I Know this is Going to be Shocking: A Review of Wearable Continuous Monitoring Systems to Detect and Treat Sudden Cardiac Arrest in Cryonicists

By Mike Darwin

The problem of a cryonicist experiencing sudden cardiac arrest (SCA) unattended is hardly theoretical. This has occurred a number of times already, with some patients going upwards of a week before being discovered. Because SCA is only reversible within the very narrow time frame of 4-6 minutes after circulation stops, there has been little incentive to detect it, and instantly relay a call for help, outside of hospital, that is. By the time help arrived, even if it was just 5 or 10 minutes away, it would be too late. This sad state of affairs has been a source of enormous frustration for cryonicists since at least 1981 – that’s when I saw the first prototype for a wearable cardiac arrest monitoring alarm system. It had been constructed by Reg Thatcher, who was then associated with Jerry Leaf’s Cryovita Labs, in Fullerrton, CA;  and it worked. It was a marvel of engineering for its time, but no one wanted to use it. It was a bit cumbersome, the wet gel electrodes caused skin irritation, and its range was very limited.

Since Reg’s efforts, a number of people in cryonics have tried to engineer a solution to this problem, most notably Ben Best and Eugen Leitl. There is no question that the technological base exists. In fact, it has existed since at least 1981, and from the standpoint of feasibly, miniaturizing such a system to the degree that it would be tolerable for most users to wear and be compliant in its use; it has probably been possible since at least 2000. This technology has been developed not because of life or death issues, but because of sports.  Shown in Figure, 1, below are three implementations of sports heart-rate monitors with high and low alarm features.

Figure 1: At left is finger-worn sports-type digital pulse monitor which use pulse oximetery technology to detect hear beat. Center,above, is an ECG-type sports watch; the chest belt contains the ECG electrodes and transmitter which sends the heat rate count to the wrist-worn watch. At right is the Garmin Forerunner 305 GPS Heart Rate Monitor which also has full GPS capability!

The one the right, the Garmin Forerunner 305 GPS Heart Rate Monitor, is not merely a continuous heart rate monitor; it is a fully capable GPS navigator. It also calculates calorie consumption based on the user’s weight, distance traveled and hills climbed, records lap history by day and week, stores up to 200 workouts in its memory and, in addition to heart rate alarms, it also has something called a “pace alarm,” which sounds if the user is running either faster or slower than their programmed pace! Oh yes, I almost forgot, it has time/distance alarm alerts when you’ve reached a desired time or distance and it sells for a mere ~ $200 US. Other manufacturers sell similar monitors with Bluetooth capability, thus allowing the watch output to be linked to mobile phones or other Bluetooth enabled devices. For example the the Nokia Symbian S60 Smartphone shown in Figure 2, below,  can even be bundled with a Bluetooth linked Polar heart rate monitor and alarm.[1]

Figure 2: The Nokia Symbian S60 Smartphone with companion Bluetooth linked Polar heart rate monitor: yours for ~ $700, US.

So what’s the problem? Why isn’t the issue of an alarm system to detect SCA for cryonicists “a done deal?” The answer is that because of US Food and Drug Administration (FDA) regulations, the devices may not use the alarm feature for anything beyond sports training purposes – and there is no sport training reason to have the phone dial a preprogrammed number in the event of cardiac arrest. The downside to this kind elegant, compact and integrated technology as seen in Figures 1 and 2 is that it is increasingly beginning to look and act like biological systems do. It isn’t possible to peel the top of your dog’s head off and rewire him to bark only at certain times, or to stop him from scratching at the door when you want to be alone. Try to do that, and all you’ll find inside is a bunch of amorphous looking goo which you can make no sense out of. And of course, your dog will either be dead, or very, very irritated with you.

The insides of the Nokia phone or Garmin Forerunner now look a lot like the insides of a living system, and it is no longer possible to easily hack, reroute, rewire or otherwise modify their function. The potentially positive side to the Nokia Symbian is that it is a Smartphone, and therefore (again in theory) it may be possible for a skilled Smartphone applications programmer to create an “app” that would autodial the phone to a predetermined series of numbers in the event of a cardiac arrest event. Presumably the speed dial button on the phone could be used to facilitate “manual” panic alarm calls. If such an app were to prove possible, then the only uncovered contingency would be a fall that leaves the person alive, but unable to call for help. This is, unfortunately, a common scenario in stroke.

Vitalsens Vital Signs Monitor

Very recently, cardiac arrest-fall-panic alarms for medical applications that meet FDA or CE (European Union) standards have been developed. So now, 30+ plus years after cryonicists made their first attempt at it, a new range of products is entering the marketplace that will more or less do the job – and in one case do considerably more.

Figure 3: The Vitalsens remote cardiac monitor and electrode array by Vitalsens Technologies of Dublin, Ireland.

The first of these is the Vitalsens ‘plug and play’ Vitalsens vital signs monitor.[1] This is a device I’ve been waiting for since Intelesens released its V-Patch Cardiac Event Monitor, the V-Patch Medical Systems (VPMS) in 2008. The Vitalsens contains transducers for ECG, heart rate, and skin temperature which are integrated with a tiny transmitter. The unit sticks to the skin with a minimally irritating disposable adhesive pad and is worn until the user removes it. The ECG electrodes and skin temperature sensor are disposable. The transmitter component of the Vitalsens monitor also contains a motion sensing device employing a 3-axis accelerometer – this allows the device to detect “man down” situations, such as a sudden fall, even when there is no cardiac arrest or arrhythmia. Most importantly, the  Vitalsens is an ”open-source” OEM[2] device designed to transmit data via Bluetooth to a PC, or any Bluetooth compatible device; and Intellisens provides it along with PC interface software. This allows the Vitalsens to be interfaced to any existing or new monitoring product. It can thus be rapidly added to or integrated into existing medical devices or alarm/monitoring systems.

What this means in theory is that it should be possible for any cryonicists with real engineering savvy out there to adapt another device, such as a smartphone, to respond to a signal from the Vitalsens. While still no easy task, it is unarguably much better than trying to build such a system de novo, or to rewire or reprogram a Nokia Symbian S60 – or your dog. More information on the Intelisens system is available at : http://intelesens.com/index.html

The NUVANT Mobile Cardiac Telemetry System

Next up is the The NUVANT Mobile Cardiac Telemetry System from Corventis, Inc., in San Jose, CA. Corventis got 510(k) FDA approval for this system early last year, and it is now up and running. The NUVANT system uses a disposable sensor array and transmitter which they call the PiiX (Figure 4, below); “an unobtrusive, leadless and water-resistant device “designed to support patient compliance.” The PiiX transmits its data to a compact relay transmitter, the zLink, that can be worn on the belt, or otherwise be secured to the user’s person. The word ‘patient’ should probably be used here because this is an FDA approved prescription device.

Figure 4: The Corventis NUVANT PiiX is an unobtrusive, leadless and water-resistant ECG sensor and transmitter, which is also disposable. It links to a small, belt-worn re-transmitter, the zLink, which in turn communicates using mobile phone technology with Corventis’ central monitoring station.

Figure 6: The NUVANT monitoring system works by activating a belt-worn unit which communicates the arrhythmia to a central monitoring station, where it is interpreted and acted upon as deemed necessary by ECG technicians.

The NUVANT technological platform was developed primarily as a competing technology to Holter monitoring, with the added advantage of 24 hour centralized monitoring of the ECG. When the device detects an arrhythmia, it activates the belt-worn transmitter and notifies ECG monitoring technicians at the central monitoring station, who can then review the arrhythmia and advise the patient directly, or the patient’s cardiologist, as appropriate. If the patient experiences symptoms, he can activate PiiX to record and automatically transmit the ECG, via the zLink transmitter device, to the Corventis Monitoring Center.

Corventis offers three levels of service, as shown in Figure 7, below. Costs vary considerably for monitoring service, depending upon the level of surveillance selected. When the device detects cardiac arrest, or a rapidly fatal arrhythmia, such as ventricular tachycardia in a patient, it captures it and sends the ECG virtual “strip” to the Corventis central monitoring facility for action or referral to the patient’s cardiologist.

Figure 7: Varying service levels available for NUVANT monitoring system.

The service is geared primarily for detection of arrhythmias for diagnostic purposes, although a stated use of the device is to monitor for acute therapeutic interventions, presumably including summoning Emergency Medical Personnel (EMS).

The Zoll LifeVest Wearable Automatic Defibrillator

The bulk of my research activity has not been in cryobiology, but rather in the area of cerebral-ischemia reperfusion injury[2] (lack of blood flow to the brain and the injury that results from this, and as a consequence of restoring blood circulation) and the “post-resuscitation syndrome.”[3] The brain is acutely and atypically sensitive to lack of blood flow. The outer limit of recovery from cardiac arrest absent neurological deficit is 6 minutes, and the vast majority of patients cannot be recovered from cardiac arrest in any condition, if the duration is as little as 10 minutes.[4] Independent of the brain injury associated with ischemia, there is also a ~ 10% decrease in survival for each minute that cardiac arrests persists absent restoration of spontaneous circulation (ROSC). That number should put into perspective why the immediate detection of cardiac arrest is such a low commercial and medical priority – the window of time to act is just too small!

Figure 8: The graph above shows the smoothed curve for chances of survival (with and without neurological deficit) as a function of time in cardiac arrest until there is effective restoration of spontaneous circulation (ROSC). Beyond 5 minutes of cardiac arrest the neurological outcome becomes progressively worse, as indicated by shading into red on the graph. The first incidents of impaired neurocognitive function following cardiac arrest occur starting ~ 2 minutes after the start of aystole.[4-8]

Each year ~300,000 people in the US will experience SCA[9] and ~70% of them will not be within reach of an Automatic External Defibrillator.[10] Of the 30% who do experience SCA within “potential” reach of an AED, the majority of these patients will not be salvageable due to delays involved in determining the patient’s condition (i.e., the bystander determining if the victim in fact have no heartbeat), locating an AED, applying it, and waiting for it to diagnose the arrhythmia and administer the anti-arrhythmic shock.[11] Once again, the logistically imposed time delay in the context of the decay curve in recovered viability, as shown in Figure 8 above, means that only a minority of patients who need it will benefit from rapid, let alone immediate defibrillation.

For at least a decade now, implantable cardiac defibrillators (ICDs) have been available.[12, 13] These units place the entire defibrillator assembly under the skin of the chest and within the patient’s thorax. They work well, but the procedure to implant them is both invasive and costly, and the batteries have a limited life, requiring re-operation every few years to replace them.[14] Because the devices and the surgical and medical management associated with their use are so costly, insurance carriers will typically only pay for ICDs in patients who have both extremely high and documented ongoing risks of sudden cardiac arrest.

Figure 9: This is very recent data (2006-07) from All-Japan Utstein Registry of the Fire and Disaster Management Agency. They selected a subpopulation of SCA their patients with out-of-hospital cardiac arrest due to ventricular fibrillation (VF), where there was witness present who was over 18 years of age and who immediately started CPR. The study ran from January 1, 2006 to December 31 2008 and the outcomes measured were survival and good neurological outcome (CPC 1 or 2). There were 24479 adults in the analysis with a mean time to bystander CPR of 1 minute. Adjusted odds ratio of the average effect per a minute was 0.23 with 95% Confidence Intervals (CI) 0.17 to 0.31.The introduction of high impulse no-pause for ventilation CPR was associated with a significant improvement in survival despite the fact that it is still not in widespread use.  As can be seen, even with essentially immediate initiation of bystander CPR, survival from cardiac arrest is not greatly improved over that achieved with defibrillation, as seen in Figure 8, above. Abstract 260: The Effect of Time to Bystander Cardiopulmonary Resuscitation on Survival From Out-of-hospital Cardiac Arrest From All-Japan Utstein Registry Data: A Validation of 3-Phase Sensitive Model. Yonemoto, N, Yokoyama, H, Nagao,K, Kimura,T, Hiroshi,N. Circulation. 2010;122:A260

This leaves a lot of people with known risks with no protection against SCA other than bystander CPR and the Emergency Medical System (EMS). Representative survival following cardiac arrest under excellent conditions of bystander and EMS response is shown in Figure 9, above and it is not greatly different than when the return of spontaneous circulation is achieved by the use of defibrillation, even absent CPR (Figure 8).[5, 7] The focus of my research towards solving this problem has been to find better methods of CPR as well as drugs that will allow for cerebral recue following periods of brain ischemia in the range of 6-30 minutes. My reason for focusing on these strategies is that because cryopreservation procedures cannot be started on humans until after pronouncement of medico-legal death, all cryonics patients will necessarily experience some normothermic ischemia. Furthermore, since it is also not legally permissible to restore spontaneous circulation to cryonics patients, they will necessarily be reliant upon some form for closed-chest circulatory support. at least until such time as extracorporeal support can be initiated.

Medical patients are not constrained to suffer “irreversible cessation” of spontaneous circulation following an incident of SCA and they can thus legally, if not practically, be immediately defibrillated. However, as has just been pointed out, only those at the highest risk qualify for ICD placement. On average, the long-term risk of sudden death after myocardial infarction (MI) (once a person has been medically stabilized for ~ 30-60 days), is between 1 – 2% per year.[15] During the first 30 days after an MI the risk is in the range of 25 to 50% and for a subpopulation of MI patients, the risk remains high. The patients with the highest risk are those who have already had (and survived) one episode of cardiac arrest; they face a ~ 20% yearly chance of another cardiac arrest. Patients with a large MI, ones in whom there has been destruction of a large area of heart muscle, also face a seriously elevated risk of SCA. A good marker for the amount of the myocardium destroyed after an MI is the ejection fraction.[16] Patients with ejection fractions above 40% have about the same risk as other post-MI patients, a ~ 1 – 2% incidence of SCA per year.[16] However, the risk of sudden death increases with lower ejection fractions, and becomes substantially higher at values of 30% or below. For this reason, anyone who has had a heart attack should have their ejection fractions measured – and should know what their ejection fraction is. Other patients who will be at greatly elevated risk, are those with infarcts in certain areas of the heart, those with co-morbidities such as diabetes, advanced age with atherosclerosis, and those with cancers and a prior history of MI.

To meet the need of these patients, particularly those who are in the high risk window period following an MI, the LifeVest wearable cardiac defibrillator (WCD) was developed by Zoll Medical (the same company that now manufactures the AutoPulse vest-CPR machine[3]).The LifeVest is the first wearable defibrillator, and in contrast to an ICD, the LifeVest is worn outside the body, rather than being implanted in the chest, as shown in Figure 10, below.[17-20]

Figure 10: The Zoll LifeVest wearable cardiac defibrillator consist of a halter-worn set of monitoring and defibrillation electrodes and a shoulder strap or belt-worn monitor, electronics package and battery pack.

The LifeVest continuously monitors the patient’s ECG with novel, dry, non-adhesive, non-irritating sensing electrodes to detect potentially lethal cardiac arrhythmias. If a life-threatening rhythm is detected, the device alerts the patient prior to delivering a counter-shock, thus allowing patients who are conscious to delay the treatment shock, or to prepare themselves physically and psychologically; for instance, to sit down if standing, or to pull over to the side of the road, if driving. If the patient becomes unconscious, the LifeVest defibrillation electrodes secrete an electroconductive gel and deliver an electrical shock to restore normal rhythm. Approximately 35,000 patients have used the LifeVest so far, with a 98% cardioversion rate to normal rhythm on the first shock.[21, 22] The overall survival rate is 92%, with patients either remaining at home following the shock, or admitted conscious to the Emergency Department (ED).[18, 23]

Since its release in 2002, when the device was manufactured by its original developer LifeCor (subsequently acquired by Zoll Medical) it has gone through 4 generations of development, with each generation resulting in more compact and lighter weight units.

The LifeVest is covered by most health plans in the United States, including commercial, state, and federal plans as Durable Medical Equipment (DME) for those patients at high risk of cardiac arrest, including:

  • Primary prevention [ Ejection fraction (EF) ≤35% and Myocardial Infarction (MI), Non Ischemic Cardiomyopathy (NICM), or other Dilated Cardiomyopathy (DCM)] including:
    • After recent MI (Coverage during the 40-day ICD waiting period)
    • Before and immediately after CABG or PTCA (Coverage during the 90-day ICD waiting period)
    • Listed for cardiac transplant
    • Recently diagnosed NICM (Coverage during the three-to-nine month ICD waiting period)
    • New York Heart Association (NYHA) Class IV heart failure
    • Terminal disease with life expectancy of less than one year
  • ICD indications when patient condition delays or prohibits ICD implantation
  • ICD explantation (patients who have had removal of an ICD but who are stillest risk of SCA)

Figure 11: The risk of sudden cardiac death (not successfully resuscitated) per 1,000-person years for men and women by age.[24]

Can Cryonicists Benefit from a WCD?

While the indications for use of a WCD like the LifeVest are clear in cardiac disease, what, if any, are the indications in the cryonics setting? Figures 11-13 should help to clarify that somewhat. As can be calculated from Figure 11, the cause of death in 4 of every 5 people older than 65, is heart disease. Some of these deaths will be due to end-stage congestive heart failure, but many will result from SCA. These data would suggest that male cryonicists, in particular those with a family history of cardiac disease, are people who should at least consider the use of WCD after age 70. Mortality from SCA is so high by >75 years that very serious consideration should be given to use of a WCD in both men and women.[15, 25]

Figure 12: The multivariable-adjusted relative risk for sudden cardiac death by quartile of the Omega-3 Index compared with other, more traditional circulating heart risk factors. The quartiles at presumed highest risk (black bars) are set at a relative risk of 1.0. Each subsequent lighter bar represents the risk at each decreasing (or, for HDL and omega-3 index, increasing) quartile. CRP, C-reactive protein; Hcy, homocysteine; TC, total cholesterol; Tg, triglycerides. Source: Physician’s Health Study. These risks factors, combined with others, may allow younger cryonicists to determine their risk of SCA, and thus decide whether to make use of WCD.

Cryonicists with diabetes who have suffered a MI have a 40% risk of experiencing lethal SCA in the following year (Figure 13, below).[26] That risk declines some with survival to the end of the second year, but still remains above 30% for the rest of the patient’s life! This subpopulation of cryonicists might also want to consider use of a WCD, or if medically indicated, an ICD. It is, of course, possible to greatly refine the risks of SCA by doing testing, such as cardiac “treadmill” testing wherein the ECG is monitored (preferably in conjunction with real-time echocardiography) during stressful exercise. An abnormal ECG and/or “stress echo” is highly predictive of the presence of coronary artery disease and thus the risk of SCA. Similarly, blood chemistry parameters, such as HDL/LDL ratio, homocysteine levels and C-reactive protein and triglyceride levels, when considered together and in the context of age and family history, can also be powerfully predictive of the risk of SCA/D as can be seen in Figure 12, above.

Figure 13: The risk of sudden cardiac death for diabetics in the first year following a myocardial infarction. The risk for male diabetics approaches 50%!

Effort on the part of cryonicists with programming and statistics backgrounds offers the prospect of taking SCA risk factor data from multiple sources and integrating them into a more comprehensive risk factor assessment program. This would allow those cryonicists with the highest risk of SCA to determine if the use of a WCD is appropriate for them.

The cost of the Life-Vest has been impossible for the author to determine so far. Since the device is sold only by prescription (and it is costly), Zoll refuses to discuss a specific “direct consumer retail price,” and instead asks for specific insurance coverage information, or a prescription by a physician. Monthly cost data are available for the UK via the NHS, and the price quoted there is in the range of 27 to 32 pounds sterling per patient, per month.

Interface Capability?

The Life Vest is a less ‘electronically compact’ system and it uses an auditory alarm that is accessible. This raises the possibility that the device can be “hacked” and the alarm output signal be coupled to a mobile phone triggered to dial a pager, or another number where 24/7/365 emergency notification service. It may even be possible to work with Zoll to custom engineer such a device as a plug-in to the unit, as long as it was not being added for any medical indication. Cryonics should still qualify as being ‘exempt’ from being a medical indication, since notification that a person is dead or dying, with no intent to render medical services, is not currently considered medicine. Obviously, if the device delivers a shock and the cryonicist is still alive, the cryonics organization will disregard the alert from the device.


A variety of FDA approved medically approved devices to detect and treat SCA are now on the market in both the US and Europe. Rapid technological advance in microelectronics and telecommunications has made these devices small enough and lightweight enough to be considered for use by cryonicists wishing to avoid the predicament of experiencing SCA, with or without a long delay to discovery. Careful consideration to adopting the use of a WCD should be given by cryonicists who are 75 or older, or who have specific medical conditions, or other risk factors that put them at high risk of SCA. Intangible factors, such as living alone, which greatly amplifies the risk of remaining undiscovered for prolonged periods of time following SCA, and the increased sense of personal security that may result from use a WCD[18] should also be factored into the decision to use or forego a WCD, or an SCA detection device.


1.            Harper R, Donnelly N, McCullough I, Francey J, Anderson J, McLaughlin JA, Catherwood PA: Evaluation of a CE approved ambulatory patient monitoring device in a general medical ward. Conf Proc IEEE Eng Med Biol Soc, 2010:94-97.

2.            Grace P: Ischaemia-reperfusion injury. Br J Surg 1994 81(5):637-647.

3.            Homer-Vanniasinkam S, Crinnion JN, Gough MJ: Post-ischaemic organ dysfunction: a review. Eur J Vasc Endovasc Surg 1997, 14(3):195-203.

4.            Mullie A, Van Hoeyweghen R, Quets A: Influence of time intervals on outcome of CPR. The Cerebral Resuscitation Study Group. Resuscitation 1989, 17 Suppl:S23-33; discussion S199-206.

5.            Becker LB, Ostrander MP, Barrett J, Kondos GT: Outcome of CPR in a large metropolitan area–where are the survivors? Ann Emerg Med 1991, 20(4):355-361.

6.            Martens PR, Mullie A, Calle P, Van Hoeyweghen R: Influence on outcome after cardiac arrest of time elapsed between call for help and start of bystander basic CPR. The Belgian Cerebral Resuscitation Study Group. Resuscitation 1993, 25(3):227-234.

7.            Swor RA, Boji B, Cynar M, Sadler E, Basse E, Dalbec DL, Grubb W, Jacobson R, Jackson RE, Maher A: Bystander vs EMS first-responder CPR: initial rhythm and outcome in witnessed nonmonitored out-of-hospital cardiac arrest. Acad Emerg Med 1995, 2(6):494-498.

8.            Troiano P, Masaryk J, Stueven HA, Olson D, Barthell E, Waite EM: The effect of bystander CPR on neurologic outcome in survivors of prehospital cardiac arrests. Resuscitation 1989, 17(1):91-98.

9.            Kong MH, Fonarow GC, Peterson ED, Curtis AB, Hernandez AF, Sanders GD, Thomas KL, Hayes DL, Al-Khatib SM: Systematic review of the incidence of sudden cardiac death in the United States. J Am Coll Cardiol, 57(7):794-801.

10.          Bardy GH, Lee KL, Mark DB, Poole JE, Toff WD, Tonkin AM, Smith W, Dorian P, Yallop JJ, Packer DL et al: Rationale and design of the Home Automatic External Defibrillator Trial (HAT). Am Heart J 2008, 155(3):445-454.

11.          Lofgren B, Molgaard O, Pedersen AK, Krarup NH: [Resuscitation with automatic external defibrillator]. Ugeskr Laeger 2007, 169(42):3584-3585.

12.          Corrado D, Calkins H, Link MS, Leoni L, Favale S, Bevilacqua M, Basso C, Ward D, Boriani G, Ricci R et al: Prophylactic implantable defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia and no prior ventricular fibrillation or sustained ventricular tachycardia. Circulation, 122(12):1144-1152.

13.          Celiker A, Olgun H, Karagoz T, Ozer S, Ozkutlu S, Alehan D: Midterm experience with implantable cardioverter-defibrillators in children and young adults. Europace, 12(12):1732-1738.

14.          Hauser RG, Maisel WH, Friedman PA, Kallinen LM, Mugglin AS, Kumar K, Hodge DO, Morrison TB, Hayes DL: Longevity of Sprint Fidelis implantable cardioverter-defibrillator leads and risk factors for failure: implications for patient management. Circulation, 123(4):358-363.

15.          Adabag AS, Luepker RV, Roger VL, Gersh BJ: Sudden cardiac death: epidemiology and risk factors. Nat Rev Cardiol, 7(4):216-225.

16.          Dai SM, Zhang S, Chen KP, Hua W, Wang FZ, Chen X: Prognostic factors affecting the all-cause death and sudden cardiac death rates of post myocardial infarction patients with low left ventricular ejection fraction. Chin Med J (Engl) 2009, 122(7):802-806.

17.          Schott R: Wearable defibrillator. J Cardiovasc Nurs 2002, 16(3):44-52.

18.          Beauregard LA: Personal security: Clinical applications of the wearable defibrillator. Pacing Clin Electrophysiol 2004, 27(1):1-3.

19.          Reek S, Meltendorf U, Klein HU: [A wearable defibrillator for patients with an intermittent risk of arrhythmia]. Dtsch Med Wochenschr 2002, 127(41):2127-2130.

20.          Morrison D, Smith J: Taking a vested interest in a wearable cardioverter defibrillator. Nursing 2009, 39(6):30-32.

21.          Auricchio A, Klein H, Geller CJ, Reek S, Heilman MS, Szymkiewicz SJ: Clinical efficacy of the wearable cardioverter-defibrillator in acutely terminating episodes of ventricular fibrillation. Am J Cardiol 1998, 81(10):1253-1256.

22.          Chung MK, Szymkiewicz SJ, Shao M, Zishiri E, Niebauer MJ, Lindsay BD, Tchou PJ: Aggregate national experience with the wearable cardioverter-defibrillator: event rates, compliance, and survival. J Am Coll Cardiol, 56(3):194-203.

23.          Feldman AM, Klein H, Tchou P, Murali S, Hall WJ, Mancini D, Boehmer J, Harvey M, Heilman MS, Szymkiewicz SJ et al: Use of a wearable defibrillator in terminating tachyarrhythmias in patients at high risk for sudden death: results of the WEARIT/BIROAD. Pacing Clin Electrophysiol 2004, 27(1):4-9.

24.          Straus S, Bleumink, GS, Dieleman JP, van der Lei, J, Stricker, BH, Sturkenboom, MC.: The incidence of sudden cardiac death in the general population. J Clin Epidemiol 2004 57(1):98-102.

25.          Calleja AM, Dommaraju S, Gaddam R, Cha S, Khandheria BK, Chaliki HP: Cardiac risk in patients aged >75 years with asymptomatic, severe aortic stenosis undergoing noncardiac surgery. Am J Cardiol, 105(8):1159-1163.

26.          Kucharska-Newton AM, Couper DJ, Pankow JS, Prineas RJ, Rea TD, Sotoodehnia N, Chakravarti A, Folsom AR, Siscovick DS, Rosamond WD: Diabetes and the risk of sudden cardiac death, the Atherosclerosis Risk in Communities study. Acta Diabetol, 47(Suppl 1):161-168.

Selected Bibliography: Wearable Cardiac Defibrillators

1. Auricchio et al., “Clinical Efficacy of the Wearable Cardioverter-Defibrillator in Acutely Terminating Episodes of Ventricular Fibrillation,” Am J Card, 1998, 81(10):1253-1256.

2. Meltendorf et al., “The Wearable Defibrillator ?a new Method to prevent Sudden Death,” PACE, 2000; 23(4, part II):606.

