Cryonics, October 1988

But What Will The Neighbors Think?
A Discourse On The History And Rationale Of Neurosuspension

by Mike Darwin


You cannot do just one thing.
-- Zen proverb.

This article expresses my own views and opinions and not necessarily those of Alcor. This article came about as a result of urging by Dr. Mike Perry to respond to an article on neurosuspension by Dr. Paul Segall of the American Cryonics Society, which appeared in the March, 1987 issue of the ACS Journal, the relevant portions of which are reproduced below.

From the American Cryonics Society Journal, March, 1988

THE NEUROPRESERVATION CONTROVERSY

Owing to the lack of public acceptance of neuropreservation, ACS and Trans Time biomedical scientists are advising the small number of their clients who are opting for this service that at the present time it is a much less secure method of preservation than whole-body freezing. While the public image of whole-body suspension is improving, neuropreservation is widely regarded as both ridiculous and gruesome, despite scientific arguments to the contrary. This unfavorable image and its consequences are very real, regardless of the validity of the supporting evidence.

There are also, however, some good scientific reasons to preserve the whole body rather than just the brain. The most important derives from cloning experiments in amphibians, which suggest the possibility that not every adult cell contains the entire genome, but merely most of it. Early stage embryos have nuclei that can give rise to adult organisms following nuclear transplantation, but transplanted adult nuclei have never allowed development past the early tadpole stage.

Perhaps certain genes are eliminated during maturation in a given cell, and these may be different for each cell type. Although there are arguments to the contrary, until we can clone a human (or at least a vertebrate) from a single cell, or until we can read the entire human genome and compare it to that of a fertilized human egg, the question cannot be entirely resolved.

While it is certainly better to preserve the brain or head rather than nothing, whole-body preservation means more biological information is rescued, and that it will be there when and if needed. Since it has not yet been determined exactly how much information is needed to revive or reconstruct an individual following cryonic suspension, whole-body suspension makes more sense from a strictly scientific point of view.

Coupled with public revulsion at the idea of neuropreservation, this makes whole body preservation even more desirable. Of course, it is more expensive. One way to offset the expense is to obtain a life insurance policy for the additional cost of whole body as compared to neuropreservation. This policy might cost only $10-30 a month, depending on the age and health of the member, and could be abandoned once cryonics established a greater degree of public acceptance, and it is ascertained scientifically either that a whole human could be constructed from a single adult cell is as informationally complete as that in an early-stage human embryo.

If techniques for whole-body reversible cryonic suspension are developed, one could convert to a whole-life insurance policy despite any unfavorable changes in health. Those insured only for neuropreservation could find themselves uninsurable should reversible cryonic suspension become closer during the next ten to fifteen years.

Promoters of neuropreservation contend that it is easier to cool and perfuse just the head rather than the whole body. However, because the circulatory system is designed to deliver a maximum amount of flow to the brain, one can cool the head by both core and surface cooling. Since the attachment of the head to the body does not alter the rate at which the head can be frozen, it makes little difference, using current cryonics techniques, whether or not the head is attached.

-- Paul Segall, Ph.D.


INTRODUCTION

Cryonics is not just a technical or scientific undertaking completely isolated from social, political, and emotional considerations. In fact, there are no disciplines which are isolated from human considerations. On the other hand, some areas of scientific and technological endeavor touch human values far more intimately than others. Of all human undertakings, cryonics is one of the most sensitive and powerful. It deals with the fundamental and basic values upon which human civilization rests: personal immortality, health, well-being, the quality and quantity of life, and the structure of powerful human institutions such as religion and philosophy. Above all, cryonics deals with the most frightening and unsettling area of human experience: death.

Until recently, the public perception of cryonics was that of preserving one's body (as a unit) for rescue and repair by the presumably more sophisticated medicine of tomorrow. Recently, this perception has been shifted somewhat by the controversy surrounding the suspension of Alcor member Dora Kent. A difficult and alien idea, namely that of having one's body frozen at "death" was perhaps made even more difficult and alien by suspension of just the patient's brain (contained within the head).

The fundamental questions raised by Dr. Segall would seem to be: "Should we carry out neurosuspension?" and, "Is the social cost worth the benefit?"

