bypass in cryopatients is typically carried out by placing a short cannula in the femoral artery, and advancing a long, large diameter cannula through the femoral vein, and into the inferior vena cava (IVC). If the intra-abdominal pressure is elevated due to ascites or edema of the visceral organs (abdominal compartment syndrome), it becomes impossible to obtain adequate venous return, because of compression of the IVC. In the case of ascites, the abdomen may be decompressed by the simple expedient of draining it via a stab wound and a fenestrated tube, as shown in the drawing at the upper left.

When blood washout and extracorporeal support are performed in the field, it is necessary to access the circulatory system by cannulating the femoral artery and vein in the groin. When cardiopulmonary bypass (CPB) is carried out in this fashion, the blood flows through the blood vessels in a retrograde fashion – in other words, in the opposite direction from which it normally flows.

Because the blood being pumped from the circuit into the patient is being pumped under pressure into the femoral artery, a short cannula of modest diameter may be used. However, the venous blood, flowing from the body and into the bypass circuit, is flowing at very low pressure, typically at 5-10 mm Hg, and its flow into the circuit reservoir is due to gravity.

As a result, a larger diameter cannula which is much longer, must be used. Ideally, we would like to position the tip of that cannula at the level of the right heart (Figure 12), where the blue arrow is on the schematic in Figure 19, above.[131, 132] However, that is usually not possible to do in the field without x-ray (fluoroscopic) or ultrasound imaging. Thus, the cannula tip is usually in the inferior vena cava (IVC), somewhere below the level of the diaphragm, where the white arrow is pointing in Figure 19.[133] This barely allows for enough venous blood flow out of the patient – even under the best conditions.[134, 135]

If the patient has a large volume of fluid in his abdomen (a condition called ascites), has pre-existing edema of the abdominal viscera, or is very obese, what happens is that the pressure from the excess fluid, fat, or edematous bowel compresses the thin, flexible and essentially unpressurized walls of the vena cava, and prevents adequate venous return.

Figure 20: Shown at left above is the fluid distended abdomen of a patient with severe ascites secondary to end-stage liver failure. The protein-rich ascitic fluid ‘weeps’ from the serosa of the liver and accumulates in the abdomen where it compresses the abdominal viscera and can impede venous return from the lower extremities. At right is a CT scan with contrast showing the enormous degree of caval compression that can occur in ascities. The aorta is clearly visible (red arrow), but the IVC, which is normally twice the diameter of the aorta, appears as a small white dot, compressed as it is by the large volume of intra-abdominal fluid (blue arrow).

The MRI at right in Figure 20, above, shows a typical ascitic abdomen in cross section. Contrast media has been given intravenously so that the blood vessels show up distinctly. The aorta is clearly visible, but the IVC, which is normally twice the diameter of the aorta, appears as a small white dot, compressed as it is by the large volume of intra-abdominal fluid.

Ascites is not uncommon in cryonics patients, since it occurs in cases of liver failure, cancer which has invaded the liver, congestive heart failure, cirrhosis, ovarian cancer and a number of other conditions. If a cryopatient presents with ascites, one of two things must be done before femoral-femoral CPB is undertaken. The ascites may be drained by the simple expedient of making a stab wound through the body wall and placing a drainage tube in the peritoneal cavity, or an alternative venous drainage site must be selected, such as the internal jugular vein.

Failure to do one or the other of these things will result in either no venous return, or inadequate venous return. In the latter case, the effect will be the very rapid development of massive systemic and cerebral edema due to the increased pressure in the venous circulation.

I would be remiss if I did not disclose that the patient whose case I am about to discuss was a lifelong friend, colleague, and personal and professional mentor to me: Curtis Henderson. My feelings for him may be summed up quite simply by saying that I loved him more than my parents, and more than most other men and women who have touched my life. He was also a man who did much to advance to cryonics; and who suffered mightily as a consequence. He deserved the best cryonics care possible. Having disclosed these caveats, I will endeavor to keep my analysis of this case objective (and as dispassionate as possible). I selected this case for review because it represents the most recent of what has been a series of repeated errors in managing ascites in the setting of cryopatient perfusion that now extends back well over a decade.

Curtis Henderson’s Transport case report (Cryonics Institute Member 165, Patient 95
Date: June 25, 2009) may be accessed at: http://www.suspendedinc.com/cases/Stabilization%20and%20Transport%20Case%20Report%20CI95.pdf

Under the heading “CANNULATION” the following narrative is present:

The vein was 4-5mm in diameter, dark, thin walled, and fragile. Blood flowed freely from it during cannulation. It was ultimately cannulated with a 15 Fr venous cannula inserted approximately 22cm, after attempts to place larger 21 Fr and 19 Fr were unsuccessful.”

Figure 21: The French (Fr) scale of catheter measurement. Even with the advent of ultra-thin-walled flat-wire femoral venous return cannulae, 21 Fr is the minimum size required to achieve adequate venous return in a 70 kg man under low flow conditions. The combined superior and inferior vena cava diameters, through which blood normally returns to the heart, are on the order 40-60 mm. Flow through tubes (cylinders) is not a linear function of tubing diameter, but rather increases or decreases as a function of the fourth power the radius of the tube (for the same liquid under the same conditions of temperature and pressure).

Even without having been present, or seeing any photo documentation, it is possible to state with near certainty that the vein cannulated, as described in the text above, was not the femoral vein. The normal femoral vein in an adult human is never 4-5 mm in diameter, but rather is 2 to 3 times that diameter, and will accommodate venous return catheters in the size range of 22 to 32 Fr (see Figure 21). One of the reasons that gross anatomy instruction has historically been accompanied by the dissection of multiple human cadavers, is that knowledge of both the topographical and internal structural elements of the body is essential to being able to perform medical and surgical procedures competently, such as femoral cut-downs; as well as to diagnose disease. While two students are typically assigned to a single human cadaver, the gross anatomy class as whole will typically be dissecting 12 to 15 cadavers, and this allows for the students to appreciate the considerable individual variation in human anatomy.

Following completion of gross anatomy and a medical education, the physician who wishes to become a surgeon, or to perform specific surgical procedures in the conduct of his practice of medicine, undertakes a residency, or assists with the procedure he wishes to master, until such time as both he and his instructor are satisfied that he has achieved a sufficient degree of competence to operate solo. This is a fairly long process with no shortcuts: there are no textbook autodidacts in the art of surgery. Historically, physician-surgeons have been unwilling to participate in human cryopreservation cases, even with the offer of substantial financial inducements. What this has meant in practice is that vascular cannulation of cryopatients has been carried out by morticians. This state of affairs was reasonably satisfactory until the advent of immediate and continuous post cardiac arrest CPS, which introduced a pressurized circulatory system into the equation and all of the complications attendant thereto, such as obstruction of the surgical field by blood from cut, bleeding tissues, frank hemorrhage, and occasionally, widespread contamination of the operator and the mortuary preparation (embalming) room with blood when a pressurized, large caliber artery was incised, absent proper precautions to control bleeding or deal with the ensuing contamination (i.e. heavy duty face shields, Tyvek or other impermeable clothing, etc.).

Beginning in the late 1970s, two non-physician-surgeon cryonics professionals, Jerry Leaf and myself, made the decision to become proficient at the modest repertoire of surgical procedures then perceived to be needed in the practice of human cryopreservation. We were fortunate in that both of us had had extensive experience in animal research (wherein we had been trained to carry out most of the procedures we sought to master) on dogs, pigs and other mammals. Additionally, both of us had undertaken independent didactic study of both human and veterinary anatomy. Still, we found it necessary to obtain access to human cadavers, and to observe the procedures we were undertaking to learn being performed by skilled surgeons on living human patients. No claim is made here, express or implied, that we ever approached the level of skill of a competent (human) general, cardiothoracic or vascular surgeon.

Our principal deficiencies were lack of speed (competent surgeons operate both with great speed and great precision) and lack of the deep base of experience that facilitates rapid identification and resolution of anomalies, or unexpected problems. These may seem formidable handicaps, and indeed they were.  However, it is uniquely in the nature of cryonics that the most complex and complication ridden parts of the operative procedures we employ present themselves when the patient is in profound, or ultraprofound hypothermia, which means we have the advantage of some ‘breathing room’ when something goes wrong. A femoral cut-down and cannulation for CPB is much less complicated than surgery, instrumentation/monitoring, and cannula placement for CPB using the aortic root and right atrium approach. Another fortunate circumstance is that femoral-femoral CPB in the dog very closely approximates the experience with humans in terms of surgical complications and difficulties, such as cannula placement, bleeding, and even the basic anatomy of the femoral vessels. Thus, extensive survival fem-fem CPB experience with dogs, coupled with (mortuary) practice on human cadavers, provided us with the skill, if not the speed, to perform femoral cannulation for CPB with a high degree of confidence and a low incidence of complications.

The case report continues:

Nearly over the top of the vein, was the artery with multiple feeder vessels between the two. The artery was 6-7mm in diameter, light colored, rubbery and heavy walled. Bright red blood flowed freely from it during cannulation. It was cannulated with a 17 Fr arterial cannula inserted approximately 12cm after attempts with a 19 Fr cannula were unsuccessful.

Figure 22: The anatomy of the femoral vessels as shown in Gray’s Anatomy (A), an idealized artist’s rendering of exposure of the femoral vein for cannulation (B), as seen in a human cryonics patient undergoing CPS in the 1970s (mortician’s cut-down) and as seen in a cadaver prepared for dissection by medical students (D). The femoral artery is quite superficial and the femoral vein is fairly deep. It is easily possible for an inexperienced operator to mistake the saphenous vein (see A & C) for the femoral vein and attempts its cannulation. Only knowledge of the anatomy of the femoral triangle, and prior experience with and observation of the femoral vein, can ensure against this mistake. The experienced operator knows the appearance, location, and above all, the large size of the femoral vein and will, if necessary, increase the depth and scope of dissection until it is identified and raised.

The keys to successful dissection, identification and cannulation of the femoral vessels are a knowledge of the anatomy of the femoral triangle (and its all too common vascular variations) and prior visual and tactile experience with the procedure. As can be seen in Figure 22, above, the femoral vein is a large caliber vessel with comparatively thick walls (for a vein), and it is easily identified, even when collapsed and denuded of color, as is evident in 22-D, above.

Figure 23: If the operator’s thumb is placed on the anterior superior iliac spine and the third finger is positioned atop the pubic tubercle, the index finger will usually be positioned approximately over the femoral neurovascular bundle, which contains the femoral artery and vein (left, above). At right, above, is an anterior view of the right thigh: V=femoral vein; A=femoral artery, N=femoral nerve, 1=adductor longus, 2=adductor brevis, 3=pectineus, 4=iliopsoas and 5=sartorius muscles. If a skin incision is made paralell to the midline as illustrated by the purple line in the figure at left, above, at the midinguinal point, the femoral vein will typically be found a few millimeters, to half a centimeter medial to the femoral artery. The use of these topographical landmarks and knowledge of the underlying muscular anatomy, is essential in performing femoral cut-downs on cryopatients, because the femoral pulse may be absent or not palpable, even when closed chest CPS is ongoing.

To facilitate rapid and accurate location of the correct anatomical area to dissect, a simple procedure may be used to make a first approximation for the skin incision, as shown in Figure 23, above.

The case report continues:

The cannulae were connected to the extracorporeal bypass circuit on the Stockert SCPC minibypass system that had been primed with MHP2 organ preservation solution and cooled by the perfusionist. No venous drainage was observed. No bubbles or air locks were visible in the circuit. The perfusionist applied mild suction and the AutoPulse was re-started to assist with drainage. Still, no venous return could be seen. The venous cannula was slowly backed out while applying suction and automated chest compressions but no return was visible.

Nasopharyngeal temperature was 15C and rectal was 25.6C. A call was made to CI to determine additional site options for cannulation. A jugular cannulation would not interfere with cryoprotection procedures. The patient’s head was repositioned to the contralateral side and the neck swabbed and prepped for external jugular vein cutdown. The AutoPulse was started to aid location of jugular vein.

Pressure to the platysma muscle did not create any obvious jugular pooling. Identification of the external jugular was then made using the mid-point between the angle of the mandible and the top of the clavicle. Using a number 10 scalpel blade, a 3cm incision was made and blunt dissection used to clear the tissue. The jugular was not immediately visible.

Figure 24: The graphic presentation of temperature data for CI Patient 95 documents the lack of venous return as an almost certain consequence of abdominal compartment syndrome, secondary to ascites. The arterial temperature shows a sharp drop as CPB is initiated, however the patient’s (circuit) venous temperature remains constant and does not begin to decline below ambient temperature until CPB is re-initiated an hour after the first attempt was made. The reader is encouraged to study all the data on this graph, and to carefully read the case report in its entirety, because I will be returning to this case and this data in a future installment of this article to make a point about another serious deficiency in the CPS of this patient. More precisely, I will be asking you, the readers, to identify this problem and ascertain its cause.

As the case narrative continues, problems encountered and overcome 20+ years ago in cryonics in-field operations (and overcome long before, in convention surgery) surface and are noted, but are not remarked upon:

“Opening an 8 cm incision and using an aneurism hook for dissection, his field quickly filled with bright red blood. He located the femorals but in separating them, he accidentally cut the artery and multiple feeders between the artery and vein. These vessels were individually ligated and the wound packed while the funeral director enlarged the jugular incision that had been opened earlier and isolated the jugular. A 17Fr venous cannula was inserted into the jugular vein approximately 30cm and connected to the venous perfusion line. Mild suction was applied.

Venous drainage was observed.”

Morticians are unprepared to perform vascular surgery on cryonics patients who are undergoing CPS, or who have been subjected to CPS with heparinization and prompt external cooling (usually with bulk ice present and compressing the tissues). The rough handling of the tissues and vessels that they are accustomed to using with impunity on corpses, quickly degenerates into catastrophes for which they have no ready solution. Additionally, the absence of high capacity electrically powered suction (‘hot’ suction) leaves the operator unable to visualize the surgical field. Attempts to blot the wound with absorbent material merely result in replacing one visualization obstruction with another; since the instant the sponge is removed from the wound, it refills with opaque blood. These are foolish and inexcusable errors only because they have been made before, are documented in the cryonics case literature,[136] and have solutions that are easily learned and implemented – but only if those attempting to practice cryonics as medicine take the time, and exercise the diligence required to learn them.

The  problem of ascites in the context of femoral-femoral CPB has occurred at least five times in cryonics cases that I know of, and in three of those five cases, it happened to personnel who had experienced the same problem before. And yet, the problem was not addressed and the same rote procedure was followed, despite the fact that problems were evident. I will say that in two cases where there was no venous return they did eventually stop perfusion because they realized that ‘something was wrong.’ In this case, the presence of a skilled perfusionist undoubtedly prevented the iatrogenic disaster of more than a very brief period of injection of arterial perfusate in absence of sufficient (or any) venous return. There are myriad other problems and deficiencies in this case (as adjudged from the report), all of which were and are avoidable with the hard-won, existing base of knowledge, wisdom and professionalism that has been generated since the scientific practice of cryonics was begun by Fred and Linda Chamberlain, Greg Fahy and me over 30 years ago.

Nevertheless, the real solutions to the problems discussed here are not easy, because they demand the acquisition of professionalism, knowledge, and skill in the context of cryonics as medicine. I personally believe that Jerry Leaf and I came very close to doing that in the decade between 1981 and 1991. But we failed. Why we failed will be discussed at a later time. Suffice it to say that the problem of maintaining professionalism is a nettlesome one in medicine, engineering and other demanding disciples that are vastly more developed than cryonics is today, and there will be no quick fixes. In cryonics, where almost all the feedback we get from our patients must be artificially generated, the problem will be much more difficult to solve. However, no progress will be made absent understanding and acknowledgement of the need to acquire and interpret the patient’s medical records in a timely fashion, whilst being informed by both medical and cryonics knowledge and professionalism.

End of Part 4

References

119.     Hippocrates: Of The Epidemics: http://classics.mit.edu/Hippocrates/epidemics.1.i.html; 400 BCE.

120.     Huikuri H, Mäkikallio, TH, Peng, CK, Goldberger, AL, Hintze, U, Møller, M.: Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction. Circulation 2000, 4(101(1)):47-53.

121.     Laitio T, Huikuri, HV, Kentala, ES, Mäkikallio, TH, Jalonen, JR, Helenius, H, Sariola-Heinonen, K, Yli-Mäyry, S, Scheinin, H.: Correlation properties and complexity of perioperative RR-interval dynamics in coronary artery bypass surgery patients. . Anesthesiology 2000, 93(1):69-80.

122.     Pikkujämsä S, Mäkikallio, TH, Sourander, LB, Räihä, IJ, Puukka, P, Skyttä, J, Peng, CK, Goldberger AL, Huikuri, HV.: Cardiac interbeat interval dynamics from childhood to senescence : comparison of conventional and new measures based on fractals and chaos theory. Circulation 1999, 27(100(4)):393-399.

123.     Schmitt D, Ivanov, PCh.: Fractal scale-invariant and nonlinear properties of cardiac dynamics remain stable with advanced age: a new mechanistic picture of cardiac control in healthy elderly. Am J Physiol Regul Integr Comp Physiol 2007, 293(5):R1923-1937.

124.     Verweij BH, Muizelaar JP, Vinas FC: Hyperacute measurement of intracranial pressure, cerebral perfusion pressure, jugular venous oxygen saturation, and laser Doppler flowmetry, before and during removal of traumatic acute subdural hematoma. J Neurosurg 2001, 95(4):569-572.

125.     Marx JA e (ed.): Head injury (Chapter 38). Philadelphia: Mosby Elsevier; 2009.

126.     Guresir E, Schuss P, Vatter H, Raabe A, Seifert V, Beck J: Decompressive craniectomy in subarachnoid hemorrhage. Neurosurg Focus 2009, 26(6):E4.

127.     Daboussi A, Minville V, Leclerc-Foucras S, Geeraerts T, Esquerre JP, Payoux P, Fourcade O: Cerebral hemodynamic changes in severe head injury patients undergoing decompressive craniectomy. J Neurosurg Anesthesiol 2009, 21(4):339-345.

128.     Eberle BM, Schnuriger B, Inaba K, Gruen JP, Demetriades D, Belzberg H: Decompressive craniectomy: surgical control of traumatic intracranial hypertension may improve outcome. Injury, 41(7):934-938.

129.     Klebanoff G: Early Clinical experience with a disposable unit for intraoperative salvage and reinfusion of blood loss intraoperative autotransfusion). Am J Surg 1970, 120:718-722.

130.     Symbas PN: Extraoperative autotransfusion from hemothorax. Surgery 1978, 1078 (84):722.

131.     Phillips SJ, Ballentine B, Slonine D, Hall J, Vandehaar J, Kongtahworn C, Zeff RH, Skinner JR, Reckmo K, Gray D: Percutaneous initiation of cardiopulmonary bypass. Ann Thorac Surg 1983, 36(2):223-225.

132.     von Segesser LK, Kalejs M, Ferrari E, Bommeli S, Maunz O, Horisberger J, Tozzi P: Superior flow for bridge to life with self-expanding venous cannulas. Eur J Cardiothorac Surg 2009, 36(4):665-669.

133.     Kirkeby-Garstad I, Tromsdal A, Sellevold OF, Bjorngaard M, Bjella LK, Berg EM, Karevold A, Haaverstad R, Wahba A, Tjomsland O et al: Guiding surgical cannulation of the inferior vena cava with transesophageal echocardiography. Anesth Analg 2003, 96(5):1288-1293, table of contents.

134.     Colangelo N, Torracca L, Lapenna E, Moriggia S, Crescenzi G, Alfieri O: Vacuum-assisted venous drainage in extrathoracic cardiopulmonary bypass management during minimally invasive cardiac surgery. Perfusion 2006, 21(6):361-365.

135.     Abdel-Sayed S, Favre J, Horisberger J, Taub S, Hayoz D, von Segesser LK: New bench test for venous cannula performance assessment. Perfusion 2007, 22(6):411-416.

136.    Darwin, M:Neuropreservation of Alcor Patient A-1068. Cryonics 1985, 6(4):10-19:  http://www.alcor.org/Library/html/casereport8504.html

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You be the Judge: Understanding and Evaluating the Quality of Human Cryopreservations from Cryonics Organization Literature and Case Report Data, Part 3

By Mike Darwin

In the narrowest sense, Standby does not begin until cryonics organization personnel are deployed on-site to care for the patient. However, elements of peri-arrest care, such as counseling the patient and family, beginning a program of premedication, and carrying out site assessment and planning for Standby, are properly considered a part of Standby operations. A local standby is one in which medico-legal death is going to be pronounced in a location that is within easy reach by ground transportation from the operating room maintained by the cryonics organization. If the organization owns an ambulance, or similar special-purpose vehicle, most of the necessary supplies and equipment required to facilitate Stabilization and Transport should be present, and already organized in the vehicle, so that they can be quickly moved to the patient’s bedside. If the cryopreservation organization does not own an ambulance, supplies will need to be organized into a kit which can be transported to the patient’s location by other means. It should be noted that reliance on commercial providers of patient transport such as mortuaries, removal services, and ambulance companies is problematic and presents many possible legal and logistic pitfalls. Because of this, this option should be used only as last resort or a ‘stop gap’ in an emergency.

Figure 5: Standby and stabilization require meticulous preparation and the deployment of a substantial amount of equipment and supplies. At right, a LUCAS cardiopulmonary support device is shown in place on a mock patient in a Portable Ice Bath (PIB). In addition to these (and many other) items of equipment, ice in large quantities must be on-site and immediately available.

A Remote Standby occurs where the patient is far enough from the cryopreservation facility for air transportation to be the preferred means of access. In this situation, the cryopreservation organization will dispatch its personnel, usually by common carrier, together with most of the equipment and supplies required to perform initial cardiopulmonary support, extracorporeal support, total body washout (i.e., blood washout with a tissue preservative solution), and refrigerated transport of the patient (again, usually by common carrier) back to the operating room for cryoprotective perfusion. For a remote transport to be performed successfully, there must be meticulous preparation and attention to detail. The Remote Standby Kit (RSK) must be carefully stocked and organized to anticipate a wide range of contingencies.

Whether a standby is local or remote, if a patient is going to receive stabilization at home and/or with the assistance of a mortuary, it is almost essential that the Transport Technician should visit the patient’s home, meet the family and the mortuary staff in person, and inspect their facilities in advance. If the home has a garage, it may be usable as a field operating room to allow extracorporeal support and blood washout immediately after legal death. The home must also be evaluated to insure that the Portable Ice Bath (PIB) or Extracorporeal Membrane Oxygenation (ECMO) cart can be moved in and out in a fully loaded condition, using available personnel.

Mortuary facilities must be similarly evaluated to insure that the Preparation Room (embalming room) has adequate space, lighting, and electrical outlets to allow for both the heart-lung resuscitator and extracorporeal support. Mortuary personnel must be instructed to remove ambulance cot(s) or gurneys from transport vehicles to make room for the PIB, if this is going to be used. Mortuary personnel must also be carefully briefed on the equipment that will be used and on the need to keep personnel and oxygen beside the patient during the journey to the mortuary from the home, hospital or nursing home. All personnel musty be brief on safety issues of importance in the Stabilization and Transport setting, such as the extreme danger of using oxygen or an open flame in a closed vehicle wile oxygen driven CPS equipment is in operation!

Figure 6: A Thomas Pack filled with Stabilization medications and ancillary supplies is an effective way to organize these items. This kit is one used by the Alcor Life Extension Foundation.

Just as important as what is in the RSK is what is not. It is both illegal and impractical to ship oxygen by common carrier. Thus, it will be critical to insure that an adequate amount of oxygen is available on-site. Similarly, it is impractical to transport ice and this key material will also have to be acquired locally. Mortuary, medical (nurse and physician), and other personnel will need to be obtained locally, and transportation for both equipment and transport personnel will need to be arranged. The transport team must be ready and willing to explain the principles of human cryopreservation, and must have a clear plan of action which spells out the roles and duties of everyone involved. They must also have documents (cryopreservation paperwork) proving that they have necessary legal authority to act. A hold-harmless or other release of liability may also be needed to reassure local medical personnel and others who are reluctant to get involved in a procedure that seems unfamiliar and potentially threatening.

Figure 7: Standby typically includes blood substitution with a tissue preservative solution, and may sometimes involve extended extracorporeal cooling using a system such as the one at left, that was developed by the Alcor Life Extension Foundation in the late 1990s.

With the advent of home-hospice care, legal death of patients at home is becoming increasingly common. In situations where adequate notice of impending legal death exists, it will be of great importance to determine the best location for legal death to occur.

Organizations that offer Standby must have an objective, evidence-based prognostication program which serves as the basis for initiating and continuing Standby. At a minimum, this will consist of the integrated use of a scoring system for predicting the time-course to cardiac arrest in slowly dying patients (i.e., those with cancer and other relentlessly progressive terminal illnesses) such as the Karnofsky Performance Scale: http://www.pennmedicine.org/homecare/hcp/elig_worksheets/Karnofsky-Performance-Status.pdf ,[106, 107] and a mix of acute illness and trauma survival prognostication tools such as the APACHE II (Acute Physiology and Chronic Health Evaluation):  http://www.sfar.org/scores2/apache22.html,[108, 109] SOFA (Sequential Organ Failure Analysis): http://www.sfar.org/scores2/sofa2.html,[109-115] TRISS (Trauma – Injury Severity Score): http://www.trauma.org/index.php/main/article/387/[116] and IMPACT (International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury): http://www.tbi-impact.org/?p=impact/calc[117, 118]. The protocol for the use of these tools in initiating Standbys must be publicly available, and subject to comment and review. The transparency of this protocol is of great personal and financial importance to the member, since the conditions under which Standbys are launched and maintained will ultimately determine the likelihood of the member personally benefitting from the service and , of course, directly or indirectly, the cost he will pay for Standby service.

Figure 8: A typical Remote Standby Kit packed in rugged, shock-resistant Pelican Cases and ready for deployment (photo courtesy of the Alcor Life Extension Foundation).

The organization must also maintain and use a Standby Manual which complements its Stabilization and Transport Manual. The Standby Manual provides comprehensive instruction for personnel in dealing with the terminally ill member and his family (psycho-social considerations), evaluation of Transport logistics, interfacing successfully with the patient’s health care providers and the patient’s C/ME, and working with the patient’s primary care physician to institute a medically appropriate, and medically acceptable program of pre-medication to reduce ischemia-reperfusion injury. The Standby Manual will also contain SOPs for laboratory monitoring of the patient during his terminal illness to allow for more accurate estimation of the likely time to cardiac arrest, as well as a determination of the patient’s Total Antioxidant Capacity (TAC) and redox status prior to cardiac arrest. These latter measurements establish a baseline that is critically important in determining the effectiveness of both premedication and post-arrest pharmacological interventions to minimize ischemia-reperfusion injury. An example of a basic Standby Manual may be found at: http://www.cryonics.com/Library/html/standby.html.

Why These Things are Important

It should be self evident that careful assessment of the patient and his environment are important to having a good outcome from Standby. If the family members, close friends, or other caregivers attending the patient are hostile, or even simply indifferent to the patient’s desire for cryopreservation, the likelihood of a successful Stabilization and Transport are greatly diminished, if not altogether eliminated. It is therefore essential that, to the extent possible, these individuals be thoroughly evaluated. This can only be done properly by meeting with them in person in the home setting and working cooperatively with them to ensure that the patient’s cryopreservation related needs will be met when the time comes.

This is a two way street, in that not only is it important that those caring for the patient know what is expected of them, the cryonics organization must also know what the family/caregiver’s needs are, both logistically and psychologically. Cryonics is unfamiliar territory for family, and the procedures attending Standby and Stabilization can perturb what in many cases will be a fragile emotional and psychological equilibrium in the patient’s home life. Organizations that fail to establish rapport, and work to ascertain and meet the needs of the patient’s family, risk non-cooperation, obstruction and even litigation. Seemingly small details, such as protecting flooring or furniture from water damage, or arranging for a few minutes of private “alone time” with the patient before he is removed from the home or care facility after acute stabilization, can mean the difference between heartfelt assistance, and bitter belligerence from the next of kin.

