Dr. Crippen on Mr. Darwin*

By introduction, I am Dave Crippen, MD, Professor of Critical Care Medicine and Neurological Surgery at the UPMC Medical Center in Pittsburgh. Some of you may know me. I’m the moderator for 18 years duration of CCM-L, the International Critical Care Internet Group (~1000 members).  If you ask almost anyone in the in critical care medicine global village, they probably know me, or know of me.

 

I have followed the saga of Mike Darwin beginning back in the day of Usenet where Mike maintained a cryonics list. I came upon this list while “surfing the ‘net” and found his editorials interesting. I wrote him an idle question and he wrote back, initiating a sixteen-year roller coaster friendship.

Now in 2012, I hope to make some observations from one who knows him intimately (not too intimately).

18 or so years ago, none of us could have predicted where the miracle of the Internet would take us.  Would any of you have believed ago that many global health care providers would have embraced a hard-core cryonicist as an authoritative voice in medicine?  By “embraced”, I mean they all hang on his every word.  Back in about 2000 they all took up a collection to purchase him a new computer to keep him on-line. Small denomination money came in from all over the world.

Because of that miracle, Mike has most assuredly entered the arena of “legitimate” medicine more than any of you can imagine.  Certainly more than anyone in the self-limiting field of cryonics.  His writings enjoy wide readership among working physicians and health care providers. He has contributed to several articles in a world-class clinical journal “Critical Care” with a journal “impact rating” (lots of clinicians read it) near the top three Critical Care journals in the world.

But it wasn’t an easy task.  As most of you know, Mike is a very unusual person on almost every level. I’ve known him for a very long time and I’ve seen the patterns emerge and descend in his life and I think I know him better than most, if for no other reason than he doesn’t keep friends long.  Like many of the rest of us, Mike has very potent talents combined with demons that keep those talents from wide expression.

Mike’s passion is what most physicians consider the pseudoscience of Cryonics, and he lives for little else. It is his passion and his obsession. At some point years ago, he reached a point in his life where his demons fully expressed themselves and he burned many bridges to those doing administrative and research Cryonics. To this day, those factions exclude him from those activities.

So for a few years around the turn of the century, he didn’t have lot to do with his time. Mike decided that he liked conversing with the members of CCM-L because it allowed him to pontificate about science and other things in life, and all always enjoyed his missives. As time progressed, he got more involved in Cryonics again, and slowly withdrew from CCM-L.

As a practical matter, his baseline default is to be culturally and socially isolated and he seems to be at home there. He works hard to maintain that isolation. He has an extensive history of effectively burning bridges over issues that could probably be resolved with even rudimentary diplomacy; an alien concept to him.

Over the years I have tried to understand why former friends and colleagues so relentlessly exclude him.  Conversations with some of them wondering why his strengths cannot be mined as his (perceived) shortcomings managed. The universal answer is that his (perceived) shortcomings have the capability of being so malignant that they are either afraid of him or any potential benefit isn’t worth the effort.

But Mike is an authentic Genius in Aspic (my term).  He chose to pursue a course of science that: 1. Limited his colleagues to a relatively small culturally isolated group, and 2.  Almost completely excludes him from many of the goals in life he would like to have in a perfect world. He is a genius trapped in Aspic and the “Richest Man in Bogota” ( H.G Wells).  His formidable talents are trapped.  Had he chosen to pursue righteous scientific disciplines, he would be mentioned in the same breath as Feynman.

My role in all this was to try to keep him visible to (for want of a better term) “traditional” science by keeping doors open for him as a writer in the literature of and speaker at meetings attended by scientists of the real world that righteously excludes Cryonics. To some degree, I have been successful in that endeavor, but it hasn’t been easy. Mike’s boundless energy, enthusiasm and confidence is pretty much limited to Cryonics, for which he writes extensive blogs and argues endlessly with critics thereof. His interest in mainstream science has dwindled, and that includes the mainstream scientists of CCM-L, for which he hasn’t much time or energy or interest in being a part of.

I’ve seen this coming for a while which is Why I chose to compile a history of his contributions to CCM-L for posterity. His response was that this volume was a waste of time and of no value to anyone, which is completely in character. I find it curious that this volume is the only book ever written about him that is complimentary.  He rejected all this and quickly evolved attempts to divert or stop altogether any involvement in these projects.

OK, he can be hard to get along with and he can be abrasive and irritating and emotional. We deal with these types with surgeons all the time, but if their benefit exceeds their detriment, we simply manage them more effectively.  Darwin is an authentic genius with a passionate and encyclopedic knowledge of medicine and science. There isn’t enough gold in Ft. Knox to buy that. It’s a gift from God.

I will tell you that I continue to use my influence to get him further inducted into the global medical community because I sincerely believe he is a valuable resource. He’s honest to a fault, beyond intelligent, has impeccable scientific integrity, works hard and has uncanny ability to communicate complex concepts to an eclectic audience. For those reasons, he has the potential to get the ear of clinical medicine.  He has great potential as a writer for medical subjects, and speaker at international meeting. Mike sitting in a 2 X 4 shack in Arizona spending his days grooming the surrounding desert is a waste when his knowledge base and communication abilities have such potential benefit to science.

There is a window of opportunity here to re-think former misadventures in terms of the current needs of science and medicine. The world evolves and we all need to evolve with it, or we’ll become extinct. Mike needs to evolve to something other than lethal or self-limiting iterations.  Who knows, he may be the ticket infiltrating the legitimacy of Cryonics in the global medical community. Weirder things have happened. We, in clinical medicine, learned long ago that the mission transcends personal problems. We learn to manage them better to facilitate a greater good.

*If you are British, yes, he is related to that Crippen, and no, I’m not related to that Darwin.

 

 

Posted in Cryonics Biography, Cryonics History | Tagged , , , , , , | 4 Comments

Cryonics: An Historical Failure Analysis, Lecture 2: Inherent Failure Mechanisms and Risks, Part 3

THE CONSEQUENCES OF FAILURE

SLIDE 137

Alcor had achieved an exponential rate of membership growth by the time Jerry Leaf was cryopreserved. Since that time, there has been only modest growth of membership and in fact, in the years since 2007, membership growth has flattened.

SLIDE 138

The growth in the patient population has been similarly stunted with almost all increase being due to the cryopreservation of members, rather than at-need cases. The time when Alcor selected the highest quality at-need cases and delivered state-of-the-art care to those patients has now become a dim memory and, with one exception, the staff at Alcor has no experience with cases where immediate CPS, followed by prompt extracorporeal support, proceeded smoothly and without incident.

While it is easy to see the risks associated with at-need cases, particularly in the absence of careful vetting and strict adherence to predetermined (and protective) acceptance criteria, it is not so easy to see the even greater cost of foregoing them.

The quality of any complex procedure, medical or otherwise, is directly dependent upon the amount of experience staff have in doing it. Even highly trained and skilled personnel benefit from the experience gained by doing large numbers of cases. In fact, in medicine it has been a consistent finding that outcome in terms of morbidity and mortality in areas as diverse as open heart surgery, radiation oncology and HIV management improves steadily as a function of the number of procedures performed, or cases handled annually. The benefit of an increased case load is even more pronounced when the transition is made from a few cases per year to a few dozen per year, or more.

Absent a case load that keeps the cryopreservation team continuously busy, the only way to maintain even a semblance of competence is to carry out a program of animal research using a survival model that employs the same equipment, facilities and procedures that are employed in human cryopreservation cases. Absent this kind of day-in, day-out experience, it becomes impossible for staff to remember (or even know) where supplies are, how to calibrate, operate and troubleshoot equipment, and just as importantly, how to work together cohesively as a team.

SLIDE 139

The person leading that team and directing that research must be a competent and motivated „mountain climber‟ – otherwise the work will be a meaningless and gruesome exercise that achieves nothing but the demoralization of those participating in it.

 

SLIDE 139

Medical malpractice is a pretty common thing and as we have seen iatrogenic deaths are commonplace. That this is so, given the extensive training and mentoring physicians receive, should give us pause for thought. To become a General Practitioner in the UK or the US requires 12 years of postgraduate training. That is a huge commitment in terms of both time and money and it requires substantial motivation over and above the likely financial returns (in the UK or the US). This level of training and commitment act as a human filter – effectively removing many people who are not suited to the task of being physicians either as a result of „defects‟ in temperament or due to lack of intellect or skill.

However, this slide is misleading in that most of the real filtration has already taken place before a student enters medical school, or perhaps I should say more appropriately, is accepted to medical school. Roughly 95% of those who score well on the MCAT (Medical College Admission Test) or the UKCAT (UK Clinical Aptitude Test) and are subsequently admitted to medical school will finish it! Most of the separation of the wheat from the chaff takes place as a result of the MCAT/UKCAT scores and during the admissions process when the complete academic and behavioral profile of the candidate is evaluated.

SLIDE 140

What this means is that in practice only about 0.01% of the ~12% of graduating secondary school students who say they want to become physicians actually do so. Yet despite this high degree of selection and the extensive and costly training that follows, iatrogenesis is still a leading cause of death in both the UK and the US!

The implications of this for cryonics are pretty straightforward, although still hard to comprehend. In fact, most cryonicists simply refuse to believe what is on the previous slide and the 5 slides that follow.

SLIDE 141

All of these errors have occurred in the period of 1991 thru the present. Some, such as reversing the arterial and venous bypass lines or pouring sterile perfusate into a feces soiled container before perfusing it through a patient defy understanding even when it is accepted that they actually took place.

SLIDE 142

As we’ve just seen, as is the case with iatrogenic errors in medicine, mistakes happen even when practitioners are highly trained and carefully vetted. Without exception all of the well respected and highly qualified critical care physicians and surgeons whom I’ve known well have told me that in the course of their careers they made errors that cost patients their lives or resulted in serious and lasting morbidity. Indeed, I’ve made mistakes in caring for patients – the most serious of which involved errors in judgment that resulted in extra minutes of exposure to warm ischemia. In hindsight, both of these errors were easily avoidable by the simple expedient of insisting that reliable, trained cryonics organization personnel stay with the patient continuously after the start of Standby – regardless of how uncomfortable or problematic that might be for the family so long as our ability to provide Standby for the patient was not compromised.

SLIDE 143

The issue here is not that errors were made, but rather the underlying reasons, the frequency and the repetitiveness of the errors. Because of the enormous surface tension of water any air bubbles present in blood that are larger in diameter than the capillaries act as obstructions, or emboli. Thus, any air introduced into the arterial circulation of a patient receiving extracorporeal treatment will result in blockage or embolization of the arteries supplying the tissues with blood. Depending upon the amount of air and the area it embolizes, “pumping air” will result in either serious injury or death.

There is an old saying amongst perfusionists: “There are two types of perfusionists: those who have pumped air (into a patient‟s circulatory system), and those who will.” Particularly in the days before microbubble detectors with automatic interrupts to shut down flow and clamp the line supplying blood to the patient were developed and put into universal use, it was typically only a matter of time until any given perfusionist made a mistake that resulted in air being perfused into a patient. This might happen once in the course of a 20 year career during which time thousands of patients would have been perfused for an aggregate of tens of thousands of clinical hours.

SLIDE 144

It should also be understood that this aphorism includes incidents where introduction of air into the patient‟s circulatory system was arguably unavoidable. Here I‟d like to speak from personal experience. For about 8 years I was a hemodialysis technician both in the outpatient and acute care (ITU) setting. During that time I „pumped air‟ once. In this photo you see me doing hemodialysis in 1978 in Indianapolis, IN.

Microbubble detection equipment was available at that time, but not used at the institution where I worked. If you look at the schematic of the extracorporeal circuit used in dialysis you‟ll note that the leg of tubing connecting the patient‟s arm (artery) to the pump will be under negative pressure with respect to the atmosphere. In order for ~250 ml/min of blood to be withdrawn from the small caliber radial artery it is necessary to “suck” on the vessel. A consequence of this is that if there are any holes – even ones too tiny to see – in the tubing between the artery and the pump raceway air will enter. The dialyzer is inverted to serve as a bubble trap and there is yet another bubble trap before the blood is returned to the patient.

However, in the event the breach in the tubing is very small the resulting bubbles are microscopic and remain suspended in the blood even as it passes through the dialyzer and the bubble trap. Fortunately, in dialysis, we are returning blood to the venous circulation as opposed to the arterial circulation and that means that we have another safety feature – an air bubble filter in the form of the lungs. In the case I‟m discussing here there was a manufacturing defect in the arterial tubing set such that where the blood conducting tubing from the patient was joined to the pump raceway there was an incomplete seal. While the defect was invisible to the eye it was of sufficient size to allow the creation of a steady stream of microbubbles.

Approximately an hour into the treatment my patient began to complain of back pain and shortly thereafter shortness of breath (SOB). I rechecked the composition of the dialysate (blood washing solution) and checked the integrity of the circuit and found nothing amiss. However, as the back pain and SOB increased in severity I became extremely concerned. I realized that these were symptoms of micro-air embolism and I got a flashlight and carefully examined the tubing carrying blood back to the patient.

There was a barely visible fine whitish line at the top of some of the tubing. This was an accumulation of microbubbles that had risen to the top of the blood flowing through the tubing. The patient was immediately removed from the machine and recovered uneventfully and with no lasting harm.

Interestingly, it took the deaths of two patients from air embolism at that institution before ultrasonic air bubble detectors were purchased and added to the dialysis machines.

SLIDE 145

At left is the Travenol RSP dialysis machine that I began my career with and at right is a contemporary, highly automated hemodialysis machine. There are bubble traps on both the arterial and venous legs of the circuit and, of course, sophisticated ultrasonic microbubble detectors which will shut down the pumps and clamp the lines in the event air in the blood is detected. Additionally, these machines mix the dialysate in real time and ensure it is safe, calculate and implement water removal from the patient and otherwise carry out a myriad of tasks we never dreamed would be possible to „automate‟ in 1978.

Most of these advances came at the price of injury or death to patients who were treated with earlier generations of less sophisticated equipment. In 1978 universal chronic hemodialysis was only 6 years old in the US and I worked in one of the pioneering units making the treatment available to hundreds of patients who previously would have died. While some of the errors and shortcomings of that program were avoidable – many were not – they came as part of the price tag for implementing a then new and demanding technology on a scale previously undreamed of.

SLIDE 146

I understand errors and I understand their increased frequency and probable severity when implementing any complicated new technology. However, that is not the kind of failure I‟m talking about here in cryonics. The errors listed in these slides are not occasional but rather have become routine. Many are so base that they rise to the level of uncaring negligence.

Consider, for example, the case where a patient frozen to dry ice temperature was removed from dry ice storage and packed in water ice for air shipment to the cryonics facility because of airline restrictions on the amount of dry ice that could be used to refrigerate the patient in transit. Obviously, the patient thawed out before arriving at the cryonics facility and had to be refrozen. That means that tissue ultrastructure that was compressed and fragmented by initial straight freezing (but ostensibly locked in place by ice) would be returned to an aqueous and diffusible state – indeed a state characterized by intense fluid turbulence and “stirring” as concentrated pools of electrolyte diffused and re-equilibrated with the large masses of nearly pure water created by melting ice crystals!

When “average” cryonicists with no technical background or training are told that an “experienced” cryopreservation team leader took a patient out of dry ice and packed him in water ice they are uniformly appalled. Most cannot even understand how or why such a decision would be made by anyone, let alone a highly experienced cryonics caregiver. The same is true of many of the other errors just discussed.

But what is perhaps most shocking and seemingly inexplicable is the complete absence of any visible emotional reaction to these errors. When I discovered microbubbles in the venous return line of the patient I was dialyzing I had an immediate and strong reaction of fear and anxiety bordering on terror. Was the patient going to be all right? Had any permanent harm been done? Next came a wave of dread and worry that I had not delivered good care. Was there something I could have or should have done to prevent the injury to the patient? Could I have detected the problem sooner and acted to prevent some of the pain the patient experienced? With years of experience in medicine I’ve come to understand that this kind of emotional response is both normal and healthy. Strong feelings of discomfort in such situations are an essential part of not repeating the error. This empathetic and self critical emotional response to iatrogenic events seems to be completely absent in an increasing number of cryonics caregivers.

THE POD PEOPLE

SLIDE 147

As it turns out, I was not alone in having noticed this phenomenon. Aschwin de Wolf, then employed at Suspended Animation, Inc. in South Florida, was observing the same kind of behavior in a range of settings within the cryonics community. We both found it puzzling to the point of incomprehensibility that people who were delivering care to cryonics patients, in some cases medically trained professionals, could be so indifferent to errors that would, in a conventional medical setting, be career ending or at very least result in costly and traumatic litigation.

This phenomenon was most pronounced in non-cryonicist medical and technical professionals who had been hired to deliver care to cryonics patients. Superficially these individuals seemed to be competent and caring, but a closer examination revealed this to be anything but the case. This was especially surprising to me because I had hired and worked with non-cryonicist medical professionals in the past and had never encountered behavior even remotely like that which Aschwin first identified. In my correspondence with Aschwin I likened such individuals to the “Pod People” in the novel and films Invasion of the Body Snatchers.

SLIDE 148

While we speculated as to the possible motivation such people might have in becoming and remaining involved in delivering cryonics services (financial gain aside) we did not have to speculate as to what constituted a “Pod Person” in cryonics.

SLIDE 149

I want to credit Aschwin with first articulating most of these characteristics. He put into words things which I had observed myself, but had not fully understood and he identified a number of traits which I had not (at that time) observed myself. Since he was a cryonicist and he was in intimate contact with a culture of non-cryonicist “employee professionals” he was uniquely situated to observe and understand what was going on.

SLIDE 150

What he discovered was that people who are not cryonicists, and who are not selected and mentored to hold the values of people who are, behaved with uncaring indifference towards their patients. Not infrequently they actually held cryonicists in contempt considering them “chumps” or “fools” who are tilting at windmills while being consumed with an unnatural and cowardly fear of death.

It seems likely that these people are, in effect, recruited from and filtered out of the larger population of caring and empathetic health care providers and professionals. Absent a cohesive program of instruction and mentoring coupled with meaningful and results-driven day to day activity it would be difficult for anyone, cryonicist

or not, to remain engaged and committed to such a job. More to the point, few if any truly competent and caring persons (professional or otherwise) would accept and remain in a job where there was no “real” day-to-day work, no leadership, and no sense of mission or accomplishment. The kind of people who stay in such a position – especially given their active contempt for their employers and patients – are not psychologically healthy and are certainly lacking not only in compassion, but in work ethic.

Such “sterile” cryonics service operations led by people who lack vision, passion and commitment to cryonics themselves become highly efficient recruitment facilities for individuals who are, at best, borderline sociopaths.

SLIDE 151

In considering the history of cryonics it became all too apparent that the existence of Pod People was by no means a new phenomenon. As many people in cryonics over the years have observed, cryonics is a magnet for frauds and charlatans. Important extensions to that observation are that the majority of these individuals are also sociopaths and that they are routinely placed in positions of power by cryonicists and cryonics organizations.

