Case Report A-1872

CryoCare’s Second Patient

by Charles Platt

From CryoCare Report #7 April 1996

On Thursday, June 16 around 6 P.M. I received a call from a man named Andrew Popper asking if CryoCare would be willing to freeze his mother, Henrietta Popper, who had died earlier that day in a hospital in Queens, New York.

It’s no secret that CryoCare is ambivalent about taking last-minute cases, which often entail lower-quality cryopreservation and greater financial risk. I was encouraged, however, when Andrew told me that he had been seriously interested in cryonics for many years and was fully aware of the concepts, the payment methods, and the diminished chances of providing good care for a patient who has already been pronounced legally dead. Andrew sounded distraught over his mother’s death, but he also seemed to have a rational, sincere interest in cryonics, and he assured me that paying for it would not create financial hardship for himself or his family. Personally I feel this is one of the most important factors, because I never want to be in the position of accepting a family’s last savings at a time of grief and stress when no one is capable of making dispassionate decisions.

I called Mike Darwin and participated in a three-way conversation with him and Andrew, during which Mike learned some of the patient’s history. After a call to CryoCare’s president Brian Wowk and to a friendly Brooklyn mortician, we decided to take the case. Since by this time it was around 7 P.M., Mike felt the quickest way to respond would be for me to supervise packing the patient in ice and shipping her to him while he assembled his team. I agreed.

I arranged to meet Andrew at the hospital (about an hour from my home in Manhattan) and I told him to bring along his father, Max, who would need to sign cryonics documents as the closest family member. A friend would also be needed as a witness.

I have participated in two cryopreservations since I initially became involved in cryonics. I have attended a portion of one of Mike Darwin’s transport training courses, and I’ve helped to edit his as-yet incomplete instructional handbook describing standby and transport procedures. Thus, I felt I should be competent to execute Henrietta Popper’s paperwork, interact with her family, and insure that she was properly transported to California. Still, this was the first time I had ever taken a decision-making role as the sole field representative of a cryonics organization, and I had one overriding concern: not to make any dumb mistakes.

Hospital Encounter

It’s 9 PM in the quiet, newly painted hallway of a small hospital in Queens. Together with Erico Narita (who designs CryoCare Report and was willing to serve as a second witness to the cryonics paperwork), I sit on a plastic chair hastily filling out documents in triplicate, pausing to make occasional credit-card calls to Mike Darwin via a nearby pay phone.

After about an hour, Andrew, Max, and a friend arrive, and I find myself dealing with an aspect of cryonics that is seldom described in detail: hostility from a family member. Max, at age 93, claims to be one of the world’s oldest competing runners and is a fit, feisty man who makes no secret of his opinions and comes out swinging. We’ve barely finished shaking hands when he starts challenging me. “Do you think you can control the future?” he demands. “What if a giant meteor hits the Earth? What then, eh?”

I do my best to explain that cryonics offers merely a hope, not a guarantee, but Max skips easily to a another track. “You think you’re going to grow her body back from a single molecule?” He glares at me, and I can see that as far as he’s concerned, this is not a viable option. I say something to the effect that all of us grew from a single cell originally, but he’s already losing interest and turning to Andrew. “I think you’re crazy!” he shouts at him. He turns back to me. “And you’re crazy, too. And you’re encouraging his fantasies.”

This presents me with a dilemma, because I cannot accept Henrietta Popper as a patient without Max Popper signing the consent forms, and his consent must be freely given. It turns out, though, that despite his skepticism, he is quite willing to sign as a favor to his son. He even agrees to allow full disclosure of details of the case. “What if a journalist wants to interview you?” I ask him.

“Oh, he’ll talk to journalists,” says Andrew. “He does it all the time, in connection with his marathon running. He’s a famous character. He loves it.”

Sure enough, Max Popper cheerfully agrees to media coverage. “But if they ask me what I think of it,” he warns me, “I’ll tell them I think it’s crazy.”

