The pursuit of cryonics as medicine

The biggest obstacle to the acceptance of cryonics is medical myopia; the idea that someone who has been pronounced dead by contemporary medical criteria will still be considered dead by future criteria. Advocates of human cryopreservation strongly argue against this. There are few things more discomforting than the idea that medical professionals of the future will look back in horror and wonder why we gave up on people who still possessed the neuroanatomical basis of their identities and memories.

But there is another kind of myopia in the public discussion of cryonics that warrants consideration. It is taken for granted by some critics of contemporary cryonics that cryonics has always been framed as a form of medicine. Nothing could be further from the truth. The history of cryonics is replete with debates between advocates of the medical model and those who believe that timely transport of the patient to a cryonics facility for low temperature storage should be adequate for future resuscitation by advanced nanotechnology. It is only because  cryonics advocates with medical and research backgrounds such as Mike Darwin and Jerry Leaf vigorously argued for adopting conventional medical techniques and protocols that today’s cryonics organizations can even be criticized  for falling short of these criteria.

There is a silver lining to a lot of the controversy that surrounds today’s cryonics . Critics now adopt the premise that cryonics is a form of medicine to make a case against practices they consider suboptimal.  It was not long ago that public critics of cryonics simply dismissed the whole idea as pseudo-science. This was never a sophisticated response but ongoing advances in cryobiology (such as vitrification of the central nervous system) and synthetic biology/nanotechnology have made this position even more of a showcase of ignorance. When people read the news about animals being cloned from straight frozen DNA they will be less receptive to tendentious claims that existing cryonics technologies are hopelessly inadequate to preserve the identity of a person.

The current development in which cryonics is being criticized from a clinical framework should have positive effects on how cryonics will be approached from a regulatory framework. It does not make sense to argue that cryonics is a pseudo-science and offering false hope but at the same time insist that cryonics organizations adopt high standards of medical care. The acceptance of the concept of “patient care” in cryonics would be incoherent without (implicitly) embracing the premise that cryonics patients have interests and deserve legal recognition of that fact. As more public information is disseminated about the quality of brain vitrification that is possible today, the need to recognize cryonics as an elective medical procedure will receive more attention from bioethicists and medical professionals.

There are those who believe that the acceptance of cryonics itself is being held back by amateurism. If this is the case there should be unexploited profit opportunities for cryonics providers that pursue the highest standards of medical care.

The "yuck factor" and cryonics

In sensationalized accounts of cryonics, explicit descriptions of cryonics procedures, and that of neuropreservation in particular, are used to invoke a negative response in the reader.  Some bioconservatives have argued that disgust experienced in response to certain ideas and practices is “the emotional expression of deep wisdom, beyond reason’s power fully to articulate it” (Leon Kass). In some cases, such as senseless violence, this is not necessarily an unreasonable approach because it may reflect a preserved instinct against behavior that is harmful to the individual or group. In such examples, however, the wisdom of repugnance can be corroborated by rational justification as well.

Where such an appeal to gut feelings is less fruitful, however, is in the context of medicine and forensics. The daily activities of many medical professionals and morticians consist of activities that would produce a strong negative gut response in most people who would observe them in all their detail. As the Alcor Life Extension Foundation points out in a document denying the mistreatment of Ted Williams:

Consider if a journalist did this expose of the funeral industry: “Funeral Home Scandal: Bodies injected with poison, organs mutilated, remains stuffed into wood boxes and covered with dirt!” It’s all true, right? Of course, if a disgruntled apprentice embalmer went to a sports magazine describing in graphic detail the use of a trocar during embalming of a sports celebrity, or the physical effects of cremation, he would be escorted out of the building by security.

The “yuck factor” that is produced in many people when they read about the details of cryonics procedures is not evidence of  pseudo-science or mistreatment. As a matter of fact, the procedures that are routinely performed in cryonics labs are designed to preserve life, not to destroy it. In this sense, the practice of cryonics can claim the moral high ground over prevailing methods of dealing with “human remains,”  where critically ill people are buried or burned because contemporary medicine has not yet found a way to treat them. If anything, it is this kind of medical myopia that should trigger the yuck factor.

The future of Alcor

Alcor’s recent news item about its 2009 Annual Board Meeting and Strategic Meeting contains a number of encouraging statements. On the front of institutional reform, however, there is not much news to report. The passage about the need to balance recruiting new Board members and preserving institutional memory reads as a rather uninspired defense of the Board’s recent decisions. In light of the growing recognition that most of Alcor’s problems over the years can be tracked back to the composition and functioning of the Board of Directors, one would have expected more innovation on this front.  A major problem with a self-perpetuating Board of Directors remains that there are few mechanisms available in case a competent Board of Directors would change in an incremental fashion into a contra-productive Board. Perhaps the idea of term limits could prevent such scenarios.

In particular, there is an urgent need to adopt institutional changes that can prevent the highly variable quality of patient care that has been observed in the history of the organization.  Another challenge that remains is the recruiting of  additional Board members with a strong knowledge of Alcor’s technical operations and the delivery of standby services. Without this knowledge (and some degree of common sense) it is highly unlikely that the Board can do a serious job of overseeing such matters.