I will state at the outset that I don't think it is possible to answer those questions in any objective way. We simply don't have sufficient information to make any hard and fast assertions, since the outcome will be determined by enormously complicated social and political processes about which we have little information. However, this is not to say that we cannot discuss the pros and cons in a thorough and thoughtful way so that everyone can draw their own conclusions from the information now available.


SOME HISTORY AND BACKGROUND

It is ironic that the intellectual seed upon which modern cryonics has been built was a "neurosuspension" story by science fiction writer Neil R. Jones (1). Robert Ettinger, the father of the cryonics movement, was no doubt significantly influenced by Jones' story "The Jameson Satellite" in which the hero, Dr. Jameson, has his body rocketed into earth orbit after death for perpetual, deep-frozen preservation. After millennia in orbit, Jameson's body is happened upon by a technologically advanced race of immortal beings with robot bodies, known as the Zoromes. The Zoromes remove Jameson's brain from his body, install it in an immortal Zorome body and invite him to join them in their never-ending interstellar adventures. Jameson's terrestrial body is discarded.

It was the publication by Doubleday of Ettinger's The Prospect Of Immortality in 1964 that launched the cryonics movement. The scenario for cryonics presented in Ettinger's book is almost exclusively that of preservation of the whole body, although Ettinger does acknowledge the primacy of the brain as the repository for personal identity and does discuss treatment of the brain in isolation in passing (2). The extent to which Ettinger considered and perhaps discarded the option of neurosuspension when he conceived of cryonics as a practical program is unknown. In any event, the cryonics movement began as a program focused exclusively on preservation of the entire body, not just the brain or head. How and why did neurosuspension evolve as an option -- an option which accounts for ten of the sixteen patients now in suspension and for nearly one-third of those signed up for cryonics protection?

The idea of suspending just a patient's brain is an obvious one. All of modern neurophysiology and neurology indicate that the brain is the repository of memory and personality. High spinal cord injuries demonstrate that neurological disconnection of the brain from the body does not destroy either consciousness or identity. The startling head transplant and isolated head perfusion experiments conducted by Dr. Robert J. White at Case Western Reserve University have demonstrated that consciousness, learned tasks, and personality are preserved intact in the isolated head (3a, 3b). It therefore stands to reason that the brain constitutes the critical repository for memory and identity. Preservation of the brain should thus be sufficient to preserve the individual.

However, the obviousness of this proposition is a long way from a decision to implement it in a practical way. In the early 1970's a handful of cryonicists began to have deep and troubling concerns about the logistic feasibility of cryonics in the absence of broad public acceptance and particularly in the face of public indifference and even hostility. I was one of the people who was most deeply affected by these concerns and I was certainly among the most vocal in expressing them. I was not alone.

My concerns were based on years of first-hand involvement in cryonics from a practical rather than a theoretical standpoint. At the age of 13 I had become involved with the Cryonics Society of New York (CSNY) and I remained involved with CSNY throughout its decline and ultimate disintegration.

All of the CSNY patients were ultimately removed from suspension and disposed of by burial or cremation. This was an extremely demoralizing and frightening experience. When I first became involved in cryonics, I had a great deal of confidence in the solidity and workability of existing organizations. This confidence was based in large measure on an inadequate understanding of the enormous difficulties involved and on an unrealistic appraisal of the size, resources, and competence of the organizations then in existence, on the basis of their literature (4).

As I grew to understand the magnitude of the task of maintaining patients in suspension over a period of decades or centuries in a world beset by cyclical military and economic catastrophes, I became even more demoralized. Cryonics was a fundamentally new undertaking. Not only was it faced with the basic problems of economic, social, and political instability over a long time course, it must also confront many unknowns of a more mundane nature including potentially catastrophic short-term problems resulting from errors in legal, financial, or administrative judgments. Many of these judgments would necessarily be made in a vacuum -- without the invaluable resource of past experience to draw upon.

Indeed, the failure of CSNY and the Cryonics Society of California (CSC) were case studies in how not to run cryonics organizations. While the failure modes of each organization were radically different, both suffered from errors in administrative and technical judgment which are obvious only in hindsight. Some of those errors are worth recounting because they were very important in subsequent cryonics efforts which led to creation of the neurosuspension option.

