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Cryonics, July, August, September 1986
INTERVIEW WITH JERRY LEAF
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One of the greatest dangers in life is to adopt a too simplistic view of the
world. Simple explanations of life have a tremendous appeal, because they offer
to boil down the whole complex panorama of existence into an easy bromide. To
some extent, the "great man theory of history" is such a simplification. Men
are not only shapers of their times, they are shaped by them. It is a complex
interaction. Nevertheless, we, the editors of CRYONICS feel justified in saying
that Jerry Leaf is arguably the most important man in cryonics since Robert
Ettinger. He has shaped cryonics more completely and surely than any man who
has come before him.
Almost singlehandedly Jerry has transformed cryonics, at least cryonics in
Southern California, into a credible, professional operation. He has also, more
than any other man improved the quality of care delivered to suspension patients.
But perhaps most importantly he has brought with him to cryonics a degree of
integrity and high values which were sorely lacking before. Jerry's integrity,
coupled with his total commitment to the use of reason and the scientific method
have forever changed cryonics and attracted the best and brightest from around
the world to make their home in Orange County and to become a part of the Cryovita
(and thus ALCOR) family. Both of us, the editors of CRYONICS, are here doing
the job we're doing, almost exclusively because of Jerry Leaf and the values
and skills he represents.
However, integrity, values, skill, competence -- while these things describe
Jerry, and while they are necessary and even critical ingredients in the makings
of a world shaper -- they are not enough. It takes more -- it takes sensitivity,
fairness and humanity to attract and hold people and to gain their loyalty and
love. Jerry is blessed with these things in abundance. Though blessed is the
wrong word to use, since it implies that "it just happened." To know Jerry is
to feel completely and at once that you are in the presence of a man who has
taken nothing, but who has made and shaped himself completely. This interview
will hopefully provide a glimpse of that tremendous sense of self control, and
of the immense reservoir of concern and competence which accompanies it.
CRYONICS Magazine: Very few of our readers know much about your background,
about what caused you to get involved in cryonics. Could you tell us a little
about yourself and your personal motivations for involvement in cryonics?
JL: My motivations go back to the beginnings of the 1960's. They began in the
jungles of Southeast Asia. I was involved in a special operations group deployed
out of Western Europe. We were assigned a highly sensitive mission in South
Vietnam, the kind that were eventually handled by special teams called Phoenix
Groups. We were further used as a test case for operations across the border
into North Vietnam. Part of what we learned was used to develop what became
known as MACV-SOG, a top secret organization involving the South Vietnamese
and American Special Forces and the CIA in mid 1964. It was during these missions
into North Vietnam that our casualty rate began to rise, eventually exceeding
50% before our return to Western Europe.
There is a special kind of chemistry and feeling that is shared by people
who face death together over a period of time. I came away from these missions
with the face of death having a very specific meaning; it was defined by a roll
call of men we carried out of North Vietnam. They went home; there were no MIA's.
I lived because of these friends, and it was the worst feeling not to be able
to reciprocate.
I left my fear of death somewhere in the jungles of Vietnam. To this day I
have absolutely no fear of death, only the fear of not being able to save someone
else that I care about. It's not that I don't want life for myself, because
I do very much. I just don't feel anything about nonexistence. I only have the
positive feeling towards life. I want more of it.
This caused me to begin to think about the fragility of life and what could
be done to prevent the loss of people that you cared about. People whose lives
were in extreme jeopardy -- or even beyond the ability of current medical science
to recover.
When I came back (we were quietly reinserted into Germany after the Southeast
Asian operations) and I was cycled back to the US for a period of time (during
which time I was involved in additional covert operations here) I began to become
increasingly concerned over the issue of life and death -- over the the tremendous
importance and preciousness of life. I began to ask questions about life itself
-- I started studying biology and philosophy in college and I became particularly
interested in suspended animation. In 1966 I heard about a lecture that was
being given by Robert Nelson of the Cryonics Society of California (CSC). I
attended that lecture and it stimulated me to contact the cryonics groups that
were in operation at that time: CSC, the Cryonics Society of New York, the Cryonics
Society of Michigan and a group in France. I contacted all of them by mail and
tried to keep in touch with some of them over the years when I was going to
college.
I was attending college in Southern California at the time. I was married
in 1965 and stayed on in Southern California for two more years at which time
I completed a B.A. degree in philosophy. Afterwards I moved to Nevada to pursue
a graduate education in biology. I was there almost 2 years. I left the graduate
program because of inadequate instrumentation and support which I needed to
pursue low temperature biology. At the time I was in a special program to get
a degree in low temperature biology. The university there is primarily oriented
toward ecological studies -- and still is. After awhile I began to realize that
I knew more about low temperature biology from my independent studies than they
did! That, coupled with the lack of equipment available for graduate research
caused me to make the decision to return to Southern California.
CM: Why did you do this? Did you plan to pursue graduate studies in cryobiology
here?
JL: No, I had pretty well determined at that point that the kind of research
which needed to be done and which I was interested in doing would require equipment
and facilities which would simply not be available to me in a University environment.
No publicly supported institution would be likely to support the kind of work
I knew needed to be done. The Southern California area represented a lucrative
market in surplus equipment -- because of the many medical centers, high technology
manufacturers and Universities in the area. I began to acquire equipment for
my own use.
I began working at UCLA in the operating rooms with the idea in mind of setting
up to do research myself in my own laboratory. I recontacted Southern California
cryonics by attending a meeting sponsored by Trans Time. This was an attempt
by Trans Time to cut into the Southern California cryonics market of Manrise
Corp. At that time, I agreed to do the first Total Body Washout (TBW) of a dog,
to be conducted at Trans Time's facilities in Emeryville. Shortly thereafter,
I met with Fred and Linda Chamberlain of ALCOR/Manrise and agreed to help them
with dog work if they were interested.
I did the first cryonics dog TBW up at Trans Time in 1977 in which the dog
lived for 17 hours. All the equipment and supplies I took up in my van, except
for some material which I relied on them to provide. That was partially a disastrous
decision I made (laughter) because the main things I relied upon them to provide
were inadequate. This was my first experience in seeing what was actually available
for cryonics. I was really surprized at the inadequacy of their equipment and
at their misconceptions about how to carry out extracorporeal perfusion. The
degree of their isolation from the mainstream of medical knowledge was particularly
surprising. They had very little insight into what was going on in clinical
medicine. They had a little insight into low temperature biology and physiology,
but they had essentially no equipment that I considered to be useful at the
time for actually accomplishing extracorporeal circulation of blood or cryoprotective
agents in a manner which would insure proper perfusion by any clinical standards.
CM: How did Cryovita Laboratories come about?
JL: After I came back from doing the experiment with Trans Time I got involved
down here with Fred and Linda Chamberlain of ALCOR/Manrise and we did a study
in which we carried out cryoprotective perfusion of a dog simulating the protocol
which had been applied to a previous ALCOR neurosuspension patient. The purpose
of this experiment was to evaluate the ultrastructural effect of the suspension
procedure on the brain. Electron microscopy was later performed on the animal's
brain to evaluate structural integrity.