Assessment of the logistics of each case is also essential. Is there space to store equipment prior to use? Can the patient be relocated from a back or upstairs bedroom to the living room or other more accessible space so that valuable time is not lost trying to gain access to the patient, or to remove him and the cardiopulmonary support equipment from the residence or care facility? These issues, and many others like them, can only be dealt with by on-site, person-to-person contact. The personnel required to carry out this type of communication and cooperation must be both technically knowledgeable and emotionally intelligent; absent both these assets, the likelihood of failure increases.

The use of patient cardiac arrest assessment or “mortality assessment” tools in a rigorous and evidence-based fashion is essential both to “getting it right” in terms of not being too late to arrive on the scene, and in containing costs by not deploying to early, or conversely, deploying under circumstances where the patient is not truly at high risk of arresting. No one prognostication tool will do the job, and in fact, it will simply not be possible in many cases to determine with any degree of precision when the patient will experience cardiac arrest. However, in the case of clearly terminal patients dying from inexorably fatal illnesses, such as end stage cancers, or untreatable multiple organ failure, the use of prognostic tools such as the Karnofsky’s Performance Assessment and the APACHE II and SOFA scoring systems (where laboratory data are available can be obtained) will help reduce uncertainty, and will definitely identify a significant subgroup of patients who will experience cardiac arrest within a window of two days, to a week at most.

While it is not possible to predict with precision when a patient with a Karnofsky score of 20 (very sick; hospital admission necessary; active supportive treatment necessary) will experience cardiac arrest, it is possible to know with a high degree of certainty that cardiac arrest is imminent. Even if this knowledge does not permit immediate deployment of a Standby Team, it may allow for local volunteers to be alerted and to be available, or on – call should the patient arrest sooner than expected, or before the Standby Team can arrive. It also allows for the placement of last minute supplies such as perfusate, extra oxygen, or the start of in-home storage of large quantities of ice in well insulated picnic chests.

The effective use of these tools and deployment of the necessary resources requires extensive documentation in the form of checklists, standard operating procedures (SOPs) (Best Practice in Europe and the Near East), and a comprehensive Standby Manual. Any cryonics organization offering Standby should have such tools and make them available for inspection and evaluation by members and clients, longstanding or prospective.

End of Part 3

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You be the Judge: Understanding and Evaluating the Quality of Human Cryopreservations from Cryonics Organization Literature and Case Report Data, Part 2

By Mike Darwin

Defining the Cryonics Organization

When cryonics began in the 1960s, the mission of the 4 cryonics societies[1] that more or less simultaneously came into existence at that time was fairly homogenous:

1) Make cryopreservation available to their members using the most advanced techniques available while seeking to minimize any post-cardiac arrest ischemic injury, and to continue and defend the cryopreservation of members until such time as resuscitation becomes possible (i.e., indefinitely),

2) Support scientific research to advance and perfect cryopreservation methods, and to generally support research in biomedicine that would facilitate resuscitation of cryopreserved patients,

3) Promote cryonics to the general public and the professions as a potentially viable mechanism for medical time travel,

4) Foster research into interventive gerontology and life span extension and work to extend the lives of members and conserve their health, delaying cryopreservation as long as possible,

5) Rehabilitate and reintegrate their cryopatients into the society or culture extant at the time that revival becomes feasible.

During the 1980s, and continuing throughout the 1990s, divergence from this model began to occur. In particular, the Cryonics Institute began to define its services and activities around a low cost model which emphasized a simplified cryopreservation procedure with minimal/no emphasis on avoiding warm or cold ischemic injury and withdrawal from any interface with or intervention in the member’s medical care. In this model of cryonics, the cryonics organization becomes actively involved only after medico-legal death has been pronounced and a licensed Funeral Director takes custody of the patient and makes the removal from the home, hospital, ECF, or facility where the patient was pronounced legally dead. CI members can elect to have Standby and Stabilization services through a third party service provider, such as Suspended Animation, Inc., of Boynton Beach, FL, though the majority of CI members do not make such arrangements.[19]

Alcor has continued to follow the prototypical cryonics society model to a greater degree, but appears to be no longer actively involved in trying to extend its members’ life spans by promoting risk reduction or health maintenance strategies, and it also appears to have ceded its activity in supporting and promoting interventive gerontological research to other organizations.[20] Contemporary cryonics organizations have thus effectively chosen to confine the scope of their operations to cryopreserving and storing their members, with or without aggressive attention to minimizing ischemic injury. Understanding these distinctions is crucial in any attempt to evaluate the performance of individual cryonics organizations, or of their service provider(s).

Measuring Quality in Cryonics

The easiest place to start in the case of trying to measure the quality of care in cryonics is at the beginning. That’s because the initial phases of the procedure very closely overlap conventional medical procedures, where hundreds of millions of dollars and countless man-years of effort have been expended developing both direct and surrogate feedback for the effectiveness of the procedures used. It might be expected that I am now about to launch into a discussion of the mechanics of providing closed-chest and extracorporeal circulatory support, or the induction of hypothermia. In fact, these interventions occur considerably downstream from the point where truly effective care of the cryopatient actually (ideally) begins.

In a very real sense, that care starts the moment the member/patient experiences his first contact with the cryonics organization that will ultimately cryopreserve him. The tenor of that first contact will likely determine the nature and course of the member’s subsequent interaction both with cryonics and his cryonics organization. If cryonics is presented as a developed product that is costly but nevertheless fairly routine, say like buying a home or an automobile, that’s very likely how it will be subsequently be treated. If, on the other hand, there is heavy emphasis on the lack of infrastructure to provide help in an emergency and the need to exercise both personal responsibility and personal preparedness, outcomes will likely differ – at least statistically, if not in each individual case.

It isn’t necessary for the reader to agree with all the criteria I am about to set out, although if you do not agree with any of them, then this article clearly isn’t for you, and you may stop reading at that point. It also isn’t the case that I’m going to cover all the bases here. To my knowledge, this is the first time that such an effort has been undertaken, and I am guaranteed to omit important elements of good care, as well as to include some which are superfluous. This is a draft document, input is welcome (indeed essential), and if it is to have any meaningful effect on the course of affairs in cryonics, this document will have to become an organic one – something that interacts dynamically and intelligently with the community it seeks to serve.

First Contact

First contact with a cryonics organization by a Prospective Member (PM) usually occurs in one of three ways: via the organization’s website, through printed literature designed for recruitment, or through a phone call to the organization’s representative(s). The critical elements which must be present in that first contact (depending upon the willingness of the PM) are:

1) If the contact is by phone or in person, is there a systematic procedure for establishing the level of understanding the PM has about cryonics? For instance, does the PM understand that the procedure is speculative, that it is not currently reversible (i.e., not suspended animation) and may never be, that it is not currently consistent with established medical and mortuary practice and that cooperation, or even non-interference by these institutions, may not be forthcoming? Do they understand the likely costs, and the general uncertainties that accompany choosing cryonics as a life extending option?

2) Is a printed handbook available which comprehensively discusses the following issues:

a) Definition and history of cryonics, which is understood to include a narrative of cryonics, including its origin, significant historical milestones (e.g., the cryopreservation of the first man, Chatsworth, legal and cryobiological milestones, and so on) and its current status.

b) Explication and discussion of the various criteria for defining life and death, and how these contrast with the information-theoretic criterion used by most contemporary cryonicists.

c) Discussion of the time-course of post-cardiac arrest biochemical and structural changes and how these are known to impact viability and to degrade tissue structures currently thought to be critical to encoding memory and personality; the likely determinants of personal identity.

d) Thorough explanation and discussion of the currently available cryopreservation modalities and what their limits are in preserving the structures thought to encode personal identity when applied under optimum conditions (i.e., straight freezing, low level cryoprotected freezing, moderate and high level cryoprotected freezing and vitrification and incomplete vitrification). Known kinds of injury must be discussed in detail and illustrated photographically in such a way that the layman can grasp the degree and extent of the damage.

e) What are the likely obstacles to optimum cryopreservation and their frequency of occurrence in the organization’s membership population? What are the ways that individual members can both assess and reduce their risks of suffering these kinds of complications?

f) What is the impact of the various complications or obstacles to optimum, or even severely compromised cryopreservation? What are the probable effects of varying periods of ischemia on subsequent cryoprotectant equilibration and the consequences of suboptimum cryoprotection on viability and ultrastructure? These examples should also be demonstrated graphically, using gross, histological and ultrastructural images of brain tissue from animals or humans cryopreserved under conditions which accurately simulate those being employed by the cryonics organization on its own patients.

g) Summary of the scientific literature and scientific evidence that supports the cryonics premise, as well as data which cast doubt on the workability of the procedure.

h) Exploration of the nature of personal identity and the controversies surrounding it and how these interact with the practice of cryonics. The literature should allow the PM to understand the spectrum of possible outcomes from cryopreservation, ranging from survival of the genome in the form of a clone to complete recovery of a continuing individual with memory and personality intact.

i) Explanation of various scenarios for repair of cryoinjury, reversal of age-associated, and other pathologies, and restoration of the patient to life, under both worst case and best case conditions.

j) The mechanics of the cryopreservation procedures the organization offers; whole body versus neuropreservation, Standby, Stabilization and Transport, Cryoprotective Perfusion, Deep Subzero Cooling and Long Term Cryogenic Care. Each of these procedures must be discussed in detail and illustrated with images that document the technology being used in such a way that the PM can understand its likely impact on himself and on his family and friends should it need to be applied in an attempt to save his life.

k) Thorough and complete explication of the legal and financial mechanisms, instruments and institutions that are being used to finance and maintain cryopreservation.

l) Costs, including a complete listing of, and charges for the infrastructure, capital equipment, and consumables employed to place a patient into cryopreservation and maintain him, indefinitely, in that state. This is understood to include financial transparency with quarterly, or at least annually prepared financial reports, preferably audited being available to members or prospective members.

m) Contingency plans for dealing with sociopolitical or economic upheaval or other changes that make the practice of cryonics problematic or impossible where the cryonics organization has its patient care (storage) facilities.

n) Explication of the terms and conditions under which cryopreservation arrangement can be terminated by either the member or the cryonics organization.

Perhaps the best example of this kind of comprehensive handbook was that published by the Alcor Life Extension Foundation in 1989, entitled Cryonics: Reaching for Tomorrow by Brian Wowk and Mike Darwin.[21]

Membership Years

Prospective members who become fully signed up members with cryopreservation arrangements must be continually educated both about the basics of cryonics (learning through repetition) and about changes and new developments in all spheres of the profession; medical, scientific, financial, legal, social and political.

Minimizing the Risk and Consequences of Sudden Cardiac Arrest (SCA)

Population studies, as well as a large number of prospective, randomized clinical trials have unequivocally established that the Mediterranean diet (also called the Cretan diet) is effective in increasing mean lifespan in humans [22-26] whilst dramatically reducing the burden of age associated degenerative diseases.[26-39] In fact, the Mediterranean diet (MD) is the only dietary intervention that has robust, Level I evidence-based support in the peer reviewed medical literature. It has been shown to dramatically reduce the incidence of the metabolic syndrome,[40-45] Type II diabetes,[46-55] atherosclerosis,[37, 38, 56-63] stroke, myocardial infarction,[60, 64-72] a number of cancers,[24, 73-86] and may reduce the incidence and severity of Alzheimer’s disease (AD) and some other age-associated dementias.[26, 87-100]

Since Sudden Cardiac Arrest (SCA) and AD represent the two most common risks for information-theoretic death in cryonicists, advocacy of the MD by cryonics organizations, and continuing education of their members about the benefits of the MD should be a high priority for all cryonics organizations. Indeed, the quality and quantity of scientific evidence for the morbidity and mortality reducing effects of the MD are now sufficiently well established that it might well be argued that failure to advocate this intervention constitutes negligence.

The cryonics organization also has an obligation to protect its members from the consequences of catastrophic sequelae resulting from sudden and unexpected medico-legal death. Such protection should include the existence and vigorous promotion of a cryonics emergency first aid program which empowers individual members and their families to act immediately in the event of sudden cardiac arrest (SCA) to initiate external cooling,[101-104] and where appropriate in the case of high risk members, to avail themselves of protection against undetected periods of prolonged warm ischemia by use of cardiac arrest and ‘man down’ detection systems and/or wearable or implantable defibrillators. [105]

Since approximately 1/3rd of members will be at risk of becoming Coroner’s or Medical Examiners (C/ME) cases preparations to reduce the risk of autopsy and to minimize the injury inflicted should it occur must be in place. Long before a member becomes a C/ME case the cryonics organization has an obligation to collect information that will help reduce delay and improve the chances of a more favorable outcome. The first step in doing this is to structure the cryonics organization ‘Membership Application’ so that all the personal information necessary to allow completion of the Death Certificate is both collected and present in the first Section of the Membership Application as shown below:

In addition to the member’s name, address, phone number and birth date, all 50 states and the US territories require additional information to complete the Death Certificate. This information is gathered for statistical purposes and is often difficult to acquire in a timely fashion at the time of legal death. Indeed, in a number of cases the author is familiar with, the next-of-kin did not know some of this information leading to long delays in completion of the Death Certificate and release of the member to the cryonics organization. The following is a list of all the information required by the states’ department of Vital Statistics. Not all of this information is required in every state; however, the list below covers the information required by the combined 50 US states and the US territories.

  • Full Legal Name
  • Street Address (residence). Note: This must be a physical address, not a P.O. Box or Rural Route Number in areas (typically rural) where this otherwise constitutes a legal address.
  • Date of Birth
  • Place of Birth: City, County, State/Province, Country
  • Birth Name (if different from legal name)
  • Race or Ethnicity
  • Spanish or Hispanic
  • City (of Country)
  • Social Security Number
  • U.S. Military Service, Branch, Dates Served (From and To)
  • Marital Status
  • Occupation (list number of years)
  • If Unemployed what was Occupation
  • Total years of education
  • Father’s Name and Birthplace: City, County, State/Province, Country
  • Mother Maiden Name and Birthplace: City, County, State/Province, Country

This information should be entered into the cryonics organization’s computerized database for rapid retrieval in the event it is needed. Paper copies should also be readily available at the cryonics organization’s headquarters in the event electronic access is not possible for some reason (power failure, IT difficulties, etc.).

End of Part 2

Footnote

[1] In order, they were the Cryonics Society of New York (CSNY), the Cryonics Society of California (CSC), the Cryonics Society of Michigan (CSM) and the Bay Area Cryonics Society (BACS). Of these, two organizations are still in existence, although using different names; CSM has become the Cryonics Institute (CI)/Immortalist Society (IS) and BACS is now the American Cryonics Society (ACS).

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101.     Darwin M: Last aid as first aid for cryonicists, Part 1: http://chronopause.com/index.php/2011/02/26/last-aid-as-first-aid-for-cryonicists-part-i/. In: Chronosphere. Munich: Chronopause Foundation; 2011.

102.     Darwin M: Last aid as first aid for cryonicists, Part 2: http://chronopause.com/index.php/2011/03/01/last-aid-as-first-aid-for-cryonicists-part-2/. In: Chronosphere. Munich: Chronopause Foundation; 2011.

103.     Darwin M: Last aid as first aid for cryonicists, Part 3: http://chronopause.com/index.php/2011/03/04/last-aid-as-first-aid-for-cryonicists-part-3/. In: Chronosphere. Munich: Chronopause Foundation; 2011.

104.     Darwin M: Last aid as first aid for cryonicists, Part 4: http://chronopause.com/index.php/2011/03/06/last-aid-as-first-aid-for-cryonicists-part-4/. In: Chronosphere. Munich: Chronopause Foundation; 2011.

105.     Darwin M: I Know this is Going to be Shocking: A Review of Wearable Continuous Monitoring Systems to Detect and Treat Sudden Cardiac Arrest in Cryonicists: http://chronopause.com/index.php/2011/03/16/i-know-this-is-going-to-be-shocking-a-review-of-wearable-continuous-monitoring-systems-to-detect-and-treat-sudden-cardiac-arrest-in-cryonicists/. In: Chronosphere. Munich: Chronopause Foundation; 2011.


Posted in Cryonics History, Cryonics Technology (General), Ischemia-Reperfusion Injury | Leave a comment

You be the Judge: Understanding and Evaluating the Quality of Human Cryopreservations from Cryonics Organization Literature and Case Report Data, Part 1

By Mike Darwin

Introduction

A short while ago, these remarks were posted in the comments section of Chronosphere: “I’ve often heard it said that case reports have been very inconsistent. I’ve read a haphazard sampling of Alcor case reports. They are in different styles with differing levels of information. I recommend you take a look at some of the case reports from different eras in addition to the ones you’ve already seen.” I have also been asked, on Cryonet, to comment on case reports in cryonics. After some reflection, I realized that I’ve been doing this, one way or another, for nearly 40 years now – arguably since “Perfusion and Freezing of a 60 Year Old Woman” was published in 1973 – which, while a case report, was also an indictment of cryonics stabilization and cryoprotective perfusion practice at that time.[1]  Clearly, that approach has not worked, and so I’ve decided to take a different tack, principally laying out the basis for evaluating case reports in such a way that any diligent layman or medical professional can do it themselves.

Figure 1: Aschwin deWolf

Aschwin de Wolf has written an excellent article discussing the importance of case reports in cryonics and has listed four key reasons case reports should be published:

1. To provide a transparent and detailed description of procedures and techniques for members of the cryonics organization and the general public.

2. To validate current protocol and procedures in general, and its actual implementation in particular.

3. To serve as a medical record to assist with future attempts to revive the patient.

4. To gain more scientific credibility.[2]

Aschwin’s article is the primer to this one, and I recommend that it be read as an essential adjunct to this one. In particular, at the end of his article he notes the need:

To establish a template for…case reports the following approach can be followed. First, it is established what kind of information is essential for doing a meta-analysis of all cryonics cases. Then these parameters are reverse-engineered to create a template for writing case reports that reconcile the need for economy of expression and documenting all the relevant aspects of a case.  One important advantage of producing such case reports is they permit easier consultation of the technical details of the case and still meet the fundamental objectives of writing case reports.

The history of case report writing in cryonics shows an erratic potpourri of approaches and styles. One of the most unfortunate victims has been the objective of using case reports to improve the practice of human cryopreservation and to formulate meaningful research questions for the sciences that inform cryonics. But if systematic thought is given to the objectives of case reporting outlined in this document, steps can be taken to leave this unsatisfactory situation behind while meeting the needs of a growing cryonics organization.”

In this he is correct, for while Jerry Leaf and I used a fairly consistent approach to case reporting and presentation of all of the available data, this has not been the case elsewhere in cryonics. A more serious problem is that even the best written cryonics case reports are largely opaque to almost all readers, including those with considerable medical knowledge; and what’s worse, poorly written case reports can be downright misleading – even if they contain all the necessary information required to draw the correct conclusions about the quality of care the patient received. The goal of this series of articles is to equip the reader with the tools necessary to make an accurate assessment of the quality of care cryonics patients, both individually and as a group,  are receiving from their respective cryonics organizations.

The Problems of Narrative and Context

Figure 2: How meaningful is pulse oximetry in the context of evaluating the efficacy of cryopatient Stabilization?

Broadly speaking, there are two obstacles to making sense of case reports. First it is necessary to establish the critical elements that must be present in the case report and to explain what they are and what they mean; and to do so in the context of cryonics. As an example, pulse oximetry a modality frequently used to evaluate the effectiveness of cardiopulmonary support (CPS) during cryopatient Stabilization is now a commonly understood physiological parameter, since it is used in a wide array of sports performance monitoring devices, and has arguably become (along with heart rate (pulse), respiration rate, blood pressure and temperature) the 5th Vital Sign in medicine.[3, 4] Most people understand, at a minimum, what the number generated by the pulse oximeter, and displayed under the heading SpO2 represents: the percentage of blood oxygen saturation ranging from 0 to 100%. It isn’t terribly important that they understand the nuances (i.e., the SpO2 is the mixed arterial and venous oxygen saturation; some of the signal comes from the venous blood, and thus the number displayed does not represent an accurate measure of the arterial blood oxygen saturation) for the SpO2 to be of value in everyday life, or even in medicine, most of the time.

However, it is important that readers, lay and medically sophisticated alike; understand the limits of SpO2 measurement in the context of cryonics Stabilization and Transport. During the agonal process many cryopatients will be in a state of profound shock for many hours prior to cardiac arrest. During this interval of depressed blood pressure and perfusion, the body attempts to maintain blood circulation to the vital organs at the expense of the peripheral tissues by reducing, or even eliminating flow to the skin and appendages; hence the dusky or even frankly gray pallor associated with shock, as well the cooling of the extremities. Most pulse oximeters are not designed to accurately read blood oxygen saturations below 70-80%, thus, depending upon the type of device being used, SpO2 readings for much of the agonal period, and in most cases much or all of the post-cardiac arrest cardiopulmonary support period, may be nothing more than meaningless numbers produced by a pulse oximeter that is in reality functioning as random number generator.[5-7]

In some patients, the agonal vasoconstriction may be so severe and so long lasting that there is simply no measureable pulse to detect in the peripheral tissues. In other words, perfusion has ceased altogether and may not return, even if an adequate blood pressure is subsequently generated by closed chest cardiopulmonary or extracorporeal support which succeeds in providing adequate perfusion to the brain and other “core” vital organs. Yet another problem is that superficial structures such as the skin of the forehead and earlobes, and the tissues of the fingertips (three common sites for measuring SpO2) will cool very rapidly and disproportionately when the patient is immersed in an ice water bath. The core temperature of an index finger coverd only partially by a compact and highly conductive SpO2 sensor may be as low as 10oC within 5 minutes of the patient being placed in the portable ice bath (PIB), while the brain core temperature may still be at 37oC.[8-11] Similarly, dehydration, also commonplace in the slowly dying cryopatient, may cause erroneous readings when present during hypothermia.[12]

Leaving aside the above possible artifacts, there is the problem that in some cryopatients, while all of the blood leaving the lungs to be distributed to the body may be fully, or nearly fully saturated with oxygen, there may not be enough oxygen actually being delivered to meet the metabolic demands of the tissues. For instance, resting cardiac output in a 75 kg man is ~ 4.5 liters of blood per minute, with a typical SpO2 of 98%. Even if the SpO2 remains at 98%, if the cardiac output drops to 1.5 LPM, tissue oxygenation will not be adequate, at least not under normothermic conditions (37oC). Obviously, local cooling of tissues where the oximeter sensor is placed will reduce the oxygen consumption of those tissues dramatically, and thus decrease the amount of oxygen extraction in turn resulting in an erroneously high SpO2 value in the context of the amount or volume of delivered oxygen (DO2) being supplied to the patient’s brain (and other core organs).[9, 13]

In reality, the accuracy of pulse oximetry during CPS in cryonics patients is even more problematic because this technology, even with the most advanced instruments, is effective only when the arterial oxygen saturation (SaO2) is greater than 22% in hemodynamically stable patients (and greater than 35% in hemodynamically unstable patients); core body temperature is greater than 32oC; cardiac index is greater than 1.5 L/min per m2 and the pulse pressure is > 20 mm Hg.[14] This is unlikely to be the case in most patients presenting for Standby and Stabilization.  Additionally, the regional physiological effects from induction of deep hypothermia in the digits and limbs (as well as the skin of the forehead and the tissue of the earlobes), such as hypothermia-induced increase in the mean carboxyhemoglobin concentration of the blood and damping of the pulse wave under conditions of profound regional hypothermia make data obtained using this modality suspect at best, and totally unreliable at worst.[9, 13] This is information that even an experienced emergency medicine physician may neither know, nor take into account, when evaluating data being presented in a cryonics case report.

Second, it is essential that the reader/evaluator of a cryonics case report have a meta-level understanding of the procedure. This is a hard thing to describe, and an even harder skill to acquire, because it requires an integrated understanding of the whole cryopreservation process with the underlying physiological and crybiological principles that determine and guide its course. A good analogy would be a narrative story which has a beginning, middle and an end; with lots of crucial and informative dialogue, events, and happenings that occur along the way. To extend this analogy a bit further, the plot of Romeo and Juliet was shopworn when Shakespeare took it up over 400 years ago, as are the plots of Casablanca, Brokeback Mountain and Who’s Afraid of Virginia Woolf. The devil is in the detail, in the context of the narrative and in the deep knowledge of the culture that is required to make sense of these four very different stories, all of which share the same basic narrative. Absent such knowledge, a cryonics case report will be about as comprehensible as an episode of The Simpson’s or Family Guy would be to a medieval peasant.

Establishing Objective Criteria

Thus, the first problem encountered when evaluating case reports is an almost oxymoronic one: how do you do it? In other words, what criteria should be used, not just to determine how well or poorly a given case proceeded, but also how well or poorly that case was documented. In fact, to a great extent, the character and thoroughness of the documentation will determine the extent to which the case can even be evaluated by a third party. The quantity and quality of the data collected will thus determine what can be inferred about the quality of care a given patient received.

Of course, it is possible to debate what events are of significance, and also to dispute how much significance to attach to them. In this respect, evaluating cryopatient case reports might be said to be “subjective” – since there are no indisputable outcomes from the procedure, such as resuscitation and subsequent scoring of neurological deficit following sudden cardiac arrest.

Resuscitation Research: A Sad and Telling Analogy

In fact, the validation of different modalities in resuscitation from cardiac arrest, and the “validation” of the effectiveness of cryonics procedures, have more in common than might reasonably be expected. Since bystander and emergency medical system CPR have been in widespread use throughout the Western world for 30 years, it would seem inevitable that there would be large and robust databases of survival and neurological outcome data from communities throughout Canada, the US and Western Europe. However, no such data exist!  In 2005 a metanalysis of the literature disclosed that there were data from only 35 US cities or townships (representing just 9% of the US population), who had documented and published data on survival and outcome from cardiac arrest in their communities.[15] This metanalysis demonstrated a survival rate for all treated cardiac arrests of 8%, and for patients with ventricular fibrillation the rate was 18%. If these figures are extrapolated to the US population as a whole there are ~ 13,000 Americans who survive cardiac arrest long enough to be discharged from hospital out of ~ 300,000 cases of SCA each year. That’s a staggering disconnect and such a slim database provides little to go on in terms of improving the outcome for patients who will experience SCA in the future.

The reasons why reporting of outcome is so dismal in CPR have striking overlap with the reasons why cryonics case reports are so sparse, inconsistent in quality, and not infrequently fail to disclose the really important data and conclusions to be drawn from it, or fail to make the significance of these data apparent to the reader, are as follows:

1) Most cryonics organizations do not have the appropriately knowledgeable staff to organize and interpret the data in a consistent and scientifically and clinically rigorous way.

2) There is no general industry wide agreement on what constitute meaningful data and what parameters should be consistently measured and by what means and at what intervals.

3) There are no industry wide mandates or agreed upon standards for collection of data in specific fashion using agreed upon common definitions.

4) Collection, organization, graphing and reduction of data and ultimately its incorporation into a standard narrative are time consuming and can be costly. Some cryonics organizations are barely able to afford the basics of delivering cryoprotective perfusion, and some do not offer standby and acute post-cardiac arrest stabilization.

5) There is very likely a “shame factor” wherein the cryonics organizations feel “embarrassed” or threatened by their inconsistent and not infrequently poor performance in the conduct of cases and find they are psychologically unable to broadcast such performance to the world.

All five of the above factors have been identified as significant barriers to the systematic and accurate reporting of outcomes from sudden cardiac arrest (SCA) in the US.[16]

If we briefly consider #3 above, the impact of something as simple as a failure to have a commonly agreed upon definition of “survival rates” in skewing and preventing meaningful interpretation of the data becomes apparent. In 199, King County, Washington (Seattle, and the surrounding communities) published a study documenting their experience with survival of patients following SCA.  They reported a survival rate ranging from 16% to 49% depending upon what the definition of “survival” was.[16] For example, when all SCA’s from all the causes are included in survival to hospital discharge, the rate was 16%. But if only witnessed arrests due to underlying heart disease (primarily myocardial infarction) with an onset of CPR of   ≥4 minutes and Advanced Cardiac Life Support within ≥8 minutes were evaluated as a subset of the data, then the survival rate increases dramatically to 49%.

Figure 3: Different clocks used to describe event time periods and intervals during resuscitation illustrate the lack of standardization in data collection which lead to reported outcomes from cardiac arrest that are all but impossible to meaningfully interpret. Reproduced from Cummins et al.[16]

By simply changing the definition of survival, it is possible to treble the survival rate in the same community. Of course, it is equally possible to go in the opposite direction by redefining as survival as something more than simply remaining alive long enough after SCA and resuscitation to be discharged from hospital. How many of such patients were discharged to extended care facilities (ECFs) in a permanent and profoundly debilitated state due to brain damage from cerebral ischemia-reperfusion injury? How many more were able to go home and live “independently” but were too neuroinjured to return to work, or to their former level of activity and social interaction with their family and their community? Apply criteria such as, “returned to pre-arrest level of neurocognitive functioning,” or even, “returned to community capable of independent living,” and you will again radically alter the picture presented by the “survival outcome data.”

