A fictional piece by Ben Best

I have tried to live a healthy and safe life in hope that rejuvenation would become available soon. But I made cryonics arrangements in case it did not.

I feared dying in my sleep or in an automobile accident. But I have gotten an aggressive form of cancer that has spread throughout my body, including to my brain, and it cannot be stopped.  My lungs are also cancerous, which means that I am now on a ventilator to keep me breathing and alive.

I have made the decision to terminate my current life before the cancer destroys too much of my brain. I will give a hand signal to have the ventilator removed.

I am in a hospice where a standby team has been assembled. The stabilization equipment is in place, and the team is ready to quickly respond as soon as I give the hand signal. A physician will be on hand to rapidly pronounce death. My power of attorney for health care is here in case I lack the power to give the hand signal.

My friends and relatives are here too. They come and say goodbye with hugs and kisses. Letting go of life is not easy. Some of my friends and family are begging me to cling to life for as long as I can. But if I do so, I will slowly disappear as the cancer destroys my brain. Possibly a miracle cure will be discovered within a few months, but that is very unlikely.

If I give the hand signal to remove the ventilator, will it be like holding a gun to my head and pulling the trigger?

How much time would it be before revival? 25 years? 50 years? 100 years? Longer? Never?

What could happen in that time?

Destruction of my liquid nitrogen container by a terrorist?

A nuclear war?

An asteroid hitting the planet?

A worldwide pandemic that destroys cryonics?

Mismanagement, lawsuits, or bitter infighting that destroys cryonics organizations?

Government action due to political pressure that destroys cryonics organizations?

Failure of cryonics technology to revive?

Several more months of life might be the last opportunity to enjoy friends, family, and all the things I love about life. I hate being in this position. My life does not go before my eyes, there is only fear and doubt. I do not want to die. I do not want my life to end.

I give the hand signal.  Consciousness stops. 

Cryonics returns to its New York roots on November 23 when Alcor New York organizes its first Alcor New York Symposium. Attend the most ambitious cryonics event in NYC in decades and learn about brain cryopreservation, molecular repair, and rejuvenation biotechnologies.

This symposium will feature 3 presentations by staff of Advanced Neural Biosciences about its neural cryobiology, revival, and deep learning research.

There are only a few tickets left. Register using the link below:

https://1stalcornewyorksymposium.splashthat.com/

Speakers announced so far:

Dr. Pedro Magalhaes – Will We Cure Aging in My Lifetime?

People have always sought eternal life and everlasting youth. Recent technological breakthroughs, and our growing understanding of ageing, have given strength to the idea that a cure for human ageing can eventually be developed. Hundreds of genes are now known to regulate ageing in model organisms and can increase longevity by up to 10 fold and retard the process of ageing as a whole in animals. In addition, a large number of potential longevity-extending drugs already exist. Studies of species with exceptional longevity or disease resistance, like naked mole rats that are resistant to cancer or bowhead whales that live over 200 years, may also help treat and prevent human diseases. Here, I will discuss recent advances in longevity science and human applications on the horizon. The scientific prospects of eradicating human ageing within the foreseeable future will also be discussed.

Dr. Regina R. Monaco – Low-Dose Pharmacological Interventions to Facilitate Healthy Aging – Reduction of Cancer Risk

As we grow in our understanding of aging as a series of biochemical pathways and systems undergoing programmed entropic degradations, which may be reversed, re-entrained, stabilized, minimized, maximized, turned off or on, or otherwise healthfully intervened in, we gain more and more tools to assist this process to maintain a healthful equilibrium. One important intervention to extend healthy life span is to use pharmaceuticals or neutraceuticals to reduce your probability of having cancer.

In this talk I present and discuss several low dose pharmacological interventions which have been shown to have strong ant-cancer properties, we well as some other benefits such as reduction of chronic inflammation. I will review the mechanisims and anti-cancer benefits of low-dose therapy of the pharmaceuticals metformin, naltrexone, aspirin, and for women, tamoxifen (breast cancer). I will also discuss benefits of targeting and inducing apoptosis (killing) to remove a percentage of senescent cells using rapamycin, and neutraceuticals fisetin, and quercitin, with or without dasatinab.