3. Reek et al., “The Wearable Cardioverter Defibrillator (WCD®) for the prevention of sudden cardiac death ?a single center experience,” Z Kardiol, 2002; 91:1044?052.

4. Schott, “The Wearable Defibrillator,” J Cardiovasc Nurs, 2002; 16(3):44-52.

5. Reek et al., “Clinical Efficacy of the Wearable Defibrillator in Acutely Terminating Episodes of Ventricular Fibrillation Using Biphasic Shocks,?PACE, 2002, 25(4, part II):577.

6. Reek et al. “A wearable defibrillator for patients with an intermittent risk of arrhythmia,” Dtsch Med Wochenschr, 2002; 127(41):2127-30.

7. Capucci et al. “Cost-effective use of a new wearable cardioverter defibrillator to protect patients at risk of SCA,” Europace, 2003, 4(Supplement 1):A44-A45.

8. Gasparini et al. “A new wearable defibrillator: Initial single center experience,” Europace, 2003, 4(Supplement 1):A45.

9. Pignatelli et al. “Use of a new wearable cardioverter defibrillator to reduce the risk of sudden cardiac death,” Europace, 2003, 4(Supplement 1):A45-A46.

10. Suzzani P et al. “The lifecor lifevest™ wearable cardioverter defibrillator,” Europace, 2003, 4(Supplement 1):A46.

11. Lang et al., “Morbidity and Mortality of UNOS Status 1B Cardiac Transplant Candidates at Home,” J Heart Lung Transplant, 2003; 22:419-426.

12. Reek et al., “Clinical Efficacy of a Wearable Defibrillator in Acutely Terminating Episodes of Ventricular Fibrillation Using Biphasic Shocks,” PACE, 2003, 26:2016-2022.

13. Beauregard, “Personal Security: Clinical Applications of the Wearable Defibrillator,” PACE, 2004; 27(1):2-3.

14. Feldman et al., “Use of a Wearable Defibrillator in Terminating Tachyarrhythmias in Patients at High Risk for Sudden Death: Results of WEARIT/BIROAD,” PACE, 2004, 27:4-9.

15. Chung et al., “Robust Long-Term Cardiac Monitoring Using Dry, Non-adhesive Capacitive Electrodes,” JACC, 2004; 43(5, suppl A):141A.

16. Joseph et al., “Compliance and Effectiveness of the Wearable Defibrillator Vest,” JACC, 2004; 43(5, suppl A):300A.

17. Meltendorf, “Using the Wearable Cardioverter Defibrillator a strategy for bridging high risk patients after CABG,” Heart Rhythm, 2005; 2(5, suppl):S32.

18. Wase, “Wearable Defibrillators: A New Tool in the Management of Ventricular Tachycardia/Ventricular Fibrillation,” EP Lab Digest, 2005; 12:22-24.

19. Szymkiewicz et al., “Analysis of Sudden Cardiac Arrests During Wearable Defibrillator Use,” Circulation, 2006; 114 (18, suppl II):II-349.

20. Gronda et al., “Heart Rhythm Considerations in Heart Transplant Candidates and Considerations for Ventricular Assist Devices: International Society for Heart and Lung Transplantation Guidelines for the Care of Cardiac Transplant Candidates?006,” J Heart Lung Transplant, 2006; 25(9):1043-1056.

21. Losordo et al., “Intramyocardial Transplantation of Autologous CD34+ Stem Cells for Intractable Angina: A Phase I/IIa Double-Blind, Randomized Controlled Trial,” Circulation, 2007; 115:3165 – 3172.

22. Traub et al., “Sudden cardiac arrest aborted by a wearable cardioverter-defibrillator in newly diagnosed non-ischemic cardiomyopathy,” Heart Rhythm, 2007; 4(5, suppl):S101.

23. Choudhuri et al., “Arrhythmic Events During the 40/90 days ‘Cooling Off’ Period: Clinical Utility of the Wearable Defibrillator,” Circulation, 2007; 116: II_348.

24. Wang et al., “Ventricular Fibrillation remains the Primary Presenting Rhythm: Results from the Wearable Cardioverter Defibrillator Human Study,” Circulation, 2007; 116: II_934 – II_935.

25. Freeman et al., “Is Severe Post-shock Bradyarrhythmia In Patients Using Wearable Defibrillators Common or Serious?” Circulation, 2007; 116: II_931.

26. LaPage et al., “A Fatal Device-Device Interaction between a Wearable Automated De?brillator and a Unipolar Ventricular Pacemaker,” PACE, 2008; 31:912?15.

27. Abi-Samra et al., “Wearable Defibrillator: Effective Bridging Substitute for ICD Implants,” Europace, 2008; 10: i160.

28. Mortada et al., “Sudden Cardiac Death” in: Jeremias A, Brown DL (eds). Cardiac Intensive Care, 2nd Edition, Elsevier, St. Louis (in press).

29. Szymkiewicz, et al. “A Comparison of Compliance and Effectiveness of Wearable Defibrillators and Home AEDs in Out-of-Hospital Sudden Cardiac Arrest,” Circulation, 2008; 118: S_1466.

30. Lewicke et al., “Exploring QT interval changes as a precursor to the onset of ventricular fibrillation/tachycardia,” Journal of Electrocardiology, 2009; 42(4):374-9.

31. Szymkiewicz, et al., “Incidence and causes of inappropriate defibrillation during wearable defibrillator use,” Heart Rhythm, 2009; 6(5): S74.

32. Morrison et al., “Taking a vested interest in a wearable cardioverter defibrillator,” Nursing, 2009; 39(6):30-2.

33. Dillon et al., “An evaluation of the effectiveness of a wearable cardioverter defibrillator detection algorithm,” Journal of Electrocardiology, 2009; (June, electronic ahead of print).

34. Saltzberg et al., “Characteristics of Peripartum Cardiomyopathy Patients Using a Wearable Cardiac Defibrillator,” Journal of Cardiac Failure, 2009; 15(6):S59.

35. Lee et al., “Role of wearable and automatic external defibrillators in improving survival in patients at risk for sudden cardiac death,” Curr Treat Options Cardiovasc Med, 2009;11(5):360-5.

36. Klein et al., “Bridging a Temporary High Risk of Sudden Arrhythmic Death. Experience with the Wearable Cardioverter Defibrillator (WCD),” PACE, 2009 Nov 2 [Epub ahead of print]

37. Prochnau, “Successful use of a wearable cardioverter-defibrillator in myocarditis with normal ejection fraction,” Clin Res Cardiol, 2009 Nov 17. [Epub ahead of print]

38. Zareba et al., “Sudden Cardiac Arrest in End-Stage Renal Disease: Successful Resuscitation With Wearable Cardiac Defibrillator,” Circulation, Nov 2009; 120: S701 – S702.

39. Klein et al. “The Wearable Cardioverter Defibrillator: Bridge to the Implantable Defibrillator,” Cardiac Electrophysiology Clinics, 2009;1(1):129-46.

40. Everitt et al., “Use of the Wearable External Cardiac Defibrillator in Children,” PACE, 2010 Feb 23. [Epub ahead of print].

41. Chung et al. “Aggregate national experience with the wearable cardioverter-defibrillator vest: event rates, compliance and survival,” JACC, 2010;55(10 suppl 1):A10.

[1] Polar is the leading manufacturer of heart rate monitoring sports watches and the bundled Polar-Nokia product is featured here: http://www.intomobile.com/2009/01/14/nokia-n79-active-bundles-polar-heart-monitor-for-health-fanatics/

[2] OEM stands for original equipment manufacturer, but in reality means a manufacturer of equipment that may be marketed by another manufacturer!

[3] Which the author most emphatically does not recommend for use in cryonics!

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

We’re Not in Kansas Anymore: A Personal Meditation on the Consequences of Increasing Social Acceptance for Contra-cultural Undertakings

By Mike Darwin

An Unusual, but Perhaps Valuable Analogy

This isn’t 1964, 1974, or even 1984 anymore, we aren’t in Kansas, and cryonics is not in the position it once was in. One of the reasons I was never a strong advocate of gay rights is that, long before it enjoyed the success it has, I could see that it would destroy one of the core values it was ostensibly launched to protect, namely the gay culture that had existed for centuries in the Western world. I used to tell my gay friends this at the time, and they would become enraged. Perhaps rightly so; they could see only the repression and injustice in a society that demonized homosexuality – and the self loathing, fear, and personal suffering that resulted. What they failed to reckon with is that homosexuality is a biological predilection, not a culture.[1-3] The culture that gay men “created” and inhabited prior to ~ 1990, was a product of both their biology and the attitude towards them of the culture they were embedded in. This two part dynamic generated a way of life and a culture that was exclusive, intimate, unique, and almost exclusively homosocial. While this microverse was a really bad place at its worst, it had many good features, as well.

What Shall it Profit a Man if he Gains the Whole World but Loses His Soul?

Literally without exception (no hyperbole here), I was the lone voice pointing out that being an outsider has some pretty powerful compensating advantages. One of the least appreciated and most profound of those advantages, is that if you are to survive under such conditions, you must, without exception, come to your own judgment about your own worth, the worth and the correctness of the core values of your culture and religion, and, should you decide to go on living, what kind of value system you will use to get you through life. Some gay men, confronted with the crucible of being told that everything they value and respect “rejects them, and even damns then to hell,” decide that there are no values in life beyond their own immediate gratification, advancement and prosperity. Three instructive examples of this from the last century are Truman Capote, Ray Cohn, and J. Edgar Hoover. The rest of us tried to try to make sense of it all. One very visible consequence of the effect of having to make those kinds of decisions, is that everything in life is on the table, and that includes the purpose of life, the justness of death, and the reliability of contemporary medical and scientific authority. No wonder then, that the first generation of cryonicists consisted of an unusually large number of gay men.

Figure 1: Former ACS President Jerry White (left).

The American Cryonics Society’s (ACS) president for many years, Jerry White, the Cryonics Institute’s one-time dynamic editor of The Immortalist, and promoter of cryonics Pat Dewey, (who was also later President of the Cryonics Society of Illinois), Carlos Mondragon, former President of Alcor, and myself (also a former President of Alcor) were all not only cryonicists, we were also publicly “out” gay men. Jerry is now in liquid nitrogen, Pat chose death in the face of AIDS, and Carlos and I will, if we are unlucky/lucky enough, get our turn pushing up bubbles in liquid nitrogen whilst awaiting rescue. If cryonics works for any of us, it will be in no small measure because we were outsiders who learned a powerful thing as small children in the hardest of ways; how to think for ourselves, independent of how society and the culture informed us were the “right and proper” ways.

Figure 2: Former Alcor President Carlos Mondragon.

But the gay men I counted as friends and associates in my youth were unmoved by my arguments, and “Comes the revolution!” was the mantra of the 1970s and ’80s. Well, the revolution is here, and now gay men from my cohort (those still living), are groaning in agony and shrieking in pain because their culture is gone – and I do mean gone. Young gay men don’t know who Oscar Wilde was, think Judy Garland is irrelevant, and what’s worse, bring straight people into gay bars and gay special interest organizations, and even more shockingly, bring children to the latter, in no small measure because they now increasingly have children of their own.

My partner is on the Board of Directors of a gay backpacking, hiking and 4-wheel driving club. Recently, after months of brutally contentious meetings, many of the old guard members have quit the organization. Why? Because the younger members now have kids, have straight friends they want to bring along on club outings, and these new faces, from an increasingly mainstreamed generation, carry with them “baggage” about things like smoking pot, nudity at summer pool parties (and on outings to hot springs), and frequent casual sexual encounters between men during club outings which, while they take place in private, are nevertheless “apparent.”  In short, the taboos and restrictions that people with children will obviously have, are now surfacing in and transforming a culture that previously had no use for them. These ‘last generation gay men’ woke up one day and found that they weren’t special anymore, and that the social norms and rules they had long left behind, were now being unexpectedly reapplied to them. Similarly, this current generation of young gay men, and those who will follow, are going to find that the price of acceptance and equality will be, in part, bleeding and dying on the battlefield, instead of writing poetry, or doing interior design, while a war rages on in someplace like Vietnam.

Figure 3: Projection of the Alcor’s Life extension Foundation’s growth in membership and patient populations prepared by Ralph Whelan in 1993.[4]

And so it is with cryonics. This first wave of seriously threatening criticism now assaulting cryonics is a sign of “progress,” of sorts. Once an outsider institution or group starts to become incorporated into the culture, the culture starts to demand compliance with its norms, its rules, and its regulations. When Alcor began to experience significant growth, gain significant assets, and began to develop a professional culture based on a scientific-medical paradigm in the mid-1980s, I became reasonably confident that cryonics would be adequately prepared to deal with the challenge of cultural integration when the time came, 20 or 30 years down the line. I and others projected we’d have ~5-10K members by now (Figure 3), a reasonably well established internal culture, and a good, solid base of scientific, procedural and administrative competence to rely upon. Regrettably, that didn’t happen.

Who’s Gaming Who?

Gay people are (and always were) just about as good or bad as the population as a whole with respect to skills, intelligence, and wealth generating capacity. Where they were and are vastly “different” is in the realm of “conventional morality.” Be born gay (or realize it as a small child) and you will learn to deceive, and to do skillfully, just to stay alive. A 20 year old may have (in the past) announced, with considerable risk and heartache, that he was a homosexual, but a 12 year old (with rare exception) had no such option – it was simply unthinkable; and in most instances would have resulted in parental or societal intervention to change him as person, to in effect wipe out a critical part of his identity. The other major difference in gay men is a consequence of the fundamental structure of male sexuality, which is highly promiscuous, whether straight or gay – something that is masked and kept in check in heterosexual males by their need for women (who do not share this trait).[5, 6] In fact, the one way in which both straight and gay men are most alike, is in their appetite for sex and their desire for promiscuity – straight men just have a much harder time getting compliance from their partners in satisfying this desire.[7] Gay men are thus “sex machines,” by comparison, and this has profound social implications. It took the breakdown of conventional sexual morality in society as a whole, before gay rights could proceed. Heterosexual GeNexters now perform oral sex with each other almost as casually (though not nearly as frequently) as gay men do – and they have (partially) uncoupled sex from romance and marriage.[8-11]

Figure 4: A sampling of public print adverts from around London that demonstrate what would be considered a homoerotic sensibility in the US, and that arguably are homoerotic, by just about any reasonable any definition. Top left Rugby player Paul Sackey, in a massive ad for the sports drink Powerade, lower left, Sky TV ad, and at right, a Dolce and Gabana underwear ad that saturated the London Underground in 2009. Photos by Mike Darwin

Some cryonicists are heard to declaim passionately that, “we’re just like everybody else.” In fact, that isn’t the case at all, and once again a careful analysis of homosexuals and the gay rights movement reveals some interesting parallels, because the same remark is often used to justify ‘equal treatment’ of homosexuals. Virtually every study of the comparative psychosocial and neurobehavioral characteristics of homosexuals and heterosexuals reveals that they are not, in fact, “the same.” Far from it; and this should be obvious given that both straights and gays do very well at identifying gay men and lesbians,  just from body language on silent, detail-masked  video, or conversely, from listening to conversation samples with no video.[12, 13] The take home message is that increased cultural acceptance of homosexuals has come not by convincing the culture to embrace gays as being the same as straights (and thus equal), but rather the reversethe culture has been transformed, in terms of both values and characteristics, to be compatible with homosexuality.

As one straight friend of mine in London remarked recently, “I don’t mind homosexuality being accepted, but I’m becoming increasingly concerned that it soon may be mandatory (see Figure 4).”[1] This is a consequence not just of the efforts of gay rights activists, but of a diverse array of mostly technologically driven cultural change resulting from the uncoupling of sex from reproduction (birth control and safe abortion), saturation exposure to the marketing machine that drives the mass media and generates heavy consumer spending, and removal of women into the workplace; with a concurrent negative impact on child rearing. Personally, I’m not persuaded that these changes to the culture are at all beneficial, but what they are is illustrative of what is possible, in terms of reshaping the culture radically and fundamentally, by exploiting the leverage provided from rapidly advancing technology’s destabilizing effect on the existing cultural equilibrium.

Technological Advance in Medicine is destroying a Centuries Old Medical Culture

The relevance of this to cryonics is that developments in medicine, like Donation after Cardiac Death, and the increasing use of reversible cryopreservation technologies to store human embryos, stem cells, and a growing range of other tissues, are forcing medicine to confront the inadequate and flawed criterion it uses to determine and pronounce death. Incremental, but steady advances in transplantation, and the growing sophistication and increased utilization of technologies like joint and eye lens replacement, dental implants, and radical plastic surgery, are having a similarly destabilizing and transformative effect – not just in medicine, but in the culture as a whole. The general effect of this creeping biological revolution in terms of things like cloning, assisted reproduction, stem cell therapies and molecularly engineered drugs for cancer treatment, is to corrode the whole world view that medicine runs on.

At first blush, that may seem all to the good, but it is vitally important to remember that it was that “old time 20th century world view of life and death” that kept us safe, because cryonics was seen as simply too ridiculous to be taken seriously. That word ridiculous is really important, because it is the perfect word, with just the right nuance, to describe the position of cryonics relative to medicine in the last century. While it is certainly true that the cryobiologists hated cryonics, they did so only because they felt threatened personally. To continue the gender conflict analogy, they found themselves suddenly recast as heterosexual male cross-dressers confronted with a bunch of raucous and demonstrative guys who really were gay! It wasn’t a happy experience for them (though I must confess, I enjoyed it immensely).

You don’t, you can’t, get too much exercised about anything that is simply ridiculous. In fact, it is in the very nature of being ridiculous that there is such refuge.  Consider the definition of the word: “Deserving or inspiring ridicule; absurd, preposterous, or silly. See Synonyms at foolish. [From Latin r diculus, laughable.]” Thus, is it any wonder that so many gay men who could not hide their homosexuality, chose to be ridiculous as a survival mechanism?

Whatever else cryonics is, it isn’t ridiculous anymore, and while the current round of critics may not amount to a hill of beans, what they have done is shown us that the culture is responding to this paradigm shift in how it views life and death, and the limits of the possible in medicine, by using a fundamentally new and different push-back tactic. That tactic is to realize that by taking cryonics just seriously enough to leverage the coercive might of the state on us, at a time and place when we are unprepared, and unable to meet the enormous associated burden of regulation and cost, and when the state is also unprepared to absorb cryonics, they can exterminate us.

In this conclusion they are almost certainly correct.

Self Defense 101

Unmoderated list serves are an unalloyed evil. I’ve now over 20 years of experience with them, and I don’t know of any responsible person who believes otherwise. I’ve watched various high quality sites implode in anesthesia, critical care medicine, and numerous other disciplines and special interest areas.

This happens because of deep, biologically determined factors in human nature. This is not an opinion; it is a statement of fact. On any serious consideration, it is hard to believe that anyone would consider a “free press” to be a newspaper without an editor. There wouldn’t be enough paper to print it, and the ratio of vile nonsense, and plain confused ranting to anything bearing even a vague resemblance to fact, would be overwhelming. So, clearly that isn’t what the Founding Fathers had in mind when they gave a Constitutional mandate to free speech, and protection of the freedom of the press in the US.[2]

Instead, what they believed was that anyone has the right to express themselves in pretty broad terms (absent doing things like shouting fire in a crowded theatre). In practice, this means that people are free to speak their mind, verbally and in print, but they are still subject to civil laws regarding libel and slander. These used to be really important control mechanisms on “evil,” “bad,” or “destructive” speech – as I’ve often pointed out, many of Abraham Lincoln’s cases were slander cases.[14] As communities and communications media grew and consolidated, the newspapers, and later the electronic media as well, became the real resource for credible “public information.” What then happened was that the libel and slander suits migrated from the sphere of interpersonal community speech, to the sphere of journalism.

Figure 5: National Enquirer article 25 December, 1966 chronicling the work of Isamu Suda and his colleagues at Kobe University in Japan, who had just published in the prestigious journal Nature that they were able to recover EEG activity in cat brains after 203 days of frozen storage at -20oC.[15] The Enquirer flew a journalist and a cameraman to Japan in order to report this story!

As the media got sued and suffered losses, a number of things began to happen. The first was that they responded by becoming more responsible: they hired editors, and the editors hired fact checkers and quote verifiers. The idea wasn’t to really ensure the “truth” was being told, or to ensure honest reporting, rather it was to ensure just enough restraint, the bare minimum in fact, to avoid getting sued, or at least to reduce the incidence of litigation to a tolerable level. The second response was a consequence of the first, and that’s that there was a “split” in the media. Some papers just continued as broadsheets, packed with lies and enough truths to keep them useful – the National Enquirer is the best example of this. The Enquirer had a policy never to run misleading or phony news stories about health or biomedicine – and as a consequence, they were for years, one of the most reliable sources of information about cutting edge developments in both healthcare and biomedical research (Figure 5). Tabloid papers such as the Enquirer got away with outright fictions such as “Elizabeth Taylor and Michael Jackson are signed up for cryopreservation,” and even a fair number of calculatedly malicious lies. But they did so only at the price of “the loss of journalistic credibility.” This is not an idle ideal. This is a big deal, because basically what that means is that people regard most of what these papers print as “entertainment” – fiction based on real peoples’ lives. This is tolerated by all concerned, mostly because it is mutually beneficial.

Liz and Michael, and Brittany, and every other celebrity, want the attention, much more than they want the truth. And if the tabloids step over the line, they will usually retract and apologize, if their “victim” howls too much. It’s a well choreographed dance. However, every once in awhile, they run a libelous story that crosses the line, and do so about someone who is not dancing the Minuet with them. Saying that comedienne and actress Carol Burnett was an alcoholic, is the classic example. Stupidly, the Enquirer refused to retract and apologize for that story, and Burnett subsequently sued them costing them so much money they were almost bankrupted.

By now, hopefully, you’ve come to see at that at no point is there truly ‘consequence free’ speech, or speech that has no regulation. Speech is, (or more properly was) in fact, heavily regulated at all (public) levels, it just isn’t apparent.

It took a lot of effort and money, before the advent of the Internet, to communicate in writing, or by broadcast, with the masses. A ‘fanzine’ might have a few hundred subscribers, but it could never reach millions. Small publications like Cryonics magazine and The Immortalist did nick artwork, and excerpt quotes of such length that larger media would have been unable to get away with, simply because they did not reach a large audience. Similarly, much relaxed standards of accountability were present on such small endeavors of publication and exercises of free speech, and that was, by and large rational, and to the good.

Then, along came the Internet, and all those centuries of largely invisible control were wiped away. Now it is possible for a single individual to broadcast with all the credibility, and all the attention getting and credibility enhancing production values of the New York Times or CBS News – and to reach many fold more people. Still more importantly, it is easily possible to selectively target the people they wish to reach in ways no newspaper editor or media mogul in the previous centuries, ever dreamed possible. That’s all wonderful, except that it has (inevitably) happened absent those critically important restraints and protections that were formerly in place – many of which were intrinsic to the high cost and labor intensive nature of mass print publication, or the infrastructure and licensing required for the broadcast media. That change can, will, and has unarguably resulted in great evil (as well as great good). It is, for instance, now perfectly possible to all but destroy someone’s professional (and personal) reputation and employment prospects, without any risk of repercussions – and there isn’t a damn thing they can do about it.

This was not something envisioned by the Founding Fathers. The idea of speech and writing being widely disseminated, completely disconnected from any accountability, was not even a technological possibility until the closing decades of the 20th century. Even the anonymous pamphleteer required a collaborator in the form of a printer, and as the scale of dissemination increased, the amount of infrastructure, resources, and public visibility increased as well. This made anonymity virtually impossible, because without the collaboration of ‘big media’ – and that didn’t happen unless the story was both true and worth the risk of publishing (i.e., Watergate) – it didn’t get disseminated. That control is missing today.

The notion that in the age of the Internet, the first “no load” global megaphone for truly free speech, that a tiny list serve within the cryonics community has an obligation to be “a free for all” is not only ridiculous, it is self destructive. We do not owe either our critics or our enemies a ‘guaranteed access’ bully pulpit at our expense. The closest analogy I can come up with would be to set up a venue in your front yard, and invite people to picket there and call you a child molester, a murderer, a psychopath, or any other wicked thing that they fancy. We don’t need to create a venue for them to do that, let alone to cater it with refreshments, and resting benches. The US Constitution gives such people the right to do that in plenty of public spaces, including on an Internet so vast and so capacious, it almost exceeds human appreciation. Unarguably hateful and crazy people can even show up at your child’s funeral, and say they’re glad he is dead, and that he “died defending faggots, and is burning in hell.” Such speech is protected here in the US, but we are not required to invite those who use it as their weapon to the graveside – nor into our patient care facilities. And every time we do so, we lend them credibility, because why else on earth would we give franchise to such people, when they can do the same damn thing on the sidewalk across the street from us?

This proposition that we cryonicists must create some “hallowed place for free speech” for our critics, let alone for our enemies, is bizarre beyond reckoning.

Finally, the only thing I find more offensive about this attitude than the direct harm it causes cryonics, is the implication that some cryonicists actually believe that the things these people are saying are, or might be, true. They aren’t. And anyone who invites someone into their venue to shout vile lies and insults at their neighbors (let alone at themselves), is crazy, stupid, or both.

This article is available as a PDF at: http://cryoeuro.eu:8080/pages/viewpageattachments.action?pageId=1441801&highlight=We_Aren%27t_In_Kansas_Anymore_Chronosophere_Darwin.pdf#Chronosphere+Posts-attachment-We_Aren%27t_In_Kansas_Anymore_Chronosophere_Darwin.pdf


1.            Lippa R, Tan, FD.: Does culture moderate the relationship between sexual orientation and gender-related personality traits? Cross-Cultural Research 2001, 35:65-87.

2.            Lippa R: Finger lengths, 2D:4D ratios, and their relation to gender-related traits and the Big Five. Biological Psychology 2006, 71:116-121.

3.            McFadden D, Loehlin, JC., Breedlove, SM., Lippa, R.A., Manning, JT, Rahman, Q.: A reanalysis of five studies on sexual orientation and the relative length of the index and ring fingers (the 2D:4D ratio). Archives of Sexual Behavior 2005, 34:341-356.

4.            Whelan R: Suspension pricing and the cost of patient care. Cryonics 1993, 14(10):9-26.

5.            Lippa RA: The relation between sex drive and sexual attraction to men and women: A cross-national study of heterosexual, bisexual, and homosexual men and women. . Archives of Sexual Behavior 2007, 36:209-222.

6.            Lippa R: Is high sex drive associated with increased sexual attraction to both sexes? It depends on whether you are male or female. Psychological Science 2006, 17:46-52.

7.            Lippa R: Sex differences and sexual orientation differences in personality: Findings from the BBC Internet survey. Archives of Sexual Behavior 2008, 37:173-187.

8.            Brady S, Halpern-Felsher, BL.: Adolescents’ reported consequences of having oral sex versus vaginal sex. . Pediatrics 2007, 19(2):229-236.

9.            Halpern-Felsher B, Cornell, JL, Kropp, RY, Tschann, JM., Apr;. Oral versus vaginal sex among adolescents: perceptions, attitudes, and behavior. . Pediatrics 2005, 115(4):845-851.

10.          Gates G, Sonenstein, FL.: Heterosexual genital sexual activity among adolescent males: 1988 and 1995. Fam Plann Perspect 2000, 32():(6):295-297, 304.