All of this brought into sharp focus the need to develop real facilities for
research. At that time I was operating out of my garage. There was so much equipment
stuffed into that two car garage that any kind of meaningful work was impossible.
Also, in order to do animal research I realized I would need to be licensed
by the Department of Agriculture. That meant M-2 zoning for the facility, so
I moved from my garage into the industrial facility which Cryovita and ALCOR
currently occupy, in 1978.
I established Cryovita as a corporation for licensing purposes and for tax
purposes -- and of course for common sense reasons of limiting my liability.
The fundamental motives were to provide a more adequate environment for research
operations and for patient perfusion services that I perceived as being unavailable
through Trans Time or Manrise.
Shortly thereafter I agreed to do perfusions for Trans Time. In the interim,
Manrise, the Southern California "for-profit" entity had been sold to Trans
Time by the Chamberlains. I ended up being the subcontractor to Trans Time doing
perfusion's for both ALCOR and the Bay Area Cryonics Society.
CM: Since Manrise had merged with Trans Time at that point, why didn't you
merge with Trans Time too?
JL: Well, I decided that rather than merging with Trans Time I should remain
a completely independent entity capable of making my own decisions about who
to become involved with, who to remain involved with, and to have the ability
to make decisions in protocol with more influence on Trans Time. If I were just
a stockholder in a larger corporation controlled by many stockholders -- even
if I were the principal stockholder -- I wouldn't have the ability to influence
the Trans Time board in what I considered to be technical decision making in
areas in which they had no expertise and I did.
CM: Do you have any regrets about having made that decision and about having
taken on the tremendous personal and financial load which Cryovita has represented
to you?
JL: No. As a matter of fact I think the decision to remain independent has
proven to be the correct one. For a number of years I enjoyed a considerable
influence on what the perfusion protocols and level of technical expertise would
be in perfusing Trans Time patients -- which was essentially all the patients
being done over that period of years. It was an opportunity for me to influence
the technological developments during those years and introduce substantial
improvements in patient care. It also provided me with an opportunity to be
involved directly in the perfusion of cryonics patients and to become involved
in training people to do suspensions. It was a tremendous educational experience
for me, and it provided me with an opportunity to provide trained people down
here in Southern California who would be directly in support of patient care
and research. It was essentially an ALCOR team direct by Cryovita Laboratories.
The nucleus of that team is still doing research at Cryovita.
CM: Up until about a year ago Cryovita was providing services to TT. What
caused the contract not to be renewed.
JL: We were expending over $20,000 per year to operate Cryovita with most of
that money going solely in support of patient perfusion operations. Trans Time
had always plead poverty and compensated Cryovita for these services in modest
amounts of money, but mostly with stock. The last three years of the contract
with Trans Time we were paid entirely with stock because I was concerned that
they wouldn't have enough cash flow to keep their doors open.
I was happy to provide them with help during these rough times. For years
I accepted this arrangement because I wanted to see them make a go of it. But
then I began to notice that windfalls and benefits which came their way as well
as research money and other cash flow was not trickling down here. Not even
in small part. It became clear that they were content to let me and the other
Southern California people absorb the tremendous cost of providing perfusion
services to them -- indefinitely. So, when we said that these services were
going to cost something, about $3,500 a year, not even enough to begin to cover
their share of the costs, the negotiations began to linger. We finally agreed
upon a combination of cash and equipment, but never signed the contract.
CM: Why not?
JL: As I said before, the technological decisions as to how to treat suspension
patients were largely left in my hands, and they were very sensitive to any
input I had. However, there were some people in Northern California who were
not happy with this. They felt that the quality of perfusion was secondary to
taking some kind of immediate action -- even if that consisted of walking into
a grocery store and buying table salt and culinary ingredients and pumping these
through someone with an embalming pump! If someone wants to do something exclusive
of cryobiology and the medical sciences, they don't need my services. I offered
to provide training for Trans Time/BACS personnel, but they would not provide
even the modest levels of funding required. Capability was set on the shelf
for future consideration.
CM: Surely you must be joking about the grocery store scenario?
JL: No. This is something which had existed as a matter of contention in cryonics
for a number of years before I came along. I just brought that difference into
sharp focus because I represented a greater extreme of technical accomplishment
than the others who had held this position previously. I think these background
issues of cost vs. quality were partly responsible for their decision not to
pursue services with Cryovita.
Some real differences between Trans Time's operations and what I considered
Cryovita's proper operation began to gel when we had difficulties with relatives
who had placed a patient into suspension. They seemed not to be aware the nature
of the process and what kinds of injury and damage these patients would be subjected
to as a result of the preservation process. In one instance Trans Time failed
to notify a relative about a serious error they made in the care of a patient
and that information was communicated second hand, and many weeks after the
incident.
As a consequence of an inability to communicate with people in a way that
was mollifying of their doubts they began to incur litigation and threats of
litigation. This resulted in the loss of at least two of the core team members
here in Southern California with these people stating that they could not justify
continuing to participate in suspensions if it jeopardized their livelihoods
and the the livelihoods of their families. Of course, the Nelson disaster in
Chatsworth only increased tensions and concerns over litigation. It also caused
me to become increasingly sensitive to the issues of informed consent and public
image.
CM: Why was this?
JL: I had given interviews to the press during this period in an attempt to
show the difference between Nelson's operation and the rest of cryonics. These
interviews were edited in such a way as to make them useless to defend the difference
between existing cryonics organizations and Nelson's CSC. This problem was only
made worse by the misuse of photographic and video materials that were taken
here at Cryovita Laboratories, with my permission, for the use of Trans Time
in promoting cryonics when the TV news people discussed the Chatsworth disaster
while showing images of a modern cryonics laboratory.
What occurred was that Trans Time had been selling these materials -- in the
beginning they sold them with inadequate controls to people not only in the
mainstream news media, but people who were making documentaries on whatever.
. . The consequence was that material depicting Cryovita was used in a "film"
entitled FACES OF DEATH. This was a film I considered to be of an extremely
negative character in as much as it packaged human death, misadventure and death
related procedures in a vulgar and exploitive way. It showed cryonics as one
of those death related procedures in a context which I found completely unacceptable.
It showed cryonics patients inadequately covered in terms of their privacy,
which I considered unacceptable for surviving relatives to see. It didn't cover
their nakedness for example, it identified them by name, and it showed team
members both in Northern and Southern California whose permission was not obtained
for this kind of thing -- including me. I considered that to be totally inappropriate
to the purposes for which I allowed Trans Time to make video recordings and
photographs in my facilities.
Consequently, before any contract could be signed between Trans Time and Cryovita,
I required that I have control over any material, photographic or video, made
at my facilities. I agreed to to allow Trans Time to use this material for promotion
on an individual, case by case basis. I further asked that they not release
any of the material which had been previously made at Cryovita to anyone without
first contacting me for my permission. Apparently, Trans Time decided that they
had made so much money from the previous sales of video material produced at
Cryovita that they were unwilling to release that control. So, there was no
longer, at that point, the possibility of my signing a contract with them.
