Alcor News Bulletin


                Number 2: December 20th, 2002



        The Cryopreservation of Alcor Member A-1034

I'm very sad to report that on the afternoon of Thursday, 
December 19th, Alcor member A-1034 experienced totally 
unexpected cardiac arrest while he was in a routine session 
of rehabitation therapy following a hip operation that he 
underwent earlier this year. 

Nurses at the rehabilitation center had been told about the 
patient's desire for cryopreservation, and they telephoned 
Alcor. Dr. Jerry Lemler passed the emergency call to me, 
and I asked the nurses to inject heparin, perform chest 
compressions, and pack the head in ice. They willingly 
agreed to do this. 

I called Southern California team leader Russell Cheney and 
asked him to take his meds kit to the rehabilitation center 
where the death had occurred. A-1034's daughter, and team 
members Peter Voss and Keith Dugue, also went to the center. 
Meanwhile I alerted our Southern California mortician, who 
dispatched some personnel from his collection service. 
Since Southern California does not have a purpose-built 
transport vehicle yet, we were unable to collect the patient 
ourselves or provide Thumper support, but Russell Cheney did 
manage to take a portable ice bath to the site. 

Russell directed team member Bobby June to go to the mortuary, 
where Bobby unpacked blood washout equipment and washout 
solution which had been stored there in anticipation of this 
kind of emergency. Bobby was joined by three medical 
researchers who are friendly to Alcor. Two of them have 
surgical experience and were willing to attempt a blood 
washout and cephalic isolation at the mortuary. (I am not 
mentioning their names, since I am not sure, yet, whether 
they wish to remain anonymous.) The blood washout equipment 
was primed successfully while the patient was being collected 
from the rehabilitation center, where nurses had been doing 
chest compressions, in shifts, for more than three hours (!) 
and Russell had been pushing some of the Alcor meds via an 
IV which was already in the patient. The doctor who had been 
present in the rehabitation center when arrest occurred was 
located, and she signed a death certificate which I had 
faxed to the center. 

At Alcor, Hugh Hixon, Mathew Sullivan, and James Sikes 
prepared the operating room with assistance from Jerry Searcy, 
Jessica Sikes, and Mike Read. (Subsequently we were joined by 
Paula Lemler, who has established herself as our primary data 
scribe.) I stayed by the phone with Dr. Jerry Lemler and tried 
to keep track of events in California. 

Our California mortician suggested that the patient could be 
transported as a whole-body case for subsequent neuroseparation 
in our Arizona facility. We consulted our Phoenix mortician 
who adamantly disagreed, since California law normally requires 
that a permit must be obtained from state officials before a 
human body can be moved out-of-state. I would have preferred 
to perform neuroseparation at Alcor after perfusion via median 
sternotomy, but we decided it was wise to follow the advice of 
our local mortician. Consequently neuroseparation would be done 
in California, since the isolated cephalon can be transported 
as an organ donation that does not require a permit.

The patient reached the mortuary after delays imposed by Los 
Angeles rush-hour traffic. The team at the mortuary performed 
a femoral cutdown, which was complicated by the patient's age 
and condition. After blood washout, neuroseparation was done 
very quickly and the cephalon was taken to an airport where a 
chartered jet was waiting at the request of the patient's 
daughter. We had been concerned that a winter storm might prevent 
the plane from taking off and would force transport by car, which 
would have taken approximately six hours. Fortunately the patient 
reached the plane before the storm became severe.

The patient arrived at Alcor at approximately 2:40 am Mountain 
Standard Time. Our usual surgeon was assisted by Jeff Kelling, 
a professional scrub nurse / surgical technician who was helping 
us for the first time. He greatly increased the speed and 
efficiency of our procedures.

Our team in California had installed two temperature probes 
attached to a DuaLogR, a handheld device which records 
temperatures at preset intervals. When the patient arrived, 
the nasopharyngeal probe showed a temperature of 3.1 Celsius 
on the DuaLogR. After we switched the output from the probe 
to our LabView system, it showed a temperature of 5 Celsius. 
We have no explanation yet for this disparity.