11.          Lindberg L, Jones, R, Santelli, JS.: Noncoital sexual activities among adolescents. J Adolesc Health 2008, 43(3):231-238.

12.          Lippa R: Sex-typing and the perception of body outlines. . Journal of Personality 1983, 51:661-683.

13.          Lippa R: Sex differences in sex drive, sociosexuality, and height across 53 nations: Testing evolutionary and social structural theories. Archives of Sexual Behavior 2009, 38(631-651).

14.          Steiner M: An Honest Calling: The Law Practice of Abraham Lincoln. DeKalb: Northern IllinoisUniversity Press; 2006.

15.          Suda I, Kito, K, Adachi, C.: Viability of long term frozen cat brain in vitro. . Nature 1966, 212:167.

[1] British TV and popular culture is saturated with homosexuality, and much the advertising and public art, is frankly homoerotic.

[2] Few Americans know this, but there is no such protection in the UK, or most of the rest of the world, for that matter.

Posted in Cryonics History, Culture & Propaganda, Medicine | 17 Comments

Chronosphere is Not a Blog!

By Mike Darwin

Some years ago, Aschwin de Wolf pushed me very hard to do a blog. We actually got to the point where, due to Aschwin’s efforts,  the site was set up on WordPress, and I had done some sandbox “posts.” However, I didn’t follow-through, in large measure because I felt the blog format was not suited to what cryonics really needed from me, and needed in general, in terms of a working group and recruitment tool. For my part, I have a lot of technical, philosophical and historical information that I believe is important to the future of cryonics, and which must be disseminated globally – literally around the world. Some of this information is material I’ve written, but much of it isn’t – or is a transmission through me, of the wisdom and knowledge of others; many of whom are no longer able to speak for themselves.

The definition of a blog is “a frequently updated personal journal chronicling links at a Web site, intended for public viewing.” While the Comments section of Chronosphere might approach that in character, the “blog” itself consists of long pieces of often technically dense information, as well as shorter, more topical posts. Most importantly, the real mission of Chronosphere is to attract some of best minds in the world, and to provide a vehicle for them to contribute to the growth, and to the ultimate success of cryonics. To achieve that end, a group of like minded and morally compatible people must come together and work together. What I am saying here, is that while it has the software format of a blog, Chronosphere is not meant to be the sphere of discourse of any one man.

Information and communications technology are evolving so fast at this time that old models of technologically mediated communication are disintegrating, morphing, and developing new forms and nuances, almost as fast as the passing months go by. In their day, Cryonics Magazine and CryoNet were the best mechanisms available for communicating information, building community, and motivating newcomers to become involved in cryonics. These two vehicles are now as limited, and therefore as obsolete, as the ox-drawn cart.

While it was not used for transport in the New World, Mesoamerican civilizations had invented the wheel; they used it as a toy – a mechanism to allow children to pull little figures around, mounted on tiny carts. Beyond that, the wheel was useless to them in part, because the rocky and overgrown terrain of the jungles in which they lived and in which they built their impressive civilizations, was unsuited for the creation of roads. People often call the Internet the “Information Super Highway.”  This couldn’t be more wrong. While it is “super,” it is nothing like a 2-dimensional, fixed-path road, or highway. It is fundamentally different – as different as a 3-dimensional, dynamically rewire-able mammalian brain is from a 1-dimension circuit board. That means that it will have lots of powerful and perilous new emergent properties.

If we cryonicists want to survive into the indefinite future, we have to be willing to own that future, or die trying. That means not just mastering, but artfully using the best of these emerging technologies (in all spheres of endeavor) to further our survival. And where there is no “perfect fit” for our needs, well then, we need to create a new space that meets our needs. So, what I am saying here is that while the WordPress blog format is an “easy entry” way to begin this effort, it isn’t a last stop, and really, it isn’t even a proper “first step.” It’s also important to point out that Chronosphere, from the start, has not been the effort of just one man. It came about due to the efforts of Eugen Leitl, Aschwin deWolf, and Brian Wowk. Since then, Steve Bridge  has pitched in, and a number of cryonicists have begun posting intelligent and productive things in the Comments section.

Mike Darwin, at right.

But this not enough, not nearly enough! There is a massive amount of work literally sitting around waiting to be done…and beyond all that catching up with the past, there is a vast amount of challenging and exciting new work needed.

Cryonics has lost touch with cryonics – and this is neither a joke, nor a play on words. There are a stack of nearly 20 books on my desk here that deal with cryonics – some in very interesting and important ways. They need to be reviewed, and not just reviewed, but commented upon, and put into context. I find it astonishing that some of the people who are mentioned in, or are significant subjects of these books have not reviewed them. And yes, I include in this category everything from lie-packed trash, like Larry Johnson’s Frozen: My journey into the World of Cryonics, Death and Deception, to thoughtful and interesting narratives like Brian Alexander’s, Rapture: How Biotech Became the New Religion. There are at least a dozen more – and that doesn’t include novels.

The penetration of cryonics into the popular culture has succeeded to an extent that was simply unimaginable to those of us who labored to get Alcor 2.0 going in 1981. And we’re not just talking generalities here. Consider the two cartoons in Figure 1, below. We were overjoyed to see this kind of humor in 1968 and in 1990, because it told us a number of important things about our efforts to communicate the idea of cryonics to the culture. It told us that our message was getting through, on at least two levels. The first level was to the slightly ‘off center’ and cynically funny people who create cartoons. These people are two things, at a minimum; smart and observant. To the extent they are successful, they have to be able not just to inform the public about a funny or bizarre idea, they have to be able to know exactly how the public will react to that idea. A good cartoonist is thus a “psychic channeler” of public opinion and zeitgeist. Some part of Richard Nixon’s fall can be rightly attributed to the cartoonists of the time.

Figure 1: At left, above, a cartoon which appeared in the major national US weekly photojournalism magazine LOOK, and at right, a cartoon from 1990 by Gary Larson, from his Far Side series.

The 1968 cartoon (above, left), as simple as it seems, is incredibly nuanced, and it reflects a concern on the part of the population at that time that would not likely be as much of an issue now; principally what happens to the soul, when you are cryopreserved? How funny would a cartoon be showing a patient in deep hypothermic circulatory arrest, or undergoing CPR with the same theme today?  Think about these facts: CPR had been invented by Peter Safar in 1960, only eight years before that cartoon appeared in LOOK magazine, the first mass citizen training in CPR was still 4 years away, and the Uniform Determination of Death Act did not become law until 1978, a full decade later. We’ve come a long way since then.

The 1990 Gary Larson cartoon is less nuanced, but it clearly shows that the idea of neurocryopreservation has made it into the cultural mainstream. Before he retired, Gary Larson was arguably the most popular cartoonists in the US.

Now, have a look at the two cartoons below, from 2006 and 2010, below. The first one may seem run of the mill, until you look at it closely – really closely. The name on the cryopatient’s drawer is MERKLE.  Similarly, the cartoon from 2010 instructs the (presumably) North African onlookers, one of whom is a medic, to “push 50,000 units of heparin and do CPR…”

Figure 2: A close inspection of the cartoon above reveals a much deeper layer of meaning, not apparent at first glance, and one that is only meaningful to a very few people in the whole of the global culture.

Figure 3: The details in this cartoon are revealing, and tell us things about our effectiveness in communicating with the culture, as well as a little about how the culture is reacting to that message.

This shows a remarkable change, principally much increased specificity and detail in the message that is being pinged back to us. I don’t think any of us in 1981 could imagine that kind of change in the culture. And while it seems that we are not (apparently) making any headway in terms of the culture’s attitude towards cryonics, analysis of the “signal” in this data, shows that we really do have the detailed attention of these two humorists, and that’s impiortant. They didn’t stop at the meta-concept of cryonics; they went a level, or perhaps a number of levels deeper. And they got it right; Ralph Merke is indeed (unfortunately) one of the most readily identified spokespersons for cryonics as a scientific enterprise, and yes, 50,000 units of heparin is absolutely correct, and so is the injunction to start CPR to circulate it. None of these details is essential to communicate the humor intended by the cartoonists, and in the case of the 2006 cartoon, it is irrelevant to all but a tiny segment of the population that the name on the freezer drawer is “Merkle.”

Figure 3: What should we make of Futurama? Is it silliness and satire, or is there a message in the medium?

That’s the sort of analysis we need of the popular culture; and keep in mind this is only the tip of the iceberg, so to speak (pun intended). There are the spheres of music, computer gaming, and other areas of the arts where cryonics has penetrated, and where there will inevitably, or at least likely, be important implications for us. Some of this material I can’t even understand, such as NVIDIA’s Cryostasis video game: http://cryostasis-game.com/ – and it’s not just because I’m too old (which I am), but because I’ve never had the kind of mind that could grasp, let alone enjoy, that kind of entertainment. Other perspectives are thus essential if we want to communicate with the full spectrum of the population (and we do).

So, for openers, we need Columnists on Chronosphere who will track the popular culture, review books, and systematically identify novel technologies that could be of benefit to cryonics, both long term, and much more importantly, now. Feature articles are also needed – good quality, thoughtful articles on every aspect of cryonics, with an emphasis on the practical and near term, or better still, on ways to improve our position here and now. It may be premature for me to be asking for this kind of participation so soon after the launch of Chronosphere. If so, I’ll do it again, and again, and again, until the time is right.

I must also confess that I don’t know how long it will take to recruit these invaluable human resources. In the 1970s, when Steve Bridge and I started Cryonics magazine after LongLife magazine folded, it took several years before we started getting consistent, high quality input. I’m hopeful that the ongoing technological transformation in communication will shorten this interval – if for no other reason than because I’m personally fast running out of time. But that may be unrealistic, because while technological advance has sped the pace of mass communication dramatically, it has also fragmented it. That is both good and bad. On the upside, it has given voice to a lot of formerly voiceless people. On the downside, the silence of many of those folks was arguably a blessing.

The rise of blogs, Facebook and Twitter, have unquestionably de-focused intelligent dialogue, and raised the noise to signal ratio to nearly impossible levels. In the past, there were very substantial barriers to an individual disseminating his ideas to the world. It cost money to print and mail broadsheets, newsletters and magazines, and it was arduous to turn ideas into printed words, let alone to illustrate and format them! Now, if I have something to say, I can (and literally am) writing the equivalent of a 110 page book a week – and doing the illustrations and the layout alone – incredible! I shudder to think what kind of output the late Isaac Asimov would have, were he alive today? Perhaps it is just as well he loathed cryonics and decided to opt out of the future?

But what technology giveth, it also so often taketh away. The good part of those “barriers” to publication were that first of all, only people who really wanted to communicate their message, would do so. That was huge and largely positive filter – none of us wants to live in a world where every idle thought has more gravitas than the sleaziest published writers of the 20th century. Because publication and dissemination of writing was so expensive in the past, most writing was processed through newspapers and publishing houses. That meant they were subjected to scrutiny, editing and review, all of which are decidedly unpleasant things to writers, but which are a nearly unalloyed blessing to readers. In this era of the blog, and of instantaneous, unedited and virtually no-cost publication of writing, it is hard to know if a filtered communication mechanism like Chronosphere can prosper. I guess we’ll find out in due course.

In the meantime, I ask you to consider contributing to this effort to a build a new world; yes, yet again, a new world – but this time, one we can live in.

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How Not to Get Ahead in Cryonics: Using Google Ngram Technology to Expose Flawed Decision Making in Cryonics

By Mike Darwin The High Price of Mortality

The slate of human experience is wiped clean approximately every two generations (~ 50 years). This so far inescapable fact has had disastrous consequences for both cultures and civilizations. While it is possible to mitigate some of this loss by the expedient of the written word, and more recently through the use of other information storage and retrieval technologies, the fact remains that the bulk of the experiential information accumulated each generation is lost with the death of that generation.

Experience is difficult to encode in the written word, or in other symbolic systems, such as mathematics, in large measure because these mechanisms do not allow for recording the full bandwidth of the available and necessary information. The juxtaposition of emotion, facts and narrative; and their integration within the minds of the individuals who have acquired them, cannot yet be captured on any recording medium. Arguably, the most important commodity that is being lost with the extinction of each generation is wisdom, which may be described as “making the best use of available knowledge.” The loss of wisdom, as well as the loss of the vast body of knowledge accumulated in the billions of individual human minds, and which is not written down or recorded, is one of the most powerful arguments in favor of practical immortality, and an end to human dying.

Institutional Memory

Aside from the written and the recorded (spoken) words of those who precede us, perhaps the most valuable defense against the loss of wisdom with the passing of  generations is institutional memory. Institutional memory is an amalgamation of facts, ideas, experiences, values, know-how,  and ideology distributed amongst a discrete group of people. Because individuals die, institutional memory requires the continuing transmission of this amalgam of knowledge, values and experiences amongst members of the group that embraces it. Another way of describing institutional memory is that it is the equivalent of oral culture, the dominant way humans passed information from generation to generation in preliterate times, using tools such as folktales, aphorisms, ballads, and songs. The continuity of character, behavior and values that cultures, societies, nations, corporations and religions frequently exhibit over long periods of time, is made possible, in large measure, by the mechanism of institutional memory.

Cryonics, the cryopreservation of terminally ill people for the purpose of medical time travel, is still a nascent undertaking 44 years after the first man was cryopreserved in 1967.[1]  In the two generations that have passed since the first patient was cryopreserved, a substantial reservoir of experience has been accumulated. During the first 20 years of cryonics, the learning curve was quite steep, and a broad range of dangerous errors and paths to failure were identified.

The Rules of Engagement

Figure 1: Cryonics Society of New York President Curtis Henderson

Many of the lessons learned during this initialization period concerned the conditions under which patients should be accepted by cryonics organizations for initial treatment (cryoprotection and solidification) and long term care (indefinite storage in liquid nitrogen).  The first of these lessons was learned by Curtis Henderson, President of the Cryonics Society of New York (CSNY), and is known as the “no third-party funding rule,” which prohibits the practice of accepting patients funded by a third party, such as a spouse, child, or sibling of the patient who was to be relied upon to make yearly, or other periodic payments, in lieu of providing the funds required for establishing a trust account, or other financial vehicle to provide for the indefinite cryogenic care of the patient in a lump sum.[2] This practice almost invariably resulted in the failure of the interested third party to continue making payments for long-term care, usually in a relatively short period of time. As a consequence, the cryonics organization responsible for the patient found itself in the position of either having to continue the patient’s indefinite care at their own expense, or to conventionally dispose of the patient’s “remains,” with the attendant moral, emotional, and sometimes legal complications.[3]

On the heels of the “no third-party funding rule” other, related lessons were learned, such as ensuring informed consent was  present, never accepting at-need cases without guaranteed funding,[1]and not accepting at-need cases where the authority of the interested party to make the decision for cryopreservation on behalf of the patient was in doubt, or likely to be contested. An additional, and critically important lesson learned during these difficult early years of cryonics, was that the security of those patients already cryopreserved, as well as that of the cryonics organization’s existing members, trumps the interest of the patient at-need and his next-of-kin, or other interested parties.  In those instances where there is a clear risk to existing members or patients from accepting an at-need case, that case must be declined.

Loss of Institutional Memory

These “rules” or “codes of conduct,” were incorporated into the institutional memory of the Alcor Life Extension Foundation (Alcor) by the participation of people who were mentored by Curtis Henderson, and by CSNY Secretary Saul Kent, as well as by the direct and indirect participation of these men in the culture of the organization, and as respected advisors.  With the cryopreservation of Jerry Leaf in 1991, and the subsequent schism of Alcor in 1992,[4] much of Alcor’s institutional memory was lost. Alcor’s management at that point consisted almost exclusively of people who had had no firsthand experience of the costly and traumatic failures that resulted from accepting at-need cases, absent proper vetting and careful assurance of adequate funding and informed consent.

In mid-January of 1993 Alcor accepted a severely depressed man as a member, who had presented to the organization asking for assistance in committing suicide via dehydration, so that he could be cryopreserved. This gentleman was not terminally ill, but rather sought to use cryopreservation as a “desperation method” of reaching effective treatment for his longstanding psychiatric problems.

On 01 February, less than a month after he became a member, he was cryopreserved by Alcor after discharging a .38 caliber handgun into his head.[5] Since he had purchased the bulk of the life insurance funding for his cryopreservation shortly before he ended his life, he was underfunded, and Alcor received only a fraction of the required minimum funding. On 11 April, 1993 Alcor cryopreserved a member who had signed up with end-stage AIDS. Alcor failed to properly validate this member’s life insurance funding, and in this case there was no financial compensation to the organization This despite the patient having been placed into cryopreservation after a costly and technically demanding standby, with continuous ECMO transport during the drive from the Bay Area, where the patient arrested, to Alcor’s cryoprotective perfusion and storage facilities in Southern California.[6]

In the intervening decade Alcor experienced marked internal conflict, with 4 Presidents, acting Presidents, or interim management teams succeeding each other, often under acrimonious circumstances. There was also increasingly heavy turn-over of staff with each round of management changes. In 1993 Jerry Lemler, M.D., a psychiatrist who had recently joined Alcor as a member, was selected as President and Chief Executive Officer by the Alcor Board of Directors. Dr. Lemler had not had prior extensive contact with cryonics. Within a short while of assuming the Presidency of Alcor, Lemler had hired onto the Alcor staff his wife, his daughter, and his son-in law.

Figure 2: Dr. Jerry Lemler, M.D., President and CEO of Alcor during the Ted Williams cryopreservation.

Several additional staff members with no prior experience in cryonics, and who were also recent Alcor members, were also brought on board during this period.

The Lure of the Magic Bullet

Within two years of the publication of The Prospect of Immortality[7] it was already apparent to the activists running the newly formed cryonics organizations that the idea of cryonics was not going to follow the trajectory of rapid acceptance anticipated for it in Ettinger’s book. Since widespread public acceptance was not forthcoming, the response to this state of affairs, by a broad cross-section of the few people genuinely interested in the idea at that time, was to look for a single, powerful event; a “magic bullet” of sorts, that would slay public distaste for, and resistance to the idea of cryonics, and usher in the era of acceptance.

The first iteration of the “magic bullet solution” was that when the first man was cryopreserved, that would “break the ice,” so to speak, by bringing the idea to the attention of the public, and making it seem something that someone had done, and that was, therefore, doable. When Dr. Bedford was cryopreserved in 1967, and the much anticipated on-rush of cryonics members and patients failed to materialize, the next iteration of the magic bullet solution was to posit that cryopreserving a celebrity – preferably a beloved and iconic one – would be the key to opening the flood gates of public acceptance for cryonics.

Figure 3: The shiny brass ring of credibility and celebrity?

Late in 2000, John Henry Williams, the son of baseball icon Ted Williams, approached Alcor about making cryopreservation arrangements for his father. At that time, Ted Williams had been through multiple and very serious health crises, and was suffering from congestive heart failure and end stage renal disease, the latter of which was being managed by thrice weekly in-home hemodialysis treatments. The prognosis for an 81 year old man with these medical conditions is bleak, and survival is typically in the range of months, to a year or two at most. Nevertheless, John Henry failed to complete the required Alcor paperwork, and to provide the necessary funding for his father’s cryopreservation.

During the period of time that elapsed from his initial contact with Alcor, John Henry remained in touch with the organization, and made at least two trips to Alcor’s facilities. John Henry was also thoroughly acquainted with Alcor’s required policies and procedures for securing cryopreservation arrangements for his father.[2] Despite many admonitions to do so, John Henry failed to make arrangements for his father, and on 05 July, 2002 Ted Williams experienced cardiovascular collapse, and shortly thereafter went into cardiac arrest.[8] Ted Williams was a patient on the operating table in Alcor’s facilities in Scottsdale, when it was determined by the author that there was no Alcor paperwork, and no transfer of funds to Alcor to provide for either the immediate, or the long term care of the patient.

In the run-up to Ted Williams’ cryopreservation, it was apparent that the management of Alcor, including its Board of Directors, considered the public relations “bonanza” that would result from the cryopreservation of a celebrity of his magnitude, with the added advantage of Williams being a “beloved icon,” and a genuine American war hero, as paramount. In a world of marginalized people pursuing and an even more marginalized idea, cryopreserving Ted Williams was seen as the equivalent of grabbing the brass ring of public credibility and celebrity for cryonics.

Figure 4: John Henry (L) and Ted Williams (R).

In fact, the chartered jet air ambulance flight which transported Williams from Northwest Florida, to Scottsdale, Arizona had been charged to the American Express card of Alcor President Jerry Lemler. In the days that followed, it became clear that John Henry was refusing to pay for his father’s cryopreservation, as well as the ~ $10K air ambulance charge. In addition, Bobby Jo Ferrell, Williams’ daughter by a marriage previous to the one that had produced John Henry, and his sister Claudia,  was unhappy, and seemed intent upon contesting her father’s  cryopreservation with the objective being to have him cremated.

Over the following months, Ted Williams’ cryopreservation became an international news story,[9] and the unfolding and acrimonious legal battles that accompanied it[10-14] became the subject of countless articles and editorial cartoons. Serious issues of consent, let alone informed consent, were raised in the media. A consequence of this, and of the very public legal maneuvering that ensued, was that what can only be described as a firestorm of unfavorable publicity engulfed both the Williams family, and Alcor. On 18, August 2003 Sports Illustrated magazine published a sensational story titled “Questions and Allegations About the Alcor Life Extension Foundation Extend Beyond the Williams case,” containing gruesome allegations about the conduct of Ted Williams’ cryopreservation, as well as the subsequent cryogenic care he received at Alcor.[15] The source of these allegations, a disgruntled former Alcor employee named Larry Johnson, subsequently published an equally sensational and gruesome book, Frozen, alleging all manner of misconduct on Alcor’s part, not just in its handling of  Ted Williams, but also with respect to a number of other of its patients.[16]

Culturomics and Google Ngrams

Three months ago, Michel, et al., published the paper founding the new discipline of culturomics in Science, entitled, “Quantitative Analysis of Culture Using Millions of Digitized Books.”[1] The authors selected 5,195,769 digitized books (~4% of all books ever published) from Google’s cache of 15 million, based upon the quality of the scans, and their ability to obtain the necessary relevant metadata, such as the year and place of publication. This is a staggering amount of data, and even using large numbers of humans to perform searches, the sheer quantity makes it impossible. As the authors point out, if a single individual “were to try to read only English-language entries (in the corpus of the books they used) from the year 2000 alone, at the reasonable pace of 200 words/min, without interruptions for food or sleep, it would take 80 years.”

They then subjected this data to a wide range of analyses and were able to demonstrate the effect of disparate social, political and cultural events on the frequency of both regional and international word usage in books within the Google corpus. Their data also showed, among many other things, dramatic changes over time in the speed with which the culture adopts and discards celebrity, as well as a many fold increase in the speed with new technologies are being accepted into the culture. Google (the company) actively encourages its users to experiment with Ngram technology using words/ideas that are of interest to them. This is exactly what the author did, initially with the word “cryonics” as the sole search term in the Google English language corpus. [Note: the data presented here are based only on Ngrams of the Google English language corpus.] The results are shown in Figure 5, below.

The High Price of Institutional Amnesia

Figure 5: Ngram of the word “cryonics” from 1964 to 2005.The areas of the plot with red lines adjacent to them are the immediately evident major discontinuities that initially provoked the author’s curiosity.

In the course of trying to understand the Google Ngram plot for cryonics, I was struck by two features that seemed in want of explanation; a drop, followed by plateau in its usage in the period from ~ 1980 to ~ 1990, and a sharp decline in the frequency of its usage starting at around 2003 and continuing through to 2005, and perhaps beyond. These are two obvious discontinuities that commanded attention, and demanded explanation, even with a cursory inspection of the data. My subsequent course of action was to generate a subjective/objective time line of what I considered to be important historical events in cryonics (see Table 1, above). The importance of some of these events would be difficult to contest, such as the publication of Ettinger’s The Prospect of Immortality in 1964, Dr. James H. Bedford’s cryopreservation in 1967, the Chatsworth debacle in 1979 wherein the loss of the 9 Cryonics Society of California (CSC) patients at Oakwood Memorial Park Cemetery in Chatsworth, California became a highly visible public scandal in 1979, the Dora Kent incident in 1987, and the cryopreservation of Ted Williams in 2002. These events, for good or ill, attracted enormous media attention, and also resulted in books that either mentioned these issues, or used them as background themes, or plot mechanisms in stories and novels.

Figure 6: Scaling Ngram measured cultural penetration.  The plot of communism vs. capitalism vs. Christianity  (A) shows the relative degree of cultural importance of these three idea-systems in the culture, from the period of 1964 to ~2005. By comparison to major ideologies and religions, celebrity resulting from film acting (Elizabeth Taylor, Doris Day and Paul Newman) or writing/performing popular music (Michael Jackson) barely register in the cultural realm of books (B).

In looking at the Ngram in Figure 5, it is important to understand that the absolute numbers are relatively small, being between 0.00000000 and 0.000004000% of the ~ 4 billion or so digitized words in the currently accessible Google English language corpus. For comparison, I’ve prepared two other plots, one of communism and Christianity (use of the “proper” case is essential to obtaining meaningful data, in this case capitalizing “Christianity”). The other is of four celebrities, all of whom had career arcs over roughly the same historical period; Elizabeth Taylor, Doris Day, Paul Newman, and Michael Jackson.  These Ngrams provide some scale, and show the relative “power” in terms of frequency of word usage, that each subject has had in the culture. Obviously, when dealing with individual names, a number of complicating or confounding factors can cause problems.

There are a number of people named Adam Smith, who have made their way into books, either as real historical individuals, or as fictional characters, only one of whom is the influential 18th century political economist and social philosopher. There are undoubtedly also other “Paul Newmans” and “Doris Days” who appear in books, and to the extent they do so, they may be considered confounders of precision.  However, in most instances, the subject being evaluated is sufficiently unique, and the magnitude of the signal generated in the data is sufficiently large, that it is possible to have a good degree of confidence in the relative value of their data signatures in the Ngrams generated using their names, in the context of the time period.

Figure 7: The frequency of the occurrence of the word cryonics in all books published from the period 1965 through 2005, as determined by a Google Ngram search. (A) Publication of The Prospect of Immortality in 1964, (B) Cryonics Reports Begins publication and the various Cryonics Societies are formed, (C) Cryopreservation of the first man, James H. Bedford, (D) Publication of We Froze The First Man, and a spate of media-visible cryopreservations, (E) First Annual National Cryonics Conference held in 1968 attracts widespread media attention, (F) In 1973, Trans Time, Inc., (TT) and its partner non-profit, the Bay Area Cryonics Society (BACS) become active in the San Francisco Bay Area and attract national media attention, while Alcor and its for profit Manrise Corporation, become active in Southern California, developing much of the perfusion platform used by TT, (G) Trans Time peaks in media & marketing activity, having launched the bulk of its marketing efforts by this time, (H) The Chatsworth Scandal becomes public, resulting in strongly negative international media coverage, (I) Alcor becomes reactivated, begins publication of Cryonics magazine and there is the public debut of “scientific-medical” cryonics, with images released to the media showing cryonics as a medical procedure; photos of cryonics patients are no longer used for promotional purposes, (J) The Cryonics Institute begins to be more media-visible with articles and images appearing in the national media. Emphasis on CI’s lower price begins to become a source of comparison with Alcor, (K) the Dora Kent incident occurs with a resulting firestorm of international media coverage, followed by the Thomas Donaldson lawsuit against the Attorney General of the State of California, (L), Alcor shifts the paradigm of communicating cryonics to the public by redefining death and providing extensive, and technically detailed information packages to media, and to those members of the public who inquire; Cryonics Reaching for Tomorrow is published, and used as the core promotional tool by Alcor, (M) Jerry Leafs experiences sudden cardiac arrest from a heart attack in 1991, and is cryopreserved, (N) Schism of Alcor, and subsequent creation of CryoCare and CryoSpan as competing cryonics organizations in 1992, (O) Demise of CryoCare and CryoSpan in 1999-2000 (effective end of scientific cryonics), (P) Baseball Hall of Famer Ted Williams is cryopreserved by Alcor in 2002, (Q) Ben Best becomes President of the Cryonics Institute, (R) A story in Sports Illustrated alleges Williams was mistreated at Alcor, the story become international in scope, and the ongoing litigation amongst the family over issue of Williams’ cryopreservation is further highlighted .