A major error that was not at all obvious at the time was accepting patients for suspension who were already legally dead and for whom the next of kin were pursuing suspension. The relatives of such individuals rarely, if ever, had a full or even adequate understanding of cryonics and were making their decision on the basis of emotional pressures and misinformation, and almost always in the absence of adequate financial resources. Such patients created almost unimaginable problems of every kind and their suspension accomplished nothing so much as to create bitterness, bankruptcy, and ruined lives.

In the early days of cryonics it was not at all obvious that this would be the case. No one could (or at any rate no one did) foresee that the relatives of these patients would become embittered and hostile when the reality of the situation fell short of their expectations. Lack of sound business sense and the failure of economies of scale to materialize put an enormous burden on early organizations. There was virtually no cash flow and absolutely no political or financial leverage to provide insulation from powerful outside forces.

Care of the patients was difficult -- more difficult than anyone had imagined. The early horizontal units which were designed for mobility and ease of handling proved an engineering nightmare requiring extraordinary maintenance and delivering abysmal economy. The second generation vertical MVE units which replaced them were reliable, but very difficult to handle and almost impossible to transport safely or economically. The MVE units also required specialized quarters and handling equipment -- a building with high overhead ceilings, appropriate zoning, and a gallows or overhead crane.

The upshot of all of this was that cryonic suspension was a labor- intensive and costly undertaking with a number of unusual and inflexible requirements. In short, it had high start-up costs both in terms of technology and labor.

My awareness of these problems made me realize that in the absence of broad acceptance of cryonics (and the resource base such acceptance represented) very large amounts of money would be required on an individual basis to insure any reasonable chance of long-term survival for a patient in suspension. Additionally, easy transport and low visibility would be impossible for patients in suspension, and over a long time course, hostility and adverse conditions of one sort or another might necessitate many moves. The decline of a civilization (such as the decline of the Spanish and British Empires) can occur within the space of several decades and the outbreak of war would necessitate even more rapid relocation. From my perspective in 1974 such untoward events seemed not at all unlikely over a time span of 100 to 200 years (my personal timescale for possible revival of patients frozen under good conditions at that time). My evaluation of the world in the intervening 18 years has served only to increase my concerns about the likelihood of these potential problems.

Sometime during the summer of 1974 I came to the conclusion that the chance represented by cryonics was simply not worth the tremendous effort demanded. Too many things could go wrong and while the things we knew about and had experienced already seemed bad enough, the problems we hadn't yet experienced and couldn't anticipate were probably much worse. Youthful optimism notwithstanding, I was ready to throw in the towel.

I shared my doubts and fears with a valued colleague. Shared is a misnomer -- delivered as a raging statement of frustration and despair probably better sums up the communication. My colleague, being a thoughtful and rational man, made a powerful and simple suggestion. He prefaced it by asking a number of leading questions which caught my interest.

What if there were some way to decrease by orders of magnitude the logistic problems associated with cryonics, while at the same time greatly reducing the cost -- perhaps by as much as an order of magnitude? Furthermore, what if it were possible to make cryonics flexible and bring its execution within the realm of "do-ability" by even a single individual? Would I reassess my decision to abandon ship?

His solution to the problems was to cut to the core of what cryonics was really all about -- personal survival. And the bare essential for personal survival is the brain. I wish I could say I was immediately persuaded of the rationality of this idea, but the truth is it took me several days to think over the implications and lock onto it. I did not reject it out of hand, but I do not recall enthusiastically embracing it either.

My introduction to neurosuspension took place in Augusta, Georgia. Unbeknownst to both my colleague and myself, others in the cryonics community were arriving at the same conclusion for many of the same reasons nearly 2500 miles away.

During the summer of 1974 my colleague and I journeyed to Southern California to assess the state of cryonics there. We planned to meet with Robert Nelson, President of CSC, and tour CSC's facilities. We also planned to meet with Fred and Linda Chamberlain of the Alcor Foundation and Manrise Corporation.