Ben Best – NAD+ Restoration and Senolytic Therapy

Ben Best has subjected himself to two age reversal therapies: (1) senolytic therapy (therapy to eliminate senescent cells using dasatinib and quercetin) and (2) NAD+ infusions (to restore NAD+ to youthful levels). He has also attended several conferences dealing with these subjects as well as studied and written about them, the results of which he will provide in his presentation.

Chana Phaedra – An Introduction to Brain Preservation Optimization

Vitrification has the advantage that it does not need different cryoprotectant protocols for different cell- and tissue types. Vitrification of the brain does presents two distinct challenges: low tolerance to ischemia and poor blood-brain barrier permeability of cryoprotectants. In this presentation I will review the history of brain cryopreservation, the status of brain cryopreservation research, and future directions.

Aschwin de Wolf – Revival of “Straight Frozen” Patients

Freezing of the brain without cryoprotectant (a “straight freeze”) is considered the worst cryopreservation scenario but there is a paucity of ultrastructural evidence how the straight frozen brain actually looks like. Aschwin de Wolf will review electron micrographs of the straight frozen brain (under a variety of conditions) and will discuss how “medical cryobots” will prepare the brain for molecular repair and infer the original non-frozen state from the damaged state.

Michael Benjamin – Alcor Meta-Analysis

Several attempts have been made to create quantitative case outcome methodologies in cryonics. Advanced Neural Biosciences has embarked on a comprehensive meta-analysis of all Alcor patient cases, an endeavor whose goal is to develop, experimentally validate, and refine a quantitative cryopreservation evaluation methodology. Michael will be presenting some preliminary statistics gathered during Phase 1 of the study so far.

Dr. Ralf Spindler – Functional evaluation of brain preservation protocols

Currently, reversible vitrification of whole brains is limited by neurotoxicity of the very concentrated vitrification solutions involved. Here, an automated assay is described which has proven to quantify synaptic connections in live-cell neuronal networks by a high-content confocal imaging method. Since it is known that synaptodentritic damage, especially the decrease in number of synaptic connections, correlates with cognitive decline the assay could be used to evaluate brain preservation protocols.

Dr. Roman Bauer – Computational Biology Methods for Tissue Cryopreservation

In contrast to most other biomedical fields, tissue cryopreservation has remained relatively untouched by computational techniques. State-of-the-art cryopreservation still predominantly relies on trial-and-error and large numbers of experiments for the determination of protocol parameters. Roman Bauer will review milestones in computational and mathematical work towards better cryopreservation protocols, and will discuss how he sees future automated cryopreservation technologies maximize post-thaw tissue quality.

Dr. Emil Kendziorra – Professionalization and Scaling of Medical Biostasis

With only a few thousand members world-wide, medical biostasis has stayed a very small field, albeit being around for decades. In Europe the topic has been even more niche. The EBF (European Biostasis Foundation) based in Switzerland, has recently set out to fundamentally change this situation with four main areas of activity – sign up / stand-by, storage, research and long-term asset management. Emil Kendziorra will present the core activities to professionalize medical biostasis and scale the field.

Dr. Robin Hanson – Hidden Motives Help Explain Why Cryonics Isn’t Popular

The usual pro-cryonics argument frames it as medicine, to be evaluated in terms of its technical ability to prolong life. However, though they are unaware of it, for most people medicine is more about showing that they care than about prolonging life. Robin Hanson reviews the evidence that many big areas of life are driven by hidden motives quite different from what people usually say, and then tries to apply this insight to help us understand why so few people actually choose cryonics.

Biostasis.com is the world’s largest independent website about cryonics and medical human biostasis.