One of the most positive items in Alcor’s report is the recognition that Alcor would benefit from substantial cost savings in its operations.  Throughout most of Alcor’s history the organization has been dependent on (unpredictable) donations from wealthy members to sustain normal operations.  Obviously, this way of funding the operations of a cryonics organization (as opposed to long term patient care) constitutes an irresponsible gamble. Donors should be commended for being reluctant to contribute to Alcor (any further) until Alcor has shown evidence of getting its financial house in order. A number of sensible proposals were discussed to generate more structural income for the organization such as increasing membership dues, raising cryopreservation minimums, introducing a recommended funding level (as opposed to just a minimum funding level), and creating income-generating endowments.

One aspect that is largely ignored in this report, however, is the potential for substantial cost reductions in Alcor’s daily operations itself. For most of its history Alcor used to be rather transparent about staff member salaries in its communications and the magazine. It may not be a coincidence that this practice disappeared  during the period when Alcor saw substantial increases in compensation for (some of) its staff members. To give some perspective, the old Tim Freeman Cryonics FAQ included the following question and answer:

7-2.  Is anyone getting rich from cryonics?  What are the salaries at these organizations like?

In December 1990, Cryonics magazine reported that the Board of Directors of Alcor voted a 25% pay cut for all of the staff, so they could keep their budget balanced.  Many of the Directors are also on the staff.  The salaries after the cut ranged from $22,500 annually for the highest paid full-time employee (the President) to $14,400 for the lowest-paid full-time employee.  None of the Alcor staff are getting rich from their salaries.

It would be a worthwhile undertaking to do a comprehensive study of Alcor’s staff and consultant compensation history and policies (or lack thereof). There is never a shortage of arguments to justify higher compensation and ad-hoc decision making in cryonics, but it is doubtful that generous salary increases in the industry over the years were necessary to recruit or retain competent staff members. It might even be argued that a number of problems in cryonics are actually linked to offering wages that exceed what the employees who receive them would otherwise earn in the market place. Similarly, substantial cost savings can be obtained by increasing productivity and decreasing staff members. Issues of compensation and staff efficiency should be essential topics of consideration in any serious discussion about Alcor becoming more self-sustaining and less dependent on wealthy donors.

Another topic that deserves attention in this context is that all of Alcor’s major technologies (medications protocols, organ preservation solutions, vitrification agents) are licensed to the organization by independent research labs. Although Alcor itself is mostly to blame for not having developed competing technologies of its own since the mid-1990s, it is important to recognize this dependence. At the very least, Alcor could benefit from a cost-benefit analysis of some of these technologies and from developing contingency plans to deal with scenarios in which these technologies would no longer be available or cost-prohibitive.

During most of its history Alcor (and later, CryoCare) promoted the idea of cryonics as a medical procedure and criticized other cryonics organizations like the Cryonics Institute for being overly optimistic and reckless.  In an ironic twist of fate, some critics of Alcor now use this perspective to criticize the organization for not living up to the idea of cryonics as medicine. As a general rule, this is to be welcomed. Where this criticism can go off track, however, is when it is insufficiently recognized that knowledge of conventional medicine is a necessary, but not a sufficient, condition to do good cryonics. One of the worst scenarios for the future of cryonics is one in which regulators impose standards upon cryonics organizations that  actually increase the challenges of providing good patient care; something that has happened already in the case of the Cryonics Institute when the organization was forced to perform a complex technical procedure like cryoprotective perfusion at a funeral home.

Faced with the technical complexities of ramped cryoprotective perfusion, Alcor has decided to develop a system that not only uses software to record perfusion parameters (concentration, pressure, temperature, refractive index etc.) but to use the same software to control them as well. Provided that this new system lives up to its expectations, this development will be a major step towards a system that can use real-time feedback to adjust perfusion parameters in a manner that so far has only been available in small organ cryobiological research. The data that will be generated during cases can, in turn, be used to create cases reports that follow a consistent, formal standard. When these reports are used in an intelligent fashion, the prospect of developing technologies and protocols that can reduce the high variability in patient care will be feasible.

The emergence of local cryonics

portlandReal estate is all about location, location, location. Location matters in cryonics as well.

The objective of standby and stabilization in cryonics is to limit injury to the brain after pronouncement of legal death. Unfortunately, many cryonics patients have not been stabilized promptly after pronouncement of legal death because the cryonics organization did a poor job of tracking the health condition of its members, was not made aware of the pending death of a member, or the case was one of rapid decline or sudden death. In other cases, the cryonics organization was aware of the critical condition of the patient but was faced with the challenge of providing services in a geographical area where few other cryonics advocates live. This creates a non-trivial challenge because premature deployment of a standby team can expose the cryonics organization to a prolonged standby in which resources are “wasted” but delayed deployment can arrive too late for the patient to receive meaningful stabilization procedures. Even in cases where a cryonics standby team is able to intervene promptly after cardiac arrest, the distance between the location of stabilization procedures and the cryonics facility in combination with the legal and logistical challenges of transporting a patient across state lines produces harmful periods of cold ischemia.

Some members who have recognized these challenges have decided to relocate to the state, or even the city, of their cryonics organization. As a general rule, these decisions are made when the member in question has retired or recognizes a high probability that the cryonics organization’s services are needed in the near future. As a consequence, the Phoenix/Scottsdale area has a larger proportion of (retired) people with cryonics arrangements than could be expected based on location alone.  So far this phenomenon has not really caught on with  Cryonics Institute (CI) members, although the desire of relocating to Michigan is a recurrent topic in discussions among CI members. In a sense, the issue is even more important for CI members because the organization itself does not offer standby and stabilization services. Unless a person has made arrangements with another organization for such services, CI members should expect non-trivial periods of warm and cold ischemia, producing brain injury and perfusion impairment during cryoprotectant perfusion (if perfusion is possible at all) as a consequence.

