Cryonics, April - May 1986 INTERVIEW WITH MIKE DARWIN by Luigi A. Warren

Mike Darwin is President of the ALCOR Life Extension Foundation. Now aged 30, his involvement with cryonics stretches back to his high school years in Indianapolis, Indiana. Few cryonicists can claim such a long history of participation at the "sharp end" of this idea.

It was Mike's "What You Can Do" article in CRYONICS which brought me to the United States from England, a year ago. That, and the fierce dedication which he communicated in all his writing, was enough to convince me that cryonics, ALCOR-style, was for me.

I am happy to report that Mike fully lived up to my expectations. He's smart and very articulate, of course. More importantly, he is utterly focused on the task of achieving physical immortality through cryonic suspension. He has no time for armchair dreamers who effervesce with proposals, good or bad, but never do anything to turn them into reality. Mike's a doer. He also has the valuable faculty of being able to fire others with some of his sense of urgency and enthusiasm concerning cryonics. That's vital in an enterprise which offers few short-term social and monetary rewards.

Mike's extraordinary range and depth of experience in every aspect of cryonics -- medical-procedural, theoretical, organizational, financial and promotional -- is perhaps his most irreplaceable asset. He's seen the rise and fall of public interest in cryonics, the vicissitudes of organizations, the projects that never materialized, the setbacks and the out-and-out disasters, as well as the years of slow, steady progress, to which he has contributed much. As a realist, his refusal to view the world through rose-tinted glasses has often generated friction with other cryonicists, who prefer to take the more optimistic view, but I have seen his judgment vindicated often enough to prefer the Mike Darwin approach. And it is doubly encouraging, therefore, that he speaks in this interview of real prospects for major technical advances and growth in the public acceptance of cryonics.

This interview was conducted at the end of a long day at Cryovita Laboratories (the early hours of the morning, actually: Mike's a creature of the night). As we sat down in the reception area of the ALCOR office, I wasn't hopeful for a productive session. It had been one of those too-frequent days when more problems came up than were resolved, and Mike seemed down. But his demeanor changed as soon as I started quizzing him on his favorite topic: cryonics. We spoke for three hours.

LW: ALCOR has conducted extensive research into the effects of cryonic suspension. What have you learned, and how has it affected your confidence in the technology?

MD: That's a lot of ground to cover; we've done a great deal of research in the last few years. I'm still confident that cryonic susension is a workable technology; that it is going to allow us to get to the other end. However, today's suspension techniques cause damage, which implies a loss of information and a reduction in the fidelity with which identity may be reconstituted. It doesn't have to be that way. I think the damage we're seeing is due largely to technical problems which could be solved given a relatively moest amount of money.

LW: What kinds of injury have you identified?

MD: Briefly, there is damage at the fine level (the cell ultrastructure) arising direcly from the freezing process and as a result of ischemic periods (without blood flow) prior to the procedure, while, on a gross scale, we are seeing serious tissue fracturing on cooling to liquid nitrogen temperature.

LW: What's happening at the "fine" level?

MD: The research we conducted in this area involved examination of tissue samples from a Northern California suspension patient, who was converted from whole body to neuro, and from cats which we perfused and froze using the best techniques available, some immediately after death and some after 24 hours of cold ischemia. Our initial light microscopy work gave us a lot of confidence that we were preserving essential structure. The cell-to-cell relationships looked well preserved.

We proceeded to do electron microscopy on the cat samples, to evaluate preservation on the level of the individual cells. I'm much less happy about the results of this work. Preservation of cell ultrastructure in the kidney and heart were very good. Liver preservation was very poor; there was almost complete loss of structure, as if the sample had been ground up in a blender. The condition of the brain was intermediate between that of the liver and the heart and kidneys.

There are a number of caveats here. Because we have a limited number of animals to work with and because electron microscopy, in particular, is very costly, we have to make some decisions about experimental technique which are based on limited information and which are to some extent arbitrary. Some of the things we are seeing may be artifacts of our experimental procedure.

LW: What kinds of artifacts?

MD: One is the phenomenon of osmotic dehydration. Before you can look at biological specimens with an electron microscope, they have to be fixed. (Fixatives, such as glutaraldehyde, lock molecules together with crosslinking bonds.) The cells in thawed tissue contain a solution of water and cryoprotectant -- glycerol in our experiments. If the fixative isn't prepared in a solution with the same concentration of cryoprotectant, then water will pass through the cell membrane by osmosis, until the concentrations are the same on both sides (this is called equilibration). If the concentration in the cell is lower than that in the fixative the cell becomes dehydrated.

Unfortunately, it's very difficult to estimate the concentration of glycerol in a particular piece of brain tissue accurately and reliably. The approach we took was to assume a value equal to the last recorded concentration of the effluent during the original perfusion with cryoprotectant.

In retrospect this may have been a poor choice. The brain does not equilibrate well with cryoprotectant, so the actual concentration of glycerol in the brain cells was probably lower than we assumed. Introducing fixative with this concentration of glycerol probably caused significant osmotic dehydration of the brain cells. This would have caused them to undergo partial collapse, which could have been responsible for some of the appearance of disruption we observed. The kidney and heart equilibrate with glycerol better than the brain, so the estimate of glycerol concentration we used in preparing the fixative was probably a better match for those tissues, and they showed up well under the electron microscope.

Another problem is that tissue which has been cooled to liquid nitrogen temperature fractures -- the gross level problem I mentioned -- making it impossible to use the circulatory system to introduce fixative evenly, as would normally be the case when preparing such samples. That's going to have some impact on the results you get from electron microscopy.

LW: What can be done to improve the quality of ultrastructural preservation in the brain?

