X-Message-Number: 23444 Date: Mon, 16 Feb 2004 18:34:14 -0500 (EST) From: Charles Platt <> Subject: Ben Best and ischemic injury References: <> I'm very glad that Ben Best is joining this discussion in a forthright and open way. I view this as a positive development. I should point out that although I am a member of Alcor, I have no special loyalties to any organization; I just want to see cryonics procedures implemented to minimize damage and maximize chances of recovery. Also I have no job title or other formal connection with Alcor at this time. > Message #23440 > From: > How can the results be evaluated? How do counts of > neurons, neuropil & synapses plus histological assays map to > preservation of personal identity & cognitive capacity? Where > damage is detected in the animals undergoing the protocol, > what damage is reparable by future science and what damage > is not reparable? I think we can all agree that no one can answer these questions. Therefore let us move on to the real issue: How should we respond to our own condition of ignorance? I see two general responses. Either we say, "We'd better do absolutely everything we can to minimize all forms of damage, because we don't know how important or how easily reversible any of it is." Or we can say, "Since we know so little, we can omit some cryonics procedures which are costly and difficult and may have marginal utility, in the knowledge that nanotechnology will be necessary for all cryonics patients anyway." Ben, are you aligning yourself with this second point of view? If so, we have a fundamental difference of orientation. This surprises me, because in your years in CryoCare, I thought you were very much aligned with the first point of view that I have expressed above. > science can repair or reconstruct. It seems prudent to > minimize damage, but damage can be difficult to quantify > and the costs of reduction may be high. I believe the cryonics organization has an ethical obligation at least to notify its members that the potential for extra damage reduction may exist. Then let the members decided whether they want to pay the extra cost. > There may be > thresholds of damage separating what future science can > repair and what it cannot. But the future is unlimited -- > what seems irreparable in 50 years may prove to be reparable > or replaceable in 100 years. This kind of statement, from my perspective, has been a problem in cryoncis from Day One. I don't think Ben is using it as an excuse to make minimal effort, but very often it _has_ been used that way, and I think that one of our tasks should be to try not to think in this way. Our goal should be to do the best possible job here and now--period. > I believe that this does prove > that CCR meds can reduce ischemic damage. But *how much* > benefit are anti-ischemic meds to a cryonics patient who has been > given immediate CPS & cooldown? If CPS & cooldown are effective > enough there should be *no* ischemic damage As I noted in a previous CryoNet message, the number of cryonics cases where instant cooling is possible has been relatively small--maybe one-third of all cases performed by organizations capable of standby work. So, we certainly cannot count on being able to administer rapid cooling. Also, even where cooling is possible, I believe no one would argue that it eliminates injury during a long transport. It merely delays the injury. Therefore, clearly (to me) meds should also be available as a standard item of equipment. > damage is irreparable. I believe that the ischemic damage > experienced during good CPS & cooldown would be easily > repaired. Again, good CPS and cooldown are not possible in the majority if cases; and the belief that ischemic injury "would be reasily repaired" is nothing more than a supposition. > Anti-ischemic meds do a great deal of psychological damage > -- possibly greatly outweighing the benefits. Local groups > have the potential to be invaluable in cryonics emergencies > -- for which traveling teams many miles away may not help. No > aspect of cryonics rescue intimidates potential local group > members more than anti-ischemic meds. I don't see any explanation or justification for this statement. If an IV line is in, almost anyone can administer the meds. If no intravenous access exists, people can still be trained to administer the meds. It isn't necessarily easy, but I watched an Alcor team member succeed on his first attempt, after training that was purely restricted to a mannikin, and during another case I listened to a paramedic give instructions over the phone which enabled a totally UNtrained person to give a series of injections, successfully, to someone who had arrested more than an hour previously and had virtually no blood pressure. Therefore I reject the assertion that administering meds is more difficult than any other aspect of standby work. > Local group members do > not know what to include in a homemade kit and cannot afford > to pay a huge fee for a pre-packaged one. Some of them certainly can afford to. And a complete meds kit should not be any more expensive than a complete portable ice bath, in my experience. > of the anti-ischemic benefit, local group members are left > feeling helpless & useless -- feeling if a traveling team > does not arrive there is nothing that can be done. This is why Alcor has offered to train local members. > and I am committed to improving CI services without raising > costs. Is there some philosophical or policy-based opposition to raising costs? If so, is this the real reason for de-emphasizing medications? What would be the harm in offering a separate extra-cost option for those who are willing to pay? > I am expecting significant advances in CI technology > in the near future and beyond. I believe cryonics will more > advance by Alcor & CI concentrating their energies on > improving service through different strategies than by > spending energy trying to destroy the other organization. The only people trying to destroy anything right now are outsiders who dislike the whole idea of cryonics. Once again I must emphasize I am not "patriotic" toward any one group. I have been an officer in CryoCare, an officer in Alcor, an officer and a director in the short-lived Kryos, and I have done work for Suspended Animation. All I want to see is the best possible treatment available for the largest number of people. I believe Ben shares these goals. What I do not know is the extent to which his answer must be limited by pre-existing policies such as those relating to cost. Is this, really, a funding issue, or is it purely a biological issue? --Charles Platt Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=23444