A useful medical analogy for this situation is to picture the fate of a critically ill person in a state with limited medical emergency services, who, after a 911 call, needs to be flown thousands of miles across state lines to a medical facility without the possibility of treatment during transport. It should not be surprising, then, that some people who have recognized this problem advocate that cryonics organizations should be local in nature. Not only in the sense of building a strong local community and emergency response system, but also by strictly confining itself to members in that area. A technical criterion to determine the area of coverage for such a cryonics organization is that the service area of the cryonics organization should not exceed the distance that, in principle, permits stabilization of a patient without loss of neurological viability of the brain by contemporary criteria.

The vision of a cryonics organization that confines itself to a specifically defined geographical area (a state or a few neighboring states) raises many practical questions but the most important question concerns its financial feasibility. Can a cryonics organization that confines itself to one state support itself and its operations? On the one hand, one is inclined to answer this question in the negative because the absolute number of people interested in cryonics is so small that even cryonics organizations that accept members from all parts of the world remain dependent on (large) donations and bequests to sustain their operations. On the other hand, a cryonics organization that operates in a strong local community of life extensionists can draw upon the enthusiasm of its members, the resources available to them, and focused regional outreach efforts.

Location is also important to cryonics because it can make or break the prospects of a viable cryonics organization. One major problem facing cryonics today is that the locations of the two major cryonics organizations (Alcor and the Cryonics Institute) offer little appeal to (young) people who could make a contribution to the science and practice of cryonics. This is not just conjecture. Alcor has great problems in attracting talent to Arizona (as evidenced by the ongoing saga of finding a suitable CEO). People who turned down offers to become more involved with Alcor (or those who left) have mentioned location as the most important reason. The situation is even worse because a number of people who are involved with Alcor in Arizona are known to dislike the location and have indicated their desire to move on in the future. Suffice it to say that such a situation limits the prospects of recruiting skilled people with long-term commitments to the organization.

The first thing that should be done is to recognize the problem and take it seriously. After this happens, efforts can be made to stimulate areas of vibrant cryonics activity with the objective of drawing more people to them. One development that is striking is that locations with a strong “cosmopolitan” identity such as New York and the Bay Area have no or little serious cryonics activity going on any longer. This is particularly painful in light of the fact that these areas have been historical hotbeds of cryonics activity. Good and dependable cryonics capabilities cannot be created overnight but there are no obstacles for creating  local organizations with a strong emphasis on education and local response capabilities.

Another important reason for creating strong local cryonics and life extension communities is  to reduce the vulnerability to political and legal events that threaten the operation of a cryonics organization. The importance of diversifying risk, and the limited ability for cryonics organizations in the US to deliver good stabilization services in Europe, is one of the major reasons why European cryonicists should be encouraged to create their own cryonics facility, complemented by basic standby and stabilization capabilities in other countries.

In the United States the author has been involved in stimulating vibrant cryonics activity in Portland, Oregon which so far has culminated in the rejuvenation of local cryonics meetings, a viable research program, and the formation of a non-profit organization to educate the general public about the benefits of cryonics. Other plans that are currently being pursued by other people in the region include the fabrication and acquisition of stabilization equipment and even preparations for the formation of a viable cryonics organization. It is hoped  that these developments will motivate more people to move to Oregon or stimulate people in other parts of the country to engage in similar activities.

Buried alive?

According to this news item the Alcor Life Extension Foundation is taking legal action against the brother and sister of an Alcor member who “denied the foundation’s request for his body and didn’t notify them of their brother’s death until months after he was buried.” Although some may question the wisdom of pursuing this case in light of the current condition of this Alcor member, Alcor is honoring its contract with the member. As Reason points out in this excellent post about the issue:

I can only imagine that the lawsuit is being undertaken as a point of principle and for the purposes of education: don’t break contracts with Alcor or this will happen….Switching around a family member’s post-mortem arrangements is little different from bullying and controlling folk who are too old and frail to defend themselves. In the case of acting to prevent cryopreservation that was organized and chosen by the deceased, it becomes something like fractional murder: removing that person’s shot at whatever the unknown probability of future revival happens to be.

Spouses and relatives of an Alcor member should not feel confident that if they hide the death of an Alcor member long enough to make cryopreservation no longer meaningful or practical that the cryonics organization will just give up and refrain from pursuing the case. There have been too many cases where hostile, greedy, or indifferent relatives have frustrated the wishes of a person who wants to be cryopreserved. Cryonics organizations should not even give the semblance that this is something they let people get away with. Alcor is to be commended for fighting back and honoring this member’s wishes, even in the most miserable of circumstances.

This episode should be another important wake-up call for potential and existing members of cryonics organizations. There are various  ways situations such as these can be minimized and we should start thinking about them. Most of all, cryonics members should execute living wills that rule out scenarios where greedy relatives will benefit from the patient not being cryopreserved. Furthermore, cryonics members should execute a Durable Power of Attorney for Health Care to ensure that the person who is authorized to make medical decisions on the cryonics member’s behalf has a strong commitment to honoring this person’s wish to be cryopreserved. This often will require giving this authority not to the person who is closest to you but to the person who  is most knowledgeable and respectful of  your cryonics arrangements (such as a long time friend with cryonics arrangements). Last, but not least, cryonics organizations should further expand their methods of determining high risk cases and improve communication with existing members. Although it is not possible, nor reasonable, to expect from cryonics organizations that they can avoid scenarios such as these in every single case, there is an urgent need to beef up membership tracking and response capabilities.

