Alcor News Bulletin
                -----------------------------
                Number 9: February 26th, 2003


               Thomas Munson, MD: 1922-2003

(a personal account by Charles Platt on behalf of Alcor)


Early on the morning of Monday, February 24th, Dr. Thomas 
Munson experienced cardiac arrest in Southern California. 
Dr. Munson had been a long-time Alcor member who formerly 
served as our medical director at a time when few 
professional physicians were willing to be associated with 
cryonics. We are extremely sad to lose him, and we hope that 
through our efforts he may have a significant chance of 
renewed life in the future.

Below are some preliminary case notes. 

At 8:50 AM (all times in this text are Mountain Standard, 
one hour later than Pacific) I answered the Alcor emergency 
line and found myself speaking to Tom Munson Jr, who was 
calling from the San Diego area. Tom Jr. explained that Dr. 
Munson had complained of nausea and shortness of breath, 
said he felt faint, and lay down to rest. His breathing had 
become slow and shallow, and finally ceased. Tom Jr. had 
called the paramedics, but while I was on the phone he told 
me that the paramedics were abandoning their attempts at 
resuscitation. I asked if they were willing to administer 
heparin, and they refused, citing the risk that Dr. Munson's 
unexpected death could cause him to become a coroner's case. 

Under California law the coroner's office may issue an 
autopsy waiver if a physician has seen the patient recently 
and will state that there is good reason to believe death 
came from natural causes. Tom Jr. started trying to contact 
his father's physician while I telephoned some members of 
Alcor's Southern California standby team and then contacted 
Joe Klockgether at his mortuary in Buena Park, near Los 
Angeles. Mr. Klockgether has helped us in numerous cryonics 
cases. When I asked him to dispatch a pickup service as 
quickly as possible, he warned me that if the patient was 
taken for autopsy, pickup would not be possible. I requested 
that the service should go out anyway in the hope that an 
autopsy waiver would be granted by the time they got there. 

Jerry Lemler was with me at Alcor, and we considered various 
transport scenarios. I estimated that Dr. Munson's location 
near San Diego was about three hours from the Klockgether 
mortuary. Should we try to find another mortuary closer to 
our patient? I decided that I could waste too much time 
pursuing this option, because it would entail negotiating 
for permission to perform procedures and then relocating our 
standby team and their equipment. It would be more time-
efficient for team members to start preparations in Buena 
Park while Mr. Klockgether's collection service retrieved 
our patient. In retrospect I believe this decision was 
correct.  

Between 9:30 and 10:00 AM we received two unexpectedly good 
pieces of news. The coroner's office granted a waiver 
eliminating the need for autopsy, and Tom Jr. found a set of 
portmortem medications which Dr. Munson had acquired some 
years ago. Alcor's paramedic, Larry Johnson, spoke to Tom 
Jr. on the phone and guided him through the procedure of 
administering several drugs, one of which was in powder form 
and had to be mixed with saline. With truly exceptional 
dedication, Tom Jr. then did chest compressions to circulate 
the meds. By about 11:00 MST the primary meds were in, and 
Tom Jr. went to get additional ice from a nearby source. 
When he returned he followed my instructions to put the ice 
in strong plastic bags with a little water, place them all 
over the patient, and perform intermittent chest 
compressions in an effort to circulate blood which would 
carry heat from the core of the patient to areas near the 
surface where the ice would provide some cooling.

I conferred with our consulting surgical team in California, 
Steve Harris MD and Sandra Russell, and their colleague Joan 
O'Farrell. They told me they were ready to respond whenever 
necessary. Once again we discussed various transport 
options, including the possibility of taking the patient 
directly from San Diego to Alcor. In the end I stuck to the 
original plan. My only remaining uncertainty was whether we 
should transport to Alcor by air or ground after procedures 
at the mortuary were complete.

The nearest airport to the Klockgether mortuary is about 
half-an-hour away. The flight to Phoenix Sky Harbor takes at 
least 1.5 hours including taxiing from the departure gate 
and to the arrival gate. Collecting the patient from an air 
cargo facility at Phoenix Sky Harbor and bringing him to 
Alcor takes at least half-an-hour. In addition, all U.S. 
airlines have imposed a mandatory two-hour waiting period on 
air cargo since the terrorist attacks of September 11. Thus 
the bare-minimum travel time for a cryopatient by scheduled 
airline, from the Klockgether mortuary to the Alcor facility, 
including an initial two-hour wait, is 4.5 hours under ideal 
conditions, assuming that a flight is available precisely 
when we need it and is not delayed for any reason. 

Actually I believe a more realistic door-to-door air 
transport time is at least six hours. This is the same time 
it takes to drive to Alcor from the Klockgether mortuary. 
Moreover, by transporting a patient ourselves we eliminate 
any paperwork problems with an airline, and avoid the risk 
of flight delays or cancellations. 

It's true that a chartered jet can circumvent most of these 
problems while reducing total travel time to about 2.5 
hours, but our patient did not have additional funding, and 
air-charter service from the Los Angeles area costs about 
$7,000. Consequently I decided to go for transportation via 
a rented van. 

