Robert C. W. Ettinger, First Life Cycle: 1918 to 2011

Robert Chester Wilson Ettinger (born December 4, 1918 – cryopreserved 23 July, 2011) was the father of cryonics as a result of the publication and widespread distribution of his book, The Prospect of Immortality (Doubleday, 1964) and because of his unceasing, forty-nine year long advocacy of the cryonics idea. He might also justly be called a “father of Transhumanism “on the basis of his 1972 book, Man Into Superman. Ettinger experienced cardiorespiratory arrest at 1600 on 23 July, 2011 at the age of 92. 

Robert Ettinger as young boy.

Ettinger served as a second lieutenant infantryman in the United States Army during World War II. Severely wounded in battle in Germany, he received the Purple Heart. He earned two Master’s degrees from Wayne State University (one in physics, one in mathematics) and spent his working career teaching physics and mathematics at both Wayne State University and Highland Park Community College in Michigan. Ettinger and his first wife, Elaine, had two children, a son David in 1951, and a daughter Shelley in 1954. David Ettinger has been active in cryonics since 1968 and currently serves as legal counsel to the Cryonics Institute and the Immortalist Society.

Ettinger recovering from war wounds around the time he conceived of the idea of cryonics.

Ettinger grew up reading Hugo Gernsback’s Amazing Stories and assumed that one day – long before he grew old – medicine would have advanced sufficiently to have overcome both disease and aging, resulting in biological immortality.  As he grew out of boyhood in the 1930s, he began to realize it might take much longer.

Ettinger read a Neil R. Jones story, “The Jameson Satellite”, which appeared in the July 1931 issue of Amazing Stories, in which one Prof. Jameson had his corpse sent into earth orbit where (as the author mistakenly thought) it would remain preserved indefinitely at near absolute zero. And so it did, in the story, until millions of years later, when, with humanity extinct, a race of mechanical men with organic brains chanced upon it. They revived and repaired Jameson’s brain, installed it in a mechanical body, and he became one of their company.

It was obvious to Ettinger that the author had missed the main point of his own story. If biological immortality is achievable through the ministrations of technologically advanced aliens repairing a frozen human corpse, then why shouldn’t everyone be cryopreserved to await later rescue by our own medically more sophisticated descendants?

Robert Ettinger in uniform during World war II.

In 1947 Ettinger wrote a short story elucidating the concept of human cryopreservation as a pathway to more sophisticated future medical technology: in effect, a form of “one-way medical time travel.” The story, “The Penultimate Trump”, was published in the March, 1948 issue of Startling Stories, and definitively establishes Ettinger’s priority as the first person to have promulgated the cryonics paradigm:  principally, that contemporary medico-legal definitions of death are relative, not absolute, and are critically dependent upon the sophistication of available medical technology. Thus, a person apparently dead of a heart attack in a tribal village in the Amazon Rainforest will soon become unequivocally so, whereas the same person, with the same condition in the emergency department of a large, industrialized city’s hospital might well be resuscitated and continue a long and healthy life. Ettinger’s genius lay in realizing that criteria for death will vary not just from place-to-place, but from time-to-time. Today’s corpse may well be tomorrow’s patient.

Ettinger waited for prominent scientists or physicians to come to the same conclusion he had, and to take a position of public advocacy. By 1960, Ettinger realized that no one else seemed to have grasped an idea which, to him, had seemed obvious. Ettinger was 42 years old and undoubtedly increasingly aware of his own mortality. In what may be characterized as one of the most important midlife crisis in history, Ettinger reflected on his life and achievements, and decided it was time to take action. He summarized the idea of cryonics in a few pages, with the emphasis on life insurance as a mechanism of affordable funding for the procedure, and sent this to approximately 200 people whom he selected from Who’s Who In America. The response was meager, and it was clear that a much longer exposition was needed. Ettinger observed that people, even the intellectually, financially and socially distinguished, would have to be educated that dying is (usually) a gradual and reversible process, and that freezing damage is so limited (even though lethal by present criteria) that its reversibility demands relatively little in future progress. Ettinger soon made an even more problematic discovery, principally that, “a great many people have to be coaxed into admitting that life is better than death, healthy is better than sick, smart is better than stupid, and immortality might be worth the trouble! [1]

The Prospect of Immortality was published in hardcover by Doubleday in 1964.

In 1962 Ettinger privately published a preliminary version of The Prospect of Immortality; this finally attracted attention of a major publisher, and led to the 1964 Doubleday hardcover and various subsequent editions which launched cryonics. Forty-seven years have elapsed since the commercial publication of The Prospect of Immortality and, without exception, all those active in cryonics today can trace their involvement to the publication of one or both of Ettinger’s books. While Ettinger was the first, most articulate, and most scientifically credible to argue the idea of cryonics, he was not the only one. In 1962, Evan Cooper had independently authored a manuscript entitled Immortality, Scientifically, Physically, Now under the pseudonym N. Durhing. Cooper’s book contained the same argument as did Ettinger’s, but it lacked both scientific and technical rigor and was not of publication quality.

Ettinger became a media celebrity, discussed in the New York Times, Time, Newsweeek, Paris Match, Der Spiegel, Christian Century, and dozens of other periodicals. He appeared on television with David Frost, Johnny Carson, Steve Allen, and others. Ettinger also spoke on radio programs coast-to-coast to promote the idea of human cryopreservation.

 Ettinger on the “Tonight Show with Johnny Carson” in 1966.

Following the publication of The Prospect of Immortality and Ettinger’s mass media expositions of the idea, he again waited for prominent scientists, industrialists, or others in authority to see the wisdom of his idea and begin implementing it. By contrast, Cooper was an activist, and must be credited with forming the first cryonics organization (although that name was not to be coined until 1965) the Life Extension Society (LES). LES advocated immediate action to implement cryopreservation and established a nationwide network of chapters and coordinators to develop a grassroots capability for delivering cryopreservation on an emergent basis. Cooper left cryonics activism in 1969, and was lost at sea in 1982, but his work with LES was indispensable in helping to launch the first Cryonics Societies. The first of these was the Cryonics Society of New York, formed in 1965 by writer Saul Kent, attorney Curtis Henderson, and mechanical engineer Karl Werner. It was Werner who coined the term “cryonics.”

At left above, Ettinger with his mother’s cryostat in the mid-1980s and at right, Rhea Chaloff Ettinger, Robert Ettinger’s mother as a young woman.

In 1966 the Cryonics Societies of California and Michigan were formed. Ettinger was elected President of the Cryonics Society of Michigan (CSM). In 1976 CSM was transformed, under the direction of Ettinger, into the Cryonics Institute (CI) and the Immortalist Society (IS was originally the Cryonics Association). CI is a nonprofit organization created to provide cryopreservation services to the public. In 1977 Ettinger’s mother, Rhea Chaloff Ettinger, became CI’s first patient. Subsequently, Ettinger’s first wife, Elaine (1987), and his second wife, Mae (Junod) Ettinger (2000) entered cryopreservation at CI. IS is a 501c3 tax exempt organization created to support research and public education into cryonics and related disciplines. Ettinger was President of both CI and IS until 2003.

From the vantage of the opening decade of the 21st century, it is not hard to understand the bewilderment and intense frustration experienced by Ettinger and virtually all other cryonics activists from 1964 through circa 1990. To its adherents, the idea of cryonics seemed at once both obvious and compelling, yet cryonics was not only ignored, it was almost uniformly ridiculed and caricatured in the media. Scientific and medical criticism was vehement, dismissive, and surprisingly superficial. Incorrect statements were made by a wide range of experts, most notably professional cryobiologists, who stated that cryopatients were irreversibly dead, that all such patients’ cells would be ruptured and reduced to debris by ice crystals, that repair of cryoinjury was scientifically impossible, and finally, that the procedure was unethical, immoral, and constituted predation of the bereaved, and others unable to accept the natural order of death and decomposition. [2]

During this period cryonics adherents had no consistent or quality access to professional medical, legal, philosophical, business, or financial expertise. Admission of interest in, or advocacy of cryopreservation evoked displays of revulsion, ridicule, or both. Media and public perception were relentlessly negative. Contrary to public perception at this time, cryonics was (and still is) a largely middle class undertaking, and the resources available were those of mortuary personnel and equipment and the procedures which cryonics adherents were able to construct and devise themselves. [3] An additional concern was the uncertain legal status of cryonics and the ever present possibility of governmental interdiction. [4]

Ettinger has speculated that this state of affairs might be due to the fact that, “I had and have, no credentials worth mentioning being only a teacher of college physics and math. It is precisely this that prevented me, for so long, from doing more: I knew I carried no weight, had no formal qualifications, and was not suited for a leadership role. But as the years passed and no one better came forward, I finally had to write, and later felt I had to form organizations (although others had come into existence). This tragedy, in various manifestations, may persist. Potentially effective leaders may have turned aside because I (and later a few other obscure people) reluctantly preempted leadership. Business people and investors may have hesitated because the small, poorly capitalized organizations already in the field have had such limited (although increasing!) success in attracting participants.” [5]

The passage of over four decades since The Prospect of Immortality was written has demonstrated that the resistance to cryonics was not rooted in any of the deficiencies on which Ettinger speculates above. Rather, the idea was and still is, ironically, far ahead of its time. In 1964 the discovery of DNA was only 11 years old. cloning, genetic engineering, routine organ transplantation (let alone heart and lung transplantation) were years to decades away. Detailed exposition of enabling technology such as molecular level cell and tissue repair were 30 years in the future. Nineteen-sixty-four was a time when vitalistic ideas pervaded both culture and medical science, and death was perceived in binary terms; a patient was either dead or alive, with no middle ground or intermediate states. Cardiopulmonary resuscitation (CPR) had been invented by  Peter Safar in 1960, only four years before the publication of The Prospect of Immortality and the first mass citizen training in CPR was still 8 years away: Leonard Cobb held the first citizen CPR training sessions in Seattle, WA in 1972. Passage of the Uniform Determination of Death Act did not occur until 1978, 14 years after the publication of The Prospect of Immortality. Successful cryopreservation of the first human embryo, a bundle of less than 60 undifferentiated cells, did not occur until 1983: 19 years after the publication of The Prospect of Immortality and 23 years after Ettinger first circulated his brief tract summarizing the idea of human cryopreseration as a means of medical time travel. At a time when most of the United States had no emergency medical system (EMS) and ambulances were hearses driven by Funeral Directors, the concept of cryopreservation as a vehicle to rescue by advanced medical technology was understandably incredible.

Cryonics depends upon a number of paradigm changing observations: Death is a gradual process rooted in progressive loss of biological structure (information) and is not a binary condition in most cases. Life does not depend upon continuous function or metabolism; widespread cryopreservation of human embryos was required to bring this idea into the public consciousness. Cryopreservation is possible for a wide range of cells and tissues, and even when uncontrolled freezing occurs, vast amounts of cell and tissue structure remain either intact or inferable (i.e., theoretically possible to reconstruct and restore to health and life from their damaged state). Advances in biology and medicine offer the prospect of growing new organs and regenerating or replacing damaged tissues; this is no longer considered wild speculation, but rather, is today progress expected by the public as a result of the logical progression of biomedicine. Finally, the ideas of nanoscale engineering and computation and their implications for cell and tissue repair (nanomedicine) are still not fully appreciated by the public, although understanding and acceptance of these ideas is growing. [6]

Robert Ettinger at the Cryonics Institute (CI) in 2009, with photos of some of some of the patients in CI’s care visible in the background. Photo by Chris Asadian

Without these paradigm shifts, cryonics appears irrational, or even bizarre, or macabre. In 1987 Ettinger, at first surprised that his idea was not rapidly accepted by society, reflected philosophically on the state of affairs 23 years after The Prospect of Immortality introduced the world to the idea of cryonics:

“Tragedy is in the eye of the beholder. As Sid Caesar (or maybe Mel Brooks  – one of those really heavy thinkers) said: “The difference between comedy and tragedy? When the saber tooth tiger eats Moe, that’s comedy. When I get a hangnail, that’s tragedy.” And if the Tiger of Death eats you, that is the ultimate tragedy; that is when the world ends, when the cosmos disappears, when Everything becomes Nothing.

The “tragedy” of the slow growth of immortalism pertains mostly to them, and perhaps to you — not so much to me or to us, the committed immortalists. We already have made our arrangements for cryostasis after clinical death — signed our contracts with existing organizations and allocated the money. We will have our chance, and with a little bit of luck will “taste the wine of centuries unborn.”

– Mike Darwin, 24 July, 2011

 

 

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The Armories of the Latter Day Laputas, Part 9

Figure 1: The Alcor facility in Riverside, California at night in June of 1987.

The Scope of the Progress

Included in what was achieved by Alcor from ~ 1982 to 1990, for an estimated total of $1,772,081 in 2010 dollars, was the Alcor facility in Riverside, California. What follows is a photographic survey of the facility that was made on 12 May, 1987 primarily for the purpose of communicating what the physical plant looked like to Alcor members, and to the subscribers of Cryonics magazine. Two rooms are missing from the photo survey reproduced below – the Cryovita office/library and the X-ray room. The X-ray room was was short-lived. After the Dora Kent crisis and the influx of additional, full time staff, as well as the effective end of dog research, the pressing need for office space caused us to convert both the ICU/recovery room and the X-ray room to offices. The Cryovita office space was not part of this photographic survey because it was sublet space and it also contained emergency communications and weapons for use in the event of an existential catastrophe, such as a major earthquake.

The article which accompanied the photos below appeared as:  A Photographic tour of the new ALCOR facility, Cryonics, 8(6)1987: 7-14.: http://www.alcor.org/cryonics/cryonics8706.txt. That issue of Cryonics magazine is currently available on-line as a text-only, so this article will represent the first time these images have been available on-line.

In April of 2011 visitors to Southern California from the Russian cryonics company KrioRus, wished to see the building that Alcor occupied from 1987 to 1994, and so I took them to 12327 Doherty Street in Riverside, so they could see what the building currently looked like and what the ambience of the area was like.

Figure 2: Two views of the building once occupied by Alcor as it appeared in April of 2010 just before sunset. Two large motor homes, apparently undergoing renovation, sit in the parking lot obscuring much of the front of the building. Photos by Stanislaw Lipin.

They were thoroughly unimpressed. They found the building and its surroundings unattractive, if not outright ugly. I would be hard pressed to disagree with their assessment, although in 1987 the industrial park was brand new, the landscaping was well maintained, and the adjacent buildings and businesses, for the most part, ran neat and well kept operations. The area has not fared well in the intervening decades and, if not quite an industrial slum, the area is certainly not an attractive one. The photos above show the building as it is today; the home of S & J Precision Tool, Inc. It seems likely it will be the home to other enterprises in the coming years, probably none of which will leave their mark on the premises in quite the way that Alcor did.

 Figure 3: Mike Darwin, shovel in hand, standing next to the Alcor Time Capsule which was buried in the footing of the Doherty Street building in September of 1986.

Buried somewhere in the soil under the footing of the building is a “time capsule” containing various memorabilia of Alcor and of cryonics as of 25 September, 1986. The shell of the capsule is a cylinder of ABS (acrylonitrile butadiene styrene) plastic pipe 4” in diameter, and approximately 4’ long which was hermetically sealed before burial. Under normal dry soil conditions in Southern California the capsule should while away the centuries un-breached.

It might be possible to infer the location of the capsule from the photograph above, but it would be a tedious and disruptive business to extract it from under the ten or so inches of steel-reinforced concrete that covers it.  The capsule has a “beacon” that allows for its precise location, but that is for those who would extract it to discover – if such entities ever exist.

Alcor Riverside Facility 12 May, 1987

As previously noted, the building Alcor and Cryovita occupied was owned by a Limited Partnership of Alcor members called the Symbex Property Group.  The choice of the building was not much of a choice. Real estate investor and entrepreneur Reg Thatcher generously volunteered to assist with finding a suitable building.[1] This search was largely non-productive. It was the strong desire of everyone in Alcor management to find a location in Los Angeles or less desirable, in North Orange County. Our reasons for this were that those areas were close to where we all lived (and in some cases worked), they were close to the Alcor membership base in the LA area, and they were close to the major universities and business infrastructure upon which we relied.

For the budget we had available, the buildings that were on offer were nothing short of dreadful. Broken down buildings in desperately bad neighborhoods were places that we became accustomed to making pilgrimages to. Finally, Reg put us in touch with a small industrial park developer named Lonnie Jenkins. Lonnie had a planned project that might fit both our budget and our needs, with the caveat that it would be located 30 minutes further east from the current Cryovita/Alcor facility in Fullteron. That meant a commute of over an hour for Jerry Leaf, and a substantial commute for most of the rest of the Alcor activists, as well. As it turned out, the Riverside building was our only viable option. No other structure we looked at was even remotely acceptable.

It is neither practical nor economically desirable for most small businesses to own the buildings they occupy. Many small businesses expand and contract with the prevailing economic conditions and they lease space to accommodate their momentary needs. Market dynamics, the relatively short lifespan of most small companies and the commitment of capital that could be spent on other aspects of operations, makes real estate ownership unattractive.

Figure 4: Front exterior of the Alcor facility in Riverside, CA on 12May, 1987 shortly after Alcor moved into the building. The vehicle bay which housed the Alcor ambulance is on the left and the patient care bay which house Alcor’s patients is on the right of the photo above.