With frequent breaks for additional sparring, and for lower-key explanations of cryonics that Andrew’s friend requires in order to witness the signatures intelligently, it takes us about an hour to complete the documents. At that point the mortician arrives, a soft-spoken, gentle, and extremely helpful man named Gomez who has assisted in several cryonics cases over the years. He has his own documents to be signed, but they’re simpler than ours, and they don’t mention difficult topics such as decapitation, so they’re done within ten minutes. A little later Andrew is allowed one last look at his mother, and then Mr. Gomez is ready to take her away.

I’m concerned that she must be thoroughly covered in ice. Mr. Gomez is familiar with cryonics protocol and has already brought along a few bags, but I feel they are insufficient. “Maybe you could pick up some more on the way back to your mortuary,” I suggest. “I think there’s a 7-11 on Queens Boulevard. I realize you probably feel this is pointless, but–”

“It doesn’t matter what I think,” he answers quickly. He nods toward Andrew. “What he wants–that’s what matters. I’ll do whatever he wants.”

A little later he takes Andrew’s mother away, while I pick up a phone in the hospital lobby to call a car service for us. The car service turns out to be one of those classic New York nightmares: the vehicle is a Chevy Caprice about 20 years old, belching oil fumes. The interior stinks of old cigarettes. The front passenger seat leans to one side and has no seat belt. The interior light is a dead naked bulb. Two bare wires sprout from the steering-wheel hub, where the horn used to be. The driver is a kid of around 18, chewing a plastic straw. He looks as if he just stole the car and is trying to figure out how to drive it.

“Do you know how to get to Atlantic Avenue?” I ask him.

He stares at me as if I’m stupid. “No,” he says.

We get in and slam the doors. The kid calls his dispatcher. “What’s the fastest way to get to Atlantic Avenue?”

“By car,” says the dispatcher, wittily.

Eventually we get directions. The kid starts driving and it soon becomes obvious that the car’s automatic transmission is permanently stuck in second gear. At first I find this hard to believe, but as I see the kid wrestling with the shifter, I realize it is true. We have to drive all the way to Brooklyn with the engine revving madly–although this does have the fortunate side effect of stopping the car from moving much above 55.

At the Mortuary

Mr. Gomez’s mortuary turns out to be a small storefront in an unpretentious neighborhood. We sit in his office while he fills out the death certificate and makes a reservation for Henrietta to be flown to California the next day. After that, even though it is now midnight, Mr. Gomez sends one of his men to file the certificate with the City of New York, which has a 24-hour office for this kind of paperwork.

I get back home around 1 AM and sleep for a couple of hours, but the emotional resonances of the evening are still bouncing around inside my head, and I have to get up and write for a while in order to organize my thoughts. Before long it’s light outside, and I have to return to Mr. Gomez’s mortuary to check that Henrietta Popper is still properly cooled before she is moved out to Kennedy Airport.

When I arrive at the mortuary I find Mr. Gomez in an uncharacteristic state of agitation. He is sitting at his desk, frowning at a badly printed formletter, all in capital letters, with badly photocopied illiterate handwriting scrawled beneath. I know immediately that this is a communication from the City of New York. No privately run business could possibly create anything so stupid and ugly.

“Read this, I want you to read this!” Mr. Gomez says. “This is something new. I have never seen anything like this before.”

Apparently his helper returned with the document during the night, when the City refused to accept Henrietta’s death certificate. Feeling terminally stupid after barely two hours of sleep, I have a hard time concentrating on the text.

“So we will go through it together,” Mr. Gomez says, regaining his equilibrium. “I will read it to you, one sentence at a time, and together we will understand it.”

That’s exactly what we do. It turns out that the City has a new regulation requiring a death certificate to be completed in a very special way when an anatomical donation is involved. The date of death must be in ink, but the date of freezing must be in pencil, for reasons only a bureaucrat could understand. Also, a form giving Permission to Cremate must be signed by next of kin, and must be notarized.

“We must get Andrew back here,” says Gomez. “And I will arrange for his mother to go out on a later flight.”

He calls the airline; I call Andrew. I get his answering machine. “If you can hear me, pick up!” I call to him. He doesn’t pick up.

“We will send someone to wake him,” says the indefatigable Mr. Gomez, who has now found another flight that takes off later but is nonstop to LAX and thus arrives earlier than the one he previously arranged to Ontario, California.