As physician and resuscitation researcher Mickey Eisenberg pointed out earlier this year:

“This is why trying to draw cross-community comparisons of (outcomes in CPR) when all parties do not agree on the definitions is like attempting to organize a tournament when each team plays by its own rules. A community, determined to be number one in cardiac arrest survival, could simply define its cases as patients with witnessed cardiac arrests in VF, who have bystander CPR, who respond to one shock with a perfusing rhythm (good blood pressure and pulse), and who wonder what’s for dinner upon arrival in the coronary care unit. Such a denominator might result in a survival rate close to 100% yet such a figure would be silly and meaningless.” http://blacklistinc.com/survive/utstein.php [17]

The Utstein Criteria

Figure 4: Utstein Abbey in the 18th Century.

This lack of uniformity of nomenclature in the resuscitation community was addressed by an international meeting held in Utstein Abbey near Stavanger, Norway in 1991. The meeting produced a detailed set of criteria with accompanying definitions, by which outcome from cardiac arrest could be uniformly measured and reported. The Utstein Criteria, established uniform and rigorous definitions, spelled out the specific data to be collected and created a template for case and group data reporting. The purpose of the Utstein Criteria was to resolve the huge discrepancies in survival after SCA across different communities and create a robust and reliable database of outcomes to facilitate improvement in resuscitation techniques.[18] In 2004 there was a further revision of the Utstein Criteria to refine definitions and further delineate the data that were deemed essential for collection. The results of this formidable, costly and now decade long effort should give heart to those who want thing to remain as they are both in cryonics and in resuscitation research; few US communities have proved willing to adopt the Utstein Criteria and reporting of outcomes from SCA remain chaotic and undecipherable.

If the conventional medical community cannot manage to impose data acquisition and reporting standards on a multibillion dollar a year, ‘life or death’ segment of the health care industry, what hope do we cryonicists have of doing anything similar? The short answer is, “None.” However, in what will likely seem an uncharacteristically optimistic statement from me, I would hasten to add that while it is impossible to impose such universal standards on cryonics organizations, it is possible to evaluate their performance and to determine, over a comparatively short periods of time, whether any meaningful change in that performance is forthcoming. If there is none, then there is a solid basis for taking actions that might previously not have been under consideration, ranging from internally lobbying for change in an accountable and calendar-driven fashion, to creating a new and more responsible organization(s) to deliver services, as an alternative to those that already exist.

End of Part I

References

1.         Federowicz M, et al.,: Perfusion and freezing of a 60-year old woman. Manrise Technical Review 1973, 3(1):7-32.

2.         De Wolf A: Case reports in cryonics In: Depressed Metabolism. Portland: Depressed Metabolism; 2011.

3.         Neff T: Routine oximetry. A fifth vital sign? . Chest 1988 94(2):227.

4.         Tierney LJ, Whooley, MA, Saint, S.: Oxygen saturation: a fifth vital sign? West J Med 1997, 166(4):285-286.

5.         Thilo E, Andersen, D, Wasserstein, ML, Schmidt, J, Luckey, D.: Saturation by pulse oximetry: comparison of the results obtained by instruments of different brands. . J Pediatr 1993, 122(4):620-626.

6.         Clayton D, Webb, RK, Ralston, AC, Duthie, D, Runciman, WB.: A comparison of the performance of 20 pulse oximeters under conditions of poor perfusion. Anaesthesia 1991, 46(1):3-10.

7.         Gehring H, Hornberger, C, Matz, H, Konecny, E, Schmucker, P.: The effects of motion artifact and low perfusion on the performance of a new generation of pulse oximeters in volunteers undergoing hypoxemia. Respir Care 2002, 47(1):48-60.

8.         Schramm W, Bartunek, A, Gilly, H.: Effect of local limb temperature on pulse oximetry and the plethysmographic pulse wave. . Int J Clin Monit Comput 1997, 14(1):17-22.

9.         Nishiyama T: Pulse oximeters demonstrate different responses during hypothermia and changes in perfusion. Can J Anaesth 2006, 53(2):136-138.

10.       Bergersen T, Hisdal, J, Walløe, L.: Perfusion of the human finger during cold-induced vasodilatation. Am J Physiol 1999, 276((3 Pt 2)):R731-737.

11.       Chen F, Liu, ZY, Holmér, I.: Hand and finger skin temperatures in convective and  contact cold exposure. . Eur J Appl Physiol Occup Physiol 1996, 72(4):372-379.

12.       O’Brien C, Montain, SJ.: Hypohydration effect on finger skin temperature and blood flow during cold-water finger immersion. . J Appl Physiol 2003, 94(2):598-603.

13.       Pälve H, Vuori, A.: Pulse oximetry during low cardiac output and hypothermia states immediately after open heart surgery. Crit Care Med 1989, 17(1):66-69.

14.       Polanco P, Pinsky, MR.: Practical issues of hemodynamic monitoring at the bedside. Surg Clin N Am 2006, 86:1431-1456.

15.       Rea T, Eisenberg, MS, Sinibaldi G, White, RD.: Incidence of EMS-treated out-of-hospital cardiac arrest in the United States. Resuscitation 2004, 63:17-24.

16.       Eisenberg M, Cummins, RO, Larsen, MP.: Numerators, denominators, and survival rates: reporting survival from out-of-hospital cardiac arrest. . Am J Emerg Med 1991, 9:544-546.

17.       Survive Cardiac Arrest [http://blacklistinc.com/survive/index.php]

18.       Cummins R, Chamberlain, DA, Abramson, NS, et al.: Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council. Circulation 1991, 84:960-975.

Posted in Cryonics Technology (General), Ischemia-Reperfusion Injury | Leave a comment

Michael G. Darwin, a Biographical Précis

Please note: A PDF of this article is available at: http://cryoeuro.eu:8080/pages/viewpageattachments.action?pageId=1441801&sortBy=date&highlight=Darwin_Michael_+G_+Biography_v4.3.pdf&

Authorship & Editing Credits

The following biography began as a Wikipedia entry authored primarily by Ben Best and a Wikipedian who identifies himself as “Cryobiologist.” In May of 2010, I was contacted by an individual who identified himself as “Kahn,” and who solicited my cooperation on “completion of a comprehensive and accurate biography (of Mike Darwin) which could be used as the basis of Wikipedia entry.” This effort was reportedly in response to a deletion notice regarding my Wikipedia biographical entry (news of which I greeted with joyful anticipation). After some negotiation, I was sent a draft of the proposed accurate and comprehensive biography, which, to my considerable surprise, I found was indeed both reasonably accurate and astonishingly comprehensive. Kahn and I exchanged many edits of the biography before he apparently lost interest and disappeared from my event horizon in the closing months of 2010.

By that time I realized that Kahn, whoever he was, had managed to do something that I had not, despite 20+ years of fitful effort; namely to construct a passable narrative of my professional life. With the maturation of the assault on cryonics began by Alan Kunzman and Larry Johnson some years before, I began to realize the importance of such a well referenced narrative, not so much for my benefit, per se, but rather because it represents a narrative of a critical period in cryonics history – and one which is the subject of the current campaign of disinformation and lies. Eugen Leitl concurred in this assessment and made considerable efforts in refining the manuscript and I want to thank for him for this and for his considerable efforts in attempting to disseminate an earlier version. Finally, Steve Bridge spent many hours editing the text, formatting and correcting the references, and preparing it for web publication. This was a boring, frustrating, and probably pretty unrewarding task. I know this because I had struggled with it for many hours myself… So, I want to extend special thanks to Steve for these tedious efforts.

Ten of the 194 citations in the References section are incomplete, and correct information and URLs would be welcomed. Similarly, the start pages for a handful of the newspaper articles cited cannot be located, and again, any help would be much appreciated.

The authorship of this document, roughly in order of contributions, should thus probably be:

By “Kahn,” Mike Darwin, Ben Best and “Cryobiologist”

Michael G. (“Mike”) Darwin, also known as Michael Federowicz, (born April 26, 1955) was the president of the cryonics organization Alcor Life Extension Foundation from 1983 to 1988, and Research Director until 1992. He was also the founder and president of BioPreservation, Inc., and a cofounder, member of the Board of Directors and Director of Research of Twenty-First Century Medicine, Inc., (a cryobiological/critical care medicine research company) from 1993 to 1999. At the time he resigned from Alcor in 1992, Alcor President Carlos Mondragon said of Darwin that he had more experience doing cryonics than “anyone else on the planet.” [1] He is noted for his technical acumen and exceptional communication skills.[2] Darwin is second only to Robert Ettinger as one of the most influential figures in the controversial field of cryonics.[3,4]

Above: Michael Darwin (Federowicz) with ‘Enkidu’ the second dog to survive and make a full recovery after 5 hours of bloodless perfusion at 5 oC; 18 March, 1984in Fullerton, CA (photo by Hugh Hixon).

Contents 

  • Personal Background
  • Early Cryonics Activities
  • Technical Accomplishments
  • General Scientific Contributions to Cryonics
  • Philosophical and Ethical Contributions to Cryonics
  • Controversies
  • 2002 to 2010
  • Media coverage
  • Books About
  • Works
  • References

Personal Background

Born Michael Federowicz in Indianapolis, Indiana, his acceptance of biological evolution and rejection of creationism earned him the nickname “Darwin” among his schoolmates. At the age of seven, he discovered his maternal cousin, Rae Rorhman, with whom he was very close, dead in her home in a state of advanced decomposition. A lifelong and noncompliant diabetic, she had died suddenly and alone, where she lay undiscovered for nearly a week. This event had a profound effect on Darwin and lead to a preoccupation with ways to slow or halt decomposition and ultimately to stop and restart life itself.

As a child, Darwin initially experimented with halting decomposition in small dead animals by immersing them in 70% isopropyl alcohol. In 1965 Darwin gained access to a copy of The Principles and Practice of Embalming by Clarence G. Strub and L. G. Frederick[5] and attempted to improve on preservation by injecting dead animals with formalin. None of these approaches yielded durable preservation and, more importantly to Darwin, none seemed to offer the prospect of allowing the restoration of life after its interruption.

An avid reader at an early age, Darwin discovered a box of Ace D-series tête-bêche science fiction novels in the attic of an abandoned house in 1965. While a number of the books in this cache had a life changing effect on him, one novel in particular, The Mechanical Monarch[6] by E.C. Tubb had a profound influence on his world view and on the direction of his interests and goals. Tubb’s novel, published in 1957, is the fictional story of the first man sent into space, who becomes marooned in the asteroid belt due to a malfunction of his spacecraft that ends his life when the hull is breached. The spacecraft undergoes decompression; after which the astronaut orbits the cold far reaches of deep space for ~200 years, frozen and lifeless. Ultimately, he is discovered by an asteroid metal miner who transports him to medical facilities on Mars where he is subsequently repaired and resuscitated. Tubb’s novel is doubly prescient in that it not only anticipates the idea of advanced medical technology being capable of reversing freezing damage and restoring life to persons apparently dead, it also clearly articulates the idea of mind uploading. When the recovered astronaut returns to earth, he ultimately discovers that the artificial intelligence that controls every aspect of human life on earth is none other than his close friend and colleague, who was in charge of the project that had sent him into space over 200 years earlier, now uploaded into a near omniscient computer.

Between 1965 and 1966, Darwin developed an obsession with the idea of suspended animation via cryopreserving organisms as a possible way to preserve life indefinitely.[7] In 1968, at the age of twelve, he qualified for the Indiana state Science Fair with his project “Suspended Animation in Plants and Animals.” He dreamed of becoming an astronaut and applying his research to space travel, as well as using it to escape death indefinitely, thus allowing him to roam the universe in an unending quest of exploration and discovery. His registration was lost and his project never judged, but he was given an honorable mention out of a sense of fair play. At the fair he learned from one of the judges that Dr. James Bedford had been frozen in California.[8] This was the beginning of Darwin’s lifelong involvement in cryonics.

Early Cryonics Activism

Darwin wrote to all of the cryonics organizations active at that time and received a considerable amount of literature from the Cryonics Society of New York (CSNY), as well as a personal letter from the organization’s Secretary, Saul Kent, who was to become a lifelong patron of Darwin’s  rapidly growing cryonics technical skills.[9] It was at this time that Darwin also began a life-long association with the then President of CSNY, Curtis Henderson, a man Darwin has described as his greatest mentor and teacher in cryonics. During the summer months of Darwin’s 15th and 16th years he was invited to stay in the Sayville, L.I. NY, home of Henderson (which also housed CSNY’s office and files). It was during this period that Darwin learned much of the practical side of cryonics as it existed at that time and was, in his own words, “mentored by a man whose honesty, integrity and willingness to unflinchingly confront truly terrible problems in cryonics shaped my own outlook and approach to the discipline.” [10] The intense hostility of Henderson’s second wife to cryonics inspired Mike Darwin to begin a study of the many cases where “hostile spouses or girlfriends have prevented, reduced or reversed the involvement of their male partner in cryonics.”[11] It was in Henderson’s home that Darwin first read and was profoundly influenced by the works of the maverick Soviet surgeon V.P. Demikhov[12] and of  the Soviet reanimatologist V. A. Negovskii. [13]

Right: Mike Darwin at his home in Indpls IN in 1973 with cryonics rescue and perfusion equipment holding a flow meter in his hands and temporary dry ice storage container constructed by Darwin (photos by Ella Vinci).

Through CSNY Darwin was introduced to, and began corresponding with an undergraduate student and cryonics activist in Costa Mesa, CA. who had established a cryonics organization for young people, the Cryonics Youth Association (CYA, shortly thereafter renamed the Student Cryonics Association; SCA) which published a monthly, national newsletter, Cryonics News. Darwin immediately joined the CYA in 1969, and in 1970 he founded the Indiana Chapter of CYA, the Student Cryonics Association of Indiana (SCAI). A core objective of the SCAI was to, “obtain perfusion and storage facilities for future members.”[14] By the winter of the following year, the 16-year-old Darwin had acquired virtually all of the equipment and chemicals necessary to carry out blood washout and cryoprotective perfusion of human cryonics patients, and had constructed a foam insulated container for dry ice storage of whole body patients.[15]

Right: Mike Darwin with cryonics patient Clara Dostal in January of 1972 (photo by Curtis Henderson).

At the age of 17 Darwin was invited by Saul Kent to participate in the cryopreservation of a CSNY member, a 60 year old woman named Clara Dostal who had experienced cardiac arrest from cancer. This experience proved traumatic for Darwin because it exposed the harsh reality that the care being delivered to cryonics patients was extremely primitive and lacking in even the rudiments of a scientific or medical foundation. As a result of the Dostal case, Darwin became extremely focused on placing cryonics on a firm scientific and biomedical footing.

In July of 1973 Darwin made a trip to Southern California to learn the state of cryonics on the West coast and, in particular, to try to determine if rumors about inadequate care of the Cryonics Society of California’s (CSC) cryonics patients had any basis in fact. Darwin met with CSC’s president Robert F. Nelson, as well as CSC’s mortician, Joseph Klockgether. These meetings, and a subsequent meeting with Fred and Linda Chamberlain, who had only recently left CSC to found Alcor, persuaded Darwin that CSC was in serious trouble and that it was very likely that the CSC patients had been thawed out, or otherwise mishandled.[16] It was also on this trip that Darwin, on the premises of an Anaheim-based cryogenics manufacturing and repair firm, Galiso, Inc., had his first personal encounter with James H. Bedford, the first man to be cryopreserved.[17]

Right: Mike Darwin and Linda Chamberlain stand next to the cryogenic dewar holding the body of James H. Bedford, in July of 1973 (photo by Fred Chamberlain, III).

In 1974 Darwin moved to California from where he was attending college in Augusta, Georgia and began a year-long collaboration with Fred and Linda Chamberlain where he conducted basic cryobiology research and worked with the Chamberlains to prepare for the cryopreservation of Fred Chamberlain’s seriously ill father.[18] When funding ran out for the effort, Darwin moved back to Indianapolis, IN where, in 1977, he  co-founded two cryonics organizations; the non-profit Institute for Advanced Biological Studies (IABS) with Stephen W. Bridge, and the for-profit cryonics service provider company, Soma, Inc., with his lover at the time, Allen J. Lopp, a computer programmer from Lanesville, IN. Soma, Inc., merged with Jerry Leaf’s Cryovita Laboratories in 1981, and IABS merged with the then-California-based Alcor Life Extension Foundation (Alcor) in 1982.[19]

When he began his career as a dialysis technician, he adopted “Darwin” as the surname for his cryonics persona, so as not to end his career in medicine by association with cryonics. He has used both names since that time, and Michael G. Darwin is a legally acknowledged a.k.a. of Michael Federowicz.

Although his only formal training was as a dialysis technician, he is a self-taught expert in the field of cerebral ischemia, [20] and a respected contributor to CCM-L, the international critical care medicine internet discussion group. In 2005 he was an invited co-author of a medical ethics article on the definition of death in the journal CRITICAL CARE.[21] He has been a frequent invited speaker at diverse conferences on critical care medicine, discussing topics ranging from obstacles to new drug development, the use of mild therapeutic hypothermia and combination drug therapy in cardiopulmonary cerebral resuscitation [22], and the possible impact of fully reversible cryopreservation of the human brain on critical care medicine.[23]

Darwin is an openly gay man who has written about the relationship between homosexuality and activism in the early days of cryonics.[24]

Technical Accomplishments

Darwin’s technical contributions to cryonics are manifold. In March of 1973 he co-authored the first technical case report documenting the procedures, problems and responses of a human patient (Clara Dostal) to cryoprotective perfusion and freezing.[25] This report was the first to document glycerol-induced dehydration of the eye by evacuation of the water from the vitreous and aqueous humors, as well as unexpectedly serious dehydration of the skin and other tissues and organs. It also revealed, for the first time, the problem of widespread infarction of skin, and thus presumably other organs, due to post-cardiac arrest blood clotting and small vessel and capillary plugging from red blood cell aggregation and white blood cell adhesion in the capillaries, as well the need to perfuse the pulmonary circulation by applying sternal compressions during perfusion. The paper proposed many changes in cryonics procedures that were not to be implemented until a decade or two later, such as biohazard safety precautions for cryonics personnel, premedication of cryonics patients with an oral anticoagulant (i.e., before medico-legal death while the patient was in the last days of life), administration of  PIPES buffer during manual and mechanical cardiopulmonary support (CPS) to combat metabolic acidosis, use of a bubble trap in the perfusion circuit, use of large volumes of cryoprotective perfusate to achieve adequate tissue concentrations of cryoprotective drug(s) before freezing, and careful and detailed documentation of the procedures used and the response of the patients to them.

It is notable that Darwin was the first to acquire and archive patient effluent samples – samples of perfusate that had passed through the patient’s circulatory system – in order to allow for extensive analysis of cryoprotectant uptake and to monitor the release of tissue enzymes indicative of cell injury or rupture. Darwin was also the first to both propose and implement that these samples be held in long term storage with the patient to allow future, as yet unanticipated, biomedical testing to be performed on them, thus avoiding any need to directly sample the cryopreserved patient.[26]

As a result of the Dastal perfusion and cryopreservation, Darwin was the first to conceive of the idea of an autonomous, bioengineered cell repair and replacement device, which he called the “anabolocyte”:

“The concept (and the name) for the anabolocyte originated in the winter of 1973 after participation in my first human cryopreservation (Clara Dastal) at the Cryonics Society of New York. I was pondering how it might be possible to repair literally billions of non-functional, severely injured cells in this cryopatient. After a restless night worrying over this problem I came up with the idea of genetically engineered leukocytes that would be able to either repair or replace damaged cells and tissue. In 1974 I sketched out some drawings and put the ideas into print.”[27,28]

In 1973 Darwin, et al., conducted the first known vitrification experiments on mammalian (guinea pig) brain slices using the Farrant technique [29] and documented that a solution of 60% (v/v) dimethyl sulfoxide (DMSO) fractures extensively when cooled below its glass transition point; a phenomenon that was later to have profound implications for both cryonics and for researchers attempting to perfect solid state organ preservation via vitrification. This work also demonstrated retention of 95% of the viability in brain slices subjected to cooling to and rewarming from -77oC in the absence of freezing that was present in control tissue as measured by oxygen consumption.[30]

In 1975, on the basis of experiments employing carbon black labeled solutions to re-perfuse ischemic rabbit brains, Darwin proposed induced hypertension during CPR using metaraminol and epinephrine; and cautioned against the use of vasodilatory drugs while CPR was underway [31] anticipating the work of Peter Safar, et al., by a year. [32] In this same document, Darwin introduced the use of methylprednisolone as a membrane stabilizer into cryonics transport procedures and advocated the use of inert gaseous perfusion of the circulatory system as a means of rapidly and evenly cooling the entire human body during freezing, and in particular the brain.

Right: First Portable Ice Bath (PIB) at the facilities of Soma, Inc. in, Indpls., IN in 1979.

In 1979, after observing the unacceptably slow rate of cooling in dogs chilled with ice in plastic bags, [33] Darwin invented the Portable Ice Bath (PIB) and documented its superiority in achieving external cooling in this model. The discovery by Darwin of the even slower rate of cooling achieved with human cryonics patients using ice packs [34] led him, starting in 1989, to widely deploy the PIB as a tool for in-field cooling during cryonics patient transport during his tenure as President of Alcor.[35] The PIB remains the standard of care for external cooling in cryonics worldwide through the present.

It was also during this period in Indiana (1977-1980) that Darwin introduced the use of refractometry into cryonics as a means of measuring cryoprotective concentration in patients undergoing cryoprotective perfusion, [36] undertook the first study in cryonics to determine the effects normothermic ischemia (clinical death) on the rabbit brain [37] and of then extant cryopreservation techniques on rabbit brain macroscopic and microscopic structure. This work also uncovered the first evidence that “fractures or planes of cleavage were developing on cooling to liquid nitrogen temperature” was occurring in whole animal brains loaded with high concentrations of DMSO or glycerol.[38]

In cooperation with Jerry Leaf, he began the systematic introduction of extracorporeal medical technology and a medical model to cryonics.[39,40] This effort lead to a collaboration between Leaf and Darwin which culminated in a joint research effort to recover dogs from extended bloodless perfusion under conditions of ultra-profound hypothermia (5oC ) using an intracellular perfusate similar to those employed in organ preservation for transplantation.[41] In these experiments Darwin introduced the use of hemodialysis to normalize blood electrolytes, concentrate plasma proteins and red blood cells, and remove excess water from the animals, eliminating the need for large volumes of costly ‘vascular rinse’ perfusate and greatly reducing the need for transfused blood which was both costly and injurious. After Leaf’s cryopreservation in July of 1991, Darwin continued this work at 21st Century Medicine, extending the length of time from which dogs could be successfully recovered from bloodless perfusion at 5oC from 4 to 5 hours, a record not yet surpassed.

In 1980 Darwin introduced the practice of cranial burr holes into human cryopreservation procedures. [42] The use of burr holes, ~15 -20 mm holes, or windows made in the skull exposing the surface of the brain to view, allowed for monitoring of the adequacy of blood washout in the brain, provided an indication of cryoprotectant equilibration (marked shrinkage or dehydration of the brain indicating poor penetration of agent) and, perhaps most importantly, allowed direct visualization of developing brain swelling (when it occurred) secondary to injury from ischemia so that cryoprotective perfusion could be halted before the brain was herniated, or squeezed out through openings in the cranium, such as those through which the cranial nerves and spinal cord pass.

Above: The utility of burr holes in the skull for monitoring the response of the brain to cryoprotective perfusion is illustrated in these photos. At the start of cryoprotective perfusion (left) the brain is of normal volume, whereas near the conclusion of perfusion (right) it has lost substantial volume due to dehydration and has disappeared from view in the burr hole opening (photo by Hugh Hixon).

In 1983 Darwin demonstrated that inexpensive hollow fiber hemodialyzers used to provide artificial renal replacement could be effectively used as oxygenators in dogs; even under the demanding conditions of rewarming from profound hypothermia.[43] This preliminary report was followed up in May of 1985 with an extensive validation of the concept by Leaf, Darwin and Hixon.[44]

In 1985 Darwin was the first to propose barbiturate, neuromuscular blockade and cardioplegic medications to improve neuroprotection, enhance cooling, and prevent ROSC during stabilization procedures used on cryonics patients. [45] Also in 1985, Leaf and Darwin were the first to successfully undertake in-field extracorporeal support and total body washout of a cryonics patient.[46]

In July of 1984 Darwin, working with Hugh Hixon, introduced silicone oil (5 centistoke polydimethylsiloxane) as a safe, non-toxic, non-inflammable heat exchange medium for cooling cryonics patients from near 0oC to -79oC, replacing isopropyl alcohol or n-propyl alcohol which had been previously used for this purpose; and which Darwin had identified as being capable of dissolving water (ice) from the tissues of cryonics patients subjected to prolonged dry ice storage.[47]

Right: Fractures in a feline kidney as a result of cooling to below Tg, in this case to -196oC, following equilibration of the whole animal with 4M glycerol. Similar fracturing occurs in the brain (photo by Hugh Hixon).

Later that year, overcoming substantial resistance within the cryonics community, Darwin secured permission to perform the first post mortem examinations ever conducted on cryopreserved patients; in this case on the bodies of thee whole body cryonics patients who had been converted to neuropreservation. This work by Darwin, Leaf and Hixon, disclosed multiple ‘cracks’ or fractures in almost every organ system, with only the liver being completely spared and the kidneys only slightly affected. In the remains of one patient, fracturing was so severe that numerous organs were often completely or almost completely transected by fractures.[48] It was Darwin who correctly posited that fracturing was occurring because the patients had been cooled significantly below the glass transition point (Tg) of the water-cryoprotectant mixture present in their body tissues; a phenomenon he had observed over a decade previously in cooling 60% (w/v) DMSO-water solution below its Tg while vitrifying brain slices. This work also demonstrated for the first time that that the cryoprotectant concentration within patients’ bodies varied widely by organ/tissue and were far lower than was either previously thought, or considered to be desirable.[49] Remarks (by Darwin) in this paper foreshadowed the difficult technical problems associated with cooling to below Tg, which continue to be a major source of concern, not only in cryonics, but also in organ and tissue preservation via vitrification, noting:

“If the latter explanation [cooling of non-homogenously cryoprotected patients below Tg] is indeed the correct one, then cooling to very low temperatures in the absence of serious fracturing may be extremely difficult in large biomasses. Perhaps the solution to this problem may be to anneal the patient for a prolonged period of time at or near Tg prior to completing the descent to -196 degrees centigrade. Alternatively, it may be determined to be both safe and feasible to pursue storage at higher temperatures, perhaps in the region of Tg, where there will be no available liquid water/cryoprotective agent to allow for appreciable propagation of chemical reactions.” [50]

In an editorial which accompanied the report documenting the technical findings of the autopsies on these three cryonics patients, Darwin noted that the kinds of damage observed would require “molecular level” repair and he urged cryonicists to abandon ‘simplistic’ macroscopic scenarios for resuscitation:

What these results do point up is that it is time for those (hopefully few) of us who have been thinking of cryonic suspension in terms of simple viability and traditional surgical repair techniques to wake up and face reality. Contemporary freezing techniques are disruptive and they will require the development of very sophisticated repair techniques. Undoubtedly we will discover damage on the molecular level which is equivalent to or even worse than the fracturing problem we have encountered on a gross level. Repairing such injury will require that we be able to move atoms around almost on a one by one level. It will require that we have tools and engineering capability on a molecular level and that we be able to build molecular repair and fabrication machines–basically our own version of enzymes.” [51]

In 1986 Darwin authored the first text on cryonics standby and transport operations, Transport Protocol for Cryonic Suspension of Humans, which documented procedures for administrative interface between cryonics organizations and medical facilities and coroners, data acquisition, cardiopulmonary support and external cooling, temperature monitoring, intravenous access, pharmacological treatment of ischemia-reperfusion injury, and procedures for safe air or ground transport of the cryonics patient from the site of cardiac arrest to the cryonics organization’s facilities. [52] This work was an extension and refinement of the very first scientifically derived procedure manual for the cryopreservation of humans, Instructions for the Induction of Solid State Hypothermia in Humans, authored by Alcor founders Fred and Linda Chamberlain in 1972.[53]

It was also during this period that Darwin, as President of Alcor, established the first international Cryonics Patient Stabilization Coordinator program which consisted of volunteers who had undergone in-house training and certification in basic cardiopulmonary support and transport procedures (i.e., Certified Alcor transport Technicians) and who had been issued emergency response kits that included a mechanical, compressed oxygen driven heart-lung resuscitator, an array of intravenous medications to reduce ischemic injury and prevent blood clotting, as well as cooling and monitoring equipment including PIBs.[54] By 1988, Darwin had deployed 5 such kits in the US, as well as ones in Toronto, Canada and London, England. [55]

From 1986 to1988 Darwin engaged in extensive in-house research on improved methods of CPR with the goal of improving perfusion and ventilation in cryonics patients. After experimenting with pneumatic vest CPR, simultaneous compression-high pressure ventilation CPR and several other modalities, Darwin settled on high impulse CPR combined with continuous compressions (not stopping compressions to administer ventilations) as a way to increase perfusion and help overcome the cerebral no-reflow phenomenon.[56] This change resulted in a marked increase in mean arterial pressure (MAP) and perfusion (as determined by end tidal CO2 monitoring) in cryonics patients (MAP of 25-30 with conventional CPR versus 60 mm Hg with high impulse continuous compression CPR).[57] Darwin worked with Michigan Instruments, Inc, of Grand Rapids, MI to develop custom-built mechanical heart-lung resuscitators to deliver this new modality of CPR and the first cryonics patient to be treated with this device was Alcor patient A-1068 on August 09,1990.[58] This approach to CPR is essentially the same as cardiocerebral resuscitation CPR, now being advocated by Gordon Ewey, M.D., of Phoenix, AZ.[59] The American Heart Association has also revised its CPR guidelines (in 2007) to alter chest compressions to conform to the high impulse approach and to eliminate pauses for ventilations between compressions, acknowledging the priority of brain perfusion for survival with CPR after cardiac arrest.[60]

Right: Schematic of the Darwin Esophageal Gastric Tube Airway (illustration by Mike Darwin).

