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

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