X-Message-Number: 17623
Date: Thu, 20 Sep 2001 03:44:19 -0400
Subject: Serious Undertakings
From:
In Message #17595, Mr. (Ms.? Well, let's make it Mr.) Driven From The
Pack wrote:
>> I don't think an undertaker would make a very good
cryopreservationist, despite the fact that they probably would possess
greater knowledge of the basics of the type of surgery required than
would the average cryonics standby team volunteer. <<
What this sentence, taken literally, says, is that Mr. Driven From The
Pack feels that undertakers are not very good, but that standby teams are
on the average even worse. Therefore (he says later on) he opts for
standbys. I have to say I don't see the logic of this.
However, I also say that the whole objection is kind of beside the point,
since -- we all know this, right? -- CI has a standby team, and standby
team services too. We feel that for patients at a distance, funeral
directors are without question the superior option, and we can't
recommend it strongly enough. But we also think members should have
every option, so try to give it to them.
>> L'Affaire Rosewater confirms my thinking <<
The Rosewater affair consists of purportedly anonymous email to Charles
Platt claiming that Barry Albin used rosewater in a perfusion 'more than
a year ago'. Barry Albin has only performed one perfusion for CI, over
four years ago, and there is no evidence, or any sensible reason, to
believe that he used anything but CI solutions exclusively -- as he has
stated. Do anonymous accusations, no motive, and no proof, automatically
mean confirmed guilt? I sure wish we could suspend people as quickly as
we seem to be able to suspend the laws of evidence.
>> So, therefore, when I go, I plan to be in the geographical area of the
standby team, and not have to rely upon an undertaker to cryopreserve me.
That's my *plan*, anyway... <<
In light of the World Trade Center bombing, I think it is fair to say
that death is not particularly cooperative when it comes to people's
plans in this regard. One might also consider Mr. Driven From The Pack's
plan from the point of view of some more relevant numbers: the president
of ACS has said that perhaps 75% of suspensions are not 'ideal'; a former
president of Alcor has put that number at two-thirds; privately, I've
heard that 80% of suspensions do not go as we all might hope. In short,
the odds are perhaps three out of four or higher that your suspension
will not go as planned. I'm sorry -- sincerely sorry.
But 'sorry' doesn't reduce ischemia. Rapid on-the-spot treatment does.
So, in the interests of cutting those atrocious odds down, CI uses a
system whereby a patient can get trained and qualified help rapidly,
wherever one happens to be at the time. I don't claim it's an ideal or
perfect system; but I do believe that the odds are that you will suffer
less ischemic damage with it than you would with any alternative.
(And incidentally -- should Mr. Pack's 'plan' work out, CI has that
possibility covered too: there are cooperating hospices near CI
facilities. So, if a member knows he or she is dying ahead of time, it's
possible to check in and have a CI team by your bedside ready to start
treatment when the time comes.)
>> The undertaker is just out to make a buck. <<
The hidden assumption here seems to be that if a person is paid to do a
competent job, he will do an incompetent one instead. Why? If a friend
offers to pull your aching tooth out with a pair of pliers for free, will
he necessarily do a better job than a dentist asking a fee? Every doctor
I know gets paid for operations, office visits, consultations, the works.
The best ones are paid quite a lot. And in the case of a funeral
director working CI, a good performance could mean further fees -- a
member's family might also be using his services, as might other CI
members in the area. As long as the guy earns the buck he makes by doing
a good job, what's wrong with that?
>> The problem is that there are no controls or feedback on what the
undertaker does with respect to the cryopreservation. <<
Um... this is not the case. States vary slightly in terms of
requirements, but in terms of controls generally, funeral directors in
the United States are state-licensed, state-certified, have degreed
training and study requirements, serve one to three year internships or
apprenticeships, and are regularly reviewed by private and governmental
agencies and associations. (See the National Funeral Directors of
America web site at http://www.nfda.org.) In terms of feedback with
regard to the cryopreservation, CI is in touch by phone during the
procedure, and patients treated by funeral directors are brought to CI as
promptly as possible afterwards, where CI's own personnel plus one or
more consulting funeral directors examine them in the course of
preparation for further cooling.