This was true in 1966 when Robert Nelson arrived on scene and it has remained the case over the course of the subsequent four decades. The Olga Visser episode is only the most public of many, many other situations where deeply disturbed or frankly sociopathic individuals have been placed in positions of power and authority in cryonics, often within weeks or months of arriving on the scene!

Charles Platt chronicled the Visser saga very well:

http://www.cryocare.org/index.cgi?subdir=ccrpt10&url=visser.html, and I excerpt it only briefly here:

On October 9th, 1995, readers of the sci.cryonics Usenet news group found themselves confronted with a strange report quoted from the South African Sunday Times. Supposedly, a 37-year-old cardiovascular perfusionist named Olga Visser had developed a new cryoprotectant that would enable human hearts to be frozen with virtually no damage, opening up exciting possibilities in the field of transplants, where organs usually have to be utilized within several hours after removal.

According to the Times Ms. Visser had started her cryoprotectant research two years previously when she helped to establish a heart-valve organ bank. Since valves can be cryopreserved using DMSO, she saw no reason why she shouldn’t be able to freeze whole hearts as well. Undeterred by her lack of knowledge of cryobiology, she consulted some experts, read some journals, and formulated her own cryoprotectant.

When she applied it to a pig heart, she reported “no damage” after the heart was rewarmed from liquid nitrogen. She described similar success with human heart tissue. Finally, “a rat heart was frozen, unfrozen, and then warmed by a special process–and started beating.

On September 8th an astonishing press release was issued jointly by Robert Ettinger, president of The Cryonics Institute (CI), and Steve Bridge, president of Alcor Foundation. Apparently Ettinger had been in discreet contact with Ms. Visser earlier in the year, had satisfied himself that her work was genuine, and then contacted Alcor.

The two groups formed an unprecedented secret alliance, contributing money to Ms. Visser’s research and ultimately flying her to Alcor’s facility in Scottsdale, Arizona. From August 30th through September 4th she demonstrated her experiment to Ettinger, Bridge, and several officers and directors of Alcor. She also gave CI and Alcor an exclusive license to use her present and future technology for cryonics applications.

SLIDE 152

Ultimately, Visser was shown to be at best a misguided incompetent, and at worst a calculating con artist. When her „novel cryoprotectant‟ was put to an objective test at Alcor‟s facilities in February of 1997, it failed utterly to protect rat hearts against freezing. The net financial hit cryonics, including licensing fees paid to Visser, air fare, equipment purchases, and contributions to support her research was estimated by Alcor‟s then President Steve Bridge to be ~ $50K. Charles Platt sums it up aptly:

Olga Visser’s brief passage through cryonics could still turn out to be a positive, salutary event if it reminds us to be more circumspect in the future. The next time a character out of a Heinlein novel turns up with a secret formula to fix our deepest fears, we may be a little less willing to pay cash for the recipe. We may even be a little more tolerant of the smart-asses who insist on reminding us that death is not an easy adversary, human biology is infernally delicate and difficult to preserve, and scientific rigor is a fundamental necessity, not a tiresome detail.

SLIDE 153

Why this happens is not much of a mystery when it is examined in the context of other disciplines that command power over and control of peoples‟ lives. Medicine is not more overrun with psychopathic quacks than it is only because there is a profession of medicine, and there are also vast bodies of regulation and law with serious penalties attached, that govern its practice. Cryonics lacks all of these safeguards. Imagine, if you will, what the situation would be if such psychopaths were empowered to fly airplanes, captain ships, or design large, heavy structures such as multi-story buildings, bridges and dams? Indeed, when such people do succeed in occupying these positions disaster is the inevitable result.

Absent these controls, both internal and external, cryonics will continue to fall prey to quacks, frauds and most dangerously, sociopaths seeking positions of perceived psychological power and control with the bonus of being increasingly well paid for indefensibly careless and sloppy work.

SLIDE 154

Remember my example of repetitive iatrogenesis associated with ascites? Just a few weeks after I gave the first version of this lecture in 2008 it happened yet again, this time to cryonics pioneer (and my personal mentor), Curtis Henderson. See :

http://www.suspendedinc.com/cases/Stabilization%20and%20Transport%20Case%20Report%20CI95.pdf

and:

http://cryonics.org/reports/CI95.html.

I am a deeply committed and seasoned veteran of cryonics and I am telling you, without hesitation, that what happened to Curtis had a devastating impact on me. Anyone with medical sophistication who reads those two case reports will most likely just walk away and dismiss cryonics as perhaps an interesting idea with some potential – but clearly not one whose time has not yet come.

THE DUNNING-KRUGER EFFECT

SLIDE 155

Finally, how do we explain the actions of people in cryonics who are sincere and committed cryonicists and yet who take on technical tasks that are beyond their knowledge and skill sets with terrible results? Much of what happened to Curtis Henderson, particularly with respect to the errors made which prevented him receiving effective cryoprotective perfusion, fall into this category.

I believe the explanation lies in something called the Dunning–Kruger Effect (DKE) The DKE was put forward in 1999 by Justin Kruger and David Dunning and it posits that unskilled people make poor decisions and reach

erroneous conclusions, but their incompetence denies them the meta-cognitive ability to realize their mistakes. Thus, the unskilled suffer from an illusion of superiority, rating their own abilities as above average and much higher than they actually are. This leads to the situation in which less competent people rate their own abilities higher than more competent people.

SLIDE 156

It also explains why actual competence may weaken self-confidence. Competent people often falsely assume that others have an equivalent understanding and degree of skill or competence. A very simple and pithy way to sum up the DKE was put to me by a Russian cryonicist in an elevator at Birkbeck College: “We are so ignorant that we do not even know what we need to know, or what we don‟t know that we don‟t know – and that is a very dangerous situation indeed.”

SLIDE 157

The moment at which I first truly understood the role of the DKE in causing technical mayhem in cryonics was actually documented by a journalist doing a story on the Cryonics UK (CUK) group at one of their meetings, held in Brighton, in the fall of 2009. I had met the new leader of the group the year before, and was more than a little surprised to hear him dismiss the Alcor ATP in-field cardiopulmonary bypass system as being “simple to operate and something any mortician would be capable of immediately mastering.” When I incredulously asked if this young man had ever actually seen the ATP, he replied that he had and that it was “just a box with tubes going in and out of it.” I wasn’t the only one who was surprised at this assessment: there was a professional perfusionist in the room from a prestigious UK hospital, and he also (to put it mildly) took considerable issue with this assertion.

SLIDE 158

A year later I was having much the same discussion with what constituted virtually all of the technical people in the CUK group. After much heated and futile discussion, I proposed that rather than argue about it, they simply get the equipment and simulate putting a patient on bypass starting from the time pronouncement had occurred. At this point, I think it best to let the newspaper account pick up the narrative:

Tim put any doubts to the back of his mind. He’s raring to go. “There’s a patient on the table dying. Hurry up, Darwin says.”

But, of course, the patient is imaginary. Tim takes the lead, explaining the ins and outs of the tubing to his less experienced fellow travellers. Meanwhile Mike Darwin watches, arms crossed reprovingly, his concern for the patient growing by the second.

“Right, I started timing you three minutes ago,” he says.

A good few minutes later Tim and his not-so-crack team are still working out where the red and blue bits plug into. “The only thing that goes wrong is if you switch it on without all the bits plugged in. It doesn’t like it and it has been known to go bang,” he says cheerily.

Darwin can’t contain himself. “If I had that kit here, I’d be scared shitless. Shitless. There are some critical things wrong with the setup of that circuit.” He tells the team they have made so many mistakes the patient would have suffered irreversible brain damage by now. Darwin suggests technology has regressed since he was in his cryonic prime 20 years ago.

But the water is pumping through the system, and Sinclair’s team are fully focused on saving their imaginary patient. Whatever Darwin tells them, they believe they are ahead of their time, not behind it.

I will add one thing that the reporter didn‟t because he had left the room to photograph some of the other CUK members before he lost his light to the setting sun. And that is that the venous blood reservoir bag in the circuit of the ATP exploded due to a misplaced clamp. The reporter apparently missed the timid request made to the meeting‟s hostess, Sylvia Sinclair, for a mop and towels to clean up the water that was all over the kitchen.

While it is true that cryonicists often have no choice but to undertake to provide and deliver care for themselves, it is equally true that they should not attempt to do so in ways that make the situation worse for the patient than had they taken a simpler approach that was, in fact, within their ability to master.

I had spent most of that day at the meeting trying to convince the CUK group that rather than the ATP, what they really needed was to use a simple, inherently „safe‟ open circuit system open circuit system equipped with a microbubble detector and auto-line clamp, to start cryoprotective perfusion as soon as was logistically feasible and to follow that with cooling of the patient to dry ice.

My lack of success in persuading obviously sincere and concerned cryonicists to undertake a course of action that was at once simpler, easier, much less costly, and vastly more likely to benefit the patient speaks to the power of the DKE and to the over-optimism and lack of realism that is endemic to cryonicists, the same over-optimism and lack of realism that makes them easy prey for con men and sociopaths.

End of Inherent Failure Mechanisms and Risks and of Lecture 2

 

Posted in Cryonics Biography, Cryonics History, Cryonics Philosophy, Cryonics Technology (General) | 3 Comments

Cryonics: An Historical Failure Analysis, Lecture 2: Inherent Failure Mechanisms and Risks, Part 2

By Mike Darwin

CRYONICS’ THIRD ERA: 1981-1991

EVIDENCE-BASED, MEDICALLY- MODELED, RESEARCH- DRIVEN

SLIDE 119

In January of 1980 I had the good fortune to perform two human cryopreservations back-to-back with Jerry Leaf (then associated with Trans Time) in Southern California. Jerry and I quickly realized that we shared a common vision for cryonics. We undertook to establish that the use of best practice in relevant areas of medicine be applied to cryopreservation cases and we sought to validate and master each biomedical facet of cryonics stabilization and cryoprotective perfusion and cool down procedures.

SLIDE 120

We began a vigorous program of research to validate each step of the procedures we were applying to human patients, starting with cardiopulmonary support, blood washout and induction of ultraprofound hypothermia. We believed that by mastering these procedures and, where possible, mastering them reversibly (i.e., recovering the test animal alive and well) we would not only gain invaluable skills, but also uncover serious errors and shortcomings in our procedures – errors and shortcomings not possible to detect by armchair theorizing.

This proved to be the case in spades. It took many attempts before we could reliably recover dogs from 4-5 hours of asanguineous perfusion at 5oC. And it was to take the better part of a decade before we were able to recover dogs following ~16 minutes of global, normothermic ischemia. In fact, Jerry did not live to see this accomplished.

SLIDE 121

An unexpected result of this research work was that a core of highly skilled cryonics personnel was created. The complexity and long duration of the experiments forced people not only to hone their individual skills, but also to work together seamlessly as a team. Survival animal research also resulted in expanded documentation and training, as well as in the beginning of the establishment of an institutional culture of professionalism and competence.

SLIDE 122

Research was also undertaken to determine to what extent our protocols for cryoprotection and freezing were conferring protection and causing injury. This work definitively characterized the nature and extent of cryoinjury using 4 M glycerol as the CPA and uncovered the problem of fracturing in tissues and organs cooled to below the glass transition point [1] Tg of the cryoprotective solution: http:

//wp.me/p1sGcr-l7

http://wp.me/p1sGcr-lH

SLIDE 123

High quality promotional literature, educational materials, and scientific publications were consistently produced and the use of the words death and dead in reference to cryonics patients was abandoned, correcting the semantic imprecision that had so handicapped cryonics since its inception. And something else began happen that was quite remarkable. Despite the fact that Alcor was very low profile with respect to the media, we began to grow. In fact, cryonics began to grow again after over a decade of near total stagnation that was the legacy of the devastating hit its reputation had taken after Chatsworth.

SLIDE 124

Because of our professional and scientific approach to cryonics we attracted the interest of important scientists and theorists far removed from our own discipline. In March of 1984 a manuscript was sent to my attention at Alcor entitled, The Future by Design. That manuscript was to become the book the The Engines of Creation and the man who sent it to me and to others at Alcor for comment and review was its author, Eric Drexler.

SLIDE 125

The ideas of nanotechnological repair and rejuvenation, and of the information-theoretic criterion for death, were introduced and vigorously promoted via both in-house and media venues.

SLIDE 126

Immediate post-arrest, in-home stabilization and cooling of patients, coupled with pharmaco-protection of the brain against ischemia-reperfusion injury, followed by blood washout in a mortuary and rapid transport to CPA perfusion facilities became routine.

SLIDE 127

The feedback we received from ongoing systematic and broad bandwidth data collection yielded new insights, allowing us to vastly improve the quality of care we were delivering. By the simple expedient of monitoring patients‟ temperature descents we were able to more than triple the rate at which patients were being externally cooled during Stabilization and Transport.

SLIDE 128

In-home extracorporeal support followed by blood washout (with external CPS as a bridge to cardiopulmonary bypass) became routine in hospice cases. Along with this technology sophisticated mechanical CPS (active compression-decompression high impulse CPR (ACD-HI-CPR) coupled with cold fluid peritoneal lavage greatly improved the post arrest patient cooling rate and reduced ischemic injury.

SLIDE 129

By continuing to collect data and do research we were able to further increase patient cooling rates to ~0.5◦C min for the first 30 min of CPS!

SLIDE 130

We also discovered that we could detect when cerebral perfusion failed during CPS by continuously recording temperature descent data from multiple sites in the patient. The abrupt leveling-off of the tympanic cooling curve shown in this slide indicates the point where cerebral perfusion during closed chest (mechanical) CPS was lost. The blue arrow indicates the point where effective cerebral perfusion (and thus cooling) was re-established after the start of cardiopulmonary bypass.

DISASTER STRIKES

SLIDE 131

And then, on 10 July, 1991 Jerry Leaf experienced sudden cardiac arrest and was cryopreserved. Jerry was the lynchpin that held the diverse interests and personalities together that comprised Alcor.

One unappreciated consequence of his sudden and unexpected cryopreservation was the impact the absence of his quiet authority and enormously stabilizing influence would have on the various strong personalities in Alcor, and on their diverse interests and objectives towards Alcor in particular, and on cryonics as a whole. Additionally, Jerry‟s control over the medical and surgical service delivery component to Alcor, via his Cryovita Laboratories, Inc., provided a powerful balancing check on internal power politics.

Thus, Jerry‟s absence critically destabilized the leadership dynamics of the organization.

SLIDE 132

The final blow to the third era of cryonics was the coming of the “tyranny” of Nanotechnology (NT) and the Singularity about which I‟ll have more to say later in these lectures.

SLIDE 133

How and why did this happen? How did Alcor go from in-home cardiopulmonary bypass to a state where patients count themselves lucky if they even receive prompt heart-lung resuscitator (HLR) support and get packed in ice?

SLIDE 134

It happened because small organizations are shaped by the personalities of the 2 or 3 people who found and operate them and because creation of a viable institutional culture requires at least one generation (~21 years) of stable, uninterrupted mentoring, and a solid base of practitioners (6-12 people).

If death or loss of emerging professionals destroys the developing culture of professionalism, then the whole system collapses, and usually any effort to recover lost quality and competence must originate outside the failed system (and away from the hard core of the well entrenched institutional cultural paradigm that will have developed in its absence).

SLIDE 135

It is important to understand that the practice of a scientific and medical model based approach to cryonics cannot be achieved by the simple expedient of finding and recruiting medical professionals or medically qualified technical specialists such as paramedics, perfusionists, physicians or nurses to “do the job” of delivering cryonics patient care. Few of you here today would presume that a General Practitioner could competently perform as a neurosurgeon – or even that a psychiatrist could pinch hit for one – even though both of latter are specialists in treating the same organ – the brain.

While the professional practice of cryonics requires a deep and interdisciplinary knowledge of medicine that is not enough. It requires much additional knowledge and training which is not available at university, nor unfortunately, in any structured form at this time. Perhaps more importantly it requires the skill-set and mindset of a highly motivated researcher knowledgeable about cryonics and capable of both asking and answering the right questions. These kinds of individuals are almost always produced by an institutional culture that mentors and motivates, as well as teaches and instructs. Absent that, they are very rare in any discipline and have been especially scarce in cryonics due to its small size and its historically bad public image and scientific reputation.

Professionalism is, at its core, a result of people who care deeply about what they are doing and genuinely believe that their art and science is making a difference and is in some way deeply transformative (or even revolutionary) with respect to the world as a whole. I suppose the most direct, if not the most elegant way to put this, is that to do cryonics well you must love cryonics – love the practice of it – not just the idea of it. That alone is not sufficient, but when coupled with capability and competence, it is the minimum that is required.

SLIDE 136

This is a very hard concept to communicate. Perhaps it can best be conveyed by analogy. The business of climbing a mountain is deceptively simple and consists of walking, climbing and crawling all of which are basic if not intrinsic human skills. However, if we consider what is required to climb a very tall peak, such as Mount Everest, we will soon realize that a great deal more is required than the basic motor skills I’ve just listed. The extremes of temperature and the scarcity of oxygen make it a formidable technical challenge, and what‟s more, a truly awesome biomedical one. All kinds of knowledge and skills both sophisticated and subtle are necessary.

But beyond the purely technical, anyone who would summit Everest must have an astonishing emotional

commitment to the task as well as incredible fortitude and strength of will. It is a horrendous effort and it is not only not for the faint of heart, it is not for anyone who lacks deep commitment to the task. A profession is very much like the sport of mountain climbing. Most of its practitioners will spend all of their professional lives summiting well trod and fairly mundane peaks and guiding others to do the same. A few will summit difficult peaks and in so doing add some small measure of knowledge to the craft. Only a very few will try to go where no others have gone before and do so under the most dangerous and demanding conditions. These individuals are extraordinarily rare and they invariably found or define the professions they practice.

So, while it is possible to train many people to climb mountains, and even to teach them the technical skills required to summit Everest or k2, it is not possible to give them the drive, the stamina and the passionate desire that are also required (at least at this time and with currently available technology).

End of  Inherent Failure Mechanisms and Risks, Part 2

Footnotes

[1] The glass transition point is the temperature at which a liquid becomes a glass – or in other words – become a solid by getting thicker and thicker as it is cooled without undergoing freezing. Frozen tissues impregnated with glass forming cryoprotectants such as DMSO or glycerol will be part ice and part glass. The more of the tissue in the glassy or vitrified state the more it will be crack or fracture when cooled below its glass transition point.

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Cryonics: An Historical Failure Analysis, Lecture 2: Inherent Failure Mechanisms and Risks, Part 1

By Mike Darwin

1972-1991

AWAKENING TO REALITY

SLIDE 96

As I said in the previous lecture, the literature produced by CSNY created an impression of competence and of the presence of a solid organization.

After I had been involved in cryonics for a little over a year I began to hear rumors that CSNY was not being run honestly and that, in particular, the patients were not being
stored submerged in liquid nitrogen and that their heads and upper bodies were well above dry ice temperature.

