From Cryonics, 3rd Quarter, 1995


The Neuropreservation Option:
Head First into the Future

by Steve Bridge
former president of Alcor Foundation

At the conclusion of most tours here at Alcor, I end up in the Patient Care Bay with an awestruck visitor staring at the 9-foot tall Bigfoot dewars. They really are an inspiring sight -- both a non-final resting place for some of the smartest people on the planet and an audacious symbol of what might be the most optimistic idea in human history. Many of these visitors come to Alcor with little knowledge of cryonics, or even of life extension, aging reversal, nanotechnology or any of the other wonders we envision. By the time we get to the big climax of the tour, their minds are spinning. Then they ask, "Wait a minute, I thought there were twenty-nine patients. But you said there are only eleven in these big cylinders. Where are the others?"

I then point at the two huge concrete vaults on the opposite wall. "Well, you see, 18 of our patients chose to have only their heads frozen. We call this neurosuspension."

The most common reaction is a stunned pause with eyes growing to the size of saucers. For them, the entire building has just melted into surreality, like Salvador Dali's clocks, sculpted in ice. A few people laugh in surprise or nervousness. A small number look queasy or disgusted. And occasionally, if I have done my job well and set up the visitor with descriptions of the repairs that will be possible in the future, the visitor will say, "Oh, that makes sense. You can just grow a new body for the brain."

Our readers' reactions are probably very similar. Some of you may be reading an issue of Cryonics for the first time; you may be reading in detail about cryonics itself for the first time. But even for people who have been involved in cryonics for many years, the issue of "how much should you freeze" can be disconcerting. It certainly took me a couple of years before I could easily throw off my instinctive reactions and appreciate the idea that the brain is the most important part (and perhaps the only necessary part) to preserve.

The most basic step in understanding neurosuspension is one on which we can all agree: our memories, personalities, and most of the other critical parts of our identities are in our brains. People can have heart and lung transplants and still be the "same person." Even someone paralyzed from the neck down thinks of himself as having the same identity. On the other hand, someone else who has lost her memory may look like the same person, and we may even use the same name for her; but clearly her identity is missing.

The primary keys are our own unique experiences, which create in us memories different from anyone else's. Each individual in a set of identical twins has the same genetic makeup and similar birth environment; but from birth on they are separate beings which experience life and acquire memories from their own unique perspectives.

There is no such thing as a "brain transplant;" a brain transferred into a new body would be a "body transplant." We are our brains.

This same understanding means that freezing the body of a patient whose brain had been removed and destroyed, or destroyed within the skull by disease or injury, would not save the identity of that person. With only the physical information in the rest of the body available, we could possibly use the DNA and chemical information to create a clone (an identical twin) with, in effect, total amnesia; but we couldn't reproduce the original memories and identity. We might be able to recreate many of those memories from the writings of that person and from memories of experiences which might be shared with family and friends; but that would be more a new creation than a "re-creation."

So, are we planning to revive neurosuspension patients as "heads on a plate," with tubing and wires sticking out? No, of course, not. Neurosuspension patients will be revived with a full body, young and healthy, just like the whole body patients. Actually, I used to say that no one would want to be "just a head;" but the variety of human existence is such that almost certainly someone will eventually think that a bodiless existence sounds deeply fulfilling. Not me, thanks.

"Young and healthy" -- think about that. Many of Alcor's whole body patients were age 65 or older when they were placed into cryonic suspension. They had cancer, heart disease, and considerable problems from basic aging. There is no point in reviving people and curing their cancer but not curing their aging. I don't want to be both near-immortal and painfully aged anymore than I want to be a head-on-a-plate. So, if cryonics works at all, aging will be reversed.

Sound difficult? Perhaps, but no more difficult than the basic concept of cryonics repair itself. If a technology can be developed to repair the injuries added to patients by our imperfect freezing processes, it will most likely have to work by making at least some repairs cell-bycell. Aging is not magical; it involves misarrangement of molecules, just like everything else that can go wrong with us. If we can repair cancer and heart disease in the cells of these frozen patients, we can surely learn to make all their cells healthy again. And healthy equals young, for all practical purposes.

It may turn out that growing new bodies for whole-body patients is even simpler than repairing them cell by cell. Look at what our bodies can do already. We can all grow skin over a cut. Our bodies can recover from the massive trauma of heart bypass surgery. Young children can often regrow a fingertip severed in a car door. The repairs possible in the future will be more extensive, because the field of medicine is putting a tremendous emphasis on accomplishing them. For instance, within 25 years, spinal injuries may not be paralyzing or fatal. Researchers are making steady progress in regrowing the connections in crushed or severed spinal cords.