I surrounded the cephalon with bags of ice while our surgeon 
made burr holes. After crackphone sensors and a temperature 
sensor were stitched into position, the patient was moved to 
our cephalon enclosure. Since the people in California had 
already isolated and clamped the major vessels, they were 
easy to access, but our surgeon experienced some difficulty 
cannulating the smallest vertebral, and we noticed plaque in 
at least one of the vessels. We have no way of knowing, for 
sure, whether plaque may have blocked some small vessels in 
the brain. However, perfusion proceeded normally with a good 
flow rate.

During preparation for perfusion, the patient's temperature 
rose only by about 1 degree. This was an exceptionally good 
performance. Other patients have picked up much more heat 
while waiting for perfusion to begin.

Currently, as I write this at 9 am, perfusion has just been 
successfully completed at our target concentration. We have 
seen no sign of significant edema, and perfusion generally 
went well. The patient has the appearance that we associate 
with probable successful vitrification.

Although A-1034 was active in cryonics for many years and was 
well known to many people in the field, his paperwork 
requested confidentiality under all circumstances, and we are 
respecting his wishes. Personally I had known him since the 
early 1990s and feel extremely sad about the loss of a man 
who helped me personally many times and had a wonderful 
spirit. Still, I'm pleased that his total transport time, 
from cardiac arrest to arrival at our facility, was only 10 
hours, even though his death was totally unexpected. All of 
our team members were immediately available and responsive, 
and I'm very pleased with the way that this case worked out.

Of course there were some problems.

--Lack of a dedicated vehicle. Since Southern California 
contains the largest regional group of Alcor members and 
maintains a good state of readiness, it should have its 
own converted van for transport. This would have enabled 
Thumper support and would have reduced transport time. The 
Alcor board has allocated funds for a California vehicle, 
but we have not had an opportunity to establish a detailed 
specification before work can begin on the conversion.

--Inability to transport a whole body out of state. 
California morticians tell us that we cannot transport a whole 
patient out of the state without a permit, which can only be 
obtained during normal business hours. Consequently, on several 
occasions, including the one last night, we have felt compelled 
to do neuroseparation in the field. This situation is 
unacceptable (especially to our whole-body California patients) 
and must be investigated further.

--We are still short of trained personnel. Our Suspension 
Readiness Director, Mathew Sullivan, was scheduled to go on 
vacation at 11 am this morning (and still hopes to catch his 
flight). If our patient had experienced cardiac arrest just one 
day later, we might have been unable to prepare the operating 
room in time. We have already taken steps to address this 
problem. For the past two days we have been interviewing job 
applicants with medical backgrounds. 

--Shortage of field personnel. If the case had occurred five or 
six days later, during the holiday season, we would have been 
unable to assemble our team rapidly in California. We were 
extremely lucky that four California members, and the people 
who performed our surgery, were immediately available.

--A relentless case load. Our rapid sequence of patients has 
left us scrambling to restock meds kits and prepare sterile 
tubing packs for washout equipment. So long as a lot of our time 
is spent on this kind of maintenance, we have insufficient time 
to make improvements that we need.

--Poor communication. Our advisor on medications assumed that 
we had distributed two recommended medications which in fact 
were still at the Alcor facility, because we assumed he knew 
that we were waiting for a comprehensive list including 
dosages and drug sequence. I want to establish a uniform meds 
inventory as soon as possible.

Under the circumstances, everyone contributed an excellent 
performance, and apart from the miscommunication, I think no 
significant errors occurred. This is the third Alcor case in 
three months, and I believe the patient received the best 
possible treatment. Morale in the operating room has improved, 
errors have diminished in number, and there is a genuinely 
cooperative spirit.

My thanks to everyone who participated. Since this text has 
not been checked with the people involved, it may contain 
inaccuracies or omissions. A full report will appear in 
Cryonics magazine.




Alcor News is written primarily by Charles Platt.
Contents are copyright 2002 by Alcor 
Foundation but permission is granted to reprint any whole 
news item, so long as Alcor is credited as the source and 
the reprint includes our URL at http://www.alcornews.org.