There were other rumors and accusations as well. The source of these turned out to be Robert Nelson, and after a great deal of difficulty I managed to speak with him by phone.

GOOD ADVICE

Nelson.s charges prompted me to call Curtis Henderson and to confront. him with Nelson’s accusations. Henderson.s response was simply to invite me to come and see for myself. He explained that it was impossible to answer accusations of the kind Nelson was
making in any meaningful way short of seeing first-hand what conditions were and spending time with the people to whom I had entrusted my life. I was 14 years old at that
time and I doubt very much if Curtis expected me to take him up on his offer – even though it was clearly sincere.

SLIDE 97

However, that is exactly what I did. I took a part time job to pay for my plane ticket and I showed up on CSNY’s  doorstep the summer after that phone call.

SLIDE 98

The image of solidity and professionalism projected by CSNY.s literature was tempered substantially by my having visited CSNY during the summers of my 14th and 15th years (yes, I went back). I was well aware that the storage facility was small and that the resources of the organization were minimal. For that reason, and because of the geographical distance, I began to accumulate the equipment and supplies required to carry out cryoprotective perfusion and cooling to dry ice temperature. I also began efforts to recruit others into cryonics.

By late 1971 I had acquired all the equipment and chemicals I believed were needed to carry out the pre-liquid nitrogen phases of cryopreservation. One of the most costly items, and one which I had to purchase new, was a thermocouple thermometer, pictured sitting atop cases of Ringer.s solution and indicated by a red arrow.

By 1972 the war of words between CSC and CSNY had reached fever pitch. One of the charges being made by CSC was that Curtis Henderson was storing patients improperly and that their heads and upper bodies were, in fact, well above dry ice temperature most of the time.

In December of 1972, Corey Noble and I journeyed from my home in Indianapolis. Indiana to visit CSNY and actually measure the temperature at the top of the MVE dewars, as well as at various points on the patient then in storage and so the TC meter in this picture was taken along on the trip.

Note the character and quantity of the equipment and supplies I had accumulated in Indianapolis: at left the Westinghouse Iron Heart; center, a dry ice box; upper right,
roller and centrifugal pumps; lower right, Ringer.s solution, DMSO, stainless steel heat exchanger, bubble trap, formaldehyde for sterilizing the perfusion circuit, perfusion
circuit, pH paper, liquid measuring equipment…

SLIDE 99

The morning after Corey and I had arrived at the CSNY facility, we were awakened by Saul Kent, who informed us that a CSNY member, a woman named Clara Dostal, had just been pronounced legally dead and that, since we were “experts” in the area of cryoprotection and perfusion, we should take charge of the case and perfuse the patient. This was the beginning of a period of agonizing cognitive dissonance for me (I cannot speak for Corey Noble).

SLIDE 100

Prior to this, perfusion and cool down as practiced by CSNY had been a black box to both Corey and me. We assumed that this procedure was carried out in a “scientific” manner and that the CSNY mortician Fred Horn, working with their biologist Paul Segall, were implementing some kind of reasonably professional and standardized care – even if it was not very sophisticated. In this we were sadly mistaken. To my horror I discovered that not only was I better prepared to perfuse and freeze patients in Indianapolis, but CSNY neither owned nor had access to a graduated cylinder for measuring out the volume of
cryoprotective agent to be added to the Ringer.s carrier solution! We were forced to measure out the glycerol to be added to the Ringer.s carrier solution by using an empty
Ringer.s solution bottle. The approximate liquid volumes molded into the glass of these IV bottles had to serve in place of an accurate measuring cylinder.

SLIDE 101

Even more surprisingly, we discovered that CSNY had no way of measuring temperature. The only thermometers at our disposal were the ones we had brought with us. There was no established protocol, no dedicated equipment, no data collection and no monitoring or observation of the patient at all. I was appalled and deeply shaken. For the first time I realized on both an emotional and intellectual level that cryonics had truly failed. Certainly, in the form I found it, it had no chance of success.

SLIDE 102

Corey and I did what we could. We carefully measured every parameter it was possible for us to measure on site, such as patient and perfusate temperature, perfusate glycerol concentration, arterial flow rate, patient cooling rate, and so on. We also collected effluent samples from the patient and divided them such that one set would remain with the patient (bottles seen at lower left in the next slide) and the other set would be taken back with us for physical and biochemical analysis (CPA concentration, pH, electrolytes, tissue specific enzymes, etc.).

The TC thermometer we had brought with us from Indianapolis proved essential for monitoring the patient’s internal temperature during perfusion as well as her temperature as she cooled to dry ice temperature. The objective was to thoroughly document her care and make recommendations for changes in the future. We both felt strongly that future patients should benefit from the knowledge and experience gained from this (and every)
case.

SLIDE 103

The paper we produced appeared in the March, 1973 issue of Manrise Technical Review, a publication produced by Alcor.s brother for-profit organization, Manrise Corporation, which was edited by Fred and Linda Chamberlain.

SLIDE 104

My experience perfusing and freezing Clara Dostal left me deeply anxious and profoundly dispirited. It took several weeks before anger replaced fear, and a relentless commitment to rapidly improve conditions replaced a near total paralysis of will. In no small measure this experience led to me seek out others who shared my vision of cryonics as a competent, well run undertaking based on a scientific and medical model in the context of good business practices.

CRYONICS’ SECOND ERA: 1972-1981

SLIDE 105

This led me to connect with Fred and Linda Chamberlain in Southern California. Following my trips to CSNY, I set out, again with Greg Fahy, to try to determine
the state of cryonics on the West Coast. What we found there, or more precisely what we didn’t find, was even more disturbing than what we had seen and experienced at CSNY. While Corey did not share my opinion, let alone my conviction, the trip to Southern California had convinced me that CSC’s patients had been badly mishandled and that
in all likelihood they had been thawed out and buried or cremated. This conviction was shared by Fred and Linda, with whom I formed strong and immediate bonds.

Fred and Linda, like me, had come to realize that cryonics was an abject failure and, with painful slowness, they had begun the process of creating facilities to provide for rescue, stabilization, perfusion and storage with two new organizations: the Alcor Life Extension Foundation, and Manrise Corporation.

SLIDE 106

We began to scour the scientific literature for information to allow for development of a rational cryobiological approach to care, and where possible experts in medicine and cryobiology were consulted. A technical publication was launched and organized research was begun into developing scientifically sound procedures and equipment – and to document them openly and in as much detail as possible.

THE BIRTH OF SCIENTIFIC CRYONICS

SLIDE 107

A modest research and patient cryopreservation facility was set up and preliminary small animal research was undertaken to evaluate then current human cryoprotection strategies.

SLIDE 108

Since we could not be assured of being able to afford permanent facilities long term, a decision was made to modularize capability and a mobile operating room was constructed using an old laundry van (lorry). Refinements were made to in-house fabricated perfusion and heat exchange equipment and testing of these systems was undertaken to establish reliability and gain familiarity with their operation. Business plans were generated and necessary equipment and consumables were acquired. Cost analysis and financial and legal issues were extensively addressed. A comprehensive program of marketing (Trans Time) coupled with financial incentives for success was undertaken. Inter-organizational cooperation began and an attempt was made establishing minimum standards of care and self-regulation.

SLIDE 109

At about the same time, a graduate student in mathematics who lived in the San Francisco Bay Area, Art Quaife, along with an electrical engineer (John Day) and several other interested cryonicists, including Paul Segall, who had relocated to the Bay Area, founded Trans Time, Inc. (TT). TT was similarly focused on “rebooting” cryonics as a proper scientific undertaking run on sound business principles. TT purchased the technological platform developed by Manrise Corporation for cryoprotective perfusion (including the Manrise perfusion machine, heat exchanger, and procedure manual) and focused primarily on producing the first truly comprehensive business analysis of cryonics. They also did much to clarify nettlesome financial and legal issues.

TT launched the first comprehensive program of marketing cryonics coupled with financial incentives for success, and they also aggressively marketed their stock to
educated investors within the cryonics community.

SLIDE 110

Dedicated (leased) storage and perfusion facilities were put in place in by TT in Northern California in 1974.

SLIDE 111

On 09 February, 1974 a decade after The Prospect of Immortality was published and seven years after Dr. Bedford was cryopreserved, Trans Time accepted its first two patients and the first human cryopreservation conducted under something approaching „controlled
conditions. took place. [The Dostal case technically qualifies but it was an ad hoc effort, not a planned undertaking.]

Despite two years of preparation there were many problems with both of these cases. As you can see in this photo, many practical details, such as how to position and anchor the perfusion tubing had not been worked out and improvised solutions were employed. Note the plastic embalming fluid bottle being used as a prop and the tubing connecting the arterial line to the patient being supported by a length of ligature twine.

Much more seriously, take a good look at the patient. This photo was taken at the end of CPA perfusion (decannulation is underway and some of the refrigerating ice has been removed). Unlike Mrs. Dostal, this patient has become markedly edematous as a consequence of CPA perfusion. This happened because what seemed best in a review of the literature did not work when applied clinically. In this case, a decision had been made to use DMSO instead of glycerol because of the former.s superior cellular permeability. Unfortunately, DMSO is quite toxic to the vascular endothelium and this effect is greatly
amplified in patients with prolonged ischemic injury. This patient received no cardiopulmonary support and had suffered well over 24 hours of cold ischemic injury.

The obvious (but unheeded) lesson was that techniques used on humans must first be evaluated in a suitable animal model under conditions as close to those that are encountered clinically as possible.

SLIDE 112

While the party line to the media had always been that patient stabilization was begun immediately upon pronouncement, it was not until Fred Chamberlain, Sr., arrested on 16 July, 1976, that this was actually done. The next such case, shown in this slide, took place under the auspices of Trans Time three years later in January of 1979. At the bottom center of the slide a blue plastic case with a small speaker next to it contains an electronic stethoscope with amplifier so that the patient could be monitored continuously and the moment of cardiac arrest determined with precision. This instrument was developed by Fred Chamberlain and me and was first used (successfully) on his father, Fred Jr.

SLIDE 113

At this point, cryonics as practiced by Alcor and Trans Time had become professionalized to the extent that there was control over and documentation of perfusion temperature, pressure, and flow. The volume of perfusate used was based upon complex mathematical modelling of CPA uptake and there was frequent and consistent measurement of the concentration of CPA in the venous effluent. Finally, in-house trained and skilled personnel were available in conjunction with an effective emergency response system (ERS).

SLIDE 114

Cooling to -79oC and -196oC were also documented and brought under some measure of control. Packing of patients in dry ice to achieve freezing was abandoned and an isopropanol bath was used in conjunction with the measured addition of dry ice in order to reduce the patient’s temperature in a controlled manner.

PAYING THE PIPER

SLIDE 115

Then, in 1979 the years of deceit and lies which had dogged cryonics from the start came to the fore. The nearly completely decomposed bodies of ten cryonics patients were discovered by an investigative reporter in the facilities of CSC in Oakwood Cemetery in Chatsworth, CA. As I have previously stated, the consequences of this scandal were devastating for cryonics. The story of the initial discovery and the subsequent civil trial that resulted remained an item in the national press well into the 1980s.

SLIDE 116

Cryonics became synonymous with “thawed bodies” and there were countless cartoons and gruesome humor pieces in magazines and newspapers. The loss of credibility and
the specter of failure resulting from Chatsworth extend into the humor, as well into the more serious criticism of cryonics today, as evidenced by this still from the animated
series Futurama. Futurama.s creator Matt Groening followed the Chatsworth scandal as a boy and some of his most successful cartoons early in his career satirized the Dora Kent debacle.

SLIDE 117

In 1980 the grotesque scene at Chatsworth was again played out, this time, mercifully, absent any media coverage. The victims were Ann DeBlasio and a woman from Beverly Hills, California, both of whom had been placed in an inadequate facility, absent any alarms or monitoring, in Mount Holiness Cemetery in Butler, New Jersey (NJ).

That facility was a duplicate of the one Nelson had constructed in Oakwood Cemetery in Chatsworth. And yes, Nelson, along with Nick DeBlasio, had built the Butler, NJ facility as well.

SLIDE 118

Eleven years after she had been cryopreserved at CSNY, this is what had become of Ann DeBlasio. After the expenditure of tens of thousands of 1970 dollars and countless hours of labor any chance these two women had of returning to life was gone.

So ended the second era in cryonics.

 End of Inherent Failure Mechanisms and Risks, Part 1

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Cryonics: Failure Analysis, Lecture 1, Initialization Failure, Part 4

By Mike Darwin

THE PROBLEM OF NO FEEDBACK

SLIDE 87

How did these things happen? How did sincere, hard working, committed people who desperately wanted cryonics for themselves allow the situations I’ve just described – the woefully inadequate perfusion capabilities (or more properly, lack thereof) and the madness of racking patients head-up in their storage dewars?

And what about Dr. Bedford? How was it possible for his care to have been so botched while the media, and the overwhelming majority of cryonicists, remained convinced that he had been cryopreserved under seemingly good conditions?

Even more incredibly, let‘s stop and reconsider Chatsworth with greater care. Yes, Robert Nelson was a fraud and sociopath – no question about that.

But the rest of CSC‘s membership was neither sociopathic nor fraudulent. They were very sincere and deeply committed cryonicists. Marie Sweet, Helen Kline, Russ Stanley, and the father of 8 year old Genivieve de la Poteri, were all CSC members who were involved with the organization for months or years before they themselves were cryopreserved and ended up as skeletal remains at Chatsworth.

Virtually all of the other CSC members were decent people. Several of them had put tens of thousands of (1968-9) dollars of their savings into the CSC facility. All of these people refused to believe that anything was amiss at the Chatsworth facility until the press broke the story in 1979! On average CSC members were intelligent professionals, entrepreneurs, small business people and, above all, independent thinkers. How was it possible that, even as evidence accumulated that “things just didn‘t add up” with CSC‘s storage operation, they continued to have confidence in CSC?

In fact, of the 30 or so “signed up” CSC members at the time, only two became suspicious, investigated, and left the organization; Fred and Linda Chamberlain. And in the cryonics community at large, only three people were likewise deeply suspicious (or virtually certain) that something was amiss with CSC: Curtis Henderson, Saul Kent and me.

SLIDE 88

In 1986 I wrote an article entitled the “Myth of the Golden Scalpel” which first delineated the problem of “no feedback” in cryonics. The article was a response to intense criticism of the application of an evidence based, medical model to cryonics and the associated increase in costs and, perhaps just as importantly, the accompanying disempowerment of “amateurs.” Prior to the entry of professionals – or people working to create professionalism in cryonics – cryonics was a “do it yourself” (DIY) undertaking and anybody could (and did) undertake to cryopreserve people. A corollary of this was that anyone‘s opinions about how cryonics should be practiced were as good and as valued as anyone else‘s. Much of this criticism came from members of the Bay Area Cryonics Society (BACS) and the Cryonics Institute (CI).

In the next part of this lecture, I will show you images of the cryoprotective perfusion of a CSNY patient from 1972. That is very close to how CI carried out their perfusions at that time, and indeed, it was not until Ben Best arrived at CI that even the simplest and most basic parameters of patient care were monitored or recorded. And even now, CPA perfusion at CI more closely resembles what you will see in the slides from 1972 than it does what you will see still later when the Chamberlains, Jerry Leaf and I began changing cryonics.

The kind of procedures being used before the application of an evidence based medical model to cryonics are best described as ritual, not science. There were no truly meaningful tests, measurements or evaluations performed to inform the people carrying out cryopreservation procedures whether things went poorly or well and whether the “standard” procedure (or a modified one) was good or bad for a given patient.

For instance, should patients with long ischemic times get a different treatment than patients with short or very little ischemic times? Perhaps a more rapid increase in CPA concentration should be used, or even no CPA perfusion at all under some circumstances? How and why such decisions are to be made should be documented and have a scientific basis which is continually being informed by ongoing research.

SLIDE 89

In conventional medicine, where personnel at all levels are extensively trained, those who control the discipline are highly educated and skilled professionals; there is licensing and government oversight, and extensive documentation of procedures and record keeping. Lethal and morbid injuries are surprisingly common. As you can see, in the US alone, there are over three quarters of a million deaths each year due to medical error (iatrogenesis).

This is a staggering number of deaths and the associated cost is an estimated $282 billion! And keep in mind this does not include the patients who are injured and do not die, or the many patients whose death or injury is either not detected, or not reported.

 SLIDE 90

As bad as the problem is, it would be much worse if it were not for the fact that in medicine the patients being treated provide feedback. If you injure a patient delivering medical care, the odds are good that the patient will show both symptoms and signs of your error. He may suffer pain, become gravely ill, behave abnormally, lose sensory or motor function, be disfigured, or die.

The image at the right of this slide is of a decubitus ulcer – a bedsore or pressure sore, in common parlance – due to failure to properly position and turn the patient. Bedsores are surprisingly common because the patient does not feel the discomfort until after the injury at the pressure point(s) has occurred. Patients in extended care facilities are also often effectively “voiceless objects” who are frequently demented and are often unable to speak articulately for themselves even when compos mente. All too often they are also being warehoused and cared for by under-trained or under-motivated personnel.

Medicine also benefits from diagnostic modalities, such as the x-ray image at right, which allows for errors to be uncovered more effectively – and thus be corrected or mitigated – where it‘s possible to do so.

Unfortunately, the cryonics patient can provide none of the feedback a living patient does and as I have often said before, a patient who is straight frozen invariably looks far better and far more lifelike and at peace than a patient who has received the best available care.

LACK OF PROFESSIONALISM

SLIDE 91

If the cryonics patient was not in a bad enough position as a result of the no feedback problem, the situation becomes even worse when he is being cared for by personnel who have no extensive real-world experience in biomedicine (both in clinical and research environments) IN ADDITION to specialized training to integrate that experience into the context of cryonics as medicine.

Here I would like to use an example which is incredibly frustrating to me because it has recurred, even with people delivering care to cryonics patients who have been told about this problem and given a clear explanation as to how to avoid it.

It‘s a “mechanical” problem that I think is easily understood, so I‘m using it as an example. There are many, many other more complex and subtle problems that would be much more difficult to communicate in the available time.

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

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

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

SLIDE 92

Now, if the patient has a large volume of fluid in his abdomen, a condition called ascites, or is very obese, what happens is that the pressure from all the fluid or fat compresses the very thin and flexible walls of the vena cava and prevents adequate venous return. In fact, it‘s a wonder that any flow can proceed under ‗normal‘ circumstances.

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

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

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

SLIDE 93

This problem has occurred at least five times in cryonics cases that I know of, and in four of those five cases, it happened to personnel who had experienced the same problem before. And yet, the problem was not addressed and the same rote procedure was followed despite the fact that problems were evident. I will say that in the two cases where there was no venous return they did eventually stop perfusion because they realized that ‗something was wrong.‘

The solutions to this problem are not easy because they demand the acquisition of professionalism, knowledge, and skill in the context of cryonics as medicine. We came very close to doing that in the decade between 1981 and 1991. But we failed. Why we failed I‘ll discuss later. Suffice it to say that the problem of maintaining professionalism is a nettlesome one in medicine, engineering and other demanding disciples, and there will be no quick fixes. In cryonics, where almost all the feedback we get from our patients must be artificially generated, the problem will be much more difficult to solve.