When I applied the list of significant historical events I had generated for cryonics to an Ngram plot for the word cryonics, I obtained the results shown in Figure 7, above. The two large negative discontinuities in the use of the word cryonics coincided with two widely and negatively publicized events: the Chatsworth debacle, and the cryopreservation of Ted Williams; H and P in Figure 7. The baseball career of Ted Williams ended on 28 September, 1960, and yet his Ngram plot shows steadily increasing fame over the ensuing 4 decades, with a plateau period from ~ 1991 to ~ 1993. In order to understand this, I obtained and read two of Williams’ biographies, and this lead me to do a search of multiple media databases, in order to track his public (media) visibility.

I quickly discovered that the “primary” sources for most of the media attention surrounding Williams were articles originating in The Boston Globe, and the New York Times. The New York Times proved the most comprehensive and the most duplicated database (for instance, Los Angeles Times articles about Williams during this period are usually the same ones that appeared in the New York Times, although sometimes with different headlines). I created a compilation of all the feature articles that appeared about Ted Williams in the New York Times for the period 1981 through 2010 (excluded from this listing were many statistical articles which appeared in the Times) from the New York Times online archives (key words: “Ted Williams,”) and the data set for this is present as Appendix A, at the end of this article. I also prepared a compendium of all English language published books by, or primarily about Williams, based on a search of the Library of Congress index. Finally, I similarly prepared a plot of articles that featured the Alcor Life Extension Foundation as their primary subject, using both the Los Angeles Times and the New York Times archives as the database (keywords: Alcor Life Extension Foundation) for the same time period, and the data set for this is present at the end of this article as Appendix B.

Figure 8: Correlation of major media articles () and books by about Ted Williams (A-H). The books relating to Williams were: A Williams, Ted, and John Underwood. Ted Williams’ Fishing the Big Three: Tarpon, Bonefish, Atlantic Salmon. New York: Simon & Schuster, 1982. ISBN 0-671-24400-0. B Baldasarro, Lawrence (ed.). The Ted Williams Reader. New York: Simon & Schuster, 1991. ISBN 0-671-73536-5. C Linn, Ed. Hitter: The Life And Turmoils of Ted Williams. Harcourt Brace and Company, 1993 then as a Harvest paperback 1994. ISBN 0-15-600091-1. D Williams, Ted, and Jim Prime. Ted Williams’ Hit List: The Best of the Best Ranks the Best of the Rest. Indianapolis: Masters Press, 1996. ISBN 1-57028-078-9. E Williams, Ted, and David Pietrusza. Ted Williams: My Life in Pictures (also published as Teddy Ballgame). Kingston, N.Y.: Total/Sports Illustrated, 2002. ISBN 1-930844-07-7. F Cramer, Richard Ben. “What Do You Think Of Ted Williams Now? – A Remembrance“. Simon & Schuster, 2002. ISBN 0-7432-4648-9. G Halberstam, David. The Teammates. New York: Hyperion, 2003. ISBN 1-4013-0057-X. H Montville, Leigh. Ted Williams: The Biography of an American Hero. New York: Doubleday, 2004. ISBN 0-385-50748-8. I Updike, John. Hub Fans Bid Kid Adieu: John Updike on Ted Williams. New York: Library of America, 2010. ISBN 978-1-59853-071-1. Articles about the Alcor Life Extension Foundation  that appeared in the LA Times( = LAT), and the NY Times ( = NYT) are plotted on the Alcor Ngram data set. Where there was a tight cluster of articles there is a number adjacent to the points, in matching color). Key events are A = Dora Kent, B = Thomas Donaldson Lawsuit, C = schism of Alcor, D = Cryopreservation of Ted Williams and E = Sports Illustrated article is published.[15]

All three of these datasets were applied to the Ngram plots of Ted Williams, and of the Alcor Life Extension Foundation, as shown in Figure 8, above. From 1990, until his cryopreservation in 2002, Williams was the subject of many media articles and a significant number of books, both of which reflect his growing celebrity for his phenomenal performance as a baseball player, and to a lesser extent, his colorful personal life and his charitable activities. These facts go a long way towards the impressive and fairly consistent increase in his fame over the course of his life after the end of his career as a player. I do not have sufficient knowledge of either Williams, or of the sport of baseball, to be able to attach any significance (if indeed, there is any) to the discontinuity in his curve of rising fame, which appears during the interval of ~ 1990 to ~1993-4. Ted Williams’ fame peaks at around the time of his cryopreservation in 2002, and declines steadily thereafter.

The Ngram plot for Alcor maps that of Williams to a surprising, and to me wholly unexpected degree. It may even be argued that the rise in fame, or cultural penetration for both subjects (Alcor and Williams), reflects not only media exposure, but an increased appreciation by the culture with the passage of time, for the worth or value of the accomplishments of both subjects. However, it is wise to remember that it is quite possible to acknowledge accomplishment without embracing it; and such acknowledgment may be negative, as well as positive. To understand this, it is only necessary to do Ngram plots for “Adolf Hiltler,” and “John Edgar Hoover” (J. Edgar Hoover). The data in Figure 8 would seem to show that the Dora Kent incident in 1987, the schism of Alcor in 1992, and the cryopreservation of Ted Williams in 2002, all had a significant negative impact on the cryonics Ngram data signal. The Dora Kent incident is represented on the polot by the cluster of articles 5 articles about Alcor that appeared in the LA Times in 1988 (Dora Kent A and the resulting press 5●●●●) and the cryopreservation of Ted Williams, and its aftermath, in 2002-5 (D-E).

Figure 9: Ngram plot of “Ted Williams” and “cryonics” (B).”The strong correlation of the downturn in the frequency of the word cryonics appearing in books associated with an increase in the frequency of the appearance of Ted Williams’ name is apparent in the Ngram above. The plot for cryonics is also displayed separately (A) to better show the magnitude of the effect, since it is not possible to manipulate multiple sets of Google Ngram data within the Google Ngram program. There is a similarly strong correlation between the cryopreservation of Ted Williams and the downturn in the appearance of the word cryonics in books published subsequent to the negative publicity that resulted from the Williams case, as can be seen in Figure 9, above.

Finally, I prepared an Ngram plot of the words “Cryonics Institute” (CI) over the same time period. I was unprepared for what I saw, principally that while the Ted Williams cryopreservation had a strong negative impact on cryonics as a whole, and especially on Alcor, it had only a moderate, transient negative impact on CI. What’s more, at no time did it suppress CI’s steady gain relative to Alcor, or its absolute growth over time. It could even be argued that Alcor’s decision to cryopreserve Ted Williams under clearly hazardous conditions has improved CI’s standing in the culture, dramatically! The apparent specificity and sensitivity of these data continue to surprise me.

Figure 10: Ngram plot of the words “Cryonics Institute” (CI) over the 1980 to 2008 time period.


In cryonics, it is extraordinarily rare to obtain reliable feedback of any kind, except that which comes in the terminal phase of a cryonics organization’s life cycle, when it ceases to be able to provide cryogenic care for its patients. What is more, making comparisons between cryonics organizations is difficult in terms of examining variables such as net and gross income, membership statistics, and other aggregate data that are used to adjudge and compare the health of most other businesses and corporations. This is the case because of fundamental differences in price structure, approach to delivering human cryopreservation services, lack of disclosure, and the inevitable distortions that occur in all self-generated data from small enterprises.[3]

Thus, other than individual subjective assessment, and to a very limited extent, assessment based on one of a few objective markers known to precede the demise of all previous cryonics organizations, such as steadily reduced frequency of edited magazine and newsletter production, ending in failure to publish at all; followed by abandonment of patient cryogenic care (CSC, CSNY), or effective refusal to take on additional patients (Trans Time), there has been no way to gauge the performance and the health of cryonics organizations in anything approaching real time.

The data presented here suggest that the Google Ngram is possibly a sensitive and specific method for evaluating the cultural penetration of not only the idea of cryonics itself, but of the established individual cryonics organizations. Furthermore, the Ngram data seem to provide this feedback (both beneficial and adverse), with a lag time of approximately 1-2 years. It would thus seem prudent to apply this measure at frequent intervals in the future, both to validate its accuracy, and to provide feedback to direct both the intermediate and long term actions of the management of cryonics organizations. Arguably, it may also be used as tool to hold the management of cryonics organizations accountable for their decisions and actions.


1.            Larsen D: Cancer Victim’s Body Frozen for Future Revival Experiment. In: Los Angeles Times. Los Angeles; 1967.

2.            Darwin M: Interview with Curtis Henderson: http://www.alcor.org/cryonics/cryonics8107.txt. Cryonics 1982(12).

3.            Perry R: Suspension Failures: Lessons from the Early Years: http://www.alcor.org/Library/html/suspensionfailures.html. Cryonics 1992. 4.            Darwin M: Jerry Leaf enters cryonic suspension: http://www.alcor.org/cryonics/cryonics9109.txt. Cryonics 1991, 12(9):19-25.

5.            Whelan R: Beginnings of Winter: Suicide and Cryonics The tragic case of patient A-1401: http://www.alcor.org/Library/html/casereport9304.html. Cryonics 1993, 14(4).

6.            Jones T: The Suspension of A-1399: http://www.alcor.org/Library/html/casereport9306.htm. Cryonics 1993, 14(6).

7.            Ettinger R: The Prospect of Immortality: http://cryonics.org/book1.html. New York City: Doubleday; 1964.

8.            Goldstein R, Thomas,T. Jr.: Ted Williams, Red Sox Slugger And Last to Hit .400, Dies at 83: http://www.nytimes.com/2002/07/06/sports/ted-williams-red-sox-slugger-and-last-to-hit-.400-dies-at-83.html?ref=tedwilliams. In: New York Times. New York City; 2002.

9.            Freezing Time; Ted Williams: http://www.nytimes.com/2002/07/11/opinion/freezing-time-ted-williams.html?ref=tedwilliams. In: New York Times. New York City; 2002.

10.          Fight for Williams’s Remains: http://www.nytimes.com/2002/07/07/sports/baseball-fight-for-williams-s-remains.html?ref=tedwilliams. In: New York Times. New York City; 2002.

11.          Friends Say Williams Wanted to Be Cremated: http://www.nytimes.com/2002/07/11/sports/baseball-friends-say-williams-wanted-to-be-cremated.html?ref=tedwilliams. In: New York Times. New York City; 2002.

12.          Janofsky M: Even for the Last .400 Hitter, Cryonics Is the Longest Shot: http://www.nytimes.com/2002/07/10/us/even-for-the-last-.400-hitter-cryonics-is-the-longest-shot.html?ref=tedwilliams. In: New York Times. New York City; 2002.

13.          Williams’s Daughter Asks For Aid Against Freezing: http://www.nytimes.com/2002/07/12/sports/baseball-williams-s-daughter-asks-for-aid-against-freezing.html?ref=tedwilliams. In: New York Times. New York City; 2002.

14.          No Will Is Filed for Estate of Williams: http://www.nytimes.com/2002/07/16/sports/baseball-no-will-is-filed-for-estate-of-williams.html?ref=tedwilliams. In: New York Times. New York City; 2002.

15.          Verducci T: Tip of the iceberg? http://sportsillustrated.cnn.com/vault/article/magazine/MAG1029492/index.htm#ixzz1GA99wCCQ. In: Sports Illusrated. 2003. 16.          Johnson L, Baldyga S: Frozen : my journey into the world of cryonics, deception, and death. [New York]: Vanguard Press; 2009.

Appendix A: Ted Williams in the New York Times

THE DOCTOR’S WORLD March 31, 1981, by Lawrence K. M.D., Science – 1267 words.

PLAYERS; THE 2 LOVES OF TED WILLIAMS August 10, 1982, by Ira Berkow, Sports – 875 words.

Sports People; Williams Honored November 11, 1988.

SPORTS OF THE TIMES; An Evening With The Kid November 12, 1988, by  Ira Berkow,

Sports BASEBALL ’91; 1941: An Unmatchable Summer April 7, 1991, by Ray Robinson,

Sports SPORTS PEOPLE: BASEBALL; Williams Recovering From Apparent Stroke December 27, 1991

Question Box, by Ray Corio, May 4, 1992 Williams Selected July 2, 1992

ON THE SIDELINES — POLITICAL MEMO; Looking to Baker to Save Bush Anew by Michael Wines, July 15, 1992

Ted Williams Offers Collectors’ Items by Richard Sandomir, May 11, 1993

ON THE SIDELINES — POLITICAL MEMO; Looking to Baker to Save Bush Anew by Michael Wines, July 15, 1992 Williams Selected July 2, 1992

Question Box by Ray Corio, May 4, 1992

SPORTS PEOPLE: BASEBALL; Williams Recovering From Apparent Stroke December 27, 1991

Sports of The Times; Hit .400? The Dinosaur Who Did It by Dave Anderson, July 13, 1993


BASEBALL; Ted Williams Suffers Stroke February 22, 1994

BACKTALK; From .400 to 75, and Still Battling by Dave Anderson, May 22, 1994

Tunnel Named For Williams AP, December 16, 1995

Ted Williams Has Advice for Belle March 26, 1997

BASEBALL: SPRING TRAINING NOTEBOOK — RED SOX; Williams Spends a Day In the Florida Sunshine March 25, 1998

Sports of The Times; On the Other Side of the River, Another Hailing of Champions by Harvey Araton, October 25, 1998

Sports of The Times; A Familiar Idol Talks About His ‘Idol in Life’, by Dave Anderson, October 29, 1998

Fans Seeking Fame, Not Infamy, for Shoeless Joe Jackson November 27, 1998

Food; Batter Up by Molly O’Neill, May 30, 1999

BASEBALL; Mets Toss Aside Piazza’s Comeback Script, by Jason Diamos, June 12, 1999

70TH ALL-STAR GAME: NOTEBOOK; Williams and Fenway: They Still Click by Jack Curry, July 14, 1999

ON BASEBALL; In Spite of Itself, the Grand Old Game Still Thrives, by Murray Chass, July 15, 1999

BASEBALL; Williams Looks Back, and Forward George Vecsey,  January 12, 2000

PLUS: BASEBALL; Ted Williams, 82, Hospitalized November 5, 2000

PLUS: BASEBALL; Williams to Receive A Pacemaker November 7, 2000

Sports of The Times; Ted Williams Still Living On His Terms by Ira Berkow, November 9, 2000

PLUS: BASEBALL; Ted Williams Leaves Hospital November 22, 2000

PLUS: BASEBALL; Williams to Have Heart SurgeryBaseball January 15, 2001

AMERICAN LEAGUE: ROUNDUP; Ted Williams Is ‘Progressing’ April 30, 2001

PLUS: BASEBALL; Ted Williams Is Back in Hospital January 25, 2002

Williams Is Out of Hospital January 29, 2002

PLUS: BASEBALL; Frail Williams Makes A Surprise Visit February 18, 2002

PLUS: BASEBALL; Frail Williams Makes A Surprise Visit February 18, 2002

Batsman Nonpareil July 6, 2002

BASEBALL: YANKEES NOTEBOOK; Jeter May Not Be Sidelined Long by Tyler Kepner, July 6, 2002

Sports of The Times; For Ted, The Eyes Had It by Dave Anderson, July 6, 2002

BASEBALL; Williams Leaves Behind An Unmatched Legacy by Murray Chase, July 6, 2002

BASEBALL; A Gift for Hitting and a Passion for Sharing It by Buster Olney, July 6, 2002

BASEBALL; Boston Tips Its Cap on the Day the Legend Dies by Fox Butterfield, July 6, 2002

Sports of The Times; For Williams, A Joy Found In the Debate by Ira Berkow, July 6, 2002

Ted Williams, Red Sox Slugger And Last to Hit .400, Dies at 83 by Richard Goldstein and Robert MCG Thomas, Jr., July 6, 2002

BASEBALL; Fight for Williams’s Remains July 7, 2002

SPORTS MEDIA; Memories of Williams Spanning the Decades by Richard Sandomir, July 7, 2002

BackTalk; It’s the Little Things That Made Williams Special by John Underwood, July 7, 2002

BASEBALL; On Day for Yankees, Praise for Old Red Sox Foe by Tyler Kepner, July 7, 2002

Stepping Up to The Plate, by Bob Herbert, July 8, 2002

BASEBALL; Williams Memorials Are Set July 8, 2002

BASEBALL: NOTEBOOK; Giambi Defeats Sosa In Home Run Derby by Jack Curry, July 9, 2002

BASEBALL; Ted Williams’s Son No Stranger to Controversy by Richard Sandomir, July 9, 2002

The Perfectionist at the Plate, David Halberstam, July 9, 2002

Even for the Last .400 Hitter, Cryonics Is the Longest Shot by Michael Janofsky, July 10, 2002

BASEBALL; Williams Returns, at Least in Spirit by Jack Curry, July 10, 2002

Freezing Time; Ted Williams July 11, 2002

BASEBALL; Friends Say Williams Wanted to Be Cremated July 11, 2002

BASEBALL; Williams’s Daughter Asks For Aid Against Freezing July 12, 2002

Sports of The Times; In Baseball Romance, Little Room for Reality by Harvey, July 14, 2002

Ideas & Trends: Just Chillin’; Putting Mortality on Ice by Henry Fountain and Anne, July 14, 2002

BASEBALL; Legends’ Images Often Change in Death by Richard Sandomir, July 15, 2002

BASEBALL; No Will Is Filed for Estate of Williams July 16, 2002

BASEBALL; Executor Says Williams’s Will Doesn’t Give His True Wishes by Richard Sandomir, July 17, 2002

BASEBALL; Williams’s Children Seek Court’s Help by Joe Callahan, July 18, 2002

Sports of The Times; Extended Family Unites in Tribute by George Vecsey, July 23, 2002

BASEBALL; Note Dated 2000 Says Williams Wanted His Remains Frozen by Richard Sandomir, July 26, 2002

BASEBALL; Daughter to Continue Fight to Have Williams Cremated by Richard Sandomir, July 27, 2002

Analysis Shows That Williams Did Sign Note by Richard Sandomir, August 9, 2002

BASEBALL; Williams Fight Goes to Court August 14, 2002

Fight Over Williams’s Frozen Body May End Soon by Richard Sandomir, September 26, 2002

Sports of The Times; Bonds Sure to See Fewer Strikes Than Williams Did in 1946 Series by George Vecsey, October 19, 2002

Daughter May Drop Fight Over Ted Williams’s Body by Richard Sandomir, December 20, 2002

BASEBALL; Williams Children Agree to Keep Their Father Frozen by Richard Sandomir, December 21, 2002

THE LIVES THEY LIVED; The Batter Who Mattered by John Updike, December 29, 2002

BASEBALL; Report Says Facility Beheaded Williams by Richard Sandomir, August 13, 2003

BASEBALL; Ted Williams Tale Gets Stranger by the Day by Richard Sandomir, August 14, 2003

No Charges Against Williams’s Kin by Richard Sandomir, August 19, 2003

John H. Williams, 35, Ted Williams’s Son by Richard Sandomir, March 10, 2004

BOOKS OF THE TIMES; Whether Sweet or Cranky, He Was Always a Slugger by Charles McGrath, May 7, 2004

SPORTS BRIEFING: COURT NEWS; Ted Williams Legal Fight Comes to an End by Richard Sandomir, June 17, 2004

What Boston Won, What Boston Lost by Nicholas Dawidoff, October 30, 2004

Suddenly We Have a Name for a Frozen Stadium Treat by Joyce Wadler, with Joe Brescia and Melena Z. Ryzik, November 18, 2004

Please Don’t Call the Customers Dead by Richard Sandomir, February 13, 2005

Why Suzuki’s Magic Number Is Really 56, Not .406 by Alan Schwarz, May 1, 2005

Who’s a Latino Baseball Legend? by Richard Sandomir, August 26, 2005

To Play Is the Thing by David, August 28, 2005

Sculptor Throws a Curve With Slugger’s Head by Richard Sandomir, September 5, 2005

Sports Briefing December 9, 2006

Baseball’s Devil May Not Be in the Details by Alan Schwarz, February 10, 2008

Essay by John Updike Defined Heroism in Ted Williams by Charles McGrath, September 26, 2010

Appendix B: Alcor Life Extension Foundation in the Los Angeles Times

  San Francisco Journal; Chilling Answer to Life After Death

January 20, 1989 – By KATHERINE BISHOP, Special to the New York Times – U.S. – 853 words

  Review/Television; On Aging, or Rather Avoidance of It

August 17, 1992 – By WALTER GOODMAN – Movies – 587 words

  SUNDAY, APRIL 17, 1994; Not Their Fault

April 17, 1994 – Magazine – 88 words

  Deathstyles of the Rich and Famous

January 12, 1997 – By DOUGLAS MARTIN – Week in Review – 810 words

  Futurist Known as FM-2030 Is Dead at 69

July 11, 2000 – By DOUGLAS MARTIN – U.S. – 862 words

  The Way We Live Now: 4-22-01: Design; Freezing Time

April 22, 2001 – By Abby Ellin – Magazine – 836 words

  BASEBALL; Fight for Williams’s Remains

July 7, 2002 – 186 words

  BASEBALL; With Cryonics, Hope Runs Ahead of Reality

July 9, 2002 – By PHILIP J. HILTS – Sports – 755 words

  BASEBALL; Ted Williams’s Son No Stranger to Controversy

July 9, 2002 – By RICHARD SANDOMIR – Sports – 802 words

  Even for the Last .400 Hitter, Cryonics Is the Longest Shot

July 10, 2002 – By MICHAEL JANOFSKY – Front Page – 1626 words

  BASEBALL; Friends Say Williams Wanted to Be Cremated

July 11, 2002 – By RICHARD SANDOMIR – Sports – 737 words

  Freezing Time; Ted Williams

July 11, 2002 – Opinion – 393 words

  Casting a Cool Eye on Cryonics

July 11, 2002 – By JESSE McKINLEY – Arts – 570 words

  BASEBALL; Williams’s Daughter Asks For Aid Against Freezing

July 12, 2002 – 451 words

  Ideas & Trends: Just Chillin’; Putting Mortality on Ice

July 14, 2002 – By HENRY FOUNTAIN and ANNE EISENBERG – Week in Review – 1096 words

  They’ve Seen the Future and Intend to Live It

July 16, 2002 – By BRUCE SCHECHTER – Technology – 1228 words

  BASEBALL; Executor Says Williams’s Will Doesn’t Give His True Wishes

July 17, 2002 – By RICHARD SANDOMIR – Sports – 1110 words

  BASEBALL; Note Dated 2000 Says Williams Wanted His Remains Frozen

July 26, 2002 – By RICHARD SANDOMIR – Sports – 1153 words

  BASEBALL; Daughter to Continue Fight to Have Williams Cremated

July 27, 2002 – By RICHARD SANDOMIR – Sports – 515 words

  Daughter May Drop Fight Over Ted Williams’s Body

December 20, 2002 – By RICHARD SANDOMIR – Sports – 410 words

  BASEBALL; Williams Children Agree to Keep Their Father Frozen

December 21, 2002 – By RICHARD SANDOMIR – Sports – 974 words

  BASEBALL; Report Says Facility Beheaded Williams

August 13, 2003 – By RICHARD SANDOMIR – Sports – 760 words

  BASEBALL; Ted Williams Tale Gets Stranger by the Day

August 14, 2003 – By RICHARD SANDOMIR – Technology – 1000 words

  No Charges Against Williams’s Kin

August 19, 2003 – By Richard Sandomir – Sports – 281 words

  Odd Outpost of Icy Immortality in Sunshine State

October 14, 2003 – By RICHARD SANDOMIR – U.S. – 1040 words

  John H. Williams, 35, Ted Williams’s Son

March 10, 2004 – By RICHARD SANDOMIR – Obituaries – 314 words

  Sports Briefing

March 14, 2004 – 405 words

  SPORTS BRIEFING: COURT NEWS; Ted Williams Legal Fight Comes to an End

June 17, 2004 – By Richard Sandomir – Sports – 299 words

   INSIDE THE NEWS; Please Don’t Call the Customers Dead

February 13, 2005 – By RICHARD SANDOMIR – Health – 2066 words

[1] Guaranteed in practice means cash in hand, or equivalent – a bond, property transfer, etc.


[2] I met with John Henry during this period and repeatedly urged him to immediately complete the core Alcor paperwork and provide the minimum funding required. I shared with him my experience in caring for hemodialysis patients with medical histories similar to that of his father, and explained that an unexpected infection, or sudden cardiac arrest could occur at any time – and that his father was at extraordinarily high risk for both.

[3] Given the recent history of large enterprises such as Wall Street Investment Banking firms and major Western Banks and mortgage franchises, this statement is probably grossly unfair!

Posted in Cryonics History, Cryonics Philosophy, Culture & Propaganda, Culturomics | 11 Comments

Poisoning the Well: Measuring the Cultural Penetration of Cryonics Using Google Ngram Technology

By Mike Darwin


The lighting-speed evolution of information technology has made new tools available to cryonics that would formerly have been so costly, that only the largest enterprises could have made use of them. And recently, a new technology has emerged that arguably no enterprise, with the possible exception of nation-states, could have mustered the resources to access. In December of 2010 Google, without fanfare, and with virtually no media announcements, released a search tool it calls Ngram.

For the better part of the past decade Google has been “quietly” scanning millions of books, with the objective of scanning the entire written human library by the mid-21st century. Their progress to date is rumored to be in the range of 15 million books, or ~12% of all books ever published. Beyond an acknowledgement from Google that they are using optical character recognition technology, other details of how they are achieving this feat has been a source of intense speculation, as has the rate at which their progress is increasing (as a result of improved mastery of  the “learning curve,” and continued technological advances in computing, imaging and robotics).

What can you do with ~ 15.2 million books and ~ 25 billion digitized words in English, French, Spanish, German, Russian, Chinese and Hebrew? The obvious thing would be to sell the books in digital format on line. Almost all of the books that have been written are not only out of print; they are often notoriously difficult and time consuming to access. And when they are accessed, they become vulnerable to loss. But of course, copyright and other legal issues create substantial handicaps to such a direct sales approach, although Google appears to be working to successfully overcome this.