>> I can just see some undertaker who finally gets the body of a
cryonicist and has to finally earn his retainer fee: He grumbles about
it a bit, wonders where he put that packet containing the
cryopreservation protocols, searches about for it a bit, and finally just
gives the cryonicist corpse the "standard treatment." The standard
treament being in large part what has been the standard practice for
undertakers for thousands of years, maybe, a witches brew containing
rosewater and lanolin, etc, etc. <<
The vision of Mr. Driven From The Pack is seeing is a trifle
hallucinatory. In the first place, funeral directors are not paid
beforehand for a suspension. They are paid after the patient arrives,
and if the patient were improperly or unprofessionally treated in any
manner, that fee -- not to mention the funeral director's job, license,
and reputation -- could be severely jeopardized. A funeral director does
not spend his times 'grumbling' and poking about for protocols. He is
instructed beforehand, repeatedly; not merely in writing, but also over
the phone by CI personnel and funeral directors experienced in the
procedure, and often by visiting CI directly -- Mr. Albin, for instance,
has twice flown from London to CI headquarters in Michigan for
instruction. When a patient dies unexpectedly, his or her wrist bracelet
or necklace and wallet notification card instructs the person finding
them to (a) cool the head *instantly* and (b) contact CI headquarters,
which itself notifies the funeral director. The funeral director is in
phone contact with experienced CI personnel during the procedure, who are
available to help, guide, and answer any question the funeral director
may have. And apart from CI's active involvement and attention, the
patient's family may well be nearby in attendance, and the funeral
director's assistants are also involved.
Do funeral directors give patients the 'standard treatment' involving a
'witches brew' some 'thousands of years' in the making? I'm afraid not:
formaldehyde was not available from medical supply houses during the
Pleistocene. Besides which, there is a marked difference between
enbalming a person with formaldehyde -- not to mention perfumed water, as
Mr. Albin was (absurdly) accused of doing -- and cryonic suspension
procedures involving cryoprotectant solutions. I don't wish to sound
rude, but you would have to be really blind not to be able to tell the
diffence between someone enbalmed with formaldehyde, not to say Old Spice
After Shave, and someone properly perfused. When a patient is received
at CI one of the organization's local funeral directors is there, and it
is simply inconceivable that people experienced in both cryonic
suspension procedures and 'standard' enbalming could fail to miss the
difference.
But Mr. Driven From The Pack is actually raising a serious point here,
and I'd like to face it directly. It's this. How do we know a funeral
director isn't doing a lousy, destructive, willfully bad job? The answer
is: (a) the patient is examined for any such malfeasance when he or she
arrives at the CI facilities, (b) the funeral director generally works
with assistants, and multiple-person conspiracies are a bit tough to
arrange and maintain, (c) the funeral director is in contact with CI
during the procedure via phone, and afterward submits a report, and it's
dumb to report one procedure and do another when you know the patient is
shortly going to be examined and any discrepencies made plain; and, not
least, (d) the funeral director's job, license, livelihood, reputation,
and fee are at stake. To deliberately lie, to deliberately do bad work,
to fake reports, is to put oneself at severe legal and financial risk.
Malpractice is not, alas, impossible -- any more than malpractice by a
standby team is impossible. But it is very tough to pull off, and very
foolish and dangerous to attempt. And -- for what? So the funeral
director can waste his own money and supplies on 'standard' solutions
when CI solutions are supplied free? So he can go to additional time and
trouble applying 'standard' enbalming procedures like cosmetics, when
'cosmetics' play no part at all in cryonic procedures? There is no
profit in doing a deliberately poor job on a patient, and possibly very
serious punishment. On the other hand, doing a good job is safe, secure,
profitable, and may result in more clients from CI and CI member
families. And in any case the director's performance will probably be
witnessed by assistants throughout and certainly reviewed at CI by both
our personnel and funeral directors of at at least equal ability.
Are these safeguards absolutely air-tight? No. But you have to put it
against the only other system around: standby teams. Standby team
members are *not* state-licensed, not state-certified, they do not have
degree-level training or study requirements, they do not serve one to
three year internships or apprenticeships, and they are not regularly
reviewed by governmental agencies or industry-wide associations. Three
days of eight-hour training, and you can be a travelling team member. No
experience necessary, no degree required. Don't misunderstand me: there
are certainly very skilled, gifted, well-trained people on standby teams.
