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Contents

• Final Agreement is Reached with The Cryonics Institute
• Problems at the Canadian Border
• Paul Genteman is Cryopreserved
• New Secretary for CryoCare
• News from CryoSpan
• Gray Areas of Cryonics
• News from BioPreservation
• Editorial
• A Note from our President
• A Positive View of Cryonics
• New Documents Available
• Emergency Phone System
• Revised Sign-Up Fees
• Subscriptions

After a great deal of discussion, we have finalized the agreement with the Cryonics Institute which we announced tentatively in our previous newsletter. Following legal death and perfusion and cooldown to dry-ice temperature by BioPreservation, our members now have two options: to be maintained in liquid nitrogen by CryoSpan (our first service provider) or by the Cryonics Institute (CI) in Michigan.

This is an exciting moment for us because it is a first step toward one of our original goals at CryoCare: to give our members unmatched freedom to choose.

The total fee for CryoCare members who choose CI will be $69,000 for neuro patients and $95,000 for whole-body patients, plus the usual fee for becoming a member of CI.

This whole-body fee for storage at CI is lower than our minimum funding of $125,000 for storage at CryoSpan. No doubt, many skeptical cryonicists will be wondering why CI should cost less, and whether there is a downside to the price reduction. This is a difficult topic which is hard to discuss in a way which will be judged fair by all the people involved. Still, we have to try.

Every cryonics organization makes different assumptions when it tries to predict the future, and every organization has a different financial situation. At CryoCare, when one of our members is declared legally dead, the balance of the person's cryopreservation fee (after we pay for expenses associated with standby, transport, and perfusion) is invested in the Independent Patient Care Foundation (IPCF), where it will be professionally managed to yield a reasonable but safe return. If the patient is being cared for at CryoSpan, interest from the patient's funds is used to pay CryoSpan's ongoing fees for liquid nitrogen and other expenses.

We require each member to have sufficient funding so that a 2 percent real return on investment managed by the IPCF will be enough to pay CryoSpan's fees. This "2 percent rule" is very conservative, but we prefer to err on the side of safety.

The Cryonics Institute has always had a different policy. Robert Ettinger, its founder, has stated that he believes the 2 percent rule is overly conservative. Also, the Cryonics Institute has received substantial donations and bequests which have made it less dependent on patient funds.

Whose view is correct: ours or his? There is no simple answer to that question. If you are interested in pursuing it further, we invite you to contact the Cryonics Institute directly. They are located at 24443 Roanoke Street, Oak Park, Michigan 48237, telephone (810) 548 9549.

You may also be wondering why the fee for storage of neuro patients with the Cryonics Institute is actually higher than our fee for storage at CryoSpan. The answer to this is more complicated, and relates to the legal responsibilities involved.

Decision-Making Authority

After legal death, CryoCare receives a patient under the Uniform Anatomical Gift Act. If you signed up with us originally, we assume this means that you chose us because you trust us and prefer our organizational structure (for example, our fund management, our standby capabilities using BioPreservation, our system of patient advocates, or our by- laws which give members some control over the election of our directors). If you give us the responsibility to look out for your interests, we assume that you want us to continue in this role indefinitely--not just so long as it is convenient.

Therefore, when a patient is maintained in a frozen state by CryoSpan, the Cryonics Institute, or some other organization which we contract with in future, we still have decision-making authority over that patient. Under certain circumstances, in consultation with the patient's legally appointed advocates, we have the right to retrieve the patient for relocation elsewhere.

Robert Ettinger agreed to this condition--but refused to accept payment for storage on the same basis that we will pay CryoSpan, via an ongoing annual fee which is generated by investing patient funds in the IPCF. Instead, Mr. Ettinger insisted that his usual fee for storage would have to be paid in full at the time of legal death and would be nonrefundable.

This presented us with a dilemma. We will remain ultimately responsible for our patients that are being maintained by the Cryonics Institute--but since we will have paid for their cryopreservation in advance, and since the fee is nonrefundable, we won't have any remaining funds to deal with any kind of emergency.

The Cryonics Institute is the oldest-established cryonics organization today, and has been conservatively managed. Still, any business can experience difficulties in the long term, and part of our original vision at CryoCare was to give ourselves the option, always, of regaining control of any of our patients if necessary.

Contingency Plan

Therefore, we had to come up with a contingency plan for patients who may be kept at CI. We decided to charge an additional fee which will be deposited with the IPCF and will sit there indefinitely, earning interest on behalf of the patient, for use only in case of emergency. (There is one other possible use for this money: it can be used to help pay for resuscitation if and when that becomes possible.)

We didn't have to take this extra precaution on our members' behalf. We could have said, "Sign up with CI if you wish, and we will respect your decision, but we will no longer be responsible on your behalf."

We discussed this option but rejected it because we think it's wrong to shed our responsibilities whenever it's convenient. Also, in practice, we know we would want to take action if one of "our" patients was endangered. Therefore, we have to charge a contingency fee.