Culturomics: A New Discipline Emerges

So, book “sales” and book preservation aside, what can you do with all that data? As it turns out, you can found a brand new discipline, “culturomics,” that makes any survey mechanism or market research antiquated, for determining the durable penetration and life history of an idea, product, or person in human intellectual history. Just 3 months ago, Michel, et al., published the paper founding the new discipline of culturomics in Science, entitled, “Quantitative Analysis of Culture Using Millions of Digitized Books.”[1] The authors selected 5,195,769 digitized books (~4% of all books ever published) from Google’s cache of 15 million (and growing) based upon the quality of the scans, and their ability to obtain the necessary relevant metadata, such as the year and place of publication. This is a staggering amount of data, and even using large numbers of humans to perform searches, the sheer quantity makes it impossible. As the authors point out, if a single individual “were to try to read only English-language entries (in the corpus of the books they used) from the year 2000 alone, at the reasonable pace of 200 words/min, without interruptions for food or sleep, it would take 80 years.” To get an idea of what is possible with this technology, look at Figure 1, below, which is taken from the Michel, et al., Science article.

Figure 1: The enormous power of culturomics to track not only the penetration of ideas in a culture, but their durability and dynamics, is illustrated above. It is also possible to measure how rapidly ideas are adopted, how rapidly they are forgotten or discarded, and how they interact with each other, all as function of time, and even place.

Examples of the kinds of data than can be mined using this technology and the Google Books database are, as shown in Figure 1, above, that the names of celebrities faded twice as fast in the mid-1900s and they did in the early 1800s. Similarly, while the mean time to adoption of a novel technology required 66 years in the early 1800s, by 1880 that number had declined to 27 years. The common perception that “things are moving faster and faster” in terms of the turnover rate of cultural content is well supported by these data. Contrawise, it is also possible to evaluate the extent to which ideas can be suppressed in a culture, either directly by the actions of nation-states, or indirectly by social, cultural and political trends that operate as a result of the introduction of new ideas, the rise and fall of religious or political ideologies, or just about any other factor you can identify, and subject to measurement.

Figure 2: Effect of political, ideological and nation-state enforced suppression on “targeted” individuals, and on intellectual activity in general, during the period of Nazi domination of Germany.

Not surprisingly, one of the examples Michel, et al., chose as an example of “suppression” was the savage censorship in Nazi Germany that began with the book burnings of 1933, and ended with the defeat of the Third Reich in 1945. They tracked the names of a selected group of individuals known to be distasteful to the Nazi Party, for instance the Impressionist and Abstract painters Henri Matisse and Pablo Picasso, as well as the architect Water Gropius. Not unexpectedly, the data showed a huge suppression of the mention of these men and their work in German language publications for the duration of the Third Reich (Figure 2B, above). However, unexpectedly, and perhaps far more interestingly, they found that the period of Nazi domination of the culture was associated with a global depression of virtually all artistic, cultural, political and literary activity within the Third Reich (Figure 2A, above). The thick red line in 2A, above, is the frequency of the occurrence of the word “Nazi” in German language books during this period. Obviously, it was a good time for that word – so good, that perhaps there was an insufficient supply of a, z, n, and i type to allow for others works to be published during this time.

Figure 3: (at left) Impact of two nation-states and their ideologies on the frequency of mention or credits given to individuals considered ideologically dangerous. In the former Soviet Union, in Russian texts (A), (with noteworthy events indicated): Trotsky’s assassination (blue arrow), Zinoviev and Kamenev executed (red arrow), the Great Purge (red highlight), and perestroika (gray arrow). In the United States (B) during the McCarthy era and the Cold War, a group of film directors and screen writers, the “Hollywood Ten,” were blacklisted (red highlight) from U.S. movie studios. Their visibility in print declined (median: thick gray line) and none were credited on any motion picture in the US, until the 1960’s.

However, lest we become too self-satisfied at the poor performance of the Nazis, we would do well to take a look at Figure 3. The suppression of the names of Trotsky, Zinoviev, and Kamanev, as they fell out of favor in the former Soviet Union, and the suppression of the (visible) work product of the “Hollywood Ten,” should clearly demonstrate that this kind of activity is a commonplace across cultures. The blacklisting of the Hollywood Ten, and many other creative talents in Hollywood, occurred as a result of these writers and directors being cited for being in contempt of Congress for refusing to give testimony to the House Committee on Un-American Activities. The executives of all of the principal movie studios at that time, acting under the umbrella of their trade association, the Motion Picture Association of America (MPAA), fired these artists in the now infamous “Waldorf Statement,” issued by MPAA President Walter Johnson from the Waldorf Astoria Hotel in New York City on 03 December, 1947.

Culturomics and Cryonics

Culturomics is powerful stuff, really powerful stuff, and I believe it can be of considerable use in cryonics, especially as the Google database expands into periodicals.[1] I have just begun to explore this tool, and while I am certainly no expert in this area, my preliminary forays have proven interesting to me, and I hope will be of interest to you, as well. Best of all, you can do your own analyses by going to: http://ngrams.googlelabs.com/ A few words of caution: search terms are case sensitive, should be comma separated (no spaces between commas and the next search term), and the choice of search terms can dramatically affect outcome; for instance “Jesus “vs. “Jesus Christ.”

In order to minimize injecting more bias into my analysis than that which will necessarily already be there, the first thing I did before attempting any interpretation of the Ngram data relating to cryonics, was to decide what events in the history of cryonics I thought were most important, and that were also publicly visible (i.e., documented in cryonics, or other publications). This is necessarily a subjective thing, but I felt it was important to do this before looking at the Ngram generated data. My list of significant events is in shown in Table 1, above.

Figure 4: The frequency of the occurrence of the word cryonics in all books published from the period 1965 through 2005, as determined by a Google Ngram search. (A) Publication of The Prospect of Immortality in 1964, (B) Cryonics Reports Begins publication and the various Cryonics Societies are formed, (C) Cryopreservation of the first man, James H. Bedford, (D) Publication of We Froze The First Man, and a spate of media-visible cryopreservations, (E) First Annual National Cryonics Conference held in 1968 attracts widespread media attention, (F) In 1973, Trans Time, Inc., (TT) and its partner non-profit, the Bay Area Cryonics Society (BACS) become active in the San Francisco Bay Area and attract national media attention, while Alcor and its for profit Manrise Corporation, become active in Southern California, developing much of the perfusion platform used by TT, (G) Trans Time peaks in media & marketing activity, having launched the bulk of its marketing efforts by this time, (H) The Chatsworth Scandal becomes public, resulting in strongly negative international media coverage, (I) Alcor becomes reactivated, begins publication of Cryonics magazine and there is the public debut of “scientific-medical” cryonics, with images released to the media showing cryonics as a medical procedure; photos of cryonics patients are no longer used for promotional purposes, (J) The Cryonics Institute begins to be more media-visible with articles and images appearing in the national media. Emphasis on CI’s lower price begins to become a source of comparison with Alcor, (K) the Dora Kent incident occurs with a resulting firestorm of international media coverage, followed by the Thomas Donaldson lawsuit against the Attorney General of the State of California, (L), Alcor shifts the paradigm of communicating cryonics to the public by redefining death and providing extensive, and technically detailed information packages to media, and to those members of the public who inquire; Cryonics Reaching for Tomorrow is published, and used as the core promotional tool by Alcor, (M) Jerry Leafs experiences sudden cardiac arrest from a heart attack in 1991, and is cryopreserved, (N) Schism of Alcor, and subsequent creation of CryoCare and CryoSpan as competing cryonics organizations in 1992, (O) Demise of CryoCare and CryoSpan in 1999-2000 (effective end of scientific cryonics), (P) Baseball Hall of Famer Ted Williams is cryopreserved by Alcor in 2002, (Q) Ben Best becomes President of the Cryonics Institute, (R) A story in Sports Illustrated alleges Williams was mistreated at Alcor, the story become international in scope, and the ongoing litigation amongst the family over issue of Williams’ cryopreservation is further highlighted .

The next step was to do the Ngram plot of the word cryonics, and then apply the dates, the results of which you see in Figure 4, above. While the impact of some of the events I chose is arguable, in a number of instances the data seem to confirm these events as having had a material effect on the penetration of word (and thus presumably the idea) of cryonics in books written from 1964 to 2005, the period for which Ngram data are available. The publication of The Prospect of Immortality in 1964, and the subsequent period of public cryonics promotional activity that continued up until 1969, are clearly visible in A-E. The next fairly unequivocal uptick in activity is associated the public debut of Trans Time, Inc., in 1973, as represented by  G in Figure 4. Trans Time aggressively marketed itself and cryonics during the interval of 1974-1960, and was the primary source of media images for cryonics from 1973, until approximately 1982.

Unfortunately, the next unequivocally significant event was H in Figure 4, which represents the loss of the 9 Cryonics Society of California (CSC) patients at Oakwood Memorial Park Cemetery in Chatsworth, California; a fact which became public in 1979. There was a firestorm of media activity surrounding both the discovery of the decomposed remains at Chatsworth, and the subsequent civil trial, which resulted a large judgment against former CSC President Robert F. Nelson, and the mortician who assisted him, Joseph Klockgether.

While those of us involved in cryonics at the time knew this event had an enormous negative impact on cryonics, I confess I am stunned to see it so dramatically confirmed, as measured by a variable so removed from day-to-day media activity, such as the publication of books, and the words (and thus subjects) discussed in them! While we cryonicists were aware that the number of people being cryopreserved declined to almost nothing during this interval, and we were inescapably aware of the effect the Chatsworth debacle had on the opinion the public held of cryonics (because we received so much angry and ridiculing criticism), I don’t believe that any of us understood the sheer magnitude of the negative impact on cryonics it had in terms of  the culture as a whole. That is clearly apparent in the culturomic measurement during the intervals represented by H- L in Figure 4, and interestingly, in Figure 6, below.

I think it’s fair to argue that the events during the time interval of 1981 through through ~1991 (I-L), were in significant measure responsible for the post-Chatsworth recovery of cryonics’ cultural impact. There also seems to be a clear negative effect resulting from the schism of Alcor in 1992 – but subsequent events, including the dissolution of CryoCare and its brother organization CryoSpan, in 1999-2000 (M-O), seem to have had no impact.

The next unequivocally significant event would appear to be the cryopreservation of Baseball Hall of Famer Ted Williams, in 2002 (P). After the expected lag time, there is a surge of cultural impact for cryonics, followed by a sharp downturn in 2003 (R), which is undoubtedly a function of the negative publicity concurrent with the publication of the Sports Illustrated and ESPN exposes’, which happened at this time. Presumably, the resulting loss of credibility of cryonics as a serious idea – or at least one which could be used in novels, and discussed in non-fiction (science oriented) books without evoking concerns over censure, or negative media stereotypes interfering with it being taken seriously as a plot mechanism, resulted from this period of sustained and adverse publicity (which continues to this day).

The “Splendid Splinter:” Ted Williams (right).

By the measure of culturomics, the immediate impact of the cryopreservation of Ted Williams, under circumstances which called into question the veracity and justification for the procedure, was incredibly damaging. While there are no data beyond 2005, if the downturn in activity seen in Figure 4 is sustained for even a year or two longer, then this event will rank with Chatsworth as being one of the most injurious things to happen cryonics in its 47 year long history. One wonders if the Directors and Officers of Alcor at that time, who were so seduced by Williams’ celebrity, and the perceived opportunity for favorable publicity for Alcor and cryonics, will be held accountable for abandoning the long standing and time tested procedures for accepting at-need cryonics cases? While there is truth to the old adage that “any press is good press,” these data are proof positive that really bad press, particularly when it alters the public perception of the morality of an undertaking, is nothing short of a disaster. By contrast, the Dora Kent incident, in which cryonics personnel were wrongly (but nevertheless very publicly) accused of murdering a patient, and indeed of decapitating her whist she was still alive, had essentially no adverse impact, and appears to have resulted in a favorable culturomic effect on cryonics. The difference presumably being that in the Dora Kent case, the follow-on to the negative media firestorm, was a general realization that the whole affair was consequence of incompetent blundering on the part of law enforcement. In the Williams case, the internecine battle amongst family members, and the poor quality of documentation submitted by his son and daughter to demonstrate his personal desire for cryopreservation, clearly left the public, and that subset of it that writes books, with grave concerns.

Figure 5: Ngram of the words” Cryonics Institute”(CI)  plotted against that of  “Alcor Life Extension Foundation” (Alcor). As can be seen, Alcor is apparently in very serious trouble, and in all likelihood CI has become the more commonly mentioned cryonics organization in the interval between 2008 (when they are about to intersect) and the present (2011).

The Google Ngram is unarguably a way for cryonics organizations to monitor the effectiveness of their literary (cultural) penetration, and if there was any doubt about the decaying position of Alcor, then at least in this regard, the issue is settled by the data in Figure 5, above. It would be fascinating to add to this graph a plot of the respective dollar amounts each organization has spent on public relations and related activities, as well as the respective annual across the board expenditures of both organizations. Of particular interest would be using culturomics to evaluate the effectiveness of public relations firms “image and marketing remakes” on cryonics, such as the costly efforts by WalshCom, Inc., (http://www.walshcom.net/) to recast Alcor’s approach to marketing cryonics to the masses.

Figure 6: Two terms competing for dominance: the Ngram of cryogenics vs. cryonics from 1965 through 2005.

In Figure 6, it is possible to see how the word cryogenics, which is often conflated with cryonics, “competes” with it over time. While cryogenics is a valid and commonly used scientific term, it is often mistakenly used to denote cryonics. There is clearly a spike in activity in the word cryogenics from 1965 through 1971-72, and this may reflect its increased use during the heyday of the space program in the early to mid-1960s, compounded by the advent of cryonics. The damage done to cryonics by the Chatsworth debacle is of course, reflected in this Ngram, since the gains the word cryonics was making on the word cryogenics are reversed in the early 1980s, at precisely the time Chatsworth’s effects are seen in Figure 4. This kind of “disparate analysis,” showing the same data in juxtaposition to a similar word, cryogenics,  provides additional evidence that the negative effect of Chatsworth is real. When I entered “cryonics” and “cryogenics” as Ngram search terms, I had no idea I would see the “suppression” of  the word cryonics relative to the word cryogenics, that I observed.

Figure 7: An NGRAM plot of the words cryonics, fusion power, life extension and physical immortality. Fusion power peaked in its cultural domination between ~ 1977 and 1982, after becoming a scientific “darling” in the 1970s, in large measure as a result of the “energy crisis” secondary to the Arab oil embargo of 1973.[19]

Figure 8: An Ngram plot the same as per Figure 7, above, but with the terms “solar power”  and “vitrification” added to the mix. In this case, solar power is making a comeback, following the decline in its cultural penetration after the “energy crisis” resulting from the Arab oil embargo in 1973.[19] Vitrification, which is term that has been in wide used in metallurgy, physics and materials science, begin to experience a marked increase in use after the introduction of the idea of cryobiological vitrification in the mid-1980s.

Ngram plots also allow for comparison between diverse ideas and technologies competing for attention within the culture at any given time. In Figure 8, the terms cryonics, fusion power, life extension, vitrification and solar power are compared. Vitrification is also the term used to described the solidification of metals, water, and other materials absent crystallization in non-biological contexts, and this can be seen as a steady rate of the occurrence of its use from prior to ~ 1965 until the late 1980s. The seminal papers proposing vitrification as an approach to cryopreserving biological systems by Fahy, et al., were published in 1984-86.[20, 21] and several years later the term begins to experience increased frequency of use, a trend which continues through 2005, and likely through the present.


The continued exponential growth in computing and information handling capacity has led to the ability to manipulate cultural datasets so large that they were previously inaccessible for analysis. This will likely have profound implications for human institutions, both large and small. In the currently tiny sphere of cryonics, this technology seems to offer sufficient precision and sensitivity to allow it to be used as a retrospective tool for evaluating the effect of a range of historical events on the penetration of cryonics (the word and the idea) into the culture. It seems likely that, factoring in the observed lag times for past events until their effect is seen (~2 years), that it may be possible to use this tool prospectively, as well. An interesting and unresolved question will be the possible impact of e-books on shortening the lag time between historical events and the materialization of their consequences in the culture.


1.            Michel J, Shen, YK, Aiden, AP, Veres, A, Gray, MK. Google-Books-Team, Pickett, JP, Hoiberg, D, Clancy, D, Norvig P, Orwant, J, Pinker, S, Nowak, MA, Aiden, EL.: Quantitative analysis of culture using millions of digitized books. Science 2011, 14(331(6014)):176-182.

2.            Ettinger R: The Prospect of Immortality: http://www.cryonics.org/book1.html. New York City: Doubleday; 1964.

3.            Kent S: Cryonics Reports 1966, 1(3):4-5.

4.            Wainwright L: The cold way to new life: http://books.google.co.uk/books?id=aVYEAAAAMBAJ&printsec=frontcover&source=gbs_atb#v=onepage&q&f=false. LIFE 1967, 62(4):16.

5.            Stanley S, Nelson, RF.: We Froze the First Man: http://cryoeuro.eu:8080/download/attachments/425990/WeFrozeTheFirstMan.pdf. New York City: Dell; 1968.

6.            Perry R: Suspension Failures: Lessons from the Early Years: http://www.alcor.org/Library/html/suspensionfailures.html. Cryonics 1992 updated June 2010, 13(2):5-16.

7.            CSNY: Proceedings of the First Annual National Cryonics Conference: http://cryoeuro.eu:8080/download/attachments/425990/Proc1stAnn+Cryo+ConfNYC1968.pdf. In: First Annual National Cryonics Conference: 1968; New York City: Cryonics Society of New York; 1968.

8.            Allen W: Sleeper. In. USA: United Artists; 1973: 89 min.

9.            TransTime: Introduction to Trans Time, Inc: http://www.transtime.com/ttinc.htm. In. San Leandro; 2003.

10.          Kunen J, Moneysmith, M.: Reruns Will Keep Sitcom Writer Dick Clair on Ice-indefinitely: http://www.people.com/people/archive/article/0,,20120770,00.html. People Magazine 1989, 32(3).

11.          Quaife A: Cryonic Interment Patients Abandoned. The Cryonicist! 1979, October (11).

12.          Babwin D: Coroner says lethal dose of drugs killed cryonics case figure. In: The Press Enterprise, Riverside County, CA. Riverside; 1988.

13.          Wowk B, Darwin, M.: Cryonics Reaching for Tomorrow. Riverside, CA: Alcor Life Extension Foundation; 1989.

14.          Darwin M: Jerry Leaf enters cryonic suspension: http://www.alcor.org/cryonics/cryonics9109.txt Cryonics 1991, 12(9):19-25.

15.          CryoCare: http://www.cryocare.org/index.cgi

16.          Best B: A history of cryonics: http://www.benbest.com/cryonics/history.html. In. Detroit: Ben Best; 2006.

17.          Hancock D: Ted Williams Frozen In Two Pieces, Meant To Be Frozen In Time; Head Decapitated, Cracked, DNA Missing – CBS News: http://www.cbsnews.com/stories/2002/12/20/national/main533849.shtml. In: CBS News. New York: CBS News, New York City; 2003.

18.          Johnson L, Baldyga , S. : Frozen: My Journey into the World of Cryonics, Deception, and Death, vol. : Vanguard Press 2009.

19.          Barsky R, Kilian, L.: Oil and the Macroeconomy Since the 1970s: http://www.sais-jhu.edu/bin/u/r/R_Oil_and_the_Macroeconomy.pdf. Journal of Economic Perspectives 2004, 18(4):115-134.

20.          Fahy G, MacFarlane, DR, Angell, CA, Meryman, HT.: Vitrification as an approach to cryopreservation. . Cryobiology 1984, 21(4):407-426.

21.          Fahy G: Vitrification: A new approach to organ cryopreservation. Prog Clin Biol Res 1986, 224:305-335.

[1] Without question, one of the most urgent priorities is to digitize newspapers and their “morgues;” the huge reservoirs of photographs, cuttings and source materials that newspaper keep on hand as resource and research material (and which have virtually proprietary or  “secret” status). The demise of the newspaper and magazine industries is leading to massive and irretrievable losses in both the original newspapers themselves, as well as in the loss of morgue material, as failing newspapers can no longer afford the overhead of storage, and send this material to the dustbin.

Posted in Cryonics History, Culture & Propaganda, Culturomics | Tagged | 7 Comments

Last Aid as First Aid for Cryonicists, Part 5

By Mike Darwin

Cooling as the First Last Aid

Unarguably one of the simplest, and also the most powerful and effective cryonics first aid measures, is to cool the patient.  At first glance, this would seem to require little in the way of preparation. After all, how hard is it to get ice and put it on the patient? The answer depends on the answers to two other questions: “How quickly do you want it done” and “where do you live?”

In cases of unexpected cardiac arrest, much valuable time can be lost running out to get ice. In many cases, the next-of-kin or the person on the scene cannot do this, because they must wait for the hospice nurse, the Coroner/Medical Examiner (C/ME), emergency medical technicians (EMTs), paramedics, or the patient’s physician to arrive and pronounce medico-legal death and/or release the patient from the C/ME system. There is also the obvious consideration that most people don’t have 30 pounds of ice in their home freezers, let alone 300 pounds. Even if you live down the street from a 24-hour convenience store well stocked with ice, it will take at least 20 minutes to go there, purchase the ice, transport it home, and pack it effectively around the patient. (Pay attention to that word effectively; more on that shortly.)

An Alternative to Ice?

In Europe, and most of the rest of the world, there is an added problem which severely compromises fast and effective cooling, principally that ice is simply not available most of the time, and is virtually never available in quantity, without advanced notice and preparation.  Even well traveled North Americans seem unable to internalize the understanding that in most of the rest of the world, ice is a rare commodity, and it is viewed neither as a luxury, nor a necessity. What’s more, this is not simply a matter of the relative wealth of nations, but rather is rooted in cultural differences. The abundance of 24-hour retailers selling ice in North America is an artifact of North American culture and tastes. Wealthy nations, with an arguably higher standard of living (unarguably, if you consider mortality and morbidity to be the ultimate yardstick), have neither water ice in quantity, nor 24-hour convenience stores. London, one of the undisputed great cities of the world, has few 24-hour shops and virtually no easy access to ice in quantity, day or night. The same is true of Moscow, Mumbai, Munich, and Paris.

Another factor to consider is that per capita, vastly fewer non-North Americans have private transportation, and in many of the big cities of the world, including London, most or even all mass transit stops at midnight, and does not resume until 0400 or 0500.

The growing number of cryonicists living in these environments needs a workable alternative to ice, and they need a realistic approach to getting help in an emergency, because another problem that is especially acute for cryonicists in Europe is that they live quite far from each other. They are also handicapped by the fact that there are no full time personnel or often even volunteers available to help. Thus, having a workable, immediately available alternative to ice is essential.

Even in the US, cryonicists living in remote areas, small towns, or who face logistical problems in getting ice in an emergency would profit from having an “instantly” available source of refrigerant that did not require a dedicated freezer, or consume all the household refrigerator’s freezer capacity. Elderly cryonicists, and others at high risk of unexpected of cardiac arrest who cannot maintain a dedicated freezer full of ice (and change it out regularly), could also benefit greatly from an always ready ice-substitute with an indefinite shelf life.

Ice (or more properly water) has enormous heat absorbing capacity in the form of its latent heat fusion (333.55 kJ/kg)[1] and I want to make it clear that there is really nothing else that can compete with ice as a safe, practical refrigerant for inducing hypothermia in cryopatients.  In other words, ice is always the first choice for use in cooling cryopatients when it is available.

When ice isn’t available, or going out to get it would delay the start of cooling, the next best thing is ammonium nitrate and water. When ammonium nitrate is mixed with water, an endothermic (heat absorbing) reaction occurs, which absorbs 26.2 kJ of heat per mole of ammonium nitrate. This happens because ammonium nitrate, like any salt dissolving in water, breaks into its constituent ions, in this case the ammonium and nitrate ions, which absorbs energy from their surroundings. The formation of new bonds between these ions and surrounding water molecules then releases that energy. However, since ammonium and nitrate ions are relatively large, the water molecules have relatively weak interactions with their diffuse charges. So, with little thermodynamic payback during this bond formation, the immediate effect of adding water to ammonium nitrate is to reduce the temperature of the mixture to about 0.5ºC (33ºF).[2]

A mole of ammonium nitrate is 80 grams, so if we compare ammonium nitrate to the heat absorbing capacity of melting ice, the comparison is surprisingly favorable, with ice absorbing 26.68 kJ of heat per 80 grams, compared to 26.2 kJ for ammonium nitrate. Of course, this analysis omits three important points, namely that 120 grams of water are required for each 80 g of ammonium nitrate, the specific heat of water (4.18 J g−1 K−1 cp for water (liquid) at 25ºC) is almost as twice as high as a 40% ammonium nitrate and water mixture (and thus is better able to absorb heat), and that the lowest point that a water-ammonium nitrate slurry reaches is 0.5ºC, as opposed to 0 degrees C for ice (and in practice the temperature is actually ~+3ºC as opposed to 1.5 to 2.0ºC for ice under real-world working conditions).[3],[4]

Figure 1: Instant cold packs use a binary system of ammonium nitrate (NH4NO3) and water. The product is activated by squeezing (and thus rupturing) the inner bag containing the water, initiating dissolution of the NH4NO3 prills (which are porous). NH4NO3 undergoes and endothermic (heat absorbing) “reaction” as it dissolves in water. The typical chemical cold pack quickly reached a temperature of 0.5ºC, which is maintained for ~30 minutes. There is a modest increase in cooling capacity if these cold packs are chilled before use.

Ammonium nitrate cooling packs are a staple in first aid kits, and are widely used in athletics for primarily the same reason they should be used in cryonics: delay in cooling, even a slight one, reduces the effectiveness of hypothermia in mitigating injury. It is better to have a more costly, slightly less efficient product immediately available, than to lose valuable time after an injury going for ice. The most widely available “instant cold pack” product is Kwik Kold,™ manufactured by the health care giant Allegiance. Kwik Kold™ is a binary product consisting of an outer plastic bag which contains small (1-2 mm) pellets of porous ammonium nitrate (prills ) and another bag that contains water. The product is activated by squeezing and bursting the water packet, and then mixing it with the ammonium nitrate, to begin the endothermic reaction.

Kwik Kold has a number of drawbacks, the first being its high cost. Ammonium nitrate is one of the least expensive bulk chemicals in the developed world, since it is most widely used as fertilizer. A case of 50 6” x 9” Kwik Kold packs retails for  ~$165.00 US, and several cases would be necessary in situations where there would be a long delay to obtaining water ice.[5] By contrast, purified ammonium nitrate purchased from scientific suppliers would cost about a third as much, $18.00 US/kg, and ammonium nitrate purchased as fertilizer would cost only $0.50 per kg. Because ammonium nitrate has been used as an expedient explosive in terrorist bombs in the US and elsewhere (ammonium nitrate was the principal explosive used by Timothy McVeigh in the Oklahoma City bombing of the Murrah Federal Building) it can typically only be purchased in agricultural form as a bulk product in 22.73 kg (50 lb) bags, and most retailers require documentation of the end-use – and often will refuse to sell it, except to known parties (farmers or agricultural concerns in their area), or to businesses with a substantial history (both credit and operational) as well as a credible use for the product.

Figure 2: Coarse mesh polyester lingerie laundry bags are ideal for holding both NH4NO3 prills and water ice. They are inexpensive and widely available in a variety of sizes and shapes. The bag shown above was purchased at Walmart for less than a dollar. A penny coin is shown for scale.