In 1987-88 Darwin developed modifications of the esophageal gastric tube airway (EGTA) and the Combitube airway to incorporate thermocouple probes so probe placement was concurrent with airway placement (eliminating delays in initiating temperature monitoring) and to allow for continuous monitoring of the intrathoracic pressure by measuring the dynamic pressure in the occlusive balloon on this device. Continuous (indirect) monitoring of intrathoracic pressure during CPR allowed for dynamic adjustment of chest compression parameters (force on chest, frequency and depth of compression as well as duty cycle) permitting for individualized optimization of cardiac output during CPR. [61]

In 1989 Darwin proposed the use of elective dehydration for terminally ill cryonics patients who found the quality of life at the end of their illness unbearable, and who were considering suicide or assisted suicide, which would likely result in autopsy. This approach was first implemented with Leaf, et al. in 1990.[62]

In 1987 Darwin proposed that visceral organs from neuropatients that would normally be discarded with the body (cremated) could be used as a surrogate(s) for determining brain viability following transport. This would serve as invaluable feedback on the effectiveness of stabilization procedures and also provide data for quality control. The kidney is an ideal organ for such evaluation because the renal cortex is similarly sensitive to ischemic injury.[63] This technique was first applied clinically in 1990, and demonstrated renal viability in a kidney removed from a cryonics patient following cryoprotective perfusion of the patient’s cephalon (2.5 days after cardiac arrest) that was compatible with survival of the organ upon transplantation.[64]

Beginning in the mid-1980s Darwin, working alone and with Leaf, began systematic evaluation of medications to reduce ischemia-reperfusion injury (IRI), including a multi-modal approach to the problem by experimenting with combinations of drugs that addressed the multiple causes of IRI in mammals.[65] This resulted in the development of an evolving combination of novel, as well as clinically available drugs that were first applied to cryonics patients in 1987.[66] Darwin and Hixon developed in-house capability for sterile preparation and small scale production of these novel injectable drugs in a stable form with a shelf life comparable to that of ethical pharmaceuticals.[67]

The first iteration of this protocol used a combination of 8 drugs not previously employed in cryonics transport operations: 6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid Trolox), a water-soluble derivative of vitamin E, ascorbic acid (vitamin C) + deferoxamine (the latter to scavenge free radicals generated by vitamin C in the presence of free iron via Fenton’s Reaction), high dose mannitol (hydroxyl radical scavenger and flow promoter) low dose nimodipine and high dose IV trisodium citrate (to reduce damaging influx of calcium into brain cells), dextran-40 (to reduce blood sludging and improve microcirculatory flow), and chlorpromazine to provide cell membrane stabilization during the period of deep hypothermic asanguineous circulatory arrest frequently required to air transport cryonics patients from remote locations where legal death occurred to the cryonics organization’s facilities for perfusion with cryoprotective drugs to reduce or prevent freezing. [68] Since that time, Trolox has become the antioxidant standard against which most other bioactive antioxidants are measured [69] and multimodal approaches to the experimental treatment cerebral IRI initially advocated by Darwin have become commonplace in both stroke and global cerebral ischemia research. [70-72]

At right: This patient’s apical heart rate (HR), versus mean arterial pressure (MAP), are a textbook presentation of the course of hypovolemic shock, particularly in the setting of compromised coronary circulation. Note that as the mean arterial pressure declines, the heart rate increases to the patient’s maximum sustainable heart rate. Once the MAP declines to ~50 mmHg, or below, coronary perfusion becomes inadequate, the MAP begins to rapidly deteriorate, HR falls precipitously, and cardiac arrest occurs.[73]

Darwin was the first to acquire, analyze, and archive, blood/effluent samples from patients.  In 1985 he initiated a systematic program of collecting and analyzing effluent samples from cryopatients and began the practice of dividing each sample into at least 3 parts; with one part staying with the patient (inviolable), one being used for immediate analysis of hematological parameters and serum chemistry and biochemistry, and one sample being archived indefinitely so that, as medicine and biotechnology advanced, retrospective studies could be carried out on patients already cryopreserved.

In1989 he introduced and implemented real time vital signs trending to aid in prediction of cardiac arrest (CA) which was first used clinically in 1990.[74]

In 1991, Darwin introduced pulse oximetry into cryonics as a tool to provide early warning of impending cardiac arrest. This was first applied clinically in 1992.[75]

Right: Darwin (bottom center) with patient receiving in-home cardiopulmonary support using the first active compression-decompression heart-lung resuscitator followed by blood washout and extracorporeal support in 1995 (photo by Billy Seidel).

After the discovery of active compression decompression CPR (ACD-CPR) in 1992, Darwin undertook experiments to determine its efficacy in dogs, with and without high impulse CPR. In 1994 Darwin designed the first combination high impulse-ACD-CPR machine which was fabricated by Michigan Instruments in 1994 [76] and applied clinically in cryonics for the time in 1995.[77]

Other technical accomplishments in the period from 1990 through 2002 include:

  • Proposed and used in-field (bedside) monitoring of urine specific gravity to monitor the progress of dehydration in cryonics patients refusing food and fluids as a result of noticing the unreliability of anuria (absent the presence of an indwelling bladder catheter in predicting cardiac arrest from dehydration.
  • Identification of hypercoagulability as a serious risk of causing sudden and unexpected cardiac arrest due to pulmonary embolism in cryonics patients dying from cancer, or undergoing dehydration during the agonal process, and proposed prophylaxis with vitamin E and aspirin (1989) and implemented it in 1990.[80] He later suggested the use of clopidrogrel (Plavix) to reduce the risk of pulmonary embolism in terminally cryopatients who are determined by their treating physicians to be hypercoagulable (2000).[81]
  • Replaced federally controlled, Schedule II barbiturate with propofol as the drug of choice for preventing the return of consciousness in cryonics patients (1997) [82] and introduced the use of potassium chloride as a first-line drug during transport to secure cardioplegia and prevent cardiac auto-resuscitation as a result of cardiopulmonary support during transport operations.[83,84]
  • Conceived of premedication of cryopatients in 1972, seriously proposed a comprehensive, evidence based medicine (EBM) level II/III protocol in 1994 [85], and designed and implemented such a protocol in 1995.[86]
  • Often during the peri-arrest period, or at or shortly after cardiac arrest, patients defecate or experience leakage of liquid stool due to loss of control of the anal sphincter. The resulting fecal contamination of the circulating water in the PIB in the setting of a cryonics transport poses a health risk to the cryonics personnel attending the patient and can cause serious difficulties with medical or mortuary personnel who may be present or assisting.

Left: Fecal retention device with associated temperature monitor.

Darwin solved this problem by developing a combination temperature monitor, cold fluid colonic lavage tube, and inflatable silicone rubber silastic retention balloon (1990) which was first applied clinically in 1994.[87] This device proved easy to place, provided a highly reliable seal, and allowed for repeated closed-system irrigation of the colon with ice-cold balanced salt solution to facilitate more rapid core cooling of the patient during transport. It is currently used by two US cryonics organizations.

  • First proposed and then implemented both colonic and peritoneal irrigation for rapid post-cardiac arrest cooling cryonics patients (1995) which resulted in the fastest non-invasive cooling of a cryonics patient yet achieved; a tympanic and pharyngeal cooling rate of 1.0oC/min for the first 10 minutes of cardiopulmonary support following pronouncement of legal death.[88]

Above: Cooling curve of a cryonics patient receiving highly efficient CPS in conjunction with external cooling in the PIB as well as peritoneal and colonic lavage with ice cold fluids.

  • Identified the presence of ascites as barrier to effective femoral-femoral cardiopulmonary bypass (CPB) and advocated in-field stab wound /fenestrated tube gravity assisted drainage of ascites before CPB (1997).[89]
  • Darwin was the first to identify melatonin and phenyl-N-tert-butylnitrone (PBN) as potent cerebroprotective agents in animal research (1993)[90] and the first to apply them to cryonics patients both as premedication in the peri-arrrest setting, as well as primary cerebroprotective drugs during transport administered immediately after cardiac arrest (1995).[91]
  • Developed first micelle-based delivery system for the cerebroprotective lipid soluble drugs d-alpha tocopherol, PBN and melatonin in 1993 [69] which were administered to the first cryonics patient in 1995.[92]
  • Selected (1993) and administered the first excitotoxicity blocker to cryopatients (kyneurinine) (1995) as part of a multimodal protocol of drug and other interventions to mitigate cerebral ischemia reperfusion injury which had proved successful in allowing resuscitation of dogs from up to 16 minutes of normothermic cardiac arrest.[93]
  • In 1994 Darwin proposed, and in 1995 with his colleagues at 21st Century Medicine conducted, the first successful experimental demonstration of uniform whole body subzero cooling and rewarming using intravascular perfluorocarbons (PFCs) in dogs.[94,95]

Right: Mike Darwin performing the first chilled perfluorocarbon lung lavage on a cryonics patient (photo by David Hayes).

Conceived of, and validated in dogs, rapid cooling of the entire body via the lungs by repeated pulmonary lavage to vital capacity (VC) with liquid perfluorocarbon (PFC) and proposed its application to cryonics patients in 1995.[96] In 1997 he invented a scheme of combined gas and liquid PFC ventilation and cooling [97,98] and with Harris, et al., developed liquid assisted pulmonary cooling using a combined gas and liquid (fractional tidal volume) ventilation approach that was demonstrated in animals (1998-2000) to be effective at allowing cooling of rates of 0.5 C/min.[99,100] Darwin carried out the first application of serial lung lavage to vital capacity using cold PFC to speed the induction of hypothermia in a human cryonics patient in 2002.[101]

He has also made notable contributions to mainstream medical research, such as the use of liquid PFC ventilation for rapidly inducing both moderate and mild therapeutic hypothermia in humans for the treatment of the post-resuscitation syndrome, heart attack, stroke and heat stroke.[102] Using the multi-modal pharmacological approach developed by Darwin, Fahy and Woods[103] and working with physician Steve Harris and a team of researchers and technicians at 21st Century Medicine, this group was able to resuscitate dogs without neurological damage following 16 minutes of warm ischemia (clinical death at normal body temperature) — a world record which remains unmatched. [104]

General Scientific Contributions to Cryonics

Along with his associates and mentors Frederick Rockwell Chamberlain III and his wife Linda, Arthur Quaife, Ph.D., and Jerry D. Leaf, Darwin was responsible for attempting to put human cryopreservation procedures employed in cryonics on a medically sound and evidenced based footing. Darwin was the leading advocate of the position that technical and scientific excellence was essential not just to progress in cryonics, but to its survival as a discipline, arguing that poor quality of care for cryonics patients and haphazard, non-scientific or pseudoscientific procedures would damage the credibility of cryonics and lead to medico-legal intervention in the field, possibly making cryonics either illegal or impractical.[105]

Darwin and Leaf placed heavy emphasis on meticulous documentation of each cryonics patient’s care, viewing each as an individual experimental procedure, using as many modalities as were feasible, including the patient’s pre-cardiac arrest medical records, as well as data gathered during the cryopreservation process such as, clinical and laboratory documented response to cardiopulmonary support, cryoprotective perfusion and cooling, imaging (X-ray, CT) photo documentation (still photography, videography) fluid and tissue sampling and thorough post mortem examination of the non-cryopreserved bodies of neuropatients.[106] Darwin worked tirelessly to ensure that autopsies were, wherever possible, conducted on both the bodies of neuropatients and those of patients removed from cryopreservation in order to understand the effects of transport procedures (thus facilitating the development of better methods), instruct cryonics personnel in the pathophysiology of the dying process, and provide teaching and training material for cryonics professionals. [107] All of these procedures have subsequently been discontinued by the two largest US cryonics organizations, Alcor and the Cryonics Institute (CI); both prohibit any photography and neither uses autopsy or tissue or effluent biochemical evaluation as a method of quality control or research.[108]

Darwin was and remains the only cryonics activist or professional to publicly criticize the use of positive, dramatic, incredible, and not reproduced published scientific studies to validate and promote cryonics [109] (i.e., data dredging), most notably the claim by Suda, et. al., to have achieved recovery of near normal metabolic and electrical activity in cats’ brains after freezing to and prolonged storage at -20oC [110,111] and the claim of Blaine C. White reporting neurologically intact resuscitation of humans after an hour of normothermic circulatory arrest via the use of a calcium channel blocking drug.[112]

Above: Illustration of milestones Darwin anticipated achieving or facilitating during his “first life cycle;” from his August, 2008 lecture, “Cryonics: Why it has failed and what you can do about It.”

Far more controversially and perhaps more importantly, Darwin has been a relentless advocate of channelling both cryonics organization efforts and resources into animal research based efforts to systematically validate each of the speculations, presumptions and extrapolations upon which cryonics depends upon for its ultimate success; such as that the normothermic ischemic intervals currently experienced by cryonics patients under the best of circumstances (i.e., 5-30 minutes) do indeed allow for survival of memory and personality, that prolonged bloodless ultra-profound hypothermia is survivable with recovery of normal mentation, and finally, that cryopreservation and long term storage do not destroy the information needed to restore cryonics patients to life and health.[113] With the exception of Saul Kent, [114] Brian Wowk, and perhaps a handful of other cryonicists, Darwin took the position, virtually from the beginning of his activism in cryonics, that the development of fully reversible suspended animation within a single human generation (i.e., his lifetime) was critical to the success of the program and to the personal survival of most of its adherents. As a result of this position, from his earliest days in cryonics Darwin was an experimentalist who undertook to validate the effectiveness (or lack thereof) of virtually all of the procedures used to carry out cryopreservation; and a central concern of his was validation that existing cryopreservation techniques were adequate to allow for repair and recovery of cryonics patients using a highly conservative interpretation of information theoretic death criteria.

Above: The work of Darwin, et al., demonstrating  extensive damage with inadequate cryoprotection due to widespread ice formation in the cryopreserved cat brain (top) and vastly better preservation via freezing using 7.5 M glycerol in the dog brain (bottom).

Beginning in 1977 using rabbit brains,[115] and continuing throughout the 1980s and 1990s, Darwin lead the effort to conduct animal research that would document the effects of cryopreservation techniques then being used on humans. In 1983, along with Jerry Leaf, he published “Cryoprotective perfusion and freezing of the ischemic and non-ischemic cat,” which showed unexpectedly poor preservation of the cat brain following perfusion with 4 molar glycerol.[116] Darwin provoked great controversy within the cryonics community when he made the following comments on this research in 1992:

I think  it is also fair to  say  that  anyone, layman or neurophysiologist, who  looks at either the pictures in the study by Darwin, et  al., or the pictures generated by Fahy of  freeze-substituted brains (showing massive histological disruption  by  ice) will be given pause for thought about the workability of cryonics.” [117]

In 1995 Darwin, et al., published the “Effects of a human cryopreservation protocol on the ultrastructure of the canine brain” demonstrating that the use of greatly increased concentrations of glycerol (adopted because of the demonstrated inadequacy of the earlier techniques employing lower glycerol concentrations) was effective at preserving brain structure such that, on the basis of electron microscopic examination, both cellular structure and neuronal interconnectivity were well preserved.[118] This is perhaps his most important scientific contribution to cryonics.

Philosophical, Ethical, and Business Contributions to Cryonics

Left: Mike Darwin during his presidency of Alcor in 1986 (photo by Luigi Warren).

In 1979 the decomposing bodies of nine cryonics patients were discovered in Oakwood Memorial Park Cemetery in Chatsworth, California, where they had been stored by the head of CSC, Robert F. Nelson (aka Frank Bucelli), under the auspices of his associated organization, Cryonic Interment, Inc.  In late July of 1980, Darwin, along with his high school friend and IABS colleague Joe Allen, removed two badly decomposed cryonics patients from their storage dewar at a facility located in Mt. Holiness Cemetery in Butler, New Jersey. The facility had been operated as a branch of Cryonic Interment, Inc. The condition of the remains and the gruesome conditions under which Darwin and his colleague had to work left a lasting impact on Darwin that are perhaps best articulated in his own words written less than a year after the event:

“What happened to those two poor souls was inexcusable, avoidable and unnecessary.  The amount of unthinkable stupidity required to produce the mess we found still awes me as I sit here at the typewriter. My experience with this case has filled me with anger and has further broken down my tolerance for those who would pursue cryonics with anything but good sense and complete commitment.” [119]

During his tenure as President of Alcor, Darwin’s approach to cryonics and its dissemination may fairly be described as radical or even militant. In his 1983 essay “Why We Are Cryonicists” he argues that cryonics is a moral imperative for human civilization on par with rendering life saving resuscitation to a victim of heart attack; and he foreshadows a major shift in communicating cryonics to the public, namely abandonment of the words “after death” and “dead” to describe cryonics and cryonics patients (subsequently more completely articulated by Brain Wowk, Ph.D. in 1988 [120] ) when Darwin states:

Cryonics is not about “freezing dead people” since we do not agree with the contemporary medical definition of death which is based solely on the physician’s immediate ability to restore function — an ability that will change as medical technology evolves. Today, no one considers a patient in cardiac arrest who is receiving CPR in an attempt to restore life as dead. Similarly, we know that cryonics patients retain the structure and information content which constitute the basis of their personal identity and humanity to allow for restoration of life. We steadfastly refuse to concede they are dead (irreversibly lost to life) because we believe medicine will advance to a point where it can repair damaged brain structure and restore them to life, health and youth.”

In 1982 Darwin co-authored with Stephen Bridge the first article to seriously address the cost of cryonics and to itemize all of the equipment and consumables used in the cryopreservation process. This article, [121,122] and a revised version, which later appeared in the Alcor publication Cryonics: Reaching For Tomorrow, which Darwin co-authored with Brian Wowk, [123,124] provided the first rigorous basis for determining the actual costs of the procedure, as well as planning for future contingencies depending upon technological changes and the degree to which cryonics was accepted, and therefore might experience economies of scale.

In March of1984, Darwin received a copy of the manuscript that was to become the book Engines of Creation by K. Eric Drexler.[125] Over the next five years Darwin and Hixon, and later Brian Wowk as well, worked to introduce the idea of nanotechnology as a possible route to repairing and resuscitating cryonics patients, while at the same time working to inform and recruit highly respected scientists such as Drexler and Ralph C. Merkle into cryonics activism.[126]

Darwin was a vocal advocate of the rights of cryopreserved patients as well as the rights of those who did not wish to be cryopreserved. He introduced the idea of informed consent into cryonics and authored the first informed consent document, a version of which is still in use by Alcor [127] and by the American Cryonics Society [128] today. Darwin began the now universal practice of hanging pictures of cryonics patients throughout the cryonics facility so that their individuality and humanity would not be taken for granted; especially by cryonics personnel, or members of the cryonics organization caring for them, who had become involved in cryonics long after those patients were cryopreserved.[129] While president of Alcor he directed that a window be placed between his office and the area of the facility where the patients were stored so that he would “always be reminded in my work that my first duty is to those who are now completely helpless and totally dependent upon Alcor for their survival.” [130]

In 1990 Darwin authored the first set of criteria for accepting “at need” (terminally ill or legally dead non-member) cases; criteria which emphasized both informed consent and the prospective patient’s legal and mental competence to execute cryopreservation; either for oneself or on behalf of another.[131] He was the first to both articulate and implement Curtis Henderson’s admonition against “ third-party funding” of cryonics patients, whereby relatives or other interested parties made periodic payments (usually quarterly or annually), to maintain a patient in cryopreservation. Under Darwin’s leadership, Alcor became the first cryonics organization to ban such arrangements and to publicly call for industry-wide adoption of same.[132] In1982 he initiated the successful effort to rescue two third party funding patients in the care of Trans Time, Inc., in Berkeley, CA whose son, who was providing the money for their care on a pay as you go basis, was killed in an automobile accident leaving them bereft of funding. [133,134] He was a strong advocate of providing charitable assistance to Alcor members in distress and worked to facilitate the cryopreservation of at least two patients now in Alcor’s care who were in financial need. In 2007 he attempted, unsuccessfully, to facilitate the cryopreservation of long time Alcor member and cryonics pioneer Marcelon Johnson working with David Pizer and his Venturist organization to raise the funds needed for her cryopreservation.[135]

Darwin was co-founder and co-editor (1977 to1988) of Alcor’s monthly magazine Cryonics, and was a prolific communicator about cryonics, via the magazine as well as via the print and electronic media, lectures and the Internet; not only about technical matters, but about business, philosophical and ethical issues in cryonics, as well. Continuing in the footsteps of his primary mentor in cryonics, Curtis Henderson, Darwin also took the immensely unpopular position that “There is no such thing as feel good cryonics,” meaning that optimism and faith in the future should never be allowed to distract cryonics advocates from the hard choices, challenges, and inadequacies of procedures in the real world.” It has been said of him that he “was the most informed and credible critic of cryonics and that, as a result, he was the most hated man in cryonics.” [136]

In 1983, in keeping with Darwin’s position of conservatism and concern about over-optimism in cryonics, he initiated two actions to provide greater safety for cryonics patients; a steel reinforced concrete vault for the storage of Alcor’s neuropatients, and a controversial policy known as the 10% Rule, whereby 10% of all revenues flowing into Alcor would be diverted (irrevocably) to the Patient Care Fund (now the Patient Care Trust) – the entity charged with providing the financial resources for the long term care and eventual resuscitation of Alcor’s patients. Darwin, a student of the history of technology, was concerned that cryonics organizations not make the mistake that many innovators and engineers do when applying novel technology to undertakings such as bridge building, steamship engineering or tall building construction by failing to provide sufficient safety margins.

He argued that it was prudent, if not essential, that the same Factor of Safety (FoS) calculations be applied to cryonics patient care funding as are routinely applied in contemporary civil construction to allow for “emergency situations, unexpected loads, misuse, or attrition.” He was also greatly influenced by George Samuel Clason’s book, The Richest Man in Babylon, and believed that cryonics patients, like their living counterparts, could only keep pace with the social, political and economic hazards of the world by the practice of ongoing savings and investment. Since cryonics patients could no longer generate personal income through work, Darwin believed it the responsibility of the organizations caring for them to save and invest for them, over and above the money they themselves had provided for their long term care and recovery from cryopreservation. In The Richest Man in Babylon, Clason advises that everyone save 10% of their gross income and Darwin proposed, and maneuvered into existence, a policy creating a savings program for Alcor’s patients in the form of 10% of the organization’s gross revenues; the 10% Rule, a policy that was implemented in 1983 [137] and subsequently abandoned by Alcor over the period of 1992-94.[138]

As was the case with the 10% Rule, the use of hardened, earthquake, fire, ballistic and blast resistant “vault protected” storage of cryonics patients, which Darwin designed and implemented with Hugh Hixon in 1983-4, (above left) [139,140] was also abandoned by Alcor not long after their move from Riverside, CA to Phoenix, AZ in 1994.[141] Darwin also originated  the idea of using underground modular, concrete lined silos (fabricated from inexpensive, pre-cast steel reinforced concrete water drainage pipes) sunk into the floor of the cryonics facility to protect patients against earthquake, wind, fire, flood, and vandalism; a proposal that was implemented by Paul Wakfer and Mark Connaughton at the facilities of CryoSpan, Corporation, in Rancho Cucamonga, CA in 1995 (above right) [142,143] but which has not been used since.

Mike Darwin stands beside discarded neuropatient protective vaults in the parking lot of the Alcor Life Extension Foundation in March, 2011 (photo by Stanislaw Lipin).

Certainly Darwin’s most underappreciated and perhaps most important contribution to cryonics, technical or otherwise, was his identification of the “no-feedback problem” [144] as a central failure mode in all cryonics operations to date. He believed that the problem with cryonics is that neither the patient nor their family or other interested parties, will experience any objectifiable results or outcome from the procedure, at least not in their lifetimes.[145,146] As Darwin has written: “There is no feedback: no normal corrective market mechanisms; no crippled patient, no person in pain, and no loss suffered and reported upon as a result of flawed cryonics procedures. A badly cryopreserved patient looks as good as or better than a well cryopreserved patient. Shortcuts, missteps, and even outright negligence that severely injure cryonics patients cannot be detected or remedied if the patient, or those caring for him, has no way of knowing that such damaging events have occurred.” Darwin saw this as “a corrosive, single point of failure that would ultimately degrade or even destroy cryonics as a whole,” unless what he termed “artificial” or “surrogate” feedback mechanisms, such as” laboratory evaluation of markers of injury, meticulous documentation of the physical procedures employed, and surrogate markers for brain viability are put into place and adhered to.” [147]

The subject of many mass media articles, his policy when president of Alcor was to avoid the mass media, believing that cryonics could not be proselytized or grown by incomplete, superficial and almost always inaccurate print and television news stories. While his mentor Curtis Henderson believed that cryonicists “were born not made,” [148] Darwin believed that cryonicists would have to be “born first and then made.”[149] In other words, that acceptance of cryonics would require that a new generation be born into a world where cryonics was a commonplace and accepted part of the popular culture; for example, be the subject of, or an accepted plot mechanism in literature, television and other manifestations of popular culture.[150] To this end, he believed that mass media coverage of specific cryonics personalities, organizations and activities had almost no immediate benefit, but that the cumulative effect was to “enrich the cultural groundwater” with the idea of cryonics thus preparing the way for a new generation to grow up comfortable and at ease with the idea; the polar opposite of the situation that existed after cryonics was first introduced in 1964.[151-153]

Controversies

In a field that arguably is the working definition of controversial, Darwin has unarguably been one of its most controversial figures. On December 9, 1987 Darwin made the decision to remove Dora Kent 83, the mother of Saul Kent, from the Care West-Mission Nursing Center in Riverside, CA where she was dying of Alzheimer’s disease and pneumonia to Alcor’s Doherty Street facility a few miles away.[154] On December 11, Alcor personnel pronounced Mrs. Kent dead and removed her head to be cryopreserved. Because the death occurred in a non-residential area, zoned for light industrial and commercial enterprises, the case was brought to the attention of the Riverside County Coroner and on December 23rd, the coroner’s office announced it was conducting an investigation to determine if cryonics procedures were initiated before Mrs Kent was legally dead. This action spawned a media firestorm that spread around the Western world with newspapers and magazines in Europe, South America and Australia reporting the story.[155,156]

On January 7, 1988 the Coroner’s Office served a search warrant on Alcor and six people, including Darwin, were taken into custody in handcuffs by the Riverside Police Department for questioning, and subsequently released. Boxes of documents and 35 mm slides were seized and authorities discovered at that time that Dora Kent’s head was nowhere to be found. Another search warrant was served on January 12 and a protracted legal battle between Alcor and the Riverside Coroner began to unfold. A consequence of this highly publicized incident was the action of the California Department of Health Services to effectively outlaw the practice of cryonics. These events had a devastating and lasting effect on Darwin leaving him unable to continue as Alcor’s president and suffering from post traumatic stress disorder.[157] Fortunately, Alcor won this legal battle, establishing an important precedent for the practice of cryonics both in California, and in the US as a whole.