Cryonics organizations are in a delicate situation. We expect them to fight for each of their members without putting existing patients at risk. One solution that has been pursued in the past, and may have to be revived again, is to separate the service delivery aspect of cryonics from long term patient care. If such changes would allow more aggressive action on behalf of existing members with no, or decreased, risk for existing patients, such changes should be pursued.

Interview with Alcor member David Croft

david_croftDavid Wallace Croft is an Alcor member in the Dallas area where he lives with his wife Shannon and five children, Ada, Ben, Tom, Abe, and Ted.  He is employed as a Java software developer and is a part-time doctoral student.  His contact information and his weblog are available at www.CroftPress.com.

1. How did you first learn about cryonics?

I first learned about cryonics from the Extropians.  I think I first learned of the Extropians from “Wired” magazine.  I really liked what I read in the Extropian Principles so I dug into this subculture online.  I was a volunteer Webmaster for the Extropy Institute for a brief period.

2. When did you join Alcor and what motivated you to become a member?

Along with every other techie, I was swept into the Silicon Valley dot com boom during the late 90’s.  I worked next to Xerox PARC so I would sometimes wander over to attend their guest lectures including a slideshow on the subject of cryonics presented by Dr. Ralph Merkle.  I had a chance to attend local cryonaut dinners and meetings including a meeting at the Shaw-Merkle residence.  Actually signing up remained on my to-do list for a few years until I saw an ad on the back of the shirt of insurance agent Mr. Rudi Hoffman at an Extropian conference.  I approached him and he helped me make it happen.

3. How does your membership impact your life plans or lifestyle?

My Alcor membership has given me some peace of mind with regard to the terror of impending death.  I lost my faith in the supernatural afterlife at an early age and I struggled with the ramifications.  Now that I am middle-aged with five children, death is less frightening but I still think about my dwindling days with some despair.  My cryonics hope keeps me functional.

I am currently in Dallas but my long-term plan is to find a job in Phoenix, possibly in academia, so that I can establish my retirement residence near Alcor.

4. What do you consider the most challenging aspect(s) of cryonics?

Even amongst my atheist allies, cryonics is considered crazy.  When I read Humanist literature, I see a “mortalist” attitude where an acceptance of death is considered the rational alternative to belief in a supernatural afterlife.

5. Have you met any other Alcor members?

I have enjoyed my fellowship with members over the years, most recently at the Alcor conferences.  Awhile back, we had a cryonauts dinner here in the Dallas area with Dr. Scott Badger, Chana de Wolf, and Todd Huffman; I note that all four of us are involved in the study of the mind and brain.  I had the opportunity to attend one of the annual get-togethers hosted by Max and Natasha More in nearby Austin.  I also sample the CryoNet, Society for Universal Immortalism, and Venturists electronic mailing lists.

6. What areas of Alcor’s program would you like to see developed over the next 5-10 years?

I would like to see more Alcor conferences.  I would also like to see Alcor establish a second operational center in another location.

7. What kind of lasting contribution would you like to make to cryonics?

I would like to help establish a democratic religion for cryonaut brights.  I was inspired by the 1933 “Humanist Manifesto” proposing Humanism as a new religion.  I am the Treasurer and a co-founder of the Society for Universal Immortalism (SfUI), formerly known as the Transhumanist Church, which requires cryonics suspension arrangements before becoming a voting member.  I have also created a website for my own personal micro-religion which I call “Optihumanism”.  In my “Optihumanist Principles”, I have attempted to blend Religious Humanism, Neo-Objectivism, and Immortalism in a concise statement of my beliefs.  Less seriously, I also have a webpage for my “Cryobaptist Church” which makes the tongue in cheek assertion that salvation can be achieved by a post-mortem baptism in liquid Nitrogen.

8. What do your friends and family members think about your cryopreservation arrangements?

In general, my friends and family think it is a bit eccentric.  I am attempting to plant seeds with my wife and children by introducing them to cryonics fiction.

9. What are your hobbies or special interests?

One of my special interests is church-state separation activism.  With the assistance of my Objectivist friend and attorney Dean Cook, my family has legal cases pending challenging the constitutionality of a couple of new laws involving religion in Texas public schools:  a mandatory moment of silence and adding “under God” to the state pledge.

I am also a part-time doctoral student in Cognition and Neuroscience at the University of Texas at Dallas.  Although my Bachelors is in Electrical Engineering, my two Masters degrees had a focus on neuroscience and neuromorphic systems.  As a programmer, I have been hired to work on a number of interesting projects including neural network chip design, intelligent software agents, peer-to-peer frameworks, and multiuser 3D environments.  My academic research could be described as pursuing artificial intelligence via a study of spiking neuronal networks.

10. What would you like to say to other members?

Many of my atheist, humanist, objectivist, and immortalist friends do not have children.  I recommend that you have them if you can.  Children are blessings we give to ourselves.

Evidence based cryonics

Cryonics patients can greatly benefit from rapid stabilization after pronouncement of legal death. One fortunate feature of stabilization procedures is that the most effective and validated procedures are relatively inexpensive and easy to perform.  The difference between no stabilization procedures at all and procedures that aim to rapidly restore blood circulation and drop the patient’s temperature is likely to be bigger than that between such basic stabilization and procedures that include administration of a large number of medications and remote blood washout.  This observation gains even more importance when it is considered that there is a serious lack of empirical data to support these more advanced procedures.