It is desirable to obtain ammonium nitrate in bulk not only because of of its affordability, but because it is desirable to repackage it for cryonics applications. Because Kwik Kold and similar products are dispensed in plastic bags, the refrigerating ability of the ammonium nitrate-water mixture is greatly reduced. The plastic bags limit the area of contact between the patient and the refrigerant, create micro-environments of stagnant (non-conducting) air between the bags and the patient’s skin, and slow dissolution of the ammonium nitrate in water.  Ideally, the ammonium nitrate should be packaged in coarse-mesh (see Figure 2, above) bags through which water can be continuously recirculated over the patient’s head, as shown in Figure 3, below.

This simple device can be easily fabricated from off the shelf items available at most Wal-Mart (Asda or Tesco in Europe) and hardware stores, such as Home Depot, for about $90 US.  This device, as well as its other applications, will be discussed in detail shortly. For now, it is sufficient to point out that the problem of purchasing bulk quantities of ammonium nitrate inexpensively needs to be solved, if for no other reason than because of the greatly increased efficiency of cooling that can be achieved. In a situation where ice may be unavailable for 12 to 24 hours, 20 to 30 kg of ammonium nitrate may be needed to hold the patient’s temperature near 0ºC. This would be cost-prohibitive for most cryonicists unless fertilizer prills are available.

Another advantage to custom packaged ammonium nitrate is that it can be stored indefinitely in air tight containers. Ammonium nitrate in instant cold pack products slowly absorbs moisture from the air, and from water vapor migrating through the plastic of the internal water reservoir bag. This results in some loss of heat absorbing capacity, but more importantly, it causes the ammonium nitrate to clump, reducing its surface area, and slowing its ability to absorb heat. Over a period of several years (depending upon storage conditions) most of the water may be lost from the water reservoir bag due to evaporation through the plastic. This would necessitate the removal of the ammonium nitrate to another bag, and the addition of a precise amount of water; hardly an acceptable option in an emergency. Nevertheless, unless and until bulk quantities of ammonium nitrate become available for last aid applications, Kwik Kold and similar products are definitely preferable to no ice at all, or to significant delays in initiating post-arrest cooling.

The message here is that there is a viable alternative to ice for non-North American cryonicists, as well those cryonicists in the US who are at high risk of unexpected death, and who cannot maintain a dedicated freezer for storage of ice (which must also be replaced frequently to prevent re-crystallization and consolidation).

Figure 3: Schematic of a simple head refrigeration device employing nylon mesh bags filled with NH4NO3 prills through which water is recirculated. This allows for cooling with about the same efficiency as if water ice were used. See Figures 14-16, below.

The Basics of Effective External Cooling

The first requirement for maximally effective external cooling is that all of the surface area of the patient be continuously in contact with refrigerant that is as near to 0ºC as possible. It is not possible to go lower than 0ºC, because the patient would freeze in the absence of cryoprotection. This constraint on the temperature of the refrigerant has profound implications for the rate at which cooling is possible. To understand why this is so, and to understand the importance of uniform and continuous contact of the patient’s skin with the refrigerant, it is first necessary to understand how cooling occurs.

A good place to start is with the simplest situation and the one most frequently encountered in sudden and unexpected arrest, where cardiopulmonary support is not possible. This situation is simple, in the sense that the only kind of cooling that will be possible is external cooling with ice (or another appropriate refrigerant) and cooling of the head/brain will be by conduction alone. This is so because the human head is a solid consisting of gels (skin, muscle, brain) and bone. Convection does not occur in solids, and the kind of cooling we get in such a situation is called non-Newtonian cooling or non-convective cooling. Conduction cooling is comparatively “simple” because the parameters which determine its behavior are fewer than in convective cooling, where there is a complex interplay between conduction, convection and radiation. However, while cooling within the patient’s head is purely conductive, cooling at the interface between the scalp and the other skin of the head will typically be convective, since it will involve not only conduction, but also convection (air movement in a morgue cooler, or liquid movement from melting ice, or even convection of water in an “unstirred” ice water bath).

Very recently, the French forensic pathologists Baccino, Cattaneo, Jouineau, et al.,[6] conducted a series of experiments using pig heads to empirically determine the rate of cooling under a variety of conditions, all of which are of importance to cryonicists. While pig heads are not human heads, the data from this study map the spotty and less rigorous data obtained in human cryonics cases. These data show something that may seem surprising, principally that cooling in an unstirred water bath at 0ºC is not even twice as effective as cooling in a still (unstirred) air bath at 0ºC, as shown in Figure 19 below.

Figure 4: Cooling rate observed in porcine heads subjected to unstirred air or water cooling at 0oC from data by Baccino, et al. [6]

The reason for this is the limitation imposed by the very low value for the heat conductivity of the human head. This has the following important practical implications:

1)         External conductive cooling of the human head/brain is extremely slow, even under ideal conditions of maximum surface contact with ice at 0oC, where the melt water is filmed over the patient’s head.[7],[8]

2) Once the surface of the patient’s head reaches 0oC, the brain cannot be cooled any faster regardless of the type or amount of conductive media used. In other words, using more conductive refrigerating media, or delivering them at higher flow rates than necessary to keep the skin at 0oC, will not work, and may well be counterproductive (i.e., consume limited battery power and cause splashing and aerosolization of potentially biohazardous cooling bath water).[9],[10]

3)         If conditions are less than ideal because of poor contact with refrigerant (and retention of melted ice water in plastic bags) then cooling is slower still, and this is undesirable.

4)         The basic requirement of uniformly cooling the surface of the patient’s head to near 0oC is, in practice, quite difficult to achieve, because holding refrigerant in contact with the patient’s head involves problems associated with melting ice, which is messy, damaging to bedding and furnishings, and can cause a slip hazard if dripped onto the floor. Containing ice (or NH4NO3 –water) in plastic bags results in considerable loss of contact with the skin, and reduces the efficiency of cooling, by causing melt water to be retained; creating a relative convective and conductive barrier. It is also virtually impossible to keep ice bags in position around the patient’s head during movement from one location to another (or for that matter, even when the patient is not being moved as can be seen in Figure 5, below)..

While there is no easy solution to problems 1 and 2 above, there is a solution to problems 3 and 4: an enclosure to hold ice or another acceptable refrigerant around the patient’s head in situations where there is no portable ice bath (PIB). This is a critical component of the Last Aid Kit (LAK), that should also contain a number of basic items to help improve patient care, when a Transport Team is not available. Why is having an “ice holder” to keep ice around the patient’s head so important? Again a look at Figure 5, below, is proof that a picture is worth a thousand words. The patient in this picture is being cooled with ice bags and Kwik Kold packs. As just noted, this cuts the effectiveness of ice dramatically by confining it to bags, and it is also messy, which decreases compliance and creates a real danger of slipping and falling for personnel, when tile or linoleum floors become wet and slick (something that is especially likely in institutions with well waxed and polished floors; and inside ambulances).

Figure 5: Cryopatient on a mechanical heart-lung resuscitator being cooled during transport using ice bags and endothermic chemical cooling packs (Kwik-Kold™).

It is also a waste of valuable personnel. The man in the vest and white shirt in the middle of the picture above was a paramedic and he was not happy about the wet floor in his ambulance. Ambulance companies in many states, and in most European countries, can be used to provide Standby and Transport assistance, as happened in the case above, but they will not be inclined to do so under conditions which expose their costly vehicles, and even more valuable personnel, to water damage.

In fact, ice in bags is such a poor refrigerant that  if your head were a bowl of potato salad, you probably wouldn’t eat it if sat around at room temperature as long as the center of your head will above or at room temperature while being cooled with ice bags—there would be too much of a chance it would have spoiled. Figure 6, below, shows just how bad ice bags are at cooling, both in absolute terms, and relative to immersion in ice water (both stirred and unstirred). Even four and a half hours after the start of ice-bag cooling, the patient’s core temperature is still above room temperature: ~ 24 degrees C!

Leaving aside the grossly inefficient nature of cooling with ice bags, how well refrigerated is the patient’s head in the photo above, and how long can anyone be expected to hold those ice bags in place by hand? This photo is not unique, in fact, to the extent it is unique it is because it shows a diligent effort being made to keep this patient’s head well refrigerated. Unfortunately, many pictures of cryopatient Transports show little or no ice around the patients’ heads and, as is the case here, comparatively poor contact of the ice bags with the surface of the head.

Figure 6: Comparison Of Cooling Methods: Above are actual cooling curves for three adult human cryopreservation patients receiving mechanical CPS support, using ice bags, the Portable Ice Bath (PIB), and the PIB augmented by SCCD (squid) cooling. Patient A-1133 weighed 56.8 kg, patient A-1169 weighed 57.3 kg, and patient A-1049 weighed 36.4 kg. As this data indicates PIB cooling is approximately two times as efficient as ice bag cooling. The SCCD appears to increase the rate of cooling by an additional 50%over that of the PIB (roughly adjusting for the difference in the patients’ body mass).[11]

Increased Convenience = Increased Compliance

Some cryopatients will have minimally cooperative family, or family who are not capable of sustained cooperation due to age, infirmity, or psychological limitations. There have been cases where both husband and wife were signed-up cryonicists, and yet when one arrested the other did not pack the patient’s head in ice with a resultant 4-hour delay until brain cooling was begun.[12] Why? How could this happen? The answer is, because they were provided with neither the tools nor the instructions to respond appropriately. Resources need to be readily at hand, and members need to be repeatedly told what to do in an emergency, and given clear, easy to use instructions on how to do it. While most of you reading this may think yourselves immune to making an error such as leaving your spouses’ head unrefrigerated for ~ 4-hours, you should take into consideration the effects that advanced age, and the emotional trauma of an unexpected loss, might have on you.

Morticians do scarcely any better. What is needed is a simple device and a simple procedure which can be rapidly implemented with supplies on hand – something that the first responder only has to do only once, and from which they can then walk away from, till more skilled help arrives on the scene. If anyone questions the need for this, consider the numbers: historically ~ 30% of Alcor members have arrested with little warning, or no Standby team present. Since the Cryonics Institute does not offer Standby, presumably most of their members could benefit. Most cryonicists will not have a portable ice bath (PIB), and most will have few other resources in an emergency. So, the issue of effective cooling of just the patient’s head is non-trivial, and in practice it can only be accomplished with a device that holds the ice, or other refrigerant, in uniform and direct contact with the patient’s head.

Figure 7: A simple, expedient head ice positioner (HIP) fabricated from a plastic garment storage box and a piece of foam pipe insulation. The thermoplastic typically used to manufacture these materials is notoriously liable to fracture during cutting and drilling. The cutout in the HIP pictured above was made using a (repeatedly) heated disposable box-cutting knife

In its simplest implementation a head ice positioner (HIP) is an open-topped box with a U-shaped cut-out to accept the patient’s head as shown in Figure 7, above. This is easily and inexpensively fabricated from off-the-shelf materials and is certainly better than nothing at all. The HIP above was made from a tall plastic garment storage box (26 x 36 x 36 cm) and a section of polyethylene foam water pipe insulation, at total materials cost of $8.56 US. This design has only one serious functional impediment and that is that there is no provision for draining off ice melt before it reaches the level of the U-shaped cut-out for the patient’s neck. It would also be desirable to have a 20-liter plastic bucket or a 20 liter water carboy to collect the melt water, and allow it to be disposed of in a safe and sanitary manner (water that has been in direct contact with a patient should be treated as biohazardous waste).  The drainage problem can be solved by installing a bung fitting with a threaded hose barb, or a tap near at the bottom side of the container as shown in Figure 8, below, or by installing a hand-pumped siphon device.  A second overflow drain, installed just below the level of the cut-out which can be left open when the patient is not being moved (to allow water to automatically flow into the waste container) can also be incorporated into the design.

Figure 8: Off-the-shelf drain/tap kit of the kind used on ice water dispensers installed on the side of HIP to drain off melt water.

The HIP above is simple and inexpensive and will serve in situations where both personnel and ice or other refrigerant are abundant. In such situations, patient contact with the refrigerant can be facilitated by a dedicated staff or family member, excess water can be drained, and refrigerant can be replenished, as needed. However, this is far from desirable. At very least, this HIP should be equipped with an insulating shroud which reduces heat-leak into the container and conserves refrigerant. Such a shroud can be a fabric “box” with either closed cell polyethylene foam or Dacron “foam” (such as NuFoam) on all sides to provide insulation.

The importance of insulation extends beyond conserving refrigerant and eliminating the mess and hazards associated with condensation. In cases where the patient must be left unattended, such as in a C/ME’s or hospital morgue, insulation is essential to prevent rapid melting of ice by convectively stirred, and much warmer, refrigerated air. Morgue coolers vary in temperature between 4ºC and 15ºC, and typically are set in the range of 7ºC to 12 ºC.  Morgue crypts in some large cities are often poorly refrigerated due to antiquated equipment and limited budgets (the latter resulting in economizing on electricity by keeping the crypt temperature high). It is thus critical to provide as much refrigerant as feasible, and to protect it against avoidable heat leak as much as possible.

Every attempt should be made to cool the core of the patient’s head to as close to 0 ºC as possible, before surrendering care of the patient to third parties, who may have little or no interest in continuing further cooling. Even under the best of circumstances, where the patient’s core (brain) temperature has reached 1-2 ºC, it must be understood that the patient’s body and neck represent a considerable heat sink and, in the case of the neck, a very considerable heat leak into the insulated enclosure of the HIP. These constraints also make it desirable that the HIP be monitored and frequently replenished with refrigerant such that the patient’s head never becomes exposed or uncovered with refrigerant.

Yet another limitation of the HIP just described is that it will not fit into some models of morgue refrigerators. While most end-loading (hatch type) morgue refrigerators have a hatch opening of 50 cm, with an available clearance of ~30 cm, most side-loading units, and some older hatch type units, have much less clearance (~20 cm).

Figure 9: Typical single body morgue refrigerator of the kind commonly used in the US, Canada and the UK.

A more sophisticated implementation of the HIP would not only hold ice or other suitable refrigerant in good contact with the entire surface of the patient’s head, but would also be insulated (excluding the neck opening) to an r-value of ≥ 3.0, with a reasonably compact insulating material that will experience minimal thermal drift over a 10-year lifespan and is non-toxic and non-irritating (acceptable materials would be closed cells foams such as polyethylene or polyester foam (NuFoam), or polyester wool batting (20 oz ). Ideally this HIP would be collapsible, and weigh no more than 5 pounds, so that even the frail elderly can handle and position it. A prototype of this device has been constructed and details will be available here in the near future.

Figure 10: The EZ-Basin in-bed shampoo basin is an inflatable device designed to allow for wet shampooing of bed-fast patients’ hair. It is inexpensive ($20 US), and has the advantage of being flexible, allowing it to be used in morgue coolers and other confined spaces where a rigid HIP will not fit.

Another excellent alternative for use in morgue coolers, or other areas where space is confined, is an inflatable shampoo basin, either used as is, or modified to improve its insulating (and thus ice holding) capability (Figure 10). This secure, form-fitting basin cushions patients neck and shoulders while attendant washes hair. The EZ Shampoo basin, marketed by Medline Industries, is an inflatable basin used for shampooing the hair of people confined to bed. It is based on the same principle as inflatable plastic pools for small children, and measures 28W x 24L x 6D, and folds up for easy storage. The insulating characteristics of the basin can be greatly improved either by filling it with expanding polyurethane foam (which will set hard in a few days), or by making slits in the air cells large enough to allow it to be stuffed with Dacron polyester wool from an inexpensive pillow (Figure 11). The slits can then be closed with vinyl repair material, all temperature foil-backed gutter repair tape, or any other durable, long lasting tape that will not dry out and become brittle over time. If stuffing the EZ-Basin is being done expediently in an emergency, then duct tape may be used.

Figure 11: The EZ-Basin can be made into a more reliable HIP by filling the air cells with either polyurethane foam or Dacron polyester wool. The lack of insulation on the bottom can be addressed by placing a cut-out of closed cell polyethylene foam inside, or preferable securing a slab of the same material to the outside bottom of the EZ-Basin. Adhesive backed Velcro strips are a good way to accomplish the latter, since they allow for the foam insulation to be removed and rolled up for more compact storage.

The EZ-Basin has several disadvantages, which can be overcome with varying degrees of ingenuity and effort. The first is that there is no insulation on the bottom of the basin – just a single ~ 10 mil sheet of vinyl. This can be remedied either by attaching a sheet of 1″ or 1/2″ expanded polyethylene foam to the bottom, or placing a cut out of such foam inside the EZ-Basin, as shown in Figure 11. The second disadvantage is that it is quite shallow, with a depth of only 6″. A reasonably good compromise when using it as a HIP in a morgue cooler is to used bagged, crushed or cubed ice heaped up over the ice that is in direct contact with the patient’s skin. Finally, The EZ-Basin has no insulating top or cover. In an emergency, any reasonably good insulating material can be used to completely cover the top (and preferably the sides, as well) of the EZ-Basin, such as a blanket, fiberglass building insulation, or Dacron polyester wool insulation removed  from a pillow, or purchased from a discount retailer in the form of quilter’s batting. If such open, “porous” insulation is used, once it is in place it should be covered with a sheet of plastic, such as a plastic trash bag, to improve its insulating qualities, and prevent warming of the refrigerant, and the patient’s head, due to air convection from the morgue refrigerator fan.

Figure 12: The EZ-Basin HIP as it would be used in the event of unexpected cardiac arrest in the home on an emergent basis.

The EZ-Basin is available from on line retailers in both the US for ~ $20:


and the UK for ~ 17 pounds:


Making Iceless Cooling  More Efficient: A More Sophisticated Implementation

As previously noted, outside the United States and Canada, ready access to ice is problematic or nearly impossible. The problem with using chemical cooling packs in place of ice is that they rapidly lose their heat absorbing capacity and then become barriers to effective heat exchange. Additionally, since the refrigerating liquid inside the packs is not stirred and is isolated from the skin by a barrier of plastic and often trapped air as well, heat exchange is very slow and inefficient.

The solution to this problem is to construct a device which circulates the water required to drive the endothermic reaction of NH4NO3 prills with water continuously through the NH4NO3 prills and over the patient’s head. Such a device, the CephaCool, is shown in Figures 14 through 16, below.

The implementation showed below uses an inexpensive evaporative (swamp) cooler pump that operates on wall current, and is available at most hardware and large retail outlets for about $15.00 US. However, a better approach would be to use a self contained, cordless, battery operated sump or bilge pump, such as the Attwood Waterbuster Cordless Pump shown in Figure 13, below.

Figure 13: The Atwood cordless bilge pump is a fully submersible pump  that runs up to 5 hours on three alkaline D batteries (6-3/8” high x 5-1/4” diameter).and pumps up to 200 gallons per hour at a head of 4’.

Figure 14: The CephaCool head cooling device is completely made from off the shelf items easily procurable at most hardware and large national retailers such as Target or Wal-Mart ( Asda or Tesco in the UK). The HIP portion of the device is fabricated from an Igloo beverage cooler. The refrigerant bags which hold the NH4NO3 prills are laundry bags used to contain and protect and delicate items of apparel during machine washing at home and available from Wal-Mart or Target. The drain valve, drain ballast and all connecting tubing are lawn watering items and again are available at most hardware stores as well as Wal-Mart and Target. The cushioning foam on the cervical cut-out is standard polyethylene household water pipe insulation of the kind used to reduce the risk of pipes freezing in the winter or to reduce heat loss from hot water pipes. It is available at most hardware and home improvement stores including the large national chain stores such as Lowes or Home Depot.




Figure 15: The circulating pump in this implementation, as previously noted, is a low capacity evaporative cooler water pump. The diffuser ring and the on-off valve controlling flow to the diffuser ring are both lawn watering items readily available at most hardware stores and at Wal-Mart and Target. The interior splash guard was made from vinyl heet goods purchased at Wal-Mart.

Figure 16: The temperature monitors, both the circulating liquid temperature and pharyngeal temperature monitors are off-the-shelf consumer indoor outdoor thermometers. The pharyngeal temperature monitor shown above also has adjustable high and low alarm features. These items typically sell for $12.00 to $15.00 US and are available at hardware, auto supply, home improvement and large national chain discount retailers.

The CephaCool, as shown above, can be assembled from parts totally ~$75.00 US. With the exception of the cervical cut-out, no tools are required to assemble the components into a fully functional device. All items either slip together or are held together with industrial strength Velcro. If the Atwood cordless bilge pump is used in place of an AC evaporative cooler pump (highly recommended for safety reasons and mandatory if NH4NO3 is to be used as the coolant) the cost increases by ~$25.00 to 30.00 (the Atwood retails for ~42.00).

The CephaCool or a device like it, along with a generous supply of NH4NO3 prills should be something that every non-North American cryonics group has as a standard piece of equipment available to members upon request or for a modest fee. Members living outside of North America who are at high risk or who have relatives who are at high risk may want to consider acquiring such a device and keeping at the ready for unexpected emergencies.

How Much NH4NO3 ?

Preliminary experiments indicate that approximately 20-25 kg of ºC are required to cool a 5 kg mass of ground beef to ~4ºC. Another 5 kg is required to cool to 2ºC. Maintenance of temperature at 2-4ºC requires ~0.5 kg per hour depending upon whether or not the circulating pump is run continuously or intermittently. If operated intermittently (2-3 minutes per 30 minutes) the requirement for NH4NO3 prills drops dramatically to ~200 g/hr. It is important to understand that NH4NO3 is not a good refrigerant for maintenance cooling; there is no substitute for ice. However, it can serve as an effective “bridge” cooling material, until ice becomes available.

Cool It!

Of course, none of these tool and techniques is of any use unless they are acquired and made ready. Properly, this should be something advocated and assisted by the cryonics organizations. However, after almost 6 years of urging such actions be taken, the author has given up, and decided that the only course of action is to attempt to communicate the resources and the importance of using them directly to other cryonicists, rather than relying on any intermediary.


1.         Mohr P, Taylor, BN, Newell, DB.: CODATA recommended values of the fundamental physical constants: 2006. Rev Mod Phys 2008, 80:633-730.

2.         Bowen N: Properties of ammonium nitrate, III. J Phys Chem 1926, 30(6):736-773.

3.         CRC: Handbook of Physics and Chemistry, 44th Edition; 1962.

4.         Bothe J, Beyer, KD.: Experimental determination of the NH4NO3/(NH4)2SO4/H2O phase diagram. J Phys Chem A 2007, 111(48):12106-12117.

5.         Cardinal: Kwik-Kold: http://www.cardinal.com/us/en/distributedproducts/ASP/103B.asp?cat=med_surg. 2011.

6.         Baccino E, Cattaneo, C, Jouineau, C, Poudoulec, J, Martrille, L.: Cooling rates of the ear and brain in pig heads submerged in water implications for postmortem interval estimation of cadavers found in still water. Am J Forensic Med Pathol 2007, 28(1):80-85.

7.         Gulyás B, Dobai, J Jr, Szilágyi, G, Csécsei, G, Székely, G Jr.: Continuous monitoring of post mortem temperature changes in the human brain. Neurochem Res 2006, 31(2):157-166.

8.         Brinkmann B, Henssge, C, Schmitt, M, Eilers, U, Wischhusen, F. : Determination of  the time of death by measurement of rectal temperature in cadavers immersed in water. Beitr Gerichtl Med 1984, 42::103-106.

9.         Nelson D, Nunneley, SA.: Brain temperature and limits on transcranial cooling in humans: quantitative modeling results. Eur J Appl Physiol Occup Physiol 1998, 78(4):353-359.

10.       Henssge C, Beckmann ER, Wischhusen, F, Brinkmann, B.: Determination of the time of death by measurement of central brain temperature. Z Rechtsmed 1984, 93(1):1-22.

11.       Darwin M: Transport Protocol for Cryonic suspension of Humans: http://www.alcor.org/Library/html/1990manual.html. Fullerton, CA; 1986.

12.       Best B: The Cryonics Institute’s 82nd Patient : http://www.cryonics.org/reports/CI82.html. 2007.

Ice recrystalizes and consolidates into a more or less solid mass over time which it makes it very difficult to use effectively for cooling and requires expenditure of  a great deal of time breaking it up into useable chunks. This process is not only time consuming but is messy and can can result injury due to haste in an emergency. Ice stored in “frost free” freezers fairly rapidly disappears due to partial melting and vaporization during the heating cycles which occur at ~6-hour intervals. These heating cycles (which vaporize ice that has formed on the refrigerating coils) also very rapidly (days) convert crushed and cubed ice into a sold mass of ice.


Prills are small beads of chemicals or metals made by spraying the material into an environment (spray tower) cold enough to facilitate solidification.

Even when ice is stored in non-frost-free chest type freezers re-crystallization and consolidation of cubed or shaved ice occurs over a period of several months.

The first person in cryonics to consider this problem was the mathematician and cryonicist Art Quaife, who did extensive mathematical modeling of this problem in the late 1970s.

As will be discussed at length later, a head ice positioner (HIP) should be used even when a PIB is available because it solves the problem for how to uniformly circulate cold water over the patient’s head.

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


By Mike Darwin

“There are so many little dyings that it doesn’t matter which of them is death.” – Kenneth Patchen

I remember.  A warm summer day, the smell of her house spilling over through the screen of the aluminum storm door: the smell of barley soup and mothballs and dried rose petals all rolled into one.  And I remember her.

“Grandma, can I come in and play checkers with you?” Her smile, warm and familiar as a sunny autumn day, always beckoned me in. The hours I spent with her! Roaming her basement on cold winter evenings, eating endless bowls of steaming soup and chocolate cake in her kitchen, my cheeks frosted pink from the snowy breeze outside. I loved her. And she loved me. I think the loves of childhood are the best: simple loves, uncritical, filled with hope and pride at a new life entering the world and struggling to make sense of its wonder, and to triumph over it. I know she loved me in that way.

I don’t know when I first realized she wasn’t my grandmother. She had lived next door to us, shared a huge, sprawling yard with us, took vacations with us, canned applesauce with us, and practically lived with us since before I was born. She had been a second mother to my Mother.  Now, she was my Grandmother, and her husband “Papaw” was my “other” grandfather.  When I was three or four, Papaw died, and she became even more a part of our lives.

Oh, oh, those endless, lovely, gilt-edged days of childhood. Silly things come back. A winter’s morning, with the smell of bacon still in the air, Grandma, and Mom and I, sitting round the old gray Formica topped kitchen table, sticking plastic dots on plain drinking glasses to “decorate” them.   One of the innocent pastimes of the 1950′s, which have been swept away in a world of Martha Stewart and Gucci. I remember her arms, her smile, her patience; the hours she spent with me, talking to me, making me feel like the center of the universe.

“Don’t ever call me granny,” she would say, “it makes me feel like an old lady. And even though I am, I can do without being reminded.”  Oh, how I loved her. But time is swift and heartless, and love, if we are to keep it, often asks a high price.

She grew old, my grandmother. There were “incidents.”  She fell down and spent hours on the floor unconscious. She began to repeat herself in conversation. Time. Time was showing its ugly hand. Her son was contacted, and after much discussion and haggling, it was decided she would go to live with him. Her house would be sold, a room would be added to her son’s home, she would move.

She had another family, of course. A son who lived some miles way (scarcely a block away by California standards). A cool and distant man, whom I never liked. His wife, Elva, was more than cool and distant: she was a hostile, hurtful woman, who I never understood. Perhaps she had her reasons. The ways of adults are often lost on children. Life is hard and can bend and twist people in ways that children can’t begin to understand. All I knew was that she was not a loving person, and that she hurt my “Grandma,” who even if she really wasn’t my grandma really was.   I remember once, when Elva and her husband were visiting, Elva went through my grandmother’s house, and informed her of this or that she wanted, when Grandma died. She came to the china set, my grandmother’s pride and joy, and told her that she thought she’d take that now, since she’d get it when Grandma died, anyway. I hated her for that. I hated her for the pain those words caused my Grandma.