In 2007 Aschwin de Wolf launched the cryonics blog Depressed Metabolism, the first professional blog to exclusively cover the science and practice of cryonics. Out of this platform emerged The Institute for Evidence-Based Cryonics (2008-2018), a non-profit aimed at educating the general public about cryonics. The Institute organized a number of groundbreaking symposiums on cryonics and dementia and cryonics revival scenarios. The Evidence-Based Cryonics Institute website also became the official host of the Scientist’s Open Letter on Cryonics and engaged in several campaigns to draw attention to recent breakthroughs in brain cryopreservation.

Biostasis continues the journey that started with Depressed Metabolism and the Institute for Evidence-Based Cryonics. Its goal remains to educate the general public about cryonics and human biostasis in all its aspects. We will keep publishing new content and historical documents relating to cryonics and remain the official host of the Scientist’s Open Letter on Cryonics. This year we will also announce the publication of the first detailed medical human biostasis protocol that will allow hospitals to educate themselves about offering cryonics as an elective medical procedure. In 2019 we will also announce a series of initiatives to study the theoretical aspects of conducting cell repairs at low-temperatures, or medical cryobotics.

All entries from the depressed metabolism and evidence-based cryonics website remain available on the biostasis website. Please update your links and spread the word about biostasis.com.

The enemies of a good cryonics case are time and temperature. Deployment of a standby team that can start rapid cooling upon circulatory arrest should take care of the temperature challenge. The time element is more challenging. Even if a patient is stabilized rapidly after pronouncement of legal death, logistical and legal challenges can interfere with timely transport to Alcor for subsequent procedures. For example, if a patient is rapidly cooled down in North Dakota but logistical challenges and flight schedules prevent arrival of the patient at Alcor until several days later, the patient will still be subjected to progressive deterioration of the fine structure of the brain, breakdown of the blood brain barrier, swelling, and a number of processes that prevent smooth cryoprotection of the brain, or even necessitate a “straight freeze” (cryopreservation without a cryoprotectant). How should Alcor deal with the challenge of having only one physical location in Arizona but being responsible for members all over the world?

The most obvious solution is for a terminal member to move to Alcor. In almost all cases this is the preferred solution because this prevents several potential logistical, legal, and technical challenges. The advantages of moving to Alcor are so great for both the cryonics organization and the patient that Alcor offers up to $10,000 in relocation assistance. To further incentivize such a choice, Alcor could consider further increasing the amount of relocation assistance and/or actively assist older and sick members to consider relocating.

Another solution is to bring all major Alcor procedures to the location of the patient. This is easier said than done. Whereas a patient relocation does not require major expenditures and logistical decisions on the part of Alcor, bringing cryoprotection to the patient is a non-trivial task because it entails performing Alcor’s operating room procedures at a remote location. In practice, this can be done, and Alcor has cautiously authorized “field cryoprotection” for overseas and selected US cases. In principle field cryoprotection is possible for both neuro-patients and whole body patients but true whole body field cryoprotection would require the creation of an adequately equipped vehicle or satellite facility, not to speak of medical expertise. Recognition of the fact that many Alcor members do not relocate when terminally ill, and potential cost savings, have prompted some Alcor officials to advocate expanding field cryoprotection to more members.

Since it is obviously easier to bring a patient to a hospital than a hospital to a patient, more effort will need to be spent in educating members of the advantages of timely relocation to the Scottsdale area.

There might be one route to bringing the hospital to the patient and that is to encourage the creation of several of “cryonics hubs” in areas with large numbers of Alcor members. Support and recognition from Alcor for such initiatives is necessary but a decentralized approach could be effective here. Local members can start with creating a cryonics infrastructure to assist professional standby teams. Such efforts can include maintaining a list of pertinent local regulations, cooperating funeral homes, local volunteers and medical professionals, and flight schedules. A more ambitious step would be to equip certain areas with a local rescue vehicle, as was done in the past in Southern California. A more ambitious step would be to equip such a vehicle for field cryoprotection or even set up such facilities in a cooperating funeral home or building. This is a formidable task that would require many hours of work and considerable expenses but it would produce a more robust response infrastructure for Alcor to utilize. It could also make some areas less vulnerable to episodes of deteriorating response capabilities at Alcor. Last but not least, bringing people together to engage in such a project will also tighten the social fabric and local visibility of cryonics.