Meanwhile, it’s time for me to get busy. Some of the ice on Henrietta has melted during the night, so I go across the street to a Spanish grocery store and buy all the ice they have–about 70 pounds.

Back at the mortuary, Mr. Gomez gives me a hammer, a plastic disposable apron, and some latex gloves. I’m soon at work scooping up the old, loose ice, bagging it, knotting the bags, and stacking them. Then I start pounding the new bags of ice with the hammer and bagging them, too. In the end I figure I have more than 100 pounds of ice. Mr. Gomez and his assistant remove the last ice remnants and melted ice from the container where Henrietta is lying, and I supervise as they repack her with the newly bagged ice. She is in a Ziegler box–a utilitarian galvanized steel container that is not watertight. Normally we would like to use BioPreservation’s purpose-built transport box, but there wasn’t time to get it here. Consequently, we will enclose the Ziegler box in one of Mr. Gomez’s best metal caskets for shipping.

To provide some heat insulation, I add layers of corrugated cardboard and bubble wrap around the Ziegler box before it goes into the casket. It doesn’t look pretty, but it will help to keep the ice frozen.

Meanwhile, Andrew has arrived to sign the new documents, which have been filled out to satisfy the new regulations. Mr. Gomez asks us to wait while he takes the papers to the city offices. Two hours later he returns triumphant. In fact, the daytime bureaucrats claim that the nighttime bureaucrats were incorrect to ask for the documents to be redone, because the patient is being shipped out of state, which means that the new regulations don’t apply anyway.

By now it is noon, and Henrietta Popper has been subjected to several additional hours of ischemic time while our tireless mortician jousted with bureaucrats. Andrew does not react well to this; like most cryonicists, he is no friend of government. Still, all the paperwork is now complete and Mr. Gomez takes Henrietta away to the airport. The only remaining formality is for me to go with Andrew to his savings bank, where he obtains a teller’s check to pay for the cryopreservation.

Conclusions

I feel satisfied with our performance in this case. Less than an hour after Andrew’s initial phone call, I was on my way to meet him with a set of sign-up documents in hand. There was a short delay while I waited for him to reach the hospital, but this was unavoidable at his end. Despite some hostility from Andrew’s father, the documents were completed correctly within another hour, and our mortician turned up promptly and was conscientious about icing the patient. The City of New York imposed a substantial time penalty, but Mr. Gomez’s assistant dealt with this as well as he could (he was actually up almost all of the night hassling with city employees) and Gomez himself was quick to react the next morning. The patient was well treated, well maintained, and shipped out on the first available flight.

The downside of course is that we were not able to provide a high quality cryopreservation. Andrew was told by the hospital that his mother died around 6 AM on the day he called me. Mr. Gomez assured us that this particular hospital has a high-quality, low-temperature morgue. Inspection of the patient (by myself and by Mr. Gomez) indicated that rigor mortis had not set in, so we felt there was a reasonable chance to achieve some perfusion, and the full BioPreservation team was mobilized at the lab in California. When they received Mrs. Popper they found she was still well packed in ice but the seeming absence of rigor turned out to be, almost certainly, secondary flaccidity–the state that occurs after rigor mortis, when the tissues themselves start to break down.

We are forced to conclude that Henrietta Popper may have died many hours earlier than the time listed by the hospital, and may have lain unobserved at room temperature during much of the night. This is, of course, speculation on our part, and the hospital may have excellent reasons for standing by its records of the case. But Andrew remains especially critical and bitter about the hospital, which is owned and operated by a large Health Maintenance Organization (HMO).

Andrew also regrets that he didn’t sign up his mother months or years earlier–and of course the moral of this story is one that we have mentioned many times before. If you’re serious about cryonics, don’t procrastinate. The longer you wait, the more you run the risk of an accident or emergency. Also, the cost of whole life insurance starts to rise radically around age 40. We have talked to some people who initially thought of signing up for cryonics ten or twenty years ago–and now find the cost of insurance prohibitive, or are unable to obtain insurance at all because they have new health problems that make them uninsurable.

This is not a promotional message specifically for CryoCare. Naturally we’d like to acquire more members; but more than that, we’d like to see the procrastinators sign with any organization rather than risk permanent death just because they put off completing their paperwork.