I have to believe their motivation was never high, and when this issue was
raised it was the end. As far as I know, this issue of public image and how
you are represented to the media is something that no organization will give
up -- and Cryovita is as sensitive about that as they are. I felt I owed an
ethical responsibility to team members, the relatives of patients, the patients
themselves and of course to myself, to protect the use of film footage and photos
made at Cryovita. So long as Trans Time would not agree that I would have equal
control over my images -- the same control they would have over their own --
there could be no contract.
CM: A mutual veto on use of images was unacceptable to them?
JL: That's correct.
CM: As you know, ALCOR has undergone quite a metamorphosis and change since
the days when you first became involved. You have been a very active participant
in that change. To what do you attribute those changes?
JL: The way things were divided up between Trans Time and Cryovita for patient
services and support was as follows: Trans Time subcontracted perfusion services
to Cryovita with the understanding that whenever it would be feasible to transport
a patient to Cryovita that would be done. Over that period there was only one
case where a patient was perfused in Northern California -- a case where the
patient lived relatively close to the Emeryville facility and there was plenty
of notice for Trans Time to prepare for that case. I flew up to Emeryville to
do the surgery and direct the perfusion.
Cryovita did not develop rescue/response capability to any great degree. There
were no full time people available down here at that time, and the overall level
of activity was very low. It was all I could do to maintain readiness at Cryovita
to handle perfusions -- and this was all I was obligated to do. All our work
in training was focused on getting team members some level of skill in perfusion
techniques.
Until the Northern California patient I alluded to earlier came along there
was little training for transport operations in either Northern or Southern
California. In 1980 I had the occasion to make personal contact with Mike Federowicz,
who I had corresponded with before. Mike had transported a Trans Time patient
to Southern California and then stayed on to help with a second suspension which
came on the heels of the first. Mike had been working in a cryonics group in
Indianapolis, Indiana for a number of years. At that time I tried to open the
door as far as doing what I could to persuade him that Southern California offered
an attractive alternative to the difficulties he was experiencing in Indiana.
I needed someone else out here to work with who had a background in clinical
medicine, such as Mike did, and he himself had begun to move toward clinical
models of perfusion -- using roller pumps and so on. I felt that he and I working
together would allow us both to accomplish a lot more than if we were working
alone. He was the only one else in the world who seemed to be aware of the fact
that something needed to be done to upgrade the level of care -- and to realize
that that meant medical technology.
When Mike came out here in 1981, (he remained "signed up" with his own organization,
the Institute for Advanced Biological Studies which he had brought with him
from Indianapolis) he came into closer involvement with ALCOR. He began to question
the adequacy of services being provided by ALCOR. There was no one in the presidency
of ALCOR who understood clinical medicine or who had the time to actually promote
growth of ALCOR.
Since ALCOR was totally dependent upon Trans Time for services at that point,
Mike began to urge changes at that level. Up at Lake Tahoe, shortly after his
arrival here, he lobbied Art Quaife, unsuccessfully, for the Trans Time purchase
of an A-2542 storage dewar. Mike felt that neuropatients should be stored in
such a dewar for reasons of safety, economy and logistics. He also strongly
urged institution of regular training for transport and perfusion, as well as
a better communications system for emergency responsiveness.
I think the beginning of the shift came shortly after the 1981 Lake Tahoe
Conference when an ALCOR member, who was also a Trans Time client and who was
dissatisfied with Trans Time's services, proposed that he purchase the A-2542
and that ALCOR pursue his father's care at Cryovita.
CM: Was Trans Time responsive to these requests for increased levels of training
and services?
JL: Mike and I felt that we needed to have a truly complete capability in Northern
and Southern California. We needed to have people locally who had rescue skills
and we needed liquid nitrogen available locally to allow us to conduct low temperature
biological studies on freezing viability and ultrastructure.
Since we hadn't developed patient storage and transport capabilities here
in Southern California it was perceived that ALCOR was really not able to respond
in the event of an emergency. Also, it had already been shown that there was
an inflexibility in Trans Time's storage of patients -- since they owned the
patient dewars and thus had a "lock" or "hold" on the patients. It was Trans
Time's policy to charge an amount of money during the initial phase of cryonics
services which was equal to the purchase price of the dewar space used by that
patient -- but not to let the ownership interest pass to the nonprofit organization
which actually had responsibility for the patient. In order to move the patient
the nonprofit organization would have to come up with thousands or tens of thousands
of dollars to purchase storage equipment which, in a real sense they'd already
paid for! It became crystal clear that the non-profit organizations, who had
final responsibility for patient care, could not move their patients from one
service company to another, regardless of the possibility of finding less expensive
or better services elsewhere, unless they owned the patient storage dewars.
There was always a lot of talk about the importance of having free market
competition and more than one cryonics service company so that if one company
went out of business others would be there to provide the needed services. But
the actual practice of BACS was to destroy their own ability to use the free
market to secure alternate services. There was a situation with interlocking
directorates between Trans Time and BACS and it certainly reeked of a conflict
of interest with regard to patient storage. I believed that the patient's interest
should always come first.
Mike felt that in order for it to be economically feasible for ALCOR to control
its own patients, and to pursue services elsewhere if necessary, ALCOR had to
own the dewars. That was impossible with Trans Time and that was a major factor
in ALCOR's deciding to provide its own patient storage.
There was also an inadequate amount of money being spent by Trans Time to
train transport teams down here. In fact there was no money being spent. There
was also no money being spent to maintain suspension team training. So ALCOR,
I think largely as a consequence of Mike's frustration over these issues --
and I supported him a lot in that -- decided that they would increasingly have
to take over the responsibility for emergency response services and storage
services. If they were going to do that, it was only a matter of time before
it came to everyone's attention that they might as well have their own independent
contract with Cryovita for necessary perfusion equipment and services.
CM: Why was this so?
JL: Well, at that time ALCOR was paying Trans Time for emergency responsibility
and perfusion services, but ALCOR was essentially providing those services.
It didn't make sense that we should have all of the responsibilities and none
of the benefits of emergency responsibility fees after costs. There wasn't enough
cash flow to support two facilities. I never expected Cryovita Laboratories
to be supported through cryonics, but to have no plan to support activities
in Southern California was a bit too much. So, when Mike was made president
of ALCOR he moved to change that relationship from one of dependence on Trans
Time to one of complete independence for ALCOR.
At that time, as now, Cryovita was completely independent so that it could
provide perfusion services to ALCOR or to any organization that it chose to
deal with. At that time that included Trans Time and the Cryonics Society of
South Florida.
CM: I'd like to change subjects for a little while and discuss your "professional
work." You work in the Thoracic Surgery Research laboratory of UCLA Medical
Center with Dr. Gerald Buckberg. A number of fascinating papers and research
results have been flowing out of that laboratory in the past few years -- much
of it of direct relevance to cryonics. Can you tell us a little about your work
there?
JL: Sure. I've been at UCLA for 15 years now. I was originally attracted to
the Thoracic Surgery Division because I realized that the techniques of perfusion
using extracorporeal circuits and artificial oxygenators to support patients
in deep hypothermia was exactly the kind of technology that would be required
in doing suspended animation research and procedures.