I was in my late teens then. A cryonicist. Old enough to know what was going to happen.  I went to see her in her new “home.”  She spent most of her time exiled in that room, cut off from a family who wanted nothing to do with her, who considered her forgetting what she had just said, and then repeating it, not merely an annoyance, but a grounds for exile.  So, she sat, watching soap operas, trying to pass the time.

“I’m so unhappy Mikey,” she told me once, with tear filled eyes.   Seeing her china sitting in Elva’s fancy glass china cupboard provided only the first of many clues as to why that should be. They hated her.   And I do not use that word lightly, or easily. It came across in everything they said and did to her. Chastising her for her forgetfulness, complaining about the crowding of her room, “with things she didn’t need anymore and should just throw out.”

A year or two after Grandma settled in, Elva died. Suddenly, of a heart attack, without a struggle, she was dead.   All that evil just coming to a stop, all at once like that, almost made me believe in God.   The china cupboard was now Grandma’s, she was now the lady of Elva’s house. But she was still not loved. They used her to cook their meals and darn their socks. Used her, needed her, but I am convinced they did not love her.

Time is relentless. One day she could not get up to make their meals. She was put in a nursing home. I was 23 by then, living in Indianapolis, with a cryonics facility of “my” own. I worked in the hemodialysis unit of the city’s largest hospital. I had not been to see my grandmother in a long while. Her son, and “distance,” had separated us more than I should have allowed. When word reached me that she was a in a nursing home, I went at once. Dear god, such a place. People, confused and food soiled, wandering the halls. The odor of urine, feces, and rotting flesh from untreated bedsores was overpowering. There were puddles of human excrement in the halls. I could not find an attendant to tell me where her room was.  But I found her. She was lying, half out of bed, half on the floor, her arms tied to a side rail of the bed with Posey restraints. She was covered, from waist down, with feces. I found an attendant. I demanded towels, water, soap, clean bed linen and a basin. I was still in scrub clothes from the hospital. They were terrified; they thought I was a doctor. They brought me what I asked for immediately. I cleaned her up. All the while she kept crying and saying “Oh Mikey, imagine you hav’in to do this, and you’re not even my own flesh and blood.” I sushed her, put her in her clean bed, sat with her for awhile.

I found the nurses’ desk in that stinking hole of a place and asked to talk to the registered nurse on duty. There was no registered nurse  on duty, there was only a licensed practical nurse to be found. A violation of state law; as if, in that chamber of horrors, it mattered. I asked to see her chart. It contained several notes from her physician complaining about the total lack of care there, and stating that, “he had urged her son to move her elsewhere.”

I returned home in a rage. I called her son. I was afraid that if I drove out to see him, I’d kill him. I told him how I had found his mother. I told him to move her to a decent place. He told me to mind my own business. I complained to the State Board of Health about the facilities.

And then I failed her. I did not go back. I could not go back. I did  not take her out of there. Had I waited. Had I walked in one evening I could have taken her out of there. Just walked out with her withered body in my arms. No one would have seen, no one would have known.  Chances are, no one would have know who to look for, or even where to look. I knew that before I ever made that call to her son.   Had I taken her out of there then and there, before  I  chose  the  other  way of  useless  calls  and  worthless indignation, I could  have saved her. I was something out of  her  past. Someone who shared a love with her that the spiteful and uncaring souls who surrounded her would never have been able to guess at.

Looking back, I know I could have done it. It would not have been easy. It  would  have required  immense  courage  on  my  part,  and  the cooperation  and courage of those around me. But I am convinced it could have been done. That is why I never went back. It is why I drove past that place, the few remaining days she had left and never stopped in.  Because I knew, I knew what I had to do. I knew the risk I had to take, and I didn’t. She would be cryopreserved now, safely with me still, waiting for time, her enemy, to unstill her hands, and set them loose on making applesauce – and sunshine on winter days.

When word of her death reached me it was like a knife through my heart. I did not go to the funeral. I could not go. A part of me was being buried, and I couldn’t stand to watch it.

It can be said that what I failed to do was to kidnap someone.   That the only thing I did was act with sense, and decorum, and within the law. That my own survival was at stake. That I could have gone to prison.  That I would have been jeopardizing everything. That my hands were tied. I thought all those things at the time. I used them as defenses to stop myself from doing what I really knew I had to do. Those excuses are as useless now as they were useless then.  They were and are excuses, but they are not answers, and they do not take away the pain.

Love is precious, it is hard-won, but harder still to keep. It demands much, if we are to be true to it. It is above  legal “justice,” beyond time. But it demands courage, and risk, and action.

No matter how long I live. No matter how many centuries unwind before me, I will carry that failure with me, always. If cryonics works for me, if I waken on distant shores, laughing at time, stepping from century to century like they were slippery, moss choked stones in a creek, I will only be partly there. Deep inside, part of me is missing.   And I let it slip away.  Always, no matter the loves, the times, the distance; part of me will ache and be broken, and there are no salves or medicines, nor any analyst’s couches that can ever fix it. Because of me.  Because I let it happen.

It is a bitter lesson. Deep inside of me, I cannot accept my failure. Deep down, I have not given up yet. I cannot, if I am to go on, if I am to live, I cannot give up on her. Not completely. Inside there is still a little hope. Hope overshadowed with grief.

Oh, Grandma, was it only yesterday you were there to take care of me, to worry over me, to clean my bottom when it was soiled, and to hold me safely in your arms. Oh, Grandma, how could I have been such a coward, how could I have ever let you slip through my loving arms?  Could you ever have understood? Could you ever have forgiven me?

Grandma – I love you, and will always love you, and I swear, no matter what, I will never stand unready again to take the risks that love demands.

Forgive me.

Posted in Cryonics History, Philosophy | 18 Comments

Last Aid as First Aid for Cryonicists, Part 4


By Mike Darwin

Determining and Documenting Cardiopulmonary Arrest

In situations where irreversibility has been established by a properly executed medical directive not to pursue cardiopulmonary resuscitation (CPR) or defibrillation (especially in cases where the patient is of advanced age, in poor health, or is terminally), it still necessary to objectively determine and document cardiopulmonary arrest.

In most countries, including the U.S., Canada, and the U.K., there are currently neither statutory rules, nor standardized criteria for the certification of death following irreversible cessation of cardiorespiratory function (or for that matter following so-called “brain death,” or more properly, pronouncement of death in the presence of mechanically assisted cardiopulmonary function using neurological criteria).[1],[2],[3],[4] As a result, current practice varies from certifying death as soon as an attempt at cardiopulmonary resuscitation is abandoned, to waiting 10 minutes, or longer, after the onset of respiratory and cardiac arrest (apnea and aystole).[5],[6],[7] Criteria used to determine apnea and aystole may vary widely from institution to institution within the same city, and additional criteria may also be required, such as the presence of fixed, unresponsive pupils (either dilated or in mid-position), absence of a corneal reflex (a response when the clear “window” of tissue covering the eye is touched with a finger tip, a gauze pad, or a cotton-tipped swab), and/or absence of response to painful stimuli such as knuckling (rubbing) the sternum or moderately depressing the globe of one eye.[1],[8] In some institutions, asystole may be determined only by careful auscultation of the chest (listening for a heartbeat with a stethoscope), while in others, the absence of a carotid pulse is considered adequate. Acceptable times for absence of heartbeat and breathing vary from immediately following failed cardiopulmonary resuscitation, to periods as short as 3 minutes or as long as ten minutes.[9],[10],[4],[11],[12]

The typical criteria taught to physicians for pronouncing death are an examination that includes, at a minimum, the general appearance of the body, no response to verbal or tactile stimulation, no pupillary light reflex (pupils fixed and dilated or fixed in mid-position), absence of breath sounds, and absence of heart sounds.[13]

MAYOR (singing): As mayor of the Munchkin City

In the county of the Land of Oz,

I welcome you most regally.

BARRISTER (singing): But we’ve got to verify it legally.

To see…If she…

Is morally, ethic’ly

CITY FATHER NO. 1:Spiritually, physically

CITY FATHER NO. 2: Positively, absolutely

ALL THE CITY FATHERS: Undeniably and reliably DEAD!

– From the film The Wizard of Oz, 1939.

In the U.S. and most of Europe, the use of painful stimuli such as deep the sternal rub or nipple twisting are now considered inappropriate, although this practice continues in some institutions and by some physicians, and still widely used in Eastern Europe and the developing world. In the scant published literature on the topic, there are some physicians who advocate additional testing for a corneal reflex (blinking when the cornea is touched with a gauze pad or cotton swab), but this is considered duplicative of pupillary reaction to light by other authors, since both reflexes require some intact brainstem function in order to occur.

Admonitions are also universally given to be aware that drug intoxication has the ability to produce complete cessation of brain function, including the electroencephalogram (EEG) (and can be completely reversible) and that total paralysis can also closely simulate death; as can certain critical illnesses such as end-stage liver disease (stage IV hepatic coma) that can make a live patient appear dead. Similarly, physicians are cautioned that profound shock (from blood loss or infection) and profound hypothermia (body temperatures below 32.2ºC or 90ºF) often require far more careful clinical examination because of reduced brain and body metabolism. Infants and children under the age of 5 are surprisingly resilient and have been known to recover completely after prolonged periods of apparent clinical death (cardiorespiratory arrest).

The problem with all these methods is that they are subjective and do not lend themselves to objective documentation. Within the fraternities of medicine and law enforcement, such lack of objective documentation is taken for granted, and this lack of rigor (surprisingly) results in fewer than a dozen cases each year (coming to public attention in the U.S. via the media) of patients awakening in the morgue, moving on the autopsy table as necropsy is begun, or otherwise being determined to have been mistakenly been pronounced dead. (A Google search using the key words “mistakenly declared dead” is all that is needed to find a roster of such cases occurring across the U.S. and around the world).

Thus, the question arises, “what criteria should be used by laypersons to determine “irreversible” cardiopulmonary arrest in the cryopatient?”

Figure 1: Procedure for application of supraorbital pressure.

Field Determination of Irreversible Cardiopulmonary Arrest (ICPA)

First, remember, looks can be deceiving. A visit to most extended care facilities (ECFs) or hospitals would probably reveal a patient or two whose status appeared questionable on initial observation. Second, follow the guidelines below to both determine the patient’s cardiopulmonary status, and to objectively document the signs used to determine “irreversible cardiopulmonary arrest” (ICPA). Above all, remember it that it is ICPA you will be determining, not death.

Field pronouncement of ICPA should follow the following protocol:

1) Whenever possible (and this should be an integral part of the Last Aid Kit (LAK)) a video recorder should be used to document the protocol, and once turned on it should be left on without interruption until the examination is completed. This secures a continuous record and establishes a documented time line. Absent this, remember that later generation mobile phones and virtually all smart phones have embedded cameras, and often video recording capabilities.

2) Use the mechanical or electronic stopwatch in the kit to formally measure the requisite time intervals for the various determinations. (Mechanical stopwatches have the advantage of not needing batteries.)

3) The patient must demonstrate lack of response to verbal or tactile stimulation. This should include calling the patient by name, and application of supraorbital pressure, as shown in Figure 1, above.

4) There must the simultaneous and irreversible onset/presence of apnea and unconsciousness in the absence of the circulation. Apnea should be demonstrated by using a clean, highly polished mirror as shown in Figure 2 below, to document that there is no fogging due to respiration for a period of 3 minutes. Apnea should be confirmed by auscultating the chest as shown in Figure 4, below, following determination of aystole (cardiac arrest) by auscultation, or use of the CapNoMask as shown in Figure 7, below.

5) Absence of circulation, as documented by absence of a carotid pulse on palpation, and the absence of heart sounds on auscultation using a quality stethoscope, as shown in Figure 3, below.

Figure 2: Portable mirror with case for determining that respirations have ceased.

6) One of the following is fulfilled:

−     The patient meets the criteria for not attempting cardiopulmonary resuscitation.

−     Attempts at CPR have failed, as documented in writing by an authorized person (attending physician or EMS personnel).

−     Treatment has been withdrawn because it has been determined to be of no further benefit to the patient and not in his/her best interest to continue, and/or in respect of the patient’s wishes, as documented in writing by the patient, or per the patient’s medical record, or per written instruction from the patient’s primary care physician, or other authorized health care provider.

Figure 3: High quality Rappaport-Sprague stethoscopes such as the one shown above are available at many home health care retail outlets for under $30.00 US.

7) The patient should be observed for a full 5 minutesto confirm that irreversible cardiorespiratory arrest has occurred.  The absence of mechanical cardiac function can be confirmed and documented with increased accuracy using any one (or a combination of) the following, if available:

−     Recorded absence of heart (and breath) sounds using the phonocardiomonitor described in Figure 5 below.

−     Absent blood pressure readings (including plethysographically acquired pulse) on the automatic blood pressure and pulse monitor, as shown Figure 6, below.

−     No exhaled carbon dioxide indication on the Capnomask shown in Figure 7, below.

Figure 4: The chest should be auscultated in multiple areas to ensure that heartbeat has ceased. The locations shown in the diagram above are good locations to listen. Regardless of what type of stethoscope head is used, always auscultate with the flat, diaphragm side of the head, as shown at far right, above. Be certain that this head is selected for listening by lightly tapping the diaphragm with a finger while the ear pieces are positioned in the ears.

8) Given, as per 6 above, that no further attempts are appropriate to restore the patient to present life, any spontaneous return of cardiac or respiratory activity during this period of observation should prompt a further five minute period of observation starting from the next point of cardiorespiratory arrest.

Figure 5: A phonocardiometer is a simple device consisting of a microphone (piezoelectric or conventional) and an amplifier and speaker. Alternatively, the microphone-amplifier assembly may be connected to a wireless transmitter to allow remote monitoring of the patient’s heart beat. The use of audible, rather than electrical monitoring of the heart eliminates the risk of pulse-less electrical activity (PEA) of the heart being confused with an actual “perfusing” heartbeat. PEA may continue for an hour or more after cardiorespiratory arrest has occurred. The unit pictured at left, above, was fabricated by Fred Chamberlain, III in 1975.A commercially available unit is the iWorx/CB Sciences (www.iworx.com) of Denver, NH, HSM-300, a simple device which converts the sound waves, created by the heart valves opening and closing, into voltages which can be recorded and displayed. A piezo-electric sensor, mounted on the side of the HSM-300 picks up the vibrations that are created by the heart sounds. The piezo crystals on the sensor convert the changes in pressure created by the vibrations into voltages. These voltages may be recorded along with the ECG of the subject to identify the specific heart sounds that occur during ventricular contraction and relaxation. The silver-colored sensing element of the HSM-300 is placed on the chest of the subject at one of the four prescribed auscultation areas. These areas are located over sections of the heart and large vessels containing the valves that create the heart sounds that can be heard with a stethoscope. The sensor of the HSM-300 picks the low frequency sound waves of the heart sounds and converts these waves into voltages that can be seen on a computer screen. The output of the HSM-300 is amplified so that the recorded waves are about 1V in amplitude

9) After 5 minutes of continued cardiorespiratory arrest, the absence of pupillary responses to light, of pupillary and corneal reflexes, and of any motor response to supra-orbital pressure, should be confirmed as shown in Figure 1.

10) The time of ICPA is recorded as the time at which these criteria are fulfilled, using the Documentation of Cardiorespiratory Arrest Form (DCAF) present as an addendum to this document.

11) Documentation should include the exam conducted, a description of the physical location where the patient was found or experienced cardiac arrest, the physical condition of the body, any significant medical history or trauma, the conditions that precluded resuscitative efforts, any contact with medical, police, or EMS personnel, and in whose custody the patient was left (i.e., EMS, C/ME, police or other peace officers, mortician, or cryonics organization representative).

Figure 6: Noninvasive plethysographically acquired automatic pulse and blood pressure monitors such as the ones shown above are another option for documenting the onset and continuing presence of cardiorespiratory arrest. State of the art machines such as the one shown on the left also incorporate oxygen saturation monitoring, but are quite costly (although they can often be leased). Another option is older used equipment, such as Critikon Dinamap 1846 SX noninvasive blood pressure and pulse monitoring system, shown at the right, above. These can be acquired refurbished from used medical equipment dealers for several hundred dollars.

12) Double check your findings with every available resource. If there is an ECG monitor attached to the patient at the time of cardiac arrest, make a recording (in two leads). Leave the leads on the body as confirmation of your assessment. If you have an automatic external defibrillator (AED) in the home (increasingly common), confirm it gives a “No Shock Advised” message when attached to the patient, and document this with videography.

Figure 7: The CapNOMask consists of and end-tidal CO2 detector that has been interfaced with a non-fenestrated mask that is easily affixed with an elastic strap. Any exhaled breaths from the patient will turn the indicator some shade of yellow or gray. Absence of any change in the indicator is definitive evidence of respiratory arrest.

Figure 8: Varying Presentations of post cardiac arrest or postmortem lividity, also called postmortem hypostasis, occurs when blood settles or pools in the lowest (dependent) areas of the body under the influence of gravity. Wherever the patient is in contact with a surface under pressure, the small vessels are prevented from filling with blood (A, D, E) and remain pale and uncolored with blood. Lividity becomes “fixed,” in other words will not redistribute if the patient is moved, 6-12 hours after cardiac arrest (E). This is often accompanied by staining of the tissues with hemoglobin (cherry red, as seen in E, above) as a consequence of red cell breakdown (hemolysis).

13) In the event the patient is discovered after the development of postmortem changes, such as rigor mortis or livor mortis (dependent lividity), it is sufficient to document these changes using ICPA form, auscultate the chest for 1-minute to establish absence of heart or breath sounds, and check for the absence of a carotid pulse. It is not necessary under such circumstances to repeat these observations or to wait the required 5-minutes for simple clinical determination of ICPA. Various presentations of livor mortis are shown in Figure 8. Livor mortis occurs when blood settles to the more dependent (lowest) areas of the body under the force of gravity where it distends the venules and the capillaries, and discolors the skin a violet or purplish red color. Livor mortis presents anywhere from twenty minutes to three hours after cardiac arrest, becomes “fixed” 4-5 hours post arrest, and peaks 6-12 hours after the onset of cardiac arrest. Lividity becomes fixed when the blood clots and/or when red cells undergo hemolysis and the tissues become stained with hemoglobin. Prior to this time, lividity may redistribute if the patient is moved. Dependent areas of the patient that are in contact with a surface and under pressure will not develop lividity. The presence of rigor or livor mortis is absolute contraindications to the initiation of CPR. If present, the location and extent of rigor or lividity should be noted on the Body Diagram that accompanies the Documentation of Cardiorespiratory Arrest Form (DCAF) present as an addendum to this document.

Caveats and Cautions

The above protocol offers no guarantees, but does provide substantial documentation of the patient’s actual condition using a nearly universal collection of accepted clinical criteria and specific methods to document irreversible cardiopulmonary arrest. “Irreversible” in this context must be understood to mean that it is either physically impossible to carry out resuscitation and/or that it is medically inappropriate or rejected as an assault on his person by the patient. Determination of medical contraindication to resuscitation must come from a physician(s) acting independently of any cryonics organization and without other conflicts of interest. Examples of the latter would be if such a physician were in any way involved with business entities related to cryonics, stands to take from the patient’s estate, and has personal or family relationships with the patient which could arguably cloud his judgment, or is paid a fee dramatically greater than the “usual and customary fee” for performing this service.

At a minimum, meticulous use of this protocol should help to protect the first responder who is giving last aid to the patient from any criminal or civil liability that might accrue as a result of erroneous or malicious accusations that he acted incompetently or recklessly in determining ICPA before proceeding with last aid measures, or even simply failing to notify and activate the EMS. Regardless of whether last aid measures are undertaken prior to pronouncement of medico-legal death; it is prudent to follow this protocol as completely as possible.

The Hazard of Electrocardiography

Restoration of any signs of life due to application of cryonics procedures, by definition, defeats the universal requirement of irreversibility or permanence which is inherent in all legally, medically and socially accepted definitions and criteria for determining and pronouncing death – from the Common Law definition as defined in Black’s Law Dictionary[14] to the commonsense definition as defined in Webster’s.[15] The criterion that the “permanence” or “irreversibility” of the loss vital signs obtain is also called for in the Harvard Criteria,[16] the American Medical Association’s guidelines,[8] the landmark Kansas statue defining death and the Uniform Declaration of Death Act[17].

Figure 9: The Premature Burial painted by Dutch artist Antoine Wiertz is as evocative today of the discomfort and anxiety felt by much of humanity when contemplating the prospect of ambiguity or error in determining when death occurs (and being certain of its permanence) as it was when Wiertz painted it in 1854.

What this means is that the decision to provide cardiopulmonary support at any time after the patient’s medico-legal death has been pronounced must, at a minimum, satisfy the criterion of irreversibility by not restoring any spontaneous signs of life including movement, agonal gasping, agonal respiration, return of mechanical or electrical activity in the heart (ECG), or return of electrical activity in the brain (EEG). Absent pharmacological intervention, it is inevitable that one, or even all of these signs, including consciousness and responsiveness to verbal stimuli, will return in a significant number of cryopatients subjected to prompt cardiopulmonary support.

While a waiting period of 5 or 10 minutes after cardiac arrest has been proposed as sufficient to prevent the return of cerebral function under normal clinical conditions,[12] this is by no means assured, and in many patients mild hypothermia and compensatory metabolic changes associated with peri-mortem pathologies that cause chronic ischemia or hypoxia (such as congestive heart failure or chronic obstructive pulmonary disease) or a prolonged agonal period, may extend the window of cerebral recoverability well beyond this interval. Additionally, on no account will such a short waiting period, or even a waiting period as long as 20 minutes, insure that there is not a return of spontaneous cardiac activity,[18] agonal gasping, or reflexive movements in response to chest compressions or other manipulations which stimulate the spinal cord.[19],[20] Indeed, agonal gasping has been documented in one study to occur in 46% of arrests secondary to myocardial infarction or other primary cardiac causes, and in 32% of arrests from other etiologies. It is also important to note that there appears to be a “plateau effect” where there is less than one-third variability in survival with intact to moderate neurological disability between moderate (5-15 min) and prolonged (>15 min) periods of cardiac arrest.[18, 21] The best estimate of the upper limit of survival in cardiac arrest in the pre-hospital setting is based upon the observation that there are no survivors of normothermic arrest beyond an interval of 30 minutes from the time of witnessed collapse to initiation of basic cardiac life support (BCLS); although survival does occur in a few cases where the interval between arrest and BCLS is estimated to have been as long as 30 minutes.[22]

PEA Reconsidered

In many patients dying slowly the cessation mechanical contraction of the heart is followed by an interval of continued electrocardiographic activity; pulseless electrical activity (PEA), formerly known as “electromechanical disassociation” (EMD). The likely frequency of PEA in the population of cryopatients who experience slow deaths is the reason why ECG is never used as a monitoring or validating modality for determining or pronouncing medico-legal death (since some clinicians and nurses are unwilling to pronounce if PEA is present). The fact that PEA was likely to return in a significant fraction of patients undergoing CPR was deemed irrelevant since survival following PEA was considered virtually non-existent. Thus, in unmonitored cryopatients, PEA was considered simply an undesirable artifact of cardiopulmonary support which, especially if undetected (i.e., no ECG monitoring in place), was irrelevant. Indeed, in many hospitals in the U.S. terminal patients exhibiting PEA are still disconnected from the ECG monitor and then pronounced using clinical criteria.[23, 24]

Figure 9: Understanding Pulseless Electrical Activity (PEA)

However, the medical perception, as well as the medical reality, of the incidence and prognosis of survival in cases of PEA in patients presenting with sudden cardiac death (SCD), as well as in patients suffering from other causes of cardiac arrest is undergoing a sea-change. In the past the PEA was exceedingly rare and its presence in either in-hospital or out-of-hospital cardiac arrest patients was considered a “hopeless” cardiac rhythm that few if any patient’s survived.

For reasons not yet fully understood PEA has gone from being a rare presenting rhythm in cardiac arrest to the most common presenting rhythm in both in-hospital[23, 24] and out-of-hospital cardiac arrests (17). While the prognosis for survival of patients with PEA is still poor, it is by no means hopeless and appears to be steadily improving.[7],[25] The likely return of PEA during CPS in cryopatients may thus take on added medico-legal significance and the return of PEA, ventricular fibrillation, or other non-perfusing rhythms in cryopatients with implanted automatic defibrillators (increasingly likely as indications for use and application of these devices rapidly expands) would result in these devices administering counter-shocks with accompanying visible movement of the patient.

In the home hospice or ECF setting this problem can best be avoided by not using ECG monitoring in any form to either detect or verify the presence of medico-legal death. Rather, the use of conventional clinical criteria, technologically augmented such as by use of plethysographically acquired pulse and blood pressure or detection of cardiac arrest by a phonocardiomonitor using piezoelectric or conventional microphones is mandated.

High Risk Members and Continuous, Long-Term Digital Video and Audio Recording

Again, as a result of the exponential growth in computing power over the last 60 years, it is has become easily technically possible and affordable to continuously digitally record the entire interior of the average 2-3 bedroom home for periods of up to 2 weeks at a time on a single hard drive, at which point the recording is, in the normal course of affairs, overwritten one day at time so that, depending upon the quality of the recording desired, 1-2 weeks of continuous video surveillance of the entire dwelling is always available.

Figure 10: Cylon Body Worn Surveillance System. Wearable DVR: 16 x 9 screen size 720 x 576, resolution 4”, display video playback – MPEG-4 SP with stereo sound. Near DVD quality up to 720×480 @ 30 f/s (NTSC), 720×576 @ 25 f/s (PAL), AVI file format. WMV9 up to 352×288 @ 30 f/s, and 800 KBit/s. Exview Camera: Instant auto focus, Hi Resolution – 1 Lux 2 CIF image, rugged, waterproof, heat resistant and  can be integrated into helmets and headwear. (Photos courtesy of The Audax Group, Plymouth, South Devon, UK, http://www.audaxuk.com/cylon/index.htm)

The advent of compact, reliable and wearable video recording equipment that could be deployed on the person(s) of those administering last aid to the patient, as well as the ready and affordable availability of continuous, forensically certifiable, digital video recording equipment, with the capability of uninterrupted recording of 2-weeks of ~250 to 450 frame per second, high quality color video (each terabyte of memory now costs approximately $400.00) have not been exploited by cryonics organizations. High capacity digital video recorders which allow for fast and easy data searches, provide self-schedule management, automatic data backup,  e-mail event alert, and offer IP Address Dispatch (for use with dynamic IP), and control of multiple systems from a remote location[26] are now in wide use in law enforcement, government and business . In-house and in-field (mobile) versions of forensic video systems are rapidly becoming the standard of practice for law enforcement where they are used to protect police officers against accusations of abuse or misconduct.[27],[28] One example widely used by law enforcement around the world is the Cylon Body Worn Surveillance System (Figure 10). The unit consists of a compact, waterproof DVR, and a high resolution color camera (worn on a headset) as shown in Figure 4, above. The DVR can store 400 hours of Mpeg-4 quality full color video and audio recording on it 100 GB hard drive and has a battery life of ~12-hours at its peak, 30 fps recording rate. Since the unit is built for law enforcement it has time/date stamping and event marking capability as well as sophisticated graphical user interface software which allows for rapid search and retrieval of recorded material.[29]

Documentation of Cardiorespiratory Arrest Form (DCAF)

The Documentation of Cardiorespiratory Arrest Form follows the format of data collection used for death certificates in all 50 US States, as well as in Canada and the UK. The information requested on the DCAF is absolutely critical to have available as soon as the patient’s physician or the C/ME arrive. In order for a death certificate to be issued, which is a necessary prerequisite to release of the patient’s body to a cryonics organization or its representative mortician or Funeral Director, all of this information must be available to the physician or mortician filling it out. Failure to have this information at hand and in an organized form can and has resulted in significant delays in the release of cryonics patients of to cryonics organizations resulting in many hours of additional ischemic time. It is strongly recommended that all persons with cryonics arrangements have a DCAF filled out in advance and stored in their Last Aid Emergency Response kit.