Mike Darwin (left) and Saul Kent (right), 12 May, 1987 at Kent’s home in Riverside, CA.

In 1993 Alcor underwent schism, with Darwin being the first to leave,[158] and Saul Kent the nexus of the rift.[159]

In order to understand the basis for this schism, and thus much of what has happened to Darwin and Alcor subsequently (including various sensational claims of alleged misconduct in a recent book by a disgruntled former Alcor employee [160]), it is necessary to understand that cryonics began as a radical social movement as much as, or more than, as a scientific or technical undertaking. Until the mid to late 1970s cryonics adherents referred to it as “the cryonics movement” or simply as “the movement.”[161,162] Cryonicists viewed cryonics as being a globally transformative idea; one that would remake, and in some cases abolish, core human institutions such as inheritance, marriage, the family, and religion with the advent of a “freezer-centered society.” [163] None held this view more strongly or vocally than CSNY’s Saul Kent [164,165] and Curtis Henderson.[166]

A consequence of this is that the dynamics of cryonics organizations, and especially of Alcor, as the ideological successor to CSNY, were often emotionally charged, and as is especially the case with any ideologically driven human institution, internal organizational conflicts and partisan politics were not infrequently heated, vituperative, and intensely personal.[167]

The lynchpin that held these diverse interests and personalities together was Alcor vice president Jerry Leaf. One unappreciated consequence of his sudden and unexpected cryopreservation in July of 1991 was the impact the absence of his quiet authority and enormously stabilizing influence would have on the various strong personalities and their diverse interests and objectives towards Alcor in particular, and cryonics as a whole. Additionally, Leaf’s control over the medical and surgical service delivery component to Alcor, via his Cryovita Laboratories, Inc., provided a powerful balancing check on internal power politics. Thus, Leaf’s absence critically destabilized the leadership dynamics of the organization.

While much has been made of the “mystery” of Darwin’s departure from Alcor in 1992, the real mystery (if any) is that this didn’t happen shortly after he resigned as president and became an employee in an organization he had formerly run. The August 6, 1992 compendium, “It’s Time for a Change” produced by Saul Kent [168], in what proved an ultimately successful, but nevertheless unsatisfactory effort to replace Alcor president Carlos Mondragon (the organization still suffered schism) provides ample reasons, and an astonishingly candid degree of insight into the proximate reasons for Darwin’s dissatisfaction and departure, as well as for the subsequent contentious split of Alcor in 1993.[169]

Darwin was a long-time friend and cryonics service provider to 1960’s counterculture movement and LSD advocate Timothy Leary. [170] When Leary changed his mind about cryopreservation, Darwin arranged for an expert in pain management and end of life consultation, David W. Crippen, MD, FCCM, Associate Professor of Critical Care Medicine at the University of Pittsburgh Medical Center in Pittsburgh, PA,[171] to visit Leary and work with local physician Steven B. Harris to enter Leary into hospice care.  Acting as a subcontractor to Alcor, Darwin also oversaw the cryoprotective perfusion of Baseball great Ted Williams in July of 2002.[172]

In the closing months of 1999 Darwin posted several written communications on the popular cryonics list-serve CryoNet, the last he was to post there for nearly a decade.  In one of the last of these posts, “Clamoring for anything better,” he reiterated his concerns about the “no-feedback problem” in cryonics and expressed what appeared to be weariness and frustration at the lack of accountability of cryonics organizations, as well as the lack of willingness of cryonicists as a whole to hold them accountable.

After leaving Twenty-First Century Medicine, Inc., in 2001, Darwin attempted, unsuccessfully, to launch a cryonics services and biomedical research company Kryos, Inc., which appears to have been modelled on his earlier effort with BioPreservation.[173] In 2002 Darwin was a principal in the start-up of Suspended Animation, Inc., and in fact selected the name of the company. His involvement with the company was brief, and he left its employ shortly after the transport and cryoprotective perfusion of Ted Williams by the company in July of 2002.

2003 to 2010

Darwin has apparently had little involvement with organized cryonics since 2003.  In 2008 he published a lengthy monograph on the blog Depressed Metabolism, dealing with the issues of anesthesia and cardioplegia in cryonics patients, and he also published there on technical matters relating to cardiopulmonary resuscitation in medicine, and cardiopulmonary support in cryonics. [174] In that same year, a book chapter, ‘The Intensive Care Unit of the Future,’ which he co-authored with Brian Wowk, and which deals with the speculative application of cryonics in the setting of critical care medicine, appeared in End-Of-Life Communication in the ICU: A Global Perspective edited by David W. Crippen, and published by Springer-Verlag.  He delivered a well reviewed lecture comprising a failure analysis of cryonics, “Cryonics: Why It has Failed and Possible ways to Fix It” to the Transhumanist organization ExtroBritannia in August of 2008.[175]

Also in 2008 he co-authored with Aschwin and Channa deWolf the intensely controversial article, “Is That What Love is? The Hostile Wife Phenomenon in Cryonics” which became the subject of a New York Times Magazine article, “Until Cryonics Do Us Part,” which in turn generated wide coverage and controversy in the blogosphere and other media.[176-181]

Darwin travels widely and has published his observations and opinions about cryonics activities outside the US and, notably, was quoted extensively in an article “The Dad’s Army of British Cryonics” about the British cryonics organization Cryonics UK, which appeared in the British national newspaper The Guardian , in November of 2009.

Media Coverage

Beginning in his teens,[183, 184] Darwin was interviewed by, or has been the subject of uncounted print media articles, [185-191] and he has been the guest on many television and radio programs; in the US, most notably: The Oprah Winfrey Show,[192] The Phil Donahue Show,[192] and CNN’s Larry King Live;[193] as well as the BBC’s Kilroy, [195] and numerous chat shows in Australia during the 1980s.

Books About

Darwin has been the subject of, or the model for a character in a number of books, including Great Mambo Chicken And The Transhuman Condition: Science Slightly Over The Edge by Ed Regis, ISBN 0-201-09258-1, Perseus Books (1990); Physical Evidence, a Dr. Eric Parker forensic thriller by Arthur Lyons and Thomas Noguchi, ISBN 9780515104530, Jove Pubs, New York, New York, U.S.A, (1990); Mothermelters: The inside story of Cryonics and the Dora Kent Homicide by former Riverside County Deputy Coroner Alan Kunzman (with Paul Nieto), ISBN 1410791998, AuthorHouse, Bloomington, IN (January 6, 2004), and most recently, Frozen: My Journey into the World of Cryonics, Deception, and Death by former Alcor employee Larry Johnson (and Scott Baldyga), Vanguard Press, New York City (October 6, 2009).

Works

Federowicz, MD, et al. Perfusion and freezing of a 60-year-old woman. Manrise Technical Review. 3(1); 9-32:1973. http://www.lifepact.com/images/MTRV3N1.pdf Retrieved 2010-08-31.

Darwin, MG. The anabolocyte: a biological approach to repairing cryoinjury. Life Extension Magazine: A Journal of the Life Extension Sciences.  1(July/August 1977):  http://www.nanomedicine.com/NMI/1.3.2.1.htm Retrieved 2010-08-31

Darwin, M. A question of time. IABS Newsletter #7, Institute for Advanced Biological Studies, Indpls, IN, August 1979, pp. 4-6. http://www.alcor.org/cryonics/cryonics8103.txt. Retrieved 2010-09-29.

Darwin, MG. Water and oil. Cryonics. Published by the Institute For Advanced Biological Studies, Inc., Indpls, IN, #9  April, 6-8:1981. http://www.alcor.org/cryonics/cryonics8104.txt. Retrieved 2010-09-29.

Darwin, MG, Leaf, JD, Noble, C. Pilot study in total body washout. Cryonics. #10                                              May,1981:11-13. http://www.alcor.org/cryonics/cryonics8105.txt. Retrieved 2010-09-29.

Darwin, MG, Interview with Curtis Henderson. Cryonics. #12, July,1981:22-29. http://www.alcor.org/cryonics/cryonics8107.txt. Retrieved 2010-09-29.

Darwin, M. Interview with Saul Kent, Cryonics. #16, November,1981:13-20. http://www.alcor.org/cryonics/cryonics8111.txt. Retrieved 2010-09-29.

Darwin, M, with Bridge, S. The bricks in the wall. Cryonics. #16, November, 1981:1-7. http://www.alcor.org/cryonics/cryonics8111.txt. Retrieved 2010-09-29.

Darwin, M. A western tragedy. Cryonics. #17, December, 1981:2-6. http://www.alcor.org/cryonics/cryonics8112.txt. Retrieved 2010-09-29.

Bridge, SW and Darwin, M, The high cost of cryonics, Part I, Cryonics, January, 1982, pp. 13-26: http://www.alcor.org/cryonics/cryonics8201.txt Retrieved 2010-08-31.

Bridge, SW and Darwin, M, The high cost of cryonics, Part II, Cryonics, February, 1982,  pp. 6-15: http://www.alcor.org/cryonics/cryonics8202.txt Retrieved 2010-08-31

Darwin, M. Report on the use of the Cordis-Dow hollow fiber dialyzer as a membrane oxygenator in profound hypothermia. Cryonics.  4(9);3-5:1983: http://www.alcor.org/cryonics/cryonics8309.txt Retrieved 2010-08-31.

Darwin, M. And Leaf, JD. Cryoprotective perfusion and freezing of the ischemic and nonischemic cat: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1389http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1390http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1391 –  http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1392 Retrieved 2010-08-31. See also: Federowicz,  MG. and Leaf JD. Cryonics. issue 30, p.14, January, 1983.   http://www.alcor.org/cryonics/cryonics8301.txt Retrieved  2010-09-04.

Leaf, JD, Federowicz, M, Hixon, H. Hemodialyzers as experimental hollow fiber oxygenators for biological research: a preliminary report. Cryonics. 5(5);10-19:1984: http://www.alcor.org/cryonics/cryonics8405.txt Retrieved 2010-08-31.

Darwin, M, Hixon, H. Evaluation of heat exchange media for use in human cryonic suspensions. Cryonics.  5(7);17-36:1984: http://www.alcor.org/cryonics/cryonics8407.txt Retrieved 2010-08-31.

Federowicz, M., Hixon, H., and Leaf J. Post-mortem examination of three cryonic suspension patients. Cryonics.  5(9);16-28:1984: http://www.alcor.org/cryonics/cryonics8409.txt Retrieved 2010-08-31

Leaf, JD, Federowicz, M, Hixon, H. Case report: two consecutive suspensions, a comparative study in experimental human suspended animation. Cryonics.  6(11):13-38;1985:  http://www.alcor.org/Library/html/casereport8511.html Retrieved 2010-08-31

Darwin, MG. Transport Protocol for Cryonic suspension of Humans.  Alcor Life Extension Foundation, Fullerton, CA, 1986. http://www.alcor.org/Library/html/1990manual.html Retrieved 2010-09-29.

Darwin, MG, Leaf, JD, Hixon, H. Case report: neuropreservation of Alcor patient A-1068. 1 of 2, Cryonics. 7(2);17-32, 1986: http://www.alcor.org/cryonics/cryonics8602.txt and Part 2 of 2: Cryonics. 7(3);15-29, 1986:   http://www.alcor.org/cryonics/cryonics8603.txt Retrieved 2011-02-05.

Darwin, M. The dog and phony show. Cryonics 8(5)1987:3-9. http://www.alcor.org/cryonics/cryonics8705.txt Retrieved 2010-09-29.

Darwin, M. with Harris, SB. How to avoid autopsy III: The problem of atherosclerotic disease. Cryonics. 8(12)1987:32-46. http://www.alcor.org/cryonics/cryonics8712.txt Retrieved 2010-09-29.

Darwin, M. Long time Alcor member enters biostasis. Cryonics. 9(6)1988:2-12. http://www.alcor.org/cryonics/cryonics8806.txt Retrieved 2010-09-29.

Darwin, M. The door into nowhere. Cryonics. 9(6)1988:16-17. http://www.alcor.org/cryonics/cryonics8806.txt Retrieved 2010-09-29

Darwin, M. Remote standby and Apache II. Cryonics. 1988 9(12):6-8.  http://www.alcor.org/cryonics/cryonics8812.txt Retrieved 2010-09-29.

Darwin, M. Them and us. Cryonics. Cryonics. 1988 9(12):8-12. http://www.alcor.org/cryonics/cryonics8809.txt Retrieved 2010-09-29.

Darwin, M. with Harris, SB, The Future of Medicine. Cryonics. 9(2)1989:31-39. http://www.alcor.org/cryonics/cryonics8802.txt Retrieved 2010-09-29.

Darwin, M. Keystone coroners. Cryonics. 9(10)1989:8-17. http://www.alcor.org/cryonics/cryonics8810.txt Retrieved 2010-09-29.

Darwin, M. But what will the neighbors think? A discourse on the history and rationale of Neurosuspension. Cryonics. 9(10)1989:40-55. http://www.alcor.org/cryonics/cryonics8810.txt Retrieved 2010-09-29

Darwin, M. Dick Jones enters biostasis. Cryonics. 10(1)1989:2-8. http://www.alcor.org/cryonics/cryonics8901.txt Retrieved 2010-09-29.

Darwin, M. A suspension in Detroit. Cryonics. 10(5)1989:21-35.  http://www.alcor.org/cryonics/cryonics8905.txt Retrieved 2010-09-29.

Darwin, M. A major advance in suspension patient support,. Cryonics. 10(8)1989:7-14. http://www.alcor.org/cryonics/cryonics8908.txt Retrieved 2010-09-29.

Darwin, M. Worst case scenario, Cryonics. 10(11)1989:20-35. http://www.alcor.org/cryonics/cryonics8911.txt Retrieved 2010-09-29.

Darwin, M. Guidelines for accepting nonmembers for cryonic suspension at Alcor. Cryonics. 199011(4)1990:6-13. http://www.alcor.org/cryonics/cryonics9004.txt Retrieved  2010-09-29.

Darwin, M. Cardiopulmonary support: Evaluation and intervention. Cryonics. 11(4)1990:26-31. 2010-09-29. http://www.alcor.org/cryonics/cryonics9004.txt Retrieved  2010-09-29.

Darwin, M, Bridge S. The cryonic suspension of A-1242. Cryonics 11(10)1990:18-22. 2010-09-29. http://www.alcor.org/cryonics/cryonics9010.txt Retrieved  2010-09-29.

Darwin, M. Looking at yesterday, seeing tomorrow. Cryonics. 12(3)1991:14-14. 2010-09-29. http://www.alcor.org/cryonics/cryonics9103.txt Retrieved  2010-09-29.

Darwin, M. Reducing ischemic damage in cryonic suspension patients by premedication.  Cryonics. 12(4)1991:13-15. 2010-09-29. http://www.alcor.org/cryonics/cryonics9104.txt Retrieved  2010-09-29.

Darwin, M. Cold war: the conflict between cryonicists and cryobiologists, part I. Cryonics 12(6)1991:4-16. http://www.alcor.org/cryonics/cryonics9106.txt Retrieved  2010-09-29.

Darwin, M. Cryonics intellectual property and the problem of the Commons. Cryonics 12(6)1991:18-22. http://www.alcor.org/cryonics/cryonics9106.txt Retrieved  2010-09-29.

Darwin, M. 2-9 Cold war: the conflict between cryonicists and cryobiologists, part II. Cryonics . 12(7)1991:2-9. http://www.alcor.org/cryonics/cryonics9107.txt Retrieved 2010-09-29.

Darwin, M. 2-9 Cold war: the conflict between cryonicists and cryobiologists, part III. Cryonics. 12(8)1991:5-10. http://www.alcor.org/cryonics/cryonics9108.txt ISSN 1054-4305. Retrieved 2010-09-29.

Darwin, M. Evaluation of the condition of Dr. James H. Bedford after 24 years of cryonic suspension. Cryonics. 12(8)1991:22-24. ISSN 1054-4305. http://www.alcor.org/cryonics/cryonics9108.txt Retrieved 2010-09-29.

Darwin, M. Total eclipse. Cryonics. 12(9)1991:16. http://www.alcor.org/cryonics/cryonics9109.txt ISSN 1054-4305. Retrieved 2010-09-29.

Darwin, M. Jerry Leaf enters cryonic suspension. 12(9)1991:19-25. http://www.alcor.org/cryonics/cryonics9109.txt ISSN 1054-4305. Retrieved 2010-09-29.

Darwin, M. How to know if sudden cardiovascular death awaits you. Cryonics. 12(12)1991:19-21. http://www.alcor.org/cryonics/cryonics9112.txt ISSN 1054-4305. Retrieved 2010-09-29.

Darwin, M. The cryonic suspension of A-1184. Cryonics. 13(8):1992:9-11. http://www.alcor.org/cryonics/cryonics9208.txt Retrieved  2010-09-29.

Darwin, M, Bridge, S, The case for neuropreservation. Cryonics.  #2, April, 1982:10-13. http://www.alcor.org/cryonics/cryonics8204.txt Retrieved  2010-09-29.

Darwin, M. Cryonics and cryobiology. Cryonics. #23, June 1982:1-9. http://www.alcor.org/cryonics/cryonics8206.txt Retrieved  2010-09-29.

Darwin, M. Cryonics and life . Cryonics. #27, October, 1982:5-6. http://www.alcor.org/cryonics/cryonics8210.txt Retrieved  2010-09-29.

Darwin, M. Cryonics earthquakes and survival. Cryonics. # 29, December, 1982:14-19. http://www.alcor.org/cryonics/cryonics8212.txt Retrieved 2010-09-29

Darwin, M. AIDS a dissertation on public health. #31, Cryonics. February,1983:18-20. http://www.alcor.org/cryonics/cryonics8302.txt Retrieved 2010-09-29

Darwin, M.  Ev Cooper. Cryonics . # 32, March, 1983:7-9. http://www.alcor.org/cryonics/cryonics8303.txt Retrieved 2010-09-29.

Darwin, M.  Medical care and cryonics. Cryonics.# 34, May, 1983:6-11. http://www.alcor.org/cryonics/cryonics8305.txt Retrieved 2010-09-29.

Darwin, M.  Ettinger on neuropreservation: Three strikes and you’re out. Cryonics. #40, November, 1983:8-14. http://www.alcor.org/cryonics/cryonics8311.txt Retrieved 2010-09-29.

Darwin, M, Hixon, H.  Simple Cryogenic techniques, Cryonics. #45, April,1983:19-23.  http://www.alcor.org/cryonics/cryonics8404.txt Retrieved 2010-09-29.

Darwin, M.  The myth of the golden scalpel. Cryonics. 7(1);15-18:1986: http://www.alcor.org/Library/html/MythOfTheGoldenScalpel.html Retrieved 2010-08-31.

Wowk, B, Darwin, M, Cryonics: Reaching for Tomorrow, Alcor Life Extension Foundation (February 1989), Riverside, CA, 1990: ISBN-101880209004: http://cryoeuro.eu:8080/download/attachments/425990/AlcorReachingForTomorrow1989.pdf Retrieved 2010-10-09.

Darwin, M. The cost of cryonics. Cryonics, 11(8);15-36:1990: http://www.alcor.org/Library/html/CostOfCryonics.html Retrieved 2010-09-09.

Darwin, M. Dear Dr. Bedford (and those who will care for you after I do). Originally published in Cryonics (Alcor Life Extension Foundation), July, 1991.  Now at:  http://www.alcor.org/Library/html/BedfordLetter.htm Retrieved 2010-08-13.

Darwin, M. The pathophysiology of cerebral ischemia.  Originally published as BPI Tech Brief #4, March 8, 1994: http://www.cryocare.org/index.cgi?subdir=bpi&url=tech4.txt Also available at: http://www.alcor.org/Library/html/ischemicinjury.html This second link  appears to be misdated as 1995.   Retrieved 2009-08-24

Leaf, JD, Darwin, M, Hixon, H. A mannitol-based perfusate for reversible 5-hour asanguineous ultraprofound hypothermia in canines. (no date)  Report on work performed from 1984-87: http://www.alcor.org/Library/html/tbwcanine.html Retrieved 2010-08-31.

Darwin, M.  Cryopreservation case report: Jerome Butler White, posted to CryoNet on 09 Jul 94 03:02:55 EDT http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2868 ; see also: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2867 and http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2874 Retrieved 2010-08-31.

Darwin, M. Cryopreservation of James Gallagher, CryoCare patient #C-2150: http://www.alcor.org/Library/html/casereportC2150.htm Retrieved 2010-08-31.

Darwin, M. Standby: End Stage Care of the Human Cryopreservation Patient, 1994: http://www.alcor.org/Library/html/standby.html Retrieved 2010-10-08.

Darwin, M, Russell, S, Wakfer, P, Wood, L, Wood, C, Effect of a human cryopreservation protocol on the ultrastructure of the canine brain. (Originally published by BioPreservation, Inc., as BPI Tech Brief 16 on CryoNet and sci.cryonics, May 31, 1995): http://www.alcor.org/Library/html/braincryopreservation2.html and http://www.alcor.org/Library/html/braincryopreservation1.html Retrieved 2010-08-31.

Darwin, M. Premedication of human cryopreservation patients, Part I. Posted on Sci.cryonics on 4 Jan 1997 08:11:24 GMT: http://www.aleph.se/Trans/Individual/Cryonics/premed.txt Retrieved 2010-10-11.

Darwin, M.  Securing anesthesia in the human cryopreservation patient.  Posted to CryoNet on 18 Jan 97 16:38:31 EST: http://www.cryocare.org/index.cgi?subdir=bpi&url=tech21.txt Retrieved 2010-08-31.

Darwin, M., Russell, S., Rasch, C., O’Farrell, J., Harris, S., A novel method of rapidly inducing or treating hypothermia or hyperpyrexia, by means of ‘mixed-mode’ (gas and liquid) ventilation using perfluorochemicals.  In: Society of Critical Care Medicine 28th Educational and Scientific Symposium. 1999, Critical Care Medicine: San Francisco. p. A81.  For-fee link at:  http://journals.lww.com/ccmjournal/Citation/1999/01001/A_Novel_Method_of_Rapidly_Inducing_or_Treating.189.aspx

Harris, S.B., Darwin, MG, et al. Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs. Resuscitation.  50; 189–204:2001: http://www.ncbi.nlm.nih.gov/pubmed/11719148 Retrieved 2010-08-31.

Darwin, MG. Cryopreservation case report: Arlene Francis Fried, A-1049: http://www.alcor.org/Library/html/fried.html Retrieved 2010-08-31.

Darwin, M. How dead is dead enough.  Depressed Metabolism, posted on 30 April, 2008: http://www.depressedmetabolism.com/how-dead-is-dead-enough/ Retrieved 2010-08-31.

Darwin, MG. Reflections on the birth of the anabolocyte. Cryonics.  29;4:2008. http://www.alcor.org/cryonics/cryonics0804.pdf Retrieved 2010-08-31.

Darwin, MG, de Wolf, C, de Wolf ], A.(September 9, 2008). “Is That What Love is? The Hostile Wife Phenomenon in Cryonics”. Depressed Metabolism. http://www.depressedmetabolism.com/is-that-what-love-is-the-hostile-wife-phenomenon-in-cryonics/ Retrieved 2010-09-27.

Whetstine L, Streat S, Darwin M, Crippen D.  Pro/Con ethics debate: when is dead really dead? Crit Care. 2005 , 9:538-542:  http://ccforum.com/inpress/CC3894 | Retrieved 2010-08-31

Darwin, M, A brief history of DMSO and glycerol in cryonics. Cryonics. 28(3); 8-11:1987:  http://www.alcor.org/Library/pdfs/Darwin_DMSO_glycerol.pdf Retrieved 2010-09-04.

Darwin, M, Russell, S, Wakfer, P, Wood, L, Wood, C, Effect of a human cryopreservation protocol on the ultrastructure of the canine brain. (Originally published by BioPreservation, Inc., as BPI Tech Brief 16 on CryoNet and sci.cryonics, May 31, 1995): http://www.alcor.org/Library/html/braincryopreservation2.html and http://www.alcor.org/Library/html/braincryopreservation1.html Retrieved 2010-08-31.

 

REFERENCES

1)         Best, B. (1992). “Suspension Capability”. Cryonics. (Alcor Life Extension Foundation). http://www.cryonics.org/immortalist/november08/History.pdf Retrieved 2009-08-26.

2)         Best, Ben (2008). “A History of Cryonics”. The Immortalist. Cryonics Institute. http://www.cryonics.org/immortalist/november08/History.pdf Retrieved 2009-08-24

3)         Regis, E. Great Mambo Chicken and The Transhuman Condition: Science Slightly Over The Edge. Westview Press, Boulder, 1991, pp. 102–103. ISBN 0201567512.

4)         Johnson, L, Baldyga , S. Frozen: My Journey into the World of Cryonics, Deception, and Death. ISBN 9781593155605, Vanguard Press (October 6, 2009).

5)         Strub, C, Frederick, C. The Principles and Practices of Embalming, 2nd Edition, Professional Training Schools, Dallas, 1961.

6)         Tubb, EC, The Mechanical Monarch, Ace Books, New York, 1957.

7)         Dewey, P. Interview with Mike Darwin, Long Life Magazine: A Journal of the Life Extension Sciences. 4(2):March/April;32-37:1980, p. 36.

8)         Darwin, M. Dear Dr. Bedford (and those who will care for you after I do). (Cryonics (Alcor Life Extension Foundation). http://www.alcor.org/Library/html/BedfordLetter.htm Retrieved 2010-08-13.

9)         Kunen, James S. “Reruns Will Keep Sitcom Writer Dick Clair on Ice—indefinitely.”  People Magazine (July 17, 1989): http://www.people.com/people/archive/article/0,,20120770,00.html Retrieved 2009-08-24.

10)      Platt, C, Darwin, M. Thus Spake Curtis Henderson. 07 October, 2010: http://cryoeuro.eu:8080/download/attachments/425990/ThusSpakeCurtisHenderson1.6.pdf Retrieved 2010-10-12.

11)      Darwin, M, de Wolf, C, de Wolf, A. “Is that what love is? The hostile wife phenomenon in cryonics”. Depressed Metabolism. (September 9, 2008). http://www.depressedmetabolism.com/is-that-what-love-is-the-hostile-wife-phenomenon-in-cryonics/ Retrieved 2010-09-27.

12) Demikhov, VP, Experimental Transplantation of Vital Organs, American Edition translated from the 1960 Russian Edition by Basil Haigh, M.A., M.B., B.Chir., Consultants Bureau Enterprises, Inc., 227 W. 17th Street, New York City, 1962: http://kryodelphi.com/experimental-transplantation-of-vital-organs.pdf Retrieved 2010-10-11.  (Note: 132 MB)

13) Negovskii, VA, Resuscitation and Artificial Hypothermia. Professor and Head, Laboratory of Experimental Physiology of Resuscitation, Academy of Medical Sciences, Moscow, U.S.S.R. American Edition translated from the 1960 Russian Edition by Basil Haigh, M.A., M.B., B.Chir., Consultants Bureau Enterprises, Inc., 227 W. 17th Street, New York City, 1962.

14) Anderson, T. Cryonics stirs interest in high schools.  Indianapolis Star, Teen Star Section, January 30, 1971. start page 5,

15)      Darwin, M. Response to Cryoken, (corrected), (a.k.a. Ken Bly ), posted to Cold Filter on June 19 2007 at 7:35 AM: http://www.network54.com/Forum/291677/message/1182252950/Response+to+Cryoken+%28corrected%29 Retrieved 2010-09-29.

16)      Darwin, M. Response to Cryoken (corrected), (a.k.a. Ken Bly ), posted to Cold Filter on June 19 2007 at 7:35 AM: http://www.network54.com/Forum/291677/message/1182252950/Response+to+Cryoken+%28corrected%29 Retrieved 2010-09-29.

