X-Message-Number: 5508
From: 
Date: Sun, 31 Dec 1995 02:17:29 -0500
Subject: comparisons & improvements

Brian Wowk (#5497), commenting on remarks of mine concerning the many
obscurities and difficulties in comparing various suspension procedures and
aspects of them,  says that it is better to use a cryoprotectant than not and
better to have good cardipulmonary support than not, and that there will be a
"world of difference" if  (among other things) the patient is given a full
spectrum of cerebro-protective medications.

Hours, days, or weeks could be spent dissecting such statements, which have a
degree of truth heavily dependent on context and assumptions. We do know, for
example (or at least it is strongly indicated by our Cryonics Institute
observations of sheep heads as well as human patients) that promptness of
cooling, washout and perfusion are more important than the details of the
procedure, within fairly broad limits. This means, for example, that a
funeral director nearby, even if limited in capabilities, may be of more use
than a team of M.D.s a continent or an ocean away--or perhaps even of more
use than a slow-reaction team of local volunteers. Again, we believe we can
(in due course) equip and train funeral directors to do any procedure anyone
else can do. (Well, Mike Darwin reports that Greg Fahy reports that only one
person in the world has the skill to use a certain patented rewarming
technique; but it seems unlikely that an effective procedure, once
established, will remain the exclusive province of a tiny number of
 unusually gifted people.)

As far as the differences in type of CPR or HLR machine is concerned, that
again is a very long story. Part of that story is that, in favorable
circumstances, one can get good circulation and oxygenation with such
machines as the Michigan Instruments thumper or even the old Westinghouse
thumper (both of which we have, among other things), as can be seen just by
noting the patient's color in various parts of the body.

Concerning burr holes in the skull to make observations during perfusion, we
don't need them for our human patients with present procedures. We already
know, from the sheep head work (with windows in the skull) and other indices,
that the brains do not show edema but rather shrinkage. (Whether this is
good, bad, or indifferent is again a long story with no sound-bite answer,
but it seems reasonably clear that a little shrinkage is better than edema,
since edema will produce intracranial pressure, especially during freezing.) 

Further, certain ostensibly "obvious" benefits are in fact not established.
All those medications Brian mentioned have, for the most part, NOT been
individually evaluated in the context of a suspension; they have merely been
hopefully adopted from clinical medicine on the theory that they might help
here too. Not all of the people experienced in hypothermia and cryothermia
believe all these medications have significant benefits--even if they cost
nothing. 

It is also true--although frequently overlooked--that if even the fanciest of
current procedures leaves damage making full-fledged nanotech or equivalent
necessary to reverse it, and if that nanotech will also be sufficient, then
nothing is gained  by the more elaborate procedure except the illusion of
improved odds (and maybe better PR and possibly better morale). Of course
this does not change the fact that even a small improvement, if it probably
occurs, should be utilized by those who can afford it; or that even a small
improvement could turn out to be a crucial one.

It is also undeniably true that, if you cannot afford the procedure, it is
totally useless to you as a prospective patient; and it is further undeniably
true that, if your organization cannot keep you frozen, then the manner of
your freezing will not matter. How much trade-off is desirable between
financial reserves (or other uses of money) and incremental but expensive
putative advantages? 

None of this is to denigrate the efforts of Alcor, BioPreservation, BioTime,
Trans Time and others (including CI and ACS) to provide the best suspensions
of which we are capable, and to expand those capabilities. As I have said
many times, Cryonics Institute will offer (if necessary as a higher priced
option) any and every procedure that we are convinced offers clear-cut
advantages, as soon as we have this conviction and capability; and we will
work with others to try to clarify the questions. I hope before the end of
1996 that we will have made substantial progress in attaining a consensus on
the kinds and degree of damage done (or avoided) by each feature of each
procedure, present and upcoming. 

As far as I know or recall, Cryonics Institute was first to demonstrate, and
to have independently verified, a procedure that produces no cracking. There
is also evidence that microscopic damage may be less with recent procedures
of BioTime or/and BioPreservation or/and Alcor. We all know of the ongoing
efforts of Greg Fahy on vitrification; and we have all seen the newspaper and
magazine reports (mentioned months ago on Cryonet by Anatole Dolinoff) of
alleged full recovery of hearts after liquid nitrogen storage in South
Africa; and armchair observers such as Doug Skrecky and Yvan Bozzonetti are
constantly making suggestions, some of which may prove to have merit. More
power to all of them, Omega Point bless them. A certain amount of competition
is going to persist, and not everyone will love everyone equally, but it
seems fairly clear that we are generally on the path of reduced friction and
better cooperation, and I think this can be sustained and improved.

Robert Ettinger
Cryonics Institute  


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