Shortly after 1 PM I learned that the mortuary pickup 
service had finally collected the patient. Bobby June was 
now at the mortuary setting up the ATP (Air Transportable 
Perfusion equipment for washout and cooling), Todd Huffman 
had brought additional medications, and Peter Voss and 
Louise Gold were on their way there. I telephoned our 
California surgical team, who had set out to the mortuary. 
Joseph Klockgether meanwhile was driving to San Diego to 
find the patient's physician, who would sign the death 
certificate, enabling Mr. Klockgether to file it with the 
county registrar and obtain a permit to move the patient 
out-of-state.

At Alcor the operating room was being prepared by Mathew 
Sullivan and Hugh Hixon with help from Jessica Sikes, James 
Sikes, Paula Lemler, and Angela Chicoine, a registered nurse 
in the Phoenix area who has been helping us at Alcor on a 
part-time basis. We discovered that our primary video camera 
had failed, and James Sikes went to buy a replacement. 

The patient reached the Klockgether mortuary soon after 
4 PM, at which point our surgical team began working to 
cannulate the femoral vessels. Finding the femoral artery 
was unexpectedly difficult, and Dr. Munson's vasculature 
turned out to be extremely fragile. Surgery was a major 
challenge, and cooling via femoral-femoral bypass was not 
completed until 8 PM. I verified that Mr. Klockgether had 
obtained the signed death certificate, and Bobby June and 
Todd Huffman set out on their road trip to Alcor.

I spoke briefly with Tom Jr. and thanked him for his 
outstanding efforts to provide initial cooling and 
medications under extremely difficult circumstances. Then I 
notified our staff in Arizona that the patient would reach 
Alcor at some time after 1:30 AM. Since most of our 
preparations were complete, many people went to get some 
rest while I stayed by the phone.

Dr. Munson arrived at our facility at 2:15 AM, with a 
DuaLogR, installed by the California team, registering a 
record-low nasopharyngeal temperature of 0.1 degrees 
Celsius. Our surgeon, Dr. Jose Kanshepolsky, was ready to 
begin around 2:30 with our surgical technician, Jeff 
Kelling. Jerry Lemler MD also assisted with surgery. 
Initially Dr. Kanshepolsky had extreme difficulty finding 
the left carotid artery, just as our friends in Southern 
California had experienced difficulty finding the femoral. I 
was relieved when Dr. Kanshepolsky solved this problem and 
found the remaining vessels very quickly. 

Around 3:30 AM the patient's temperature had risen to 6.5 
degrees Celsius, which was still comfortably below our 
initial perfusate temperature of 10 degrees. Dr. Munson was 
signed up for neuropreservation, and we completed surgery in 
the controlled-temperature environment of the neuro 
enclosure which has been modified and refined over the past 
year by Hugh Hixon. By 4 AM cannulation was complete and 
cryoprotective perfusion began. The initial venous return 
contained some small blood clots, but they cleared fairly 
rapidly, and we were very pleased when there was no sign of 
edema. I decided that I could safely leave the facility and 
drive to my home in Northern Arizona, about 140 miles away. 
I arrived at about 7:30 AM and called Hugh Hixon, who 
reassured me that there was still no sign of edema. Also,
he saw no evidence of asymmetry in the perfusion. He said
that cryoprotection would be complete ahead of schedule, by 
8:00 AM, at which time the patient would be moved to our 
cooldown dewar.

Overall, although this case occurred with absolutely no 
warning, it was completed very successfully. Total time from 
cardiac arrest to cooling via bypass at the mortuary was 
about twelve hours, and all the procedures at Alcor were 
completed within six hours.

I have used Dr. Munson's name in this account because he 
stated in his Alcor signup documents that did not request 
anonymity. His son also agreed to be named since he believes 
that this is what his father would have wanted.

Many thanks to all the people who provided outstanding help 
to our patient. In chronological order: Tom Munson Jr., 
Larry Johnson, Jennifer Chapman, Jerry Lemler MD, Bobby 
June, Todd Huffman, Louise Gold, Peter Voss, Joe 
Klockgether, Steve Rude, Steve Harris MD, Sandra Russell, 
Joan O'Farrell, Michael Riskin, Russell Cheney, Mathew 
Sullivan, Hugh Hixon, James Sikes, Jessica Sikes, Paula 
Lemler, Angela Chicoine, Jerry Searcy, Jeff Kelling, Jose 
Kanshepolsky, Mike Read, and Mike Perry.

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       Alcor CEO will Speak at Cambridge University

Anti-aging scientist Aubrey de Gray, who chairs the Tenth 
Conference of the International Association of Biomedical 
Gerontology, has invited Alcor CEO Jerry Lemler MD to speak 
at the conference, which will take place this year from 
September 19th through 23rd at Queens College, Cambridge, 
England. Dr. Lemler will give a twenty-minute speech 
explaining fundamental concepts of cryonics. Other speakers 
participating in the conference will include Bruce Ames, a 
winner of the U.S. Medal of Science in 1998; Mario Capecchi, 
who was awarded a U.S. Medal of Science in 2001; Arthur 
Caplan, the first president of the American Association of 
Bioethics; William Haseltine, Chairman and CEO of Human 
Genome Sciences; and Michael West, President and CEO of 
Advanced Cell Technology.

We are excited that Dr. Lemler will have this opportunity to 
talk about Alcor and cryonics at a prestigious international 
event.




Alcor News is written primarily by Charles Platt.
Contents are copyright 2003 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.