The exceptions to this are businesses that have little choice but to own their own property, of which Alcor and Cryovita were examples. What we did not understand is that there were other such businesses, and that these enterprises were mostly of a kind that landlords and neighboring tenants would find undesirable, or even obnoxious. Thus, of the nine buildings in the Doherty Street  development, at least a third were occupied by enterprises that were either noisy, presented an unkempt appearance, or, in the case of our immediate neighbor to the west, Starving Students Movers, filled their parking lot with large, garishly painted moving trucks.

Still, it could have been worse. A few years before we relocated from Fullerton, the occupant of the industrial bay next to ours was both evicted and “raided” by the Fullerton Fire Department. This nice, quiet and uncomplaining neighbor was in the business of subsurface “seismic mapping” of oil and gas deposits for wildcatters in the oil business. Such subterranean imaging is done by setting off substantial underground explosive charges and then constructing images from the seismic echoes that result. Little did we know that during much of our stay in Fullerton we were sitting next to a veritable ammunition dump of explosives!

As can be seen Figure 4, above, the building was nondescript and there was no sign on it announcing Alcor’s presence. There would be no sign until we were told it was a legal requirement that we have one during the Dora Kent case (one of the many peculiarities of the Riverside planning and zoning code of which we unaware, and which we subsequently learned was selectively enforced).

Figure 5: The reception area of the Alcor facility.

We had the glass in the reception and front office areas mirror-reflective coated almost as soon as we took possession of the building. Both the reception and office spaces were tiny, and the wall of glass that fronted them became boiling hot (literally) in the summer sun. The heat was intolerable and the small, window mounted heat pump that was standard issue for these buildings (Figure 8 top photo) was completely unable to cool these spaces. Even with the installation of reflective film and light colored mini-blinds it was often intolerably hot. During the Dora Kent case Alcor was repeatedly accused of trying to hide its presence in Riverside, to “remain anonymous,” and to have “mirrored glass to keep prying eyes out.”

The irony in this was not just that it wasn’t true about the glass, but that we had announced our presence, and there had been a lengthily article about or relocation to Riverside on the front of the “B Section” (the local section) of The Riverside Press Enterprise newspaper – an article which had resulted from my visit to the Riverside County Coroner’s Office to inform them of our arrival in the community and to become acquainted with local regulatory milieu. It is probably also worth noting that we had no sign because we didn’t see the need for the expenditure, since we didn’t interface directly with the public, and had nothing to gain in terms of “advertising” or promotion from, such a sign. [Who would know what Alcor was, or care?]

Figure 6: The reception area looking in towards the interior of the building. That there were three Alcor patients at this time is easy to infer from the three photos of patients above the commissary cart.

The reception area was quite small, but then we had no need for anything larger. The only visitors to the building were the occasional vendor or contractor, and much more rarely, a prospective member. Media visits were almost unheard of, and regulators usually came and went quickly, without time (or reason) to either sit down or be kept waiting.

Figure 7: Shower and toilet.

Immediately upon passing through the door in Figure 6, was one of two lavatories in the building. We converted this from a “code compliant” handicapped lavatory to one that met our needs; principally a lavatory with a shower, so the personnel could clean up after both human cases and animal experiments. This is an example of an “illegal code violation,” the kind of which is still a commonplace in many, if not most communities in the US. Indeed, I have rarely been in a small business operation in the US or the UK without observing such code violations. The cost of complete compliance with all existing regulations would prevent most businesses, including large ones, from operating.

Figure 8: Two views of the front office with two work stations adjoining the reception area.

The office space was the same size as the reception area and while it was a cramped space to work in, it was a considerable improvement over the conditions in Fullerton. The era is clearly defined by the presence of the KayPro MS-DOS computer and the daisy wheel printer – both of which were used for virtually all of Alcor’s administration and for the production of Cryonics magazine.

Figure 9: The central work area where solutions were mixed, equipment checked and assembled, and where Cryonics magazine was pasted-up each month prior to being taken to the printer. The Alcor administrative files were in the black filing cabinets visible at the right of the photo.

The short hallway through the door in Figure 6 opened into a large centrally located workspace. The scrub, lab and utility sinks can be seen at the left of the photo. The operating room was located directly opposite the hallway adjacent to the scrub sinks. Perfusate preparation, as well as dry lab operations, was carried out in this area. The Cryovita office opened off the right of the hallway with the black administrative filing cabinets, and the X-ray and ICU rooms opened off this hallway to the left (not visible in the photo above).

Figure 10: The central work area extended in front the patient care bay and opened into it.

The central work area extended perhaps 15-20’ in front the patient care bay (PCB) and an oversized door opened into the PCB. This custom made door was both tall enough and wide enough to allow a dual patient dewar to be wheeled into the central work area. This was essential because the PCB had no heating or air-conditioning and patient cool-downs were manually controlled at that time. This meant that personnel had to be present and seated next to the dewar continuously for 3-4 days. Temperatures in the PCB were often in excess of 39C in the summer and below 12C in the winter, with no way to heat or cool this space.

With the exception of the operating room and the small reception area front office, the building had no central heating, ventilating or air conditioning system! Climate control was achieved by a combination of passive and low cost, low technology active systems. In the summer, the emergency exit hatch in the room of the facility was opened and a high capacity exhaust fan was placed in the opening. One of the roll up doors was then then opened approximate 2’ (Figure 1). In the desert there is an enormous hysteresis between daytime and nighttime temperatures. The clear night sky allows for rapid radiation of heat back into space with consequent cooling of the both the ambient and surface temperatures. By pumping this air into the facility at night we were able to cool the large mass of wood, gypsum and concrete by ~15C each night. The building was completely (and heavily) insulated on all sides, with the exception of the vehicle and patient care bays. During the day, the hatch was closed and the building was kept cool by its thermal inertia and the excellent insulation. We improved on this system by eventually adding an evaporative cooling unit which exhausted into the central work area. Heating in the winter was by kerosene space heaters (monitored by carbon monoxide detectors) and supplemental electrical resistance heating. These maneuvers saved Alcor tens of thousands of dollars in utility expenses. [There was no natural gas service available to the Doherty Street buildings, which would have meant the use of all-electric heating and cooling which would have been cost-prohibitive].

Figure 11: The stairway in Figure 1o led to a loft that was used for the storage of equipment and supplies, as a conference area and for additional office space.

The stairway visible in Figure 10 led up to a large loft area that contained additional office space, a conference and eating area, and storage space for equipment and supplies.  The interior construction was done to UBC requirements, but could not meet the Riverside code for second story construction which had been amended to require concrete footings under all load bearing walls. We had re-engineered the panel joins and used small, post footings with massive bolts; but these were not considered acceptable even though they likely provided greater seismic protection than the code-required footing.

Figure 12: Conference/eating area, Mike Darwin’s office and some of the Alcor library in the loft. The small window at the left my desk opened into the patient care bay.

Figure 13: The “art office” where custom illustrations for Cryonics magazine were prepared using an Apple Macintosh computer and dot-matrix printer.

At the top of the stairs to the left were the conference/eating area and two offices. My office adjoined the conference table and I had a window cut into the wall overlooking the PCB so that I could be reminded while working that the patients were my first priority as the President of Alcor. The other work space was used by volunteers when it was not being used to produce artwork to illustrate Cryonics magazine.

Figure 14: The loft space over the operating room was ultimately use to store infrequently used hardware and building supplies. In May of 1987 the most prominent fixture was a metal casket lined with foam and containing a metal air shipping box which served as the cooling bath for chilling whole body patients to dry ice temperature.

Figure 15: The bulk of the loft space was used to store biomedical equipment and supplies to support the operating room.

The loft was already crowded in May of 1987 and quickly became more so. Unfortunately, most of the parenteral products and other supplies purchased for planned research had to be discarded due to the passage of time and the inability of Alcor to carry out its planned research.

Fire 16: Two views of the operating room: note the 15,000 BTU air conditioner in the upper left of the photo, which opened exhausted its heat into the central work area.

Having worked under miserably cramped and hazardous conditions for years, Jerry Leaf was intent upon having an operating theater of adequate size to properly accommodate cryonics operations.  Power points were installed in the ceiling to eliminate the hazard and inconvenience of extension cords and wires on the floor and operating table was at last surrounded by an ocean of space sufficient to allow fluoroscopy and other imaging and monitoring equipment to be present without causing problems. We were also anticipating the creation of a refrigerated enclosure for patient perfusion – an apparatus that would be necessary for implementing vitrification technology.

Figure 17: Acute post-operative care and ICU room.

A separate and well equipped post-operative recovery and ICU room was incorporated into the Riverside facility. This room had the capability of allowing for acute and intermediate care of dogs after surgical procedures and was equipped with the necessary consumable supplies as well as needed laboratory equipment of analysis of blood samples.

Figure 18: The crew room where personnel could sleep during lengthily experiments. This room ultimately became the permanent residence of Hugh Hixon and Mike Perry.

Sleeping quarters were incorporated into the facility to allow personnel to rest during lengthily experiments and to house a caretaker who was to be in residence continuously to oversee the welfare of the patients. The crew room could accommodate three people in a pinch and could be use in “hot bunk” fashion to sleep up to six people per 24 hour work cycle (e.g., 2 shirts of 12 hours each).

Figure 19: The laundry and utility room of the facility; it also housed a second toilet.

The other lavatory which was adjacent to the front office was re-plumbed to accept a heavy duty Maytag washer and dryer stack. This was absolutely necessary to safely manage blood and body fluid soiled laundry generated during human cases and animal research. Such laundry must be done on site and not removed from the physical plant where it could contaminate vehicles and other facilities. This was, of course, yet another code violation since it defeated the “handicap access compliance” of the lavatory which was required by the Americans with Disabilities Act (ADA).

Figure 20: The patient care bay with one neuro-vault, one upright MVE dual patient dewar (not in service) and the horizontal dewar containing James Bedford (barely visible at the lower right of the photo).

The patient care bay was a mirror of the vehicle bay in terms of size and layout. Alcor had three patients at the time this photo was taken and would have 27 by the time the Riverside facility was vacated on 23, 1994. A second neuro-vault joined the first one shortly after this picture was taken and the first bigfoot dewar was likely on order or about to be ordered at around this time.

 Figure 21: Vehicle bay and shop also served as the chemicals storage area.

Figure 22: The shop.

Figure 23: The Alcor ambulance with the Mobile Advanced Life Support System (MALSS) cart just visible in the open rear doors.

The vehicle bay also served as the shop and the row of wooden cabinets at left in Figure 21 housed the non-flammable inorganic chemicals. Most of the space in this area was usually consumed by the Alcor ambulance which had to be stored under moderately controlled conditions to avoid damage to the equipment inside. Medications and other heat-sensitive items were stored inside the climate controlled area of the facility.

Since the pictures above are devoid of people it seems appropriate to close this article by noting that on Memorial Day weekend (May 25, 1987) Alcor held a “Grand Opening” celebration for the Riverside facility. They keynote speaker was Timothy Leary, and extraordinary number of Alcor members from across the US made the pilgrimage to see the new place – 80 people attended at a time when there were less than 200 cryonicists in the world. A luncheon was held at the Red Onion restaurant, ultra-light airplane rides were on offer, and extensive socializing took place at Saul Kent’s home, which he had just recently purchased in the nearby suburb of Woodcrest.

Figure 24: Former pilot Curtis Henderson prepares for a flight on an ultra-light aircraft as Mike Darwin looks on; his first time aboard a plane of any kind in many years.

Figure 25: Some of the attendees of the Grand Opening at a local Riverside eatery.

Figure 26: From left to right with faces to the camera: Thomas Donaldson, Fred Chamberlain, Linda Chamberlain and Billy Seidel (in profile).

Figure 27: Parking jam in back of Saul Kent’s Riverside home in Woodcrest.

Figure 28: Left to right: Arel Lucas, Steve Harris, Virginia Gregory, Hugh Hixon, Keith Henson and David London.

End of Part 9



[1] Reg Thatcher was a good friend to Alcor in the mid-1970s through the mid-1980s. He could never decide whether commit to cryonics personally and he died some years ago and was not cryopreserved.

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The Armories of the Latter Day Laputas, Part 8

Figure 1: Enkidu, Alcor/Cryovita canine total body washout (TBW) # 2. At top, Enkidu lies chilled to ~5C, his blood replaced with a specially designed preservative solution (perfusate), near the end of his 4-hours of cold, bloodless perfusion. The perfusate used was hyperosmolar and this resulted in dehydration of the aqueous and vitreous humors of the eyes resulting in ocular dehydration given the globes of the eyes of a flaccid and sunken appearance. Below, Enkidu 24 hours after reperfusion with blood and rewarming to normothermia.

Understanding the Environment

The history of Alcor during the period 1983 and 1991 can be subdivided into two eras. The first was 1983 to 1987 and the second was from 1987 to 1991. The first era was the time period during which the most remarkable and enduring technical and administrative accomplishments occurred, despite the fact that there was very little cash flowing into or otherwise available to either Cryovita or Alcor at this time, and that there were virtually no paid staff. There were many reasons for this, and I feel certain that I will not succeed in identifying them all here.

Certainly one material factor was our ability to focus our efforts on research, technical matters, and core administrative development without distractions, and in a quiet, peaceful environment. Alcor neither sought nor had a significant media presence during these years and in fact, both Jerry Leaf and I were actively hostile to media coverage of the activities of Cryovita and Alcor.  The staff was small, cohesion and sense of shared mission was present, and the character and quality of activist recruits was uniformly high. Whilst money was scarce, there were neither distractions nor conflicts that interfered with its focused application.

In the decades that have passed since those days, I have had the opportunity to observe, first-hand, the workings of many enterprises of many kinds, the world over. My experience in this respect was much more limited before and during 1991. Most of the companies that I did interact with were at least “sanely” operated in that it was uncommon to observe blatantly self destructive or even criminal behavior. Many regulations were flouted, but usually not in what I would describe as in suicidal or careless ways. My experience in this regard may be an artifact of the kinds of businesses I was dealing with, and in their location.

Since that time, I have observed acts of corporate careless, negligence and outright stupidity that have had a profound effect on my attitude towards regulation. It would be easy to attribute these bad behaviors to exploitation on the part of owners or managers. However, I have all too often observed these people not only operate their facilities in blatantly dangerous ways, but to do so while exposing themselves to the same (or greater) risks of injury or death than they do to their employees, or customers. As but one example, I have repeatedly observed facilities here in the US with locked fire exists, disabled sprinkler systems, no working fire extinguishers, heavy burdens of flammable materials, makeshift and highly dangerous wiring, poor lighting, no lighted or marked fire exits and which also permitted smoking on the premises. The most shocking thing about this was that the owners worked in this environment alongside their employees and customers, and thus shared the same risk!  I have seen pharmaceutical and food handling facilities operate under conditions of not just grossly deficient worker safety, but also of disgustingly poor or absent procedures for maintaining basic cleanliness and sanitary products. I would also note that this phenomenon has recently been observed (repeatedly) amongst the giants of the pharmaceutical industry; the disgraceful behavior of McNeil Pharmaceuticals (Tylenol) /Johnson & Johnson are but one of many examples.[1, 2]

These experiences have altered my attitude towards to government regulation. First, the anger and outrage these experience have provoked in me have created a strong desire to see to it that such callous disregard for human life do not go uncorrected. Second, I have observed that much of the most basic regulation and code enforcement are carried out with at least a modicum of common sense and flexibility and that, despite its many shortcomings, basic government regulation at the community level is effective at both reducing the number of scofflaws, and educating businesses in what they need to do to have a reasonably safe, or at least not overtly dangerous, workplace. In short, I have become to believe that an unacceptably large cross-section of the business community is (mix and match as appropriate): ignorant, expedient, lacking in common sense, in denial, careless, negligent, and in some cases criminally indifferent to even the most fundamental elements of workplace safety; pretty much in that order. Behave badly, and someone is likely to come mind your business for you.

Figure 2: The first human cryonics case done at Cryovita Laboratories on 14 July, 1978 prompted a visit from the Fullerton police and the Orange County Coroner. Only photos were taken and footprints left behind. No harm was done to cryonics or to its patients in the process…

I’ve engaged in the above digression because I believe that one very significant reason for the fast pace of progress from 1983-1997 was that we were left unmolested. The fire department came and saw our non-permitted construction, but also saw that it was safe and sound and met UBC. They noted that we had extension cords running many places, including on the floor; but they also noted that where they trod upon, they were covered with vinyl protectors and that they conducted power not to space heaters or motors, but to low wattage analytical equipment, or to briefly and intermittently used devices like a sternal saw or a video recorder. It was a different time and place; an era where regulation was flexibly interpreted to accommodate both common sense and people who were acutely aware of their infrastructure shortcomings and were working to mitigate, or improve them.

