X-Message-Number: 279 Date: 18 Feb 91 02:10:25 EST From: Steve Bridge <> To: KEVIN <> Subject: Cheap Freeze Evaluation Message-Id: <"910218071025 72320.1642 EHI22-1"@CompuServe.COM> TO: Kevin 2-18-91 Detailed Commentary on Cheap Freeze Approach By Steve Bridge, Midwest Coordinator Alcor Life Extension Foundation In October, 1990, Richard Schroeppel proposed a "home storage" option for cryonics, which he believed would allow families to place their relatives into cryonic suspension and to maintain them in their garages or spare rooms at a fraction of the cost required by Alcor. The objections to this proposal by Ralph Merkle, Brian Wowk, Thomas Donaldson, Keith Henson, and Steve Harris were accurate as far as they went; but, oddly enough, everyone appeared to accept his basic argument that home storage would in fact be CHEAPER. After looking at this approach for quite a while, and discussing price estimates with Mike Darwin of Alcor, it seems obvious to me that Richard's entire plan is based on several false premises of cost. Maintenance of individual patients in private homes would be much more expensive than at Alcor, and it seems likely that the upfront costs would be at least as expensive, even without perfusion. I give cost estimates in the discussion following, plus some other comments I have on Richard's proposal. I do not wish to argue this proposal indefinitely nor to put Richard through public embarrassment. However, ideas like this surface every few years, and better answers are required. Other newcomers to cryonics may learn quite a bit from studying this issue. To begin with the essential point: In his first proposal, Richard assumes that: "The can will cost a couple of thousand dollars; the suspension another thousand. We offer to buy back the can for the first three months, so people feel they can change their minds. It's cheap enough that almost anyone faced with a dying parent or the surprise death of a spouse or child can make the decision to freeze instantly. They can pick up the phone, call Cheap Freeze, and charge the suspension on MasterCard. The truck zips over to the victim's house or hospital room and starts the cooling; we come back in a day or so with the can, and arrange payment or credit. The victim's body remains in the possession of the relatives, who are responsible for topping up the LN2 every couple of months. We tell him where to buy LN2, or we make deliveries occasionally. This costs maybe a hundred dollars a year." OK, Richard, let's examine this. (Figures to follow are from "The Cost of Cryonics" by Mike Darwin, in the August, 1990 issue of CRYONICS Magazine.) Right now, Alcor must pay $13,000 for its two-patient (whole body) dewars and $18,000 for its four-patient dewars. A specialized one- patient tank will not cost simply half the cost of a two-patient unit. Certain basic costs are intrinsic in starting up production, and it seems very likely these units could not be produced for under $8,000. Perhaps a production schedule of 100 tanks per year would drop that cost somewhat, but not to $2,000. Besides, it is the FIRST people to do this at home that you are interested in. If it doesn't become fairly easy to do for the first people, there will be no way to get the economies of scale later. No one will be the first. Perhaps you could devise a more cheaply made tank, but that would decrease safety and increase liquid nitrogen boil-off rates (more on that to come). These tanks must be STAND-UP models, around 8' tall. Lay-down models have terrible disadvantages. Primarily, the horizontal units have to be sealed units, with a valve for boil-off, or the nitrogen pours out on the floor. Also, having the nitrogen in contact with some kind of unsealed lid increases the boil-off. "So," you say, "what's the problem? Just seal it." Unfortunately, every known sort of dewar capable of storing liquid nitrogen develops vacuum failure within 20-25 years. (A more cheaply-made tank would be expected to fail sooner.) These storage tanks are made like a Thermos bottle, with a vacuum between the inner and outer stainless steel cylinders. The vacuum is what prevents heat transfer. When the vacuum weakens or disappears altogether, the boil-off rate approximates that of an open pail of LN2, which is pretty useless. You would have a difficult time getting nitrogen fast enough to keep the tank full. So the patient must be removed from the tank and placed in another one -- within 30-40 minutes, or the patient's temperature starts to rise, and one thing we are VERY sure of through research is that temperature fluctuations, even where the subject stays frozen, are extremely damaging to tissue. Removing the end of a sealed tank requires that 1) you allow the nitrogen to boil-off below the level of the neck-tube and 2) you use a welding torch to cut off the end of the tank. Imagine how THAT temperature fluctuation is going to affect the patient. In fact, Alcor is currently working on a plan to do exactly that with the one ancient lay-down tank we have, in order to transfer the patient to a regular standup model. The preparations required to protect the patient are agonizing, and it will still be dangerous. So let