As we’ve already seen, patients can even have completely decomposed – and the cryonics organization can continue to operate, not just for weeks or months, but for years after this has occurred – all the while continuing to accept more patients!

I selected the image for this slide with special care, because it points up one of the many serious problems lack of professionalism in cryonics has caused. Repeatedly in the history of cryonics those in leadership positions within cryonics organizations have hired and placed in positions of power family members, close friends and cronies, with little (and usually no) respect to their qualifications. The most glaring recent example of this was when a former CEO of a cryonics organization hired his wife, his daughter and his son-in-law as paid full and part time staff. Professionalism is anathema to nepotism. Professionalism is first and foremost a meritocracy.

SLIDE 94

What is cryonics professionalism? The short answer is that it does not yet exist, per se. If and when it does, the short definition is that cryonics professionalism is adherence to a set of values comprising both a formally agreed-upon code of conduct and the informal expectations of colleagues, clients and the cryonics community.

The key values include acting in a patient’s interest, striving to improve the quality and length of a patient‘s pre-cryopreservation life, and maintaining the highest standards of excellence in the practice of cryonics and in the generation and dissemination of knowledge. In addition to scientific, medical, technical knowledge and skills, cryonics professionals should present psychosocial and humane qualities such as caring, empathy, humility and compassion, as well as deep commitment to assisting the individual patient and the community of cryonicists as a whole in their pursuit of indefinitely extended life and health. All these qualities are expected of members of highly trained cryonics professionals. I believe that, at a minimum, these things must be present in the cryonics professional:

Professional Commitment to Patient Welfare constitutes the essence of professionalism and is based on the rule that the best interest of patients and not self-interest is the professional obligation. Professional Accountability is an important element of professionalism which is required of cryonics professionals at several levels: to their patients for fulfilling the implied contract governing the patient/professional relationship, to the cryonics community for addressing their health needs, and to their profession for adhering to cryonics‘ ethical precepts.

Professional Duty can be expressed by the free acceptance of a commitment to service, availability and responsiveness when “on call,” accepting inconvenience to meet the needs of patients, by enduring unavoidable risks to oneself when a patient’s welfare is at stake, and by advocating the best possible care regardless of the patient’s ability to pay. It is a willingness to seek an active role in professional organizations and volunteering ones skills and expertise for the welfare of cryonics as a discipline and a way of life, and of the cryonics community.

Professional Excellence entails a conscientious effort to exceed ordinary expectations. Commitment to excellence is an acknowledged goal for all cryonics professionals and includes a commitment to life-long learning.

Professional Honor and Integrity implies being fair, being truthful, keeping one’s word, meeting commitments, and being straightforward. It also requires recognition of the possibility of conflict of interest and avoiding any situation in which the interest of the cryonics professional is placed above that of the patient or allowing personal gain to supersede the best interest of the patient. This is an integral part of professionalism. The importance of professionalism in the patient/cryonics professional relationship cannot be overstated.

Professional Respect for Others is reflected in the respect towards the patients and their families, other cryonics professionals and professional colleagues such as physicians, nurses, perfusionists, paramedics, and health sciences technicians and therapists. It is the essence of basic, decent conduct and is both central to professionalism and fundamental to enhancing collegiality among cryonics professionals.

SLIDE 95

Until a solid professional base is created in cryonics there can be no enduring success. What you see here are the elements of a mature professionalism, in this case in medicine. You will note that at the left that formal (written) standards and practices, a code of conduct and governance for implementing these things, are among the first elements of professionalism.

It is not necessary for cryonics, in its current microscopic and flawed implementation to create all of the elements shown here – nor is it possible. But what we must do is to begin at the beginning and create standards and practices for every element of the program and both follow and enforce them diligently.

 End of Initialization Failure, Part 4

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Specimen Standards for Evidence-Based Human Cryopreservation Organizations, Part 1

By Mike Darwin

 A Brief History of Attempts to Create and Implement Minimum Standards in Cryonics

INTRODUCTION

First Era 1964-1972

The first attempt to create formal minimum standards for cryonics organizations in the form of the Cryonics Societies of America (CSA) was initiated by in 1968 and was implemented largely through the efforts of the Cryonics Society of New York. The CSA was to be a national standards and enforcement organization, comprised of representatives elected by the individual, member cryonics societies.

Figure 1: Requirements for membership in the Cryonics Societies of America.

Creation of the CSA, and the terms of its incorporation were agreed to by the Officers/Directors of the then extant cryonics organizations: Cryonics Society of New York (CSNY), Cryonics Society of Michigan (CSM) and Cryonics Society of California (CSC). CSA was incorporated late in 1969.

The CSA called for basic accountability in matters such as public communications, information inquiries, membership rolls, financial and member/patient record keeping (submission of quarterly financial records), documentation of cryopreservations (including at least one “confidential” photo), uniformity of letterhead and logos, submission of regular progress reports and investigation of all persons or corporations offering cryonics services or promoting cryonics. Basic requirements were maintenance  of a phone and book listing under the heading “cryonics”, updated list of Officers & Directors, valid addresses for organization and Officers,  and subscription to “Cryonics Reports” for all local group members and a complete log of all written and telephonic information inquiries.

Ironically, one of the driving forces behind CSA was Robert Nelson who, in particular, wanted a standardized procedure generated to administer cryopreservation, particularly with respect to perfusion. A committee consisting of Ettinger, Nelson and Saul Kent was created in April of 1968 to do this, however, according to Kent and Henderson, there was no progress on this, the committee never met, and Nelson did not answer correspondence nor generate the promised liaison with Dante Brunol, M.D., and the CSC mortician Jeff Hicks. Despite misgivings, CSNY committed to be the central body and administration for CSA, and the artist Vaugn Bode generated a logo. Letterhead for national organization was created and standards for regional letterheads were created and implemented.

Figure 2: Vaughn Bode’s CSA logo of a side-view of a Phoenix in flight.

Another critical function of the CSA, and the one which may have motivated its initiation, was the creation of a Scientific Advisory Council (SAC) to the CSA. This Board was to have provided scientific and technical advice related to patient care, evaluated research proposals and recommended funding, and lastly and most importantly, serve to improve the public and professional credibility of cryonics. By 1968, resistance in the scientific community at large was hardening and the cryobiological community was well on its way to becoming highly polarized against cryonics. By this time the mother of cryobiology, Audrey Smith, had already made her public statement calling Ettinger “that horrible man” and Robert W. Prehoda was writing his virulently anti-cryonics book chapters in Suspended Animation: “The Night of January 12, 1967 and “The Lunatic Fringe.” There is some indication that Saul Kent, and perhaps others, may have either seen a precis of these chapters, or otherwise been appraised of their tone, if not their content (CSNY Correspondence Log, 1968).

Figure 2: The 28 April, 1969 letter from Saul Kent laying out the basic parameters required for a national cryonics standards organization to operate.

The SAC was formed on 05 August, 1968 and the relevant documents as well as its composition were published in Cryonics Reports in September, 1968:

Figure 3: The charter of the Scientific Advisory Council (SAC) to the Cryonics Societies of America (CSA). The SAC was to provide the scientific oversight and vetting that would be needed to determine which cryopreservation procedures were applied clinically, and to help direct research to improve them.

There is little known surviving historical documentation of the activities of SAC. According to both Saul Kent and Curtis Henderson, the SAC was not very active and not very responsive to requests for help, although, as they both noted, the areas in which help were most urgently needed either required speculation and expertise (expert speculation from a cryonics perspective, as it were) that the SAC scientists did not have (e.g., formulating perfusion, cooling and storage protocols) or required resources neither the CSA nor its member organizations had available (financing for research). It is clear from correspondence and conversations with some of the principals (Henderson, Kent, Barner and Gouras) that the major obstacle to the SAC’s long term viability was the inability of the CSA to provide anticipated funds for research to be generated by the CSA. There is no evidence that the CSA, acting as unit, provided any input or material support, scientific or technical. The list of the SAC members was used extensively to lend credibility to cryonics for promotional purposes and the list was reprinted as a full page of Cryonics Reports magazine until the SAC gradually disintegrated due to members resigning.

The CSA did remain modestly active for perhaps a year after its inception. There is documentation of essentially complete compliance with the CSA’s requirements in the archival files of CSNY, and much of this material survives and is being digitized. There is evidence that CSM provided substantial compliance, including providing membership rolls, records of information requests, and at least semi-annual bookkeeping summaries. CSC did not provide membership lists, patient records, or financial data. They did provide photographic evidence of the cryopreservation of Marie Phelps Sweet, under substantial pressure and amid allegations (untrue as it turned out) that Ms. Sweet‘s cryopreservation may have been a hoax used to raise money for CSC or Robert Nelson, and those photographs have survived and been digitized.

Figure 4: Robert F. Nelson, President of the Cryonics Society of California

While the CSA was neither very active nor effective, it did continue to exist, at least in name, until serious concerns about the operations of CSC, Cryonic Interment and the integrity of Robert F. Nelson were raised, and finally aired publicly by Saul Kent in an editorial in Cryonics Reports entitled “Trouble in Southern California?” which questioned the integrity of CSC’s patient storage operations (Cryonics Reports: 4(12) 1969; p 2) as noted in this quote from that article:

“At last years’ national cryonics conference in Ann Arbor, Mich. [actually held in April 1969, 8 months before--MP], and Marshall Neel’s presentation concerned a new cryonic storage facility which, according to Mr. Neel, was close to completion. Slides showing the process of construction were offered, and it was stated that within a short time there would be a grand opening before the media, at which several bodies then in individual cryonic storage would be placed into a large multiple-body unit. Cryonic Interment Inc. was the name of the company that was said to own the facility; Mr. Neel was announced as President.

 Since the conference there have been continual statements emanating from the leadership of the Los Angeles based company about the imminence of the opening of the facility.

 As of December, 1969, the facility has not been opened and there is no evidence to indicate that it will.

 We don’t know what has been going on in Southern California because the entire operation has been veiled in secrecy. It is just this air of secrecy that troubles us.”

 The CSA probably became legally defunct within a year or so thereafter since there are unpaid bills for corporation taxes and no evidence of disbursements for these from, either the CSNY or CSC financial archives which are complete for this period. Unless the fees were paid by CSM or by an individual(s) the CSA would have legally ceased to exist sometime in 1970.

 Second Era 1972-1976

Figure 5: Fred and Linda Chamberlain began a second round of unsuccessful efforts in the early 1970s to create a minimum standards  and compliance self- regulatory framework for cryonics. This effort, as had the previous one in the form of the CSA, proved unsuccessful.

The next attempt to establish industry-wide binding standards was initiated by Fred and Linda Chamberlain of the Alcor Foundation in 1972. The effort had, if I recall correctly, the acronym DOMSAC which stood for ” Document of Minimum Standards and Compliance” (DOMSAC). The core requirement of the DOMSAC were to:

“Set minimum standards for all technical aspects of perfusion and cool-down, including data collection formats, parameters to be logged, frequency of data acquisition, minimum equipment and chemical to kept on hand at all times, and so on.” The objectives of the DOMSAC were to:

  • Established a basic standard for organization, reporting and public disclosure of patient case data.
  • Required continuous public accountability (address, identification, a.k.a. and d.b.a. history on all Officers and Directors).
  • Established minimum requirements for emergency notification and communication systems.
  • Limited the scope and nature of claims that could be made to the public or prospective members/clients about cryonics.
  • Impose substantial administrative requirements, as well as mechanics for handling non-compliance and provisions for punitive measures if necessary.

Figure 6: Former President of the Cryonics Society of California, Robert F. Nelson (aka Frank Bucelli) being warmly received by Robert C. W. Ettinger, one of the two originators of the cryonics movement in 20

This document provoked extended haggling and arguments from Trans Time (TT) and the Bay Area Cryonics Society (BACS). (BACS and TT were essentially run by the same management at that time), and to a lesser extent from the Cryonics Society of Michigan (CSM).  The was concern expressed on the part of TT/BACS that the DOMSAC constituted an unacceptable step towards the surrender of autonomy, even if it was in the form of mutual oversight.” To what extent these sentiments were justified it is impossible to know. It certainly has been the case that getting cryonicists, even within their own organizations, to submit to oversight and regulation has so far proven impossible. For instance, Robert F. Nelson was in no way punished for his misdeeds at Chatsworth within the cryonics community, and he is welcomed at both CI and other cryonics functions, where he is treated cordially and has indicated he might reenter the cryonics business in the future.

What was clearly not understood then, or now, is that this “issue” inside cryonics is not a drawing room matter, or even a dirty political backroom matter. It stopped being either of those things when the first patient decomposed at Chatsworth or, more accurately, when Bedford was mishandled by Cryonics Society of California personnel on 12 January, 1967, with the knowledge and complicity of other key people in the cryonics movement.

 

Specimen Standards for Human

Cryopreservation Organizations Draft 2.4

Core Objectives and Related Considerations

The objective of these specimen standards is to return cryonics to the paradigm that was developed initially by the Cryonics Society of New York (i.e., fairness, openness, use of the scientific method, Evidence Based Cryonics (EBC) and diligent communication of comprehensive and accurate information to cryonics organization members or clients), and greatly elaborated by Alcor under the influence of Jerry Leaf and Mike Darwin in the 1980s. This paradigm can be articulated by the following points:

Organizational (Corporate) Structure & Governance

The organizational structure considered here will be that of the non-profit corporation United States corporation,  either charitable (501(c)3) or non-charitable.

The cryonics organization shall be a legally incorporated entity which complies with all applicable federal laws and regulations, as well as applicable laws and regulations of the states and the local jurisdictions in which it is based or operates. If the organization conducts programs outside the United States, it must also abide by applicable international laws, regulations and conventions that are legally binding on the United States.

The organization shall have a formally adopted, written code of ethics with which all of its directors or trustees, staff and volunteers are familiar and to which they adhere and they will adopt and implement policies and procedures to ensure that all conflicts of interest, or the appearance thereof, within the organization and the board are appropriately managed through disclosure, recusal, or other means. This Code of Ethics shall cover accountability, finances, openness, client/member rights, patient rights, confidentiality of medical and cryopreservation records, conduct of staff, and basic procedures for filing and adjudicating grievances within the organization by clients/patients and professional employees.

The cryonics organization shall establish and implement policies and procedures that enable individuals to come forward with information on illegal practices or violations of organizational policies. This “whistle blower” policy should specify that the organization will not retaliate against, and will protect the confidentiality of, individuals who make good-faith reports.

The organization shall have in place policies and procedures to protect and preserve the organization’s important documents and business records.

The organization’s board must ensure that the organization has adequate plans to protect its assets—its property, financial and human resources, programmatic content and material, and its integrity and reputation—against damage or loss. The board should review regularly the organization’s need for general liability and directors’ and officers’ liability insurance, as well as take other actions necessary to mitigate risks.

The organization must have a detailed, written plan of action to protects its patients in cryopreservation against legal or legislative attack, economic instability, insurgent attack by anti-cryonics individuals or entities, as well as plans to cope with and prevail over known existential risks to which its patients may be subject (i.e., hurricanes, tornadoes, earthquakes, blizzards, etc.).

Figure 1: Cryonics organizations must maintain transparency with respect to administrative, financial, scientific, technical and patient care procedures.

The organization must  make information about its operations, including its governance, finances, programs and activities, widely available to the public. Charitable (501(c)3) organizations shall make information available on the methods they use to evaluate the outcomes of their work and must share the results of those evaluations with members.

The cryonics organization must have a governing body that is responsible for reviewing and approving the organization’s mission and strategic direction, annual budget and key financial transactions, compensation practices and policies, and fiscal and governance policies.

Figure 2: The board of directors of the cryonics organization are elected by the cryopreservation members or clients of the organization who have been cryopreservation members or clients of the cryonics organization for at least 3 consecutive years. Directors’ terms may not exceed 4 years.

The board of directors shall be elected by the cryopreservation members or clients of the organization who have been cryopreservation members or clients of the cryonics organization for at least 3 consecutive years. Cryopreservation members with 10 or more years of consecutive cryopreservation arrangements may, at the organization’s discretion, be granted 2 votes in electing directors.

Candidates for the board shall be examined for psychosocial and fiscal suitability by a thorough, objective and written set of standards and examinations.

Directors term limits, order of service (staggered or otherwise) are that the discretion of the cryonics organization. However the length of any director’s term in office cannot exceed 4 years.

The organization must meet regularly enough to conduct its business and fulfill its duties. Directors’ meetings shall be held monthly and combined directors and membership meeting shall be held no less than annually.

The board of organization should establish its own size and structure and review these periodically. The board should have enough members to allow for full deliberation and diversity of thinking on governance and other organizational matters. Except for very small organizations, this generally means that the board should have at least five members.

The board of the  organization must include members with the diverse background (including, but not limited to, ethnic, racial and gender perspectives), experience, and organizational and financial skills necessary to advance the organization’s mission. All directors and officers must be have been cryopreservation members or clients of the organization for a minimum of 3 consecutive years before becoming eligible to serve as a director or officer. In the case of newly forming cryonics organizations, officers and directors must have been members or clients of another cryonics organization for a minimum of 3 consecutive years.

At least two-thirds of the board members, should be independent. Independent members should not: (1) be compensated by the organization as employees or independent contractors; (2) have their compensation determined by individuals who are compensated by the organization; (3) receive, directly or indirectly, material financial benefits from the organization except as a member of the charitable class served by the organization; or (4) be related to anyone described above (as a spouse, sibling, parent or child), or reside with any person so described.

The board shall hire, oversee, and biannually evaluate the performance of the chief executive officer of the organization, and should conduct such an evaluation prior to any change in that officer’s compensation, unless there is a multi-year contract in force or the change consists solely of routine adjustments for inflation or cost of living.

The board of any cryonics organization that has paid staff should ensure that the positions of chief staff officer, board chair, and board treasurer are held by separate individuals. Organizations without paid staff should ensure that the positions of board chair and treasurer are held by separate individuals.

The board shall establish an effective, systematic process for educating and communicating with board members to ensure that they are aware of their legal and ethical responsibilities, are knowledgeable about the programs and activities of the organization, and can carry out their oversight functions effectively.

Board members should evaluate their performance as a group and as individuals no less frequently than every 2 years, and should have clear, written  procedures for removing board members who are unable to fulfill their responsibilities.

Beyond the requirement of 3 consecutive years as a cryopreservation member or client, the board shall establish clear policies and procedures setting the length of terms and the number of consecutive terms a board member may serve.

The board should review organizational and governing instruments no less frequently than every 3 years.

The board shall establish and review regularly the organization’s mission and goals and should evaluate, no less frequently than every five years, the organization’s programs, goals and activities to be sure they advance its mission and make prudent use of its resources.