When Cryovita received its first patient for perfusion and freezing the coroner and the police were called by a nosy neighbor. They came, they photographed, they pondered the law, and they left. Years later, in the dead of night, we were unloading a dual patient dewar from a Ryder rental truck (the HiCube, the same style used by Timothy Mc Veigh to blow up the Murrah Building in Oklahoma City) transported at ~45 degree angle from Emeryville, in Northern California. The dewar’s castered cradle barely fit onto the sloping lift gate and it was heavily belayed to the truck with ropes to prevent a mishap. As the dewar was moved from the box of the truck and positioned on the lift gate, the jostling liquid nitrogen inside began to aggressively boil. It was a warm, humid night in North Orange County and clouds of steamy vapor began to issue from the top of the dewar. On routine patrol, a Fullerton Police Department cruiser pulled up and stopped in the driveway ahead of us. The two uniformed officers got out and said, “Wow! that is really neat! Do you mind if we watch?” Of course we didn’t mind. They sat and watched the 15 minute unloading in respectful silence, seemingly aware of the difficulty and risk attending the operation. When we were done, they thanked us, asked a few questions and left. I can still see them in my memory driving away in the midnight moonlight.

Because we had little media interface or attention during that time, and because we were free to focus exclusively on the things we deemed both important and possible to do, we were free to progress as fast as our capital and our abilities would allow. The move from Fullerton to Riverside in 1987 seemed rich with promise. The new facility offered more space, improved credibility, and increased cash flow – the last as a result of reducing the expense of rent, insurance and the increased member support due to the “mobilizing effect” of the insurance crisis. However, the move to Riverside signaled the end of invisibility and of “flying below the radar.” When the Dora Kent incident began to unfold in the closing days of that same year,[3] the era of tranquil progress was over, in part because of the media and government assaults that followed, but also to a significant degree because of the way we ultimately responded to them.

Figure 3: In 1990 Dr. Thomas Donaldson, a long-time Alcor member and an important thinker and activist in cryonics sued the Attorney General (AG) of the state of California for the right to be cryopreserved while still legally alive. Dr. Donaldson had been diagnosed with a Grade II astrocytoma in 1988, a usually lethal malignant brain tumor. Dr. Donaldson responded well to a course of radiotherapy, but ultimately succumbed to the cancer and was presumably cryopreserved in 2006. The suit against the AG was unsuccessful.[4]

There can be no question that Alcor had to respond, and respond exactly as it did, to both the Dora Kent and DHS cases. To have done otherwise would have destroyed Alcor and very likely some or all of its patients.[5] The successful outcome of these, and associated legal cases, resulted both in membership growth and in lasting high public visibility for Alcor. With those changes came an alteration in asset allocation and in priorities. Alcor became focused on growth over both research and improved technical and biomedical performance. In addition to its intrinsic justice, the litigation launched against the California Attorney General by Alcor and Thomas Donaldson to allow “pre-mortem” cryopreservation was seen as promotional tool, and as a potential practical bonanza, should Donaldson have prevailed and cryopreservation prior to legal death become permissible in California. With the sudden and unexpected cryopreservation of Jerry Leaf in July of 1991,[6] the die was cast, and Alcor became almost exclusively focused on matters other than research or charitable activity, inside or outside the cryonics community.

Figure 4: Spreadsheet of some of Alcor’s financial parameters from fiscal year ending 1984 through the end of fiscal year 2007. The total revenues column in highlighted in purple and the expenditures for research column is highlighted in red. Expemditures for research as a fraction of total revenues declined dramatically after the Dora Kent crisis in 1988. In the ensuing 19 year expenditure for research remained a tiny fraction of Alcor’s total revenues, and with the exception of three years, failed to even approach in absolute dollar amounts the yearly disbursements for research in the years prior to 1988.

This shift in priorities was by no means subjective, or a matter of opinion. It is reflected in Alcor’s financial reports, as can be seen in Figure 4, above. The reality, in terms of the impact on research productivity, was actually much grimmer in terms of value returned for the few research dollars expended after 1988, because of two factors which do not appear on any balance sheet generated to date; the absence of donated labor and the end of the era of free parenteral products, drugs and medical consumables recovered from the medical/drug supplier waste-stream.

Figure 5: Alcor’s all-volunteer research team provided an otherwise unaffordable asset in the form of thousands of hours of contributed labor in support of Alcor’s various research undertakings.

Another development which increased costs and decreased the buying power of research dollars was the effective end of “pound seizure” in the closing years of the 1980s in Southern California. Pound seizure is the process whereby animals slated for destruction in municipal impound facilities, primarily dogs and cats, were sold, for a small fee, to federally licensed animal research facilities.

This practice was effectively eliminated by animal rights activists, although a few cities and counties still have pound seizure laws on the books.[7] The end of pound seizure raised the cost of research dogs from ~$60.00 in the early 1980s to ~ $600 by the mid-1990s. Animal rights activism also dramatically raised the cost of non-rodent animal research by requiring costly infrastructure and specialized training and certification of personnel.[8] Thus, even the very small amounts expended on research as compared to the 1980s, both relatively and absolutely, had greatly reduced buying power.

The Scope of the Progress

What follows is a listing of what was achieved by Alcor from ~ 1982 to 1990 for an estimated total of $1,772,081 in 2010 dollars.  

Basic & Applied Cryonics Research

Beginning in 1982, Alcor continued the research to establish the degree to which ultrastructure was being preserved using existing human cryopreservation techniques begun by IABS in the late 1970s. The work at IABS employed rabbits, however it was decided to use cats as the experimental animals in the Alcor work because of the previous work done on brain cryopreservation by Isamu Suda and because it was anticipated that this work would progress to the evaluation of brain viability using electrophysiology – a model that was, at that time, largely confined to the cat. This research disclosed a number of previously unknown and unexpected findings, including the presence of macroscopic fractures in the animals as a result of cooling to below the glass transition point (Tg) of the water-cryoprotectant solution present in the tissues, as well as much more serious ultrastructural disruption due to freezing damage, than was previously expected.  This work constituted the first comprehensive evaluation of human cryopreservation techniques and was also the first to examine the effects of ischemia on cryopreservation injury.

Darwin, M. And Leaf, JD. Cryoprotective perfusion and freezing of the ischemic and nonischemic cat: http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1389 –  http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1390http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1391http://www.cryonet.org/cgi-bin/dsp.cgi?msg=1392

See also: Federowicz,  MG. and Leaf JD. Cryonics. issue 30, p.14, January, 1983.   http://www.alcor.org/cryonics/cryonics8301.txt __________________________________________

Leaf and Darwin believed that cryonics procedures should be validated in-house to the extent that it was technologically possible to do so. Building on the pioneering work of Gerald Klerbanoff and his associates at Lackland Air Force base,[9-13]  Alcor and Cryovita undertook to apply the technology being developed for extended hypothermic solid organ preservation (for transplant) to whole animals. In the early 1980s, the use of “intracellular perfusates,” principally Collins’ Solution, [14-18] and what was later to become University of Wisconsin (UW) solution,[19, 20] was allowing for 12-24 hour cold storage of human kidneys, livers and pancreases. An experimental solution which had demonstrated even better results at the Red Cross Blood Research Laboratory, Renal Preservative Solution-2 (RPS-2) was adapted for use on dogs. This solution, Mannitol-HEPES Perfusate-1 (MHP-1), allowed for the consistent recovery of dogs from 4 hours of perfusion at ~5C without neurological deficit and with uneventful survival of the animals into old age. The record of 4 hours for asanguineous ultraprofound hypothermic perfusion remains unbroken today.

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

____________________________________________

By carrying out autopsies and conducting histological and ultrastructural studies on the bodies of human patients converted from whole body cryopreservation to neurocryopreservation, Alcor was the first to discover that the macroscopic fracturing of organs and tissues that were occurring in experimental animals were also occurring in human patients. This work demonstrated that existing perfusion techniques were not delivering an adequate amount of cryoprotectant to the tissues. It was also the first demonstration that at the histological level, 3M glycerol was effective in preserving tissue architecture in a state indistinguishable from that of seen in unfrozen humans.

Noble, C. Histological Examination of a temporarily cryopreserved human. Cryonics. # 52, November, 1984, pp. 13-32: http://www.alcor.org/cryonics/cryonics8411.txt

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

Alcor research demonstrated that hollow fiber dialyzers could be effectively used as oxygenators for extracorporeal support of animals, including adult ~25 kg dogs. This work was conducted 4 years before the first hollow fiber blood oxygenators entered clinical trials and five years before they entered routine clinical use.[21, 22]

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

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

In 1983 Alcor developed a silicone heat exchange medium as a replacement for flammable alcohol, acetone and methanol, all of which has been previously used as heat exchange media for cooling cryonics patients. This non-toxic, low flammability liquid was later marketed by several firms, including Dow Chemical, the original supplier of the polydimethylsiloxane species used by Alcor as its low temperature heat exchange medium. The Dow product is currently sold under the brand name Syltherm.

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

A wide range of technical and scientific advances resulted from Alcor treating each human case as what it was; an experimental procedure to be learned from by careful observation and documentation of data. Observations of the inadequacy of conventional closed chest mechanical cardiopulmonary support (CPS) led to the development and application of High Impulse CPS. Observations showing unacceptably slow rates of cooling with ice bags led to the development of the Portable Ice Bath and profound improvement in the efficiency with which hypothermia was induced. Alcor also pioneered pharmacotherapy to mitigate the ischemia-reperfusion injury cryonics patients necessarily suffer as a result of having to wait for the pronouncement of medico-legal death prior to the start of the procedure.

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

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

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

Basic Research: Applied Biomedical Technology

Alcor applied research led to the development of a field-able platform for rapid post-cardiac arrest extracorporeal support of cryonics patients.

Leaf, J.D.,  Phases of cryonic suspension. Lecture given at the Lake Tahoe Life Extension Festival, Lake Tahoe, CA,May, 1986: http://www.lifepact.com/tahoe.htm  [68 minutes, 263 mb, .wmv, 320x240, 30 fps].

Legal & Administrative Advances

Throughout the 1980s Alcor led the way both the legal and administrative spheres of cryonics. Alcor developed the first informed consent documents for cryonics members/patients and the administrative paperwork developed by Steve Bridge (pictured below), Ron Buth and Mike Darwin has served as the model for cryonics organizations in the US and Europe. Staff, SUMS updated. Cryonics. 7(6)1986;2: http://www.alcor.org/cryonics/cryonics8606.txt

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

Applied Research: Cryogenic Engineering & Patient Storage

Alcor pioneered high efficiency storage for cryonics patients with the use of the MVE A-2542 cryogenic dewar for storing neuropatients and the subsequent development of  the “bigfoot” dewar which can store four whole body patients and 4 neuropatients. Alcor was the first cryonics organization to offer seismic, ballistic and blast protection to its patients with the development of the “neurovault” in 1984.

Darwin, M. Cephalarium vault arrives. Cryonics. December, 1984, p. 1: http://www.alcor.org/cryonics/cryonics8412.txt

Editorial Staff, The cephalarium vault. Cryonics, Oct 1988, page 24:  http://www.alcor.org/cryonics/cryonics8410.txt

Editorial Staff: Bigfoot Arrives. Cryonics. 1990, 11(6):12: http://www.alcor.org/cryonics/cryonics9101.pdf

Charitable Cryonics Care Alcor engaged in considerable charity work during the 1980s taking over the care of three unfunded patients and assisting two other patients with inadequate funding into cryopreservation. This record of charitable cryogenic care of patients in need is unique to Alcor through to the present.

Editorial Staff, Making charity do good work. Cryonics, January, Issue #30, 1983: http://www.alcor.org/cryonics/cryonics8301.txt

Editorial Staff, Three patients converted to neuropreservation. Cryonics,  Issue #42, January,1984 p. 3: http://www.alcor.org/cryonics/cryonics8401.txt

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

Scientific Education & Promotion of Cryonics

Throughout the 1980s and into the 1990s Alcor engaged in a vigorous program of public education and of the promotion of cryonics. Speaking engagements and outreach to the community were commonplace and an extensive package of scientific, technical and organizational information was mailed out to anyone who requested it.

Editorial Staff, Molecular engineering. Cryonics. Issue 45, April 1984 p. 5: http://www.alcor.org/cryonics/cryonics8404.txt

Drexler, KE, Molecular technology and cell repair machines, Part 1. Cryonics. 6(12)1985; 16-24: http://www.alcor.org/cryonics/cryonics8512.txt

Drexler, KE, Molecular technology and cell repair machines, Part 2. Cryonics. 7(1)1985; 19-28: 7(1)

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

 

 

Alcor pioneered promotion of the idea of nanotechnology and was the first organization to promote nanotechnology as possible pathway to allowing the recovery of cryonics patients. Wowk, BW, The death of death in cryonics. Cryonics.  9(6);30-71:988:  http://www.alcor.org/cryonics/cryonics8806.txt

Alcor also pioneered paradigm shifting ideas in the promotion of cryonics, not the least of which was the excision of the words “death” and “dead” from discussions regarding the status of cryonics patients.

Teaching and Training in Cryonics Procedures

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

Improved Emergency Response & Readiness

This period was also one of great growth in the technology for providing in-field support of patients experiencing cardiac arrest remote from Alcor’s facilities. Alcor conceived of an implemented the idea of remote standby and was the first cryonics organization to offer extended extracorporeal support during ultraprofound hypothermic transport of patients.

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

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

Similarly, Alcor was the first cryonics organization to develop facilities for remote cryoprotective perfusion with the creation of the Alcor facility in South Florida.

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

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

Social & Legal Issues

Alcor’s aggressive defense of its patients and its litigation to establish the legality of cryonics in the state of California are without peer. The Dora Kent and Department of Health Services cases consumed hundreds of thousands of dollars in legal expenses and exacted a heavy human toll on the Alcor staff. End of Part 8 References

1.            Loftus P: Whistleblower’s Long Journey: http://online.wsj.com/article/SB10001424052702303443904575578713255698500.html. In: Wall Street Journal. 2010.

2.            National News Briefs; Schering-Plough Recalls Medication for Asthma:  http://www.nytimes.com/1999/12/03/us/national-news-briefs-schering-plough-recalls-medication-for-asthma.html. New York Times 1999.

3.            Darwin M: Multiple articles relating to the Dora Kent case: http://www.alcor.org/cryonics/cryonics8801.txt. Cryonics 1988, 9(1):1-35.

4.            Wikipedia: Thomas K. Donaldson: http://en.wikipedia.org/wiki/Thomas_K._Donaldson. In.; 2011.

5.            Mondragon C: A stunning legal victory for Alcor: http://www.alcor.org/Library/html/LegalVictory.html. Cryonics 1990, 11(11):3-7.

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

7.            Hecht L (ed.): Pound seizure: when will it end :http://www.banpoundseizure.org/ps2.pdf. Park City: Citizens for Alternatives to Animal Labs.

8.            Hubel D: Animal rights movement  threatens progress of US medical research. The Scientist 1993, 7(22):11.

9.            Cline RE, Klebanoff G, Armstrong RG, Stanford W: Extracorporal circulation in hypothermia as used for total-body washout in stage IV hepatic coma. Ann Thorac Surg 1973, 16(1):44-51.

10.          Haff RC, Klebanoff G, Brown BG, Koreski WR: Asanguineous hypothermic perfusion as a means of total organism preservation. J Surg Res 1975, 19(1):13-19.

11.          Klebanoff G, Hollander D, Cosimi AB, Stanford W, Kemmerer WT: Asanguineous hypothermic total body perfusion (TBW) in the treatment of stage IV hepatic coma. J Surg Res 1972, 12(1):1-7.

12.          Klebanoff G, Langdon D, Wilen S, Tobias H: Total-body washout in hepatic coma. N Engl J Med 1973, 289(15):807.

13.          Klebanoff G, Phillips J: Temporary suspension of animation using total body perfusion and hypothermia: a preliminary report. Cryobiology 1969, 6(2):121-125.

14.          Carter JN, Collins GM, Halasz NA: Subzero nonfreezing kidney preservation. Transplant Proc 1981, 13(1 Pt 2):718-720.

15.          Collins GM, Bravo-Shugarman M, Novom S, Terasaki PI: Kidney preservation for transplantation. I. Twelve-hour storage in rabbits. Transplant Proc 1969, 1(3):801-807.

16.          Collins GM, Halasz NA: Forty-eight-hour ice storage of kidneys: importance of flush solution cation content. Surg Forum 1975, 26:337-338.

17.          Collins GM, Halasz NA: Forty-eight hour ice storage of kidneys: importance of cation content. Surgery 1976, 79(4):432-435.

18.          Hartley LC, Collins GM, Clunie GJ: Kidney preservation for transportation. Function of 29 human-cadaver kidneys preserved with an intracellular perfusate. N Engl J Med 1971, 285(19):1049-1052.

19.          Belzer FO, Glass NR, Sollinger HW, Hoffmann RM, Southard JH: A new perfusate for kidney preservation. Transplantation 1982, 33(3):322-323.

20.          Southard JH, Belzer FO: Control of canine kidney cortex slice volume and ion distribution at hypothermia by impermeable anions. Cryobiology 1980, 17(6):540-548.

21.          Haworth WS: The development of the modern oxygenator. Ann Thorac Surg 2003, 76(6):S2216-2219.

22.          Karlson KE, Massimino R, Singh AK, Cooper GN, Jr., Moran JM: Initial clinical experience with a more efficient hollow fiber oxygenator of unique design. J Cardiovasc Surg (Torino) 1987, 28(4):384-387.