MD: It may well be possible to eliminate most of the damage we are seeing at this level by vitrifying instead of freezing. Vitrification involves introducing relatively high concentrations of antifreeze compounds during perfusion. Instead of freezing, the water-cryoprotectant solution gets thicker and thicker until it forms a solid, without any crystalline structure -- a glass. Vitrification occurs gradually, over a temperature range of several degrees. There's no sudden phase change, as with freezing. This is advantageous because we believe that the damage we're seeing comes about largely through mechanical disruption when ice crystals are formed, and from the increased concentration of chemicals which were formerly dissolved in the water and are "frozen out" in the phase change.

On the other hand, very high concentrations of antifreeze compounds are toxic. But a number of researchers, including Fahy, Takahashi, and Rall, have shown that a wide range of tissues can be vitrified without significant injury. Embryos can now be vitrified and recovered. A certain type of white cell, which has proven to be highly resistant to freezing, can now be vitrified. Fahy has shown that kidney slices can be loaded and unloaded with the requisite concentrations of cryoprotectant with only a slight reduction in viability. I understand that, in unpublished work, liver slices have been treated similarly, with virtually no diminution of viability.

There are many technical problems that must be solved before we can apply vitrification successfully. The biggest is getting high enough concentrations of cryoprotectant to penetrate the fatty myelin which covers the white matter in the brain. I think that answers could be had with the application of relatively little money. Preliminary experiments which we have conducted with propylene glycol and DMSO indicate that this cryoprotectant combination will penetrate the brain, and do so rapidly.

LW: However, you also mentioned that there is ultrastructural injury due to ischemia. Vitrification won't help there. What are you finding, and what can we do about it?

MD: We know that a tremendous amount of damage is occurring due to ischemic periods, when the brain is deprived of oxygen and nutrients. There were large areas in the brains of the animals that had been subjected to ischemia where it was obvious that cryoprotectant had not penetrated well. There were blood filled capillaries where clotting had occurred that had sequestered tissue from flow. There was extensive interstitial edema and breakdown of structure, and much debris and loss of structure and ground substance (the basic molecular framework which comprises the tissue).

LW: Are you saying that ischemia, in addition to causing damage prior to freezing, also impairs the permeation of cryoprotectant into the brain?

MD: It's probably worse than that. That is certainly a fair statement, but ischemia may also cause the cryoprotectant perfusion to do a lot of additional injury. If you look at ischemic tissue without having restarted circulation, it looks very good. It's only when you restart circulation that everything falls apart. You're then supplying oxygen, which generates a lot of free radicals, and metabolites, which restart metabolism in fashions which are inappropriate or awry. A tremendous amount of injury that we see in animals or people who are revived after ischemia is what we call "reperfusion injury," due to the restarting of normal circulation. I think that what we may be seeing in our frozen ischemic animals is also reperfusion injury, due to the attempt to introduce cryoprotective agents.

One highly speculative conclusion that might be drawn is that it might be better to simply proceed with straight freezing, without cryoprotectants, when presented with ischemic patients. This needs to be evaluated. In fact, we have tissue from animals that have been straight frozen, with and without ischemia, sitting in storage now, but we don't have the money to evaluate them. The answer to the question is probably sitting in the back of Cryovita Laboratories right now, but we need $3000-$5000 to do the research that could give us some definitive answers. That infuriates me.

LW: Do all suspension patients undergo significant ischemia?

MD: No. In fact I can think of suspensions I have participated in where that wasn't the case. In one case the patient had a total of only about 60 seconds of ischemia. That's trivial, especially when you can provide good metabolic support by getting the patient on a Heart Lung Resuscitator quickly, and then on to a blood pump within fifteen or twenty minutes from the time of cardiac arrest.

There will always be ischemic episodes for some patients, when death occurs suddenly and there is no cardiopulmonary support, or when the ability to provide effective gas exchange or cardiac output is minimized due to the dying process. If you have someone whose lungs are 80% malignant tissue, or who has pulmonary edema so that the lungs are filled with fluid, then there's very little gas exchange area -- the patient essentially dies from suffocation -- and CPR is not going to be very effective. There are also cases of elderly patients with extensive arteriosclerosis, where a fairly high perfusion pressure is needed to get adequate circulation -- and CPR isn't going to give you that kind of pressure. An issue which will have to be addressed sooner or later is: do we want to wait around for these kinds of terrible injuries to be imposed on us as a result of the dying process, or do we want to proceed with suspension before we're subjected to that kind of injury?

Many other people, however, die from failure of a single organ system, for example a myocardial infarction. In these cases death can be fairly abrupt and yet take place in a situation where good stabilization and metabolic support are available.

LW: Hasn't Dr. Blaine White of Detroit Receiving Hospital demonstrated that it's possible to recover people without brain damage after an hour of ischemia?

MD: He claims to have done that, and I think that there is certainly some merit to his claims. We have tried to recover one animal, a dog, after thirty minutes of warm ischemia. We succeeded in recovering every organ system to good functioning -- with the exception of the brain. A number of studies have demonstrated recovery of animals after fifteen to thirty minutes of ischemia at normal body temperature, with little neurological injury. But I don't think that applying these techniques to human beings is going to be as straightforward as the popular medical press, or the cryonics press, has made out. We have probably been guilty of hyping that research to some extent, and this should stop.

LW: So we can say that ischemia is a serious problem, which greatly amplifies the damage attendant to cryonic suspension?

MD: There is no question but that this is the case. Anyone who thinks otherwise is being sadly misled.

When patients living a distance from us can see deanimation coming, or become at increased risk due to poor health or advanced age, they ought to make every effort to minimize the chances of ischemic episodes at their end, or relocate closer to one of our facilities. It may be painful economically and personally to become separated from a familiar environment at a time when one needs support, physically and emotionally, but those are the brutal realities.