I'm in the Department of Surgery, Division of Thoracic Surgery, attached to
the UCLA School of Medicine. My primary responsibility is in the research laboratory.
However, I've worked on the clinical open heart team in the Operating Rooms,
and I'm a Board Eligible Cardiopulmonary Perfusionist. I've been through the
ECMO (Extracorporeal Membrane Oxygenation) training program at the University
of Michigan as well. The research has required me to acquire competence in thoracic
surgery techniques. I'm involved in training neophyte thoracic surgeons in the
laboratory environment as well as participating in research. My expertise in
low temperature biology has been useful, since most of the techniques for protecting
the heart involve hypothermia. You could say that I've had something more than
a graduate education in cardiac physiology. I've been functioning as a scientist
and have been co-author of over 25 papers coming out of the UCLA laboratory.
This is a distinction usually shared only with MD's and PhD's. I've also set
up the entire aortic valve/conduit storage program at UCLA, which involves the
cryogenic storage of human heart valves and arteries for transplantation into
children. But let's go on to the research and its clinical applications.
Most of the research focus when I began work at UCLA was aimed at protecting
the heart during operative procedures. At that time the heart was arrested so
that surgery could be performed on it -- it is almost impossible to carry out
delicate surgical procedures on a heart when it is beating normally in the chest
-- by electrically fibrillating it and applying topical hypothermia (ice slush).
One of the first discoveries that was made just previous to my coming there
was that electrical fibrillation caused the heart to consume 300% more energy
than it would use in the beating empty state -- where the heart would be contracting
but not pumping blood. Dr. Buckberg asked a fundamental question: "Why are patients
going home after we correct what's wrong with the heart and they're coming back
five years later in worse condition than when we got them and corrected the
problems that they had at first?"
He began to try to answer these questions by doing basic physiology on the
heart; what were the blood flow requirements, oxygen requirements? What did
hypothermia do? What did then currently used methods of achieving cardiac standstill
during surgery do to the heart long term?
Buckberg began to re-examine the technique of pharmacological arrest, a technique
where you use potassium to depolarize the heart's nervous system so that the
heart cannot contract. You can further reduce the ability of the muscle fibers
to contract by using a low calcium perfusate, and that's one of the things that
we looked at also. Ten years previously a surgeon named Melrose had thought
that an obvious technique for stopping the heart would be to introduce potassium
into the circulation of the heart and depolarize the neurons to inhibit contraction.
This was a sound principal, except that he didn't determine how much potassium
was needed -- and he used such high doses of potassium that it caused fatalities.
As a consequence of his suggestions employing such high doses of potassium,
the technique was assumed to be inappropriate and was abandoned for ten years.
Our laboratory, and a couple of others, reassessed this method, called pharmacological
arrest, and determined that if the proper dosages are used, this technique is
far more physiologic and results in far less injury to the heart than the electrical
fibrillation and direct icing which had been widely used before. The pharmacological
solutions used to arrest the heart are now called cardioplegic (heart paralysis)
solutions.
A natural extension of this work was to try to optimize the cardioplegia solution
-- to make it as supportive and nondamaging as possible. We decided that the
best vehicle to use for the potassium was blood itself -- the body's own best
perfusate. We systematically developed blood cardioplegia to stop the heart
quickly, to maintain it hypothermically with no injury and then to provide it
with metabolic substrate while in the hypothermic arrested state. Along the
way we discovered the importance of maintaining an alkalotic pH during hypothermia,
such as poikilotherm animals (turtles, frogs, and so on), do.
Recently our attention has been focused on providing adequate support for
hearts that have been subjected to ischemia, to no blood flow as a result of
atherosclerosis or heart attack. We began to look at patients who were coming
into the emergency room who had completely occluded coronary arteries in which
segments of the left ventricle, which does the real work of pumping blood to
the body, were beginning to fail. We had already demonstrated that we were able
to restart cardiac metabolism after periods of time which would have previously
been considered hopeless.
CM: Why was this work undertaken? What was the reason you made this discovery
about being able to "jump start" so called "dead" hearts?
JL: The reason that we looked at periods of normothermic ischemia was because
there were always cases in the operating room where the patient would have an
area of his heart that was so poorly perfused or not perfused at all because
of infarct or narrowing of a coronary vessel, that when you gave your cardioplegia
and arrested the heart, the cardioplegia solution couldn't reach the flow restricted
area. So, that area was subjected to a total arrest of blood flow without being
metabolically protected and without being cooled by the cardioplegia solution.
Often it was 45 minutes or more before good flow to that area could be re-established
with a graft. And those were the areas of the heart that needed protection and
metabolic support the most! So, you'd have warm ischemia in those areas until
you got the grafts in.
About this time the concept of reperfusion injury was coming to the fore.
There was work by Denton Cooley at the Texas Heart Institute, and others, which
indicated that the precipitation of calcium in the mitochondria in the cells
was a key cause of damage when circulation to an ischemic area was restarted.
This occurred because the cells were metabolically exhausted and unable to regulate
their ionic content. The important realization here was that the actual injurious
event came after the re-establishment of blood flow -- it was an indirect, not
a direct result of lack of oxygen and nutrients.
The natural question to ask was "What would happen if you gave the cells time
to recover to the point where they could once again handle the reintroduction
of normal ion levels?" We had, early on with our research with blood cardioplegia,
found it necessary to develop techniques for controlling the level of calcium
in the blood we were delivering to the heart -- since in hypothermia the heart
also cannot regulate its ionic milieu very well. We reduced the available ionic
calcium level in the blood using citrate. Later on of course, we used calcium
channel blocking agents in conjunction with that.
This was only the first and most obvious reperfusion injury. It was characterized
as the calcium paradox. You need calcium for normal contraction of the muscle,
but paradoxically if you reintroduce calcium before the cells are able to regulate
its level, you kill the cells.
This began to raise other questions about reperfusion injury. If calcium is
a problem are there other problems that can be addressed and solved? Since we
had demonstrated that controlling ionic calcium could redefine myocardial death,
at what point is the heart beyond recall? At what point should we give up trying
to salvage a heart? We don't know.
CM: What are the clinical limits right now? How long after an infarct has occurred
and the tissue has been deprived of flow is it possible to intervene and restore
function?
JL: Actually measuring the blood flow in an area of the heart which has suffered
an infarct is a difficult thing to do in a clinical situation. We have done
it in the research lab in dogs. In a clinical situation, the advance of disease
has usually been slow and the tissues have had time to compensate for it metabolically
by the development of collateral flow. So, it's hard to directly compare the
dog work with the human work. It's easy enough to measure blood flow through
an occluded artery and find there isn't any, but it is far harder to rule out
the presence of collateral flow -- flow from vessels feeding adjacent areas
of the heart. When you have one area of the heart's blood supply cut off you
can have such low pressure in that area of the heart that a trickle of blood
from adjacent areas can continue to flow through the infarcted area.
CM: What is the limit in the laboratory using the dog model where complete
absence of perfusion has been established?
JL: At the start of our work on regional ischemia in 1980, the accepted wisdom
of the time was that after three hours of 100% occlusion of the coronary arteries,
those areas served by those arteries would be 100% lost. Of course there were
always areas that were at risk in the perimeter of the infarct that would eventually
recover, because they weren't totally ischemic due to the presence of collateral
circulation.