I have no doubt that they have done superb jobs on occasion. They are
not bums: if anything they're heroes, exhibiting a commitment to
cryonics that puts the rest of us to shame. But commitment does not
automatically translate into skills and experience, and it is simply a
fact that standby team members are, on average, simply not as
well-trained or as extensively experienced as funeral directors, and not
overseen *at all* by independent reviewing organizations. I personally
do not think that even one standby team member is 'evil' or willfully
incompetent, much less that several would engage in a conspiracy to
deliberately mistreat patients and then cover it up. But the comparative
lack of training and oversight makes it a lot easier to do so in the one
case than in the other. Funeral directors are without exception
constantly practicing licensed professionaIs; travelling team members
are, with few exceptions, sporadically used volunteers and amateurs. It
stands to reason that unprofessional behavior will more likely come from
the latter than the former. But do we ever hear about standby team
members are 'grumbling' as they dish out 'witches' brew'? We're willing
to give amateurs the benefit of the doubt. Why aren't we willing to do
so to professionals?
>> The undertaker is in a hurry; he has customers waiting...and so when
he has to fill out the report for the cryonics org, he just writes in
something about how he followed the "standard protocol I received from
the cryonics org..." Totally "unexceptionable." <<
Undertakers are rarely in a hurry preparing someone deceased, since those
deceased people sometimes have AIDS, hepatitis, infectious diseases, and
so on. One learns not to hurry; it can be fatal. As for deliberately
filing a false report, I believe that may be both illegal and actionable.
>> I suspect that this has happened several times, especially in, ahem,
"remote locations." <<
Proof, sir? One -- just one -- single bit of evidence? *I* suspect this
has *never* happened, for all the reasons above, because CI is involved
with the procedure as it occurs, and sees the results of the funeral
director's work when the patient arrives.
>> Cryonics might be something that takes some passion. I know that I
would much prefer having someone with some
passion (and a little training, at least) cryopreserving me... <<
Primal Scream therapists have passion and very little training. Good
luck. Personally I prefer someone with institutional surgical and
pathological training, a degree, state licensure and oversight, and a
minimum of years of experience. But, hey, to each his own.
I should nonetheless point out to other readers, who may want to gauge
funeral-directorial passions directly, that CI encourages members to
choose for themselves which funeral director they want. Thus, if you
happen to be living in Texas, CI does not 'assign' a funeral director
there to you. We encourage members to locate the nearest funeral homes
themselves and speak to the funeral directors in person. Thus you can
find out exactly how qualified they are, exactly what their training is,
exactly how committed they are, and so on. When a member is personally
convinced that a funeral director is honest, capable, has a good record,
is sincerely interested in implementing CI protocols properly, then CI --
after checking his qualifications -- signs him on. If a member doesn't
consider a funeral director sufficiently qualified, or even sufficiently
'passionate', he doesn't have to take him. You pick the person you
trust, and you're treated by the person you trust.
> However, I know that I would rather be cryopreserved by an undertaker,
than to not be cryopreserved at all. Hell, it just MIGHT work. <<
Words of wisdom!
>> I really do suspect that even brains poorly cryopreserved will one day
be resurrected in some form. <<
I do too. (Though to be frank, the thought of some of the brains on
Cryonet being *perfectly* preserved makes me shudder. Hopefully the
nanobots will tuck in a little additional neocortex here and there.)
(And in passing: the day before, Mr. Mike Darwin wrote: "I can say only
that I once saw a newspaper article quoting him [Albin] (I believe it may
have been British in origin and may be in the clipping archive started by
Arthur McCombs at Alcor) wherein he is quoted to the effect that (sic)
"his cryonics cases were first injected with lanolin and Rosewater and
the treated with glycerine to protect against freezing injury." I am very
certain that I read that article because I remembered at the time
thinking that he must have been misinformed. That had to be prior to
1993. This makes it more credible that a second remark (over a decade
later) about Rosewater to the press was accurate (not necessarily that he
used it but that he said it; these can be two very different things)."