Posted in Cryobiology, Cryonics Biography, Cryonics History, Cryonics Philosophy, Cryonics Technology (General), Culture & Propaganda | 3 Comments

In Camera Historia: Cryonics Institute Facility, 1978

On 21 March, 1978 the Cryonics Institute (CI) acquired their first facility, a storefront building in the Detroit Metro area. The CI building was the first wholly owned (cash purchase) patient storage facility in the history of cryonics, and remains one of only two in the world today.  The May, 1978 issue of the Immortalist Society newsletter, The Immortalist, described the facility thusly:

The place has three rooms, two lavatories is air conditioned and has a gas-fired furnace and hot water heater. The building is in very good condition and modern in appearance with wood paneled interior walls, and acoustical ceilings. The exterior is brick.[1]

As was the case with all cryonics organizations’ initial facilities, the CI facility was small and cramped. It also lacked the ceiling height necessary for upright (open at the top) cryostats and this limitation was an additional impetus for CI to develop the fiberglass-epoxy resin type of cryostat (using perlite and low vacuum insulation) that they currently use to store their patients.  The socioeconomic meltdown of the Detroit Metro area was well underway in 1978, and the CI facility was not located in a desirable area of the city. Few photos of the first CI facility were ever published; one being a photo that appeared on the cover of The Immortalist in June of 1978.[2] The purchase price of the first CI facility was rumored to be in the range of $10,000 to $15,000.

The exterior photos of that first CI facility (below) were taken by the author in January of 1987.

Above: The CI facility as seen from the street corner a block away in Detroit Michigan.

 Above: The first CI facility was quite small and was tucked in between other businesses in a residential area of Detroit.

Above: The entrance to the CI facility in 1978.

Above: The rear of the CI facility in 1978.

Above: CI’s first cryostat. This cryostat was fabricated in CI’s first facility by Andy Zawacki and Robert Ettinger, and was later transported to their second, much larger facility in Clinton Township (see below). Photo by Taryn Simon, 2008.

 Above and below: American Cryonics Society (ACS) patient being readied for cool-down to liquid nitrogen temperature. Control of temperature descent was by slowly lowering the patient towards a pool of liquid nitrogen in the bottom of rectangular, vacuum insulated fiberglass and epoxy resin cryostat. Above, Robert Ettinger (left) and Andy Zawacki (right) and  below. Robert Ettinger (far right) and Andy Zawacki (right). Photos by Jim Yount.

In 1994 CI acquired their current facility, the Erfurt-Runkel Building in Clinton Township (above), which is a suburb northeast of Detroit for about $300,000. The current CI facility is a spacious and attractive building filled with clinically white cryostats containing 103 human patients. The building is named after two long time CI activists and Directors, Walter Runkel and John Erfurt whose bequests funded the purchase of the Clinton Township building.

Above and below: The interior of the CI facility patient storage area in Clinton Township, MI. Photos by Murray Ballard (2009).

 

 References



[1] Junod, M. CI buys headquarters. The Immortalist 9(5)1978;1.

[2] The Immortalist, 9(6)1978.

Posted in Cryonics History | 3 Comments

The Armories of the Latter Day Laputas, Part 7

Figure 1: Fred and Linda Chamberlain with an early prototype perfusion machine.

By Mike Darwin

Lessons from the Alcor Experience?

The Alcor Life Extension Foundation, Inc. (Alcor) and its brother for-profit organization, Manrise Corporation (Manrise), were founded in 1972 by Fred and Linda Chamberlain (Figure 1). The Chamberlains had previously been members of the Cryonics Society of California (CSC) and both had served as officers of CSC. When they became suspicious about the integrity of CSC’s financial and cryogenic patient care operations and were unable to obtain answers to their questions, they left CSC and founded Alcor/Manrise.

As was the model at the time, Alcor was the 501c3 non-profit organization tasked with accepting cryonics patients under the Uniform Anatomical Gift Act (UAGA) and acting as their custodian and advocate until such time as reanimation might become possible.

The function of Manrise was to provide the biomedical services required to cryopreserve patients and possibly to  provide long term cryogenic storage, as well.[1] There were at least seven reasons at that time for dividing organizational responsibility in this way. The first was that the UAGA expressly forbade the acceptance of anatomical gift by for-profit entities; the second was that the IRS does not permit 501c3 organizations to engage in “fee for service” activities, and the third reason was the tax advantage conferred by 501c3 status. This allowed all contributed and invested income of the 501c3 organization to be exempt from taxation – including taxation by the state of California. The fourth reason was that Manrise Corporation could theoretically make a profit, but far more importantly, because it was a privately held corporation, it could shield the costly physical assets required for cryopreservation from takeover or seizure by an influx of new members into the non-profit Alcor. An associated benefit was that individuals wanting who were unwilling to contribute money to further cryonics might well be willing to invest it with the added incentives of both a financial and proprietary gain. The seventh and final reason was that it was perceived that there would be a substantial public relations advantage to having the cryonics organization responsible for the indefinite care of the patients to be a non-profit corporation.

Figure 2: Fred and Linda Chamberlain with Fred’s father, Frederick Rockwell Chamberlain, Jr., in December of 1974.

In addition to wishing to have a reliable cryonics capability for themselves, the Chamberlains were under considerable pressure, because Fred’s father, Fred Chamberlain, Jr., was elderly, in poor health, and bed-bound following a stroke (Figure 2). It was anticipated that he would be the first Alcor patient, and in 1975 this anticipation was realized. The period from 1972 to 1976 was a highly productive period for Alcor.  Solid platforms for administration, emergency stabilization, cryoprotective perfusion and cooling to -79C were put into place.

Substantial basic and applied research was also carried out and the first procedure manual for cryopreserving humans was written and published by Alcor/Manrise. In 1977 the Chamberlain’s decided to relocate to Lake Tahoe, CA where they began a real estate and property business. Trans Time, Inc., (TT) of Emeryville, CA was contracted with to provide all of the administrative and technical aspects of cryonics, including storage, for Alcor’s members and patients. It was during this time that TT was aggressively trying to brand itself as the leading provider of cryonics services in the US – and succeeding.

Cryovita, IABS and Soma

The departure of the Chamberlains marked a period of steep decline for Alcor. Alcor became primarily an agency to collect fees to forward to TT, and most Alcor–initiated cryonics activity had ground to a halt by 1981. It was at this time that Alcor and the

Figure 3: Operating room of Soma, Inc., and the Institute for Advanced Biological Studies (IABS) in Indianapolis, IN in 1979.

Institute for Advanced Biological Studies, another small, struggling cryonics group based in Indianapolis, IN merged. Thus began the second dynamic period in Alcor’s growth and in its generation of scientific and technical advances in cryonics. While Manrise Corporation had merged with TT, a new company and a new person had entered cryonics, Cryovita Laboratories and Jerry Leaf.  It was Jerry Leaf and his lab that prompted my move to Fullerton, CA and it was Jerry’s technical expertise and immense personal authority that were critical to establishing Alcor’s credibility. When Alcor and IABS merged in late 1981, Jerry was a subcontractor to TT. However, he chafed at this relationship and soon decided to focus his resources and efforts on the people he was surrounded with in Southern California – the same people who were contributing most generously of their time, money and effort to his research projects – Alcor members.

Hidden Resources

It is important to understand the relationship between Cryovita and Alcor because failure to do so will lead to a critically distorted and skewed picture of the capital and labor required to achieve what was achieved from ~1982 to 1991. This same admonition pertains to most other cryonics organizations that have existed where there was an associated for-profit entity. In the case of the Bay Area Cryonics Society (BACS) and TT, the majority of the capitalization in cash and contributed labor was to TT, not BACS.

The complete financial records of Cryovita exist from the period of 1981 to 1991 – every cancelled check and every receipt carefully catalogued by internal account. It is a large mass of data of about the volume of 3 “banker’s boxes.” Providing this data is preserved (and preferably digitally captured) it will be possible to dissect the exact contribution Cryovita made (and it is very substantial). It will also be possible to see to what extent Alcor had direct financial input into this contribution by virtue of the accounts receivable from Alcor to Cryovita. For now, all I can do is to give a seat of the pants estimate and suggest that over that ~10 year period, Cryovita added at least half again as much value to the efforts described below as did Alcor, if not more so.  That would be ~ $625,000 inflation adjusted to 2010 dollars.

However, that does not take into account to the considerable time and the unique expertise and intelligence brought to bear in acquiring assets. For instance, it is likely that by 1983, Jerry Leaf and I[2] had spent perhaps $150,000 in 1982 dollars on biomedical equipment ($334,359 in 2010 dollars). Almost all of that equipment was acquired at university surplus property sales, government auctions, and from salvage medical equipment dealers for between $0.01 and $0.10 on the dollar of the new purchase price. Such equipment, if intelligently purchased, is almost always serviceable, but it requires enormous amounts of time to acquire it, it must be refurbished as needed, and it required considerably more effort then ( in the pre-Internet era) than now to acquire documentation to operate and service it. It was thus both reasonable and conservative for Jerry to estimate the current (new) replacement cost at ~ $1 million in 1982 dollars.

Figure 4: The entrance to Cryovita Laboratories located at 4030 N. Palm, Unit 304 in Fullerton, CA circa 1979.

The Business Liability Insurance Crisis

An additional consideration is that early in 1985 it became impossible for Cryovita to obtain basic business liability insurance due to the liability insurance crisis of the 1980s. Since Alcor was a rent free co-tenant with Cryovita this meant that both companies faced imminent eviction, since it was (and is) a requirement of most commercial landlords that the tenants maintain a substantial sum in coverage. In the case of Cryovita and Alcor, this was $ 500,000 in 1985 dollars. The liability insurance crisis had profound implications for cryonics because it meant that Cryovita and Alcor could not simply find another landlord, or even obtain a loan to purchase a building, since any institutional loan would need to be secured against tort action with liability insurance. It was thus necessary to identify and purchase a suitable facility in cash, and as quickly as possible.

In order to purchase such a facility, a limited liability partnership called the Symbex Property Group, was created by the author in 1985 and $193,000 in capital was raised over a~ 3 year period: $158,000 was raised by closing time on the building, which took place on 24 December, 1986 ($365, 445 in 2010 dollars). Alcor directly owned $31,267 in Symbex shares. When the building sold on 24 May, 1995 during a major depression in Southern California commercial real estate prices it sold for $127,000. It thus seems reasonable to credit to Alcor half the inflation adjusted purchase price ($187,722).[3] If the capital contribution from Cryovita is added to the estimated capital contribution from Symbex, that works out to an additional $522,081 inflation-adjusted (2010) dollars that might reasonably be added to the $1.25 million in direct expenditures by Alcor between 1983 and 1989, for a very roughly estimated total of $1,772,081.[4]

In hindsight, that seems an impossibly small number given what was accomplished. In 1981-2 we had virtually no money beyond covering the lease and the utilities. Buying a can of spray paint to spruce up the battered appearance of otherwise serviceable equipment was a luxury, and a painful one, at that. Virtually all of my surplus income was going into the two operations, as was Jerry Leaf’s. In fact, in Jerry’s case, the bulk of the salary he earned as a researcher in the Department of Thoracic Surgery at UCLA was going to support Cryovita, while his wife and two children were largely being supported by his wife’s income as a Registered Nurse in a supervisory position at a community hospital.

Figure 5: Cryovita occupied a small, impossibly cramped industrial bay in Fullerton, California.  Animal research and human cryonics cases were carried out using the same facilities. At left, above, Jerry Leaf stands next to Alcor’s first dual patient cryogenic dewar, proudly sporting the MVE logo.

Figure 6:  With the exception of the operating room and the office/reception area, the bay was neither subdivided not heated or cooled. It was often miserably cold in the winter (~ 15C) and brutally hot in the summer. Dust, which poured in from over and around the roll-up door at the back of the bay and through the skylight, was a constant problem.Above is the Alcor office at appeared in 1983.

Figure 7: Before the operating room was constructed, patient cryopreservations and research work were conducted in the undivided industrial bay. Wiring was makeshift, comfort was non-existent, and the whole operation functioned on a shoestring. Above, a canine total body washout conducted at Cryovita in 1978 or 1979.

Figure 8: The all-volunteer research staff at Cryovita during a canine TBW after the (unsuccessful) experiment circa 1978-79. Left to right: Jerry Leaf (hands), Betty Leaf, Reg Thatcher, Greg Fahy, Tom the Perfusionist, Cath Woof and (barely in frame) Thomas Donaldson.

Waste Recovery

Two other sources of revenue thus should be mentioned. The first is the enormous wealth and the enormous waste of the US at that time (and to a lesser extent, now) both in general, and in the healthcare sector, in particular. It is currently estimated by the Government Accounting Agency (GAO) that there is $60 to $90 billion a year in Medicare fraud.  This represents deliberate, overt fraud – not waste in the system, or what I would call “soft” fraud, where perfectly serviceable equipment is replaced with the latest model, acceptable consumables are replaced with a different brand because of physician/administrator preference, or more rarely, because of kickbacks from suppliers.

A commonplace example was that of a cardiac surgeon wishing to switch the brand of oxygenator, tubing packs or other consumable supplies used in the operating room. Such a change in vendors may reflect a real medical advantage, or may even be worthwhile because it increases the safety and efficiency of the surgeon, or his supporting staff. Often, however, any perceived technical advantages are illusory. The primary reason for switch-overs is economic: the hospital corporation has negotiated a better deal with a different supplier. Where complex devices are involved, such as blood oxygenators, there needs to be in-house training (in-services) for the new device, and switchover needs to be abrupt and complete, to avoid possible confusion.

A result of this is that whatever remains of the existing stock of devices is discarded. Often the new vendor takes custody of these devices and destroys them to prevent any possible price depression resulting from a bolus of “free” oxygenators entering the marketplace (the same procedure is also often used with hardware, such as dialysis machines and IV pumps).  Of course, sales people are by nature entrepreneurial and if they can find a market outside of the clinic where they are sure the product they were supposed to have destroyed will not harm their market, they are not adverse to selling it for whatever that market will bear; typically 25% to 30% of the wholesale price. These kinds of vendor-change generated surpluses were a major source of consumables for us during those years.

Figure 9: A Clay Adams Becton-Dickinson 0151 Analytical Centrifuge of the kind commonly discarded after home-dialysis patients died or returned to –in-center hemodialysis. These units retailed for ~$500 in 1982.

A similar bonanza was to be had, in this case free for the taking, with respect to hemodialysis (artificial kidney) supplies.  A small fraction of patients receiving hemodialysis undergo the treatment at home where it is administered by a spouse, friend, or paid private giver. Medicare pays for the procedure and provisions the patients’ homes with both consumables and hardware. In the event the patient returns to in-center dialysis or dies, the consumable supplies cannot be returned for use by other patients because of concerns over storage conditions and the (remote) risk of infectious disease transmission. Hardware, such as centrifuges use for hematocrit determination[5] that were difficult to clean and impossible to sterilize, were also discarded.[6] Usually all it took was a phone call to the patient, or his next-of-kin, to get these supplies at no cost – in fact, most people were grateful to have the many cases of dialysate, dialyzers and many other supplies carted off from their home.

Figure 10: Cryovita was located in an industrial park a few hundred yards from a major Southern California drug wholesale warehouse. Experimental dogs were walked along the concrete wash (photo at lower right) or in the field on the other side of the wash. A red X marks the location of the PRN dumpster where we used to recover discarded medical products. The image is from Google Earth and the building which currently occupies the lot labeled “Dog Exercise Field” has been removed using Photoshop.

Another artifact of great wealth and careless government spending on healthcare is waste due to inefficiency. When Jerry Leaf leased the Cryovita industrial bay, he had no idea what a fortuitous choice he had made. As it turned out, a wholesale drug house was located only a few hundred yards from Cryovita. In the early 1980s, the lot adjacent to the drainage wash that lay in back of the building opposite Cryovita was not yet developed. We initially used the area along the wash to walk our research dogs. However, concerns over possible exposure to the long duration defoliant agent used on the ground along wash, led us to begin walking the animals in the empty lot on the other side of it. Being inveterate dumpster divers, Hugh Hixon and I soon discovered that the PRN Wholesale Drug warehouse discarded its expired products in a dumpster that tantalizingly abutted the vacant lot where we exercised the dogs.

Figure 11: Above left, dozens of doses of Unipen (nafcillin) parenteral antibiotic recovered from the dumpster of PRN. At right, boxes of perfusion supplies, dialyzers and ethylene oxide sterilization wrap all obtained for free, or at pennies on the dollar. Photo 28 May, 1995.

Typically, several times a week varying quantities of expired medications and IV fluids would be deposited in the dumpster stilli9n its original shipping packaging. The sheer variety and volume of parenteral products that were discarded still boggles my mind these many years later. Often, product was discarded months before its expiry, because customers will often refuse to accept medications that might expire before they can use them. Expiration dates on most drug products are set very conservatively, and in any event, preparations that consist only of simple molecules, or otherwise stable molecules, may be safely used for years beyond their expiry,[7] depending upon how they are packaged and how they are stored.

Lyophilized, stable molecules stored in glass under a vacuum have an indefinite shell life, as do IV fluids (in glass) such as saline, Ringer’s solution and other solutions containing only simple ions.[8] Thus, if the solution is clear, free of particulates and still under vacuum it may be safely used. Most antibiotics cannot be used safely much beyond their specified expiry, but this time may be greatly extended by simple refrigeration of the vacuum packed powder.