us say you agree to the stand-up model. A back-up is needed. A cryonics organization can solve this by having a spare dewar always available for patient transfer, so the original dewar could be repaired. Having two dewars available puts the cost up to $16,000. Sure, several families could go together on a back-up (after several nearby families have frozen relatives -- these things are not easy to transport great distances). Or the cryonics organization you propose could have extras available. But either option increases the required costs and complications. An 8" tall tank filled with LN2 weighs around a ton. You want to keep this in a spare-bedroom? Even the smaller weight of water beds can damage floors in some homes. Besides, you need a way to get that patient out of the tank. The only way Alcor has found to do this safely is to have the patient tied to a specialized tray in the tank, and use a winch to hoist the tray and patient out of the tank, move the tank out of the way (a three person job, even with good casters), move the other tank in, and slide the patient in. For this you need a ceiling space of about 20-25 feet, or a skylight with a framework on top. How many people's garages even have an 8' high door? How much more would putting in a skylight, winch, and frame add to the cost of the suspension? And to be used only once every couple of decades? (although it would also make the tank filling easier). Even having enough space to remove the lid and fill the tank requires at least four feet above the height of the dewar. A 12' ceiling in a garage will require a lot of remodeling. Bob Ettinger at Cryonics Institute in Michigan has developed semi- vacuum units of reinforced foam; but even these are about 12 feet long and 8 feet wide. And the technology is not currently readily available like the vacuum dewars are. It gets even more complicated. Liquid nitrogen is dangerous stuff. Several people a year die or are severely injured from mishandling of it. If it is kept in a poorly ventilated room, in some weather conditions it can displace the oxygen, causing people to asphyxiate. This is especially true in case of a spill in such a room or vehicle. LN2 in a sealed container will build up pressure and explode. A University of Alabama chemistry student was blinded last year fooling around with LN2 in a capped soft drink bottle. Are you going to have children around the garage? Of course, spilled LN2 can kill or injure though direct freezing injury. And it is possible to just fall into the tank while examining it or filling it. If many untrained people were handling liquid nitrogen, a number of them will get killed or maimed, creating monstrous public relations and liability problems for your group. This is why it is illegal to deliver LN2 and many other sealed gases to private homes in California. I don't know about other states, but a few colorful accidents like this would give regulators good reason to shut off delivery there, too. The individuals would probably have to buy their own delivery tank (another few thousand dollars) and pick up their own LN2, which is probably illegal in many states, too. Even if a way could be found to convince the government to allow this, and even if a nitrogen supplier could be persuaded to deliver such small amounts to individuals, the cost of LN2 alone would be much more than the $100.00 per year that Richard suggests. Even Alcor's LN2 cost for a whole body patient in a two-person unit right now is $821 per year. Alcor buys enough LN2 that they only have to pay 29 cents a liter. An individual would have to pay at least $1.50 per liter -- FIVE TIMES GREATER. That gives us a nitrogen cost of $4,100 per year, and even that assumes the best possible dewars. That does not include the delivery charges, the cost of the filling apparatus itself, the alarms on the tanks (which are an ongoing expense, since you need a telephone service to respond to the alarm), or liability insurance to protect against accidents to visitors (if an insurance company could even be found which WOULD write such insurance. More likely they would refuse you ANY fire or liability insurance on your home at all). Let's also not forget that the initial amount of liquid nitrogen necessary to lower a single whole body down to -320 F and to fill the tank the first time is at least 400 liters (Alcor requires 850 liters for cooldown of one patient in the two patient tank, so I'm not absolutely sure how the numbers translate) = $600.00. Now let's move to the dry ice costs. You need a large insulated box for the patient. Alcor places the patient in silicone fluid and adds the dry ice to that. This is very efficient and allows for cooldown to -110 C in less than one day. Let's assume that your home freezers won't use the silicone, which is fairly expensive, so they might get away with a modified casket liner. (Your suggestion for a wooden box filled with alcohol would be immediately nixed by the local fire department. Talk about an expensive cremation, not to mention burning down the house! That hazard is why Alcor hasn't used an alcohol bath for many years.) Say $500.00 cost for the box construction, an expense which could be