Board members are generally expected to serve without compensation, other than reimbursement for expenses incurred to fulfill their board duties. A charitable organization that provides compensation to its board members should use appropriate comparability data to determine the amount to be paid, document the decision and provide full disclosure to anyone, upon request, of the amount and rationale for the compensation.

The cryonics organization must keep complete, current, and accurate financial records. Its board should receive and review timely reports of the organization’s financial activities and should have a qualified, independent financial expert audit or review these statements annually in a manner appropriate to the organization’s size and scale of operations. For cryonics organizations with more than $500,000 U.S. in assets the independent financial expert must be certified public accountant (CPA).

Cryonics organizations with assets of $1 million U.S., shall have an audit committee composed of independent board members with appropriate financial expertise. By reducing possible conflicts of interest between outside auditors and the organization’s paid staff, an audit committee can provide the board greater assurance that the audit has been conducted appropriately. If state law permits, the board may appoint non-voting, non-staff advisers, rather than board members, to the audit committee.

The board of the organization must institute policies and procedures to ensure that the organization (and, if applicable, its subsidiaries) manages and invests its funds responsibly, in accordance with all legal requirements. The full board should review and approve the organization’s annual budget and should monitor actual performance against the budget.

The cryonics organization should not provide loans (or the equivalent, such as loan guarantees, purchasing or transferring ownership of a residence or office, or relieving a debt or lease obligation) to directors, officers, or trustees.

The organization shall spend at least 30% of its annual budget on programs that pursue its mission. The budget should also provide sufficient resources for effective administration of the organization, and, if it solicits contributions, for appropriate fundraising activities.

Figure 3:  Reimbursement for expenses, as well as compensation for services for directors must be unambiguous and in written form.

The  cryonics organization shall establish clear, written policies for paying or reimbursing expenses incurred by anyone conducting business or traveling on behalf of the organization, including the types of expenses that can be paid for or reimbursed and the documentation required. Such policies should require that travel on behalf of the organization is to be undertaken in a cost-effective manner.

The organization shall neither pay for nor reimburse travel expenditures for spouses, dependents or others who are accompanying someone conducting business for the organization unless they, too, are conducting such business.

Solicitation materials and other communications addressed to donors and the public must clearly identify the organization and be accurate and truthful.

Without exception, contributions must be used for purposes consistent with the donor’s intent, whether as described in the relevant solicitation materials or as specifically directed by the donor.

The organization, if a 501(c)3, must provide donors with specific acknowledgments of charitable contributions, in accordance with IRS requirements, as well as information to facilitate the donors’ compliance with tax law requirements.

The organization must have clear, written policies, based on its purpose as a cryonics organization to determine whether accepting a gift would compromise its ethics, financial circumstances, program focus or the well-being of the patients in its care.

The cryonics organization should provide appropriate training and supervision of the people soliciting funds on its behalf to ensure that they understand their responsibilities and applicable federal, state and local laws, and do not employ techniques that are coercive, intimidating, or intended to harass potential donors.

The organization shall not compensate internal or external fundraisers based on a commission or a percentage of the amount raised.

The cryonics organization shall respect the privacy of individual donors and, except where disclosure is required by law, shall not sell or otherwise make available the names and contact information of its donors without providing them an opportunity at least once a year to opt out of the use of their names.

The board shall prepare a written job description for individual board members as well as prepare an annual schedule of meetings, determined a year in advance.

The board she see to it its members receive clear and thorough information materials, including an agenda, to all members two to three weeks before each meeting.

Figure 4: The comprehensive and complete minutes of every directors’ meeting must be recorded on paper, as well as electronically and must be c9ompiled into readily accessible books or volumes for inspection by cryopreservation members or clients at any reasonable time. Similarly, electronic copies of minutes shall also be available so that members distant from the organization’s headquarters may have access to the minutes.

The cryonics organization shall maintain complete and accurate minutes of all meetings which shall be gathered into volumes organized by month and year. These minutes shall be kept at the cryonics organization’s principal place of business and be available for inspection upon the request of any  cryopreservation member or client. Additionally, multiple electronic copies  shall be kept in discrete separate locations to prevent loss due to existential or other disasters and so that they can be made available to members or clients who are far distant from the organization’s principal place of business.

Each board member shall serve on at least one board committee or task force. (For new members, one committee assignment is sufficient.)

The board shall prepare written statements of committee and task force responsibilities, guidelines and goals. These organizational documents, which should be approved by the board chair, are to be reviewed annually, and revised if necessary. The CEO shall assign an appropriate staff member to work with each committee

The board shall create a written system of checks and balances to monitor committee members’ work and assure that tasks are completed on schedule.

Nondiscrimination

The medical model of cryonics as an emergency room (Accident & Emergency) where all comers able to meet the publicly specified requirements of the organization are competently and equally treated, regardless of age, religion, politics, criminal history, gender, sexual orientation, community influence, or celebrity. “Equally” is understood to mean here that all clients will receive the same minimum standards of care set out as being available upon meeting the specified minimum requirements of the organization. It does not imply that higher standards of care may not be paid for by clients able to afford them.  However, it does mean that if such higher standards are offered, or are available for an added fee or other considerations, that all clients shall be apprised of the availability of such non-standard services, as soon as such options are made available.

Figure 5: Cryonics organizations must not discriminate on the basis of age, religion, politics, criminal history, gender, sexual orientation, community influence, or celebrity.

Additionally, the cryonics organization shall adopt the following non-discrimination policy:

The cryonics organization believes that every person has a right to choose and arrange for his or her own cryopreservation and to enjoy its possible benefits of greatly extended lifespan. To this end, the cryonics organization does not discriminate against any person on the basis of race, religion, color, creed, age, marital status, national origin, ancestry, sex, sexual orientation or preference, medical condition, or handicap.

However, nothing in this statement prevents the cryonics organization from avoiding any situation that genuinely threatens the health or safety of cryonics organization employees, volunteers, patients in cryopreservation, or the public, or from requiring reasonable medical evaluations in some instances where a genuine threat to health or safety may be suspected to exist, or where the legal status of an individual with regard to mental competency may be in question.

Feedback, Quality Assurance & Quality Control

Quality control measures which provide feedback about the nature and effectiveness of all of the organization’s procedures will be publicly disclosed in an open and timely fashion. This is understood to include not only medical, cryobiological, patient care, or other technical and scientific procedures, but also financial, administrative and business procedures as well. Both classes of disclosure, technical and administrative, will be discussed with varying level of detail in this document. In administrative areas where there are long established and demonstrably workable resources, the discussion will be more superficial. In technical, ethical and other areas where there is little or no precedent, the discussion will be exhaustive and often accompanied by detailed examples of the required work product.

The clear message of this point is that a culture of openness and accountability is perhaps the most important ingredient to the long term success of any cryonics organization or, for that matter, any quality scientific, technical, or medical institution.

It is important to digress briefly here and discuss the problematic nature of such a high degree of accountability with respect to cryonics organizations, in particular. All human institutions, whether cryonics organizations or otherwise, find this level of accountability difficult to achieve. There are many reasons for this; however these two are by far the most significant: the basic human desire to avoid owning failure, error or misdeeds, and the ammunition public knowledge of failure, error, or misdeeds provides an enemy[1] — which segues into the next point.

Need for a Defensive Organization (a.k.a. Cryonics Defense League)

Cryonics as a whole has become fear-driven and in nearly constant crisis mode. Crises driven operation is necessarily mostly reactive rather than proactive. This is not how any successful organization advances scientifically or financially. Indeed, it is not how success is achieved in any area of organizational operations, even in successfully defending the organization in the long run. Because of this situation it is especially difficult for cryonics organizations to have a high level of accountability, even about seemingly harmless facts pertaining to their procedures and policies, because cryonics is not an established business institution, has an (arguably) increasing number of serious enemies, is widely misunderstood, has been subject to unjustified distortion and sensationalism, has been subjected to repeated rounds of invasive and destructive media siege, and is increasingly coming under governmental scrutiny. Under such circumstances it is completely understandable for a “bunker mentality” to develop.

Further, in order to protect its human cryopatients, a cryonics organization may have to develop not only a bunker mentality, but very aggressive and covert means to defend the well being of its patients. The author has spent the past several years reading extensively the history of emerging medical, social, political and religious movements. In no case was social acceptance or tolerance of any major paradigm changing movement achieved without the use of force and fraud. I even include Darwin’s theory of evolution in this analysis since, as Stephen Jay Gould noted just a few years ago in his book The Structure of Evolutionary Theory, Evolution is neither widely understood nor accepted – this, more than a hundred years after it was publicly espoused.

Cryonics organizations need a separate, defensive organization which can act semi-covertly or covertly as needed to deal with lethal threats, which all conventional approaches have failed to stop. Separating defensive capability from other operations would allow accountability to continue in every area of operations except the last and most desperate measures needed for defense of patients and members. This would allow some measure of psychological tranquility to exist in the organization as a whole, even in the midst of extreme threats, and thus for business as usual to continue and a high degree of experimentation and openness to be maintained even under difficult circumstances.  The most immediate analogy is one of the intelligence and military apparatus of a nation-state. Because these assets exist in a hostile world it is not necessary for citizens, businesses, churches, or charities to anguish over every threat to their existence. Yes, in times of severe crises, or all out attack, all of these entities may divert some or all of their efforts, attention, and support to the crisis, but on a daily basis, it is not necessary that they be consumed with the problems of their own defense. However, more relevant analogies would the Jewish Defense League (JDL) or the Worldwide Guardian Office employed by Scientology.

Until cryonics organizations can rely on a defense force which is competent and properly equipped to deal with even the worst crises, the organization as a whole will be drained of energy and other resources, and most importantly, will be paralyzed by anxiety, and become increasingly afraid to take any actions which expose more of its flank to attack. This is a response characteristic of most life forms more complex than viruses, and is one which must be dealt with. Every organization charged with protecting the survival of its members has such defensive mechanisms, from the amoebae to the U.S. Federal Government.  This is a critical need, which has heretofore been unappreciated in cryonics. The absence of such a defensive mechanism in cryonics is the principal cause of the increasing risk-averseness, and willingness to surrender authority over patients to the regulatory bodies of nation-states.

End of Part 1

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Cryonics: Failure Analysis, Lecture 1, Initialization Failure, Part 3

By Mike Darwin

FRAUDS & FAKIRS

SLIDE 57

While this small corps of serious and honest people was hard at work trying to re-launch cryonics on a solid footing, the legacy of the first era of careless and irresponsible cryonics activity was maturing into what can only be described as a failure of truly catastrophic proportions.

SLIDE 58

As early as 1965 Ettinger had appeared on national television and, in effect, endorsed cryonics operations which were either outright frauds, or were operated by an incompetent sociopath. No effort was made to verify any claims made, and all attempts to establish minimum standards for financial and technical conduct were rebuffed.

SLIDE 59

Wealthy and influential individuals with a deep personal interest in cryonics were put in touch with charlatans and con men that took their money and promptly disappeared. The men who appear on this slide were giants in their respective fields of music, television and cardiothoracic surgery. All were soon alienated by con artists such as Milgram and Gold

SLIDE 60

These internationally known and respected celebrities experienced similar mishandling, with similar results.

SLIDE 61

When the long awaited ‗freezing‘ of the first man took place on 12 January, 1967, the man in charge was Robert F. Nelson, aka Frank Bucelli, a Santa Monica TV repairman. Bucelli was much more than a TV repairman; he was a convicted felon with a long criminal record beginning in his youth; including violent offenses such as assault and battery as well as numerous charges, and several convictions for fraud and theft.

This background had been uncovered in 1966 by CSNY President Curtis Henderson, who had commissioned an investigative report on Nelson/Bucelli by the Pinkerton Agency, the most respected private detective service in the US at that time. This report was forwarded to Ettinger – but no action was taken. Nelson “froze the first man,” and in so doing he established the conditions under which cryonics would subsequently be practiced: lots of superficial media attention giving the appearance of openness and transparency, while at the same time operating in virtually complete secrecy from both the membership of his cryonics society (the Cryonics Society of California: CSC) as well as the press, the public and the regulatory authorities.

SLIDE 62

At the press conference CSC held following Dr. Bedford‘s freezing, the media were told that the first man had been frozen under “controlled conditions.” That a physician had been standing by with a mechanical CPR device (a Westinghouse Iron Heart) and that CPR had been initiated as soon ―as the patient‘s heart stopped,‖ followed by immediate packing in ice and cryoprotective perfusion and cooling to dry ice temperature (~ -77◦C).

The Method: Description of the “Method for Freezing Humans,” By Dante Brunol, M.D., In: Robert F. Nelson, We Froze The First Man, Dell, New York, 1968, pp. 136-156.

SLIDE 63

Subsequently, an elaborate protocol that was purported to have been used called ‗The Method,‘ was circulated to cryonics society officials across the US, and shortly thereafter published in a supposedly factual book about Dr. Bedford‘s cryopreservation produced by Nelson in collaboration with a professional writer, Sandra Stanley (We Froze the First Man).

SLIDE 64

The Press Release: “The first reported freezing of a human at death, under controlled conditions, occurred on Thursday, January 12, 1967.” Robert F. Nelson, We Froze The First Man, Dell, New York, 1968, p. 72.

There has been a great deal of effort of late to portray Nelson as a victim of circumstance, as a well intentioned man who ―got in over his head and handled it badly.‖ Nothing could be further from the truth. As the press release quoted on this slide makes clear, Nelson lied, and he lied from the start. Dr. Bedford‘s cryopreservation in no way even remotely matched the brief description in the press release announcing his “freezing.”

SLIDE 65

Nor was the reality of what had in fact happened in any way reflected in the myriad of subsequent media stories chronicling Dr. Bedford‘s cryopreservation. The media reported what they were told, principally that Dr. Bedford had received immediate post cardiac arrest cardiopulmonary support, cryoprotective perfusion with a DMSO-containing perfusate, and controlled cooling to dry ice temperature (~ -77◦C).

SLIDE 66

This slide graphically documents what the cryonics community and the world were told had been done for Dr. Bedford. The Amtec roller pump pictured here is the very model that is said to have been used in ‗the method‘ employed to cryoprotect and freeze Dr. Bedford. This newspaper article detailing his cryoprotective perfusion is the very article that caused me to become involved in cryonics in 1968.

SLIDE 67

It wasn‘t until the mid-1970s that I began to piece together a very different story of what had happened to Dr. Bedford on that January night in 1967. A picture began to emerge of negligence fused with gross incompetence. When Dr. Bedford was pronounced legally dead, Nelson was nowhere to be found. There was no answering service, no list of numbers where he might be reached, and no equipment or supplies assembled, tested and at the ready.

It was, in fact, hours before Nelson could be located. There was no oxygen to power the heart lung resuscitator. The Amtec pump was owned by CSNY, not CSC, and there was in fact no pump, no perfusion and not even a cooperating mortuary.

SLIDE 68

On 25 May, 1991, I at last had the opportunity to see for myself what Nelson and his cohorts had done to Dr. Bedford. On that sunny spring day we removed Dr. Bedford from his inefficient horizontal dewar to place him in an upright, “Bigfoot,” multi-patient storage vessel.

With careful preparation, this allowed us to examine Dr. Bedford externally, document his condition and take some (peripheral) tissue samples. We placed him in a large, foam insulated, open-topped tank of liquid nitrogen. This allowed us to examine him and evaluate his condition while keeping him continuously submerged in liquid nitrogen, thus precluding any danger of warming him.

SLIDE 69

This afforded us an opportunity to examine him for the first time in 24 years. Now, you too will have the same opportunity.

SLIDE 70

This is the reality of the “care” that Nelson gave Dr. Bedford. He was not perfused, but rather pin-cushioned with syringes of either neat, or highly concentrated DMSO. The large areas of scalded looking skin are probably a result of the hemolytic action of the DMSO solution which was being injected into the vicinity of the carotid arteries in the neck.

The frozen bloody exudate from his mouth and nose is a result of incompetently performed manual chest compressions administered in an attempt to ‗circulate‘ the DMSO to his brain and other vital organs.

SLIDE 71

This deceit and evasiveness alienated competent individuals and caused a cascade of problems that made the environment for cryonics more hostile. This in turn contributed to the lack of adequate capitalization and denial of access to high quality profession and technical services such as physicians, cryobiologists, businessmen and cryogenic equipment manufacturers.

It also provoked intense hostility from the scientific community at large and last, but by no means least, it resulted in Chatsworth. Nelson‘s lies hadn’t stopped with Bedford and they would not end until cryonics was nearly destroyed by his misconduct at Chatsworth where 9 people were found to have been allowed to thaw out (or in some cases had never been

frozen at all) and decompose under shocking conditions. Chatsworth resulted in a nearly decade long hiatus in progress in cryonics and the number of people cryopreserved dwindled to less than 1 per year during the interval of 1975 to 1987!

ABSENCE OF PREPARATION AND PLANNING

SLIDE 72

While fraud and deceit drove the failure of cryonics on the West Coast of the US, other factors were in play on the East Coast. In contrast to CSC, CSNY was operated in an open, above board and honest manner. While CSC‘s patients were decomposing at Chatsworth, CSNY‘s patients were relatively well cared for. In a sense, cryonics existed as two parallel universes a continent apart. This had a polarizing effect, dividing the few cryonics adherents who existed at that time (both the committed and the less so) into opposing camps; each suspicious of and unable to cooperate with the other.

SLIDE 73

On the East Coast, CSNY was making mistakes that would also prove damaging and eventually lethal. While fraud was not an element in these errors, lack of planning and foresight certainly contributed mightily. CSNY and its brother organization Cryo-Span, Inc. had no business plan, no protocols or procedures for delivering the technical aspects of care, and no emergency communication or response system. As CSNY‘s

President, Curtis Henderson was later to say, “We were just making it up as we went along.” On 28 July, 1968 CSNY cryopreserved its first member, Steven J. Mandel.

In the slides that follow I want to give you some visual images that will hopefully provide you with a feeling for what cryonics was like at that time, both in terms of its technology and in terms of its public image.

SLIDE 74

Steven was a 24-year-old aeronautical engineering student from New York City who was already gravely ill when he made arrangements with CSNY and purchased his life insurance. In fact, he was uninsurable, and experienced legal death well

before the non-contestability period of the policy had elapsed. There was no money to pay for the immediate expenses of perfusing and freezing him, let alone to cover the cost of indefinite storage in liquid nitrogen. This situation became known to the management of CSNY within days of Steven‘s cryopreservation.

SLIDE 75

Despite the absence of funding, CSNY proceeded to place Steven into long term storage and rely upon promises from his mother, Pauline Mandel, to provide regular payments for his long term care.

SLIDE 76

This decision was made for many reasons including lack of experience, naiveté, and a strong desire to ‗keep up with the Nelsons‘ and garner media attention which it was believed would further the program and attract additional members and customers.

SLIDE 77

This decision depleted the organization of its capital equipment and cash and subjected it to the considerable expense in time and money of operating a storage facility for whole body patients. While in some ways this was beneficial in that it ‗forced‘ these facilities into existence and also forced the principals of CSNY to confront the logistic, technical and business realities of actually delivering human cryopreservation services, it did not provide them with either the capital or human resources to do these things effectively.