To date, no single neuroprotective agent has been approved for the treatment of global or focal ischemia. Despite this fact, cryonics organizations like Alcor and Suspended Animation administer an unorthodox number of medications to protect the brain and prevent impairment of circulation. While there are peer reviewed papers that combine a number of medications, there is no precedent in mainstream medicine or biomedical research in using such a large number of medications (in contemporary cryonics, medications protocol exceeds 12 different drugs and fluids). The only existing justification for using current protocol reflects work done at Critical Care Research in the 1990s. Although scattered reports exist about the effectiveness of this protocol in resuscitating dogs from up to 17 minutes of normothermic global ischemia, no detailed (peer reviewed) paper has been published about these experiments.  Another concern involves the extrapolation of these findings to cryonics. It would go beyond the general nature of this piece to document all the differences between these controlled experiments and cryonics as practiced in the real world, but suffice it to say that the factors of shorter and longer delays, longer  drug administration times, suboptimal “post-ischemia” circulation, and induction of hypothermia introduce many unknowns about the efficacy of these drugs for cryonics patients.  In the case of some medications, like streptokinase, heparin, and dextran 40, a case could be made that the potential benefits outweigh the unknowns, but should this argument be extended to all medications?

Even more complexity is introduced when cryonics organizations make an attempt to wash out the blood and substitute it with a universal organ preservation solution. The rationale for this procedure is found in conventional organ preservation and emergency medicine research. The question in organ preservation research is no longer whether hypothermic organs benefit from blood substitution with a synthetic solution, but what the ideal composition of such a solution should be. In emergency medicine research asanguineous hypothermic circulatory arrest is increasingly being investigated to stabilize trauma victims. But it is a major step from these developments to the practice of remote blood washout of ischemic patients with expected transport times of 24 hours or more. At present the only sure benefit of remote blood washout is that it enables more rapid cooling of the patient, a benefit that should not be underestimated. But when liquid ventilation becomes available to cryonics patients, rapid cooling rates will be possible without extracorporeal circulation.

The lack of relevant published data to support the administration of large numbers of drugs and remote blood washout in cryonics is not just a matter of risking performing redundant procedures. A lot of time and resources are being spent in cryonics on obtaining and maintaining equipment and supplies for these procedures, in addition to the licensing fees paid to use some of these technologies and the training and recruiting of people to perform them. But perhaps the most troublesome problem is that the preparation and execution of these procedures during actual cryonics cases can seriously interfere with rapid and effective cardiopulmonary support and induction of hypothermia.

There is an urgent need to move from extrapolation based cryonics to evidence based cryonics. This will require a comprehensive research program aimed at creating realistic cryonics research models. It will also require vast improvements in the monitoring and evaluation of cryonics cases.  The current debate should no longer be between advocates and opponents of standby and stabilization but about what stabilization procedures should be used by cryonics organizations given our current knowledge.

Viewing cryonics as an experimental medical procedure does not necessarily commit one to the position that substantial amounts of money and resources should be allocated to recruiting medical professionals and expensive equipment. The most common sense implication of the views outlined above is that the most effective measures to improve the care of cryonics patients are encouraging members to relocate to the area of their cryonics organization, improved health tracking of existing members, and cryonics training aimed at teaching the basic procedures and techniques that confer real evidence based benefits.

Interview with Alcor readiness coordinator Regina Pancake

This is the second in a series of interviews with individuals in the life extension and cryonics movement. The first interview was with Cryonics Institute president Ben Best. This interview is with Regina Pancake, Alcor’s Readiness Coordinator.

How did you get involved in cryonics?

My story is not your typical in the details, but in the overall it was a brush with death, which is more common in our membership.

Cryonics was on my radar back in the 80’s when I lived in San Francisco. I had seen it only briefly on a nightly news cast, and I knew someday I’d sign up for such. What better fast forward button could you have, was my theory. It would allow me to fight what seemed, until that moment during the evening news, the inevitable.  So sometime after that epiphany, when I moved back to L.A in 1990 and I was then physically close enough to the facility, I took the tour, which was given by Mike Darwin.  I then started volunteering for manual labor level projects at the facility on weekends. I’m the kind that dives in and I wanted to know all the people. But signing up was too expensive for me at the time I thought.

What pushed me over the line and into sign-up was a very fateful trip to Mexico in 1991. Four of us went to view the full eclipse of the sun that occurred on July 11th that year. We had a great time, but after we saw what we came to see we were driving back to L.A. the next day when at about the half way point, 50 miles north of Guerrero Negro (600 miles south Tijuana in Baja California) something blew apart on the truck and we had a roll over accident. I’m still not sure to this day what exactly happened. I was in a position facing out the driver’s side back window of the shell, lying on a futon, next to Max More who was also on the trip. As the truck rolled over on its first toss, I went through the window and landed on my feet in a crouching position and stood up in time to watch my truck take two more turns before it came to rest on its wheels, off to the side of the road, now facing southbound, though we had been moving northbound.  My landing was a total fluke, no ninja-like qualities here. It was the most surreal experience I think I’ve ever had.