Addendum: Documentation of Cardiorespiratory Arrest Form (DCAF):

End of Part 2


Some may find this statement disagreeable and will point to the 1981 report by the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research entitled Defining Death: A Report on the Medical, Legal and Ethical Issues in the Determination of Death, or to the diverse and wildly different state laws for determining death, which, at last count, came in 27 different flavors, as evidence of statutory criteria. In fact, close reading of all these laws devolves to the final common denominators that  death “constitutes an irreversible cessation of vital functions” as determined by physicians or others so authorized “”based on ordinary standards of medical practice” or “according to usual and customary standards of medical practice” or “in accordance with reasonable medical standards” or “in accordance with accepted medical standards”… In short, there are no discrete diagnostic modalities or procedures specified by law.

An excellent review of the medico-legal definition of death and the problem presented by the requirement for permanence or irreversibility can be found in Persons, Humanity, and the Definition of Death by Lizza, JP. Persons, Humanity, and the Definition of Death. Boston: Johns Hopkins University Press; 2006..

An upend example is the Toshiba EVR RAID-5 32 channels DVR 480 fps (15fps per cam) security video recorder which can accommodate up to 4 terabytes of memory and retails (1 terabyte) for just under $6,000. Such a system would allow continuous video surveillance of every room of a large residence with 6-weeks of audio-video storage capacity.


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2.Pearle M: Texas law on pronouncement of death. Healthtexas 1993, 49(1):8.

3.Das C: Death certificates in Germany, England, The Netherlands, Belgium and the USA. Eur J Health Law 2005, 12(3):193-211.

4.Cole D: Statutory definitions of death and the management of terminally ill patients who may become organ donors after death. Kennedy Inst Ethics J 1993, 3(2):145-155.

5.Doig C, Rocker, G.: Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues. Can J Anaesth 2003, 50(10):1069-1076.

6.Marchand L, Kushner, KP. : Death Pronouncement: survival tips for residents: http://www.aafp.org/afp/980700ap/rsvoice.htmlAmerican Family Physician 1998, N/A(July).

7.van Walraven C, Forster, AJ, Stiell, IG.: Derivation of a clinical decision rule for the discontinuation of in-hospital cardiac arrest resuscitations. Arch Intern Med 1999, 159:129-134.

8.AMA: Guidelines for the determination of death. . JAMA 1981, 246(19):2184-2186.

9.Brook N, Waller, JR, Nicholson, ML.: Nonheart-beating kidney donation: current practice and future developments. Kidney Int 2003, 63(4):516-529.


10.Capron A, Kass, LR.: A statutory definition of the standards for determining human death (Kans Stat Ann (suppl 197 1):77-202.). Univ Pa L Rev 1978:87-118.

11.Daemen J, de Wit, RJ, Bronkhorst, MW, Yin, M, Heineman, E, Kootstra, G.: Non-heart-beating donor program contributes 40% of kidneys for transplantation. Transplant Proc 1996, 28(1):105-106.

12.DeVita M, Snyder, JV., , Jun;: Development of the University of Pittsburgh Medical Center policy for the care of terminally ill patients who may become organ donors after death following the removal of life support. Kennedy Inst Ethics J 1993, 3(2):31-43.

13.Heidenreich C, Weissman, DE.: Death Pronouncement and Death Notification: What the Resident Needs to Know: http://www.journeyofhearts.org/kirstimd/AMSA/pronounce.htm. In.: EPERC (End-of-Life Physician Education Resource Center). 2000

14.Garner BA: Black’s Law Dictionary

Thompson West; 2004

15.Webster’s Revised Unabridged Dictionary Springfield: G & C. Merriam Co.; 1913.

16.Ad Hoc Committee of the Harvard Medical School to examine the definition of brain death: a definition of irreversible coma. . JAMA 1968, 205:337-340.

17.Uniform Determination of Death Act. In. Chicago: National Conference of Commissioners on Uniform State Laws 1981.

18.Vukmir R, Bircher,, N, Radovsky, A, Safar, P.: Sodium bicarbonate may improve outcome in dogs with brief or prolonged cardiac arrest. Crit Care Med 1995, 23:515-522.

19.Jain S, DeGeorgia, M.: Brain death-associated reflexes and automatisms. Neurocrit Care 2005, 3(2):122-126.

20.Dosemeci L, Cengiz,. M, Yilmaz, M, Ramazanoglu, A., : Frequency of spinal reflex movements in brain-dead patients. 2004, 36(1):17-19.

21.Clark J, Larsen, MP, Culley, LL, Graves, JR, Eisenberg, MS.: Incidence of agonal respirations in sudden cardiac arrest.

. Ann Emerg Med 1992 21(12):1464-1467.

22.DeBehnke D: Resuscitation time limits in experimental pulseless electrical activity cardiac arrest using cardiopulmonary bypass. Resuscitation 1994 27(3):221-229.

23.Parish D, Dane, FC, Montgomery, M, Wynn, LJ, Durham, MD, Brown, TD.: Resuscitation in the hospital: relationship of year and rhythm to outcome. Resuscitation 2000, 47:219-229.

24.Parish D, Dinesh, KM, Francis, C, Dane, C.. Success changes the problem: Why ventricular fibrillation is declining,why pulseless electrical activity is emerging, and what to do about it. Resuscitation 2003, 58 31-35.

25.Stiell I, Wells, GA, Field, BJ, et al.: Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program. JAMA 1999, 281:1175-1181.

26.Toshiba EVR Series Security DVR With 4 Terabytes of Memory [http://www.mp50.com/8070/DVRUPG1RT525TR5.asp]

27.Castro H: Police cars get digital cameras; Seattle department first to use new wireless capability. In.: Seattle Post-Intelligencer Reporter


28.Digital video recorders give more reliable, accurate footage to police March, 2007. [http://www.policeone.com/police-products/vehicle-equipment/in-car-video/articles/99438/]

29.Cylon Body Worn Surveillance System [http://www.intelcam.co.uk/]

ahn S, Sullivan, FJ, DeLuca, AM, Bacher, JD, Liebmann, J, Krishna, MC, Coffin, D, Mitchell, JB. Hemodynamic effect of the nitroxide superoxide dismutase mimics. Free Radic Biol Med 1999;27((5-6)):529-35.

25.Darwin M. Transport Protocol for Cryonic Suspension of Humans, Fourth Edition. 1990.

Posted in Cryonics Technology (General), Ischemia-Reperfusion Injury | 3 Comments

Poisoning the Well: “Mom in Love & Daddy in Space”

Monitoring the CryoCultural Penetration of the Groundwater

By Mike Darwin

We had arrived ahead of our host, and it was starting to rain. We were unprepared for the rain, and it wasn’t just a matter our getting a little damp; there was the laptop computer to consider, and all the other “personal electronic” devices, now essential to survival in the 21st century. Unfortunately, the two men dressed completely in black, guarding the entryway with automatic weapons, seemed disinclined to be moved by our plight. A few calls over the building’s intercom secured us entrance, and a short time later the Oligarch who we were there to meet arrived and escorted us into the office suite, to carry on the day’s discussions.  The discussions were long and unproductive – at least from my point of view. My position was that cryonics required a dynamic and coherent philosophy, coupled to an organizational framework that would sustain it, through what I believed were very difficult times to come. The others were more interested in the brass  tacks of business than the golden words of philosophy.

I was getting nowhere, and, late in the day, my host for this visit, who was clearly fatigued from the days’ labors, brightened and said, “Come over here, I want to show this to you, this has been popular here.” I presume he accessed http://rutube.ru/tracks/1011220.html?v=5ebd95ec8a8706396bd3cc90d541c698 on his computer, and within a few seconds, “Mom in Love and Daddy in Space” by the Danish rock group Kashmir[1] took shape on the small screen of the laptop. The Russian link was to a blurry video, but it didn’t matter much. The images were haunting, and strangely cryonically archaic. The music began with visuals of the interior of a massive, futuristic home where a woman sits working at a table, while a man plays an unrecognizable game with a young boy, using a silvery metal board with scooped out divots, holding countless silver metal beads the size of BBs. (A high quality video of the song is available at: http://www.youtube.com/watch?v=11kep5f0cgo )

The video cuts to a man in nondescript, but vaguely futuristic business attire, who mounts a staircase embedded in walls made from raw concrete, left with exposed joints and formwork in its surface, and the words begin:

Walking bones
Choose your own direction
Go have fun
Some place else

Bring your soul
And your Beach Boys records
I can’t stand
To have you here

The message is clear: death is not welcome here – go somewhere else, in this place we have no use for you, and will no longer tolerate your presence. It becomes apparent that the woman is in the process of creating a bio-duplicate of her husband – what will, in fact, be the third such duplicate. There are two Dads in this house and this world, but why, and at what cost? The lyrics continue, along with the haunting and melancholy music.

The lights flicker throughout the house, as if there has been a short in the circuitry, and the father rises from the game with the boy, leaves the boy behind, and meets with his duplicate outside the room he has just exited. They begin their descent in unison, side by side, down a curved staircase that seems to be be floating in the air:

So worn out
Cold and dehydrated
The fortune is spent
And dad is in space

The boy turns his attention to an aquarium in the room his Father has just departed.

Every home should have a mom in love
And a daddy in space
Chinese porcelain cats
To guard her love
In the window space
Show her some respect
She’s all worn down

The two Dads find the Mother collapsed on the floor. One reaches out and palpates her carotid pulse, only to find her lifeless.

For years to come
I will not forget you
As my son
As my pain

They consult a set of laminated pocket flip-cards entitled “Cryonic Suspension Manual”and abbreviated “CSM.”

Meanwhile, the water in the aquarium filled with tropical fish that the boy has been watching nucleates, and almost instantaneously flashes over into ice.

The two Dads pick up the lifeless body of the Mother and place her on a stainless steel gurney. The lyrics continue:

Time will heal
What now feels so wounded
Tears are spilled
And the holes will fill

Every home should have a mom in love
And a daddy in space
Chinese porcelain cats
To guard her love
In the window space
Show her some respect
She’s all worn down
Show her some respect
She’s all worn down
Show her some respect
She’s all worn down

The images on the screen show the CSM being consulted, with the instructions to “lower body temperature.” Mom is seen surrounded by a cocoon of aluminized Mylar, with ice packed around her – two cubes rest in her sternal notch in a puddle of melted water.

Every home should have a mom in love
And a daddy in space
Chinese porcelain cats
To guard her love
In the window space

The music and the lyrics continue and repeat, and the boy is seen seated at a table that is covered in snow, as his Mom is wheeled out of the great room of the house on the gurney, shrouded in Mylar foil, with just her face exposed.

The boy is seen standing in a hallway as his two Dads wheel his mother into some (presumably?) subterranean space. His expression is one of concern, and perhaps shock.

While he stands in the background looking on, his two Dads place his Mother’s naked body into an aquarium-like cryogenic vat, where she sinks to the bottom of the vapor covered liquid.

The boy has earlier been given what appears to be one of the laminated cards from the CSM and, after the departure of his Dads, he pensively approaches the tank containing his Mother and lays the card gently, with poignant reverence and anticipation, atop the cryogenic vessel.

We are shown that the card is imprinted with a photo of his Mom with the word “FUTURE:”above it.

The last image in the video is that of the foot-end of the cryo-vessel, with the words FREEZE-WAIT-REANIMATE printed on it.

I found myself both deeply moved and deeply surprised. The video and the music perfectly captured the pain, longing, and hope that was and is cryonics. But the images, and the language, are cryo-relics. They come from the early days of cryonics in the 1960s, as does the “retro-futuristic” computer-font used on the CSM cards. Does CSM stand for the Cryonics Society of Michigan, I wondered to myself? Freeze-Wait-Reanimate has not been in use in cryonics since the mid-1960s, when the word “cryonics” was coined, and displaced it from the lexicon as a descriptor of the discipline of cryopreserving people. The same is true for the aluminized Mylar (or aluminum foil) in which early cryonics patients were wrapped.

E. Francis Hope, photographed with a model posing wrapped in Mylar foil for a publicity photo, made circa 1967 at Cryo-Care Equipment Corporation in Phoenix, AZ.

I was struck by two conflicting interpretations of what I’d just seen. Was the vision in this video a delayed playback of images inserted into the culture nearly 50 years ago, or was it instead, a retrofuturistic or a paleofuturistic (http://www.paleofuture.com/) view of cryonics? It was impossible to tell.

A few months ago, in the muffled distance, I heard the haunting score of the same Kashmir video, quite unexpectedly, in one of the dark warrens that comprise the city of Los Angles’ underbelly. At first, I mistook it for the opening chords of the Eagles’ “Hotel California,” but as I walked towards the source of the sound, I realized it was “Mom in Love…” It was a recording of a live performance by Kashmir, made somewhere in Europe a few years ago, from the look of it. It was streaming from the Internet through the tinny speakers of a careworn laptop. I stood next to the man who owned the computer, exchanged a glance of permission, and listened until the music stopped, and the moving image froze.

Whatever its origin, the source code had come through loud and clear. The song was full of loss, and hope, and longing, and as I looked into the face of the laptop’s owner, I could see he had heard the message, too.

Sadly, I guess that’s really all we can ask for, or at least all we can expect to get, 50 years after cryonics was first loosed on the world.

[1] Kashmir is a Danish rock band formed in 1991 by Kasper Eistrup (vocals and lead guitar) with Mads Tunebjerg (bass); Asger Techau (drums) and Henrik Lindstrand (keyboards and guitar). In November 2009, Kashmir released their first single “Mouthful of Wasps” on the band’s website. Trespassers, the band’s sixth full-length album, was released in February of last year.

Posted in Cryonics History, Culture & Propaganda | 4 Comments

Last Aid as First Aid for Cryonicists, Part 3

By Mike Darwin

Sudden Death and Unexpected Death: Is there a Difference and Does it Matter?

Most cryonicists understand what sudden death is: it is cardiac arrest due to sudden cardiac arrest (SCA), rapidly fatal stroke, accident, homicide, and yes, even suicide. Most sudden cardiac arrests are caused by myocardial infarction (MI), with stroke and accident being the next two most likely causes. Other than sudden death, people die in one of three ways, as illustrated in Figure 1, below.  Death from a chronic, progressive, fatal illness in one of the forms shown in Figure 1 is what most cryonicists expect to befall them, if they expect to die at all; being optimists, quite a few expect interventive gerontology to come to their rescue before they confront such unpleasantness. However, the reality is that it simply isn’t possible for any of us to know how, let alone when, we are going to arrest and, strange as it may seem, that applies even to those of us who are already terminally ill and “dying” now.

Which brings us to the issue of unexpected death: Unexpected death includes all forms of sudden death, but also encompasses deaths from things like cancer and other “predictable” illnesses that occurred sooner (or later) than expected, and as a consequence preclude or derail preparations made to deal with it. It is unfortunately all too common for someone who is terminally ill to either experience cardiac arrest (unexpectedly) sooner than was predicted, or to rally, live days or even months longer than was anticipated, and then arrest unexpectedly after the Standby team has stood-down or downsized dramatically. Too few cryonicists appreciate this reality, and as a consequence, many are caught unprepared.


Figure 1: The three patterns of “predictable” death: Historically death from malignancies (pattern 1) has resulted in a relentless and comparatively predictable decline with a brief period (~2-4 weeks) of sharp decline near the end of the illness. As targeted and rationally designed pharmacological treatments for neoplasms become available over the next decade, death from cancer may become less predictable. Congestive heart failure and chronic obstructive pulmonary disease (pattern 2) are characterized by progressive disability punctuated with acute episodes of acute decompensation the outcome of which (for any given episode) is difficult or impossible to predict. The third category of patients suffering from progressive frailty (often as a result of sarcopenia, osteoporosis and diffuse deterioration in cognitive and motor faculties) or dementia (pattern 3) may arrest suddenly and without warning secondary to heart attack, stroke, or pulmonary embolism, or they may provide warning (in widely variable amounts) in the form of the refusal (or inability) to take in food and fluids, or develop pneumonia, urosepsis, or some other infectious process.

The take-home-message in all of this is very simple; 25% to 30% of cryonicists will arrest with little warning or no Standby team present. While it is true that the number of sudden and unexpected deaths can almost certainly be reduced among cryonicists; that is a topic for another article. As it stands now, the chances of North American cryonicists experiencing cardiac arrest without Standby, due solely to medical causes, are presented in Figure 2, below. Approximately 57% of all deaths in the US are sudden in nature with the balance, of approximately 43%, presumably being candidates for Standby and Transport. However, this presumes there are no financial or logistic barriers to your cryonics organization deploying in a timely fashion. Not considered are snow storms, hurricanes, fuel shortages, or even more mundane problems, such as traffic jams or a breakdown in the complex web of communications and logistics required to get rescue team members organized and deployed. For cryonicists living outside the US, things may be better or worse, in terms of the medical and other causes of sudden death, but beyond that, at least for now, the odds of getting rapid and effective emergency care in the event of unanticipated cardiac arrest are almost nil.

Figure 2:  Approximate U.S. distribution of predictable deaths by cause based on 2004 data. Note that ~57% of all deaths occur sufficiently suddenly, or under circumstances such as accidents, which preclude standby or other cryonics stabilization measures. Chart derived from data: [National Vital Statistics Report, Volume 53, Number 5 (October 2004)].

The obvious problem with unexpected arrests is that they usually prevent Standby, and even when a response team is available locally, such emergencies invariably result in delay. Many cryonicists seem to have the same two ideas about sudden or unexpected arrest: 1) it isn’t going to happen to me, and 2) if it does, I’ll be a Coroner’s or Medical Examiner’s (C/ME’s) case and I’ll either be autopsied, or be unable to receive any emergency cryonics care until the C/ME releases me, too many hours later. The fact is, that both of these assumptions are often wrong. Cryonicists in seemingly good health, with few or even no risk factors for SCA or stroke, have arrested suddenly. Sometimes this has occurred as a result of undetected atherosclerosis, but it has also happened due to cardiac arrhythmia unrelated to coronary heart disease, and as a result of accidents, suicides and even homicides. Cryonicists have arrested as a result of falling off a ladder, being hit by an automobile while walking the dog, due to impulsive, self-inflicted gunshot wound to the chest, and from a pulmonary embolism due to a blood clot (that silently formed in the leg) suddenly breaking free and cutting off blood flow to the lungs. The unexpected is, by definition, just that; unexpected.

In most cases of SCA, the patient becomes a C/ME case with the C/ME at least taking custody of the body and, worst case, performing a complete autopsy (including dissection of the brain). This is not the case in many instances of unexpected death where the person was terminally ill and often already enrolled in a hospice program.  It is also often not the case when an elderly nursing home or hospital patient dies suddenly under unremarkable conditions. If the C/ME is contacted at all in such cases, usually he will immediately (or very quickly – 15 to 20 minutes) issue a release number and allow the patient to be “disposed of” in the same manner as if the death was outside his purview. In at least a dozen cryonics cases the C/MEs have even waived taking custody and performing an autopsy where the “death” occurred at home from SCA or in the setting of chronic illness, and in one case, even though the death was a result of a motor vehicle accident (the member was fatally struck by a car skidding on an icy street while she was walking her dog). CM/Es have enormous discretionary power and how they behave is often dictated more by their personal inclination and mood than it is by the law. A fair number of CM/Es have allowed cryonicists to pack a patient (or in some cases just his head) in ice in the morgue cooler, while others have autopsied cryopatients for no reason, other than to show their contempt for cryonics, and the people who practice it.

Thus, it is not the case that all sudden or unexpected deaths invariably end in the CM/E’s office with “hopelessly” long delays until meaningful emergency care can be started or with no possibility of beneficial intervention because of autopsy. In those cases where cryonics first aid is possible, the quality of that care can make a huge difference in the amount of damage the patient sustains. My purpose here is to lay out a variety of things that you can do to improve your readiness in such an emergency, ranging from fairly simple and inexpensive things, to more complicated and costly preparations. All of the things I will be discussing in these articles will provide stand-alone benefit. In other words, each one will work to improve your chances independently of the others. At the same time, these preparations are largely synergistic, in that when used together, they will help reduce the amount of damage you are likely to sustain if you arrest absent a skilled cryonics team waiting in the next room.


Defining Death?

“[Determination of Death.] An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.”

– Uniform Determination of Death Act as proposed by the National Conference of Commissioners on Uniform State Laws, May, 1980.


“Theoretically, even destruction of an organ does not prevent its functions from being restored. Any decision to recognize “the end” is inevitably restricted by the limits of available medical knowledge and techniques. Since “irreversibility” adjusts to the times, the proposed statute can incorporate new clinical capabilities. Many patients declared dead fifty years ago because of heart failure would have not experienced an “irreversible cessation of circulatory and respiratory functions” in the hands of a modern hospital.”

Defining Death: A Report on the Medical, Legal and Ethical Issues in the Determination of Death prepared by the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research

In The Uncertainty of the Signs of Death and the Danger of Precipitate Interments in 1740, Jean-Jacques Winslow advanced the proposition that putrefaction was the only sure sign of death.

The Problem of Pronouncement


As Coroner, I must aver

I thoroughly examined her

And she’s not only MERELY dead,

She’s really, most SINCERELY dead.


—Coroner, after examining the remains of the Wicked Witch of the East, from the film The Wizard of Oz, 1939.


Despite its obvious importance and its restriction to the medical and law enforcement professions (coroners are typically peace officers, and have full police authority) both the criteria and the specific procedures used to pronounce death are surprisingly casual and ill defined. While U.S. law governing the minutiae of who may legally pronounce death varies somewhat from state to state, in general the authority to pronounce, or legally declare death, is reserved for physicians, C/ME’s and their deputized or authorized personnel, and in many states, registered nurses participating in an authorized hospice program.  A search of medical textbooks, peer-reviewed publications, hospital, extended care facility, and even hospice standard operating procedure (SOP) manuals reveals a striking absence of standardized protocols for diagnosing death. In fact, to find any documented or specified procedure at all is the exception, rather than the rule.

A singular problem with cryonics last aid is that the patient actually be clinically dead, and not a candidate for resuscitation before any last aid procedures are applied.  In circumstances where an attending physician, nurse, or other legally authorized person has pronounced death and the patient is not a C/ME’s case, there should be no problem with carrying out the last aid procedures described in these articles. This will particularly be the case in situations where the patient is wearing a medical alert bracelet (and possibly a medical jump drive) with instructions to carry out these procedures (i.e., pack in ice, administer CPR, and so on).  In cases where medico-legal death has not been pronounced, the application of last aid carries with it unknown and possibly serious risks. In such situations it will be up to the member (now patient) and to those around him in positions of authority to decide whether the risk of proceeding outweighs the potential benefit.

While it may seem easy to objectify this decision, in fact it is a highly personal decision and one which ideally should take into account the particulars of the situation at hand; particulars which are often impossible to predict in advance. Since the first cryonics case in 1967 there have been at least 20 instances where one or more a last aid maneuvers have been carried out prior to the legal pronouncement of death. None of these cases resulted in either medical or legal problems. However, this is not a guarantee that such problems could not occur in the future. In order to make an informed decision about applying last aid measures in the absence of legally certified death it is necessary to understand the risks. Those risks, in order of seriousness, are that:

a)      The authorities (physician, nurse, C/ME, other peace officer, or even the prosecutor, decide that the patient was not medically dead (i.e., “irreversible” cardiopulmonary arrest) before last aid procedures were started and that some or all of such procedures either caused or hastened death.

b)      The authorities are concerned that last aid procedures may have been initiated before medical death occurred and that an autopsy is necessary to resolve the issue.

c)      The authorities believe that the patient was a candidate for resuscitation and, while not disputing the absence of cardiopulmonary function, decide that CPR and activation of the emergency medical system (EMS) by calling 911 should have been undertaken.

d)     One or more empowered authorities are irritated, offended, or threatened by cryonics in general or last aid procedures in particular, and decide that they are ground for either declaring the patient a C/ME’s case or for carrying out a post mortem examination.

Individual circumstances will have a great deal to do with whether last aid is prudent , not the least of which will be the temperament and prejudices, as well as the formal policies and procedures, of the relevant authorities. To the extent possible, members should investigate these factors in advance, and at regular intervals, being mindful that CM/E’s are elected or appointed officials, and that they remain in office for highly variable periods of time. It is also important to realize that CM/Es are not in the office round the clock, 365 days a year, but rather have chief deputies and executives under them who are empowered to act in their stead. Discussing your cryonics arrangements and the last aid measures you wish carried out with these legal authorities is of paramount importance – especially in the event you charge those around you with the responsibility of acting before medico-legal death occurs. The same injunction to determine the “lay of the land” with regard to cryonics and last aid measures, also applies to your primary care physician, and to other members of your healthcare team who may have responsibility for you when medico-legal death occurs.

Beyond the disposition of these professionals, the circumstances under which arrest occurs will likely have a profound bearing on the advisability of undertaking even the simplest last aid measures.  In the past, elderly members in poor health or who suffered from well documented coronary artery disease have arrested suddenly only to be discovered by friends or family beyond the window where resuscitation was possible, or in situations where explicit, written instructions were in place that neither CPR nor defibrillation were desired by the member in the event of cardiac arrest. In some of these situations close friends or family members have honored the patient’s wishes and packed the patient’s head in ice prior to medico-legal pronouncement. This has been especially beneficial (and understandable) in rural environments where there would be a long delay between calling EMS personnel and their arrival on the scene. In other instances patients have been packed in ice (head) after EMS personnel arrived, but before formal pronouncement of death. In still other cases patients have received more sophisticated last aid, including CPR and more extensive icing in the interval between cardiorespiratory arrest and the arrival of the home hospice nurse or family physician that is authorized to pronounce medico-legal death.

In all such cases it is absolutely essential that if a decision to proceed with any form of last is made, that the patient’s condition of “irreversible” cardiorespiratory arrest be systematically and thoroughly documented prior to proceeding with any last aid measures. The first step in such documentation is to establish unequivocal evidence of irreversibility in the form of written instructions from the patient that he not be resuscitated in the event of cardiopulmonary arrest, that the patient has unequivocal injuries (decapitation/dismemberment) or postmortem signs that would preclude resuscitation (such as the presence of rigor mortis, livor mortis, or evidence of decomposition), or that the patient has failed medically sanctioned resuscitation (failed effort by EMS to achieve resuscitation on the scene). Written directions not to resuscitate, failed resuscitation and the presence of clearly lethal injuries or postmortem changes are the only true signs of irreversible cardiopulmonary arrest. Cardiopulmonary arrest in all other situations constitutes a prognosis of death, not its diagnosis.

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