Originally published as a column in Cryonics magazine, November – December, 2018

Cryonics has limited appeal but cryonics organizations have assumed global responsibility to cryopreserve their members timely and competently. A hybrid model in which local members and volunteers work together with medical staff members and contractors to deliver the best possible cryonics care is the best answer to this situation. Taking Alcor as an example, what does this model entail in terms of infrastructure and staffing?

The most important response mandate of a cryonics organization is to ensure competent local response capabilities through full-time employment of medical professionals and cryonics experts at the facility. Unlike remote response capabilities, Alcor’s response to local cases should not be dependent on erratic, case-by-case, contracting with local medical professionals. While such professionals can supplement Alcor’s own capabilities, Alcor should never find itself in a situation where it cannot deploy an effective standby due to a shortage of available staff members. This mandate requires that Alcor’s staffing policy cannot be allowed to outcrowd its local response capabilities. In practice, this means having at least three staff members available for local case work with at least two of them being proficient (and preferably certified) in conducting medical procedures that are elemental to cryonics stabilization (placing IV lines, placing an endotracheal tube etc.).

A strong mandate to primarily deliver state-of-the-art care in the Scottsdale area may look rather meager in light of its global responsibilities, but considering the fact most Alcor members do not die suddenly, and are eligible for an attractive Alcor relocation-reimbursement, out-of-state cases may increasingly be seen as reflecting choices made by Alcor members, as opposed to inevitable events happening to them. The significantly higher costs, and potential logistical and legal complications, of out-of-state cases are a strong argument to further increase Alcor’s relocation reimbursement amount.

The next layer is to coordinate a network of professional cryonics response providers (such as Suspended Animation and ICE) and local groups to respond effectively to out-of-state cases. Such companies can provide a valuable element to deliver rapid response provided that access to such services does not lead to allowing the atrophy of local groups and response capabilities. Professional standby companies usually deploy out of a single state (or two at most), which means that relying on local capabilities created by members remains an essential component for responding timely to time-sensitive cases. To ensure consistent and competent non-local response coverage, the coordination and monitoring of non-local response capabilities should be an important job responsibility of a full-time Alcor staff member.

To augment the services of cryonics standby organizations and the resources available to local members, regions with substantial numbers of Alcor members should be encouraged and supported in creating robust physical cryonics responsibilities. In such areas, maintenance of a full set of standby kits, a response vehicle, and even on-site field cryoprotection capabilities should be pursued. These non-Scottsdale cryonics “hubs” should be allowed some degree of autonomy, provided their efforts conform with Alcor’s protocols and standards. Further enhancement of these cryonics hubs can be reaped if such efforts are supported by other cryonics-supporting activities such as research and public outreach. Examples of areas where such hubs would be feasible and desirable include New York City, Los Angeles, and San Francisco. The mandate for these areas should be to close the gap between Scottsdale-based cases and local cases.

International cases are a formidable challenge for Alcor and the cryonics hub idea will need to be extended to countries (or even a set of neighboring countries). Collaboration between members of different cryonics organizations is often a necessity in international cases. Transport times to the US necessitate the use of procedures such as field cryoprotection and shipping on dry ice

Originally published as a column in Cryonics magazine, September – October, 2018

In the 15 years I have been involved in cryonics I have observed a predictable pattern. An enthusiastic group of people want to create a new cryonics organization. Reasons can range from wanting to have a cryonics organization in their own continent or country (Europe, Australia) to having a distinctly different vision how cryonics should be practiced. Some of these attempts have succeeded and others have failed. The common denominator I have seen in the failed attempts is to do “something else” first before offering long-term maintenance. If this “something else” would simply comprise exercising due diligence in having a sensible financial and legal framework in place before accepting patients that is understandable. But here “something else” concerns achieving something even harder as a precondition for building a storage facility: creating state-of-the-art response capabilities.