The meeting with Nelson did not go well -- he was evasive and deceitful and we were not allowed to tour CSC's storage facilities. Evidence I gathered on that trip strongly suggested that CSC had aleady succumbed to the problems that plaged CSNY and that our solution to the logstic and financial nightmares had arrived too late to benefit any CSC patients.

The meeting with the Chamberlains went far better. We had corresponded with them at length and thus were somewhat prepared for what we found: two energetic and highly competent people who had virtually single-handedly revolutionized cryonics by develping the first perfusion system, the first training and procedural manual, and the first real scientific approach to perfusate design.

Our meeting with the Chamberlains was at their home in the foothills of the San Gabriel mountains, north of L.A. The house was secluded and tucked away amidst dense foliage and the grounds were patrolled by two well-trained German Shepherds. During the course of our outdoor meal we began to discuss the problems associated with cryonics in earnest. Gingerly we broached the issue of neurosuspension. This was the first time we had discussed this idea with anyone else. What would the response be? Fred and Linda seemed to take the idea in stride. They evinced no reaction other than to discuss the pros and cons calmly and add to a number of points we made. As we finished our meal, Fred and Linda looked at each other knowingly and then Fred said that he had something he wanted to show us before the sun went down. We were led to a small storage shed at the back of the property. Inside was the prototype of their first perfusion machine (already obsolete) and a number of other odds and ends used in developing the suspension capability they had put together.

Immediately inside the door and to our left were two nearly waist-high cardboard boxes, one of which Fred proceeded to open. Deftly he extracted an LR-40 cryogenic dewar. This, he explained, was the storage unit his terminally ill father was going to be placed in. Both Fred and Linda eyed us expectantly. It was very clear at that moment that not only had they considered the problems in the same light we had -- and arrived at the same conclusion -- they had every intention of acting on that conclusion.

I cannot speak for my colleague, but I was both dumbfounded and excited. Here was the answer to so many problems. Here was a workable way to practice cryonics.

For Fred and Linda there was little choice but to pursue the neurosuspension option for Fred's father. The financial resources were simply not there to allow for whole body suspension. If Fred Jr. (Fred's father) was to have any chance at making it into the future, this was going to be it.

Two years later, in July of 1976, Fred Jr. became the first cryonics patient to be placed into neurosus- pension (5).

The Chamberlains' decision to pursue neurosuspenson for Fred Jr. and for themselves was based not only on the logistic considerations I have outlined above but also on financial and cryoiological considerations. Treatment of the patient's brain (head) in isolation meant an opportunity to better control the introduction of cryoprotective agent (CPA), to minimize exposure time (and thus toxicity) to the CPA, and to achieve better control of cooling (again with the consequence of less CPA toxicty and less damage due to prolonged exposure to high subzero temperatures while the whole body is cooled).

Treatment of just the patient's brain also meant that storage and long-term care could be pursued without high overhead and exorbitant start-up costs. There would be no delay in going to liquid nitrogen storage while a costly custom whole-body dewar was ordered and no need to pursue storage in a specialized structure. There was economy and flexibility of an unprecedented degree.


OBJECTIONS AND ANSWERS

The above is, I think, a fairly reasonable evaluation of how and why neurosuspension came to be. And yet, despite the many advantages cited above, neurosuspension has not become the exclusive or even the dominant method of suspension in the cryonics community as a whole. Why is this? In the following pages I will attempt to answer that question by critically evaluating many of the objections to neurosuspension that have been made since the procedure was first implemented in 1976.

The most frequently cited objection to neuropreservation is aesthetic. People associate decapitation with death and generally regard invasive or dismembering procedures as repugnant.

This is a largely irrational objection. It does, however, have strong roots in past human experience. Traditionally, decapitation or removal of the brain has been associated with the end of life rather than its beginning. Additionally, human beings, as they are currently configured have a very limited capacity for self-repair. Mutilating or amputating injuries in higher vertebrates are not reversible. There is thus strong social pressure present to avoid such injuries. In addition to being catastrophic when they do occur, they are also uncommon.

Such injuries are catastrophic because they cause profound functional losses and these losses translate into loss of sense of self. If a man can no longer work due to a dismembering injury, his social self is profoundly injured as well as his somatic self.