SLIDE 78

Unlike Nelson, who was able to show impressive drawings of his non-existent facility, CSNY had to be content with exposing its modest, indeed crude appearing operation to public scrutiny. The rough nature of the operation, housed as it was in the groundskeepers‘ room of a Long Island cemetery did not inspire confidence in the public or in CSNY’s own members.

SLIDE 79

Despite, and in large measure because of these difficult experiences, Curtis Henderson became focused on developing reliable cryogenic storage equipment, and one beneficial outcome of CSNY‘s efforts was the creation of the first reliable and cost-effective equipment for human cryogenic storage, the Minnesota Valley Engineering dual patient upright, Superinsulated™ high vacuum dewar.

The previous horizontal units manufactured by Cryo-Care Corporation of Phoenix, AZ were notoriously unreliable and very inefficient making long term care cost-prohibitive.

SLIDE 80

Because the patients accepted by CSNY were all third-party cases – situations where the relatives had either initiated cryopreservation or were expected to pay for it, decisions about how patient‘s were cared for became disconnected from rational, scientific or even simple and straightforward technical requirements. The relationship of the cryonics organization was not with the patient, but rather with his next-of-kin.

SLIDE 81

When the MVE dewars were first put into service in August of 1969, it was argued that for commonsense reasons of safety, patients should be racked in the dewar in a head down position. In the early 1970s I argued strenuously that in addition to providing extra protection in the event of vacuum failure, racking patients in a head-down position in the dewar would prevent the enormous thermal cycling that the head and brain were experiencing each time the unit was topped up with liquid nitrogen (i.e., quench cooling of the head from ~ -145oC to -196oC in a matter of minutes).

This proposal was met with fierce opposition by relatives, and (some) CSNY members, alike. Emotional and public relations considerations were paramount. I was told, “We can‘t have our patients in there upside down standing on their heads! People will really think we are crazy!” If you look carefully at the photo of the patient at the upper left of this slide, you can see a line demarking the liquid nitrogen level. Because liquid nitrogen is dispensed in 160 liter containers the liquid level after filling had to be allowed to fall to approximately mid-chest level, exposing the upper body to a continuous series of cycles of cooling and warming with a delta T of ~50oC.

SLIDE 82

The third party problem was greatly exacerbated when CSNY cryopreserved Ann DeBlasio in January of 1969. Mrs. DeBlasio was the wife of a blustering and contentious New York City police officer who often ended discussions by waving his firearm menacingly.

SLIDE 83

DeBlasio, seen looking in through the doorway as his wife‘s dewar is consecrated by the family priest, Rev. Severio Mattei, had no idea of what cryonics was really like.

Understandably, he expected a professional operation with a solid technical basis and, at least, a reasonable aesthetic front. What he was confronted with were a group of people who defied convention in almost every way and a primitive facility that could not even be locked and where groundskeepers tossed their cigarette butts onto the floor and left the waste from their lunches on his wife‘s temporary storage container.

SLIDE 84

So, while Ann DeBlasio became CSNY‘s second patient in long term storage, the situation was not stable and there was dissatisfaction and unhappiness on all sides.

SLIDE 85

This cramped, crude CSNY facility, coupled with a lack of professionalism and the absence of a business-like approach crippled, and arguably destroyed CSNY – and did much to injury cryonics as a whole.

SLIDE 86

While the men who ran CSNY were honest and made no attempt to hide their shortcomings, they nevertheless projected, through their publications and literature, an image of competence and skill that was wholly lacking. In fairness, they understood much of what needed to be done, but having committed themselves to the formidable and unrelenting task of actually delivering cryogenic care (in the absence of adequate resources) it became virtually impossible for them to pursue the proper course of action.

End of Initialization Failure, Part 3

 

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Cryonics: Failure Analysis: Lecture 1: Initialization Failure, Part 2

By Mike Darwin

FAILURE OF HUSBANDRY

SLIDE 34

The core ideas of cryonics, that death is a function of remaining biological structure (information), technological sophistication, and that deep cooling can arrest decay and preserve structure indefinitely to await resurrection by a more sophisticated future medical technology were first promulgated by Robert Chester Wilson Ettinger in a science fiction story, The Penultimate Trump, in 1948.

SLIDE 35

Ettinger did nothing beyond laying the idea out in his story until 1962, at which time he began to be concerned that no one else had come to the same conclusions he had. It occurred to him that if he did not act to at least inject the idea into the culture, he might not benefit from it himself. Ettinger, in turn, had been inspired to create cryonics based on a 1931 science fiction story, The Jameson Satellite by Neil R. Jones, in which one Professor Jameson has his body rocketed into orbit following his death where he remains, frozen, until many millennia later his brain is removed and repaired by aliens, the Zoromes, who place him in a robotic body and allow him to accompany them on their romps around the galaxy.

SLIDE 36

At about the same time, an intellectual and remittance man named Evan (Ev) Cooper had come to the same conclusions as had Ettinger and he privately published a manuscript that proposed a “freezer program.” Cooper, unlike Ettinger, had no scientific training and his proposals for using arctic or Antarctic storage lacked scientific rigor.

SLIDE 37

In 1964 Ettinger published The Prospect of Immortality after it passed scientific review by universally respected experts at the time, such as Isaac Asimov and the maverick cardiac surgeon and cryobiologist Richard Lillihei.

SLIDE 38

Aside from the idea of cryonics, Cooper and Ettinger had a number of other things in common. Both men were intellectuals (academic-types) who possessed large personal libraries, read voraciously and were described by their contemporaries as “visionaries” preoccupied with ideas. Both men sought leadership positions, and both men looked to others (governments, NGOs, corporations, entrepreneurs) to subsume and implement cryonics.

SLIDE 39

Their personalities were those of the classic introvert. I want to be at pains to point out that this is in no way a criticism of either man. In general, we do not get to pick our personalities or temperaments, and these men were what they were: there is no fault or blame involved in being either an extrovert or an introvert.

SLIDE 40

Both men saw cryonics as integrating into and augmenting the existing cultural paradigm; Cooper, from a left of centre perspective, believed cryonics should be implemented by the United Nations and administered from a top-down, central-planning perspective as a public welfare measure, while Ettinger, from a right of centre perspective, envisioned cryonics being implemented by large corporations and entrepreneurs offering a wide range of services in a largely laissez faire manner.

SLIDE 41

Nevertheless, these traits had consequences for cryonics that were, on balance, not conducive to its successful launch. Things might have been different if either man had had a Huxley to his Darwin – a vigorous, outspoken, charismatic, articulate and, above all, honest and well informed advocate of their ideas.

SLIDE 42

Precisely for the reasons outlined above, two highly influential men who understood cryonics, and believed in its technical feasibility, rejected it, one personally and privately, and the other vocally and publicly. The science fiction writer, savant and media darling Isaac Asimov, understood immediately that cryonics would up-end the existing order and ultimately lead to a fundamental transformation of mankind into something other than human. He found this extremely disturbing and “unnatural,” and wrote and spoke extensively against cryonics on social, environmental and moral grounds.

The widely respected science fiction author and futurist Fred Pohl also understood the likely workability of cryonics and in fact wrote a very positive cryonics themed novel, The Age of the Pussyfoot (first published in 1966). Pohl rejected cryonics exclusively on the basis of survivorship guilt and concern over his ability to adapt to a world transformed by technologies even he might not be able to imagine. Pohl actually turned down an offer for a no-cost cryopreservation from me and several others active in cryonics on September 1st, 1979, and he expressed his reasons for doing so pleasantly, articulately and in person.

FIRST ERA: 1964-1972

SLIDE 43

Despite these shortcomings and setbacks, cryonics was initially received fairly well in the US. There was enormous publicity and most of the initial newspaper, radio, magazine and

TV coverage was open minded, and not infrequently positive. There was a great deal of public interest, and media appearances by Ettinger, and others, typically resulted in hundreds of requests for information.

SLIDE 44

But the culture, both scientific and popular, was woefully unprepared for the idea. It is difficult, today, to communicate what the world was like in 1964. The discovery of the structure of DNA was only 11-years old, CPR was only 4-years old (Leonard Cobb would not hold the first citizen CPR training sessions in Seattle, WA until 1972 (8 years later), the Uniform Determination of Death Act was not passed until 1978 (14-years later) and the first heart transplant was 3-years in the future (1967). People uniformly saw life and death as binary states and the idea that the soul, or some other mystical life force left the body at, or shortly after the moment of death, was nearly universal in the general population.

SLIDE 45

Recovery from apparent (clinical) death which, is now widely understood and taken for granted, was a new phenomenon in 1964, and the Emergency Medical System (EMS) as we understand it today, did not exist. In most communities the mortician‘s hearse doubled as the ambulance and the person most likely to transport you to the hospital if you were gravely ill or injured was your local Funeral Director, or one of his embalmer employees.

SLIDE 46

It is debatable whether these formidable cultural obstacles could have been overcome. But what is not in dispute is that overcoming them was hopeless in the absence of careful planning and entrepreneurship of the cryonics idea. Both Ettinger and Cooper abdicated any responsibility for implementation of cryonics to others, and neither made any real efforts at a first approximation of the technological specifications or necessary business planning.

In Ettinger’s case, he uncritically and actively endorsed con men, frauds and the incompetent – actions that were to badly damage the credibility of cryonics with people of means and influence, as well as those in the scientific community and the professions.

SLIDE 47

Powerful, paradigm changing ideas require careful husbandry and meticulous planning. A good example of this that stands in sharp contrast to cryonics, is the idea of molecular nanotechnology, as first articulated and promulgated by Eric Drexler. Drexler understood not only the potential benefits of nanotechnology, but also its downsides: its nearly endless capacity for harm, ranging from mischief to catastrophe.

He also understood the need to back up general statements and assertions about the capabilities of nanotechnology with detailed scientific analysis and modeling. He did not write Engines of Creation and stop there; he followed through with Nanosystems, and he surrounded himself with talented, honest, competent and articulate people who could and did promote his ideas in a responsible way – to extraordinarily favorable reception. It is worth noting that Drexler, like Ettinger and Cooper, is also an introvert who shares most of the same personality traits with both men.

SLIDE 48

Drexler was both a scientist and an engineer, and he approached communication of his ideas to both the scientific community and the public, with care and precision. He clearly defined terms and, where necessary, created new language to express ideas that could not be effectively communicated otherwise. By contrast, those promoting cryonics gave no thought to making important semantic distinctions, such as the difference between the sloppy and imprecise contemporary medico-legal definitions of death, and the new reality that cryonics implied.

SLIDE 49

Similarly, identification and alliance of cryonics with the mortuary and cemetery trades (as opposed to the medical and scientific professions), and failure to develop any in-house standards of care; either technical or financial; lead to a total failure to professionalize cryonics.

SLIDE 50

This in turn led to the empowerment of amateurs and laypersons, usually with “outsider” personalities, often with accompanying deficits in social and emotional intelligence. These people attracted dysfunctional and sometimes frankly sociopathic personalities as members (and sometimes as activists). The problem of sociopaths in positions of power and authority in cryonics is a serious one which I will return to in detail later in these lectures.

SLIDE 51

In a rare moment of candor, Ettinger came close to acknowledging this interpretation of the failure of cryonics to launch, as possibly being material to how things turned out, and implicit in this statement is the acknowledgement that cryonics ‗failed,‘ that it did not succeed in either becoming a dominant force in the culture, or even in establishing itself as a respected (or feared) minority player. Consider, by contrast, the outcome for Scientology, a movement started by another of Ettinger‘s cohorts (fellow science fiction writer L. Ron Hubbard) 11 years earlier, in 1953.

Today Scientology is a multimillion dollar enterprise that makes or breaks legislation in the US, elects representatives to Congress, tell the IRS what to do, and has at least 50,000 hard core adherents in the US alone. While it is a tiny entity, and has by no means come to dominate the culture, it has managed to survive withering attacks and to carve out a place of safe harbor and exert enormous political influence relative to its size. That happened because of careful planning and clever strategizing. It was no accident and it was by no means inevitable.

SLIDE 52

And this brings us to the all important question, ―What was, at a minimum, required to launch cryonics successfully in 1964 – and perhaps more to the point, what are the implications for cryonics today; particularly as it is presented to new cultures that are effectively tabula rasa with respect to cryonics? The former Soviet Union and China are two prime examples of places where cryonics has not penetrated the culture: or is just beginning to.

Are there lessons to be learned and mistakes to be avoided from the first period of failure in the US? Are the nascent cryonics groups in these ‗new markets‘ behaving responsibly, are they repeating the mistakes made by those of us in the US from 1964 to 1972?

To answer that question it is necessary to spec out what should have happened in 1964. First, there needed to be a thorough explication of all the required technical elements of the program including necessary equipment (all phases of program), required personnel and their qualifications, an analysis of the market and obstacles to implementation of the proposed program. And, of course, essential to any complex enterprise, there needed to be a business plan including corporate structure (profit, NGO, etc.), cost estimation, timeline to implementation…and so on. None of his was done.

SLIDE 53

To make clear what I‘m talking about here, I’ve created a block diagram of the vital elements of any cryonics operation, whether being created in 1964, or today. This is the bare minimum framework of functional elements required. Each of these, in turn, breaks down into supporting subsystems.

SLIDE 54

As an example, I’ve chosen the Emergency Response System (ERS) because it is the first link in the chain of member recovery in the event of life threatening illness or cardiac arrest. If the Cryonics Society (CS) can neither be reached nor respond when members or clients need them, then they have little to offer in the way of effective services, and certainly, they have nothing to offer in terms of confidence.

I’ve also listed every item, from cotton balls to capital equipment, required to undertake stabilization and transport based on what the technology available in 1964. These assets, both physical and organizational, may seem impossible to have achieved then, and may seem equally impossible to achieve now, in places where cryonics is starting over, or starting out for the first time.

SLIDE 55

However, history shows this is not the case, and I am in the unique position of having been both a witness and a participant in events that prove that it was possible to put all of these critical elements in place using a handful of people and far less resources (dollars expended) than were brought to bear on the failed launch of cryonics during the first 8 years of its existence in the US.

This slide shows what was achieved by 4 activist individuals who were part of a group of less than 30 people. Single-handedly, the Chamberlains wrote a comprehensive procedure manual and established best practices documentation (Standard Operating Procedures; SOPs in the US and Canada) to support it. They detailed protocols for taking call (responding to an emergency when the Alcor pager went off), hired a medical answering service to field emergency calls, developed and deployed emergency response kits and trained volunteer staff to administer cryonics first aid: manual & mechanical CPR, external cooling, anticoagulation & buffer administration, and transportation of the patient.

They built and tested perfusion equipment, contracted with an ambulance company and mortuary for technical and transportation services and, finally, constructed a mobile perfusion facility where cryoprotective perfusion and freezing could be carried out.

In addition to all of this, they kept the books, put out a technical publication, Manrise Technical Review, and practiced and drilled relentlessly to hone their skills and familiarize themselves with the equipment they would be using. And before they did any of this, they created a business plan which was realistic and scaled to the (very small) market they estimated they would be servicing.

And, I should add, all of us were employed full time during this period at demanding jobs; Linda was an executive secretary, Fred was an IEEE at the Jet Propulsion Laboratories and I was a full time student putting in 30-40 hr/wk at McDonald‘s (literally making hamburgers). Total dollars expended (adjusted for inflation) = $350,000.

SLIDE 56

Data collection sheets, flow charts and thorough documentation on how to use equipment, prepare perfusate and carry out cryoprotective perfusion and freezing were all put in place and rigorously validated before the first Alcor patient presented for care in the summer of 1976. Our competence and attention to detail had the effect of quickly attracting the best

and brightest in cryonics to Alcor (and Trans Time) and our professionalism ultimately attracted and deeply involved medically competent individuals such as Allen McDaniels, M.D., Jerry Leaf, Virginia Jacobs, and others. To approach cryonics with anything less than this is not merely to invite disaster, it is to ensure it.

 End of Initialization Failure, Part 2


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Cryonics: Failure Analysis: Lecture 1: Preface and Initialization Failure, Part 1

 

By Mike Darwin

This series of lectures had its origin in a presentation entitled Cryonics: Why it has failed, and possible ways to fix it, which was delivered at an ExtroBritannia meeting on Saturday August 2, 2008 at Birkberk College in London, UK.

PREFACE

SLIDE 1

Before I begin the formal, structured part of this presentation, a few words are in order to put it into context. We live in an age where passion and strong emotion have been largely removed from daily discourse and are now considered acceptable only in the realm of fiction; in movies and video games. Characters there are free to speak in extremes and to speak passionately; not so those of us who inhabit the real world. I will be breaking that taboo today because what I am going to talk about is a life or death issue for you, for me, and for the 7 billion or so other human beings on this planet. My life matters to me a great deal, and I‘m not ashamed to admit it.

Most of the people on this planet get through life on a daily basis by being carefully shielded from certain images and ideas which they find uniquely disturbing and destabilizing. Of course, if they were, in fact, immortal supermen, these images and ideas would have a very different effect. But, they aren’t immortal supermen; and neither are we.

So, some of the images you will see in this presentation, should you choose to stay, may be unsettling or even frightening. I do not apologize for this; I believe they are essential to communicate understanding and are, in fact, the only way to communicate that understanding effectively. So, if you are likely to be disturbed by images of death and decomposition, I suggest you make your exit now. You’ve been warned.

Finally, I want each of you to understand that I believe cryonics is the most powerful and humane idea in the world today, and I treat it as such. I don‘t ask you to do the same (yet), but I do ask you to understand and to respect that this is my perspective, and I have the floor. I do not suffer fools gladly and a good part of what I have to say today is the direct result of people tolerating fools and foolishness in cryonics.

SLIDE 2

It is impossible to understand what I have to say without understanding something of who I am and how I got to be that way. It has been said that a happy childhood is the worst possible preparation for life, and I can certainly attest to that. I grew up in a stable and secure environment; I lived in the house my grandfather had built and in which my mother had been born. While my parents were working class, they afforded me everything necessary for good intellectual and emotional development. As an only child in a loving extended family, necessities were assured and an enriched environment was a given.

SLIDE 3

Unfortunately, the one thing my parents and extended family could not protect me from was the reality of the inevitability of disease and death. My parents were in their mid-30s when I was born, and a consequence of this was that my grandparents and aunts and uncles began to suffer age associated morbidity and mortality when I was still young and most of them had died by the time I was a pre-teen.

The red symbols above indicate people who are now dead, many long dead. I‘m the babe in arms sucking his thumb. While my mother (holding me) and my father (who took the picture) are both still alive, my mother has descended into the dark hell of Alzheimer‘s disease. Several of the people still alive from the day in 1956 when that photo was taken are in failing health and will soon be dead. [Note: both of my parents died in November of 2011.]