We began using our substrate-enhanced cardioplegia to perfuse these areas.
We didn't, as you might first expect, perfuse these areas with cold blood cardioplegia,
because we wanted to enhance the metabolic state of the cells; and in order
to do this, we had to provide substrate at a temperature at which the cells
would be able to actively use it. So we used warm blood cardioplegia which was
substrate enhanced; containing amino acids such as aspartate and glutamate which
we had previously shown as being effective in "sparking" metabolism and restoring
the levels of important high energy compounds required for operation of the
cells.
Using this approach we were actually able to get hearts back after six hours,
which was twice what the common wisdom would have had you believe was possible.
During this same period of time we looked at some of the markers of irreversible
injury, such as ATP levels and vital staining (a marker of key enzyme levels
inside the cells) and we found that none of them were adequate to predict irreversible
injury. Whatever marker or barometer you want to use for irreversible injury,
one thing you can be sure of is that if the cells are able to function, then
they are not irreversibly dead! If the heart is able to pump blood and support
the life of the organism, then it's not dead. Therefore, all of the so-called
accepted indicators that we had looked at were inadequate to tell if there was
a state of irreversible injury. We demonstrated that what were thought to be
irreversible, end-stage levels of ATP were simply false. It was analogous to
saying that because you only have a sixteenth of a tank full of gas that your
engine won't run. What we found is that no matter how little gasoline you have
in your tank, the engine will run as long as there is some gasoline present
-- providing the engine was still in working order.
What we found was that myocardial cells would function normally even if you
had ATPs that were one-half of what was then felt to be the threshold of irreversible
injury. Likewise, we found that vital staining techniques which rely upon the
presence of myocardial enzymes (they do not stain the areas that have low levels
of enzymes -- supposedly indicating "cell death") were not really predictive
of irreversibility. We found that the areas that were unstained using these
vital dyes were actually capable of contracting and contributing to cardiac
output -- which is not possible if the tissue is dead!
We've looked at a range of other markers as well -- high energy compound levels,
a range of vital staining techniques, ultrasonic crystal evaluation of myocardial
cell work performance, and electron microscopy (to evaluate structural changes
after hours of ischemia). What we've found, working in conjunction with Dr.
Schostrand, who is the world's foremost expert on the ultrastructure of the
mitochondrion, is a perfect correlation between the structural condition of
the mitochondria and the functional state that the cells containing these mitochondria
were able to achieve.
CM: So in other words, your basis for pronouncing a piece of tissue or a cell
irreversibly injured has shifted from the rather indirect approaches represented
by markers such as vital staining and ATP levels, to the much more direct criteria
of structural changes?
JL: Our conception of myocardial death has evolved essentially to become perfectly
analogous to the cryonics position on irreversible death. That is to say, if
we look at the cells and there's nothing there -- that is to say there is no
structure present in a key area, such as the mitochondria, we find a high correlation
of no function. On the other hand, if we find structure there, we find that
the only reason it doesn't function is that we haven't learned how to make it
function yet. The farther we go, the more we learn about how to make cells function
which still have structure left! The only thing you have to have is structure.
In other words, if the cells exist, if their components are reasonably intact,
at this point we have to say that every time we do something else (so far) we
are able to restore function. There is no identifiable cell with structure that
we haven't been able to adequately reperfuse and recover to function at this
point. Of course, we haven't looked at cells that have had no energy input into
them beyond a certain point -- in the dog model we've looked at ischemic episodes
of up to 16 hours duration -- which is twice what anyone else though was possible
to achieve.
We've gone on to apply these principles to the treatment of patients in the
clinic. We've gone far beyond what we have developed in the dog lab. We've done
many patients who've had 12 hours of ischemia and we've done some patients who've
had 24 hours of regional ischemia in the myocardium. Sure enough, if you reperfuse
them exactly the same way as we reperfuse ischemic dog hearts, 6 days later
the patients are going home with normally contracting left ventricles. If you
compare those to patients who were in better condition to begin with who've
been given the standard treatment of simply re-establishing blood flow to the
affected areas using streptokinase (a clot dissolving enzyme) or balloon angioplasty
(to dialate plaque clogged arteries) in which you get an adequate blood supply
to the ischemic areas, those patients typically come into the catheritization
lab not in cardiogenic shock and they typically leave the catheritization lab
in cardiogenic shock! Which is to say that they are worse off than when they
arrived -- they have suffered reperfusion injury. So they've had injury added
to insult and in following up these patients we've found that the infarcted
areas of the myocardium scar over and suffer tremendous loss of tissue and consequently
of function. That is, the structure was destroyed by inappropriate treatment,
with a subsequent loss of function.
At this point in time the patients that the cardiologists are willing to hand
over to us for our clinical trials are the patients who are in the worst shape.
They are in cardiogenic shock and the cardiologists themselves are reluctant
to try to treat them -- since conventional approaches which simply revascularize
the injured area will initially only worsen the patient's condition. This is
something these critically ill patients cannot tolerate. Indeed, they have lost
more than a few such patients in the catheritization lab using streptokinase
and balloon angioplasty.
Thus the cardiologists have increasingly begun to turn over these patients
to us for controlled reperfusion in the operating room. The groups of patients
that we've compared using controlled reperfusion versus those who've simply
been revascularized with streptokinase and balloon angioplasty have shown a
striking contrast. The ones that we've done have all left the hospital with
functioning ventricles. As a matter of fact they've all shown some degree of
return of function immediately after treatment. If the patients are in cardiogenic
shock, or are requiring extra support such as an intra-aortic balloon pump then
by the end of the procedure they usually no longer need it. By contrast the
patients who are inappropriately reperfused typically experience a reperfusion
injury and go into cardiogenic shock and often have to be placed on intra-aortic
balloon support. So my exposure to dealing with the so-called markers of irreversible
death in the research laboratory at UCLA has only served to reaffirm my previous
intentions and my previous beliefs that if we knew how to treat a patient who
had been without adequate blood flow we could deal with this -- in principle.
In at least one organ, the heart, we have been able to deal effectively with
reversing the injury due to both ischemia and reperfusion such that we have
had to completely discard what were then accepted criteria for irreversible
injury. I think this is a principle that may well be applied across the board
to virtually every organ system in the human body.
CM: What research areas in cryonics do you feel need to be addressed in the
next few years?
JL: Virtually every aspect of the procedure (laughter). We're like children
standing the middle of the Hershey factory at lunch time. We've got all these
goodies begging for our attention in virtually every direction that we look.
It's very difficult to decide what to do first. We need to do everything. We
need to do virtually everything that clinical medicine itself is beginning to
look at. Namely, the causes of ischemic and cryoinjury and how to control them.
How do we prevent real cellular death as represented by overwhelming loss of
cell structure?