Unfortunately, dying people are rarely blessed with tremendous emotional or financial resources. It's often not clear that it is time to resign yourself to the fact that you are going to die. Waiting until you're dying before moving sounds fine in principal, but in practice it's almost never done.

Some of us have made that decision already -- I'm a long way from my friends and family in Indiana. You yourself have come a long distance from your own country to a completely new kind of life. People have had to deal with hard realities in the past, and make tough decisions in order to survive. Many people have to pursue medical help in unfamiliar cities, away from friends and family. This is something people are simply going to have to face -- or they're going to have to face a more difficult alternative, which is to create the kind of facilities and support structure to provide quality cryonic care on a local level. Those are really the only alternatives.

LW: Let's move to the problem of cracking. What causes this phenomenon?

MD: Cracking occurs because the various tissues that make up the human body -- skin, bone, muscle, brain tissue -- contract at different rates as they are cooled. The different tissues are bonded together in a solid matrix formed by the mixture of water and cryoprotectant, which vitrifies (becomes a glass) at around -135øC. Stresses build up as the tissues attempt to slide by one another, leading to fractures. The problem is less serious in fiber-reinforced tissues, such as the skeletal muscles and skin. It is worst in soft tissues like the brain, kidney, liver, and lungs.

LW: If the stresses occur where different tissue types adjoin, couldn't you solve this problem for neuropatients by removing the brain from the skull, prior to cooling to liquid nitrogen temperature?

MD: You could do that, and it might be a solution to the problem. However, the brain is very fragile. Left on a counter top, an unsupported brain quickly develops tears under its own weight. That's a formidable technical problem. Also, if the brain is in contact with its container during freezing, you have the same problem; it will be bonded to the container walls.

There's probably a better way to solve the problem: find a safe temperature for long term storage which is higher than the temperature at which cracking occurs. We have cooled dogs to -112øC and rewarmed them, and have established that there is no cracking at that temperature. I think that the only safe temperatures for long term storage are in the range -135 to -140øC -- the range in which water and most cryoprotectant solutions vitrify.

You have to realize that from a biological standpoint, there simply isn't any need to go to liquid nitrogen temperature. Safe storage can be carried out on the basis of immobilizing the system -- locking up the reactive molecules in a matrix of solid material. When you lock up the position of potential reactants, the Arrhenius equation (which predicts rates of reaction versus temperature) ceases to apply. Dry ice temperature, or room temperature for that matter, would be safe from this standpoint, if only they solidified the system. But they don't. What a lot of people fail to realize is that even though there is a lot of solidification of the system at dry ice temperature (-79øC) in the form of water frozen out as ice, the inside of the cells are not frozen.

LW: Why are the cell interiors unfrozen?

MD: That's a rather complicated issue which I won't go into in detail. Suffice it to say that ice always forms first outside of cells and as the ice grows it removes water from the cell. This concentrates the cryoprotective and salt mixture present inside the cell until you get a very high concentration of antifreeze cryoprotective agent and salts present intracellularly. At -79øC this solution is liquid and diffusion and chemical reactions can proceed apace, per the Arrhenius equation. If you look at the Arrhenius equation and its predictions for the rate of reactions at -79øC the numbers are not very reassuring.

I think it's also worth pointing out that when you cool the typical frozen, cryoprotective treated biological system described above to below the glass transition point or to liquid nitrogen temperature, what in reality happens is that the intracellular milieu vitrifies. The rate at which you have to cool and rewarm to achieve intracellular vitrification will be determined by the concentration of protective agent in the tissue. The higher the concentration, the slower you can afford to go without getting lethal intracellular freezing. This is why, when you use low concentrations of agent such as 10% or 15% glycerol or DMSO you have to freeze at rates of at least 1øC/min or more and rewarm at rates of 100øC/min or more.

I mention all of this to point out that even with so-called freezing of cells or tissues, the cells survive only by virtue of the fact that they vitrify, even though most or all of the extracellular fluid is frozen.

LW: So patients may have to be stored in a fairly narrow temperature range indefinitely?

MD: That's right. And in a range that doesn't include the boiling point of liquid nitrogen.

LW: Or any other economical cooling medium?

MD: There are things which boil in the right range, but they are prohibitively expensive, and in some cases present serious handling problems. We have to come up with an alternative approach to maintaining stable temperatures in the range we're interested in.

LW: How might that be achieved?

MD: A mechanical refrigeration system is one possibility. There are systems available off the shelf today which can maintain temperatures of - 130øC or so. Unfortunately, they are fraught with problems. For one thing, they need electrical power to operate. So you're sharply dependent on a continuous power supply. Contrast that with our present liquid nitrogen storage system. If something goes wrong, a vacuum failure for instance, then there is a tremendous heat-sink, in the form of a reservoir of liquid nitrogen which has to boil off before patient temperature is affected.

Another problem with existing mechanical refrigeration systems is their lack of heat moving or "pull down" capacity. These systems are basically capable only of maintaining a low temperature on a precooled sample. This may not sound like a serious limitation, but in reality, when the unit needs to be entered on a regular basis, it is. Every time you enter the system you introduce the possibility of serious warming. Also, the durability and maintenance requirements of these systems are pretty bad.

An alternative approach, which I see as more promising, would be to develop a system in which patients are maintained in vapor boiling off from a reservoir of liquid nitrogen.

LW: You would need some form of active temperature control, unlike the present system in which the temperature is naturally fixed at the boiling point of liquid nitrogen?

MD: Yes, that's true. However, the system I envision would be mechanically very simple. It would use the pressure generated by the boiloff from a liquid nitrogen reservoir to pump vapor into the cooling chamber: temperature control could be achieved through a thermostat controlling the vapor flow rate. It may be possible to eliminate any requirement for blowers to circulate the vapor, by allowing liquid nitrogen to passively cool the system.