One argument for this approach is that without adequate standby and stabilization having a cryonics storage facility is pointless. I do not think this is true and if this argument is followed to its logical conclusion there will never be a good moment to start offering storage as long as cryonics is as unpopular as it is right now. Sure, it is indisputable that a cryonics patient who receives a prompt response and good stabilization procedures will sustain less damage and better cryoprotection. This does not mean, however, that anything that falls short of this is doomed. The ultrastructure of the post-mortem brain is more robust than even most cryonicists assume and ice formation does not necessarily render the original structure of the brain un-inferable.

The other argument is often a variant on the idea that the most challenging element of a cryonics endeavour (i.e. storage) should be done last. But the hardest part of cryonics is not storage but standby. Creating cost-effective, dependable, responsible capabilities for a region larger than a city or small country is a non-trivial challenge. Let’s consider Europe for example. Providing standby coverage for all countries would require a massive initial investment with numerous medical professionals on retainers being available for a case at the right time at the right place…a case which may not happen for many years. Will such an organization be able to keep its supporters motivated and financially committed? In reality this mandate often creates a situation where the organization cannot live up to its standby claims, storage is (indefinitely) postponed, and interest wanes until the next attempt is made to do the same thing. It is no surprise, in my opinion, that some of the newer cryonics organizations (KrioRus, Oregon Cryonics) accepted patients for long term care from the get-go.

Standby is important and I do not pretend that it will take care of itself when there is storage. But whereas storage needs to be centralized (having a storage facility in each of the European countries at this point would be ludicrous) having sound and dependable standby capabilities is a decentralized process which can be pursued by different groups in different states or countries based on their different needs and (financial resources). As we speak, the UK and the Netherlands have made impressive efforts to create such capabilities and these efforts will further grow and spread when there is a facility with patients to care for. One needs to start somewhere and the most realistic path is to first create a sensible storage solution followed by de-centralized efforts to transport patients to the facility in the best possible condition.

Originally published as a column in Cryonics magazine, July – August, 2018

Ralph Merkle’s new article “Revival of Alcor Patients” constitutes an important contribution to the growing cryonics survival literature. What sets Merkle’s latest piece apart from (his) prior efforts is its extensive treatment of the validation of revival attempts (“did we do it right?”) and the ethical principles of revival.

The most important distinction between revival methodologies concerns those that involve in-situ repair and revival and those that aim for repair and revival on a different substrate (i.e. “mind uploading”) after conducting a (molecular) scan. Merkle also presents a revival scenario that involves a destructive scan of the cryopreserved individual, followed by in-silico repair, and biological revival. Some cryonicists (including the “godfather” of cryonics, Robert Ettinger) have expressed concerns that some of these proposals will not produce meaningful individual survival. In particular, it is argued that “running” a complete simulation of the brain on a computer won’t give rise to consciousness, let alone produce individual survival.

Since it may be quite some time before technology is at a state to favor one position over the other, we need sound principles to make prudent decisions now. In his article “Brain Preservation and Personal Survival: The Importance of Promoting Cryonics-Specific Research” (Cryonics magazine, November-December, 2017), Alexandre Erler introduces a new kind of “wager” to make such decisions when faced with philosophical uncertainty concerning the nature of identity and consciousness.

The use of Pascal-style “wagers” is nothing new in cryonics. The most famous wager was proposed by Ralph Merkle himself to compare the potential outcomes for an individual who faces a choice between signing up for cryonics or not. “Merkle’s Wager” consists of a matrix of four choices: Sign up and it works; sign up and it doesn’t work; don’t sign up and it works; don’t sign up and it doesn’t work. Merkle concludes that signing up for cryonics is the favored rational option. Michael O’Neil and Aschwin de Wolf extended this wager to making a choice between neuropreservation and whole body cryopreservation in their “The Case for Whole Body Cryopreservation” article (Cryonics magazine, expanded version, June 2014). Most readers may not be too concerned about the loss of identity-critical information in either cryopreservation option but being wrong on the nature of consciousness could be fatal. If consciousness is substrate-dependent and/or destroying the original brain (during a scan) excludes personal survival, choosing a wrong revival method can produce certain death, despite having received an excellent cryopreservation.