An answer to this objection is relatively easy. Clearly any technology capable of reversing extensive cryoinjury (as currently experienced by suspension patients) by making molecular-level repairs should be able to rebuild or regenerate any dismembering injury, including replacement of the entire body. As a minimum, transplantation of the patient's brain into an anencephalic clone should be possible. Much recent work supports the ability of the spinal cord to be regenerated, and clinical treatments for transecting spinal injuries are acknowledged by many experts to be no more than a decade or at most two decades away.

Closely related to, and perhaps even an extension of the aesthetic objection is the social objection. In short, what will other people think and what impact will this have on cryonics and cryonicists?

Will society tend to view neuropatients as hunks of tissue rather than as people? Will the seemingly gruesome or outlandish nature of neurosuspension polarize people against cryonics who would not have been hostile otherwise? This is a difficult question to answer. On the surface the answer would seem to be: "Yes." Most people find the notion of storing isolated brains, or worse still, isolated heads, gruesome. And yet, there was and is no widespread, grass-roots reaction against Alcor or any neurosuspension, including that of Dora Kent. Despite all the recent publicity, much of it luridly orchestrated by the local press, there has been not one single piece of hate mail received by Alcor. Early on in the media circus, Chief Deputy Coroner Dan Cupido said the Riverside Coroner's office had received exactly zero complaints or calls from concerned citizens (6).

The mood in the national media seemed to be one of humorus japing. Neurosuspension was simply too outrageous to be taken seriously. That may well be an unexpected bonanza. One thing is very clear: there was no widespread public outrage or outcry.

Where the courts and the educated person or professional is concerned, the case seems clearer. Alcor's February 1st victory in the Dora Kent case (7) is proof that competent, thoughtful people can and will respect neuropatients as more than just specimens. The declaations of the scientists who came forward to support Alcor also attest to this.

A more subjective but perhaps more valid assessment is the reaction of the local community to Alcor staffers when they make purchases using Alcor checks or are otherwise recognized. In every case people have been supportive, have recognized the Coroner's actions as a witch-hunt, and have often remarked to the effect "Why don't those people just leave you alone. . . ?"

Paradoxically, neurosuspension in the form of the Kent case may have acted to increase Alcor's overall level of credibility with the people that count. Since the publicity surrounding Dora Kent's suspension and subsequent disappearance, a number of politically powerful and intellectually influential people have become associated with Alcor. This has been in no small measure because Alcor had put the brass tacks aspects of patient care ahead of harder-to-quantify social considerations.

What the long run will hold is impossible to know at this point. But two things are clear: First, if Dora Kent had been a whole-body patient she would have been autopsied long ago. Second, due to economic considerations most cryonics patients today (not just those at Alcor) could not have been placed or maintained in suspension if it had not been for the neurosuspension option.

The first and simplest of the scientific/technical objections to neurosuspension raised by Dr. Segall is that "since the attachment of the head to the body does not alter the rate at which the head can be frozen, it makes little difference, using current cryonics techniques, whether or not the head is attached."

This statement is true only if a decision is made to disregard the proper cooling of the patient's body during descent to -79°C. Unless the patient is allowed to freeze uniformly, he or she will experience shell freezing. Shell freezing occurs when the outside of the patient freezes solidly before the interior of the patient freezes. Subsequent freezing and expansion of the interior water deforms the frozen, rigid outer shell of material, causing it to crack and promoting intracellular freezing.

The mass and diameter of the head allow it to be cooled far faster than the mass of the patient's body, and to avoid shell freezing careful control between surface and core temperatures is required. A decision has to be made as to whether or not this will be between oral and brain surface temperatures or between rectal and abdominal surface temperatures. Dr. Segall fails to make this clear in his article.

Dr. Segall also leaves unaddressed the issue of the longer perfusion times required to introduce (and presumably remove) cryoprotective agent (CPA) in whole body patients. As Dr. Perry's paper elsewhere in this issue indicates, whole body patients will experience roughly a 60% longer exposure of the brain to toxic CPA because of the "high flow" nature of cerebral circulation as compared to the remainder of the body (8). Additionally, the logistics of handling whole body patients and the thermal inertia they represent to the cooling bath mean that they will experience even longer periods of relatively high temperature exposure to CPA than their neurosuspension contemporaries.