The impact of these lost lives on me as a child was immense and terrifying and I soon came to the conclusion that, as Mike Perry has so eloquently put it, ―The individual ought to endure – for a life rightly lived is never rightly ended.

SLIDE 4

A particularly traumatic event, and one that was to shape my life, occurred when I was ~ 8 years old. I discovered my maternal cousin, Rae Rohrman, with whom I was very close, dead in her home a few doors down the street from where we lived. Rae was a non-compliant diabetic who died suddenly during the summer and was not discovered until I entered her home approximately a week after her death. She was in an advanced state of decomposition and there were none of the considerable resources or “contexting” of the mortuary industry or the church to soften the hard reality of what death really is.

It is an ugly, destructive process and in confronting it I began to realize that the mystical explanations I was being given as to why it was both necessary and good were merely a coping mechanism adults used to stop themselves from going insane, a version of Santa Claus and the Tooth Fairy for grownups which someone, someone quite human, had made up to keep the world as barely sane and orderly as it was. It was crystal clear to me that no one in their right mind would want what I saw had happened to Rae, to happen to them.

SLIDE 5

“That event and the deaths of others close to me, launched on me a quest to find a way to halt decomposition, and, shortly thereafter, to prevent death. I began experimenting with ways to interrupt and restart life processes in plants, insects and small vertebrates (red eared slider turtles) by cooling and freezing. In 1966 I was introduced to cryoprotectants and to tissue culture, and by 1968 I had amassed a substantial amount of experimental expertise and results. It was clear to me that cryopreservation offered the most likely path to achieving suspended animation.

With suspended animation would come two great boons: the ability to travel to distant star systems and explore the universe, and the ability to enter a state of indefinitely long waiting if death threatened. While I did not foresee reversal of aging or the application of this technology after so-called death had occurred, I found it enormously reassuring that death and decomposition could be forestalled, essentially indefinitely, and that even if experiencing life was not possible forever, in theory, avoiding death was.

During the course of a science fair project in 1967 entitled, ‗Suspended Animation in Plants and Animals‘ I was handed a newspaper clipping that introduced me to the idea of cryonics by telling the story of one Professor James Hiram Bedford who had been frozen after “death” to await a cure for his cancer, as well as rejuvenation from old age, to a state of healthy vigor.

SLIDE 6

I promptly contacted the various cryonics organizations extant at that time, and quickly joined the Cryonics Society of New York (CSNY) as a suspension member, taking jobs mowing lawns and doing yard work to pay for my life insurance. In 1972, while visiting CSNY on my secondary school holiday, I was asked, along with a young graduate student, Corey Noble, to perfuse and freeze a CSNY member, Clara Dostal, who had been pronounced legally dead a few hours earlier.

I was 17 at the time and had already amassed a considerable amount of hands-on experience in cryonics. This event, as you shall see a bit later, also had a profound emotional and intellectual effect upon me.

THE PROBLEM OF PARADIGM CHANGING IDEAS

SLIDE 7

The beginning of cryonics is probably best dated to the publication of Robert Ettinger‘s The Prospect of Immortality in 1964. This date is important because it provides context for much that was to adversely affect cryonics, so you should keep it in mind as we proceed.

SLIDE 8

I did not live in a vacuum, and my interests in science and coming developments in technology was keen. I was an avid reader of classic 1950s-60s science fiction as well as popular and “hard” science publications and books. In 1968 my country was the richest and most technologically sophisticated in the world, and it was about to land a man on the moon, and return him safely to earth.

In fact, it was about to land a number of men on the moon and recover them all safely. At that time, the United States (US) Federal Government was funding the National Aeronautics and Space Administration to an unprecedented degree. Not since the Manhattan Project had so much money and effort been expended upon a scientific undertaking.

A world view emerged from this effort, and it was a world view promulgated, endorsed by, and made completely credible to the populace by the US government. That world view was one that posited as inevitable the construction of a large, orbiting space station, the establishment of a permanent lunar base, and the beginning of the expansion of humanity into the solar system – and more speculatively, beyond.

This worldview is best summarized and most accessible today in the first half of the film 2001: A Space Odyssey which premiered in 1968, the year I was becoming deeply involved in cryonics. While the film was undeniably science fiction in its premise of encountering extraterrestrial life, it‘s technological predictions of what life would be like at the turn of century were universally considered completely reasonable by far sighted and respected scientists and futurists – even conservative ones such Dandridge Cole and Isaac Asimov.

That world, 33 years in the future, became my model, and the model for millions of other thinking people, young and old alike, for how the future would be. It was a world where space colonization was underway, life spans had been modestly extended, human hibernation was a reality and solid state organ cryopreservation was in use for storing transplanted organs. It was a reassuring view of the future, and in particular of my future, if I didn’t die before getting there.

SLIDE 9

By 1976 I was becoming uncomfortably aware that the future I expected was not materializing at a rate consistent with the worldview in 2001. Organ cryopreservation programs had been abandoned in all but one facility in world, the US manned space program was doomed, and interest in serious, interventive gerontology, let alone meaningful research, was nil.

The money and intellectual resources required to achieve these goals had been redirected to an endless series of wars, first in Vietnam and later in the Middle East and East, as well as a succession of botched and unsuccessful programs to end poverty in the US (the Great Society), cure cancer, and deal with longstanding mishandling of the environment. The spending spree of the latter days of the Cold War bankrupted the Soviet Union and, in truth, bankrupted the West, as well. The focus of the planet‘s population was on protecting itself against bogeymen of its own making and it spent and spent maniacally to create weapons systems of vast lethality and ever increasing complexity.

So, sometime in late in 1976 I wrote out a timeline of milestones that I thought would be necessary if I were to survive. This was a simple list of critical achievements with the dates by which they must be accomplished alongside them. It took a conservative and probably all too unfortunately realistic prediction, of the likely arc of my productive life.

While it has proved a more accurate road map than my naive first imaginings of my future, it too has fallen short and has proven flawed, perhaps fatally flawed. Since I was not then, nor am I now, either poorly informed about cryonics or lacking in real world experience in its practice, I suggest you might want to pay careful attention to what went wrong with this very conservative timeline, because it very likely has important implications for your future as well.

SLIDE 10

This quote, suggested by Robert Ettinger for the opening of Robert Nelson‘s book We Froze the First Man, was meant to imply that the success of cryonics was inevitable meant to imply that the success of cryonics was inevitable – that it was an idea whose time had come. Victor Hugo was an idealist, and a man who had the good fortune to live in an age where the time had indeed come for most of the ideas he cared passionately about and championed.

Overlooked by Ettinger was that powerful, paradigm disrupting and socially inflammable ideas require careful preparation of the culture before they can flourish. No thinking person would imagine it possible to arrive in a Stone Age culture, such as the Pirotribe, in the Amazon basin, and begin discoursing successfully on Quantum Electrodynamics or Natural Selection. The dismal experience of Western Christian missionaries (and of their “flocks” ) with African and Polynesian cultures similarly points to the futility of attempting to convert an unprepared culture to ethical or ideological standards that are alien to their environment and destructive to their culture and their entire way of life.

SLIDE 11

While applied engineering and electronics were undergoing explosive advances in 1964, the biological sciences lagged far behind. In the medical, biomedical and cultural context of 1964, the year Ettinger‘s The Prospect of Immortality was published, the discovery of the structure of DNA was only 11-years old, CPR was only 4-years old, the Uniform Determination of Death Act would be not be passed until 1978 (14-years later), the first heart transplant was 3-years in the future (1967), and most of the United States had no emergency medical system (EMS): ambulances were hearses driven by Funeral Directors.

Some Definitions “Culture“: The sum total of values, norms, assumptions, beliefs and ways of living built up by a group of people and transmitted from one generation to another.” Innovation: “The adoption of a new practice, process, or paradigm by a community —not just a new product or service. “Creativity“: To cause to come into being, as something unique that would not naturally evolve or would not exist via ordinary processes. Resulting from originality of thought.”

SLIDE 12

To understand the impact this primitive state of affairs in the life sciences was to have on the launch of cryonics, it is first necessary to examine the way scientific advancement proceeds in a culture, and in order to do that we must define some key concepts. Culture: The sum total of values, norms, assumptions, beliefs and ways of living built up by a group of people and transmitted from one generation to another. Innovation: The adoption of a new practice, process, or paradigm by a community — not just a new product or service. Creativity: To cause to come into being, as something unique that would not naturally evolve or would not exist via ordinary processes and resulting from originality of thought.

 

SLIDE 13

There are, fundamentally, two types of new ideas: Conventional: incremental innovations, with a high likelihood of success and a modest return on investment and Radical: (Paradigm Changing): favoring or effecting fundamental or revolutionary changes in current practices, conditions, or institutions with a low likelihood of success and a large return on investment.

SLIDE 14

In the early 1970s, again well after cryonics had attempted to launch, the philosopher and historian of science Imre Lakatos created a new model for how scientific change occurs. He posited that scientific advance proceeds on two fundamental and very different levels. Most of scientific and technological progress is incremental; it involves testing and validation or invalidation of the dominant scientific paradigm of the age.

For instance, in a world where the earth is presumed to be the center of the universe, all astronomical work will consist of the careful accumulation of information designed to support this view and to reconcile observed phenomenon with the core tenet that the sun, and other heavenly bodies, revolve around the earth.

At some point, discontinuities in the observed data may lead to an alternative paradigm; one completely add odds with, and antithetical to, the accepted explanation (theory) of how the universe works. This second type of progress is not incremental, but rather is revolutionary: it overturns the entire structure of the previous paradigm. It penetrates the protective belt of gentle scientific inquiry and smashes the hard core of the existing paradigm.

We tend to forget that scientific ideas do not exist in a moral, social or philosophical vacuum – or in a political one, for that matter. Scientific theories such as how the solar system is organized, how old the universe is, and how life arose and became diversified, inform human beliefs about their purpose and their place in the universe. And, they impact the complex web of powerful social institutions that create and enforce philosophical and behavioral norms.

The Copernican theory gutted the authority of the Catholic Church and, to a significant extent, of the Christian religion, because it challenged the veracity of these institutions‘ teachings – teachings which, in order to hold moral authority, had to be absolute and infallible.

SLIDE 15

So, the success of novel ideas depends upon more than their being provable by observation or demonstration; they must also have compatibility with fundamental philosophical, moral, ethical, social, and political paradigms of the culture, and, of course, be technologically and economically feasible. They must also, critically, have credible, articulate and aggressive advocates.

SLIDE 16

As it turns out, there are, very broadly, two ways that paradigm changing ideas can be introduced into cultures. The first and easiest is by SEDUCTION: Incremental (limited) powerful desire for benefits absent any understanding of understanding of detriments (including destruction of the existing order). The second way is by INSURGENCY: Organized, forceful and determined effort to establish a new paradigm by subversion of the existing order.

SLIDE 17

Perhaps the best example of introduction of an idea by seduction is that of agriculture. Sometime between 100,000 and 80,000 years ago, humans began to make the transition from a hunter-gather life-style to agriculture. Today, we take agriculture for granted and we by and large uncritically accept it as an unblemished good.

However, the goodness or desirability of agriculture is hardly the picture of universal plenty that comes to mind when the word is uttered today, 100 or so millennia after agriculture was invented. In the context of hunter-gather society, agriculture was an unmitigated disaster that completely destroyed their culture, religion, way of life, and ultimately, much of their health and well being.

SLIDE 18

Hunter-gatherers controlled their population size, lived in small intimate groups, and were constantly on the move. Because they moved frequently they did not ingest or come into contact with their own wastes, or the wastes of the animals they fed from. They lived their entire lives in the open air under uncrowded conditions, and they ate a nutritionally diverse diet that was almost completely devoid of empty calories. As a result, they had little or no communicable infectious disease: no typhoid, cholera, or other water borne illnesses that result from fecal contamination of the drinking water supply.

In addition, group size was far too small to sustain communicable epidemic diseases such as smallpox, measles, mumps and tuberculosis (TB). TB, in particular, is an urban disease that requires close quarters and poor ventilation to be self sustaining and epidemic. It is also a zoonotic disease: one acquired from living commensally with animals – a necessary facet of agricultural life.

The quality and quantity of the hunter-gatherer life was thus both surprisingly high and long. Paleolithic man appears to have had a mean lifespan of between 45 and 53 years. Morbidity was brief and death came suddenly from misadventure or homicide. With the advent of agriculture during the Neolithic, life spans plummeted and remained well below hunter-gatherer levels until the first decade of 20th century in the US, and not until mid-century, globally.

SLIDE 19

The toll exacted by agriculture in terms of human suffering was immense. Agriculture allowed for a rapid expansion in the number of humans at the cost of hunger, starvation and an almost unimaginable disease burden. Cities became not only possible, but necessary, and up until the 19th century they were veritable killing machines which sucked in the surplus population generated by satellite farming communities and killed them off with infectious disease and dangerous working conditions. Cities did not become self sustaining in terms of population until late in the 18th century!

It seems clear that if our hunter-gatherer ancestors understood that agriculture would virtually exterminate their way of life, and create millions and even billions of starving and dispossessed people, they would have fled from it and burned the first would-be farmers alive. This didn’t happen because the immediate benefits of agriculture were so overwhelming: the ability to create a steady, seemingly reliable supply of food in superabundance was incredibly seductive.

Seeing the downsides was a virtual impossibility for people in those circumstances who lacked the scientific method, lacked the written word, and had little experience with new ideas or rapid change.

SLIDE 20

A similar state of affairs pertained in the late 18th and early 19th centuries when the Industrial Revolution began. The Industrial Revolution allowed for the prodigious production of high quality goods on a scale previously unimaginable. It created a cornucopia of wealth allowing the average man, and even the poor man, to enjoy goods and services that previously royalty, or the richest of the elite, could not have purchased at any price. The human cost of this was, again, very high: child labor, dangerous working conditions that crippled and maimed, and a reduction in air and water quality that killed thousands at a time often in the space of few days.

SLIDE 21

And again, as with agriculture, the Industrial Revolution was a fiat accompli before our species began to understand the adverse global environmental impact and come to the realization that the whole foundation of technological civilization was not sustainable. Hunter-gatherers lived in ecological balance with their environment; technological man cannot. To sustain ever advancing technology man must expand his environmental horizons into the solar system, and beyond.

SLIDE 22

Finally, telecommunications are an example of paradigm changing scientific advance operating via seduction.

SLIDE 23

Within my lifetime TV, mobile phones, and the Internet have transformed the culture and degraded or destroyed some of its more cherished institutions.

SLIDE 24

This tableau is how I grew up: the evening family meal taken in a stereotypical fashion with lots of opportunity to talk and socially interact with both my parents, and with members of my extended family. It was not understood by any of the participants to be a critical element in a cohesive and functional family life – it was just something everyone did and took for granted. But, in fact, it was (and is) a critical tool for facilitating communication, and allowing time and the proper conditions, to reflect on the day‘s events and consider what was necessary to be done tomorrow.

SLIDE 25

This slide lists but a few of the social and cultural sea changes caused by telecommunications with a high profile casualty being that family meal together, where people with comparatively uniform values and experiences communed with each other.

SLIDE 26

Not all novel paradigm changing ideas are seductive. Many are immediately and rightly perceived by the culture to be dangerous to the established order; ideas which can overturn political and social control mechanisms and completely disenfranchise, or even destroy bedrock institutions.

Because ideas about biology and medicine impinge upon the territory of religion in explaining man‘s purpose in the universe, and also on providing comfort and succor to the sick and dying, they are particularly scrutinized areas in terms of their compatibility with the hard core of the existing scientific paradigm – a paradigm in which the culture and its most powerful institutions are heavily invested.

Natural Selection, Germ Theory and Scientific Surgery created serious threats to the existing order that were immediately appreciated.

All of these ideas challenged the traditional view of Vitalism, and were steps towards “reducing” man, and indeed all living things, to the status of mechanisms: clockworks that could be rationally explained, understood and eventually manipulated at will. These novel ideas had the power, at least in theory, to confer on men the knowledge and ability formerly reserved only for god. If life was a natural phenomenon governed by the same physical laws that enabled the construction of timepieces, factories, bridges and manufacturing machines, what was to stop man from creating life itself and, in essence, usurping the role of god?

Insurgent attack on the hard core of critical paradigms is dangerous…

SLIDE 27

The culture quite rapidly comes to understand that such ideas are exceedingly dangerous and almost invariably takes extra-scientific steps – social, political and economic – to protect the existing paradigm and defend its hard core at almost any cost. The fate of Galileo for promulgating Heliocentrism is a classic case in point. And Galileo was lucky – extremely lucky. His fate was to be forced to recant his heretical ideas and spend the remaining years of his life under house arrest.

SLIDE 28

By contrast, consider the fate of Giordano Bruno, the Italian Dominican friar, philosopher, mathematician and astronomer, who is best known as a proponent of the infinity of the universe (his cosmological theories went beyond the Copernican model in identifying the Sun as just one of an infinite number of independently moving heavenly bodies: he is the first European man to have conceptualized the universe as a continuum where the stars we see at night are identical in nature to the Sun).

He was burned at the stake by the authorities in 1600, after the Roman Inquisition found him guilty of heresy. Challenging the hard core of critical scientific (and thus social, cultural and political) paradigms is dangerous and often deadly…

THE INHERENTLY DISRUPTIVE CHARACTER OF CRYONICS

SLIDE 29

…and at the very least it is inconvenient, incredibly unpleasant, and costly.

The real reason the Dora Kent drama played out was that cryonics, practiced well (optimally) caused extreme cognitive dissonance in the medical and legal authorities in the community in which we were operating. Over and over again they kept badgering me with the statement that, “Two minutes was NOT long enough to wait after cardiac arrest before starting cryonics procedures.” To which I responded repeatedly, “Well then how long is long enough? How dead does someone have to be before it is OK to start working on them? You define death as when cardiorespiratory arrest occurs; you say nothing about what can or should be done afterwards.” They found that enormously disconcerting and it made them angry, really angry.

SLIDE 30

So, if we look at cryonics objectively and in the context of this culture and this civilization at this time, then cryonics is just about the most disruptive and threatening idea that has ever come along. Unlike Natural Selection or Germ Theory, or even Heliocentrism, cryonics will inevitably overturn the Vitalistic view of life, challenge the conventional definition of death, erode the need for a mystical afterlife, invalidate the core tenets of contemporary medicine, and radically redistribute capital and disrupt inheritance, bequests, and mortuary customs!

 

SLIDE 31

What‘s more, it mandates a complete change in reproduction, perturbs generational succession, requires space colonization, requires (and supports) profoundly disruptive technologies such as cloning, regenerative medicine, nanotechnology, and AI, and most frighteningly of all, it Ends the Species and enables Transhumanism.

Cryonics is Profoundly Disruptive of the Hard Core of Contemporary Civilization Creates Survivorship Guilt; Indefinitely extends anxiety and uncertainty accompanying life-threatening illness; Prevents the psychological closure of  “true” death with disposition of remains; Creates indefinite anxiety about the well-being of cryopreserved loved ones.