In order to address that issue I think you have to look at what you do when
you put someone into cryonic suspension. It's a process that starts out at some
point, you go through some definitive procedures, and you end up at liquid nitrogen
temperature. Let's take a look at step one. What can be done at step one, transport
of the patient? What can we do to improve the chances of that patient getting
through transport with the least amount of injury? I think it's of critical
importance that we mobilize all that we can from clinical medicine to minimize
the amount of ischemic injury the patient gets. There is a definitely a time-related,
quantitative change in the structural content of the cells -- in the amount
of damage done -- versus temperature and the overall treatment of the patient.
That's something we can measure and get a handle on. We know that the longer
a patient is ischemic the worse the injury is going to be; from the work of
others and from our own experience as well. We also know that simple reduction
of the temperature will go a long way toward reducing the severity of the injury.
We need to improve our responsiveness and our ability to rapidly reduce the
patient's temperature while providing circulatory and metabolic support. We
need to improve our pharmacological intervention to further minimize ischemic
damage.
CM: Those are certainly very practical things, but they are not exactly what
we had in mind as far as pure research goals.
JL: What I'm saying is that we have to start at the beginning. We need to concentrate
on protecting the brain from ischemic injury. This is a problem which needs
a lot of attention in terms of research and improved capability.
I'm not saying that you can afford to ignore cryobiological research -- which
cryoprotective agent to use, what's the best concentration, how do we avoid
cracking, and so on. We already know that no matter how good we get at cryoprotection
or ischemia injury reduction, we've still got the terrible phenomenon of cracking
of patients who are cooled to liquid nitrogen temperatures. As I said at the
outset, there are lots of areas which urgently need attention and these areas
all need attention and need it now.
I think it's very important to avoid the state of mind that people have typically
had in cryonics in the past of being willing to accept any kind of injury as
long as the tissue has been reduced to the solid state. That seems to have been
the hallmark of success in cryonics in the past: if you get them frozen, nothing
else matters. I think it's going to take more than this for cryonics to work.
It's tremendously important to know that you are preserving cell structure rather
than blindly proceeding and hoping that future medical and biological scientists
will be able to straighten everything out. Where we have to start in accomplishing
this is to do everything we know to do. If we start with the attitude: "Well,
this doesn't matter, they'll figure out how to fix that tomorrow," then we've
surrendered before we've started to fight.
Once we're doing everything we know to do, then we can start working on areas
where we don't have any clear ideas of what we can do to improve preservation
of structure.
CM: But certainly there's a cost vs. benefit ratio here. One wouldn't for instance
want to apply a technique which would improve structural preservation by 1%
but which would raise the cost of the procedure 1000%! How do you address that
interplay between cost and quality?
JL: We don't have an adequate yardstick for making such an evaluation. In some
areas we don't know what the hell the result will be. And that's a problem we've
had all along. Of course, that's been a major focus of ALCOR and Cryovita's
research. The work we've been doing on ultrastructural preservation, on structural
changes during ischemia, and in frozen patients are critical in establishing
this baseline. What we need to do is assess any changes in protocol that we
make on the basis of improvements in structural preservation.
Once this correlation is established for a given procedure, it then becomes
an economic and personal question, not a scientific one. Are people willing
to pay for it? Do they want to pay 1000% more for a 1% improvement in structural
integrity? At least we can tell them what we can do and what it is going to
cost.
CM: How do you feel about offering a range of services in terms of quality?
One of the reasons some people, such as many of the older CI members, have given
as to why they are not signed up with ALCOR is that they can't afford the quality
of the services offered -- and perhaps don't feel the extra dollars spent return
a sufficient dividend in terms of structural preservation.
JL: I think that the baseline that we have to measure other techniques against
is the one that we're developing and currently assessing. If someone can't afford
the techniques we offer and the protocols we apply, then we are obligated, before
we offer any other protocol, to quantify and qualify this in some way by doing
the studies that will document just exactly what it is we're delivering. I can't
allow myself ethically to be in a position of having someone who is not involved
in clinical medicine, who is not involved in doing cryonic suspensions, who
has no clear idea of what the impact of what they want done to them will be,
to be telling me how to do cryonic suspensions. They're coming to me and asking
me to do something for them which neither of us understands. They're just hoping
that whatever is done will be adequate. I have to have some confidence that
the procedure I'm employing will work or has a some reasonable chance of working.
Everyone involved, both the patient and me, have to be informed about what's
being done. Informed consent is a critical and important medical standard which
should not be tossed aside.
CM: So what you're in effect saying is that a clear understanding of any proposed
lower-cost protocol has to be had, or at least as clear an understanding as
is present for existing protocols, and this understanding must be translated
into a set of caveats or an informed consent document of some kind?
JL: Absolutely. For example, it may be possible to preserve a patient's life
by amputating his leg if he has a crushing injury, or it may be possible to
save his life and the limb by doing a very complicated and costly vascular surgery
procedure on his leg. One patient may say "I don't have the money and I can't
get it, so I'll have to go with the amputation because I want to live." It's
very difficult for us to be that definitive in developing protocols to preserve
structure. I think we will eventually get to the point where we'll be able to
look at structure and say "This is probably adequate structure to allow for
a reasonable chance at recovery of function."
They're asking for decisions based on criteria and evidence which are not
yet developed. That's part of the immediate research goals that need to be developed.
What is the necessary degree of structural integrity which can reasonably be
envisioned to allow for restoration of function? What are the minimum protocols
required to achieve that degree of structural preservation?
Our existing transport procedures are aimed at preventing ischemic injury
by providing adequate circulation. If ischemic injury has already occurred,
what can be done to reverse this injury or limit its effects before perfusion
with cryoprotective agents? Our transport pharmacological protocol is an attempt
to affect ischemic injury.
An area that begs to be studied is how our cryoprotective perfusion protocols
affect cellular structure in terms of reperfusion injury to patients who have
been exposed to ischemic injury. Cryoprotectant toxicity and its effects on
structure is another area. We already know that freezing, with storage at LN2
temperatures, causes fracturing. We have to develop methods of low temperature
storage that will avoid fracturing, which may mean higher storage temperatures
for frozen tissues. The most compelling concept in cryobiology in recent years
is vitrification, which avoids freezing, but requires higher storage temperatures.
Whatever direction our research goes, structural preservation of cells and tissues
will be our "gold standard" in the near term.
CM: You've been involved in a long-standing battle with the Society for Cryobiology
over the legitimacy of cryonics and over cryonicists presenting conventional
cryobiological research at Society meetings and publishing scientific papers
in their journal CRYOBIOLOGY. Could you discuss your point of view on these
issues?
JL: Some years ago I heard that some members of the Society for Cryobiology
were totally opposed to cryonics. I've been a member since 1970 and occasionally
I'd hear offhand remarks about cryonicists from a few members of the Society.
Nothing very serious, just offhand negative comments which indicated that they
knew almost nothing about cryonics -- usually comments made in the context of
talking about other things.
It only became an issue with me during the 1982 meeting in Houston, Texas
when there was a policy statement about cryonics put before the Board of Governors
for approval which I considered to be inappropriate. It stated that cryonics
was not scientific in nature, and while it was not the business of the Society
to judge what people's beliefs should be, they nevertheless considered cryonics
to be inappropriate. Basically they wanted to disassociate themselves from cryonics.