LW: How would you protect against failure of the system?

MD: You'd need a heat sink of some kind. The heat sink would maintain cryogenic temperatures for a few hours, or even a day or two, in the event of a problem with the primary cooling system. The ideal candidate would probably be dry ice.

LW: Won't tissue devitrify if it's rewarmed to dry ice temperature?

MD: The word you're looking for is liquefy. Devitrification means to freeze during rewarming. Depending upon the concentration of agent present, patients stored in the vitreous state would be at risk for either freezing during rewarming (devitrification) or liquefication. The former would be a very serious matter, since it would wipe out any advantage gained from vitrification in the first place (the purpose of which is to avoid freezing injury). The latter might not be so serious, since the worst that would be expected would be resumption of biochemical activity at a very reduced level, until resolidification of the system by cooling was reimposed.

LW: Will cycling between the vitrified and unvitrified states cause tissue damage?

MD: Once again, that depends on whether or not enough cryoprotective agent was introduced to allow for vitrification at 1 atmosphere of pressure. Many of the schemes currently under evaluation involve use of lower concentrations of agent, which are "coerced" into vitrifying by the application of 20,000 to 30,000 pounds of pressure and relatively high rates of cooling. I think it unlikely that such approaches will be used in the vitrification of suspension patients -- the costs and logistics would be staggering. Nevertheless, if a reversible technique of cryopreservation for the brain hinges on such a strategy, then it may well be pursued, in which case very, very careful control of storage temperature will be essential to avoid ice formation. Accidental warm-ups of the system will be intolerable.

LW: What form will ALCOR's future storage systems take if vapor storage is adopted?

MD: It's probably not economical to build a system like this for one or two patients, so it's going to be a big system. A unit would probably hold five or ten whole body patients, and have the ability to accommodate neuro patients as well. That would, incidentally, eliminate the wide differential in the standard of security provided for the two different classes of patient that we have today. Both kinds of patients would be stored in the same unit.

The operating temperature would be high enough that we could probably get away from vacuum technology and use high-quality foam insulation instead. We've looked at the numbers and it appears that foam will be economical in a system that works at around -135øC.

I foresee a system contained within a large, probably room sized, concrete utility vault, which is a relatively inexpensive off-the-shelf item. It must be a rugged structure that can take earthquake and fire. The interior would be lined with perhaps a foot of foam insulation and held at about -140øC by a cooling system of the kind I've described. There would be massive amounts of dry ice to act as a heat sink. The patients might be in individual insulated cassettes -- foam-lined metal or wood boxes. The cassettes might have heat exchangers in them as well, for active cooling during transport.

LW: Why go for such a large system if it will be feasible and even necessary to have individual cooling systems for each patient?

MD: The cooling systems in each cassette, if we go that route, would be inefficient for long-term storage. It wouldn't be practical to have each patient contained within a foot of insulation: boiloff of liquid nitrogen would be very high. Cassettes would only be useful as a stopgap, for times when the patient has to be moved, for example for transfer to another facility.

Another feature we might include in the cassette design would be a removable foam plug, to permit viewing of the patient's face. That may be important for psychological, legal and logistical reasons.

LW: Will it be possible for personnel to enter the vault?

MD: It's conceivable, but I think there will be very little dead space in the early versions of this system. I imagine that the vault will be almost completely filled with dry ice, except for the cassettes. Access to patients would be via a hatch in the side of the vault.

LW: ALCOR has already been criticized in THE IMMORTALIST for pursuing the best technology without regard to the affordability of cryonics to the average person. Won't this drive up costs even more?

MD: I don't know. This would be a radically different system from any that has been employed before in cryonics. I think the capital costs are going to be higher. On the other hand, the amortization schedules are going to be a lot longer than with the short-lived high vacuum systems we're using now. The unit I've described should last almost indefinitely, especially if the concrete vault is protected from the weather.

The components of the system will be generally low technology, simple and rugged. Even the cooling system should be very simple with the right design. The only part of the system which may require relatively sophisticated technology will be the monitoring equipment used to evaluate the system's performance and alert us to problems. Ideally I would like a computer display showing temperature readings throughout the vault, to pinpoint hot spots or other unexpected effects.

LW: How will liquid nitrogen requirements be affected?

MD: At this point I can't estimate that precisely. I emphasize that what I've described is very preliminary. We haven't yet looked at this problem in much detail. A completely different approach may turn out to be superior.

I do feel reasonably confident that I've identified some of the major features any vapor system is going to have. Some kind of heat sink material, whether it's dry ice or something else, is going to be necessary. If we can get away from high-vacuum insulation, which should be possible in the temperature range we're talking about, that has to be very desirable, because vacuum-based systems are troublesome, they're expensive, they don't last very long, and they're not very safe.

LW: Is the development of a vapor storage system within ALCOR's capabilities?

MD: Not today, no. We would have to shift our priorities considerably to undertake the project. The first step would be to establish a safe storage temperature, through research. We've been very slow to do this, because there's been no money for that kind of work. The construction of a vapor storage system will be challenging, technically and financially. But until we do it, patients are going to continue to suffer fracturing injuries.

LW: What would be the upshot of solving the technical difficulties you have described?

MD: Techniques which are either close to, or actually do represent viable preservation of the central nervous system.

LW: In other words, reversible suspended animation for the brain?

MD: Yes, and probably for other organs too. I think that both the heart and the liver may be the objects of reversible vitrification in the near future -- in 5 to 10 years if there's any significant application of resources.

LW: What about whole bodies?

MD: Vitrification is less likely to give us a practical technique for whole body suspended animation in the near term because of problems with non-vascular water that is inaccessible through the circulation -- in the gut and in the eyes for example. Also, there is probably going to be wide variation in the sensitivity of different tissues to the toxicity of the cryoprotective agents.