SLIDE 32

Beyond these inevitable long term effects, cryonics has a number of poorly appreciated (by cryonicists) severely psychologically damaging adverse effects. As Curtis Henderson once observed,  “All biographies end in tragedy; everybody dies. Always.” A consequence of this is that no one need feel guilty about living – in the end we all end up dead – there are no survivors.

Cryonics changes that, because people now living have an opportunity to possibly ‗cheat‘ death, and that means that if they choose to do so and succeed, they will have to face the prospect that they did not act quickly enough, or aggressively enough, to save the lives of all their other loved ones who have died or will die and not be cryopreserved. This survivorship guilt can be crippling, and in some cases all consuming – but at the very least, it is always painful.

One of the few advantages of death is that it is final. It puts an end to the suffering and anxious uncertainty that must inevitably accompany life threatening illness. Anyone who has agonized over the fate of a loved one in the Intensive Treatment Unit (ITU) can at least begin to understand the psychological impact of stretching out that period of uncertainty over a lifetime, and beyond.

The devastating effects of this kind of limbo are often seen in cases where children are abducted and not found, or soldiers are lost in battle, but no remains are recovered. Cryopreservation prevents the psychological closure of ‗true‘ death with disposition of remains and creates indefinite anxiety about the well-being of cryopreserved loved ones. Cryopreserved people are not put away in a cemetery where no further harm can come to them. Rather, they require indefinite care, vigilance and protection. This is often a source of extreme anxiety in survivors.

SLIDE 33

These immediate detrimental effects of cryonics become intensified during the terminal phase of a cryonics patient‘s life. The presence of the Standby/Stabilization team and their equipment and supplies disrupts intimacy during the “dying” process, may bitterly divide family members (those opposed vs. those in favour), and block deeply held (conditioned from childhood) mechanisms for coping with death and bereavement: no wake, funeral, and other comforting rituals.

With the understanding of these general and largely unavoidable obstacles, we are now prepared to examine in greater detail the specifics of why cryonics failed to launch in 1964.

 End of Preface and Initialization Failure, Part 1

Posted in Cryonics Biography, Cryonics History, Cryonics Philosophy | 6 Comments

Much Less Than Half a Chance Part 5

How to avoid autopsy and long ‘down-time’

(ischemia) ~85% of the time!

 

Saving Lives Now?

Coronary Artery Disease and Vasculopathy

I’ve been at pains here to emphasize that the primary purpose of the DSS is to alert cryonicists to the presence of a lethal or potentially lethal morbid process, so that we can make rational preparations for cryopreservation and avoid prolonged ischemia and autopsy. The question naturally arises, “Can this technology be used to extend or improve the quality of life now, during this life cycle?” In the case of atherosclerotic disease this seems likely, and several activist organizations within the conventional medical community are urging the adoption of cardiac CT calcium scans as screening to tool to allow for subsequent invasive, drug and dietary interventions, as necessary, to avoid heart attack. This is approach is not yet proven to reduce death from CAD, or to reduce the incidence of severity of heart attacks. However, it seems an eminently reasonable approach and, considering that each year 785,000 Americans experience their first heart attack, 470,000 more have a second, third…heart attack and 325,000 more experience sudden cardiac death. (Rogers, 2012)

In the past 48 hours I’ve learned that three acquaintances have died from SCA. Two of the three were a father and his daughter who suffered fatal heart attacks within a week of each other. Their brother had undergone coronary bypass surgery a few years previously, and the incidence of CAD and SCA in their family history was high. This case presents special irony, because the brother had undergone a CUS (which showed intimal thickening) and then a cardiac CT, which showed heavily calcified coronary vessels. It is hard not to believe that these diagnostic tests did not at least spare him a heart attack. He is now on aggressive drug and dietary treatment for his vasculopathy (he also has atherosclerosis in his peripheral vessels and in one renal artery). Whether a meaningful extension of life span will ensue can only be determined by large scale application of such screening, with accompanying long term outcome studies. However, from a cryonics perspective, it seems clear that, were this man a cryonicist,  this technology would have granted him a clear opportunity to benefit in at least the following ways:

* Notify his CO, his physician and possibly his local coroner or medical examiner that he has a (superbly) documented history of severe CAD. Since he lives alone and the circumstances of his life are placid, if he does suffer SCA, this makes it much less likely he will be autopsied.

* Consider acquiring and using a wearable automatic defibrillator, at least until such time as (if) his CAD has shown demonstrated reversal by angiography as a consequence of drug/diet treatment.

* Relocate to near his cryonics service provider to minimize both cold and warm ischemic times following medico-legal death.

* Use an emergency alert system to signal either (or both) cryonics or medical personnel that he has experienced cardiac arrest. Possible options here are the Vitalsens system by Intelesens and the NUVANT Mobile Cardiac Telemetry System.

* Alert family and friends to “check & report” on him so that he is not ischemic for days, or longer, in the event of SCA.

*Acquire cryonics first aid supplies, such as ice, instant ice packs, a head ice positioner, and other items that might be appropriate to his circumstances.

The ability to engage in these preparations alone is a huge improvement from a cryonics standpoint.

The illustration that opens this article is of two of the finest men I’ve ever had the privilege to know: Jerry Leaf and Dennis Ross. Both were long time cryonicists. Jerry is, of course, well known for his enormous contributions to cryonics, both personally and professionally. Dennis was not so visible, but was an important and energizing presence in cryonics as well. Dennis was one of the founding members of the Cryonics Society of South Florida, and was a source of good advice and wise counsel for me, and I’m sure for others in cryonics as well. Both Jerry and Dennis deanimated as a consequence of vascular lesions that could arguably have been detected with the imaging techniques available today that have just been discussed here. In Jerry’s case, the technology was nascent in 1991 when he suffered his heart attack. In Dennis’ case, the technology was mature, readily available and easily affordable to anyone whose income is middle class, or better and who appreciates the need to access it.

This is ever the sad paradox of medical singularities, in that there is almost always a considerable lag time between their introduction, and their working acceptance. As we’ve seen in this article, there are many sound logistic and practical reasons for delays in the widespread application of novel medical technologies. The devil is in the details, as has certainly been the case with the PSA test. And bite back can be punishing, as can be the unforeseen adverse effects of the new modality; cancer in the case of x-rays, and cancer again in the case of hormone replacement therapy in menopausal women (a treatment that has caused many malignancies and deaths).

The uniquely attractive thing about quantum advances in areas of medicine like imaging, is that they offer such powerful advantages with such little potential for harm – if they are used intelligently. In this unusual case, we have a great deal of prior (bad) experience with screening technologies to guide us, and we also have the long history of experience with using these modalities in their less spectacular form. We know, for instance, about the adverse effects of ionizing radiation and we know about the relative safety of MRI. The “singularity” making aspects of medical imaging as discussed here are thus not the application of new imaging means, but rather are a result of the exponential growth in computing under the overdrive force of Moore’s Law.

Cancer & Others

Unlike atherosclerosis, neoplastic disease follows a course that is more nearly exponential than linear. The earliest phases of malignant transformation occur on the molecular and the microscopic level, with many tumors remaining very small for a consider period of the time course of the disease. Even where tumors are detected “early” via imaging techniques, the outcome is variable, depending upon the nature of the malignancy and the effectiveness of the treatments available.

With the notable exception of prostate cancer (Schroder, 2009), the majority of cancers are diagnosed when the disease is well advanced – usually late Stage II, or later. In the case of breast and colorectal cancer, earlier diagnosis has proved effective at improving long term survival. Early trials of lung cancer screening for smokers are also proving encouraging. While there is considerable debate about the utility of early screening in reducing deaths from other cancers, it seems reasonable in the current treatment milieu that the earlier the disease is diagnosed, the better the chances are for survival. (Hanley, 2010)

Figure 30 : Cumulative percentage of people diagnosed with prostate, ovarian, pancreatic and lung cancer at each stage of the disease. Source: Wired Magazine, 17:01;80-122, 2009.

To a great extent the value of early diagnosis may depend upon continuing advances in the treatment of cancer at the molecular level. The past decade has seen the emergence of “molecularly targeted” drugs, such as Gleevec, and more are in the pipe. If cancer treatment becomes more rationalized and targeted, it seems possible that earlier detection will be of greater value. Alternatively, definitive treatment for cancers that inhibit tumor cell proliferation or induce selective tumor cell death, may render the need for the “earliest possible diagnosis” a thing of the past.

In the case of cancers, it bears repeating that DSSing is not intended, nor is it likely to serve as more than a warning of impending deanimation. Any “saves” that occur as a consequence will thus be incidental, and the scans should not be relied upon to disclose treatable neoplastic disease.

 Neuronal  Attrition Disorder of Aging (NADA)

As was pointed out earlier, all interventions to extend life span by effectively treating or delaying non-brain degenerative diseases will ultimately result in “brain failure.”  The question not asked by the legions of clinicians, activists, NGOs and others working to find a cure for AD (and the other dementias) is just exactly what will happen when they do? As they often point out, AD is a discrete pathology, and not a “normal” part of aging.

But curing it begs the question of what happens next, because brain cell death (both neuronal and glial) is a process that begins at ~ 2 years of age – at least for the neurons that comprise the gray matter of the cerebral cortex, and which proceeds relentlessly throughout the individual’s lifetime (Giorgio, 2010) Brain cell loss and degeneration become morphologically apparent in the brain’s white matter by the time we are in our early 20’s, although there is evidence that more subtle changes have been afoot for much longer. (Hedden, 2004) Losses in gray matter volume proceed approximately linearly with age in normal aging, and the average gray matter volume decreases from ~390 mL at age 22, to ~300 ml at age 82. (Courchesne, 2000) Total loss in brain mass between age 20 and age 80 is, on average, ~450 g, or roughly 1/3rd of our youthful brain volume.

Figure 31: Gray matter loss with aging.

Top: Voxel Based Morphometry (VBM) analysis of gray matter changes in aging. (A) Colored voxels show regions demonstrating significant negative correlations between gray matter volume and age (p < 0.05, fully corrected for multiple comparisons across space). Clusters are overlaid on the MNI152 template brain. Images are shown in radiological convention. (B) Plot to illustrate relationship between age and mean gray matter volume across all significant voxels. The pink triangles represent female subjects. [From: Giorgio, A, Santelli, L, Tomassini, V, Bosnell, R, Smith, S, De Stefano, N, Johansen-Berg, H. Age-related changes in grey and white matter structure throughout adulthood. Neuroimage. 2010;51(3):943-51.Epub 2010 Mar 6.]

Bottom: Growth and aging changes in gray matter for 116 living healthy individuals. Gray matter volume reached maximum by 6 to 9 years of age and thereafter declined linearly. [From: Courchesne E, Chisum HJ, Townsend J, et al.: Normal brain development and aging: quantitative analysis at in vivo MR imaging in healthy volunteers. Radiology. 2000;216:672.]

Medicine currently has no name for the grotesque pathological state that will emerge when this failure mode is allowed to manifest itself as a result of the elimination of AD and the continued extension of the life span via various incremental advances in treating other, non-brain degenerative diseases. So that we can have a common shorthand for discussing this soon to be problematic malady, I have labeled it the Neuronal Attrition Disorder of Aging, or NADA, for short.

The near linear loss of gray matter volume and the accompanying heavy losses in gray matter neurons poses a severe problem for the aging cryonicist because they imply that ever more sophisticated advances in 1/2TM, and even HTM, exclusive of true brain rejuvenation, will lead to our becoming neurological struldbrugs,[1] and that is a condition from which not even cryonics can resurrect us.

 

Figure 32: VBM-style analysis of WM changes with age. (A) Colored voxels show regions where WM volume shows a significant linear (blue) or non-linear (green) relationship with age (p < 0.05, fully corrected for multiple comparisons across space). Clusters are overlaid on the MNI152 template brain. Images are shown in radiological convention. (B, C) Plots to illustrate relationship between age and mean WM volume across all voxels showing a significant linear (B) or nonlinear (C) relationship with age. The pink triangles represent female subjects. Giorgio et al. The graph in the green bordered box below shows white matter volume as evaluated by conventional MRI using T1 weighted imaging. This data shows a steady increase in WM volume until age ~40, followed by a modest decline in advanced old age. However, using more sophisticated directional Voxel Based Morphometric imaging, as shown in the purple bordered box at the top of this page, WM changes are revealed to be complex, inhomogeneous between brain hemispheres, and begin in the early 20’s. As can be seen in the VBM white matter graph (purple box) there are, in fact, extensive loses in WM, however they are regional in nature as opposed to the global losses experienced by gray matter as a function of ‘normal’ aging. Growth and aging changes in white matter for 116 living healthy individuals. White matter volume rapidly increased until 12 to 15 years of age, and thereafter increased at a slower rate, plateauing at approximately the fourth decade of life. [From Courchesne E, Chisum HJ, Townsend J, et al.: Normal brain development and aging: quantitative analysis at in vivo MR imaging in healthy volunteers. Radiology. 2000;216:672.]

Beginning in middle age there is a very noticeable steady degradation in the integrity of the white matter tracts, particularly those in the hippocampus (the brain’s memory trafficking center). In particular, the perforant pathway (PP) is seriously affected, and there is typically a loss of upwards of 25% of PP axons with aging.(Hyman, 1986; Scheff, 2006)

 Figure 33: Group-averaged diffusion tensor images of anisotropy of white matter in young and normal elderly. Parallel movement of water molecules through white matter results in anisotropic diffusion, with greater anisotropy (and so greater white matter density) indicated by brighter areas. Older adults tend to show decreased white matter integrity compared with younger adults, with the greatest age-related declines occurring in anterior cortex. (Head, D. et al. Differential vulnerability of anterior white matter in non-demented aging with minimal acceleration in dementia of the Alzheimer type: evidence from diffusion tensor imaging. Cereb. Cortex (in press). This paper offers a comprehensive DTI study of white matter changes in normal and demented aging and demonstrates the loss of fiber tracts, gliosis and scarring that occur in the so called ‘healthy’ aging brain.

Until a scant few years ago, it was impossible to image the structural changes in long nerve processes in the brain. Now, with the advent of a technique called diffusion tensor imaging (DTI) (Dennis, 2007) it is not only possible to image these changes but also to quantify of alterations in white matter microstructure during aging.  Thus, for the first time, literally within the past 2-3 years, we are getting a clearer picture of the neuropathology of ‘normal’ aging, and it isn’t a pretty one. (Augustinack, 2010; Yassa; 2010; Abe, 2002)

The development of DTI has been especially useful in documenting age-related changes in white matter, and there is now solid evidence that one of first areas of the brain to undergo age-related white matter decay is the medial temporal lobe (MTL),41 which is the area of the brain that is central to the formation of new memories, and in particular, to the acquisition of new factual information and to remembering events.(Wang, 2010; Sauvage, 2010, Bjornekbekk, 2010) Changes in the MTL are first observed (and remain most pronounced in) the perforant path (PP). The PP is so called because it perforates the subiculum[2] and carries input from the entorhinal cortex to the hippocampus, where memory consolidation and encoding are thought to be moderated.(Yassa, 2010; Burke, 2006)

The importance of NADA to cryonicists should be obvious, while perhaps the relationship between NADA and DISSing, is not as clear. Even if there is currently little or nothing we can do to halt NADA, we do need to know the speed and extent at which it is progressing. This will help us to plan more effectively about the conditions under which we would like to be cryopreserved, and it will also offer us an opportunity to determine if any interventions we try to slow, halt, or reverse NADA are working. We don’t get the luxury of a do-over in this situation. The way that DSSing will be of use in this respect is by providing both a baseline (if you are younger than ~ 35-40) scan of brain morphology and volume, as well scans progressively documenting brain structure and mass changes as we age.

In the coming decades it seems entirely possible, if not likely, that therapeutic and lifestyle approaches will be identified that slow NADA. There are currently a number of promising drugs in the laboratory (some already clinically available for other uses) which decrease or partially reverse the brain mass loss associated with aging. It is an irony of NADA that one of the first and most precious capabilities of which it robs many, is the ability to see that it is happening at all. The decrease in raw processing capability due to neuronal loss concurrently decreases our ability to perceive the deficits it is creating. While the positive offset of accumulated life experience provides a great deal of compensation for the functional losses, the result is that most aging people have very little conception of just how seriously their brains are being degraded over time. The very slow and subtle character of the changes also allows for “continuous adaptation” to a condition then interpreted as “normal.”  In short, DSSing will provide a powerful source of objective, quantifiable feedback about the impact of aging on our brains.

FUD: “I have seen my death!”

 Figure 34: First x-ray of human hand; Anna Bertha Röntgen, 1895.

On 22 December, 1895 Wilhelm Conrad Röntgen made the first x-ray of human being. The subject was his wife, Anna Bertha, or more accurately, her hand. Anna Bertha’s reaction upon viewing the developed film was to exclaim, “I have seen my death!” (Hase, 1997) Prior to that time, there was virtually no way a living human being could see the skeleton of another, except after decomposition of the soft tissues was complete, following death. At that time to see one’s skeletal hand must have been a shocking reminder of mortality.

DSSing has the same potential psychological effect and it seems only fair to go further and speculate that the major obstacle to the effective use of this technology may not be the medical, ethical, financial or organizational ones, but rather, the fear uncertainty and dread (FUD) it may provoke. I have no answer to this. I would simply note that a major factor in even communicating about cryonics to the rest of the world is the FUD it provokes. Death scares the hell out people, as well it should. We cryonicists are extraordinary out of measure in our ability to either overcome that fear, or in some cases, to hardly perceive it at all.

As is the case with cryonics itself, DSSing provides us with an opportunity to extend our lives – but again, only at the cost of confronting our own mortality. The difference being that in the case of DSSing, it will be objectified, repetitive and incrementally worse with each passing interval of time. That’s not much of an advertisement for a technology, but again, as is the case with cryonics, it comes down to how acceptable you consider the alternative?

End

 Footnotes

[1] In Jonathan Swift’s savagely satirical novel Gulliver’s Travels, the name struldbrug is given to those humans in the country of Luggnagg who are born normal, but are in fact immortal. Although the struldbrugs do not die, they do nonetheless continue aging. Swift describes the plight of the struldbrugs in terms almost any resident in an nursing home today (who is still compos mentis) would immediately understand: “when they have completed the term of eighty years, they are looked on as dead in law; their heirs immediately succeed to their estates; only a small pittance is reserved for their support; and the poor ones are maintained at the public charge. After that period, they are held incapable of any employment of trust or profit; they cannot purchase lands, or take leases; neither are they allowed to be witnesses in any cause, either civil or criminal, not even for the decision of meers and bounds.”

[2] The subiculum receives input from CA1 and entorhinal cortical layer III pyramidal neurons and is the main output of the hippocampus. The pyramidal neurons send projections to the nucleus accumbens, septal nuclei, prefrontal cortex, lateral hypothalamus, nucleus reuniens, mammillary nuclei, entorhinal cortex and amygdala and as such, is the principal routing network for information from the hippocampus. The subiculum is also critically involved in the formation of procedural memories.

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