Another common technical objection to neurosuspension also voiced by Dr. Segall is that not all of the information necessary to reconstitute the individual is present in the brain or head.

This objection can take any of a number of forms. The most common and perhaps the most valid is that the body is somehow possibly a repository of critical but currently unappreciated identity information. There are two broad categories of the argument. The first and the simplest is the "discarded genome" argument which states simply that not all of the genetic information needed to reconstitute the individual is present in somatic or body cells.

In other words, some of the genes involved in development and differentiation are discarded or lost in body cells and are present only in embryonic tissue or sex cells (some nematodes are known to discard up to 70% of their genome in this way (9)). This argument is fairly easy to dispose of. The only "evidence" that adult mammalian somatic cells don't have the full genetic complement is that efforts to clone mammals and other vertebrates from adult body cells have so far failed. Of course, this does not necessarily mean that the information is not there -- it may be simply be turned off or otherwise made inaccessible.

By contrast, there is a considerable body of evidence that human (and other vertebrate) somatic cells are totipotent (i.e., contain the organism's entire genetic blueprint). Unlike the previously mentioned nematodes who discard most of the genome in body cells, adult human cells show the same number of chromosomes as do embryonic cells or fertilized ova and a number of studies have shown relative constancy of DNA content in a wide range of somatic and embryonic cells. (10), (11). Several decades of extensive genetic manipulation of adult somatic cells have also not disclosed any noticeable absence of information. Additionally, the results of Gurdon with the cloning of frogs also suggest strongly that most somatic cells are totipotent (12). The view that adult somatic cells contain all of the genetic information necessary to reconstitute the individual has thus become widely and generally accepted (13).

Additionally, certain disease states such as cancer often lead to the expression of fetal genes in somatic tissues. Colon cancers will often produce fetal proteins, and fetal hemoglobins are produced in other types of malignancies similarly unrelated to the blood producing tissues (14). These abnormalities suggest that the genome is conserved in adult cells, but is not normally expressed. In other words, the information is there but, like a book on a shelf in a library, is not currently in use.

But even if there were wholesale loss or deletion of genetic information from brain or other body cells, is this a serious obstacle to resuscitation of neurosuspension patients? The answer is a resounding "No!" The problem could be addressed in any of a number ways. The simplest would be to take samples of various organs and tissues (including reproductive organs if they are available) and preserve them with the patient. This is done almost routinely by Alcor when carrying out neurosuspensions (14)).

The second solution is to get such "generic" genetic information from other people. Clearly that part of the genome necessary to carry out day- to-day operation of the brain has to be in the patient's brain cells. Recent experiments with various nerve growth factors have also demonstrated that aged, adult nervous tissue can be induced to undergo cell division, sprouting, and remodeling with stimulation by relatively simple chemicals (15). This indicates that genes coding for growth, development, and differentiation of brain cells are also present in adult neurons -- even aged adult neurons.

If other critical body genes are missing, copies can be obtained from other people. Indeed, this may even be desirable in many instances. I, for one, would like a number of new genes including ones for stronger muscles, nondefective veins, a much better looking face, improved cholesterol metabolism and so on. In fact, I hope for a much better body all around. The point is that much of the genetic information which makes us up is almost certainly not essential to conserving our identity. It is not identity-critical. Much of our genome is probably not only not essential to survival, but contrasurvival.

These objections and their answers bring us to the second class of "loss of identity-critical information" objection. That objection can best be best summed up as the Stradivarius Objection (SO for short). SO enthusiasts believe that body may be like a Stradivarius violin. Very easy to understand and reproduce in outline, but possessed of subtle and identity-critical propert- ies which are not yet appreciated.

In this worldview bodies are like violins played by masters (or yokels for that matter). They are not just their genome, rather they are the complex interaction of genome with environment and brain with body with environment. . . . In other words, a person's peripheral nervous system, immune system, heart, lungs, and so on all interact with each other in complex ways to produce the person.