CM: What was the reason given for this action?
JL: They stated that they had had inquiries about cryonics from the general
public and the news media and that they needed a formal way to respond to these.
By directly questioning them at the time I learned that these inquiries had
amounted to a grand total of three over the previous year. This is not what
I would consider a nuisance level of inquiries about cryonics. I considered
that the reason they were making this policy statement was not because the inquiries
were a nuisance to them or likely to result in cryonics being associated with
the Society in the media or public mind. Rather, I feel it was because there
were specific individuals on the Board who were antagonistic to cryonics --
for reasons which were never stated.
CM: But don't you feel the Society has the right to distance itself scientifically
from activities of which it doesn't approve and of which it doesn't feel are
workable or ethical?
JL: I certainly think that the Society has the right to do anything that it
wants in the context of its stated purposes and Bylaws. I do not feel it is
the purpose of the Society to make pronouncements about activities (such as
cryonics) about which they are not well advised. It has been my personal experience
that they are not advised about what cryonics is about, or about what we are
doing of a scientific nature -- or where the science leaves off and where aspects
they would consider nonscientific begin. So, they have some sort of personal
views which cause them to be antagonistic. I don't know what those views are,
since I'm not in their confidence.
However, there have been statements from people such as Dr. Harold Meryman
(a founder and past President of the Society) in the written form in which he
has expressed the opinion that cryonics and the idea of biological immortality
are mischievous in the extreme and socially undesirable. The general flavor
of his written statements has been that he feels cryonics has the potential
of diverting funds from what he considers legitimate research in low temperature
biology. He seems to feel that if cryonics was accepted as a legitimate endeavor,
then money which would go to laboratories such as the one he oversees would
be diminished.
CM: The Society's initial policy statement seems fairly benign. Certainly it's
one that ALCOR has no trouble with. It seems a fair policy statement and it
is our opinion that Society for Cryobiology has the right to distance itself
from cryonics or from other endeavors which they deem unscientific or unworkable.
JL: There was something else that occurred at that meeting in 1982 and that
was a general overhauling of the Bylaws of the Society. I felt that there were
a number of issues touched on in the Bylaws that reflected on the control that
the Board of Governors would be able to exercise with regard to membership and
the possibility of practicing exclusionary policies towards individuals who
might be known to be engaged in cryonics activities.
It is one matter to issue a statement of "nonsupport" or to express your opinion
about an area of endeavor, and quite another to interfere with presentation
of legitimate, conservative scientific research or to interfere with access
to cryobiological research by others just because you don't endorse or approve
of their "nonscientific" endeavors.
CM: Why do you feel that it's important for cryonicists to be able to participate
in the Society for Cryobiology and to attend meetings and become members?
JL: I think that it's important for anyone who's doing research on suspended
animation and who's interested in the effects of low temperatures, cryoprotective
agents and so forth on mammalian tissue to be involved with the Society as a
scientist. I think that there is absolutely no conflict of interest between
a cryonicist who's doing actual animal research on the cryobiology of mammals
and his membership in the Society just because he also happens to be a cryonicist.
Participation in the Society offers a public platform in which an investigator
can present his findings and get feedback at scientific meetings from some of
the world's foremost experts in cryobiology. If an investigator is doing good
work -- work they would normally accept as legitimate and be willing to listen
to -- then what difference does it make if he is also involved in cryonics or
if the ultimate aim of that work is to further cryonics? What they are doing
is making a moral judgement about the motivations and purpose of that investigator
and his work. That is totally outside the realm of their charter, their Bylaws,
or accepted practice in such matters. I challenge them to show that the goal
of cryonics, which is survival, is either unscientific or unethical.
CM: If the Society for Cryobiology decides to prohibit the attendance and participation
at meetings and the publication of papers by cryonicists, papers which deal
strictly with so called "legitimate" or "conventional" cryobiology, what sort
of action do you feel should be taken?
JL: It is my understanding the a new resolution has been formulated and approved
by the Board of Governors in which members can be expelled from the Society
and forbidden from participating at meetings if they have a known public association
with cryonics. It is my belief that my chances of having any additional work
presented before the Society is minimal because they know that I am associated
with cryonics.
I simply must wait to see if they prevent any more of my work from being presented.
At that time I will have to consult with a lawyer and see what can be done.
UCLA has paid for my attendance at Society for Cryobiology meetings for a number
of years, and the reason that they did that was because our work at UCLA involves
the effects of hypothermia on the heart. As a consequence we need someone in
the laboratory who is current on the effects of hypothermia on the myocardium
and on other tissues as well. It's important to UCLA that I attend those meetings
and remain current in that area. Part of keeping current on any endeavor is
the opportunity to present research and to interact with others at the meetings
-- to experience peer review.
It is also of critical importance to realize that work that's being presented
at scientific meetings is considerably ahead of what's being published in journals
and books. It's cutting edge stuff -- and that can be essential to providing
good patient care in cryonics as well as to a successful professional career.
So, I would have to take real exception to being excluded from meetings and
membership.
CM: Do you really feel that litigation is a constructive approach here? Do
you think that people can, in essence, be forced to cooperate with you?
JL: I don't consider it forcing people to cooperate with me. I consider it
trying to prevent people from taking unjust action against me. There's no loss
to them as a result of my participation in the meetings of the Society for Cryobiology.
But there is a personal loss to me -- professionally -- if I'm unable to attend
the meetings. I'm only asking that they cease and desist in taking action against
me. The purpose of a scientific society is to promote and disseminate information
-- not pass judgment about people's philosophical, personal, or political beliefs.
The legitimacy of my participation, or any other person's, should be judged
on the basis of my scientific work. That is the standard that is accepted in
science and it is the only standard which should be applied.
CM: Litigation against the Society would be an extremely costly, time consuming,
and draining affair. Do you feel it will be worth the effort considering the
many other pressing issues which need to be addressed in cryonics?
JL: I think that when you take the overall effect of the kinds of actions the
Society would be taking in order to exclude me from membership and meetings
and to prevent scientifically valid and useful research information from being
disseminated to peers and the public, then I think there are substantial ethical,
economic, scientific, and personal issues at stake. Not to fight is to tacitly
endorse such witch hunting. It also cuts off our access to minds which have
the ability to improve the state of the art with respect to cryonics and suspended
animation. I don't think the issues are just personal ones by any means. They
are very practical ones as well in the long run.
As to the costs, I have limited funds and I would be willing to commit some
of these to such a fight. I would no doubt need help from others: financial
support, free legal advice, and so on. How far I would get would depend upon
how much support I would get from others in the cryonics community who feel
as I do.
CM: What do you feel is the future for cryonics as a whole?
JL: Since I've been involved in cryonics there have been ups and downs. This
involves a fairly short period of time so I can't really say what the future
will hold. However, there certainly has been a real growth in membership over
the last few years and there certainly is more research going on than has ever
gone on before in the history of cryonics. Even when we were hitting lows in
membership and public interest in the years preceding these last few, the research
work continued to advance. I think we're becoming more professional in almost
every aspect of our operations and that bodes well for our future. The better
our research base becomes, the more convincing our program will become. That
should lead to greater public involvement and even faster rates of growth.