PRN also sold a wide range of the most commonly used medical disposables, such as syringes, needles, catheter over needle IV access devices, gauze, dressings and topical products. As a consequence of this essentially free largesse, Cryovita/Alcor was supplied with most of the “routine” parenteral products needed for research, as well syringes, needles, dressings, and so on. Figure 11, above, is a photograph of a large lot of Wyeth Unipen (nafcillin) antibiotic. At that time, most staph was still not resistant to nafcillin and this bonanza of free antibiotic carried us through ~5 years of animal experiments (it was stored at -20C in a non-frost free household freezer).

Without a very careful analysis of the research done during this period, it would be impossible for me to gauge the contribution that this kind “underground” materiel represented in terms of dollars and cents. Certainly it amounted to many thousands of dollars and perhaps tens of thousands until ~1987 when the FDA mandated drug suppliers destroy expired or discarded product to prevent it from being re-utilized.

End of Part 7

Footnotes



[1] The primary focus of Manrise was on developing rescue and cryoprotective perfusion capability, since Trans Time, Inc., was already providing storage service in the Bay Area.

[2] When IABS merged with Alcor, Soma, Inc., the for profit brother organization to IABS, of which I was the principal stockholder, merged with Cryovita. This combined the capital assets of both entities.

[3] This is so because those shareholders who did not recover their investment may be reasonably considered to have subsidized Alcor’s occupancy of the building with their losses since the rent Alcor paid during its tenure in the Symbex building was well below market rate (~ $1,000/mo; the precise amount was determined on the basis of Alcor’s yearly income.)

[4] The reader should feel free to round those numbers up to $2 million or down to $1.5 million per their preference. My own guess is that the $1.5 million (inflation adjusted to 2010 dollars) figure is the more accurate.

[5] I note that one of the same model Clay Adams Becton-Dickinson 0151 Analytical Centrifuges I used to obtain from deceased home dialysis patients’ homes has a “buy it now” price on eBay of $449.99: http://cgi.ebay.com/Clay-Adams-Becton-Dickinson-0151-Analytical-Centrifuge-/230378218928.

[6] Hepatitis B (HBV) was endemic amongst dialysis patients and their caretakers due to their need for frequent blood transfusions. There was no vaccine at that time, and this blood-borne illness had considerably morbidity, and a long-term mortality rate of 3-5%. Blood handling equipment was often heavily contaminated with the virus. Since I had been infected with and recovered from HBV, this was not a concern for me and I could safely invest the time to sanitize the equipment.

[7] This used to be a major cost-saving “subsidy” for animal research. However, animal rights activists successfully lobbied the USDA to forbid the use of expired product – drugs or devices – on experimental animals.

[8] Stopper composition is also critical; with butyl rubber stoppers offering the longest post-expiry shelf life.

Posted in Cryonics Biography, Cryonics History, Cryonics Philosophy, Cryonics Technology (General), Culture & Propaganda | 1 Comment

Are You Really Sure You Want to Die? A Response and Commentary on the Inevitability of Aging and Death

By Mike Darwin

A short while ago the comment appeared on a medical list serve where I post in response to the article “Going, Going, Gone…” which appeared here on Chronosphere about brain aging and the need to develop effective strategies to halt and reverse it. (http://chronopause.com/index.php/2011/05/30/going-going-gone/, http://chronopause.com/index.php/2011/05/31/going-going-gone%E2%80%A6-part-2/, http://chronopause.com/index.php/2011/05/31/going-going-gone-part-3/):

“This is really depressing.  I am 58 years old and still trying to “learn” a number of things.  It does explain that I have to really work at what comes easy to my kids (25 – 35yrs old). I can stay on top of computer and tech stuff just by working at it a bit. The real drop has already hit in music.  I started back playing music at 50 and although practice a lot and absolutely love to play, I can see that I need the lyrics, chord progression and such even for old songs that I played 35 – 40 years ago.

 I’m in a new job and out of critical care on a day to day basis.  Again, I see the slippage.  I have to work really hard to keep up with the changing literature, new drugs, and details of mechanisms of action etc.

 So now I read it doesn’t matter, and my brain is already 50% fried – perhaps more.

On a slow decline with increasing speed into the twilight of existence.. Not a pretty thought.

 R.A.”

What follows was my response. I wish I could have been more specific, more positive and more activist in my response. However, past experience has shown it would do no good to suggest that support be given to cryonics, or to interventive gerontology research. It is not possible to reach people in this community in that way. Sadly, all that can be done is to raise awareness in the younger readers of such lists, often at the expense of considerable emotional discomfort to the older ones. This approach isn’t particularly just, but I see no alternative. Thus, I am very much hoping for insights from others who will read this here and perhaps be able to suggest how to take sparking awareness of impending death and decay into something more immediately productive:

Incredible! And I’m not being either snide or cruel here; finally somebody get’s it!

What I’ve been trying to say for a decade and half here on this list serve (and much longer elsewhere) is that medical progress to date has been both relatively and, in an absolute sense, illusory. And history will record it as such, and you will be just another sad, anonymous and forgotten statistic.

Figure 1: Sir Astley Cooper (1768 –1841).

In the past, people died very young and mostly “functionally old” (i.e., in their 60s and 70s). They died en masse of infectious disease, they died as children and young adults. They died horribly. An excellent and very worthwhile read is the new biography of Sir Astley Cooper, Digging Up the Dead:Uncovering the Life and Times of an Extraordinary Surgeon (ISBN-10: 1845950135). I am a hardened SOB, long exposed to animal research and human suffering in the clinic, and I had to put that book down at several points, because it upset me too much to read on. Life for the sick and dying was worse than I had imagined; and I am a serious student of medical history. Life for experimental animals was unspeakable.

Figure 2: Today we have antisepsis, anesthesia, and injectable pain killers. Medical and dying have been made seemingly more palatable. But are they, really?

 Now we have antisepsis, anesthesia, parenteral pain killers, effective anxieolytics…life is better, right (Figure 2)? Well, both relatively and absolutely, I suppose that’s true – but much depends on what you want and expect from life. The fact is that most people were just as content to suffer and die in 1760 as in 1960 or in 2011. They did so in more pain, but they had some advantages we don’t; namely they almost always remained cognitively intact, and they had a more credible and matter fact belief in religion and a well specified afterlife that was both eternal, and included friends and loved ones.

Figure 3: Then and now: At left above, a tuberculosis (TB) ward in the late 19th or early 20th century was a place fear, loneliness and often little or no hope. A contemporary nursing home (above, right) is little different, except that the people dying there are, on average 30 or 40 years older and they, unlike the TB patients of the previous centuries, know with certainty that for them there will be no escape.

Today, you stand a very good chance of being demented if you live long enough – sometimes pleasantly so – mostly not. In 1760 people simply denied their basic condition. They didn’t think about it and mostly they didn’t look at it. Just consider the current to-do about Betty Ford making breast cancer a “de-stigmatized” illness. When I was a child, people whispered the word cancer, and all kinds of people died of it without any acknowledgement that that was what was what was happening. There was near complete denial. That is exactly as it was with TB, and other horrors as bad or worse, right into the first half of the 20th century. The situation was too horrible to be “looked at in eyes.”

Consider nursing homes and the cognitive and other functional declines of aging today (Figure 3). We simply refuse to see the magnitude of the horror. We refuse to see it. If we could honestly be objective about it, it we would be not just depressing, it would be terrifying. It turns out we have a deeply embedded psychological defense called “terror management” that kicks in to prevent us from being objective and seeing our situation. This is useful, because we’d be even crazier than we already are, if it were not present. The cultural anthropologist  Ernest Becker came to a similar conclusion in his brilliant book, The Denial of Death (ISBN 0-02-902310-6).

Figure 4: Death is death; the end result is the same; non-existence and oblivion. It is also an illusion that the horror and suffering are really less today than they were yesterday, or will be tomorrow. If anything, extension of the mean lifespan in the absence of regenerative and rejuvenating medicine extends the period of suffering and increases the terror. The average lifespan of a patient with Alzheimer’s disease is 8 years from diagnosis to death. More people are interned in extended care facilities today than were ever imprisoned at Auschwitz, Dachau, or all the Nazi concentration camps combined. And unlike many patients dying from infectious disease in the previous centuries, patients in nursing homes and care facilities (if they are not demented) know that for them there is no hope of escape. That is a condition that even the Nazis never managed to uniformly impose on their victims.

We can look at the early and pre-20th century world and shudder, whilst briefly considering it, because we can see the horrors and appreciate the impossible magnitude of the suffering. We are now distant from that, and our situation is “better.” And, in some ways, it is. We do live longer, and early mortality is largely gone. People get to see their grandchildren and often their great grandchildren. But, they still die horribly, depending upon your definition of horrible. If your brain and abilities and body decaying and falling to ruin is acceptable to you and considered inevitable, then there has been a huge absolute improvement in the human condition. Ideally, You might indeed get to be Jane Fonda or Cher, instead of the hobbling, nearly blind, pain-ridden old people that you may remember from your childhood. That’s good, but it is only a delay; you will get to the bad part and it will be sooner, rather than later (Figure 4). As Cicero said, “Nothing that has end is long.”

Figure 5: The Singularity is I fear, not near.

I don’t believe in any magical technological Singularity where we will all wake up someday soon; both immortal and in utopia.

Bullshit.

The best you can hope for is that medicine reaches the same pace of advance now present  in consumer electronics, where every device you buy (literally) is in the trash 2 years later – I just yesterday brought home an ENVISION 19″ flat screen monitor, thoughtfully returned to its original box before being pitched in the trash. But, that isn’t likely to happen in medicine, because we aren’t fault-tolerant in developing new technologies in that area, and we can’t relentlessly experiment on the marketplace (human beings) with the same abandon the makers of iPads, printers, and MP3 players do. So, it will be a long, hard, slow slog.

And again, for those who have already accepted and comfortably surrendered much of their youthful capability, aging and death aren’t so bad. However, be aware that a lot of that acceptance is because of terror management and the fact that what is really happening is hidden from you until someone like me rubs your nose in it; for which I will no doubt be punished severely.

This is your reality and mine, and no one escapes it:

Figure 6: Loss of cognitive capabilities is universal; no man or woman who lives past their teenage years escapes them. The graph above shows the average rate of cognitive decline in humans. Two cognitive functions, verbal ability and numeric ability, show improvement in the middle decades of life as a result of accumulated life experience.

If we survive as a both a humane and a technologically sophisticated species, there will come a time in the not too distant future, when people will not grow old and die as we do. They will have other problems, most of which we can’t even guess at. And it won’t be utopia; any more than your life with computers and the Internet is utopia today. But rest assured, it will be vastly better than the life you are leading and losing now. And those people will look back on this time and they will shake their heads, and they will turn away when they can, and when they can’t, they will weep.

But they will NOT weep for you. They will weep for the whole sordid situation that was the human condition in the first decades of the 21st century. They won’t weep for you because you will be forgotten – utterly and completely forgotten as the person you were – even if you are Cher, or the best, the richest, and the most famous surgeon of your day, as was Astley Cooper. And who really remembers him?

In London, the inevitable has happened and the cemeteries, too expensive to maintain, are being abandoned to become urban wilderness preserves; the tress are growing up, the tombstones being overturned and buried, and in another 50 years it will all be a dim memory (Figure 7).

Your death will make as much, or more accurately, as little sense as the deaths of all those anonymous souls who coughed their lungs out a bit at a time from TB. Keats and Poe: yes their deaths from TB are remembered, as are their works. But they are not remembered. And here, here is the final and most important insight I can try to communicate: only you can remember yourself. And when you are dead you are, in fact, gone and gone forever. And no one will be able to, no matter how much they would like to (and mostly they wouldn’t), remember you. That is the central and ultimate tragedy in your life and the universe doesn’t give a damn. Blind evolution “made” you and it will just as blindly and uncaringly kill you. It will do so without malice and without “intent.” It doesn’t care because it can’t – anymore than a TB bacillus could care about the death of Keats, or Poe, or Chopin.

Figure 7: No marker or monument endures and no man’s life, let alone his personal identity, can be written down on paper in words.

Either you understand that, or you don’t. If you do understand it, then either you face it and decide to fight, or you decide to turn away and accept oblivion. That is a highly personal decision. But I would caution you that if you choose to join the ranks of the dead, rather than fight to stay amongst the living, sooner, much sooner rather than later, nobody will give a damn, or even remember who you were – beyond a name on a genealogy chart, or perhaps a brief biography Or if you are both extraordinary and lucky (or in reality, both), maybe even a book-length biography. If 250 or 350 or 650 pages of print is who you think you are, and all you think you or are, or even just the most important part of who you are, well then, your fate is sealed, even if it is not just.

We do not now inhabit a just world and it will a long while, if ever, before we do.

Posted in Cryonics Philosophy, Culture & Propaganda, Gerontology, Medicine, Uncategorized | Leave a comment

Harry Potter and the Deathly Hallows, Part 2

Question: How did God create heaven and earth?

Answer: God created heaven and earth from nothing by His word only; that is, by a single act of His all-powerful will.

Question:  Why did God make you?

Answer: God made me to know Him, to love Him, and to serve Him in this world, and to be happy with Him forever in heaven.

                         – Baltimore Catechism, Revised Edition (1941)

By Mike Darwin

No.

If this universe we inhabit was created by an intelligenc(s), then it was not in that way, and not for those reasons. I think I know what one of those reasons might really be.

Early this morning I saw Harry Potter and the Deathly Hallows – Part 2 (2011) in one of its opening release showings in state-of-the-art digital video and surround sound. It is a gorgeous work of art – a successful assault on the pinnacle of what is now possible cinematically. The imagery and mood of the film are evocative of those in the recently published and surreally beautiful book, Beauty in Decay: The Art of Urban Exploration by RomanyWG (Gingko Press, July 15, 2010, ISBN-10: 1584234202).

The resolution of the images, both real and computer generated (CGI), is superb and unassailable. The credibility of CGI has surpassed that of what is possible when merely capturing reality on film, and by this I mean that the unreal trumps the real and the unbelievable is more credible than the believable. Sitting there dazzled by the sheer beauty of the film’s imagery, it occurred to me why god(s), if there are any, made the universe – because they could realize a place vastly more beautiful and wonderful, and vastly more terrible and dark than the world which they themselves are confined to.

This film is, of course, only the barest and the most basic realization of that possibility. It represents the best efforts of a species with only sub-picoscopic knowledge of their universe to imagine a credibly different one. And it is for just that reason that this film is so amazing. The imagined living systems brought to life before the viewer reflect an understanding, rendered into equations and countless lines of code, of some of the fundamental principles of how biological things move and flex and interact in our world – of how they actually behave on a macroscopic level.

The labored respiratory movements of captive, half-blind dragon, and the animation of the creatures that populate the film are not just flawless, they are beyond that, because if you realize that these movements cannot be simply scaled up or down from some simple model, you then begin to realize some of the technical magnificence of the film. The CGI programmers are beginning to render their worlds from first principles, and armed with those, they are creating brand new worlds that are more credible and more real than any in our former imaginings. Artists can draw and paint, but the texture of their fantasies always falls short of truly achieving reality, let alone exceeding it. This film shows us the barest beginnings of what that excess is likely to hold, and it is at once exhilarating, and deeply disturbing. I looked at the unfolding of this “film,” a misnomer now, for it is far, far removed from the technology of unruly chemical reactions on a plastic membrane, and I was struck by the thought, “I can see now that we will soon be able to imagine not only much nicer places than we inhabit, but places that will be much realer, and more compelling too.”

By “nicer” I do not necessarily mean more “pleasant.” There are physical limits imposed by our universe on how much pain, how much suffering, how much physical distortion, disruption and rending of the flesh are possible, before life ceases. It is the sorrow of every sadist and every masochist that the flesh of the body can only be tortured in so few, and so finite ways. What are the implications of that?  Perhaps it would be wise for us to reflect on the quote from Milton’s Paradise Lost, “The mind is its own place, and in itself can make a Heaven of Hell, a Hell of Heaven.” And perhaps as well on a quote from the film itself, when Harry Potter asks about a postmortem experience he is having, “Is this just happening in my head, or is it real?” to which Dumbledore replies with alacrity, “What makes you think that just because it is happening in your head it is not real?”

The story line of the film captures with perfection the essential values of this culture. The “final” battle between good and evil is played out; Lord Voldemort, whom the author of the Harry Potter books has described as “a raging psychopath, devoid of the normal human responses to other people’s suffering,” is bent upon removing the last obstacle to his immortal existence and his ongoing journey to conquer his world. And that obstacle is the boyishly genteel Harry Potter. Now a man – emotionally, physically, and intellectually mature, Potter is repeatedly confronted in the film with the choice to grasp ultimate power, or to suffer and die. He chooses the latter, not once, but twice (Rowlings trumps Christianity, there). As the film ends, he finds himself holding “The Elder Wand” and realizes that it will grant him supreme power: his response is to break it in two and cast the pieces away.

The closing sequence of the film is of Harry Potter and his cohorts as mature men and women living in the everyday world we all inhabit. He has a child now, and it is time to send him off to Hogwarts boarding school to learn the craft of Wizardry. Age has begun to mark Harry Potter, and these scenes are meant to show us that by his deeds, he has ensured and acceded to the triumph of generational mortality. Harry Potter will grow old and die, as will his children, and his children’s children. Immortality is not for men, nor is super-knowledge beyond that already granted to Wizards, which is, of course, vastly greater than that granted to the mere “muggles” whose world they cohabit.