shared among many users. Let's call it a $100.00 charge for rental and delivery. Don't forget, your company will need several of these. Without silicone or other heat transfer medium, the cooling will go more slowly, probably at least three days. In practicality, many or most patients will probably be on dry ice for more than a week, as the family makes the other necessary arrangements and decides whether they want to pursue this situation further. Alcor estimates costs of $147.00 for enough dry ice for cooldown in silicone. This does not work out to $147 per day for subsequent days, since the dry ice usage will go down after the patient's temperature has been reduced all of the way. But let us estimate probably $300 for dry ice for the first three days (in the less efficient cooling system) and $25 a day after that: $400.00 for the first week. Now, what is going to be the charge from your company for the labor and advice of your people? It cannot be all volunteer. Someone has to be full time to coordinate, advertise, answer phones. Oh, yes, you have phone expenses, beeper expenses, building rental or ownership to store all of those boxes, tanks, trays, and other equipment you will have to store to sell people. How about postage, copying, FAX, printing, maintenance expenses, incorporation fees, legal expenses (no, you can't do a quickie incorporation on this kind of business. You will have unique liabilities that several attorneys are going to scratch their heads over, even if you do manage to avoid having a contract with the family.). How about your upfront engineering and inventory costs? As a simple example, engineering for the patient trays alone took 6 different prototypes, and each one currently requires 2 full work days to make. Economies of scale only occur after popularity, remember. I estimate several hundred thousand in start-up costs, plus some unknown figure of over $100,000 per year in expenses. Isn't real life fun? You estimate that "we could start immediately and be on-line in six months." Haven't started any businesses, have you, Richard? One couldn't start such an organization in 6 months with the best lawyers in the world. There are too many new problems to be worked out. If you DO try to avoid the attorneys in the set-up, better have a few million in the bank for PERSONAL liability claims, just in case a judge later decides that you are not properly incorporated. Up-front expenses for one patient: Patient dewar $ 8,000 Backup dewar share 2,000 Building remodel 5,000 Sleeping bag, gloves, ice, other misc. expenses 500 Dry ice (1 week) 400 Dry ice box share 100 1st cool and fill 600 Alarms, fill app. 300 LN2 storage tank 2,000 Cryo company charge ??? Subtotal up-front $18,900 + On-going annual charges: Liquid nitrogen $ 4,100 Alarm charges 200 Subtotal annual $ 4,300 TOTAL FIRST YEAR $23,200 + At this rate, it only takes *** 18 YEARS *** to spend $100,000. I have a $100,000 insurance policy for which I pay $60.00 per month. I can stop payments on it after 10 years and still have $100,000 in permanent insurance. Now, who is saving money? That covers the financial aspect; but I want to make a few other comments, too. What Steve Harris said about the illegality of keeping human remains at home is crucial to understand. It has taken hundreds of thousands of dollars in legal expenses to get ALCOR the legal (and still uncertain) right to maintain these frozen patients. This victory, should it become complete, will not automatically be extended to just anyone with a large garage. Then there is the problem of long-term care. Cryonics is all about continuity over a long period of time. Families are no longer continuous. My four cousins, all raised near Indianapolis, are now in Chicago, Houston, Wyoming, and Indianapolis. And this family is emotionally very CLOSE. 50% or more of American families with children include at least one divorced parent. Extending this to grandchildren is very speculative. It is much more likely that a solid organization will survive than a family. What happens when a family wants to go on vacation or has to spend time out of town with another dying relative? It is not so easy to find dependable neighbors and friends to check on Gramps. One New York cryonicist had a professional cryogenics crew checking on his wife's dewar while he was out of town. They damaged the tank, lost vacuum, and eventually the wife thawed out. Another consideration: who is going to pick up the patient from the hospital or nursing home? Who is going to file the death certificate? Who is going to remove the patient's clothes, clean him up, wrap him in the sleeping bag (or whatever); and after the patient has gotten down to dry ice temperature, who will put him in the tank, fill the tank, and train people to care for the tank and patient? Usually these various tasks are done by the mortician and the cryonics company. Everything that will still be done by a mortician or cryonics organization will result in additional costs that must be paid for by somebody. Everything that the family does will be a new experience that someone will have to help them with. Could you do any of these things without special training? The