17)      Darwin, M. Dear Dr. Bedford (and those who will care for you after I do). (Cryonics (Alcor Life Extension Foundation): http://www.alcor.org/Library/html/BedfordLetter.htm Retrieved 2010-08-13.

18)      Chamberlain, F, aka boundlesslife, posted to ImmInst.org Forums > Science & Technology on 14-Feb 2009, 01:19 AM: http://www.longecity.org/forum/topic/11950-neuro-head-only-vs-whole-body-suspension/page__st__90__p__303194 Retrieved 2010-07-19.

19)      Best, Ben (2008). “A History of Cryonics”. The Immortalist. Cryonics Institute: http://www.cryonics.org/immortalist/november08/History.pdf Retrieved 2010-08-24.

20)      Darwin, M. The pathophysiology of cerebral ischemia: http://www.alcor.org/Library/html/ischemicinjury.html Retrieved 2009-08-24.

21)      Whetstine L, Streat S, Darwin M, Crippen D.  Pro/Con ethics debate: when is dead really dead? Crit Care. 2005 , 9:538-542:  http://ccforum.com/inpress/CC3894 | Retrieved 2010-08-31

22)      Darwin, M. “Experimental strategies in overcoming cerebral ischemia-reperfusion injury.” 6th Annual Conference of Indian Society of Critical Care Medicine & International Critical Care congress, CRITICARE 2000, Hyderabad, India

23)      Darwin, M. “Suspended animation and the future of critical care medicine”, 5th Annual Critical Care Medicine Symposium, Royal Oldham Hospital, 15 November 2009  Manchester, UK: http://www.critcaresymposium.co.uk/site/index.php?option=com_content&view=article&id=57:5th-annual-critical-care-symposium&catid=38:symposiums&Itemid=62: Retrieved 2010-10-12.

24)      Darwin, M. Homosexuals, cryonics and the “natural order.” CryoNet Message-Number: 16562, Date: Sun, 17 Jun 2001 08:02:15 EDT: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=16562 Retrieved 09-10-2010.

25)      Federowicz, MD, et al. Perfusion and freezing of a 60-year-old woman. Manrise Technical Review. 3(1); 9-32:1973. http://www.lifepact.com/images/MTRV3N1.pdf Retrieved 2010-08-31

26)      Reference Needed.

27)      Darwin, MG. The anabolocyte: a biological approach to repairing cryoinjury. Life Extension Magazine: A Journal of the Life Extension Sciences.  1(July/August 1977):  http://www.nanomedicine.com/NMI/1.3.2.1.htm Retrieved 2010-08-31.

28)      Darwin, MG. Reflections on the birth of the anabolocyte. Cryonics.  29;4:2008. http://www.alcor.org/cryonics/cryonics0804.pdf Retrieved 2010-08-31.

29)      Farrant, J. Mechanism of cell damage during freezing and thawing and its prevention. Nature.  205:1284;1965.

30)      Federowicz, M.D., et al., Metabolic impact of liquid state cryothermia and vitrifracture in the mammalian cerebral cortex.  Cryobiology. 11: 572-573, 1974.

31)      Federowicz, M. Preparation and use of parenterals in suspended animation. Memorandum prepared for Manrise Corporation, La Canada, CA, 1975: http://cryoeuro.eu:8080/download/attachments/425990/Cryonic+Suspension+Protocol+Discussion+1975-1977001.pdf Retrieved 2010-10-07.

32)      Safar P, Stezoski, SW. Nemoto, EM. Amelioration of brain damage after 12 minutes cardiac arrest in dogs. Arch Neural.3:91-95;1976.

33)      Dewey, P. Interview with Mike Darwin, Long Life Magazine: A Journal of the Life Extension Sciences. 4(2):March/April;32-37:1980, p. 36: http://cryoeuro.eu:8080/download/attachments/425990/LongLifeMag4%282%2917_1980.pdf Retrieved 2010-10-07.

34)      Leaf, JD, Federowicz, M, Hixon,H. Case report: two consecutive suspensions, a comparative study in experimental human suspended animation. Cryonics.  6(11):13-38;1985:  http://www.alcor.org/Library/html/casereport8511.html Retrieved 2010-08-31.

35)      Darwin, M. Dave Pizer: Alcor outstanding support award nominee, Coordinators column. Cryonics. 10(7);11-14:1989: http://www.alcor.org/cryonics/cryonics8907.txt Retrieved 2010-08-31.

36)      Darwin, MG. Refractometric determination of cryoprotective agent concentration. Long Life Magazine: A Journal of the Life Extension Sciences. 2;14-16:1978. http://cryoeuro.eu:8080/download/attachments/425990/LifeExtensionMag2%281%29_1978.pdf Retrieved 2010-10-07.

37)      Darwin, M, Cerebral ischemia-I: Metabolic effects. Long Life Magazine: A Journal of the Life Extension Sciences. 1(4);110-114:1977: http://cryoeuro.eu:8080/download/attachments/425990/LifeExtensionMag1%284%29_1977.pdf Retrieved 2010-10-07.

38)      Dewey, P. Interview with Mike Darwin, Long Life Magazine: A Journal of the Life Extension Sciences. 4(2):March/April;32-37:1980, p 33: http://cryoeuro.eu:8080/download/attachments/425990/LongLifeMag4%282%2917_1980.pdf Retrieved 2010-10-07.

39)      Darwin, M, Interview with Jerry Leaf, Part I. Cryonics. 7(7);26-34:1986. http://www.alcor.org/Library/html/Interview-JerryLeaf.html Retrieved 2010-08-31.

40)      Darwin, M, Interview with Jerry Leaf, Part II. Cryonics. 7(8);21-28;1986: http://www.alcor.org/Library/html/Interview-JerryLeaf.html Retrieved 2010-08-31.

41)      Leaf, JD, Darwin, M, Hixon, H. A mannitol-based perfusate for reversible 5-hour asanguineous ultraprofound hypothermia in canines: http://www.alcor.org/Library/html/tbwcanine.html Retrieved 2010-08-31.

42)      Leaf, JD, Federowicz, M, Hixon, H. Case report: two consecutive suspensions, a comparative study in experimental human suspended animation. Cryonics. 6(11);13-38:1985. http://www.alcor.org/Library/html/casereport8511.html Retrieved 2010-09-10.

43)      Darwin, M. Report on the use of the Cordis-Dow hollow fiber dialyzer as a membrane oxygenator in profound hypothermia. Cryonics.  4(9);3-5:1983: http://www.alcor.org/cryonics/cryonics8309.txt Retrieved 2010-08-31.

44)      Leaf, JD, Federowicz, M, Hixon, H. Hemodialyzers as experimental hollow fiber oxygenators for biological research: a preliminary report. Cryonics. 5(5);10-19:1984: http://www.alcor.org/cryonics/cryonics8405.txt Retrieved 2010-08-31.

45)      Darwin, M. Reflections on a suspension. Cryonics.  6(7);10-13:1985: http://alcor.org/Library/html/casereport8504.html Retrieved 2011-01-31.

46)      Darwin, MG, Leaf, JD, Hixon, H. Case report: neuropreservation of Alcor patient A-1068. 1 of 2, Cryonics. 7(2);17-321986: http://www.alcor.org/cryonics/cryonics8504.txt Retrieved 2010-08-31.

47)      Darwin, M, Hixon, H. Evaluation of heat exchange media for use in human cryonic suspensions. Cryonics.  5(7);17-36:1984: http://www.alcor.org/cryonics/cryonics8407.txt Retrieved 2010-08-31.

48)      Federowicz, M., Hixon, H., and Leaf J. Post-mortem examination of three cryonic suspension patients. Cryonics.  5(9);16-28:1984: http://www.alcor.org/cryonics/cryonics8409.txt Retrieved 2010-08-31

49)      Darwin, M. Post mortem results: some perspectives. Cryonics. 5(9);1-4:1984: http://www.alcor.org/cryonics/cryonics8409.txt Retrieved 2010-08-31.

50)      Federowicz, M., Hixon, H., and Leaf J. Post-mortem examination of three cryonic suspension patients. Cryonics, 5(9);16-28:1984: http://www.alcor.org/cryonics/cryonics8409.txt Retrieved 2010-08-31.

51)      Federowicz, M., Hixon, H., and Leaf J. Post-mortem examination of three cryonic suspension patients. Cryonics. 5(9);16-28:1984: http://www.alcor.org/cryonics/cryonics8409.txt Retrieved 2010-08-31.

52)      Darwin, MG. Transport Protocol for Cryonic suspension of Humans.  Alcor Life Extension Foundation, Fullerton, CA, 1986. http://www.alcor.org/Library/html/1990manual.html Retrieved 2010-07-05.

53)      Chamberlain, FRC and Chamberlain, LLC.  Instructions for the induction of solid state hypothermia in humans. Manrise Corporation, La Crescenta, CA, 1972: http://www.lifepact.com/mm/mrm001.htm Retrieved 2010-08-31.

54)      Editorial Staff. Alcor Coordinators: more progress. Cryonics. 6(12);2-4:1985: http://www.alcor.org/cryonics/cryonics8512.txt Retrieved 2010-08-31.

55)      Editorial Staff. Alcor Coordinators: training and equipment deployment. Cryonics. 7(1);2-4:1986: http://www.alcor.org/cryonics/cryonics8601.txt Retrieved 2010-08-31.

56)      Darwin, M. A major advance in suspension patient support. Cryonics.  10(8);7-14:1989: http://www.alcor.org/cryonics/cryonics8908.txt Retrieved 2010-09-11.

57)      Darwin, MG. Cryopreservation case report: Arlene Francis Fried, A-1049: http://www.alcor.org/Library/html/fried.html Retrieved 2010-08-31.

58)      Darwin, MG. Cryopreservation case report: Arlene Francis Fried, A-1049: http://www.alcor.org/Library/html/fried.html Retrieved 2010-08-31.

59)      Doctor pushes for compression-only CPR. Published: Jan. 19, 2010 at 2:34 PM, http://www.upi.com/Health_News/2010/01/19/Doctor-pushes-for-compression-only-CPR/UPI-15321263929688/ Retrieved 2010-08-31.

60)      American Heart Association, Part 7.2: Management of Cardiac Arrest. DOI: 10.1161/CIRCULATIONAHA.105.166557, Circulation 2005;112;IV-58-IV-66; originally published online Nov 28, 2005, http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-58 Retrieved 2010-08-31.

61)      Darwin, M. Cryopreservation case report: Jerome Butler White, posted to CryoNet on 09 Jul 94 03:02:55 EDT http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2868, see also: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2867 and http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2874 Retrieved 2010-08-31.

62)      Donovan, C and Donovan, J. A dream in his pocket: the cryonic suspension of Eugene T. Donovan. Cryonics. 11(2);29-45:1990:   http://www.alcor.org/Library/html/casereport9002.html Retrieved 2010-08-31.

63)      Florack, G,  Sutherland, DER, Ascherl, R, et al., Definition of normothermic ischemia limits for kidney and pancreas grafts. Journal of Surgical Research. 40(6); 1986:550-563.

64)      Darwin, MG. Cryopreservation case report: Arlene Francis Fried, A-1049: http://www.alcor.org/Library/html/fried.html Retrieved 2010-08-31.

65)      Darwin, M. Premedication of human cryopreservation patients, Part I. Posted on Sci,cryonics on 4 Jan 1997 08:11:24 GMT: http://www.aleph.se/Trans/Individual/Cryonics/premed.txt Retrieved 2010-10-11.

66)      Bridge, S, Darwin, M. The cryonic suspension of Alice Black. Cryonics. 9(11);1988:15-25:  http://www.alcor.org/Library/html/casereport8811.html Retrieved 2010-08-31.

67)      Alcor Staff.  Meds prep: changes in suspension transport protocol. Cryonics. 10(7);15-6:1989: http://www.alcor.org/cryonics/cryonics8907.txt Retrieved 2010-08-31.

68)      Darwin, MG. Cryopreservation case report: Arlene Francis Fried, A-1049: http://www.alcor.org/Library/html/fried.html Retrieved 2010-08-31.

69)      Wang, CC, et al.  Trolox-equivalent antioxidant capacity assay versus oxygen radical absorbance capacity assay in plasma. Clinical Chemistry. 50: 952-954, 2004; 10.1373/clinchem.2004.031526:  http://www.clinchem.org/cgi/content/full/50/5/952 Retrieved 2010-08-31.

70)      Spinnewyn B, Cornet S, Auguet M, Chabrier PE. Synergistic protective effects of antioxidant and nitric oxide synthase inhibitors in transient focal ischemia.  J Cereb Blood Flow Metab.19:139–14:1999.

71)      Gupta,S, Kaul, CL, Sharma, S. Neuroprotective effect of combination of poly (ADP-ribose) polymerase inhibitor and antioxidant in middle cerebral artery occlusion induced focal ischemia in rats. Neurological Research. 26;103-107:2004.

72)      LIiu, XL, Nozaria, A, Basu, S, Ronquist, G, Rubertsson, S, Wiklund, L. Neurological outcome after experimental cardiopulmonary resuscitation: a result of delayed and potentially treatable neuronal injury? Acta anaesthesiologica scandinavica. 46(5); 537-546:2002.

73)      Darwin, MG. Cryopreservation case report: Arlene Francis Fried, A-1049: http://www.alcor.org/Library/html/fried.html Retrieved 2010-08-31.

74)      Darwin, MG, Cryopreservation case report: Arlene Francis Fried, A-1049: http://www.alcor.org/Library/html/fried.html Retrieved 2010-08-31.

75)      Henson, K, Darwin, MG. Neurosuspension of patient A-1260. Cryonics. 13(5); 13-20:1992,: http://www.alcor.org/Library/html/casereport9205.html Retrieved 2010-08-31.

76)      Darwin, M. A new kind of CPR. CryoCare Report #2 online edition, July 1994: http://www.cryocare.org/index.cgi?subdir=&url=ccrpt2.html#GUIDELINES Retrieved 2010-08-31.

77)      Darwin, M. Cryopreservation of James Gallagher, CryoCare patient #C-2150: http://www.alcor.org/Library/html/casereportC2150.htm Retrieved 2010-08-31

78)      Henson, K, Darwin, MG. Neurosuspension of patient A-1260. Cryonics. 13(5); 13-20:1992:  http://www.alcor.org/Library/html/casereport9205.html Retrieved 2010-08-31.

79)      Darwin, M. Cryopreservation case report: Jerome Butler White, posted to CryoNet on 09 Jul 94 03:02:55 EDT http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2868 –  see also: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2867 and http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2874 Retrieved 2010-08-31.

80)      Darwin, MG, Cryopreservation case report: Arlene Francis Fried, A-1049: http://www.alcor.org/Library/html/fried.html Retrieved 2010-08-31.

81)      Darwin, M. Prophylactic anticoagulation in the hypercoagulable human cryonics patient. Monograph prepared for Suspended Animation, Inc., Boca Raton, FL, 15 April, 2002, not yet published.

82)      Darwin, M. Securing anesthesia in the human cryopreservation patient. Posted to CryoNet on 18 Jan 97 16:38:31 EST: http://www.cryocare.org/index.cgi?subdir=bpi&url=tech21.txt Retrieved 2010-08-31.

83)      Bridge, S, Darwin, M.  The cryonic suspension of Alice Black. Cryonics. 9(11);15-25:1988: http://www.alcor.org/Library/html/casereport8811.html Retrieved 2010-08-31.

84)      Darwin, M. How dead is dead enough.  Depressed Metabolism, posted on 30 April, 2008: http://www.depressedmetabolism.com/how-dead-is-dead-enough/ Retrieved 2010-08-31.

85)      Darwin, M. Premedication of the cryonics patient, Part I: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=7409 — posted to CryoNet on 03 Jan 97 01:21:28 EST and Premedication of the cryonics patient, Part II: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=7414 — posted to CryoNet on 03 Jan 97 19:09:18 EST. Retrieved 2010-08-31.

86)      Darwin, M. Cryopreservation of James Gallagher, CryoCare patient #C-2150: http://www.alcor.org/Library/html/casereportC2150.htm Retrieved 2010-08-31.

87)      Darwin, M. Cryopreservation case report: Jerome Butler White. American Cryonics Society ID #: ACS 9577, Cryopreservation date: 02-05-1994, un-redacted & unpublished version, and Darwin, M, Darwin, M. Temperature Monitoring of Cryopatients, posted on: 22 Jan 97, 21:55:51 EST: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2868 — see also: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2867 and http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2874 Retrieved 2010-08-31.

88)      Darwin, M. Cryopreservation of James Gallagher, CryoCare patient #C-2150: http://www.alcor.org/Library/html/casereportC2150.htm Retrieved 2010-08-31.

89)      Darwin, M. Personal communication to Tanya Jones dated 15 May, 1997 re: CryoTransport case report: Edward W. Kuhrt, Patient A-A-110, 15 April,1997:  http://www.alcor.org/Library/pdfs/casereport9701.pdf (Retrieved 2010-08-31),

90)      Federowicz, M, et al. Treatment or prevention of anoxic or ischemic brain injury with melatonin-containing compositions. United States Patent  5,700,828 filed December 7, 1995, issued December 23, 1997: http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&u=%2Fnetahtml%2FPTO%2Fsearch-adv.htm&r=18&f=G&l=50&d=PTXT&p=1&p=1&S1=5,700,828&OS=5,700,828&RS=5,700,828 Retrieved 2010-08-31.

91)      Darwin, M. Cryopreservation of James Gallagher, CryoCare patient #C-2150: http://www.alcor.org/Library/html/casereportC2150.htm Retrieved 2010-08-31.

92)      Federowicz, M, et al. Treatment or prevention of anoxic or ischemic brain injury with melatonin-containing compositions. United States Patent  5,700,828 filed December 7, 1995, issued December 23, 1997: http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&p=1&u=%2Fnetahtml%2FPTO%2Fsearch-bool.html&r=18&f=G&l=50&co1=AND&d=PTXT&s1=5,700,828&OS=5,700,828&RS=5,700,828 Retrieved 2010-08-31.

93)      Lemler, J, et al. The arrest of biological time as a bridge to engineered negligible senescence, Ann. N.Y. Acad. Sci. 1019:559–563;2004.

94)      Wowk, BG, Federowicz, MG, Russell, SR Harris, SB. Method for rapid cooling and warming of biological materials. United States Patent  6,274,303, filed: May 10,1999, issued:  August 14, 2001; http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&p=1&u=%2Fnetahtml%2FPTO%2Fsearch-bool.html&r=3&f=G&l=50&co1=AND&d=PTXT&s1=6,274,303&OS=6,274,303&RS=6,274,303 Retrieved 2010-08-31.

95)      Darwin, M, 21CM Patent: Some answers and questions. Message-Number: 12464, posted to CryoNet on 28 Sep 1999 01:19:37: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=12464 Retrieved 2010-08-31.

96)      Darwin, M. News from BioPreservation, A bypass on the way to bypass. CryoCare Report, #7, online edition, April 1996: http://www.cryocare.org/index.cgi?subdir=&url=ccrpt7.html Retrieved 2010-08-31.

97)      Federowicz , et al. Mixed-mode liquid ventilation gas and heat exchange. United States Patent 6,694,977 filed : April 5, 2000, issued February 24, 2004: http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&p=1&u=%2Fnetahtml%2FPTO%2Fsearch-bool.html&r=5&f=G&l=50&co1=AND&d=PTXT&s1=6,694,977&OS=6,694,977&RS=6,694,977 Retrieved 2010-08-31.

98)      Platt, CP. Here, breathe this liquid. Discover Magazine, October, 2001: http://web.archive.org/web/20080119132718/http:/www.skyaid.org/Skyaid+Org/Medical/Heart_Cool_Oxygen.htm Retrieved 2010-09-25.

99)      Harris, SB, et al. Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs. Resuscitation.  50; 189–204:2001: http://www.ncbi.nlm.nih.gov/pubmed/11719148 Retrieved 2010-08-31.  Also at: http://cryoeuro.eu:8080/download/attachments/425990/Rapid0.5degCMinCoolPLVHarris.pdf?version=1&modificationDate=1285909788128 Retrieved 2010-10-07.

100)    Darwin, M., Russell, S, Rasch, C, O’Farrell, J, Harris, S., A novel method of rapidly inducing or treating hypothermia or hyperpyrexia, by means of ‘mixed-mode’ (gas and liquid) ventilation using perfluorochemicals.  In: Society of Critical Care Medicine 28th Educational and Scientific Symposium. 1999, Critical Care Medicine: San Francisco. p. A81.  For-fee link at:  http://journals.lww.com/ccmjournal/Citation/1999/01001/A_Novel_Method_of_Rapidly_Inducing_or_Treating.189.aspx

101)    Platt, CP, Fear, anger and hope: the cryopreservation of Alcor patient A-1876. Cryonics.  23(1);5-10:2002: http://www.alcor.org/CryonicsMagazine/cryonics2002.html Retrieved 2011-02-08.

102)    Darwin, M., Russell, S, Rasch, C, O’Farrell, J, Harris, S., A novel method of rapidly inducing or treating hypothermia or hyperpyrexia, by means of ‘mixed-mode’ (gas and liquid) ventilation using perfluorochemicals. In: Society of Critical Care Medicine 28th Educational and Scientific Symposium. 1999, Critical Care Medicine: San Francisco. p. A81.

103)    Federowicz, M, et al. Treatment or prevention of anoxic or ischemic brain injury with melatonin-containing compositions. United States Patent  5,700,828 filed December 7, 1995, issued December 23, 1997: http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&u=%2Fnetahtml%2FPTO%2Fsearch-adv.htm&r=18&f=G&l=50&d=PTXT&p=1&p=1&S1=5,700,828&OS=5,700,828&RS=5,700,828 Retrieved 2010-09-22.

104)    Lemler, J, et al. The arrest of biological time as a bridge to engineered negligible senescence, Ann. N.Y. Acad. Sci. 1019:559–563:2004.

105)    Darwin, M, Regarding Research in the Cryonics Community. Message Number 1780, posted to CryoNet  on 20 Feb 93 18:50:48 EST: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1780 Retrieved 2010-08-31.

106)    Darwin (Federowicz) M, Leaf, JD, Hixon, HL. Post mortem examination of three cryonic suspension patients. Cryonics. 4(issue 50):16-28;1984: http://www.alcor.org/Library/html/postmortemexamination.html Retrieved 2010-08-31.  Retrieved 2010-09-04.

107)    Darwin, M. The problem of cryonics.  CryoNet Message-Number: 2520, posted on 07 Jan 94 04:43:29 EST: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2520 Retrieved 2010-08-04.

108)    Reference Needed.

109)    Warren, LA. Interview with Mike Darwin. Cryonics.  7(4-5);1968: http://www.alcor.org/Library/html/Interview-MikeDarwin.html Retrieved 2010-08-31.

110)    Suda, I., Kito, K, Adachi, C. Viability of Long Term Frozen Cat Brain in Vitro. Nature. v. 212, Oct. 15, p. 167:1966: http://cryoeuro.eu:8080/download/attachments/425990/SudaNature1966.pdf Retrieved 2010-10-07.

111)    Suda, I., Kito, K, Adachi, C. Bioelectric discharges of isolated cat brain after revival from years of frozen storage. Brain Res.  70;527-531:1974: http://www.ncbi.nlm.nih.gov/pubmed/5970120?dopt=Abstract Retrieved 2010-08-31

112)    Calcium channel blockers may save brains denied blood up to 1 hour. Medical World News. January 18, 1982, pages 11-13.

113)    Reference Needed.

114)    Kent, S. The failure of the cryonics movement Part I Message #9556, posted to CryoNet  on  Tue, 28 Apr 1998 22:18:03 -0400: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=9556 Kent, S. The failure of the cryonics movement Part II Message-Number: 9557 posted to CryoNet: Tue, 28 Apr 1998 22:17:56 -  http://www.cryonet.org/cgi-bin/dsp.cgi?msg=9557 Retrieved 2010-09-04

115)    Darwin, M, A brief history of DMSO and glycerol in cryonics. Cryonics. 28(3); 8-11:1987:  http://www.alcor.org/Library/pdfs/Darwin_DMSO_glycerol.pdf Retrieved 2010-09-04.

116)    Darwin, M. And Leaf, JD. Cryoprotective perfusion and freezing of the ischemic and nonischemic cat: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1389 –  http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1390http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1391http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1392 Retrieved 2010-08-31. See also: Federowicz,  MG. and Leaf JD. Cryonics. issue 30, p.14, January, 1983.   http://www.alcor.org/cryonics/cryonics8301.txt Retrieved  2010-09-04.

117)    Darwin, M, Cryonics freezing damage (Darwin) part I, Message-Number: 1389, posted to CryoNet: 03 Dec 92 06:49:03 EST:  http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1389http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1390 –  http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1391 Retrieved 2010-09-04.

118)    Darwin, M, Russell, S, Wakfer, P, Wood, L, Wood, C, Effect of a human cryopreservation protocol on the ultrastructure of the canine brain. (Originally published by BioPreservation, Inc., as BPI Tech Brief 16 on CryoNet and sci.cryonics, May 31, 1995): http://www.alcor.org/Library/html/braincryopreservation2.html and http://www.alcor.org/Library/html/braincryopreservation1.html Retrieved 2010-08-31.

119)    Darwin, M. A question of time. IABS Newsletter #7, Institute for Advanced Biological Studies, Indpls, IN, August 1979, pp. 4-6: http://www.alcor.org/cryonics/cryonics8103.txt Retrieved 2010-10-07

120)    Wowk, BW, The death of death in cryonics. Cryonics.  9(6);30-71:988:  http://www.alcor.org/cryonics/cryonics8806.txt Retrieved 2010-09-02.

121)    Bridge, S. and Darwin, M, The high cost of cryonics, Part I, Cryonics, January, 1982, pp. 13-26: http://www.alcor.org/cryonics/cryonics8201.txt Retrieved 2010-08-31.

122)    Bridge, S. and Darwin, M, The high cost of cryonics, Part II, Cryonics, February, 1982,  pp. 6-15: http://www.alcor.org/cryonics/cryonics8202.txt Retrieved 2010-08-31.

123)    Wowk, B, Darwin, M, Cryonics: Reaching for Tomorrow, Alcor Life Extension Foundation (February 1989), Riverside, CA, 1990: ISBN-101880209004.

124)    Darwin, M. The cost of cryonics. Cryonics, 11(8);15-36:1990: http://www.alcor.org/Library/html/CostOfCryonics.html Retrieved 2010-09-09.

125)    Darwin, M. Molecular engineering: are we just around the corner? Cryonics. April, 1984, pp. 5-6: http://www.alcor.org/cryonics/cryonics8404.txt Retrieved  2010-09-01.

126)   Reference needed.

127)    Alcor Life Extension Foundation, 7895 East Acoma Drive, Suite 110, Scottsdale, AZ 85260: Consent for cryonic suspension: http://www.alcor.org/Library/pdfs/signup-ConsentForCryopreservation.pdf Retrieved 2010-08-31

128)    American Cryonics Society, P.O. Box 1509, Cupertino, California 95015, ACS Consent for cryopreservation: http://www.americancryonics.org/Forms/99ConsentforCryopreservation.PDF Retrieved 2010-08-31

129)    Reference Needed.

130)    Reference Needed.

131)    Darwin, M. guidelines for accepting non-members for cryonic suspension with Alcor. Cryonics. 11(4); 6-13: 1990: http://www.alcor.org/cryonics/cryonics9004.txt Retrieved 2010-08-31

132)    Steve Bridge may be help with this: I cannot find it in Cryonics which means it is probably in the Alcor Minutes or Resolutions: Swb1948@cs.com.

133)    Editorial Staff. Three patients converted to neuropreservation. Cryonics. January, 1984, p. 3. http://www.alcor.org/cryonics/cryonics8401.txt Retrieved 2010-08-31

134)    Editorial Staff, Making charity do good work. Cryonics.  January, 1983, pp. 3-5: http://www.alcor.org/cryonics/cryonics8301.txt Retrieved 2010-08-31

135)    Darwin, M. Marce Johnson dies and is not cryopreserved. Depressed Metabolism, 24 January, 2009: http://www.depressedmetabolism.com/tag/mike-darwin/ Retrieved 2010-08-31

136)    Kashmir, Review of Cryonics: Why it has failed, and possible ways to fix it – with Mike Darwin, ImmInst.org Forums > Science & Technology : Cryonics   http://www.imminst.org/forum/topic/6938-mike-darwin/ Retrieved 2010-09-04

137)    Darwin, M. Alcor adopts 10% rule. Cryonics.  October, 1983, p. 2: http://www.alcor.org/cryonics/cryonics8310.txt Retrieved 2010-08-31

138)    Reference Needed.