The word hallows means to honor as holy, to make holy, or to consecrate. “Deathly Hallows” indeed – the perfect title for this beautifully made and imagined film, with a poisonous message as old as Christianity, or or the denouement of the Epic of Gilgamesh.

Posted in Cryonics Philosophy, Culture & Propaganda, Philosophy | 6 Comments

Status Report: 15 July, 2011

One of the unfortunate things about being as isolated as I am from easy dialogue with others (something much of the cryonics community suffers from) is that I don’t have much opportunity to sit around and verbally discuss the meaning of events of (seeming) importance. I thus have only on my opinions, and those are of limited use, at best.

The statistics I present below are below are interesting and I’m fairly sure they contain important in formation. I’ll refrain from commenting on them much beyond labeling points on the graphic section to show what a given day’s post was.

31.          suPAR Power: A rapid, inexpensive, highly accurate method of predicting all-cause and disease specific mortality: 2011/07/15

30.          The Armories of the Latter Day Laputas, Part 5: 2011/07/11

29.          The Armories of the Latter Day Laputas, Part 4: 2011/07/07

28.          In Camera Historia, Trans Time, Inc.: 2011/07/05 and In Camera Historia,” Air Hearse”:  2011/07/07

27.          Casual Conversation, 29 June, 2011: 2011/06/30

26.          Future Babble: A Review and Commentary: 2011/06/29

25.          Induction of Hypothermia in the Cryonics Patient: Theory and Technique, Part 2: 2011/06/29

24.          Induction of Hypothermia in the Cryonics Patient: Theory and Technique, Part 1: 2011/06/28

23.          Commercial Air Transport of the Cryopreservation Patient: 2011/06/26

22.          Going, Going, Gone… Part 1-3: 2011/05/31

21.          A Visit to Alcor: 2011/05/29

20.          Cryonics, Nanotechnology and Transhumanism: Utopia Then and Now: 2011/04/19

19.          Cryonicists, Teach Your Children Well: 2011/04/14

18           You be the Judge: Understanding and Evaluating the Quality of Human Cryopreservations from Cryonics Organization Literature and Case Report Data, Part 4: 2011/04/11, 2011/04/05, 2011/04/04

17.          Michael G. Darwin, a Biographical Précis: 2011/04/04

16.          Letter to the Aspirants: 2011/03/18

15.          1968 AD > Cryonics > Reboot: 2011/03/17

14.          We’re Not in Kansas Anymore: A Personal Meditation on the Consequences of Increasing Social Acceptance for Contra-cultural Undertakings: 2011/03/13

13.          Chronosphere is Not a Blog!: 2011/03/12

12.          How Not to Get Ahead in Cryonics: Using Google Ngram Technology to Expose Flawed Decision Making in Cryonics: 2011/03/10

11.          Poisoning the Well: Measuring the Cultural Penetration of Cryonics Using Google Ngram Technology: 2011/03/07

10.          I Know this is Going to be Shocking: A Review of Wearable Continuous Monitoring Systems to Detect and Treat Sudden Cardiac Arrest in Cryonicists: 2011/03/16

9.            Pearl: 2011/03/05

8.            Last Aid as First Aid for Cryonicists: 2011/03/06, 2011/03/04, 2011/03/01,2011/02/28

7.            Maxim, Pumps, and Flow Measurement: 2011/02/27

6              Response to Maxim’s Rant about Automation in Cardiopulmonary Bypass: 2011/02/26

5.            Last Aid as First Aid for Cryonicists, Part 1: 2011/02/26

4.            Don’t Ask, But Do Tell: 2011/02/24

3.            Does Personal Identity Survive Cryopreservation?: 2011/02/23

2.            The Pathophysiology of Ischemic Injury: Impact on the Human Cryopreservation Patient, Part 4: 2011/02/14

1.            Achieving Truly Universal Health Care: 2011/02/14

Unfortunately, the statistical plug-in that Chronosphere uses does not allow for the graphic data to be dynamically adjusted in terms of the periods of days displayed, or the dates of the weeks rather the number in which they occur in the year. Thus, I can only display stats from 06/16 through the present. The numbers assigned to the posts are arbitrary and do not reflect the count from the first post. — Mike Darwin

 

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suPAR Power: A rapid, inexpensive, highly accurate method of predicting all-cause and disease specific mortality

By Mike Darwin

Introduction: The Magical Biomarker

As I was leaving the conference exhibitors area, I was waylaid by Dr. Veerappan Chithambaram, the conference organizer. “Mike, there is someone I think you should talk to. I don’t know exactly why, but I think it is important for the two of you to meet.” “What is our area of mutual interest?” I asked. “Well, you must come and meet Henrik, and then you will know.”

After the presentations were over for the day, Henrik Tommerup and I sat in the bar of the hotel and talked. The bar was deserted. Prince William and Kate Middleton were getting married and it was the day of the traditional “wedding parties,” where citizens of the Empire throw their own celebrations, often in the form of street parties a day or two before the royal wedding itself. Henrik Tommerup is Vice President of Business Development for the Danish biotechnology company, ViroGates.  He is an intelligent and highly articulate man whose most outstanding characteristic is his earnest and controlled enthusiasm. As we talk, I rather imagine that this must have been what it must have been like to talk with one of that wave of young merchants who created the East India Company.  As the conversation proceeds and heats up, Henrik hands me journal article after journal article. As I begin to absorb the graphic data – it occurs to me why I am thinking of him in such terms. What he is telling me is potentially of great importance. In fact, if it is real, it will be of comparable importance to the discovery of the link between hypertension and death and disease from heart attack, stroke and kidney failure.

Figure 1: Soluble urokinase plasma receptor (suPAR). Panel A – Schematic representation of the amino acid sequence of human uPAR showing its three homologous LU domains. Consensus disulfide bonds defining the LU domains are coloured black. The position of the C-terminal glycolipid anchor (GPI) is shown (modified from Ploug and Ellis, 1994, with permission). Insert: The archetypical three-finger fold is illustrated by a ribbon diagram for a single secreted LU-domain protein (snake venom toxin-a) using the PDB coordinates 1NEA and PyMOLTM (DeLano Scientific). Panel B – LU domain signatures in the primary sequence of human uPAR. The three LU domains (DI, DII and DIII) of uPAR are aligned with the consensus structures being highlighted (disulfide bonds in yellow and the invariant asparagines in red). The number of residues between the individual cysteines is represented by dots or numbers in brackets (modified from Kjaergaard et al., 2008). Panel C – The crystal structure solved for uPAR in complex with a peptide antagonist is shown as a ribbon diagram (Llinas et al., 2005). The individual LU domains are colour-coded (DI in yellow, DII in blue and DIII in red), and N-linked carbohydrates are shown as white sticks. The attachment to the cell surface by a glycolipid anchor is modelled in this cartoon. The insert shows uPAR in a surface representation, with the hydrophobic ligand-binding cavity marked with hatched lines; carbon, nitrogen and oxygen atoms are coloured white, blue and red, respectively. These structures are visualized by PyMOLTM (DeLano Scientific), using the PDB coordinates 1YWH (reproduced from Kjaergaard et al., 2008).[1]

Soluble urokinase receptor, or suPAR, for short, is the soluble form of the urokinase plasminogen activator receptor (uPAR), which is expressed in a fairly broad range of immune cells. uPAR is a fascinating molecule. It is part of the tissue plasminogen activation system which is critically involved in tissue remodeling and reorganization, such as occurs in wound healing, tumor growth and mammary gland involution.[1]  In order for tissue remodeling to proceed it is first necessary to degrade and destroy the existing cellular and extracellular structures. This is accomplished in part by activation of the plasminogen activation cascade. uPAR acts to confine plasminogen activation to the vicinity of the cell membranes involved in  remodeling by binding to urokinase and inhibiting its proteolytic activity. Studies suggest that suPAR is a regulator of uPAR/uPA actions through competitive inhibition of uPAR; and several studies conclude that the cleaved receptor is a chemotatic agent promoting the immune response.

Figure 2:  Schematic representation of urokinase receptor The GPI-anchor links uPAR to the cell membrane making it available for uPA to bind to the receptor. When the receptor is cleaved between the GPI-anchor and D3, it becomes soluble (suPAR). suPAR is a stable protein that can be measured in various body fluids. uPA: urokinase-type plasminogen activator, uPAR: uPA receptor, suPAR: soluble uPAR, 1: Domain 1, D2: Domain 2, D3: Domain 3.

Under conditions of inflammation – any inflammation –  uPAR is cleaved from the cell surfaces by proteases and converted to the soluble form of the receptor (suPAR), which subsequently becomes distributed in blood, urine and cerebrospinal fluid.[2-5] Immune activation caused by infectious disease, atherosclerosis, autoimmune disease and a wide variety of solid tumors results in the cleavage of uPAR from cell membranes and thus creates an easily detectable signal in the form of  increased levels of suPAR in body fluids. As a consequence, serum suPAR levels are believed to mirror the degree of immunoactivation in an individual.

It appears that suPAR may be the Holy Grail of inflammation, since it is exquisitely sensitive at detecting immune-mediated inflammation in HIV, malaria, tuberculosis, and in healthy subjects subjected to pro-inflammatory stressors, such as cigarette smoking, lack of exercise and poor diet.[6, 7] suPAR level is positively correlated with markers of inflammation and immune activation such as CRP (hsCRP), TNF-a, s-TREM-1, MIF, GM-CSF, the pro-inflammatory ILs and total white blood cell count.[2] Thus, suPAR may be a novel marker of inflammation, and increased inflammation has in recent years been suggested as the primary  driving mechanism in age-associated degenerative diseases. Nevertheless, suPAR remains associated with disease endpoints after the adjustment of other inflammatory markers and is less related to metabolic variables than CRP. Thus suPAR may reflect another aspect of inflammation than do the classical markers.

Figure 3: uPAR ligands. Schematic representation of the functions of uPAR via its interaction with uPA, integrins, and vitronectin (modified from Kjaergaard et al., 2008)[1].

Since there are no genetic polymorphisms in humans which cause suPAR to be expressed in the absence of inflammation, elevated suPAR levels are always a marker for the presence of active inflammation.  suPAR levels are also rapidly and uniformly responsive to positive treatment intervention. In acute infections disease such as sepsis, suPAR levels begin to decline in response to effective treatment within a few hours. Getting the treatment “right” quickly for septic patients is critical, because every hour spent in a state of hyper-immune driven organ injury translates to a big increase in mortality, as well as in costly time spent in the ICU

What are Your Risks?

What  ViroGates (or more accurately one of its co-founders, Jesper Eugen-Olsen[4, 6]) has discovered, it seems, is a cheap, simple and inexpensive test that will tell a person what his chances are of dying from anything other than accident, homicide, and (maybe) suicide. No, they aren’t claiming that, and the current market for their product is mostly Africa. They are Dutch and the Dutch are, if anything, all about understatement. Nevetheless, Henrik knows that I know exactly what the score is. And what’s more, we both now understood why Veerappan had brought us together. This is going to be big, really big, and my mind boggled as I sat there looking at the data.

The test ViroGates has developed is called suPARnostic® and it is an rapid, enzyme-linked serum assay (ELISA) for the suPAR protein. ELISA technology has undergone rapid perfection over the past decade and now allows for effective diagnosis of everything from HIV to urinary tract infections. ELISA technology has revolutionized the detection of sexually transmitted diseases; it is no longer necessary to painfully invade the urethra with a wire loop to obtain a culture swab for gonorrhea – a few drops of urine suffice and the test can be done in the privacy of your own home. Similarly, Chlamydia, which is almost impossible to culture, and which is the organism primarily responsible for pelvic inflammatory disease in women and what was formerly called non-specific urethritis (NSU) in men, can be detected with a few drops urine. As I sit listening to Henrik and taking in the data, the first thought that comes into my mind is the life insurance industry.

ViroGates’ test is so sensitive and specific it could revolutionize life insurance. Not since the first actuaries began their toils for the Society for Equitable Assurances on Lives and Survivorships in London, in 1762, has anything so potentially profitable come along for the life (and health) insurance industry. In his 1939 story “Life-Line,” science fiction writer Robert Heinlein (1907-1988) posited the invention of a device that would predict, with accuracy, when a person would die. In his story, the device devastates the life insurance industry, because potential customers could stack the deck against the insurers. Why Heinlein didn’t see the more obvious outcome, namely that the insurance companies would stack the deck against their customers, I have no idea. However, Henrik is not enthused about the life insurance application. After all, it is painfully obvious, it would be illegal in Europe, he informs me, and I can see the idea offends his Dutch sense of fair play.

As I look at paper after paper the truly global import of this single biomarker begins to come into focus. The MONICA10 study was a population-based cohort recruited from Copenhagen, Denmark, that  included 2,602 individuals aged 41, 51, 61 or 71 years.[8] Its purpose was to determine if suPAR levels predicted mortality in representative cohorts of the population in urban Denmark: i.e., an ethnically and comparatively genetically homogenous Caucasian population. Blood samples were collected from the study participants over a 12.5 year period and were analyzed for suPAR levels using the suPARnostic® enzyme-linked immunosorbent assay. Other biomarkers of inflammation, such as C-reactive protein, were also evaluated. The study results demonstrated that risk of cancer CVD and overall mortality (assessed with a multivariate proportional hazards model using Cox regression) was strongly correlated with suPAR levels. This correlation was more prognostic in men than in women, and in younger as compared with older individuals.[7]

Figure 4: The optimum level of circulating suPAR appears to be below 2.0 ng/mL in men and 2.5 ng/mL or lower in women. In the healthy population, risk of disease or death rises sharply as the suPAR level increases. The circulating suPAR level increases sensitively with lifestyle choices know to be associated with increased risk of illness and death, such as tobacco abuse, obesity and a sedentary lifestyle – but not to the same degree in all individuals. In fact, suPARnostic® testing may allow clinicians (and theoretically tobacco companies and smokers) to determine those patients for whom smoking, obesity or other “harmful” lifestyle choices pose much less risk.

The presence of an elevated baseline suPAR level was associated with an increased risk of cancer, cardiovascular disease (CVD), diabetes and overall mortality during the course of the study. An elevated serum suPAR level was most strongly associated with cancer, CVD and with mortality in men as opposed to women, and in younger compared with older individuals. Elevated suPAR remained significantly associated with the risk of negative outcome even after adjustment for a number of relevant risk factors, including C-reactive protein levels. The ability of the suPARnostic® test to predict mortality and morbidity in the study population was ~ 85%![9]  In other words, 85% of the population who experienced death or serious illness from degenerative disease (cancer, CVD, etc.) had markedly elevated suPAR levels.

This is perhaps not surprising when consideration is given to the fact that the common pathophysiological mechanism/finding in virtually all degenerative diseases is inflammation. An important caveat is that this study will have to be extended and expanded to verify its validity in ethically more diverse populations. Because of where it was carried out, the MONICA10 study was confined almost exclusively to Caucasians. Other tests for biomarkers of inflammation such as C -reactive protein, Tumor Necrosis Factor (TNF), and various pro-inflammatory cytokines (IL-1[1], IL-6, IL-8, GM-CSF, TNF-alpha, sTREM-1, and MIF) show too much fluctuation and individual variability to be of similarly potent prognostic use.[7, 8, 10-12] This may be because these molecules are elaborated much further downstream in the inflammation process than is suPAR and they may be elaborated in response to intercurrent processes that take place over the long course of a morbid, pro-inflammatory illness. Conversely, suPAR levels decline with remarkable speed once the inflammation process is halted or moderated by effective treatment.

suPARnostic® in the Critically Ill

The use of suPAR measurement seems likely to be of great value as triage tool for patients admitted to the Emergency Department (ED). Elderly patients with sepsis or who are in the early stages of the Systemic Inflammatory Response Syndrome (SIRS), often present with minimal symptoms. Even when septic they may not have markedly elevated temperatures and their white blood cell count may not be alarmingly high; old age is, after all, a potent immunosuppressant. It is frequently difficult to rapidly determine just how sick these individuals are. The use of suPARnostic® could prove lifesaving such a situation. Even patients who are clearly seriously ill are difficult to categorize or prognosticate. Which patients need immediate and aggressive treatment in the Intensive Care Unit? suPARnostic® measurements of 6.0 ng/mL to double digit levels are indicative of serious illness that is progressing rapidly and is potentially life threatening and patients with suPARnostic® levels above 15 ng/m have been found to be uniformly gravely ill, with many of them dying shortly after presentation and suPAR level measurement. The power of an objective clinical measurement to categorize patients by prognostication with such a high degree of accuracy should prove invaluable, both in saving lives and in containing health care costs. The ability of suPARnostic® testing as compared to the commonly used multiplex immunoassay for pro-inflammatory cytokines to predict 30-day mortality  and 180-day mortality in a prospective study of a group of patients presenting to hospital with SIRS in shown in Figure 5.