LW: Is there any prospect that vitrification can be developed into a technique which could be applied before legal death?

MD: Yes.

LW: Even if the technique is only reversible when applied to the brain, and not the whole body?

MD: I think that you could plausibly argue that brain death could be prevented by suspension of the brain with a reversible technique. The first cases where it might be applied would be those in which the patient's brain is being destroyed by disease -- severe multiple sclerosis, Alzheimer's disease, or Huntington's chorea for example -- and the patient faces inevitable personality loss followed by death. Under such circumstances, I think that many medical authorities would agree that the patient has nothing to lose by opting for reversible cryopreservation of the brain.

Perceptions may change radically if Dr. Robert White, or someone following in his footsteps, ever performs a head transfer -- whole body transplant -- on a human patient. White has conducted the procedure on animals on numerous occasions. At present it is not possible to rejoin the spinal cord after the procedure. However, there are many cases of patients who are already paralyzed and suffer terminal illnesses, such as cancer, which are restricted to the body. Some of these patients might find the option attractive.

LW: How soon could a reversible suspension technique for the brain become available?

MD: I think that there's every reason for optimism that it can be achieved in ten to fifteen years, if the money is there. And I didn't feel that in the past. Our work, and the work of Fahy and others on vitrification, makes me feel that this is now a real possibility.

The problems we face, if we move to vitrification, are basically technical problems, as opposed to the fundamental theoretical problems we face with freezing. We still don't have a good understanding of the mechanisms of freezing injury, and even if we did that doesn't necessarily mean that there are ways of overcoming them. Because freezing causes injury by several quite different mechanisms -- mechanical damage from ice, precipitation of solutes that are forced out of solution, and so on -- it may be that freezing of organs like the brain or the lung or the heart will never be possible without major tissue damage.

All the problems associated with vitrification arise through one mechanism: the toxicity of the cryoprotective agent. We are in a much better position to focus on that problem than we are to deal with the multiple difficulties of freezing. The message should go out to people with money, who want to stay alive and see cryonics or suspended animation as a means to that end: we're now very close to perfecting a technique which can provide a much better shot at indefinitely long life, and your $10,000 or $100,000 can have tremendous leverage in allowing that technology to be developed soon, rather than in the distant future.

On the other hand, I want to go to great lengths to point out that we are not talking about vitrifying people tomorrow. There are tremendous technical and logistic problems which would have to be overcome before this would be possible, and an immense amount of research needs to be done. I think the important message here is the tremendous potential of the technique. What's done with it, how much money is spent and so on, will really determine what will happen and whether it will ever see application to humans.

LW: You've been highly critical of the Northern California cryonics organizations, Trans-Time and the American Cryonics Society (ACS). Why?

MD: I don't want to answer that question, as you've put it. I'd rather address specific issues.

LW: Okay. ALCOR and the American Cryonics Society are managed in radically different fashions. You've criticized the management of the Northern California organization. How would you compare the two approaches?

MD: ALCOR is run more entrepreneurially, whereas control is collectivized to a much greater extent in the North. ALCOR is run by people who are hardcore, whereas I think many of the people running the Northern California organizations are relatively softcore -- despite the fact that much of the leadership there has a very long history of involvement in cryonics. A number of the people in control there are not signed up: they don't have full legal and financial arrangements for their own cryonic suspensions in place. There are people who are essentially dilettantes or hangers-on who are involved in running the organization. I believe that is unacceptable and it amazes me.

It obviously amazes some of their members as well -- so much so, in some cases, that they have changed organizaions and signed up with ALCOR. I would guess that around a fourth of our membership has come to us from ACS (the former BACS). The bottom line is that your survival depends on the performnce of the organization to which you belong. There is only so much you can do to effect change from within. Aparently, a number of highly valuable, committed cryonicists in the Northern California group have already decided that course of action is no longer tenable.

LW: Another area of criticism has been the research approach taken by ACS board members Dr. Paul Segall and Dr. Harry Waitz. They've concentrated on research using a small mammal model, the hamster, as opposed to ALCOR's dogs and cats, and the emphasis in their work has been on achieving suspended animation at relatively high temperatures (though still in the solid state) rather than on perfecting existing suspension techniques. Isn't that approach equally valid?

MD: One of the major problems is that I really don't think that either of those individuals has a very good theoretical understanding of cryobiology. I also don't believe that they have been sufficiently critical in evaluating the results of their own work. I think that if you talk to professional cryobiologists, even those that are sympathetic to cryonics, you will be told that they do not think the work is nearly as promising as it has been sold as being.

I think that the results they have obtained are interesting, but I also believe that we have achieved far more, with the expenditure of far less resources. Our Total Body Washout series has demonstrated recovery of a large non-hibernator from up to four hours of deep hypothermia, with extracorporeal perfusion going on. After four or five years, with a much greater input of time and money, they have demonstrated long-term survival in hamsters after fifteen to twenty minutes hypothermia in the asanguineous state, without any active perfusion. I understand that they also experience a very high loss rate of animals. We have asked them repeatedly to publish statistics on the survival of their animals, and on the condition of those that do survive -- for instance, whether neurological deficits occur -- but they have not been forthcoming.

There's no question that a workable small animal model would be a useful thing to have. But, such a model must satisfy a few basic criteria; it must be reproducible a reasonable amount of the time, it must be cost effective, and the experimental results should not be confused by variables which cannot be easily separated from the questions you're trying to answer.