Of course, the media have long had a romance with cryonics and I don't see
that changing. So, if things continue as they have and cryonics continues to
grow, I think its future looks great!
CM: What do you see as the prospects for cooperation in the future between
the various cryonics groups?
JL: Well, historically the various groups have always had different individuals
who had different philosophies of how to make cryonics work in terms of selling
the idea to the public. Cryonics groups have tended to have a single individual
which each local group has rallied around. Those were largely personal issues
rather than substantive philosophical or procedural issues which determined
how the various groups got along.
However, in later years there have been increasing differences based on issues
rather than personalities. In particular issues involving investment in technology,
doing research, safe practices of patient storage and handling, these began
to evolve into real differences.
In Southern California with ALCOR we've tended to push for advancing technology
both in terms of perfusion and greater safety in terms of patient storage and
handling. I think these advances and concerns will stand us in good stead when
we go to the public and try to interest them in cryonics. Others have taken
the reverse view that if you can just get people interested in cryonics you
can raise the money to pay for the technology. Well, when you're intimately
involved in patient care the technological issues become more acutely appreciated.
I've been involved in doing most of the cryonic suspensions which have been
done over the past few years and to me those are the critical issues, issues
which have to be addressed up front. In other words, we have to show that we
can do something before we can convince people that there is a degree of hope
and the prospect of success.
CM: So are you saying that you don't see the likelihood of cooperation between
the various groups as being good until the underlying philosophical and technical
differences are resolved?
JL: I think that cryonics is a scientifically and technologically demanding
process. I think it simply cannot be done without using certain minimum standards
of technology. If there is anyone out there who thinks that you can rely on
future medical advances to restore what you've lost by your lack of technology
or effort, there will never be a unified front in cryonics which will form a
basis for mutual cooperation. I certainly am unwilling to yield on the issue
of good patient care. Anyone who wants to do less than I already know should
be done can look elsewhere to achieve unity and political cooperation.
At ALCOR we find it impossible to wait for every cent of money to be raised
for research or to do other things that need to be done. That's why a lot of
us put our personal money into it. In Michigan they seem to have a point of
view which relies almost completely on future technology to make up for their
own inadequacies now. That is a view which I find there is no room for agreement
with. It is not a view I can accept or cooperate with.
The stated reason for the differences in the level of technology between Northern
and Southern California is that the Northern California group has said that
when they have enough money to support high technology then they will do so.
But until then, no.
CM: In fairness to CI, that's essentially the position they claim they are
in. They say they have many retired members who do not have the money to afford
the kind of technology ALCOR offers. They do not believe the neuro option is
acceptable and they say they would rather accept the extra injury rather than
go neuro.
JL: If they're maintaining that it is appropriate to maintain a low level of
technology because some of their members cannot afford the higher level then
what about the new members that are coming? What about the consideration that
the charges being used by everyone else in cryonics are much higher than theirs?
Where is their supporting information and data? Where are the case histories
and technical information which offer their members the information they need
to make a choice about what kind of service they want? People can't make an
informed decision in a vacuum.
Their statement that they are willing to back high technology when the money
becomes available is acceptable. What is not acceptable is that they are not
willing to arrange a cooperative relationship with another organization which
already has the technological capability to serve their members. That's a consideration
that maybe they should give more thought to. When they start talking about those
issues, then we can start talking in a positive way.
In regard to their position on neuropreservation vs. whole body suspension:
Historically, neuropreservation has been perceived as the low cost option in
cryonics. However, there are those who think that it is perhaps a safer long
term method of cryonic suspension due to ease of handling patient storage and
the less likelihood of failure of storage systems and so on. It's a complicated
issue, but I consider it untenable of them to take the view that the neuro option
is not feasible or unlikely to succeed. I've never seen them give any evidence
to support their views on that. At least none that was of a scientific or technical
nature. The only view I've heard them give was one of a social nature. They
felt that espousing neuropreservation would be unacceptable to the public and
therefore would affect their ability to deal with the public in terms of acquiring
new members.
Since that is contradicted by the reality that ALCOR is able to acquire new
neuro as well as whole body suspension members, to me that's a nonissue and
one that represents some prejudice on the part of the leadership in Michigan.
CM: Do you have any regrets about your life? About the lives you've taken,
your war experiences or about your involvement in cryonics?
JL: I'll start with the last part first. I have absolutely no regrets about
my involvement with cryonics and science. I think for the most part that I've
probably taken an adequate course to contribute to the history of cryonics and
suspended animation. As things have evolved these are activities which are not
being pursued by very many and a career in medicine would not have allowed me
to pursue these things in an institutional environment. So, my involvement in
cryonics has worked out better than if I had taken other courses in a professional
life.
As far as my war experiences are concerned I have no regrets about my involvement
in the war or the activities that I participated in. The only thing that even
remotely would be considered a regret in that respect would be the effect that
it has had on my life over the past two years in which I found myself returning
to those memories of that conflict. Memories not of activities which I thought
were not appropriate, but rather to the feelings that I had about the friends
that I lost in that conflict. Secondarily, re- experiencing those losses and
dealing with those emotions, which is something I didn't do completely before
because of the social environment that was imposed on soldiers returning from
that conflict, cost me a relationship, one that I valued very much. The loss
of that romantic relationship is something that I'll probably regret the rest
of my life. Even so, I do not regret having fought against an organized political
system, which, even today, threatens the freedom of its own citizens and those
of neighboring countries.
CM: What do you plan to do if this thing really works? What are your long term
goals and ambitions?
JL: To be a free man who is allowed to pursue whatever in life allows me to
contribute to my wellbeing. I've done a lot of things in the life that I've
already lived. I suppose the outstanding things in my own mind about my life
are things that have been adventurous in one way or another. I think the things
that have impressed me the most have been things which stimulated me both intellectually
and physically.
I'm probably like most people who enjoy living. I like to use all my senses.
I like to see things that look good, smell things that smell good and use my
body and mind to the fullest.
If I wake up in the future some time and I have to get a job on the basis of
what I've already done I'd probably become involved in science and technology
on some level. Although I would like to have also the romance and adventure
that I've already experienced on some occasions in my life -- only more of it
and more lasting in the future.
CM: That surprises us a little. We figured you more as a spacedog or soldier/adventurer,
solar sail ship captain. . .
JL: I was getting to that (laughter). As a soldier, as someone who has worked
in secret military operations and as an assassin I would be able to get a job
perhaps as a blade runner (laughter). That would be an easy one for me because
that's the kind of job that by its very nature only requires a limited amount
of specialized skill and capability. It mostly requires good senses, guts, and
physical ability. The environment that you operate in is the only thing that
requires specialized training and that can be acquired rapidly. So, yes, when
I was asked the question as to what I would be in the future at one of the Tahoe
meetings I said that I would like to live long enough to become an Interstellar
Smuggler -- such as Han Solo of STAR WARS. That would suit my lifestyle well.
Particularly if I could find a Princess Leia out there among the stardust.
Jerry Leaf was cryopreserved in 1991.
See Jerry Leaf Enters Cryonic
Suspension.
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