A simple example of this would be someone with a hyperactive thyroid. Such a person will be temperamentally different than someone without a hyperactive thyroid. Similarly, someone with exceptionally fine peripheral nervous connections may have certain skills and abilities that others lack. SO people believe that such subtle and possibly random connections and interactions all go to shape or make up the essence of the person. Many of the connections and positions of cells in the body which determine the character or function of the brain may thus be lost if the body is discarded. For instance, it is known that the interconnection of nerve cells in the spinal cord and brain are not determined completely by genetics but by other, "random" influences. The most visible evidence of the randomness of some of our features is that fingerprints are not identical in identical twins. Similarly, sexual orientation, aggressiveness and so on are also sometimes at variance in animals or people with exactly the same genetic make-up.

SO advocates argue that there may be subtle, as yet unappreciated identity-critical information present in the body. They view the organism as a unit, not as any one of its parts.

The SO objection is a more difficult one to answer and in fact can probably not be answered with 100% confidence given the state of today's knowledge an experience. Am I to any significant degree my kidneys or my little finger?

Despite the fact that no one has undergone a head transplant or been fitted with a regrown body, the questions raised by the Stradivarius Objection proponents are not totally unanswerable. As usual, a host of modern pathologies and medical treatments provides some indirect, but very powerful and persuasive insight.

People with high spinal cord injuries do not suddenly cease to be themselves or experience changes in their personalities unrelated to the disability inflicted by such a currently irreversible medical catastrophe. Despite the fact that their brain is disconnected from their central nervous system, such people are obviously still the same people. Multiple organ transplant recipients also demonstrate continuity of memory, personality, and identity. Such patients do not take on the character or personality of the donor of the tissue. While they often experience profound improvement in well-being, they do not cease to be who they were. Indeed, it can be argued that such changes enhance their personhood and allow them to be more of who they are (15).

Less conclusive are the results of primate head transplants, such as the work conducted by Dr. Robert White of Case Western Reserve University in Cleveland, Ohio. I have spoken with Dr. White about the results of his monkey head transplants and he has told me that not only do the animals regain consciousness but their ability to repeat learned information (such as sound-eyeblink responses) is intact (16). Obviously, monkeys are not people and they cannot verbalize any more subtle emotional or cognitive problems.

In short, nothing in contemporary medical experience suggests that replacement of the body with a healthy, functioning duplicate or even with another "generic" human body will have any catastrophic impact on personal identity. But there is a deeper point here. It is the brain that senses and responds to the body. It is the brain that holds memories of what was and what is. And it is the brain that decides. If we awake with a body that is not the Stradivarius we remember, we will be able to fine tune and to make changes. Indeed, for many of us the nightmare is not that we will waken without the body we had, but rather that we will waken with it. We want more and will be disappointed (but grateful) if what we have now is all we get.

Yet another objection is that neuropatients may come back without bodies at all or otherwise with substandard hardware.

This objection can be answered easily and straightforwardly: If tomorrow's medicine cannot regrow or replace the body, revival won't be possible in the first place. Existing preservation techniques cause serious damage which will require nearly complete control over life at the molecular level to repair. Any technology capable of repairing and rebuilding individually damaged brain cells will be able to clone or regrow a new body around the existing (repaired) brain. Concerns about the inability to regrow bodies are like concerns about being unable to build a bottle rocket if you can build a Saturn Five. As a worst case, new bodies could be produced the old-fashioned way, by fusion of gametes and production of an anencephalic infant body which could then be supported until it had matured to a sufficient degree. (The brain is immunologically privileged, so rejection would not even have to be solved to overcome this problem.)

A variant of the previous objection is that it may not be possible to reconnect spinal cords.

A variety of lower vertebrates such as the salamander, A. Punctatum, can reconnect severed spinal cords (17) and there is a growing body of evidence that higher mammals can do the same (18). Limited experimental regeneration of the spinal cord is already a research reality. Even mainstream popular science magazines such as Discover are beginning to run review articles summarizing recent progress in this field (19). Today's whole-body suspension patients experience complete, multiple severance of the spinal cord and brain due to cooling-induced differential contraction and the resultant fracturing. Ice formation in the brain may also occasionally sever long processes. These injuries must be reversible by any technology that seeks to revive today's patients. A corollary of such a capability is the ability to repair severed spinal cords.

Finally, there is the delayed revival scenario.