I thank Mr. Darwin for graciously and properly pointing out that saying a
thing is not necessarily the same thing as doing it. (If it were, the
verbal exchanges on Cryonet would be a sea of dead bodies.) However I
have to point out that the remembered quote in question has a couple of
weaknesses. Mr. Albin was first contacted by CI in 1992, and first
visited CI headquarters in 1993. Thus, it is just possible that he spoke
to a reporter about cryonics in '92, as Mr. Darwin says. However it is
not likely that Mr. Albin waxed eloquent on his injecting rosewater (now
lanolin) mixture into his cryonics 'cases' then since he didn't have any
cryonics 'cases': He's only had one. And that one did not take place
till about five years after the alleged quote. As for Mr. Albin being
quoted ('sic'?) to that effect t all, I don't believe the quote above is
his, since "his cryonics cases" is not the way a person refers to himself
when speaking. "My cases," yes; "his cases," no. If Mr. McCombs has any
such article, he can get CI's mailing address easily enough. Let's see
it. )
I'd like to end this oration on funeral directors with a small personal
aside. I really kind of sympathize with Mr. Driven From The Pack,
because, though his notions about funeral directors really are
demonstrably thin, I felt the same way myself when I was first thinking
of cryonics. Standby teams -- cutting-edge dudes in Star Trek uniforms,
hurrah! 'Funeral directors'? Humpbacked nineteenth-century
grave-robbers out of the pages of Dickens --ugh. I had no idea what
their qualifications were, or even what 'enbalming' was. Spraying with
fixative maybe? I didn't know. But the longer I looked into it and
studied the facts, the different things started to look. The plain fact
is that funeral directors are on average far more and far better trained
in surgical skills, much more experienced. Check it out:
http://www.nfda.org. But -- best of all -- they're *there*, on the spot,
virtually everywhere. I mean, let's face it: cryonics members and
organizations have a real problem: the vast majority of members just
don't live next door to a standby team. Hell, CI has members in Hungary,
Israel, Spain, Switzerland, Alaska. What do we do if they die? Let them
lie there while we gather up our merry band and pack our toothbrushes and
CPRs and catch a flight? What if something like this Trade Center
bombing happens and flights are cancelled or re-directed or put on hold?
Five *minutes* of warm ischemia can cause devastating damage. What do
you think *days* of it can cause? This is a problem that has to be
addressed. And the best solution we have, I believe, consists of using
funeral directors. They're surgically trained, they're licensed, they're
on the spot, they're used to dealing with hospitals and doctors, with
legal paperwork and transport, with grieving relatives -- they are, quite
simply, the best option that *most* of us have.
I am not saying that you *have* to go with that option. If you happen to
live in Phoenix and you have exactly ten days to live, fine: sign with
Alcor, and use their standby team. If you happen to live in the Detroit
area, fine: sign with CI, and use our standby team. But I think we
should all at least acknowledge that CI, in adopting its funeral director
policy, has adopted a serious and *reasoned* policy which certainly
deserves better than this 'witches brew' caricature that we are forever
getting. CI's policy here -- and elsewhere -- is a well-thought-out
response to an extremely serious problem that cryonicists face. And I
think CI's policy will in most cases reduce ischemic damage and in some
cases save entire lives. I think panning it, particularly in the
mean-spirited way of 'anonymous' posts, unproven accusations, and cartoon
slander, contributes absolutely nothing. No, I don't consider the
funeral director system to be ideal. Ideally, one day, cryo-trained
ambulance attendants will take patients to cryo-trained medical doctors
in cryo-ready hospitals where state-of-the-art procedures will be
performed in operating theatres. One day. But this is not that day.
Here, now, we are obliged to provide cryonics members with the best
treatment that we reasonably can under present-day real-life
circumstances. Trained professional funeral directors can provide it
quicker and better than distant, comparatively unskilled, comparatively
inexperienced volunteers.
And just suppose something. Suppose that, as CI expands, we find
ourselves one day in a situation where a CI funeral director -- a person
with surgical skills, cryonics-specific training, and perfusing equipment
and solutions at hand -- is standing there ready for an emergency in
every major city in the United States, perhaps even in Europe. Guess
what: it really might not be that far away. Would that be such a
tragedy? Maybe -- with a little better cooperation between organizations
-- it might prevent a tragedy. Maybe several.
David Pascal
http://www.cryonics.org
Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=17623