Figure 5: Receiver operating characteristic (ROC) curve comparing composite marker’s ability to predict mortality. ROC curves comparing suPAR measured with suPARnostic® (V-suPAR) combined with age (AUC=0.92), soluble triggering receptor expressed on myoloid cells-1 (sTREM-1) combined with age, V-suPAR, sTREM-1 and macrophage migration inhibitory factor ROC curves combined as the 3-marker, and the 3-marker combined with age. Prediction of 30-day mortality (a) and 180-day mortality (b) prospectively collected cohort of patients with systemic inflammatory response syndrome (SIRS) that were admitted to an emergency department and a department of infectious diseases at a university hospital.[12]

A Focus on the Third World

When suPARnostic® testing was combined with the patients age, or with the patients age and 3 pro-inflammatory biomarkers known to be ass0ciated with increased mortality, suPARnostic® testing was highly predictive of outcome. Cytokine testing, the current competitor to the uPARnostic® test is costly and difficult to do and for these reasons is not routinely used in hospital. Outcomes in patients with TB, meningitis, and HIV are also well prognosticated by suPAR levels during treatment. In fact, the major focus of ViroGates is not on the degenerative diseases of the Developed World, but rather on the diseases of Africa and the Third world; primarily malaria[13], TB[14-17] and HIV. suParnostic® testing has proved highly predictive of both response to treatment and to outcome. It will also very likely be of use in determining which patients with HIV need highly active anti-retroviral treatment (HAART) and which patients can delay treatment, since suPAR levels are closely correlated with the progression of the disease from infection to serious immunosuppresion and death.[16, 18-20] Being able to select only those patients in need of treatment offers the potential benefit of greatly reducing costs, reducing viral resistance, and reducing the morbidity due to the toxicity of HAART.[16, 19]

The Tobacco (and Junk Food) Companies’ Wet Dream?

It is the job of epidemiologist to find correlations between morbidity and mortality and factors in the environment. Prior to the 20th century, this concern was focused almost exclusively on infectious disease. Whilst people died from cardiovascular disease and cancer, most simply didn’t live long enough to develop these diseases of aging. As life spans grew longer due to public health measures and reduced infant mortality, the focus of epidemiology shifted to non-communicable environmental risk factors. Cardiovascular disease and cancer quickly became the leading causes of illness and death and it slowly became apparent that the biggest risk factors associated with those diseases (other than aging itself) were carcinogens in the environment, excessive calorie consumption (obesity) and a sedentary lifestyle – with alcohol abuse coming in closer to the bottom than the top (a fact that would have shocked and surprised the temperance advocates of the 19th and 20th centuries). Of all the environmental carcinogens, none proved as powerful a contributor to disease and death as tobacco use, and cigarette smoking, in particular.

However, it is important to understand that epidemiologists deal with humans mostly in herds. Their pronouncements in the arena of environmental hazards are necessarily statistical and that is something that physicians and moralists all too often forget. We are told that smoking causes cancer – and indeed it does – but in whom? On the question of precisely which individuals in the population are or are not risk, epidemiology is necessarily silent. However, if you  are much older than 30 and you pay attention to the people being picked off by death around you, you can’t help but notice that some people seem to get to break the rules.

My own father is a case in point. He began smoking when he was 13 years old – his preference was Camels – 3 packs a day – fortunately, unfiltered.[3] He is 90 today – alive and living independently. In addition to smoking, he consumed alcohol well beyond the medically countenanced “healthy limits” for much of his life. He did require replacement of his abdominal aorta 6 years ago – at which point he finally quit smoking. Aside from the intra-abdominal aortic aneurysm, peripheral artery disease of long standing, and some coronary insufficiency nearly 20 years ago (angioplasty) he has not developed either of the other two big smoking related illnesses; cancer and emphysema. Similarly, history abounds with people like Winston Churchill, who smoked and drank with abandon, and yet still lived into old age. Why?

The answer is that these individuals have something fundamentally different about the way they handle environmental insults and very likely how they moderate their immune-inflammatory response. They may also have better DNA repair. The point is, it would be incredibly valuable for tobacco companies, and the purveyor of junk food and alcohol, to determine who can safely use their products, and who will be killed by them. It would be even more useful if  their customers could titrate the “dose” of these products to an acceptable level of risk. Maybe you can’t smoke 3-packs of cigarettes a day, but a 1-pack a day habit may carry very little risk – for you. While suPAR alone is not likely to prove a magic bullet in this respect, it seems very likely, bordering on certain, that evaluation of a combination of biomarkers may allow individuals (or corporations) to quantify their risks with a high degree of precision.

Cryonics and Life Extension

As Henrik and I talked on past the setting sun in Manchester, I had only two “novel” suggestions to make regarding potential immediate markets for suPARnostic®: the life extension and cryonics communities. The latter is clearly not going to be a significant market, but the former may well be worth ViroGates pursuing.  Currently, biomarkers for disease are disease specific. An elevated CRP is certainly suggestive of increased risk of CVD, and so are elevated HDLs , low LDLs and a high total cholesterol. However none of these tests is very specific and if you want to know what your risk for falling over from a heart attack or stroke is, then you must do multiples of these tests, and preferably others as well, such as homocysteine levels, blood pressure, redox status, and so on.

Figure 6: Monitoring of suPAR levels over time is likely to produce data such as is hypothesized above. Adverse and persistent poor lifestyle choices lead to a gradual elevation of suPAR until a lethal event occurs; in this case metastatic colon cancer. suPAR monitoring may allow for early detection of “acute” morbid processes such as cancer.

This is costly and time consuming and mostly it tells you just one thing – what your risk is for CVD. It says nothing about cancer, nothing about diabetes, and nothing about your overall likelihood of dying. Other tests are required to determine individual disease-specific risks.  suPARnostic® testing offers the very real prospect of changing all that. If your suPAR level is elevated and remains so, then it is a foregone conclusion that you have a serious pro-inflammatory process underway. And what that means is that probably sooner, rather than later, you are going to get sick – very sick.

While it may seems strange to discuss exercise under the heading of tobacco and junk food, suPARnostic® testing may help to resolve another heretofore nettlesome and contentious issue, namely is there such a thing as too much exercise? The studies haven’t been done yet but it is clear that too little exercise raises suPAR levels and that people who engage in chronic high impact exercise also have elevated levels. So the question is, can  suPARnostic® testing provide a way for the individual to determine out how much exercise is “just right” for him?

Preventative Prognostication

suPARnostic® testing will also tell you what your risk of dying is with greater and greater precision the longer your suPAR level remains elevated. It is also very likely that by looking at the plot of an individual’s plasma suPAR over time it may be possible to observe the risk of mortality reach a critical threshold (Figure 6). Because suPAR levels increase sharply with the onset of cancer and some infectious diseases, it may be possible to detect illness early and intervene. The suPARnostic® website http://suparnostic.com/ provides a couple case examples which are probably representative of what the test can do in the Developed World:

CASE 2: Healthy male, age 25 years, experienced a continuing “feeling sick” and symptoms like being pale, being tired. Repeated doctors visits resulted in no diagnosis, all blood values were normal, no further tests were authorized.

The slowly rising suPAR value predicted that the person was developing a potential critical condition, and at suPAR value 4,1 the person was admitted to an Emergency Room at request of ViroGates.

A series of more elaborate tests diagnosed the person with latent tuberculosis and mononucleosis. As a result of the early recognition, the person did not require a single hospital day, no drug treatment and had to take almost no sick days. More sleep, no sport, no alcohol were sufficient for healing.    

Too late recognition would have involved sick days, medical treatment and eventually even hospitalization days.  suPARnostic® was an early and correct warning sign.

CASE 3: Healthy male, age 45, experienced the same symptoms as Case 2 above, including loss of some weight. Blood values were normal and the person’s suPAR level was slightly elevated, but was not rising into the critical area

Adjustment of lifestyle (more sleep, better food, more sport) lowered the suPAR level a few months later into the “normal” area. suPARnostic® recognized correctly that this person was not a critical case requiring immediate hospital attention.

Summary

Figure 8: The ELISA-based suPARnostic® test system is available not only in a high throughput configuration, but also as individual tests that can be performed on-site and in real time, in the same way that the “instant” ELISA-based at-home tests for HIV, Hepatitis C, gonorrhea, Chlamydia, syphilis now do: http://www.curaherbdistributor.com/

In Heinlein’s story about the death prognosticating machine, a great deal of the pathos that attended the invention was that there was nothing that could be done to influence the outcome. The machine told you when you were going to die with certainty. The only planning open to you was to set your affairs in order. Clearly, suPARnostic® testing will have this characteristic in many cases, but it also offers the possibility of intervention to alter the outcome. By changing lifestyle and seeking medical attention earlier it should be possible to reduce disease and delay mortality.  For a few of us, it may even offer the prospect of having our cake and eating it too.

Since suPAR levels rise only modestly in “normal healthy” aging it will not likely be a useful biomarker for evaluating interventive gerontology strategies. It should, however, alert us to the importance of doing (and remaining compliant in doing) those things we already know will extend healthy and productive lifespan, such as taking adequate exercise, following an anti-inflammatory diet such as the Mediterranean diet, and avoiding drug, tobacco and alcohol abuse.

In the setting of cryonics, when patients are diagnosed with a serious and potentially fatal illness, such as cancer or cardiovascular disease, suPARnostic® testing should be useful in allowing both the patient and the cryonics organization to better understand the patient’s response to treatment, when failure of treatment has occurred, and finally to better bound the time course to the agonal phase of the illness.

I’ve not been in touch with Henrik since the conference in Manchester. I doubt very much that any of the suggestions I made were of much use to him, or ViroGates. That being said, I’m very glad that I took the opportunity Veerappan provided me with to talk to him. suPARnostic testing is by no means a diagnostic panacea, but I think it will very likely be a game changer in both public health and in critical care medicine. I’m grateful to have had a sneak peek at the goods before they roll out to fully take their place in history.

References

1.            Kjaergaard M, Hansen LV, Jacobsen B, Gardsvoll H, Ploug M: Structure and ligand interactions of the urokinase receptor (uPAR). Front Biosci 2008, 13:5441-5461.

2.            Stephens R, Pedersen, AN, Nielsen, HJ, Hamers, MJ, Hoyer-Hansen, G, Ronne, E, Dybkjaer, E, Dano, K, Brunner, N. : ELISA determination of soluble urokinase receptor in blood from healthy donors and cancer patients. Clin Chem 1997, 43::1868-1876.

3.            Sier C, Sidenius, N, Mariani, A, Aletti, G, Agape, V, Ferrar,i A, Casetta, G, Stephens, RW, Brunner, N, Blasi, F.: Presence of urokinase-type plasminogen activator receptor in urine of cancer patients and its possible clinical relevance. Lab Invest 1999, 79:717-722.

4.            Ostergaard C, Benfield, T, Lundgren, JD, Eugen-Olsen, J.: Soluble urokinase receptor is elevated in cerebrospinal fluid from patients with purulent meningitis and is associated with fatal outcome. Scand J Infect Dis  2004, 36:14-19.

5.            De Witte H, Sweep, F, Brunner, N, Heuvel, J, Beex, L, Grebenschikov, N, Benraad, T.: Complexes between urokinase-type plasminogen activator and its receptor in blood as determined by enzyme-linked immunosorbent assay. Int J Cancer 1998, 77:236-242.

6.            Eugen-Olsen J, Gustafson, P, Sidenius, N, Fischer, TK, Parner, J, Aaby, P, Gomes, VF, Lisse I. : The serum level of soluble urokinase receptor is elevated in tuberculosis patients and predicts mortality during treatment: a community study from Guinea-Bissau. Int J Tuberc Lung Dis 2002,, 6:686-692. 7.            Cobos E, Jumper C, Lox C: Pretreatment determination of the serum urokinase plasminogen activator and its soluble receptor in advanced small-cell lung cancer or non-small-cell lung cancer. Clin Appl Thromb Hemost 2003, 9(3):241-246.

8.            Eugen-Olsen J, Andersen, O, Linneberg, A, Ladelund, S, Hansen, TW, Langkilde, A, Petersen, J, Pielak, T, Møller, LN, Jeppesen, J, Lyngbaek, S, Fenger, M, Olsen, MH, Hildebrandt, PR, Borch-Johnsen, K, Jørgensen, T, Haugaard SB.: Circulating soluble urokinase plasminogen activator receptor predicts cancer, cardiovascular disease, diabetes and mortality in the general population. J Intern Med 2010 268(3):296-308.

9.            Thunø M, Macho, B, Eugen-Olsen, J.: suPAR: the molecular crystal ball. Dis Markers 2009, 27(3):157-172.

10.          Boedhi-Darmojo R, Setianto B, Sutedjo, Kusmana D, Andradi, Supari F, Salan R: A study of baseline risk factors for coronary heart disease: results of population screening in a developing country. Rev Epidemiol Sante Publique 1990, 38(5-6):487-491.

11.          Supariwala A, Uretsky S, Singh P, Memon S, Khokhar SS, Wever-Pinzon O, Atluri P, Hersh J, Koppuravuri HK, Rozanski A: Synergistic effect of coronary artery disease risk factors on long-term survival in patients with normal exercise SPECT studies. J Nucl Cardiol, 18(2):207-214; quiz 217.

12.          Kofoed K, Eugen-Olsen, J, Petersen, J, Larsen, K, and Andersen O.: Predicting mortality in patients with systemic inflammatory response syndrome: an evaluation of two prognostic models, two soluble receptors, and a macrophage migration inhibitory factor. Eur J Clin Microbiol Infect Dis 2008, 52:1284-1293.

13.          Ostrowski SR, Ullum H, Goka BQ, Hoyer-Hansen G, Obeng-Adjei G, Pedersen BK, Akanmori BD, Kurtzhals JA: Plasma concentrations of soluble urokinase-type plasminogen activator receptor are increased in patients with malaria and are associated with a poor clinical or a fatal outcome. J Infect Dis 2005, 191(8):1331-1341.

14.          Ostrowski SR, Ravn P, Hoyer-Hansen G, Ullum H, Andersen AB: Elevated levels of soluble urokinase receptor in serum from mycobacteria infected patients: still looking for a marker of treatment efficacy. Scand J Infect Dis 2006, 38(11-12):1028-1032.

15.          Eugen-Olsen J, Gustafson P, Sidenius N, Fischer TK, Parner J, Aaby P, Gomes VF, Lisse I: The serum level of soluble urokinase receptor is elevated in tuberculosis patients and predicts mortality during treatment: a community study from Guinea-Bissau. Int J Tuberc Lung Dis 2002, 6(8):686-692.

16.          Ostrowski SR, Piironen T, Hoyer-Hansen G, Gerstoft J, Pedersen BK, Ullum H: High plasma levels of intact and cleaved soluble urokinase receptor reflect immune activation and are independent predictors of mortality in HIV-1-infected patients. J Acquir Immune Defic Syndr 2005, 39(1):23-31.

17.          Rabna P, Andersen A, Wejse C, Oliveira I, Gomes VF, Haaland MB, Aaby P, Eugen-Olsen J: High mortality risk among individuals assumed to be TB-negative can be predicted using a simple test. Trop Med Int Health 2009, 14(9):986-994.

18.          Ostrowski SR, Katzenstein TL, Piironen T, Gerstoft J, Pedersen BK, Ullum H: Soluble urokinase receptor levels in plasma during 5 years of highly active antiretroviral therapy in HIV-1-infected patients. J Acquir Immune Defic Syndr 2004, 35(4):337-342.

19.          Lawn SD, Myer L, Bangani N, Vogt M, Wood R: Plasma levels of soluble urokinase-type plasminogen activator receptor (suPAR) and early mortality risk among patients enrolling for antiretroviral treatment in South Africa. BMC Infect Dis 2007, 7:41.

20.          Sidenius N, Sier CF, Ullum H, Pedersen BK, Lepri AC, Blasi F, Eugen-Olsen J: Serum level of soluble urokinase-type plasminogen activator receptor is a strong and independent predictor of survival in human immunodeficiency virus infection. Blood 2000, 96(13):4091-4095.


Footnotes


[1] Mammary gland involution is a complex, multi-step process in which the lactating gland is remodeled into a morphological state almost indistinguishable from its pre-pregnancy condition.  This is of considerable interest because the process involves many elements common to tissue/organ regeneration in reptiles and amphibians.
[2] CRP=C-Reactive Protein, TNF-a=Tumor Necrosis Factor –alpha, MIF=, s-TREM-1= Soluble Triggering Receptor Expressed on Myeloid Cells 1, MIF= Macrophage Migration Inhibitory Factor, GM-CSF=Granulocyte-Macrophage Colony Stimulating Factor, ILs= interlukins= IL-1 , IL-6, IL-8.
[3] Not only do filtered cigarettes do nothing to reduce the risk of disease from smoking, the first generation “filter tipped” cigarettes contained asbestos and other pro-carcinogens. The number one risk of developing asbestos related cancers such as mesothelioma is tobacco abuse!
Posted in Cryonics Technology (General), Medicine | Leave a comment

The Armories of the Latter Day Laputas, Part 6

Figure 1: Corporations were created by people to be potentially immortal, and yet, on average, they have life spans much shorter than people. Very interestingly, they have about the same maximum life span as people: ~120 years.

By Mike Darwin

On the Importance of the Longevity of Corporations to Cryonics

So what did 6 years and $1.25 million of last years’ money buy for Alcor and cryonics between 1983 and 1989? In the next part of this article, I’ll endeavor to answer to that question. I’ve listed most of the milestones Alcor logged during that interval as documented in Cryonics magazine, but I’m sure I’ve missed some. Since I lived those years and they were, for me personally extraordinarily happy and productive ones, I’m simply too close to them to have any pretense to objectivity. However, I think it likely that others will readily supply anything lacking in that regard. If any of you reading this have suggestions for what should appear on that list, please email them to me at m2darwin@aol.com.