139)    Darwin, M. The myth of the golden scalpel. Cryonics. 7(1);15-18:1986: http://www.alcor.org/Library/html/MythOfTheGoldenScalpel.html Retrieved 2010-08-31.

140)    Darwin, M, Increasing security for neuropatients.  Cryonics.  December, 1983, pp. 3-4: http://www.alcor.org/cryonics/cryonics8312.txt Retrieved 2010-08-31

141)    Darwin, M. Cephalarium vault arrives. Cryonics. December, 1984, p. 1: http://www.alcor.org/cryonics/cryonics8412.txt Retrieved 2010-08-31

142)    Reference Needed.

143)    Darwin, M. Ground zero. Message-Number: 2663, posted to CryoNet on 23 Mar 94 23:47:23: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2663 Retrieved 2010-08-31

144)    Wakfer, P.  CryoSpan’s storage risks.  Message-Number: 2668, posted to CryoNet on 28 Mar 94 05:09:44 EST: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=2668 Retrieved 2010-09-04

145)    Darwin, M. The myth of the golden scalpel. Cryonics. 7(1);15-18:1986, p http://www.alcor.org/Library/html/MythOfTheGoldenScalpel.html Retrieved 2010-09-04

146)    Dawin, M. On technology. Message-Number: 3088 posted to CryoNet on 09 Sep 94 00:54:02 EDT: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=3088 Retrieved 2010-08-31

146)    Darwin, M.  Quality control and cryonics. Message-Number, 17803: posted to CryoNet on Mon, 22 Oct 2001 01:19:44 EDT:                           http://www.cryonet.org/cgi-bin/dsp.cgi?msg=17803 Retrieved 2010-08-31

147)    Kashmir, Review of Cryonics: Why it has failed, and possible ways to fix it – with Mike Darwin, ImmInst.org Forums > Science & Technology : Cryonics http://www.imminst.org/forum/topic/6938-mike-darwin/ Retrieved 2010-09-04

148)    Kashmir, Review of Cryonics: Why it has failed, and possible ways to fix it – with Mike Darwin, ImmInst.org Forums > Science & Technology : Cryonics  http://www.imminst.org/forum/topic/6938-mike-darwin/ Retrieved 2010-09-04

149)    Kashmir, Review of Cryonics: Why it has failed, and possible ways to fix it – with Mike Darwin, ImmInst.org Forums > Science & Technology : Cryonics  http://www.imminst.org/forum/topic/6938-mike-darwin/ Retrieved 2010-09-04

150)    Kashmir, Review of Cryonics: Why it has failed, and possible ways to fix it – with Mike Darwin, ImmInst.org Forums > Science & Technology : Cryonics  http://www.imminst.org/forum/topic/6938-mike-darwin/ Retrieved 2010-09-04

151)    Frisch, BH, The cryogenic underground, Science Digest. June, 1967, p. 22-3: http://cryoeuro.eu:8080/download/attachments/425990/DeepFrrezePeople_Science+Digest_Jun1967.pdf Retrieved 2010-10-07.

152)    Friedman, BJ, Frozen guys. Playboy Magazine.  August, 1978, start page 103: http://cryoeuro.eu:8080/download/attachments/425990/Frozen_Guys_Playboy%2C_August_1978.pdf Retrieved 2010-10-07.

153)    Asimov, I. See you in the hereafter. Penthouse Magazine, December 1972 Volume 4 Number 5, pp. 176-182: http://cryoeuro.eu:8080/download/attachments/425990/SeeYouintheHereafter_+Penthouse_1971.pdf Retrieved 2010-10-07.

154)    Babwin, D. Coroner says lethal dose of drugs killed cryonics case figure. The Press Enterprise, Riverside County, CA, 28 February, 1988, start page: A-1

155)    Freisinger, G, Der traum vom ewigen lieben, Wissenschaft, Dezember, 1987.

156)    Cryonics: a burning belief in life for the frozen dead. Sydney Morning Herald, Section: News and Features. Page: 8.

157)    Reference Needed.

158)    Darwin, M. Au revoir, but hopefully not goodbye: a communication from Mike Darwin.   Message-Number: 1332, posted to CryoNet on 18 Nov 92 07:10:42 EST, Subject: Mike Darwin Cancels Suspension Membership: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1332 Retrieved 2010-09-04

159)    Kent, S. It’s time for a change! Evidence to justify the replacement of Carlos Mondragon as president and chief executive officer of the Alcor Life Extension Foundation, Riverside, CA, Second Edition, August 6, 1992. http://cryoeuro.eu:8080/download/attachments/425990/its-time-for-a-change-ii-aug-6-1992-part1.pdfhttp://cryoeuro.eu:8080/download/attachments/425990/its-time-for-a-change-ii-aug-6-1992-part2.pdf –  http://cryoeuro.eu:8080/download/attachments/425990/its-time-for-a-change-ii-aug-6-1992-part3.pdf Retrieved 2010-12-22.

160)    Johnson, L, Baldyga , S. Frozen: My Journey into the World of Cryonics, Deception, and Death. ISBN 9781593155605, Vanguard Press (October 6, 2009).

161)    Sheshkin, A. Cryonics Sociology of Death and Bereavement, Irvington Pub (June 1980), ISBN-13: 978-0829338775.

162)    Greene, D. The cry of cryonics: freeze, wait, reanimate. National Observer, Washington, D.C., Monday, April 29, 1968: http://cryoeuro.eu:8080/download/attachments/425990/CryofCryonics_Natnl_Observer_March1966C.pdf Retrieved 2010-10-07.

163)    Ettinger, RCW, The Prospect of Immortality. Doubleday, New York, 1964: http://www.cryonics.org/book1.html Retrieved 2010-09-04

164)    Kent, S. Cryonics editorial. Cryonics Reports. 4(4);5:1965: http://cryoeuro.eu:8080/download/attachments/425990/CryonicsReports4%284%291969.pdf Retrieved 2010-10-07.

165)    Kent, S. Cryonics editorial. Cryonics Reports. 3(6);111-113:1968: http://cryoeuro.eu:8080/download/attachments/425990/CryonicsReports3%286%291968.pdf Retrieved 2010-10-07.

166)    Chevalier, LR. No, thank you, I’d rather not live twice. Ladies Home Journal. Volume 86, March 1969; Start page: 68: http://cryoeuro.eu:8080/download/attachments/425990/NoThankYou%2CI%27d+RatherNotLiveTwice_LadiesHomeJ_03_1969.pdf Retrieved 2010-10-07.

167)    Kent, S. It’s time for a change! Evidence to justify the replacement of Carlos Mondragon as president and chief executive officer of the Alcor Life Extension Foundation, Riverside, CA, Second Edition, August 6, 1992. http://cryoeuro.eu:8080/download/attachments/425990/its-time-for-a-change-ii-aug-6-1992-part1.pdfhttp://cryoeuro.eu:8080/download/attachments/425990/its-time-for-a-change-ii-aug-6-1992-part2.pdf –  http://cryoeuro.eu:8080/download/attachments/425990/its-time-for-a-change-ii-aug-6-1992-part3.pdf Retrieved 2010-12-22.

168)    Kent, S. It’s time for a change! Evidence to justify the replacement of Carlos Mondragon as president and chief executive officer of the Alcor Life Extension Foundation, Riverside, CA, Second Edition, August 6, 1992. http://cryoeuro.eu:8080/download/attachments/425990/its-time-for-a-change-ii-aug-6-1992-part1.pdfhttp://cryoeuro.eu:8080/download/attachments/425990/its-time-for-a-change-ii-aug-6-1992-part2.pdf –  http://cryoeuro.eu:8080/download/attachments/425990/its-time-for-a-change-ii-aug-6-1992-part3.pdf Retrieved 2010-12-22.

169)    “CryoCare Foundation”. http://www.cryocare.org/index.cgi Retrieved 2010-09-26

170)    Darwin, Mike (September 1988). “Dr. Leary Joins Up…”. Alcor Life Extension Foundation. http://www.alcor.org/cryonics/cryonics8809.txt Retrieved 2009-08-24.

171)    Crippen, DW.  Timothy Leary died at 12:15 AM on 5/31/96. I cannot resist some personal notes on his passing. http://www.ccm-l.org/editorials1/tim.html Retrieved 2011-02-05.

172)    Johnson, L, Baldyga, S.  Gruesome tale of Ted Williams’ botched decapitation is captured in gory detail in new book ‘Frozen.’ New York Daily News. Saturday, October 10th 2009, 7:47 PM  http://www.nydailynews.com/sports/baseball/2009/10/10/2009-10-10_gruesome_tale_of_ted_williams_decapitation.html Retrieved 2010-09-04

173)    Darwin, M. Kryos News #1, Message-Number: 16114. Posted to CryoNet on Tue, 24 Apr 2001 01:29:07 EDT: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=16114 Retrieved 2011-09-11

174)    Darwin, M. How dead is dead enough.  Depressed Metabolism, posted on 30 April, 2008: http://www.depressedmetabolism.com/how-dead-is-dead-enough/ Retrieved 2010-08-31

175)    Wood, D. Human obstacles to audacious technical advances. Review of Cryonics: Why it has failed, and possible ways to fix it. Extrobritannia, 23 August, 2008; 2:00pm – 4:00pm. Birkbeck College, Torrington Square, London WC1E 7HX: http://dw2blog.com/2008/08/03/human-obstacles-to-audacious-technical-advances Retrieved 2011-02-08.

176)    New York Times Sunday Magazine, Readers’ comments on “Until Cryonics do us part” by Kerry Howley: http://community.nytimes.com/comments/www.nytimes.com/2010/07/11/magazine/11cryonics-t.html Retrieved 2010-09-11.

177)    Beyerstein, L.  The Big Chill: When Cryonics Divides a Marriage. Posted to Focal Point on July 12, 2010, 1:32 PM: http://bigthink.com/ideas/20888 Retrieved 2010-09-11

178)    Marcotte, A. Hostile wives right again: Posted on Slate XX Factor on July 12, 2010 at 3:44 PM: http://www.doublex.com/blog/xxfactor/hostile-wives-right-again Retrieved 2010-09-11

179)    Schulman, AN. Are “hostile wives” too cool toward science? Posted to The New Atlantis on Monday, July 26, 2010: http://futurisms.thenewatlantis.com/2010/07/are-hostile-wives-too-cool-toward.html Retrieved 2010-09-11

180)    Shea, C. The frigid-spouse problem. Posted to Boston.com, Brainiac on December 19, 2008 03:28 PM: http://www.boston.com/bostonglobe/ideas/brainiac/2008/12/what_to_do_abou.html Retrieved 2010-09-11

181)    Anissimov, M. New York Times features Robin Hanson and the “hostile wife phenomenon” in cryonics posted to Accelerating Future on Friday, July 9, 2010: http://www.acceleratingfuture.com/michael/blog/2010/07/new-york-times-features-robin-hanson-and-the-hostile-wife-phenomenon-in-cryonics/ Retrieved 2010-09-11

182)    Anderson, T. Cryonics stirs interest in high schools.  Indianapolis Star, Teen Star Section, January 30, 1971. start page 5.

183)    Ransler, B, Teen wants be frozen after death.  Indianapolis News, 1971: http://cryoeuro.eu:8080/download/attachments/425990/TeenWantsCryonics_1971_Indpls_Star.jpg .  Date and start page needed.

184)    The big chill: society freeze bodies for future rebirth.  Daily News of Los Angeles, (CA), October 27, 1985.

185)    Frozen human heads stored in hope of rebirth some day. The San Francisco Chronicle, December 17, 1985.

186)    Eddy, S. The big chill: weird science is a matter of faith for cryonics group.  Orange County Register, 23 October, 1985, start page needed.

187)    Six questioned, facility searched where body parts are frozen.  San Jose Mercury News, (CA) January 8, 1988, start page needed.

188)    Death from AIDS, TV writer has body frozen.  The San Francisco Chronicle, December 17, 1988, start page needed.

189)    Sanger, E, Freezing heads.  New York Newsday Magazine, 31 January, 1988: http://cryoeuro.eu:8080/download/attachments/425990/Freezing+Heads%2CNew+York+Newsday+Sunday+Magazine%2C+31+January%2C+1988.pdf Retrieved 2010-10-07.

190)    Trausch, S, Cool customers, Boston Globe Sunday Magazine.  24 January, 1988, start page 16:  http://pqasb.pqarchiver.com/boston/access/59578088.html?FMT=ABS&date=Jan%2024,%201988 Retrieved 2010-08-31

191)    The Oprah Winfrey Show, WLS-TV, Chicago, Illinois, aired December 11, 1985.

192)    Phil Donahue Show, WLDW, New York City, New York, taped May 17 and aired July 16, 17, or 18, 1990,1990: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=201 Retrieved 2010-12-23.

193)    Larry King Live, CNN, United States, aired live, 11 July, 1989: http://www.alcor.org/cryonics/cryonics9107.txt Retrieved 2010-12-23.

194)    Kilroy, BBC, United Kingdom, 3 March, 1989: http://www.alcor.org/cryonics/cryonics9107.txt Retrieved 2010-12-23.

 

 

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Posted in Cryonics Biography, Cryonics History, Cryonics Technology (General) | 1 Comment

Letter to the Aspirants

The following is an edited for publication version of a letter that has been written in various versions to various people over the past 5 years. This, the last version, was written in 2008. These letters always began Dear _________, with the name of nascent group or company where the blank space is. In re-reading this letter I am reminded a bit, and whimsically, of St. Paul’s letters to various aspiring small groups of Christians, geographically remote from each other, and yet in search of community and competence in their mission. Hence the title here, “Letter to the Aspirants.”

– Mike Darwin

My comments have been invited about you efforts to establish a new cryonics organization, and I hope that they will not be unwelcome, and indeed, that they will be of genuine benefit to all of you.

I would like to start by saying that you are all to be commended for deciding to take action to improve your situation and to make reliable and hopefully reasonably high quality cryopreservation services available in your country. The very acts of seeing the need for this, and then taking the decision to proceed, are rare achievements in and of themselves. Congratulations!

What I have to say to next is likely to be misunderstood, and all I can hope for is that you realize that my perspective is born of over four decades of hard won experience; much of it bad. I have neither interest in, nor prospects for involvement in involvement in your undertaking,  so what I have to say here is said free from any conflicts of interest, or taint of personal ambition.

In reviewing the thousands of documents that chronicle the birth of cryonics in the United States (US), I have come to realize that a number of critical and potentially avoidable errors were made which doomed all of the first cryonics organizations to failure, and severely damaged the credibility and viability of cryonics in the  US and, to some extent, in the rest of the Western World. I believe it is possible to learn from these mistakes and to not repeat them.

I am not going to go into the underlying cultural and social reasons that complicated the attempted launch of cryonics in 1964 in the US here. They are critically important and I urge you to understand them, because they still largely apply, and they will impact your efforts much as they did in 1964. Suffice it to say here and now, that if you want to have any hope of launching a controversial and socially destabilizing new enterprise that will certainly encounter resistance and hostility, you absolutely must have solid planning,. and near complete mastery of the practical aspects of the operation, before you launch.

I think it helps to think of starting a cryonics operation in the same terms as if you were starting any other high technology enterprise that requires substantial physical infrastructure and wide-ranging expertise in both hands-on and theoretical areas. If you were planning on launching a stem cell treatment clinic, or a small scale custom biochemical synthesis operation, you would be facing a far, far easier task than starting a cryonics operation.

For one thing, you would have the luxury of failing with these enterprises, repeatedly if necessary; and that is not a luxury you will enjoy with cryonics. And certainly not after you have your first patients in storage. Failure carries with it likely catastrophic consequences, not just for your particular undertaking, but for cryonics in the world in general. You have only to look at the sorry situation in France today, to have an example of how mishandling the launch of cryonics can cause devastating and lasting prohibitions. The escapades of Anatole Doilinoff and Rene’ Martinot, coupled with the adverse experience of Chatsworth in the US, were all it took to make cryonics practically impossible in France for the last decade.

From a practical standpoint, what went wrong with the launch of cryonics in the US was that there were no skilled experts in cryonics, and the people launching the first cryonics organizations did not realize that they first and foremost needed to become experts themselves (to the extent that that was possible), before attempting to ‘sell’ cryonics to the public, or even to sell it to other cryonicists.

I assume that none of you would presume to start a stem cell clinic, or carry out small batch biochemical synthesis without first mastering these areas, or hiring the relevant experts. To just leap into it and ‘learn as you go’ would be a disaster and, in a world of regulations and controls, would lead to punishment, or other sanctions. Maim, injure or kill people through incompetence with chemistry or medicine, and you will end up in a great deal of trouble – at least in the West, today.

The same is true of cryonics. It was true in 1964 and it is true today. The difference is that 45 years have elapsed since 1964 and there are now experts, and substantial bodies of expertise in almost every area of cryonics. The problem is that few cryonicists recognize this, or even recognize the need for such expertise, or often that such expertise even exists! Indeed, both CI and Alcor operate with huge holes in these areas, and only remain in business because they do have expertise in the one area of cryonics operations which provides unequivocal feedback, and in which it is absolutely unacceptable (i.e., lethal) to fail: long term cryogenic care.

Sadly, most people who currently run cryonics organizations, or who aspire to operate them, actually believe they are experts in the biomedical aspects of cryonics and that their organizations represent the current practical limits of the state of the art. Depending upon what level of preservation you consider acceptable, they may arguably be right. However, if an objective standard, based on what is currently cryobiologically and medically possible (and practical) is used as the reference, then they are all woeful failures.

There was a time in cryonics (1981 to 1995) when every Alcor or CryoCare patient who could benefit from it received immediate and effective post-arrest cardiopulmonary support, prompt blood washout, and thorough and complication (iatrogenesis) free cryoprotective perfusion. The limiting factor on the ‘quality’ of the resultant preservation was not post-arrest ischemia, but rather was peri-mortem pathology and ischemia and, most importantly, cryoinjury due to freezing. Alcor (and later CryoCare) had reached the point where, under good conditions (i.e., the slowly dying patient with an intact brain) the only limit on viability after cryopreservation was cryoinjury. By now, it should have been the case that most patients presenting for cryopreservation with advanced notice (about 1/3rd of all cryopatients) should be suffering only biochemical injury from cryoprotectant agent (CPA) toxicity, minor mechanical injury from osmotic stress (primarily in the brain) and limited fracturing damage if intermediate temperature storage (ITS) was used in place of liquid nitrogen storage. Instead, it is now the case that ischemic injury and long post-arrest delays constitute the biggest source of injury; and very likely typically preclude vitrification. It is virtually impossible to achieve CPA equilibration in patients with significant warm and cold ischemic injury. In my opinion, this is a terrible tragedy that has compromised advancing the credibility of cryonics within medicine, and within our society at large. It has also caused intense demoralization within the ranks of activist cryonicists in the US; no one feels good about grossly injurious, often sloppy, and always amateurish (and incompetent) patient stabilizations and perfusions.

So, my injunction here is simple and absolute: become competent at offering whatever level of cryopreservation technology you decide is necessary or acceptable before you commence public operations. Yes, you may have to cryopreserve some of your own under haphazard conditions, but this should be a temporary situation, and should not include the public (or last-minute, “at-need” non-member cases). Get core competence before you commence commercial operations.

It may help to review what went wrong and what went right in the launch of US cryonics. The first problem was that both Ev Cooper and Robert Ettinger were idealistic ‘dreamer types’ with little practical experience in any hands-on endeavour. This not meant to be a disparaging remark. Clearly, they were ideally suited to conceiving the idea of cryonics and it was not for lack of trying that they were unable to find the “right” people to help them execute it:

Both men were introverts:

The character of these two men and the ‘outrageous’ nature of cryonics, more or less precluded the kind of careful planning required to launch such a complex, controversial and failure intolerant idea, and its associated enterprises.

In short, there was a failure to take personal responsibility for the success or failure of implementing cryonics and a near total failure to understand the enormous negative impact of missteps, or outright failure, on the credibility and viability of the idea.

Cryonics was ‘launched’ on a ‘make it up as you go along basis’ with essentially no concern for the cost of private, let alone highly public failures. Everything was done in front of the media. and much of what was done, including how patients were stored, was driven by a desire to attract and hold the interest of the media in the mistaken belief that publicity would lead to rapid success and acceptance.

Lots of money went into appealing promotional materials, when there was in fact nothing of substance to promote and, in the case of the Cryonics Society of California, nothing at all to promote!

There was a complete lack of even ‘first-cut’ armchair business plan-style planning.

This lack of planning and anticipation of the basic technological requirements to deliver a responsible service lead to what can only be described as a grotesque lack of professionalism:

In fact, Robert Ettinger himself has remarked on this:

What was really required was sound, detailed planning, and I can give you a concrete example of what this should have looked like. I know it was possible because it was done 8 years after cryonics was launched and with less available resources than were present when cryonics was initialized between 1964-1968.

Space and time do not permit detailing every aspect of the planning that should have been put into place, so I’ll use one element of what was needed as an example. In this case, I’ll use the emergency response and stabilization system, as it should have been planned and prepared for prior to the launch of the first cryonics operations in 1967-8:

That such planning was possible, and that it would have resulted in a basically competent and viable operation, was demonstrated in 1972 by Fred & Linda Chamberlain. While they made mistakes, they mostly ‘got it right.’ They started out by seeking out and employing experts where they had to, and by mastering, with hands on experience, every type of technology essential to cryonics that was required.

They established a working emergency response system from scratch including bracelets, pagers, and the communication system and its allied written standard operating procedures and data collection forms. They purchased and learned to reliably use a mechanical cardiopulmonary resuscitator and airway management and ventilation equipment. It took us dozens of hours in countless practice sessions to become proficient with this equipment. I know this because I joined them in this effort in 1974.

We built perfusion equipment and we tested it in the wet lab under static conditions and with animals. Below is a photo of the prototyping lab that was set up in the back bedroom of the Chamberlains’ home in La Crescenta, CA circa 1973:

Second generation perfusion machine, perfusate reservoir, and heat exchanger in its first use on a cryopatient:

We determined, in advance and in consultation with experts, the procedures with which we were going to cryopreserve our patients, including standards for monitoring of the process and data collection and documentation:

Every aspect of the operation, business, financial, promotional and technical were planned in advance. In many cases our plans did not long survive contact with reality, but the very act and discipline of planning allowed us to quickly learn, and to document and build upon experiences, both good and bad.

We constructed a mobile operating room to carry out perfusion and built and tested cool down equipment. We started with an old second-hand laundry lorry and transformed it into a credible perfusion room:

We acquired cryogenic storage equipment and familiarized ourselves with every aspect of its safe operation and the safe handling of liquid nitrogen. We did this first by didactic study and then followed-up the book-learning with careful, incremental, hands-on experience.

During this time we were documenting what we learned and what we proposed to do in a variety of publications:

Below is an emergency contact list (ECL) (redacted for privacy) from 1979; the oldest I have scanned in at this time.

These lists were updated no less frequently than quarterly by Linda Chamberlain, and they were maintained current in an era when there were no personal computers and at a time when these lists had to be typed by hand, and then mailed out via snail mail to all the Alcor Representatives. Beyond these technological handicaps, there was the fact that the people running Alcor had demanding full time jobs. From the period of 1972 to 1976 not only was the ECL maintained and distributed without fail by three people holding full time jobs, these same three individuals also:

• Wrote the first procedure manual for human cryopreservation and assembled the first emergency response kit:

• Produced a wide range of brochures and literature as well as produced a monthly newsletter (2 pages 8.5” x 14”) during much of that interval.

• Conducted fundamental cryonics research:

• Corresponded extensively (using a typewriter):

• Edited a  sophisticated technical magazine (Manrise Technical Review). It is also worth mentioning that the graphics reproduced above were drawn by hand by both Fred and Linda Chamberlain, and were then cut into wax stencils for in-house printing, using an Addressograph machine. Pages were collated, stapled and bound with black electric tape; again, in-house, and by hand.

• Kept the books and prepared meticulous financial statements using an IBM Selectric typewriter:

I think it is most important to point out that all of this effort was undertaken prior to placing our services ‘on offer’ to the public and attracting media (and thus regulatory) attention. We made ourselves into professionals first. We taught ourselves hypothermic organ preservation, basic surgical skills, the fundamentals of extracorporeal perfusion, a great deal of pharmacology and medicine, a fair bit of practical cryogenic engineering, and lots of crafts skills; ranging from electrical wiring, simple circuit design, wood working and basic construction….  And we mastered the biomedical and surgical procedures required to conduct animal research.

It took us 4 years of concentrated effort to do these things, and tremendous outreach, correspondence and collaboration with every ‘expert’ we could find and who was willing to help us. Only after all of this was in place did we (fortunately) do the first case.

Without question this is how cryonics should have been launched in 1964. It was unarguably tragic that competent and utterly dedicated medical, engineering and scientific minds did not arrive on the scene until the late 1960s, and were not empowered to act until the early 1970s. Indeed, the primary reason that proper planning and implementation of cryonics were delayed, was the fact that when the Chamberlains, Greg Fahy, Art Quaife, John Day (another engineer) and I became involved, we were (for years) mislead into believing that cryonics was, in fact, being competently implemented. It was the realization by Fred, Linda, Greg, Art and I that CSC was a fraud, and that the Cryonics Society of New York was failing, that spurred the creation of Alcor and Trans Time.

So, this is my advice to you: Master cryonics first. Realize that no one else will do this but you. Reach out to and employ experts whenever you can. Gather and master the 45 years worth of knowledge so painfully acquired in launching cryonics in the US. Be prepared to suffer a great deal and to have things move much more slowly that you anticipate.  Ask questions, communicate, and generate a comprehensive technical and business plan which calls out and prices of all the elements of the program, in terms of both materiel, and human resources.

Mike Darwin

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1968 AD > Cryonics > Reboot

Work out your own salvation with fear and trembling.”

-      Philippians 2:12-13

Left: Mike Darwin at the Cryonics Society of New York in1971 (Inset: in Russia July, 2008).

Future Shock Now

By the time you are 50, if not before, you will inevitably encounter a shocking realization: some of the people who are your colleagues, friends and even family, will have no idea what you are talking about when you mention an event or an object that is as fundamental to your experience as a shopping excursion, making a telephone call, eating ice cream, or using a pencil. For the first time it becomes clear to you that many of the most important and formative experiences in your life are rapidly passing out of living memory for most of those with whom you now inhabit the world. When this happens, it is at once shocking and painful, because it forces the twin realizations upon you that you are no longer young, and that you have begun to outlive your time.

If you are a cryonicist this experience unavoidably raises the spectre of how much more shocking, painful and disorienting the really extreme temporal displacement of being revived from decades, or even centuries in cryopreservation will be.

Age Distribution of the Population in the United States as of 2000

Roughly half of the people alive in the US today are 30 or younger, were born in 1978 or later, and are thus 25 years younger than me. They have no experience of a world without tiny, hand-held electronic calculators (most do not know what a slide-rule is), mobile phones, or readily available and affordable photocopying. The impact of these technological developments has been at once profound and subtle. As one small example; I began my intellectual life searching for scientific papers using walls of bound volumes known as the Index Medicus.

A small part of the Index Medicus, now in the museum of the Weill Cornell Medical Library.

I obtained information from papers that I read in the library not by photocopying them, or parts of them, but by making copious notes on 3”x5” cards and in a bound composition book. Onionskin tracing paper was used to copy graphs or charts deemed critical. Being forced to obtain information from publications in this way fostered careful reading and subsequent abstraction of important ideas in a concise and efficient way; it was a much poorer world then, and even 3”x5” cards were a significant expense.

Typical Mid-20th Century Slide Rule: The slide rule was a simple analog computer; essentially a mechanical look-up table. It was a useful tool for finding roots and logarithms and allowed for multiplication and division, but, unfortunately for me, did not permit addition or subtraction.