Erler simply asks the question what would be the prudent choice to make given that we cannot know with certainty (right now) which philosophical position is right. The short answer is that in-situ repair and revival of the preserved brain (or whole organism) will give rise to individual survival regardless of which philosophical view is correct.

One thing that is important to emphasize here, which is also discussed in Ralph’s repair article, is that non-destructive (molecular) scans of some kind and in-silico repair may still be a necessary step for in-situ biological repair and revival. The conservative position on revival is limited to the claim that it would not be prudent to instruct the cryonics organization to discard the original brain and seek revival by “running” that model on a computer.

Alcor allows for members to express their revival preferences. One complex question is whether it is currently possible to give informed consent for a revival scenario other than in-situ biological repair. A related question is to what degree cryonics organizations should honor requests for enhancements during the revival process, especially if these requests are (then) known to produce substantial identity-altering effects. There has been little in-depth discussion of these topics to date.


Originally published as a column in Cryonics magazine, May – June, 2018

First aid in medicine is defined as “the assistance given to any person suffering a sudden illness or injury, with care provided to preserve life, prevent the condition from worsening, or to promote recovery.” Its aims can be summed up as the three P’s: preserve life, prevent further harm, and promote recovery. With the exception of the aim of “promoting recovery” this framework is applicable to cryonics, too.

The rationale for allowing laypersons to provide basic medical procedures rests on the recognition that the health condition of a person can rapidly change and/or professional responders may be unable get to the patient in a timely fashion. A major difference between mainstream medicine and cryonics, however, is that in cryonics there often is no local professional response team that can deploy quickly to stabilize the patient. As a consequence, one would expect to see more situations in which the initial, or even all, aspects of a cryonics case will need to be done by local volunteers—and that is exactly what has been observed. This does not necessarily indicate a deficiency on the part of professional cryonics standby organizations. Cryonics is simply not big enough to have professional response teams in every state and major city.

The objective of professional cryonics standby teams and cryonics first aid are the same: stabilize the condition of the patient. What sets cryonics first aid apart from the comprehensive protocols of professional standby organizations is the degree to which this objective can be accomplished and the equipment used.

Cryonics first response entails three procedures: cooling, circulation, and medications administration. One clear advantage that cryonics first aid responders have is that our most effective procedure, cooling, is also the easiest to implement. What usually sets good cryonics first aid apart from suboptimal cryonics first aid is the efficiency of cooling achieved and whether induction of hypothermia is augmented by chest compressions and medications administration. When cryonics first aid is done competently response time is fast, cooling rates are fast, circulation is restored, and a basic medications protocol to prevent clotting, brain injury, and swelling is administered.

The topic of cryonics first aid has not received as much attention as other topics in cryonics. In the early days of cryonics it did not make sense to draw a distinction between cryonics first aid and advanced procedures because all procedures were done by (trained) volunteers. And later, when professional cryonics standby organizations were formed, the topic also received little attention because it was not sufficiently recognized that there would still be a large role to play for local cryonics groups in the provision of cryonics procedures. It is only now when we have come to appreciate the advantages of a “hybrid” standby model in which local team members provide first aid, or interact with professional standby organizations, that there is a need to clearly define the objectives, scope, and physical infrastructure associated with cryonics first aid.

Some of the current questions about cryonics first aid that Alcor seeks to address include: What is the exact cryonics first aid protocol? Which items should be in a cryonics first aid kit? Should cryonics first aid kits be available to groups or also to individual members? What makes a local group eligible for a full set of standby kits instead of a first aid kit? What will cryonics first aid training comprise? What is the difference between Alcor’s first aid protocol and Alcor’s abbreviated protocol designed for professional standby teams in case of a delayed response? How do professional standby teams such as ICE and SA interact with local cryonics first aid responders? Should first aid capabilities be enhanced in areas with many members and an active local community?

Originally published as a column in Cryonics magazine, March – April, 2018