Our understanding of how cells operate and grow is expanding rapidly. Someday we will learn why the child can regrow that fingertip and use that knowledge to regrow entire missing limbs. At that point, we won't need organ transplants from deceased donors -- we will simply have new copies of our own hearts or livers grown for us, with genetic flaws eliminated. Eventually physicians may develop such fine control that they can spot the damage early on and renovate the injured organs from the inside out, with no replacement necessary.

We all grew a body once. One tiny cell's molecular machinery and DNA instructions combined the chemicals available (supplied at first by the mother's womb and later by the grocery store) and eventually assembled them into us big people. These instructions are not lost when we become adults; the DNA is still there. Considering this everyday miracle, growing a new, improved copy of your body for your brain (i.e., you) to occupy seems almost easy.

So if the final outcome will be the same, what are the advantages and disadvantages of neurosuspension vs. whole body suspension?

Let's start with the easy one: cost. Alcor requires a minimum suspension funding donation of $120,000 for whole body suspension and only $50,000 for neurosuspension. (Each option carries a $10,000 surcharge for members outside the United States.) That's a pretty large difference for most people. Even if you are funding your suspension with life insurance, the premiums are obviously higher for the larger policy.

Why the difference in cost? The upfront expenses of both types of suspensions are similar. Even in a neurosuspension we need the complete circulatory system so we may perfuse the patient's brain with chemicals to protect the cells from cooling and freezing damage. The head and the body are not separated until after the glycerol perfusion has been completed. We do save some expense on a neurosuspension by clamping off the circulation to the lower body, so we require less total solution. The real difference is in storage costs. All of the patients are stored in liquid nitrogen at - 320 F. No matter how well insulated, liquid nitrogen is constantly evaporating and returning to the air. We have to add more nitrogen to the dewars each week. Alcor has to pay a local supplier for this liquid. One of our steel Bigfoot dewars boils off about 12-15 liters of nitrogen per day, whether it contains one whole body patient or the maximum of four. Each neurosuspension dewar (inside a concrete vault) holds nine patients and loses nitrogen at only half the rate of the whole-body units. This means the nitrogen cost per neuropatient is only about one-ninth of the cost per whole-body patient.

There are many other factors in the storage costs that are more evenly divided between neuro and whole-body patients, so the total difference is not 1/9; but it is still large. To ensure enough principal in the Patient Care Fund so that the earnings can cover expenses, we invest $70,000 (at least) of the suspension funding for whole body patients. We only have to invest about $17,000 to achieve the same result for neuropatients.

Neuropatients are also easier to transport in an emergency. The Bigfoot units are about nine feet tall, weigh almost 2 1/2 tons, and take several people to move. However, we can quickly move the neuropatients to small, individual dewars that can be placed in the back of a van or pickup truck and handled easily by two people. You might not at first think of that as an advantage, since taking care of the patients is a rather passive activity. However, we were certainly glad that Dora Kent was a neuropatient in 1988 when the Riverside Coroner wanted to autopsy her already frozen head. She was out of the building when the Coroner's deputies arrived. (Alcor later obtained an injunction against the Coroner to protect Mrs. Kent and to prevent future attempts to seize patients.) You can imagine your own paranoid scenarios about possible legal problems or natural disasters in the future when the neuropatients might have a transport advantage (except it's not "paranoid" on the days when they really are out to get you).

There may be at least one repair advantage to having a complete body to work with. Certainly a whole body patient takes more total information along into the future, although it is still hard to say how significant the added information is. For some people, the pattern of nerve growth development in the body may be very important to their identity -- for a dancer or musician, for instance. On the other hand, enough of that information may be encoded in brain development that the same result can be achieved either way. We don't know yet; so we can't say for sure if you are risking anything by leaving your body behind.

Neurosuspension may convey a significant upfront biological advantage, however. If the cryonic suspension team can concentrate on just the brain, and not worry about the best suspension methods for the liver, muscles, and intestines, more sophisticated techniques may eventually be developed that result in a higher level of brain preservation. Certainly, a tight focus on the brain today results in shorter perfusion times; and once the freezing process begins, the smaller package of the head can be more rapidly cooled to temperatures where the biological and chemical activity are halted.

One important consideration for cryonicists is which method will result in less time in suspension. Suspension patients can no longer make their own decisions. Their vulnerability means that time in suspension is time at risk. But I can see nothing credible which convinces me that one method will result in resuscitation sooner than the other. In fact, my personal guess is that the technology to repair a body cell by cell and the technology to grow a new body will occur at about the same time and involve nearly the same processes. Besides, in both cases the most important limiting factor will be the same and will be the hardest task by far: the brain must be restored to proper function and consciousness.