Note that the contingency fee is sufficient (in our opinion) to retrieve a neuropatient and relocate that person with a different cryonics provider. In the case of a whole- body patient, the fee is sufficient only to convert that person to neuro status prior to relocation. Naturally, you can arrange for a larger contingency fee to be deposited in the IPCF if you are a whole-body patient, you select CI for long-term care, you want CryoCare to retain responsibility for your welfare, and you do not want to risk conversion to neuro under any circumstances whatsoever.

CryoSpan Contingency

Perhaps this discussion raises another question: why don't we have a similar contingency fee for people who opt to be frozen at CryoSpan?

The answer is that CryoSpan does not require a lump-sum payment in advance. CryoSpan is willing to bill us on an ongoing quarterly basis, on the assumption that patient funds will be properly managed in the IPCF and will yield sufficient interest.

Meanwhile, if anything goes wrong at CryoSpan, we still have the principal of the patient's money in the IPCF, so we can still pay for maintenance of the patient elsewhere if relocation becomes necessary.

Note that this news report is only a general discussion of the issues, and is not a full statement of the contractual terms. Please call or write for full information.

For Neuro Patients: 

40,000         Standby, transport, perfusion, cooldown* 
 1,000         One-time CryoCare administration fee 
 2,000         Independent Patient Care Foundation admin fee** 
 2,500         CryoCare long-term administration fee** 
   500         Transport to Michigan 
10,000         Minimum funding for Cryonics Institute 
   500         Reserve for emergency transport to 
                    another storage company*** 
12,500         Contingency for neuro storage elsewhere*** 
------       
69,000         Total 
       
-------------

For Whole-Body patients: 

42,500         Standby, transport, perfusion, cooldown* 
 1,000         One-time CryoCare administration fee 
 2,000         Independent Patient Care Foundation admin fee** 
 2,500         CryoCare long-term administration fee** 
 2,000         Transport to Michigan 
28,000         Minimum funding for Cryonics Institute 
 4,500         Reserve for emergency conversion to neuro and 
                    transport to another storage company*** 
12,500         Contingency for neuro storage elsewhere*** 
------       
95,000         Total 

     * This service is provided by BioPreservation, Inc. 
     ** Funds will be invested in IPCF and will earn 
interest. The principal will remain untouched. $50 per year 
of interest earned will be used for administrative expenses. 
Any remaining interest will roll over. 
     *** Funds will be invested in IPCF and will earn 
interest. All the interest will roll over. The total funds 
will be used only in an emergency or if it becomes possible 
to revive the patient. 

Anyone who selects CI for storage must pay the usual fee for joining CI at the time of signing contracts: $1,250 per person or $1,875 for a couple. There is no additional yearly fee.

Earlier this year, Mike Darwin of BioPreservation was stopped, interrogated, searched, and detained for an hour by immigration author-ities when he attempted to enter Canada on business relating to cryonics. Mike was eventually allowed into the country but was warned that he was technically violating Canadian law by attempting to "work" there (even though he was pursuing a personal project which involved no remuneration for him at all). He was also warned that he should not expect to enter Canada in the future unless he obtains permission to work; and this permission may have to be obtained in advance of each visit.

Mike was not operating on behalf of CryoCare on this occasion, but obviously we are very concerned about its implications in the future. In fact, all American cryonics groups are now unable to count on doing a standby in Canada in the foreseeable future.

Ben Best, the new Secretary of CryoCare and a longtime Canadian cryonicist, has begun negotiating with the government re its immigration policy which seems to prevent any emergency medical personnel (cryonicists or otherwise) from conducting procedures in Canada. Ben writes:

"I have been told by a medical student that surgeons and other medical professionals typically do not come to Canada for emergency procedures. To practice medicine in a Canadian province, it is necessary to be licensed for that province. It is common for patients to be taken to the US, sometimes by air ambulence, for medical procedures. . . . Canadian law makes certain allowances for non-Canadians who wish to perform pre-specified kinds of work (including emergency repair of industrial equipment) where the worker is eligible for an employment authorization. The North American Free Trade Agreement also makes special provisions for professionals listed in Appendix D-1 of that document. Both arrangements require a certified employer. I do not yet know whether the Cryonics Society of Canada would qualify."

Brenda Peters, President of CryoCare, comments: "Though we have been fortunate in the past, it was naive to expect to continue crossing borders and performing cryonics services without some sort of work permits, licenses, visas, or employment authorizations. At least this border incident did not occur during a CryoCare emergency. And it offers an opportunity for BioPreservation and CryoCare to iron out the international red tape now and avoid a crisis situation later. When we identify what the Canadian government's requirements are, I hope that we can then proceed to systematically satisfy those requirements. This may prove to be expensive, both in terms of time and money, but at least we had the opportunity to identify a problem, and now to work on a solution."

Meanwhile, Steve Bridge of the Alcor Foundation reports that Alcor has assigned one of its directors to petition the Canadian consulate here in the United States to allow cryonics emergency teams free access to Canada.

