X-Message-Number: 3737
Date: 24 Jan 95 00:29:54 EST
From: Mike Darwin <>
Subject: CRYONICS More response to Ettinger

Bob says:

>What we do not have, that Alcor and BioPreservation may have, is a traveling
>team to do the work on-site. This is a matter of personnel and expense. But
>it is SELDOM possible for members at a distance to get prompt service from
>ANYONE in case of death with little warning. (Even when there is warning, the
>time estimates are usually so uncertain that the expense of a traveling-team
>standby is prohibitive. It is also easy to have foul-ups in travel
>arrangements, as recent history attests.

This is all completely true.  The problem here isn't what  Bob *says* above, it
is what he DOESN'T say.  I will summarizer as follows:

1) At least 80% of all deaths are slow and give warning.

2) The technology to predict WHEN (more precisely) legal death will occur is
advancing quite rapidly here at BPI; this will reduce standby costs.

3) Many patients have benefitted from a standby team in both the ACS and Alcor
experience (others could have benefitted had their cryonics organization been
equipped and ready (I know of at least three patients in the past in the Bay

Area where the was warning of SEVERAL HOURS of impending death and no action was
taken).  In the case of ACS (recently) and Alcor in the past and present (AT
LEAST 17 of Alcor's current 28(?)) patients had a team at the bedside either
before or at the time of cardiac arrest.  In Alcor's case if we include a team
on-site within minutes of cardiac arrest then I know of two addition cases.
Even excluding the two cases where the team arrived AFTER the arrest this is
about 60% of the Alcor patient population.  An excellent record! Granted, not
80%, but close!

I have done three cryopreservations for ACS.  One was a suicide/coroner's case
in which case there was little we could do immediately, although we had
personnel on site the MOMENT the patient became available (to pack her head in

The second case was sudden death and here again we had personnel on-site quickly
with good cooperation from the nursing home; the perfusion went very well.  And
the first case was Jerry White where we stood by and started within a minute or
two, or less, of cardiac arrest.

4) What I find irritating and seemingly unfair about Bob's remarks (although I
realize that this may not have been his intention) are the following remarks
from Bob:

>The conclusion that traveling teams are NOT the answer is shared by at least
>some who are close to Mike, including Mr. Mugler's group in the Washing DC
>area, who want to equip and train local volunteers. For anyone living in a
>city, local help will usually be better--both in effectiveness and
>expense--than traveling teams.

I find these remarks irritating because it was none other than Mike Darwinin
early and mid 80's, in the face of significant internal and external criticism

who put equipment LOCALLY and trained people to use it!  In fact as early as the
mid '80's I had kits in New York, Indiana, Northern California and Florida and

regularly conducted training sessions.  In fact, I wrote the book (literally) on
how to do field transports and train and deploy equipment LOCALLY for them.  In
fact, the first edition with the red cover of Transport Protocol for Cryonic
Suspension of humans is copyrighted 1986!

During this period when I was buying and equipping local grous with few members
in the area they were deployed I was harshly criticized by some in Alcor at the
time and scorned by some outside Alcor.

5) I have spoken to Mark Mugler a few time by phone and received one letter from
him.  I do not consider myself close to him or even that I know him very well,
ditto for the rest of the DC group whom I've met once (with one or two

6) I have consistently supported  (over the last 5 years) local training and
stand willing and able to train morticians to due in-field washouts (without
introducing air) using simple equipment.  In fact, in a case with a human and

two others with  wih animals (pets) I have guided morticiand step by step on the
phone once: in Australia for hours.

7) No one is denying the effectiveness of local groups and I am still working
hard to that end.  Naonmi Reynolds drives around with a minikit, Thumper and

oxygen at all times.  ACS has purchased a complete local/remote standby kit, and
I am in the process of placing kits in Canada, with sandra Russell in San
Francisco, and on the Eastern Seaboard in the US.

8) Having said this, I still believe there is a place for the travelling
transport team where it is: a) logistically possible and b) financially
possible.  One unmentioned advantage of these "central teams" is that they
usually incorporate local people: for instance I use Jim and Naomi (ACS and
Alcor members respectively. in remote standby setiings).  Each time they do one
of these they gain EXPERIENCE, KNOWLEDGE and SELF CONFIDENCE.  This makes them
better able to act when a sudden local emeergency occurs and it is not possible
to bring in the "big guns".

9) Centrally (travelling team) organized standbys have another feature which is
of acute interest to me and of I believe great benefit to cryonics as a whole:

a) They allow tremendous data collection about the agonal process which adds to
our database allowing more meaningful predictions of when cardiac arrest will

b) They allow in-field research in terms of data gathering on how the patient
responds to the interventions being used and thus if they are worthwhile and
cost effective.  In fact, it was precisely BECAUSE I did so many standby's that

I came to invent the Portable Ice Bath which nearly triples patient cooling rate
over ice in bags.  Further, it was in-field observations about the
ineffectiveness of CPR that lead to our use first of HI impulse CPR and now
combined HI CPR and Active Decompression CPR -- in fact it was due to our work
in this area that CI indirectly *got its Ambu CardioPump for ACD-CPR!*

c) They allow a higher standard of care for many patients.  A patient who starts
to wake-up on support (postmortem) clearly has suffered no ischemic injury and
is in better shape than one who has hours of down time even packed ice.

10) The cooling rates (which you acknowledge are very important) for patients in

the absence of STIRRED ICE WATER IMMERSION *and* effective blood circulation are
extremely slow.  This problem was uncovered during in-field standbys where

people with more than the basic skills were able to gather data and document the
patient care.  A local (untrained) mortician will be of no use there.  Just

packing a patient in bags of ice with typical ineffective CPR it will take about

*8 hours* for brain core temperature to fall below 20xC (room temperature).  You
wouldn'd eat potato salad left out at that temperature for that long!  And
again, as I've pointed out to Bob before, cryonics patients are NOT cold water
drowing victims.  They do NOT have beating hearts, they perfuse poorly with CPR
and the often have had pre death (agonal) shock which further compromises heat

The take home message here: BOTH kinds of team are useful.  I plan to put
full-fledged washout kits and minikits in as many places as I can, and to train
as many good people as I can.  Morticians included.

Finally, I would like to see the colling curve rom death to ice temperatures on
ANY of CI patients.  Just post the raw data.

Mike Darwin

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