The silence after the truck’s repeated massive collisions with the pavement was like time had stopped in a freeze frame. As I took in the scene of all our belongings strewn across Highway One, Mike Perry (who was another one of the four in the vehicle) was the worst hurt. In the hours that followed after the accident, we had several points where we could have lost him. He had essentially been scalped and his skull was now exposed. The skin from the top of his head had been peeled back to the nape of his neck. Luckily for us all, the fourth person in the vehicle, Karl Martin, who had been driving that shift, had paramedic training and one hell of a first aid kit. He saved Mike from dying in those early minutes.

After many an American stopped to help we were taken by Mexican soldiers to an ambulance and brought to a small clinic some fifty miles south, back at Guerrero Negro. Took me an hour and a half to get through to Alcor because the phone lines were horrible, and being that this was ’91 there were no cell phones to speak of.  But once I did get through, it was Mike Darwin who answered the phone. After I had him speak to the only doctor there, I got the phone handed back to me and I’ll never forget Mike Darwin, in a very commanding yet reassuring voice saying, “Don’t you let them touch him! We’ll be there very soon!”  Sure enough, 8 minutes later (yes, eight minutes), a rapid extraction team/air ambulance called Flight for Life came through the doors. I cannot tell you how grateful I was at that very moment, to be a part of the society that had such capability!

They then stabilized Mike Perry who had been groggy but conscious now for awhile, and as they wheeled him through the doors and into the waiting ambulance that would take him to the air strip that was less than a mile from us, he sat up on the gurney with what seemed to be his last rally of strength, pointed at me and said in the most pleading voice, “Regina! Sign up with Alcor!” and then he collapsed onto the gurney. I swore to him I would if I made it out of Mexico alive, which was still an open question at the time.

When we got back, I promptly signed up and I got my necklace and bracelet by that October. I refer to this entire story as our “Mexican Odyssey.”   After we all had seen doctors in the States the next day, Max called me on the phone to tell me what he had learned had occurred whilst we had been in Mexico. Jerry Leaf had gone down. Alcor nearly had two back-to-back cases.

What is a typical day at Alcor like for you?

I start some of the work at home in the morning, reading any technical reports or ongoing school work for my education in emergency medicine over the first cup of coffee. Then it’s off to the Alcor facility. There are always projects in the works. I try to keep it to only two to three at a time, but I have a prioritized list that stretches a good ways. I come in in the morning, and after I check for messages, return or make phone calls while people are most likely at their desks around the country or other places where I’m looking for products and check with management for any burning issues that might become the priority of the day. All that and not necessarily in that order.  Beyond that ritual, I dive into the more physical stuff early. Moving of heavy things, etc. By afternoon I turn my attention to the writing. Returning of emails, fleshing out of inventory lists and Excel sheets galore. Right now, the focus is on retooling of the transport kits. Of the four basic cases that it consists of, I’m on number two.

What is your favorite part of the job?

Talking with the people that are our membership. I love talking to fellow cryonicists.  Seeing progress in shades as this place continues to transform. And then there’s building things. Equipment, networks of people, systems of organization.  I do enjoy all that.

How is Alcor’s regional stabilization team expansion/growth coming along? What regions are most active / least active? What is your strategy for increasing volunteer participation in underactive regions?

At this point, I’m in retooling mode. I was tasked with that first and then second would be the expansion from our existing six teams to a total of fourteen.

Our six existing teams are: Southern California, Northern California, Nevada, Florida, Massachusetts and the United Kingdom. Of those teams, the most active is the Southern California team with more than ten people on it. They practice once a month. The Florida and Nevada teams are professionals with our Alcor kits. The Florida kit is at Suspended Animation and would be utilized by the professional team there if needed. Nevada is also a professional team that is staged in Laughlin. And when I say “professional” I mean this is their day job. Nevada’s team are EMTs and paramedics of one level or another all in the employ of the major casino there. They get daily practice with their talents just by doing their EMS services for non-cryonicists. Our protocols are similar. Although there is a departure point when they are just beyond the normal EMS processes. They practice our protocols to keep fresh at least once a quarter. If anyone wants to know more, just call me. The number is 480.905.1906. My extension is #100.

Massachusetts is on the other end of the scale. I’ve only got two guys out there. They could stand a beefing up. I’m not blaming anybody here, its just they need more people on that team. Its a tad shy to say the least. How I’ll go about augmenting teams in need would be researching who in our membership would fit the bill, approaching them individually through email first, then phone call if they are so amiable. Also by casting a wide net through advertising for these regions within our own magazine. I think I can get that done. I know the editor. [grin]

Where we would be expanding into with new teams are as follows:

Melbourne, Florida

Portland, Oregon (that’s you Aschwin!)

The Midwest

Texas

and then three places in Canada, only one of which I’ve got a leader for up there at this time. Christine Gaspar. In Toronto. She’s an ER nurse and cryonicist.

What have you learned since coming to work at Alcor?

Besides how to put up with living in the desert, a lot more about emergency medicine that is for sure. And how non-profits differ from the film industry….in high contrast sometimes. But human nature is fairly similar at its roots everywhere.

How have your experiences at Alcor changed your perception of cryonics? What would you like to tell other cryonicists based on that change of view?

Don’t fall for the “Our Friends from the Future will save us” syndrome. WE are responsible for our own survival and it is up to WE the Living, in the constant “now” to deal with what our pieces of this generational puzzle are. In the film industry there was something similar. During production you’d always hear someone say, “Don’t worry, we’ll fix it in post.” Production people are a somewhat different set from post-production people. Production would assume that the “magic” of Computer Generated Imaging (CGI) would save the day. More than half the time they would be very wrong.  This is human nature again, and we are subject to it unless we make a conscious effort to not give into that.  And we need to get away from this “just do me” attitude. Less passive, more active cryonicists.