I'm frequently unhappy about the way their research is presented. A recent ACS newsletter announces "Hamster Thawed, Survives Seventeen Days." Well, the fact of the matter is that the hamster in question was never frozen. Thawing is a word which implies phase change. Frequently when we explain our Total Body Washout experiments to visitors they latch on to the notion that the dogs have been frozen. Of course they haven't been, and that's a whole area that's yet to be addressed. The use of the word "thawed" is misleading, and unfortunately I believe that this instance is not atypical of the way Segall and Waitz present their work. It's fine to write for the layman, and it's fine to communicate excitement at research progress, but you must be ruthlessly honest in discussing the limitations of your work. This is not nitpicking either. It's of critical importance that we be careful to present things as they are and to go out of our way to correct mistaken impressions. I think it's misleading to give the impression that reversible suspended animation, through freezing at high temperatures, is a near-term prospect, as I believe Segall has done.

Another serious criticism I have is that I don't see evidence of quality control or attempts to get the maximum feedback they could from their work: they haven't, in the past, examined their animals' histology, or looked at blood chemistries in order to discover what their procedures are doing or what the physiology of the hypothermic asanguineous state is really like. That's poor science, in my view.

LW: How would you respond to those who say that such criticism and dissension harms cryonics?

MD: I would say, first of all, just who are we to keep these issues and discussions quiet from? Whose delicate ears are we trying to protect? You're dreaming if you think the press hangs on every word that's printed in CRYONICS magazine.

What those people are saying is that we should keep cryonicists from knowing about legitimate differences in philosophy, or about serious questions concerning the way a program is being pursued, or the moral integrity or technical competence of individuals involved in a program.

The people who get CRYONICS magazine, cryonicists and potential cryonicists, must be informed about controversies and setbacks, as well as the good news. I believe that one of the reasons that cryonics Michigan-tyle, and Northern California-style, has historically failed to attract people is that, if you only tell people what you've accomplished in positive terms, and you never tell them about the problems and about how they can make a difference in solving those problems, they're going to sit on their butts out there and think that everything is just fine. And that's not the case.

LW: Why do you feel so strongly about this?

MD: I've taken a lot of criticism for being openly negative about certain aspects of the cryonics scene, from Mae Junod (editor of THE IMMORTALIST), from Bob Ettinger, and lately from Art Quaife. I have several comments on that.

First of all, any objective reading of ALCOR's literature and CRYONICS magazine will reveal that we're not just focused on problems. In fact, we have carried out and reported more positive work than the Northern California and Michigan groups combined, I believe.

Secondly, those individuals haven't lived through the aching, unpleasant experiences I have had -- cleaning up messes that resulted from over-optimistic attitudes and blindness to problems: the debacle at Chatsworth, and the terrible situation which occurred in New Jersey a few years ago, when two patients thawed out and decomposed due to carelessness and incompetence on the part of the individual who cared for them. I had to suffer through those things. It was Mike Darwin who went out there and dug those people out, in pieces, and had to deal with the loss; the knowledge that those people had been allowed to disappear forever.

Those catastrophes occurred, in part, because of moral support given by other cryonicists, who didn't want to be stern and give tough advice on how to handle things or go public with the problems. They knew, or should have known, that the course of action being pursued was one which was doomed to fail. The son of one of the women who thawed out in New Jersey was very concerned about her care, but was out of touch with what was happening. He would have listened, I believe, had he been told that the man who was caring for her was incompetent and dishonest and/or deluded. The moral burden for this incident, and for Chatsworth, rests to no small extent with those people who could have spoken out but didn't.

I have seen the loss of lives of people I cared about due to stupidity or incompetence on the part of people in control. That has got to stop. I at least am not going to be a party to it by adopting a Pollyanna attitude. At the time that Gillian Cummings died there were things written by myself and other cryonicists that dealt with the problems: information that would have communicated to people on an intellectual and emotional level that this is a serious business we're involved in, and that things can go wrong. THE IMMORTALIST refused to publish such "negative" material. They ran a brief notice explaining that a real sad thing had happened, Gillian had died and basically implying "this all too complicated and terrible for you poor readers to bother your heads about."

Never will you find in the pages of THE IMMORTALIST any useful discussion of just what exactly you do if your husband drops dead 1,000 miles away from Detroit and the local coroner wants to autopsy him. Or, more to the point, what kinds of hard things you might have to do to prevent yourself from getting in that situation to begin with. It has an air of unreality about it, as if cryonics were taking place as some idle discussion in a very proper Victorian salon. That's unconscionable, and it is a sad commentary on the state of cryonics in Michigan.

Being judgmental, taking a position when you have a high degree of certainty about a situation, is not wrong -- it's the moral high ground. The approach that's now being taken in Michigan and in Northern California is a refusal to confront reality. My god, if the issue at stake was the competency or adequacy of a heart surgeon people would demand a hue and cry if there was even the possibility of incompetence! The only reason cryonics is different is the reduced level of feedback and the snail's pace at which things have (historically) moved.

A major criticism I have of THE IMMORTALIST and ACS NOTEBOOK is their failure to discuss anything negative about cryonics. The refusal to be critical, or to go out and search for existing problems, when you don't have a patient who can sit there and complain about a wound infection due to sloppy sterile technique, or a poor surgical result, or poor food, is a course that can only lead to disaster. It becomes easier and easier to lie to yourself, if you refuse to confront negative things and deal with them forthrightly.

LW: This brings up the issue of feedback, which you addressed in "The Myth of the Golden Scalpel" (CRYONICS, 7(1), 15 (Jan, 1986)).

MD: Yes. Because we're merchants of hope, to some extent, we have to have feedback, to know whether the techniques we're using are doing the job, and whether we're making errors. Otherwise, anybody can claim anything. People can claim that you don't need to freeze people at all: just dry them out and sit them in the sun, or drop them into a peat bog somewhere.

It's a legal problem, too. When a trust is created to handle money, (and we're not the trustee) the question of accountability arises. How does the trustee know that care has been delivered as the contract specified? How do the trustees know that the patient isn't being stored at -20øC and only cooled down to a lower temperature when an inspection is due? How can they even identify the patients?