Typing dozens of pages of right justified text using a mechanical typewriter (and carbon paper to make copies) is probably unimaginable to this cohort of the population, yet these are experiences that were not only routine, it was not even imagined that they would ever end. Futurists in 1968 envisioned human interplanetary space travel and intelligent computers for the year 2001; not personal computers, the Internet, or tiny electronic devices that easily fit in your pocket, let you talk to anyone almost anywhere in the world for a pittance, watch television (all 200+ channels; there were 4 channels when I left home at the age of 18), and read your (electronic) mail, pay bills… It was inconceivable that the same device would also allow you to get restaurant recommendations, place your dinner order and then guide you, turn by turn, (on foot or driving) to your destination in a calm, mechanical voice.[1] It was even more inconceivable that these feats would be achieved in part, using a plethora of satellites in geosynchronous orbit that also tell you where you are, anywhere on the planet’s surface, with accuracy to within a meter or so.

While these changes have had profound cultural impact, arguably they do not have as much human impact. Imagine a world where the birth control pill has not been invented, a twice divorced and remarried woman could justifiably be expected to suffer social ostracism, and a woman being beaten by her husband, within limits, was a distasteful, but in practice, not actionable event. That was the world I was born into and it is a world I remember well. To those Americans under 30, the words Khrushchev, Vietnam, hippie, Saturn-5 and Nixon, will forever be abstractions, if they mean anything at all. If reanimation for those cryopreserved now becomes possible, they will be facing a shift in technology and values that is hard to comprehend.

Adjusting To Revival from Cryopreservation

In pondering this problem many years ago, I conceived of the idea of having patients virtually live through the interval between the time they were cryopreserved and the time they were revived in order to catch up, or adjust. This would be an accelerated process where a week, a day or even an hour of real time would equate to a year of subjective time “lost” in storage. Clearly, this would take place as a simulation, and beyond the purpose of defusing shock, it could also serve to educate and rehabilitate. The patient would wake up one day in his life at a point before his cardiac arrest deemed appropriate, get out of bed, and continue, as usual, with the normal routine of his life. The trajectory of his experience would alter gradually, probably in ways not now imaginable; in order to ultimately equip him with the insights, knowledge and skills needed to survive in a world transformed by time and technology.

Most of you reading this will have had the thought, be it a fantasy or a nightmare, that you might be living in a simulation, or that otherwise the reality you are experiencing is being manipulated in some way. I should imagine that if you are sane, this idea is just a remote gedanken experiment – the kind of thing that is very far removed from logical, let alone emotional reality.

Time Warp

One night a few weeks ago, while I was visiting Russia, I was walking along the street in Moscow with a small group of Russian cryonicists and we were passionately discussing the mechanics of cryonics. My visit to Russia had been intense; non-stop work and conversation from 0900 to 2200 or 2300 most days. We had walked past a large black statue of Comrade Lenin, with his arm outstretched, and now we were passing a McDonald’s. Ahead, the red and white logo of a KFC, with

“the Colonel” on it, lit up the sidewalk. I had been on a very similar street 40 years before, in Soviet times, also at night, but with a Soviet Intourist[2] minder and no glaring capitalist kitsch.

A McDonald’s Restaurant in Moscow

Now, consider these facts: I am 53 years old. I am in Moscow with two Russians who were not even born when l was last in Russia. Cryonics is in a ghastly state and is something from which I am effectively exiled. And, again, try to understand: I am walking by a McDonald’s restaurant in Moscow, Russia. The young men I was with could not understand the cognitive dissonance that the words “McDonald’s restaurant in Moscow, Russia” evoked in me. They were all in their 20s, or early 30s.

But, more interesting still, as I walked along the street it dawned on me that I am in cryonics again. Only, it is not 2008, it is 1968. No, it is not the 1968 that happened six years after the Cuban Missile Crisis in the US. It is an alternate1968.

Russia is, in many ways, much like the US was circa 1962-1968. While it is not the US then, nor is it any place but what it is: Russia in 2008 CE, there is nevertheless, the powerful sense that I am back in time; literally back in time. In part, this feeling is due to my growing awareness of countless little things that had vanished from my everyday experience without my noticing them having gone. I see old people limping along the streets with canes, and I gradually realize that this once utterly commonplace sight is largely gone in “my” world because now, if you are old and suffer from degenerative joint disease, you either have a hip replacement, a knee replacement, ride around on an electric scooter, or you are bedbound or dead.

I smell body odor in the air while waiting in line at the market near where I am staying, and sometimes I smell it on the Metro. Not bad, not offensive, just something that was commonplace in my childhood and that has also vanished in an era of advertiser-mandated ‘deodorant’ use. I realize, too, that here in Russia some people still have distinctive odors; the odor of pipe tobacco and menthol, camphor and horehound, or the smell of smoke from standing around open fires. Some old women smell of lilacs or something sweet like vanilla, as they once did in my daily experience ‘long’ ago.

To me, this Russia is a pastiche of the years in the US between 1955 and 1968: people are dressed more plainly than in the West today, and it is clear that clothing and shoes are still at a premium here. I remember from my boyhood how expensive shoes were, and how it was a minor ritual to buy a new pair.

Things are dirtier there, much, much dirtier than they are now in the US and Europe. I then remembered how much infrastructure was covered in grime the US in my youth, and I’ve noticed that white people (not brown people, but white people) pick up the trash and wash the floors in public spaces with a bucket and a brush just as in the US in my childhood years.

And I’ve noticed that there are no black people, absolutely no black people to be seen. In fact, in my 2 weeks in Moscow and Russia, I did not see a single person of color, with the exception of the occasional Mongol, or affluent Chinese tourists. This, in 2 weeks of extensive, daily travel in Russia – travel on the Metro, on the rail system – in the city and in the suburbs – not a single observed black person and barely a hint of people with skin darker than a light skinned Hispanic, or a well tanned Midwestern farmer in summer.

Paint was a very expensive thing when I was growing up and money was tight. Things didn’t get painted as much in that era and that is how it is in Russia today, especially in the countryside. I sometimes see drunken men in shabby clothes at a train station or on a residential block; and it comes back to me how common this was in the US in my youth. There is also the relative absence of regulation. There are no zoning and planning commissions, no suffocating mire of regulatory restrictions on the purchase of chemicals, or experimentation with animals. The Russian attitude towards vivisection and invasive experiments on dogs, cats or other mammals is even more indifferent than was the case in the US 40 years ago. In any choice between the welfare of people and the welfare of other animals, people come first. There is no mortuary or cemetery regulation in Russia, no OSHA, no Pharmacy Board and no Bureau of Medical Quality Assurance. In an eye blink one the most regulated countries in the world became one of the least regulated. And while this is rapidly changing as abuse begets government intervention, the situation today is mostly one where graft determines the outcome of almost any regulatory issue.

I realize how vastly wealthier in chattels we in the West have become since that 13-year interval in the middle of the last century. People owned far, far fewer things during that period in history (and before) in the US. Clear mental pictures of my Aunts’ and Uncles’ apartments in New York City, and of their friends’ apartments there have been flooding my mind. They were sparse spaces even when crowded with many peoples’ things. It wasn’t just that people owned fewer things; there were fewer things to own. Yes, computers are everywhere in Moscow, and mobile phones, but in that world between 1955 and 1968 there were no food processors, no televisions in kitchens and bedrooms, no curling irons, fondue pots, or walls covered with well proportioned and nicely matted and framed art. Walls had bad art; small pictures that interrupted the expanse of blank plaster, like a postage stamp on an unaddressed envelope; out of proportion and out of place. All of these things I had forgotten, and yet, here I was and it was all just as it once was in my experience 40 years ago.

And then there is cryonics. It is only 15 years since the Soviet Union collapsed. Before that time (and even now) Russia was cut off from the rest of world in many ways. It is still very, very difficult to get information in Russia on scientific matters unless you can read English; and even then it can be problematic. In short, the whole history of cryonics, all the media coverage, all the seepage of the idea into the cultural water supply that has happened over the past forty years effectively never happened in Russia! Robert F. Nelson never picked up a tabloid newspaper and decided to become involved in cryonics. Chatsworth has not happened. None of the past 40-years of my life experience exists in this place where I am.

The cryonicists I am with, and with whom I am talking, are behaving in the same way and talking about the same things, and doing so in exactly the same manner as happened over 40 years ago in the US. I realize it has been decades since I have had such conversations about cryonics with anyone. Most of the topics we are so earnestly discussing are now consigned to the past, because they are long ago decided issues. What expedient legal mechanisms should be used to gain and maintain custody of patients? Should cryopreservation funding be configured as an insurance program administered and profited from by the cryonics organization itself, or should conventional insurers be used? Should there even be members, or should there be clients or customers instead? What kind of place is suitable to store cryopatients; a cemetery, a dedicated building, a leased industrial building? These are all issues long ago debated and put to rest in cryonics – in the West, at least.

Where the Present is My Past

Here, my present is my past, because exactly the same problems have begun to occur in exactly the same way with exactly the same results. In every detail it is the same, exactly the same. The relatives of most of the patients were unhappy at the condition of the KrioRus facility and have moved their loved ones to private care that each is managing personally. I can hear, actually hear Pauline Mandel and Nick BeBlasio carping about the Cryo-Span facility on Long Island, and complaining that patients shouldn’t be stored that way – only they are speaking Russian! I cannot understand a single word they are saying, yet I understand every word of it, with perfect clarity.

Fred Horn, Curtis Henderson and Saul Kent circa1969-1972

I meet people who speak little or no English, but they are people I knew well: Curtis Henderson (at 40), Saul Kent (in his late 20s), Paul Segall (in his early 20s) and Fred Horn (in his late 40s). They are all there; not a single person is missing from that time in my life. Yes, they speak Russian not English, and no, they do not look the same; and yet they feel exactly the same; the facial expressions, the ‘unique’ combination of personality traits each person had, their world view, their approach to problem solving (or lack of approach), it is all the same – functionally identical. I meet John Bull as he was 40 years ago, and Marce Johnson and Lucille Doty and Herman Earl and Bob Krueger as they were then in the early days of cryonics. They occupy the same stations in life, live the same lifestyles, and appear to think the same thoughts. I try, but I cannot find a single person from the early days of cryonics who is not there; including the now nameless and mostly forgotten hangers-on, lunatics, fools, and – not be omitted from my inventory – the occasional man or woman who only now, with many years of life experience, I recognize as distilled, sociopathic evil.

It is 1968 in cryonics here. Bedford and the first wave of patients that followed him have just been frozen; they have different names, genders and stories, but it is as it was then. The same events are playing out; the same frustrations and the same mistakes are happening again, along with the same faltering steps at progress. I have reached the point where I know what certain people will say before I ever meet them, and I realize that I more often than not I know the course of events exactly as they unfolded, even though I have not yet been given the narrative. The story is the same, and that is terrifying. But, strangely, it is something else as well, because, you see, it is still 1968 in cryonics in Russia – and I can see the future. I can see it with a clarity that no one has been granted since Cassandra – and Cassandra was a myth.

A Different Culture and a Different World

I fear I know what is to come, more or less. Yes, yes, it is mostly playing out as it did then; the idea of cryonics has entered the culture and important people in intellectual and academic life have taken note and become interested. It is also true that there is the supernova of media; just as there was when cryonics first began; the endless cycle of chat shows (very much in the style of the late 1960s in the US), the newspaper and magazine articles…

Left: Danila Medvedev, President of KrioRus

Cryonics is new, completely new all over again, but with differences, big differences, possibly critical differences. The guests and audiences on the chat shows do yet not mock KrioRus President Danila Medvedev, or the others who advocate cryonics; they listen with some interest. Isaac Asimov exists here, but his name is Yuri Nikitin, and he is signed up for cryonics and a vocal advocate for cryonics, not a relentless public adversary. He is a man undertaking life extension interventions on his 90+ year-old mother and himself. He is one of Russia’s most popular science fiction and fantasy authors.

But it is also important to remember that Russia is not, and never was the US, or Europe for that matter. Ninety-one years previously an alternate history played out there; its people were stripped of the fog of religion, and their culture was remodelled in ways never experienced in the West. But, deeper than that, much deeper, is something that I’ve known for a long time, but that has been submerged beneath the turbulent surface of my consciousness: Russia was never the West.

Konstantin Tsilkovsky Vladimir Mayakovsky Nikolai F. Fyodorov

Russia produced Fyodorov, Tsilkovsky and Mayakovsky — men who were immortalists and Transhumanists at the start of the 20th Century, not at its close. And it was Russia that produced Bryukhonenko, Demikhov, and Negovskii: the men who invented extracorporeal circulation, transplantation and resuscitation medicine, and who first demonstrated that consciousness and identity reside in the brain. It was in Russia, not in the US or Europe, that one of the country’s leading heart surgeons,  Nikolai Amosov, wrote Note’s From the Future; a novel about cryonics, a novel in the tradition of Mayakovsky – a tradition that had been forged 60 years previously.

Nikolai Amosoff, 1913-2002

Russia is a country where 40% of the population are atheists and less than 15% identify themselves as Orthodox Christian. Russia is an Anglo version of Japan and China; all whites, no minorities, and they are keeping it that way by intention, and doing so with stunning effectiveness. Russia is also a country where 14% of the adult population states, with no qualifications, that they want to live forever, and where 40% state that they “want to live as long as possible in good health.”

No, it is not the US in 1968 and it is not cryonics in the US in 1968 and, perhaps most significantly, the worst mistakes made in the history of cryonics in the US have not been made in Russia, not yet. Perhaps they need not be made at all?

A Moment of Clarity or a Moment of Madness

So, there I was, walking by a McDonald’s in the country that, when I was 7-years-old, seared into me forever black and white memories of Kennedy, President Kennedy, standing before huge enlargements of photographs and pointing out oblong shapes in the Cuban soil that looked like insect egg casings – at once fascinating and disturbing. I sat in front of the television with my parents watching as the President  pointed out those strange shapes while telling me, in tense and measured words, that the world was on the brink of war, indeed on the brink of nuclear annihilation. What does a 7-year old-boy understand of global thermonuclear war? What can he understand? Nothing, really, nothing more or less than the inescapable reality that his parents are afraid, deeply, viscerally afraid, and that that is something completely new to his experience; something he has never seen before, and never wants to see again.

Vladimir Demihkov (1950); inset conscious juvenile dog (head and upper body) engrafted on adult (supporting dog), circa 1942.

I am in Moscow, in the hub, the core, the gravitational black hole of what once was Soviet Communism and the heart of an empire that could make the West tremble and spend, and tremble and spend. I am in Moscow, in Russia, and I am thinking all these things that I have written about here, and more besides, and it comes to me that this cannot, this absolutely cannot be real and that someone is toying with me. Somehow, somewhere, sometime ago, my heart stopped, I was formally pronounced dead and then, all the right things were done. I was lucky. I had been incredibly lucky.

But when had it happened? Had I sickened with AIDS in late 1980s, like most of the other gay men that I knew? Had Jerry Leaf sawed through my sternum and cut off my head? And if so, who had placed the Thumper on me? Who had given me the meds and poured the ice around me in the PIB?

Mike Darwin at the Museum of the  History of Cardiovascular Surgery, Scientific Center of Cardiovascular Surgery of the Russian  Academy of Medical  Science with S.S. Bryukhonenko’s “autojector,” the first successful extracorporeal support device, 2008. Inset:  Bryukhonenko with the autojector, 1933.

Or had it been a heart attack? Was it me and not Jerry who suffered a sudden cardiac arrest late that July night in 1991? I certainly had the family history for it; it would not be surprising. Was it cancer, or some twisted, unusual thing, like an abscessed tooth that flashes over into sepsis, unconsciousness and death – or in my case – an interruption in life, a reboot?

If that was so, then surely it must have been then that it had happened, at that time in my life when things were going well, when I was happy and productive. That would make sense! It must have happened before the nightmare began, before Dora Kent. Yes, that had to be it! Everything from sometime before that December, that terrible December in 1987, was not real. It was a punishment, a penance, or maybe some kind of test, or necessary learning experience to teach me things I had not learned before, and that I must know before I was turned loose in the world again?

There was simply no other explanation for the utterly alien nature of this “future” I now inhabited. That was the only answer that made sense, and it was the answer that, for a few moments in time, I instinctively knew was the right one, and believed.

I turned to my companions and tried to explain what had just happened inside my head. I tried to explain while still under the ether of the experience; still groggy with the fading emotional certainty that I had been ‘suspended,’ for the word cryopreserved was still in the future, yet to be applied to cryonics by Brian Wowk. I tried to explain, and I failed utterly, probably as I have failed again here, and will always fail in attempting to communicate what I experienced that night in Moscow.

Second Sight

As the Aeroflot Airbus A319 gained altitude leaving Moscow behind, I looked out the cabin window, wistful and wondering. How will cryonics turn out this time, in this place? Cryonics is just beginning to take root in the land receding below me, and in almost every respect it is still 1968 for cryonics in Russia. As I turn toward the steward making his way down the aisle, I catch the ghostly, reflected glimpse of myself in the cabin window. Moscow is behind me now, and while it may be 1968 for cryonics there, it is not 1968 for me, and it has not been so for 40 years. I am old and growing rapidly older. All the second sight that 40 years of life spent in the service of cryonics has given me cannot restore the youth required to start life anew. I turn and contemplate that visage in the window, more clearly visible now as the sun edges closer to the horizon, and the Perspex becomes reflective.

Second sight, the dictionary tells me, is a noun defined as “the power of discerning what is not visible to the physical eye, or of foreseeing future events, especially such as are of a disastrous kind; the capacity of a seer; prophetic vision.” This gift allows me to look, effortlessly, past the skin and bone of my face, deep into my brain, and deeper still to peruse the layers of tangled cells woven into a fabric that is briefly, rhythmically distorted by each pulse of blood racing through it. The fabric has begun to look thin and is frankly threadbare in spots. It is a shadow of the dense and pulsing tangle it once was in my youth. It is pared down – well compensated considering the number of neurons lost, and the even greater diminution of the connections between them. It is a folded and refolded blanket of cells racing towards dotage, and already two-thirds of the way to its destination. There is horror in this vision and in the realization it invokes in me, and I am, once again, walking along that street in Moscow with a group of young Russian cryonicists.

As Aschwin deWolf so elegantly wrote[3], “We often wonder why not more people choose cryonics to improve the odds of being part of the future. Could it be that important reasons for not doing so involve scenarios of the future that are too unpleasant to discuss in decent company?” He goes on to quote, appropriately enough, Fydor Dostoevsky:

“Every man has some reminiscences which he would not tell to everyone, but only to his friends. He has others which he would not reveal even to his friends, but only to himself, and that in secret. But finally there are still others which a man is even afraid to tell himself, and every decent man has a considerable number of such things stored away.”

Maybe that blinding flash of insight was the reality after all. I reflect on Dostoevsky’s remarks and search my soul. There is, I suppose, always a silver lining. If this is a life of penance, perhaps to be followed by some meting out of justice, then I have many years ahead of me before I descend either into dotage or redemption. I smile inwardly as I think that sins such as mine might even take an eternity to atone for.

But no, this not the case: the world is as it seems, and I am headed home.

Milton’s words that repose framed in wood and glass next to the front door of my home in Northern Arizona (sometimes baking in the desert heat and sometimes freezing in its cold) march slowly through my mind:


“Is this the region, this the soil, the clime,”
Said then the lost Archangel, “this the seat
That we must change for Heaven?–this mournful gloom
For that celestial light? Be it so, since he
Who now is sovereign can dispose and bid
What shall be right: farthest from him is best
Whom reason hath equalled, force hath made supreme
Above his equals. Farewell, happy fields,
Where joy for ever dwells! Hail, horrors! hail,
Infernal world! and thou, profoundest Hell,
Receive thy new possessor–one who brings
A mind not to be changed by place or time.
The mind is its own place, and in itself
Can make a Heaven of Hell, a Hell of Heaven.
What matter where, if I be still the same,
And what I should be, all but less than he
Whom thunder hath made greater? Here at least
We shall be free; th’ Almighty hath not built
Here for his envy, will not drive us hence:
Here we may reign secure; and, in my choice,
To reign is worth ambition, though in Hell:
Better to reign in Hell than serve in Heaven.
But wherefore let we then our faithful friends,
Th’ associates and co-partners of our loss,
Lie thus astonished on th’ oblivious pool,
And call them not to share with us their part
In this unhappy mansion, or once more
With rallied arms to try what may be yet
Regained in Heaven, or what more lost in Hell?”

God, I reflect, was kinder to Lucifer than to us. Consigned to Hell, He was at least allowed to live. And he was not subjected to the horror of disease, old age and death.

The aircraft is now over the vast expanse of the North Sea. Hell, I reflect, is only an ocean away, and I will be there soon enough. Yes, God was infinitely kinder to Lucifer, for even in his Lake of Fire, the Fallen Angel could reflect with some satisfaction that, “To reign is worth ambition, though in Hell; Better to reign in Hell than serve in Heaven.” God and the Devil, Heaven and Hell; in Russia these ideas are only for the ignorant, the foolish, the feeble minded, and the crafty users of men who prey on thir inborn fear of senseless suffering, death and oblivion.

We are solidly in the stratosphere now and headed West towards the setting sun. I think of myself standing in the dusty streets of Luxor in southern Egypt. I look out across the Nile in my mind’s eye. The Ancient Egyptians had divided the city into two parts along the banks of the Nile. The East, the province of the rising sun and day, was the land of the living, while the Western shore of the Nile was the land of the dead. I am headed due west now, but where am I headed, towards life, or death? The steward has just brought me tea and has asked if there is anything else I want? “Yes,” I reply, “immortality and happiness.” “You are a Christian?” he asks, warily. “No, no, I respond,” smiling, “just a tired old man afraid of the coming dark.” He withdraws with a guarded look, no doubt thinking to himself, “Another crazy American.”

The image above was originally created to appear in Life Magazine in January, 1967 to accompany a feature article documenting the cryopreservation of the first man, Dr. James H. Bedford. However, due to the tragic deaths of the three Apollo astronauts Chaffe, Grissom and White, the presses were stopped after less than a million copies had been printed. A second first week of February issue of Life was printed and substituted. Copies of the original 3 February issue that had been printed were distributed to subscribers who lived mostly in Southern or rural areas of the US.  As a consequence, the image above did not achieve widespread media distribution until 1968. It continues to be a staple image used by media around the world to illustrate stories about cryonics even though the technology pictured has not been used since 1968. The photograph was taken by the renowned Life photographer Henry Groskinsky.

Notes from the Future

I pick up one of the Russian language magazines the steward has left as reading material for the remainder of the flight. As I leaf through its pages of incomprehensible Cyrillic, my eye is caught by what is, to me, an iconic image. It is a photograph that saturated print stories about cryonics in 1968. The article that accompanies it begins: “Крионика – это практика замораживания обречённых на смерть пациентов до ультранизких (криогенных) температур и их дальнейшего сохранения в жидком азоте.”

When the steward returns for my empty cup I ask him what that sentence means. He looks intently at the page and clearly reads on beyond that first line.

“It’s about preserving dying people in the extreme cold until they can cure them,” he says.

“Does it say dying people or dead people,” I ask him?” “Dying people,” he responds, “why would anyone want to do that to dead people? If your heart stops you are not always dead, no?” he responds. I thank him and look out the window. For onto 40 years now, I have been going back and forth and walking up and down over that earth, now spread out below me, in order to make exactly that point. Possibly, just possibly, there is some hope after all.

- Mike Darwin, August, 2008, London, England


[1] I was at least was prepared for the idea of such a device by reading SF author Fred Pohl’s prescient book The Age of the Pussyfoot (1965) about a cryopatient , Charles Forrester, who  is revived from cryopreservation in the year 2527, having been killed in a fire 500 years earlier.  Pohl envisioned that everyone would have a ‘Joymaker’ a person communications device that had all of these functions: Access to basic computing power for money management and similar activities; Access to libraries at any time, in any place; Education of children, each of whom had a special Joymaker; Health and medical care- the Joymaker continuously monitored vital signs, physiological and psychological status. and the central computer could order it to dispense medication, or it could solicit emergency medical assistance; Message store and forward functions, which we now call voice mail; Ordering food and drink, whether at home or in public; All payment was done using the central computer; Ordering other goods for delivery; Public Address system – any group of people could hear a public announcement on their Joymakers; Locating people; the central computer could track the position of any Joymaker, and by extension, its owner. This information could be made available (at the owner’s discretion); Jobs not requiring physical presence such as product evaluation and psychological reactions of the ‘employee’ to advertising, entertainment or news. (http://en.wikipedia.org/wiki/The_Age_of_the_Pussyfoot)

[2] Intourist was the official state travel agency of the Soviet Union, in fact it was the only travel agency and the only way to visit the Soviet union as a tourist.  It was founded in 1929 by Joseph Stalin and was staffed by NKVD (which became the KGB) officials. Intourist was responsible for managing the great majority of foreigners’ access to, and travel within, the Soviet Union. Intourist was, at one time, the largest tourism organization in the world incorporating or co-opting banks, hotels, and bureaux de changes. Vistors to the Soviet Union were assigned an Intourist minder who stayed with them throughout their visit and supervised all interactions of the tourist with the local population.

[3] http://www.depressedmetabolism.com/sophistry-and-illusion-can-economic-man-resurrect-ethics/

Posted in Cryonics History, Culture & Propaganda, Perfusion, Philosophy | 4 Comments

The Russians are Coming!

By Mike Darwin

In 2008 I had the privilege of visiting the Russian Federation and meeting with Russian cryonicists in Moscow and Veronezh. Moscow was an alien and bizarre experience for me – one which I have likened to being recovered from cryopreservation – familiar, and yet utterly transformed – expected, and yet deeply dissonant. One of my central messages to the Russian cryonicists was to go and see other cryonics organizations everywhere in the world, and in particular, to see those in the US. There was nothing America-centric in this recommendation. It was made as emphatically as it was because this where cryonics was born, where it has struggled the longest, and without doubt, where most of the lessons have been learned to date.

And this isn’t model airplane building, or stamp collecting, we’re talking about here. Mistakes in cryonics can cost lives and break hearts. What’s more, because the world is now “flat” a serious failure of cryonics 6,000 miles away might as well be next door. Today, everybody has a stake in the action. Indeed, one of the reasons I like living in the middle of nowhere (sometimes) is that the best neighbors are no neighbors.

Travel from Russia to the US, or vice versa, is not easy, and in fact under some circumstances it may have become more difficult than it was during the Introurist days, under the former Soviet Union. It has taken some time, but the Russian cryonicists have prevailed, and they will be coming to US and will be in the West Coast area from 22-25 March – just a few days from now!

The visitors are:

Danila Medvedev, President of the Russian Transhumanist Association and a principal in the Russian cryonics company, KrioRus.

Valerija Pride, President of KrioRus

Dimitry Chikunov, the head of the Rostock Group, which is a biotech company with ~ $175 million US in assets focused on gerontology and chronic pain research: http://grostok.ru/en/

Sergey  Filonov http://www.linkedin.com/pub/sergey-filonov/12/21/569  who is the International Marketing and Sales Manager at Skyeton Aircraft Industrial Company in Ukraine http://www.skyeton.com/  Skyeton is the principal manufacturer of small aircraft for the Russian consumer market; basically the Russian equivalent of Cessna.

I will be hosting them during the West Coast part of their journey, and I am doing what I can to facilitate visits to cryobiological and cryonics points of interest in these environs.  I know they would very much like to meet with US cryonicists other than myself, and so I thought it a good idea to let others know of their imminent arrival, and see if there was interest in a get-together somewhere in the greater Los Angeles area.  Hopefully, they will be going to Scottsdale to visit the Alcor facility, and I said I would make public inquiries to find out if the local cryonicists there were interested in meeting with them. My home in Ash Fork, AZ, 3 hours north of Phoenix is also available, including fire pit for barbecuing and its considerable collection of cryomebilia. I should also add they will be staying  with me in Yucca Valley, CA, which is not the most convenient spot in Southern California, as it is located 30 minutes east of  Palm Springs (~ 2 hour drive from LA).

If there is interest in a get-together either here in Yucca Valley, or at some location closer to the heart of the action in Los Angeles, please let me know, and I’ll try to make it happen.  As the schedule fleshes out in the next few days, I should be able to be more definite about specific times and dates. As it is, they just received their visas a few days ago, and the trip was confirmed only on Monday last!

Finally, I would like to note, and to offer thanks for the truly great hospitality the Russian cryonicists have shown me, and a number of other British and American cryonicists, journalists, and photographers. I only hope I can in some small way repay their hospitality during their visit here.

Posted in Cryonics History, Culture & Propaganda | 4 Comments