In retrospect, looking back to when you moved to Arizona from California and started working at Alcor, has what you expected the Alcor Experience to be, mostly proven to be the same?  If it turned out quite different from what you expected, describe how.

That’s rather hard to quantify. I had mixed feelings about the whole thing. I hate the desert.

I knew what I was getting into though, due to the fact that I was running the team in LA with Peter Voss’s help for about 5+ years. I had started to turn up the focus on our team about halfway through that time period. As I internally acknowledged my own passion for this capability of reversing death and aging, it came into sharper focus.  I’d been out to Alcor several times during that. So no real surprises.

If you could change one seemingly impossible thing about Alcor, what would it be?

That we need this whole thing at all. It is, after all, the second worst thing that can happen to you. The first being that you die and melt back into the environment. Other than that, it would be to professionalize the whole place with nothing but well funded medical professionals with a laser like focus as if this was the Manhattan Project. Then I’d just be serving coffee here.

Do you agree that Alcor should allow for more membership involvement in formal decision making?

As Bertrand Russell once said, “The only thing that will redeem mankind is cooperation.” I think we can all appreciate the relevance of that here in our community.

I’m not here to deal with those more puzzling aspects of Alcor’s cryonics culture.

I see both sides on this though. I do think there should be some open door policies. Some mechanisms in the system of our interactions between the triad of staff, board and membership. But on the other hand, you can put too much of your time and energy just defending your positions on whether to turn right or left. Getting cryonicists to agree on anything can be like herding cats. There has to be a balance struck. Cooperation, like our lives depend on it….which it does.

How many people have signed up for cryonics due to your direct influence?

Only one that claims it. Todd Huffman. I went on a hiking trip in Utah with him and a group that John Smart put together in 2003 and had eight hours in the car with him both ways. We had a lot of time to talk this through. Maybe others. I don’t know, I don’t have any hash marks on my desk top if you get my meaning.

What is your vision of the future of cryonics?

In the next few years I want to see us pull off deployment of regional whole body cryopreservation. This will allow us to deal with the issues of logistics that are currently playing against us. We really have a narrow window in which to give a patient a high quality cryopreservation. And every town/city/state has variants of different rules for the transportation of what they, at that point, consider human remains. Regional whole body cryopreservation is the lynchpin to turning that around and having time then playing on our side. Which is what we’re doing with cryonics in the first place. We’re taking that ambulance ride though time rather than through space. Gotta start that ride sooner and closer to where we tend to deanimate. Which is at home near family, if you’re lucky.

Ideally though, what I’d really like to see is that we will be able to reverse it in my lifetime.

What do you consider the biggest difference between working in the movie business and cryonics?

The people in the movie industry are more entertaining. No offense people, but by far there is no other place that attracts so many fevered egos in one place that are so talented and charismatic. Watch the movie “The Player” with Tim Robbins. It completely rings true as to what it is like to a T.  The stress levels are through the roof. Ages you fast. The film industry runs at 45 while Alcor runs at 33 and a third. (If you don’t get that reference, count yourself lucky to be that young and Google it up.)  That said, one thing I can no longer say as a calming mantra is, “Relax, its only a movie.” Cryonics is slower and more serious.

What are your hobbies and interests?

Science fiction, films of all genres, space advocacy, cats, (I’m destined to be a cat lady the rest of my life), non-linear editing of films and online media content, and transhumanism,  among many many others and not necessarily in this order.

What is your ALL TIME favorite movie and why?

Gads! Just one?! Can’t do that. So I’m going to color outside the lines of your question.

Black and White Sci fi hands down is: The Day the Earth Stood Still.

In truly mind bending content: Waking Life.

In Anime: Ghost in the Shell and then there is Blade Runner (director’s cut only).

All these speak to me. If you’ve seen any or all of these and you understand, then you’d know what I’m talking about.

Then there’s Minority Report, Vanilla Sky, Star Trek (pretty much all of them), 12 Monkeys (actually anything from Terry Gilliam)….you get the idea. There is just no way I can say ALL TIME favorite. Too limiting. And as a cryonicist, you know we don’t like those, now do we?

The secular case against immortality

In 2003 George Hart published an article called “The Immortal’s Dilemma: Decontructing Eternal Life” , making a secular case against immortality.  Hart mainly uses logical arguments and provides a fair amount of room to address a number of possible objections to his position. In a nutshell, Hart considers two variants of immortality, one without the option of termination and another with this option. The former is argued to be undesirable (a position that most life extensionists would agree with) and the latter is impossible because of the (logical) inevitability of a deathwish among immortals:

“Personal immortality poses this dilemma: without the termination option, we will face infinite periods of time when we will wish we could terminate our immortality; with the termination option, we will eventually and inevitably face a period when we will exercise the termination option and thus put the lie to our supposed immortality.”

In his 2004 article “Deconstructing Deathism: Answering a Recent Critique and Other Objections to Immortality,” mathematician, cryonics activist, and author of “Forever for All,” Mike Perry, reviews a number of arguments against immortality and those of George Hart in particular. Perry does not find Hart’s position on the inevitability of an executed deathwish persuasive. Perry also takes issue with Hart’s position on personhood and the memory and information requirements of immortals.