In every other area of human life feedback is available in something approaching real time. If you have someone in a nursing home, for example, an ombudsman can go in and look at that home, and talk to or examine the patient to evaluate care in some kind of objective way. That's just not possible with cryonics. There's simply no easy way of determining if a patient has been kept continuously within an appropriate temperature range, or whether structure and viability have been preserved to any degree.

LW: Can you see a way out?

MD: I think that the only proposals I have -- and I spend a lot of time thinking about this problem -- are meticulous record keeping, making you're facilities as open to inspection as possible, and being as free with disclosure of problems, as well as possibilities, as one can be.

The absence of any clear-cut means of determining the quality of the care we're providing could destroy cryonics, or at least prevent its wide acceptance, even if the technology improves.

LW: Thomas Donaldson has argued that cryonics can survive and succeed while staying very small, and virtually unnoticed by the majority. What's you're position on that?

MD: I feel that he's very likely mistaken. It's very simple. There are very few "states" in the universe that are favorable to life. And very few of the possible political and economic states that could arise in this country in the future are going to be favorable to cryonics. Unless you have the resources to manipulate the environment -- to defend yourself -- then sooner or later you're liable to be stepped on like a bug. The amount of resources required to do that is significant.

We've just been lucky so far that we haven't become an issue, that no one gives a damn. To some extent that's because we are small. However, it's also because we take fierce beatings in silence. "You want to autopsy her? Well, yessir Mr. Coroner sir! But please, Mr. Corner sir, would you give us your leavings?" When I think of how we are forced to suffer hideously and die right now it makes me ill. What can I say to someone lying in a nursing home smelling themselves rot away, feeling their mind slipping away, knowing their resources are being consumed? How do I reassure them there's going to be anything of their mind left worth freezing by the time "natural" death intervenes? What can I do but hope and pray the same thing doesn't happen to me? That's what staying the same size means.

One of the major marketing barriers we face is the tremendous uncertainty surrounding our long term survival, which relates greatly to our small size and the limited reserves of money and talent available to us. If we had the resources of Scientology, or the political clout of the Catholic Church or General Motors, we'd be able to deal with problems like compulsory autopsy, or the issue of people whose brains are slowly falling apart from Alzheimer's while they're still alive. These are not trivial problems: as things stand today, twenty percent of our members will be subject to compulsory autopsy. We need to have the political muscle to change this, or the economic resources to insulate ourselves from the way the rest of society is structured.

The idea that we can survive while staying the same size is very attractive, because it means that we can sit on our fannies and not worry about the fact that we're going to die and disappear forever. This is the approach that has been followed by every cryonics group but ALCOR, to some extent. The idea of growth was always there, and was paid lip service, but in reality it hasn't been pursued vigorously or realistically.

Look at the situation we're in now: single individuals have a tremendous impact on the function and stability of the various cryonics organizations. That's a dangerous thing. Robert Ettinger has criticized ALCOR, in personal communications, for being over-dependent on Jerry Leaf and Mike Darwin. Of course the Michigan group is in an even worse position, since as far as I can tell there's only one person who's been at all effective at doing anything there in the leadership area, and that's Bob Ettinger.

We're vulnerable right now; if we lose a key individual, we lose a big hunk of our resources. That's an untenable situation. We need a far larger pool of people to draw from, for general talent, technical talent, financial expertise, and leadership. Leadership is a critical element, and it only emerges when you have a reasonably large sized pool of people to pull from. The pool is just too small right now. Many of the people who are doing this work, including myself, are doing it on the basis of necessity rather than competence. There are certainly more qualified people out there to do financial management, more qualified researchers, and probably more qualified leaders, strategists, and planners. It's absurd to believe that we represent the best that's available. We need to attract more people.

LW: How can we spread the cryonics "meme"?

MD: We've got a lot of work to do. It's exciting because it's such a challenge. It's frightening too, because the odds are against us, I think. We have to make cryonics a more competitive meme. As Keith Henson has speculated and as our membership surveys seem to confirm, the cryonics meme occupies the place normally taken up by the religion meme. Unfortunately, we have an inferior product, from a marketing standpoint. We can't claim any high degree of certainty that cryonics is going to work. The religionists do: they promise that if you do certain things you're going to live forever in paradise. We can never promise that. On the other hand, we can produce physical evidence in support of our viewpoint. Our total body washout experiments on dogs are very suggestive. That work has impressed people. One of our top priorities must be to improve the product, to make it more credible.

The other thing we need to do is to educate people better. Most people have incorrect notions of what death constitutes, and what identity and life constitute. They have to be re-educated to understand that living things are patterns of information, that it's the structure, the information content that counts. They have to then be convinced that we're preserving enough of that structure to allow people to be recovered, which is where our research comes in.

There are all kinds of little things we need to do too. Our literature needs to be improved, with more professional presentation. We need to get ourselves into a facility that we own; one sufficiently impressive in terms of size and permanence that people will have some confidence that we're going to be here fifty or a hundred years from now.

LW: What is your vision for what ALCOR should be ten years from now?

MD: A lot bigger, and a lot more sophisticated. It should be an organization of high-quality individuals: people who are disciplined, who have significant economic resources, who have a strong commitment to this idea, to seeing cryonics improved as a product and to seeing it succeed. We should have made tremendous strides in research. We should be producing high quality literature to educate people about the service we offer and the prospects for the future. ALCOR should be an organization of people who are confident that they're going somewhere, and confident in the technology that's being used to preserve people.