This scenario holds that the technology required to revive some (if not all) suspension patients will be equal to reviving whole body patients first since "all of them is already there." In other words, it is easier to repair than to replace. This argument has both strengths and weaknesses. First, let's look at the strengths. For a patient who is young, suffering from a "simple" disease like leukemia or muscular dystrophy, and who is suspended using only slightly damaging techniques, revival might occur decades or even a century or so sooner than if he went the neurosuspension route.

This argument may very well be valid. For this reason both Alcor and I recommend that people provide for the likelihood of improved suspension techniques and suspension while comparatively young. Unfortunately, such a scenario does not describe the average person entering suspension. Current suspension techniques are damaging, and the vast majority of people who need suspension are old and suffering from multiple organ system failure. To act as if this were not the case now would seem very foolish. It makes sense to prepare for the worst (and most likely) scenario and hold the best (and currently least likely scenario) as a contingency to be exercised when it is appropriate to do so.

But for those suspended now or in the foreseeable future, a case could be made that neuropatients will be revived first because it will be much more difficult to "repair" than "replace." Many people object to regeneration of the body because it will be made up of different material. Repair thus implies that the original molecules are retained, the original "stuff" which makes the person up. What will happen in the case of an elderly person in need of enormous structural overhaul? Having to deal with complicated repairs laden with philosophical issues may greatly delay revival! Certainly no one today tries to repair worn out and broken parts in either complicated or simple equipment -- they are replaced because it is cost-effective and faster by far to do so.


CONCLUSION

The foregoing objections to neurosuspension are all that I have commonly heard. Despite the prevalence of whole-body suspension members in the cryonics movement as a whole (2/3rds as a best guess) there has, to my knowledge, never been any thorough argument for the rational basis of the procedure. The many challenges offered by advocates of neurosuspension over the years have gone unanswered.

Two of the three existing cryonics organizations have dealt with the issue by simply not offering neurosuspension and restricting its discussion.

Where does all of this leave us? Clearly the Dora Kent case demonstrated that the Judiciary will take the issue of a frozen patient's rights seriously -- even if the frozen patient happens to be an isolated head. Nowhere in all the media coverage was Dora Kent ever reduced to the status of a tissue specimen. Nor were the reporters, many of whom were not the brightest or most reflective of creatures, unable to grasp the essence of what we were doing. Most surprisingly, the reporters failed to raise the host of so-called "insurmountable objections" they were expected to raise. It was a "given" that if science could thaw out and rejuvenate an 83-year-old lady's diseased and damaged brain, it could find or clone a body to put it in. Clearly, the absence of Dora Kent's body hasn't hurt her brain. Not with the media, not with the courts, and not with the scientists who stepped forward to support Dora Kent and Alcor.

The recent positive reaction of media to the announcement by Dr. Timothy Leary of his plans for neurosuspension (20, 21, 22) also attest to the fact that neurosuspension presents no overwhelming public relations obstacles.

Finally, what the whole issue of neuro vs. whole body reduces to is a decision about what's important. Cryonic suspension has been likened to escaping from a burning building. This analogy is a correct one, with an added condition being that the escape is being made from a fourth-story window using a rope of knotted towels and bedsheets. In such a situation a decision has to be made about what's important to save. The antique bedroom furniture, the grand piano, even the family jewels must all be weighed against the urgency of the situation. Obviously, what is important to save in such a crisis is yourself. Everything that we know about biology and medicine indicates that the human brain is the human being. When an individual decides to take more than that (particularly in light of the uncertain legal, financial and political status of cryonics today) they are taking a potentially very large added risk. Each individual must weigh this risk and decide. For some of us it has been an easy decision.

Alcor and I started down the neurosuspension road because it was the rational and moral thing to do. It offered us an opportunity to save the lives of those we loved when we would otherwise have been unable to do so. If history later demonstrates that it was the wrong thing to do from a "political" or "greater good" standpoint I hope we are not judged too harshly. For the fact is, it was really the only thing we could have done and still remained human.

It's strange how things work out. Who would have ever dreamed that cutting off your mother's head could be the ultimate act of caring love and the best chance of saving her life?

It is a strange, strange world.


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