One aspect that seems to be prevalent in philosophical arguments against immortality is the alternate use of personhood and boredom objections. When it is argued that immortality does not necessarily have to be boring, critics of immortality answer that an unending life with infinite experiences necessitates demands on  memory information storage that will undermine the requirement that immortality is only meaningful if it is experienced by the same person. Alternatively, when an unchanging personality is assumed, it is argued that boredom will inevitability occur. But the choice between loss of personhood or boredom may not be necessary if personhood is not defined in such a “dogmatic” fashion but allows for both psychological continuity and meaningful identification with the past. As Perry notes:

trying as we are to anticipate the possible future before it happens, and how we will deal with our problem of memory superabundance when many new options should have opened up. In that hopefully happy time a “science of personal continuation” should have taken shape to properly deal with the matter. Nay-sayers like Hart try to discount any such prospects once and for all, based on today’s perspectives with their inevitable limitations.”

Toward the end of the article, Hart’s personal position on immortality becomes more pronounced and his reasoning less careful. Hart speculates that it may be “that only a finite life can be meaningful because only a finite life can be a story that has a beginning, middle and end. Death is what frames our life, and only a framed life can have meaning.” But why life can only be meaningful when it is perceived as a story with an ending instead of a never ending story remains obscure. Toward the end of the article , the author becomes even more blunt when he states that “life is meaningful when it is lived; that is enough. To ask for more is almost greedy.” But this argument is proving too much and would undermine any case to prolong life by scientific means, including conventional medicine. Hart is too fine of a writer to mean this. So how long is too long?

Although arguments against immortality should be evaluated on their philosophical merits, it is often not hard to detect the person behind the argument. As discussed before, this issue is particularly present among writers who stress the issue of boredom and stagnation in relation to immortality, employing a one-dimensional and unimaginative view of life and experience in order to make the case.

When discussing the (logical) inevitability of a deathwish among immortals, Perry further notes that “the rather morbid dwelling on a putative, recurring death-wish suggests that Hart may not be so happy with his own life,” as evidenced by statements such as:

“In theory you can imagine without contradiction what it would be like to be alive for a trillion or even a trillion trillion years from now. This thought experiment creates its own horror, one that is mind-numbing and nauseating.”

Perhaps secular “pro-death” philosophers believe that the case against religion is strengthened by debunking one  of the reasons people believe in the supernatural (the promise of immortality). But this would be throwing away the baby with the bathwater. If scientific means will become available to extend the maximum human life span, there is no a-priori reason why secular thinkers should not rejoice in that development, just as we are now embracing advances in medicine to heal and prolong life.

Although speculation about how immortality may affect human psychology can be intriguing, our limited  knowledge about the universe and lack of empirical observations of actual immortals make this a highly speculative affair, leaving much room for injecting personal feelings and wishful thinking. These feeling can be negative, as evidenced by the life extension cynics, or meliorist in nature, as expressed in the writings of Mike Perry:

“Clearly there are many possibilities, but I conjecture that personality types capable of and desiring very long survival will not be so varied or inscrutable as to baffle our understanding today. Instead they should basically be profoundly benevolent, desirous of benefiting others as well as themselves, and respectful of sentient creatures in general. They will acknowledge that enlightened self-interest requires a stance with a strong element of what we would call altruism. They will be intensely moral, but also joyful in the exercise and contemplation of their profound moral virtues—for an element of joy will be essential in finding life worth living, even as it is today. These joyful, good-hearted beings, then, will be the types to endure, and will refine their good natures as time progresses, so as to increasingly approximate some of our ideas of angelic or godlike personalities, as endless wonders unfold to their growing understanding. “

Few philosophers against immortality argue that today’s lifespan is too long. Which again raises the question, how long is too long? Ultimately, such an answer can only be answered empirically by the individuals who will live a much longer lifespan than those living today.

Mike Perry – Deconstructing Deathism: Answering a Recent Critique and Other Objections to Immortality

Refractometry in cryonics

Contrary to popular opinion, in cryonics the blood of the patient is replaced with a cryoprotective agent to reduce freezing, or more recently, to eliminate ice formation altogether through vitrification. This procedure requires surgical access to the circulatory system of the patient to wash out the blood and replace it with a cryoprotective agent. But how do we know what the concentration of the cryoprotective agent is in the brain of the patient?

There are a number of methods to estimate the concentration of the cryoprotective agent including specific gravity (SG) and freezing point depression osmometry. Such methods can be impractical and time consuming. In the following article from Long Life Magazine (1978), Mike Darwin introduced refractometry as a method to determine cryoprotective agent concentration. Measuring the refractive index of the perfusate to estimate the concentration of the cryoprotectant in the patient is still practiced in cryonics today by taking samples of the arterial, venous, and burr hole effluent.

The sort of handheld refractometer that is discussed in Darwin’s article was used by Alcor  for manual refractometry measurements until the  organization obtained a benchtop refractometer in the mid-2000’s.  Alcor also collects continuous refractive index measurements using LabView and in-line industrial refractometers.  In 2007, Aschwin de Wolf  recommended the Reichert AR2000, a digital handheld refractometer, which is convenient to use, offers a wide reading range and a choice of different scales, and can be used with software to automatically record data.  The Reichert AR2000 is currently used by the Cryonics Institute.

Mike Darwin – Refractometric Determination of Cryoprotective Agent Concentration PDF