Figure 2: Some of the principals who contributed to Trans Time’s dynamicity in the 1970s and 1980s. From foreground to background and left to right: Jim Yount, Jerry White, Art Quaife, Judy & Paul Segall, Dick Marsh, John Day, Norm Lewis, Carmen Brewer and Ron Viner. It is soberi9ng to note that Jerry White, Dick Marsh and Paul Segall are now in cryopreservation and Carmen Brewer is decased.

It is also important to understand that Alcor was and is but one organization and one epoch in the history of cryonics. During the 1970s and into the early 1980s Trans Time, Inc., (TT) under the leadership of Art Quaife, Jim Yount and John Day (operating in the San Francisco Bay Area) reshaped the way cryonics was both perceived and marketed. They also made a number of significant technical advances in engineering and in the mathematics of heat flow and cryoprotectant equilibration. They brought dynamicity and renewed hope and energy to cryonics and were in no small measure responsible for recruiting a number of people who were subsequently essential to Alcor’s success throughout the 1980s, and beyond. I would be remiss if I did not note their enormous contribution.  What’s more, I believe it is likely of considerable importance that a thorough analysis of the history of TT be undertaken. TT produced shareholders’ reports with detailed financials, and they produced voluminous minutes of their monthly meetings.

However, that is not data I have access to and it is not a task I’m well suited to perform. I would, however, note that given the nanoscopic experience base in cryonics compared to the rest of the institutional world, we need to carefully dissect every failure and every success. Why? Because our undertaking is fundamentally different than any that have come before it. Biological evolution proceeds with stunning results in just about the cruelest and least efficient way imaginable.[1] At no point does the process itself, or the organisms that comprise its unfolding need to stop and consider their predicament, or decide what to do next. As the gutter philosophers say, “Shit happens.”  The price of such a blind, unreasoning process is the death and destruction of countless organisms, species, communities and cultures. Tennyson summed it up perfectly in “The Charge of the Light Brigade:” “Ours not to reason why, ours but to do and die.”

The modern corporation traces its roots to the 17th century, and the emergence of “chartered companies,” such as the Dutch East India Company. It is thus a species that is only ~ 500 years old. Until the 19th century, almost no attention was paid to why and how businesses came into and went out of existence. It was just something that happened, and it was taken for granted, like old age and death in the biological world. And it was not until the opening of the 20th century that scientific methods were brought to bear to study the fates of business enterprises – for profit or otherwise – and even now, such studies are comparatively few and lack rigor.

This should come as no surprise because there really isn’t much reason for anyone to care. Enterprises are like rabbits on a farm; as long as the population as a whole is healthy, there will be plenty of them and the fate of the individuals is of no consequence. It is only when epidemic disease, or another systemic calamity devastates the hutches, that there is concern over mortality. The same is true of epidemiologists; they are concerned with the fate of individual humans only as it impacts population-wide mortality and morbidity. A consequence of this is that we know shockingly little about how to extend the lifespan of corporations. Put another (and far more ominous way), cryonicists are faced with the task of finding not just a way to indefinitely extend the human lifespan, they must also find a way to indefinitely extend the lifespan of the corporate entities they propose will care for them and recover them from cryopreservation over a period of many decades,  or centuries.

Corporation Gerontology?

The seminal cryonics thinker Thomas Donaldson was preoccupied with examples of institutions which lasted for centuries. He liked to cite the examples of the King’s Colleges in England, and of Westminster Abbey. I remember thinking at the time, “Well, that’s interesting and exciting, but it is also, I think, pretty uncommon. More to the point, how do we make that happen for our organizations?” Thomas and I exchanged letters about this, but I was never able to communicate to him that just because it has happened doesn’t mean it is likely, and it doesn’t mean it will happen for us. Thirty plus years ago, when we had those discussions, no one had yet generated any statistical data on the longevity of corporations over time.

We now know that the odds of a corporation surviving for 100 years is probably in the range of 1.0 to 1.5% , and of one surviving for 500 years, much, much lower; even if institutions like Oxford and Westminster Abbey are included in the data set. In fact, the average life expectancy for even multinational corporations of Fortune 500 caliber, or its equivalent, is only 40 to 50 years. And what about corporations as a whole, a 2002 study by Ellen de Rooij of the Stratix Group in Amsterdam indicates that the average life expectancy of all firms, regardless of size, measured in Japan and much of Europe, is only 12.5 years. Incredibly, no data exist for US corporations that I’ve been able to find.

Figure 3: The author standing next to the “John Snow Pump” on Broadwick Street, Soho, London in May of 2011. Snow is justly considered the father of epidemilogy for his work in pinpointingthe source of cholera outbreak in London in 1849 as the public water pump on Broad Street (now Broadwick Street). The municipal authorities removed the handle from the pump to prevent the local residents from usingthe water. The handle remains off of the pump except for one day of the year, John Snow Day, when it is cerimoniously put back in place.

Figure 4: The Living Company: Habits for Survival in a Turbulent Business Environment by Arie  De Geus is one of the first books to examine why corporations have the life spans that they do. As such, it is a seminal work much deserving of cryonicists’ attention.

The study of corporate hygiene and pathology seems to be where medicine was in the 17th century. There is a great deal of cupping, blistering, bleeding and amputation – mostly to no good effect – and mostly carried out by incompetents (e.g., politicians, governments and nation-states). The concept of the “public health of corporations” is still nascent and the equivalent of the “John Snow moment” [2]  of discovering how to halt the spread of business-killing epidemics, such as the one we are suffering right now, seems still in the future. The idea of a discipline in corporate medicine whose job it is to study the corporate aging process and extend corporate life span, has apparently just occurred to economists and business analysts.[1, 2] Like so much else in cryonics, no one else has the slightest clue or the slightest incentive to systematically study this problem and come up with solutions. It is simply a brutal fact of our time and place in history that the need to understand the processes attending corporate morbidity and mortality has simply not (yet) become an issue for human civilization.[3]

Figure 5: Trajectories of projectiles launched at different elevation angles but the same speed of 10 m/s in a vacuum and uniform downward gravity field of 10 m/s2. Points are at 0.05 s intervals and length of their tails is linearly proportional to their speed. t = time from launch, T = time of flight, R = range and H = highest point of trajectory (indicated with arrows). Corporations have similar arcs from launch to crash back to earth.

Clearly, some corporations remain fantastically innovative and productive over time while most do not; and there is evidence that they survive the longest. Two notable examples of the former are 3M (Minnesota Mining and Manufacturing) and Apple Computer. For a contrast with 3M, pick just about any has-been industrial giant of the past century. For a contrast with Apple there is Microsoft. While Microsoft is unarguably richer and larger, and no doubt most of those laboring there feel very secure, it is neither an exciting place to work, nor a particularly creative one. A careful analysis of these two examples of corporate robustness is beyond the scope of this series of articles, and most probably beyond the range of this author’s abilities. For now, it is sufficient to point out that these companies have interesting histories which may have value to cryonics. They also highlight the fact that most enterprises experience an arc, akin to that of a ballistic trajectory. In his seminal book The Living Company: Habits for Survival in a Turbulent Business Environment, Arie  De Geus, the former head of Royal Dutch Shell’s Strategic Planning Group, maps out a life span arc for corporations (Figure 7)and notes that currently corporations “ exist at a primitive stage of evolution; they develop and exploit only a fraction of their potential.”

DeGeus may well be one of the first people to carefully consider why corporations have such appallingly short life spans when their very raison d entrée was their potential for immortality. I believe De Geus’s work is important for cryonicists to pay attention to, and I am going to quote him at length here on his observations regarding the characteristics of long lived corporations:

 Figure 6: Arie De Geus

“After all of our detective work, we found four key factors in common:

1. Long-lived companies were sensitive to their environment. Whether they had built their fortunes on knowledge (such as DuPont’s technological innovations) or on natural resources (such as the Hudson Bay Company’s access to the furs of Canadian forests), they remained in harmony with the world around them. As wars, depressions, technologies, and political changes surged and ebbed around them, they always seemed to excel at keeping their feelers out, tuned to what-ever was going on around them. They did this, it seemed, de-spite the fact that in the past there were little data available, let alone the communications facilities to give them a global view of the business environment. They sometimes had to rely for information on packets carried over vast distances by portage and ship. Moreover, societal considerations were rarely given prominence in the deliberations of company boards. Yet they managed to react in timely fashion to the conditions of society around them.

Figure 7: The arc of the corporate life span as proposed by by Arie De Geus. Note that the terminal phase is bureaucracy where in the corporation becomes unresponsive to its environment and becomes increasingly insulated from both new opportunities and from its customers by bureaucratic mechanisms.

2. Long-lived companies were cohesive, with a strong sense of identity. No matter how widely diversified they were, their employees (and even their suppliers, at times) felt they were all part of one entity. One company, Unilever, saw itself as a fleet of ships, each ship independent, yet the whole fleet stronger than the sum of its parts. This sense of belonging to an organization and being able to identify with its achievements can easily be dismissed as a “soft” or abstract feature of change. But case histories repeatedly showed that strong employee links were essential for survival amid change. This cohesion around the idea of “community” meant that managers were typically chosen for advancement from within; they succeeded through the generational flow of members and considered themselves stewards of the longstanding enterprise. Each management generation was only a link in a long chain. Except during conditions of crisis, the management’s top priority and concern was the health of the institution as a whole.

3. Long-lived companies were tolerant. At first, when we wrote our Shell report, we called this point “decentralization.” Long-lived companies, as we pointed out, generally avoided exercising any centralized control over attempts to diversify the company. Later, when I considered our research again, I realized that seventeenth-, eighteenth-, and nineteenth-century managers would never have used the word decentralized; it was a twentieth-century invention. In what terms, then, would they have thought about their own company policies? As I studied the histories, I kept returning to the idea of “tolerance.” These companies were particularly tolerant of activities on the margin: outliers, experiments, and eccentricities within the boundaries of the cohesive firm, which kept stretching their understanding of possibilities.

4. Long-lived companies were conservative in financing. They were frugal and did not risk their capital gratuitously. They understood the meaning of money in an old-fashioned way; they knew the usefulness of having spare cash in the kitty. Having money in hand gave them flexibility and independence of action. They could pursue options that their competitors could not. They could grasp opportunities without first having to convince third-party financiers of their attractiveness.

It did not take us long to notice the factors that did not appear on the list. The ability to return investment to shareholders seemed to have nothing to do with longevity. The profitability of a company was a symptom of corporate health, but not a predictor or determinant of corporate health. Certainly, a manager in a long-lived company needed all the accounting figures that he or she could lay hands on. But those companies seemed to recognize that figures, even when accurate, de-scribe the past. They do not indicate the underlying conditions that will lead to deteriorating health in the future. The financial reports at General Motors, Philips Electronics, and IBM during the mid-1970s gave no clue of the trouble that lay in store for those companies within a decade. Once the problems cropped up on the balance sheet, it was too late to prevent the trouble.

Nor did longevity seem to have anything to do with a company’s material assets, its particular industry or product line, or its country of origin. Indeed, the 40- to 50-year life expectancy seems to be equally valid in countries as wide apart as the United States, Europe, and Japan, and in industries ranging from manufacturing to retailing to financial services to agriculture to energy.

At the time, we chose not to make the Shell study available to the general public, and it still remains unpublished today. The reasons had to do with the lack of scientific reliability for our conclusions. Our sample of 30 companies was too small. Our documentation was not always complete. And, as the management thinker Russell Ackoff once pointed out to me, our four key factors represented a statistical correlation; our results should therefore be treated with suspicion. Finally, as the authors of the study noted in their introduction, “Analysis, so far completed, raises considerable doubts about whether it is realistic to expect business history to give much guidance for business futures, given the extent of business environmental changes which have occurred during the present century.”

Nonetheless, our conclusions have recently received corroboration from a source with a great deal of academic respectability. Between 1988 and 1994, Stanford University professors James Collins and Jerry Porras asked 700 chief executives of U.S. companies-large and small, private and public, industrial and service-to name the firms they most admired. From the responses, they culled a list of 18 “visionary” companies. They didn’t set out to find long-lived companies, but, as it happened, most of the firms that the CEOs chose had existed for 60 years or longer. (The only exceptions were Sony and Wal-Mart.) Collins and Porras paired these companies up with key competitors (Ford with General Motors, Procter & Gamble with Colgate, Motorola with Zenith) and began to look at the differences. The visionary companies put a lower priority on maximizing shareholder wealth or profits. Just as we had discovered, Collins and Porras found that their most-admired companies combined sensitivity to their environment with a strong sense of identity: “Visionary companies display a powerful drive for progress that enables them to change and adapt without compromising their cherished core ideals.” [3]

Who are we Kidding?

Of course, as De Geus himself points out, these observations are just that – observations – they lack scientific rigor and they point up just how nascent an endeavor the study of corporate longevity is. There is also the fact that all of these studies are of for-profit corporations, and will likely continue to be, because that’s where the money is. Religious institutions and nation-states are already certain that they are immortal, so it seems unlikely there will be much study done in those areas of corporate health and longevity.

So, let us pause here and consider our predicament. For onto 50 years cryonicists have been trying to sell, promote, foster and even give away cryonics with very little success. What’s more, we are genuinely astonished when people look at us as if we are credulous fools. We can’t understand why they don’t “get it.” Can’t they see the dire fix they are in and thus appreciate that we’re the only in game in town?

Regrettably, that statement of the situation is a straw man; it is not necessarily a binary situation wherein if you opt for cryonics you may live again; and if you don’t you will certainly die. A good hard look at the data suggests that it is perfectly reasonable for people to believe that you can opt for cryonics and that it may be technically possible to achieve reanimation, but that you will still end up dead. Most people don’t need to run the numbers on a spreadsheet to understand this, because they are arguably more in touch with the reality of just how fragile the secular world is than are cryonicists. Indeed, the only institutions in common experience that endure for more than a century – or even just for a century, are religions, nation-states and fraternal organizations – and the odds aren’t very good (and the life spans aren’t very long) even for most of those institutions.  England, as a continuously functioning nation-state, only goes back to the Restoration after Cromwell in 1660, a mere 351 years ago. The US has an even shorter lifespan of 235 years.

 Figure 8: Offering someone a costly ticket on a plane that has a negligible probability of making the journey without falling out of sky is not much of an alternative to staying put, even in the face of certain death. At least you have the opportunity to enjoy the money you would have spent on a ticket to nowhere.

So, just who are we kidding? By way of analogy, it may be perfectly possible that a much better life in California awaits an unhappy man in the slums of Haiti today. However, he can understandably be excused if he fails to lunge at the opportunity to make the trip in an aircraft that has a 0.00000001 chance of successfully making the journey. The Cryonics Calculator is a useful tool for allowing us to objectify our assumptions about risk. But it isn’t the only such tool. The fact is that most people run that calculation at least once in their life (when they first hear of cryonics), and some run it a second time; when they find out they are dying. If cryonics doesn’t pass the credibility sniff test, then it simply does not exist as a reality for most people. They think we are as crazy as we think they are – we for buying into cryonics and them for buying into religion. But, and you have to give them this, leaving the workability of the product aside, they still have us beat when it comes to demonstrating even the barest possibility of institutional longevity much beyond a century – or three or four at most.

Think about that, and consider very carefully what we have done to demonstrate that the craft we propose to fly us across the decades, or if need be the centuries, possess any credible degree of airworthiness?

Footnotes


[1] Or so it seems to us, because we can reason and plan. Evolution is not a conscious process that can design prospectively. If that “defect” in its algorithm of progress is understood, then it is in fact remarkably efficient.

[2] Snow was a skeptic of the then dominant miasma theory that stated that diseases such as cholera or the Black Death were caused by pollution or a noxious form of “bad air”. The germ theory of disease did not come the scene until 1861 when it was proved by Pastuer. As a consequence, Snow was unaware of the mechanism by which cholera was transmitted, but evidence led him to believe that it was not due to breathing foul air. He first publicized his theory in an essay “On the Mode of Communication of Cholera” in 1849. By interviewing Soho residents with help drom  Reverend Henry Whitehead, he identified the source of the outbreak as the public water pump on Broad Street (now Broadwick Street). Although Snow’s chemical and microscope examination of a sample of the Broad Street pump water was not able to conclusively prove its danger, his studies of the pattern of the disease were convincing enough to persuade the local council to disable the well pump by removing its handle.

[3] By contrast, a great deal of largely unscientific effort has been focused on the “biology” of nation-states and empires. Arnold Tonybee’s blighted 12 volume “A Study of History” is a classic case in point (A Study of History: Abridgement of Vols I-VI, with a preface by Toynbee (Oxford University Press 1946).

References

1.            De Geus A: The Living Company: Habits for Survival in a Turbulent Business Environment Harvard Business Press; 2002.

2.            Sheth J: The Self-Destructive Habits of Good Companies: …And How to Break Them Wharton School Publishing; 2007.

3.            De Gues A: The Lifespan of a Company: http://www.businessweek.com/chapter/degeus.htm. Bloomberg Bussinessweek 2002.

Posted in Cryonics History, Cryonics Philosophy, Economics | 5 Comments