And I might add that we are seeing the seeds of these developments today. We are beginning to attract more professional people, people who aren't mentally ill or simply looking for cryonics to provide some kind of personal meaning on a day to day basis. I think early on in cryonics it was a lot more common to see people trying to become involved for all the wrong reasons. They looked to cryonics to solve their personal problems, rather than as a solution to the physical problem of dying. A lot of people who came to cryonics early on did so because of dissatisfaction with their lives, because of feelings of inadequacy and a hope that the future is going to solve all their problems; that when they're thawed out on the other end, all their problems will be put right. Now, that may not be an altogether unwarranted supposition, but if that's the kind of person you're attracting, it doesn't do the cryonics movement a lot of good.

LW: Are you saying that's the only kind of person who was involved in cryonics in the early days?

MD: No, hardly. But it was more common to see such people show up on our doorsteps. I think this was so because cryonics was so much more theoretical then. "Cocktail cryonics" is what Curtis Henderson called it. Believe me, if you hand some idle dreamer a mop and tell him to swab the operating room floor he's going to walk away. Or worse, give you a 2-hour lecture on why we won't need to mop floors when we're thawed out. When cryonics finally got to the point where we had operating rooms and had floors to mop, an awful lot of these people got up and walked out. What I am saying is that today it's largely people who're willing to mop floors or deal with reality in some other concrete way who're around or who come around.

LW: Then you see this trend continuing?

MD: Yes, one of the things that makes me optimistic is that over the last few years there has been a tremendous shift in the kind of person we're attracting. They're solid, middle class or upper middle class people, or even millionaires: people who have made it in a very tough competitive world. People with a lot of talent and a lot of competence. Increasingly, they're willing to offer their talent and competence and money. We have to be unafraid to ask them for those things, to demand those things if they expect us to help them effectively.

LW: Where are you going to find more of these people?

MD: The same places we're getting them from now. You have to work very hard to attract them, which is something very few people are willing to do. You have to pay close attention to every detail of the program: how do you look? how does your literature look? how does your research work look? what are you doing and what are you asking from people? The bottom line is: do you have a quality product, do you really care about what you're doing? Everything else is secondary.

We've been timid in the past about asking people for commitments, asking them to change their lives, to just get up and move. If you have a life in London, or Australia, or wherever, we should be saying, leave it, this is more important. Or be willing to take the far more difficult course of creating a cryonics group where you are. Cryonics is more important than your day to day comfort. It's more important than a hundred thousand dollars in the bank, because whether you have a hundred thousand dollars or a hundred million dollars in the bank, when they put you in a box and drop you in a hole in the ground, all that can be said about you is that you were a very rich man. One of the founders of ALCOR, Fred Chamberlain, said that as he watched the newscast of Howard Hughes' body being unloaded from his private jet: "There was a very rich man."

Cryonics is the most important thing that people can do. It's the only thing which really offers them the prospect of indefinitely long life. People need to realize that, and we need to make them realize it, and take nothing less than that kind of commitment.

LW: Is ALCOR sufficiently focused on achieving that vision?

MD: Yes. The last six months have been a time of reassessing where we're at, and crystallizing in our own minds where we want to go. I think we've done that now. It's just a matter, as it always is, of having the personal discipline to go there.

But we cannot do it alone. One of the very frustrating problems we face is that people want us to do things, and are willing to pay for us to do things, that we really don't want to do, or that we don't have as a top priority. We find that there's a lot of money available right now for promotion. People are excited by the research work we've done and the administrative framework that we've put in place, and by the increased understanding of how we're going to go about repairing and resuscitating people with molecular technology. And they want quick progress.

In the last few months something in the vicinity of twenty to twenty- five thousand dollars has become available, earmarked solely for public relations work, for educating people. And that's good, you can't argue against spending that kind of money on public relations. A lot more needs to be spent on public relations -- I wouldn't argue with that. However, there are research possibilities on the horizon which offer the potential for the development of techniques which preserve with very little damage; techniques which could be available in the near future provided the funding is there. That's going to improve the marketability of cryonics more than anything we can do in the area of promotion. Unfortunately there have not been concomitant amounts of support coming forth for research. If those two things ever get seriously out of balance for any length of time, I firmly believe that it will be a disaster, for ALCOR and cryonics as a whole.

LW: If you had $50,000 at your disposal for cryonics, how would you use it?

MD: Divided between promotion and research, with the lion's share going to research because I feel that's the bigger priority. And of course, 10% goes to patient care. As you know, 10% of everything that comes in goes to the patient care fund.

I would certainly spend some of the money, perhaps ten thousand dollars, on advertising. We know of some specialist markets that return members and sell subscriptions with something approaching the success rate experienced by normal businesses when they advertise.

I would like to get a laser printer. This would allow us to greatly improve the presentation of the magazine and of our other literature, while freeing up more time for research. That would cost around $5,000.

I think I'd use ten or fifteen thousand for further work looking at preservation of brain ultrastructure. We still have substantial amounts of material sitting in the back of the lab, which we haven't looked at for lack of funds.

The remaining twenty to twenty-five thousand I would spend on researching solutions to the problems we have identified in the areas of patient cracking and poor ultrastructural preservation in the brain. The cracking problem I would probably address through the development of a vapor cooling technique, to maintain patients at a temperature low enough for long term storage but high enough to minimize thermal stresses during cooling. I would tackle the ultrastructural problems by pursuing the use of cryoprotectants which we know do a much better job of penetrating the brain, and by the development of vitrification as an alternative to freezing.

Your question is an important one: every CEO of a cryonics organization ought to be able to provide a good answer, quickly, because if you don't have a plan for how you're going to spend resources, then you have no business trying to get them.

LW: Are you optimistic about the future?

MD: I think that we're at a very exciting time in cryonics, more exciting than at any time in the past, except possibly at the very beginning, when I think that there was a lot of excitement based on false optimism about how easy it was going to be to get this thing off the ground. I thing that now -- at last -- we have good reason to be excited about the prospect before us.