Finally, there are the possible social disadvantages of having only your head frozen. No, I don't mean that telling people of the future you were once a neuropatient will get you fewer dates. "I was always a head of my time" will still be a good way to start a conversation. The problems may occur with your less imaginative friends and relatives today. Let's face it: no matter how logical I make neurosuspension sound and how many advantages it may have, we've all seen too many movies about the French Revolution and other kinds of sharp-edged activities which made it pretty clear that a head without a body had no future at all. The concept of cryonics is hard enough to explain and sell to most people on its own, even without explaining how the missing bodies will be replaced.

So you have to decide what's important to you. If you can afford whole body suspension, and you feel it is either a truly better option, and you just can't deal with the alternative -- or you can't deal with telling people about the alternative, then your choice is easy. However, if you cannot afford $120,000 in cash or life insurance, then you have to start working on that old logic circuit in your brain. Start talking with your family and friends about cryonics and cell repair right away so they get used to the basic concept. Then when you spring frozen heads on them later, they may not see it as such a strange idea.

Either way, you cannot totally avoid the idea of neurosuspension. You see, we at Alcor long ago decided that no matter which method was truly the best, burial was infinitely worse than either. So we have this important clause in our Cryonic Suspension Agreement -- "Emergency Conversion to Neurosuspension." Basically, this says that if the economy totally collapses or the legal climate turns against cryonics or some other calamity occurs so that we can only save or afford to maintain the neuropatients -- then everyone will become neuropatients. All Alcor suspension members have to agree to this in their Suspension Agreements. We're adamant about maintaining whole body patients in whole body suspension and we'll do everything we can to meet that obligation. But if the choice is between burial/cremation or switching everyone to head-only, there is no doubt in our mind what we will do. We haven't spent all of these years protecting our patients just to surrender when the going gets tough.

So how do you choose which kind of suspension you want now, and how do you keep your future options open? You must compare your definition of "ideal" with what you can afford. One of the biggest unknowns in the future is how much the true cost of cryonics will be as it becomes more popular. Some things will grow more expensive, some probably less. But the strength and continuation of your cryonics organization will be one of the most critical factors, and possibly the true key, as to whether or not you stay in suspension. Doing the minimum possible as a member is not a survival characteristic.

I recommend you consider the solution I have chosen myself. At least for the next ten years, in these early days of cryonics, if you can afford $120,000 in insurance or other funds, then plan for that amount but choose neurosuspension. If it happens that you need to be suspended in the next decade, instead of spending money on keeping all of that extra mass frozen, let those extra funds go toward research, marketing, legal funds, and otherwise making sure your organization can thrive. If you're still kicking up your heels in ten years, and Alcor is so rich and powerful that your measly extra thousands won't make a bit of difference, then you can reconsider. If it won't harm your organization, you could switch your choice to whole body and take the extra information along. If you want whole body suspension today, I recommend funding it at a level of $200,000, for the same reasons. For insurance, the difference in premiums won't be that much; and it could make all the difference in the world to your cryonics group -- which could mean all the time in the world to you.

SIDEBAR

The two questions that everyone wants answered but that they really don't want to ask:

1. So, umm, how do you, uhh, you know ... remove the head?

Actually, we think of it as removing the body. And you already know the answer. Since evolution and genetic technology have failed to come up with neck zippers, pop tops, or screw-off heads, we have to use a scalpel and a surgical saw, just as a surgeon would use for amputating a leg. No way around it.

2. What do you feel like when you do that?

Perhaps the most important thing that all medical and emergency workers must learn is that one often has to do unpleasant procedures to save someone's life. A surgeon does not enjoy removing a child's leg which has been mangled in an accident; but the surgeon knows his level of technology is not good enough to save the leg -- only to save the life. To do nothing would certainly condemn the child to death. So the surgeon does what he has to do and knows it is the only choice he has.

It is not much harder emotionally to perform a neurosuspension than a whole body suspension. We don't know if cryonics will work in general or if it will work for the particular acquaintance, friend, or relative we are trying to save today. But like the emergency workers and the surgeon, we know that not to act at all means sure failure. We do the best we can for our patients, even if that rescue work requires that we perform emotionally difficult tasks like removing their bodies. We do this because we care about them and want to see them alive and healthy again someday. And we do it because we want that same attitude to be present if our own turn for suspension should come.