question of handling the remains is especially troubling. A century ago, many American families, especially in rural areas, still cared for their own dead. They sat with the family member while he died, washed and clothed the body, organized the wake, built the casket, and dug the grave. For most people today, death is a sterile event. Patients die in hospitals and nursing homes, whereupon death specialists take over. EMT's, nurses, orderlies, morticians, and cryonics technicians do all of the touching, cleaning, and clothing. Grandpa doesn't look too good after cancer, pneumonia, heart disease, kidney failure, and liver failure. He won't be much fun to handle, especially if the family member is at all dubious that this person is still savable. How about a patient who is a bloody, mutilated mess after death in an auto accident? Or one who is decapitated in an accident? Think about the emotional load for the family if the patient was murdered? (Not to mention the sensitive negotiations that must take place with the coroner to prevent further mutilation!) What if Grandpa died of AIDS, or septicemia, or some even more nasty communicable disease? Do you see why this is both a question of public health and of mental health? I can certainly understand why relatives would be dubious about taking on this kind of responsibility. I have met only a handful of families even willing to HELP ALCOR with the suspensions. Read about the Donovan family's work with Alcor to get their father suspended (reprint from CRYONICS magazine available from Alcor). It took them 6 months of work and arrangements to pull off that suspension, with Alcor and me working with them all the way. They participated in every step, including the surgery in California. But do I think they would have been willing to freeze and store their father at home? No. And this was the most committed family I can imagine. You seem to assume that an organization which merely sells the equipment and advice to the relatives would somehow be immune from the lawsuits which would trouble "a controversial organization with ... an identifiable lump of money." Wrong. If you sell the tank or give advice, you could be found liable for various types of failures. And as many of my friends have discovered, you can be sued for anything. It can cost thousands of dollars just to have your name removed from a lawsuit that you are not even rationally connected with. Several people have commented on the issue of viability, and I agree with them. Cheap plans which do not result in saving the individual are a bigger waste of money than procedures which may later be shown to do too much. The issue is saving the individual. In a later reply to Brian Wowk, Richard, you miss the point when you say that "Both cases that Brian Wowk refers to (Cryo Soc New York & Cryo Soc California) were organizational failures, where the whole thing failed at once." This is simply not true. The point is that both organizations depended entirely on payments from relatives to keep patients in suspension. After a few years, the relatives were no longer interested in making the payments. CSNY slowly died from lack of payments and eventually lack of interest; it was not "corrupt." Financially, the CSC situation was only slightly different. While some fraud was possibly involved, the big problem was apathy on the part of the relatives. NONE chose even to visit the organization to check on the suspensions. Most slowly stopped making payments over the years. Finally, Richard, you suggest that Alcor or other cryonics companies might be willing to help set up something like this or to sell or give technology developments to such an organization. I think this is unlikely. Most or all of these organizations will see this as a proposition which is likely to fail. It will likely fail for many individuals, bringing emotional stress (and lawsuits). Some suspensions will likely fail in spectacular and grisly ways, killing or injuring family members or endangering the public health. This will result in restrictive legislation which may harm all of the cryonics organizations. And there is, of course, the pride in doing the job right, which I expect from my own organization, at least, and have a right to expect from the others. Yes, cryonics does fly in the face of history in some ways; but that does not mean IGNORANCE of history. The old saw about "those who do not read history are doomed to repeat it" is no less true for being old. Cryonics today is run the way it is precisely because of evolution. Bad ideas did not survive. There are no doubt many bad ideas still part of our systems which will eventually be dropped; with luck and careful attention on our part, they will not kill the organizations, too. Attempting to revive bad ideas will only lead to more failures. We do need new ideas, of course, and we hope that, as you learn more about what is already being done in cryonics, you will be one of the people providing new ideas. Don't give up on having ideas; but don't forget to ask questions first. And be prepared for pretty stiff arguments even when you are right. Steve Bridge Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=279