CryoCare has warned its Canadian members that Mike Darwin cannot currently enter their country legally. He has now received application forms for temporary worker status, but, he says, "there will be long delays while they establish the legality of my doing human cryopreservation, whether there are others in Canada who can do this work, what exceptions they can make, and whether I will be required to have a Canadian business sponsor." Mike is willing to consider incorporating a branch of BioPreservation in Canada if this will help to resolve the problem.

He recommends that in the meantime, any Canadian cryonicist who is contemplating an elective medical procedure which carries a risk of mortality should postpone the operation or have it carried out in the United States. "I am not willing to respond to emergency calls by crossing the Canadian border illegally," he says, pointing out that there could be serious repercussions for the patient and for him personally.

It's unfortunate that immigration authorities in many countries operate less predictably, and with less accountability, than most areas of law enforcement. In the past, Canadian officials have shown little interest in enforcing the letter of the law, and American cryonics teams have entered the country without incident. Unfortunately, we can no longer count on this being possible. So long as the matter remains unresolved, CryoCare cannot offer full BioPreservation standby services in Canada. Fortunately, two of CryoCare's most active members, Ben Best and Brian Wowk, are trained cryonics transport technicians. Personal circumstances permitting, they are prepared to respond to CryoCare emergencies in Canada until a more satisfactory solution to this problem is achieved.

We hope to have an update on the situation in our next newsletter. If any important developments occur in the meantime, we will contact our Canadian members directly.

CryoCare is sad to report that Paul Genteman, one of the most beloved gentlemen in cryonics, experienced an untimely death and was cryopreserved by Alcor in January. Paul's wife and family have stated that they would prefer all tributes to Paul to be published in CryoCare Report. If you wish to write a tribute, please send it to our editorial address: 1133 Broadway (room 1214), New York, NY 10010. CryoCare plans a formal tribute to Paul, a man who was very dear to many of us, in our next issue.

We're very pleased to announce that Ben Best has accepted the position of Secretary of CryoCare.

Ben is a long-time cryonics activist who was one of the first to sign up as a member of CryoCare. He is a Senior Programmer/Analyst for ScotiaMcLeod, Inc., the largest bond trader in Canada, and has degrees in Pharmacy, Physics, Computing Science, and Finance.

Ben has served as Treasurer of Toronto MENSA and Treasurer of the International APL computer-language conference held in Toronto in 1993. He has already worked on behalf of CryoCare at conferences and conventions in 1994.

We were initially concerned that Ben's position as President of the Cryonics Society of Canada might be a conflict of interest prohibited by our by-laws.

In fact, however, our bylaws state that no officer of CryoCare should hold a position in any other organization which provides cryopreservation services. The Cryonics Society of Canada exists merely as an affinity group to promote understanding of cryonics; it doesn't cryopreserve anyone or anything. Therefore, Ben is free to continue his role in CSC while also serving us as Secretary, and we're delighted that he is willing to donate some of his time and talents to CryoCare.

Many thanks to Kevin Q. Brown, our treasurer, who performed the additional role of Secretary on a temporary basis during the past year.

Vault Update

In the last six months CryoSpan has acquired two patients, one of them Margaret Bradshaw (a member of the American Cryonics Society), the other a neuropatient whose name is confidential. At the time of writing, this latter patient is in the cooldown process from dry-ice to liquid nitrogen temperature.

Meanwhile, CryoSpan's director, Paul Wakfer, has been working with Mark Connaughton on the project to build concrete vaults which will provide complete physical protection--including earthquake protection--for cryopreserved patients. The design has been completed and is waiting for final approval from the city of Rancho Cucamonga.

The vaults will consist of cylindrical reinforced concrete silos that have been designed to withstand 2 gravities of acceleration in every direction. The geotechnologist who was employed to survey the site and do soil analysis reported that an earthquake caused by any of the three nearest faults should create tremors measuring no more than .47 gravities; consequently, there will be a substantial safety factor.

The vaults will be underground, but groundwater is not a source of concern since the water table is 400 feet below the surface. In the event of a flood--for example, from the sprinkler system of the building--an exit pipe three feet below ground level will drain the vault to the downhill neighbor's parking lot.

The vault design was done by General Physics Corporation of San Diego, which has had experience shock-mounting dewars at Rockwell, a major aeronautical engineering firm and defense contractor. Each vault will consist of a cavity tall enough to enclose the full length of a four-patient dewar with room to spare. There will be a poured concrete base at the bottom, and a cylindrical liner of hardened concrete which will be precast, incorporating reinforcement rods specially designed to resist forces in all directions. This liner will come in four sections which will be stacked and glued together with special epoxy glue. The construction is being done by General Constructors Corporation of Corona, which specializes in seismic concrete work.

The vaults are similar to underground enclosures which are widely used to protect electrical equipment under manholes all over the Los Angeles area. After the Northridge earthquake, which measured above 7 on the Richter scale, Paul Wakfer checked with the two largest vault companies and found that they had received no reports that any of their vaults had suffered any damage at all. Even their flat-walled vaults, which would be structurally weaker than CryoSpan's cylindrical design, survived without incident.

CryoSpan has done considerable analysis of the effect of sudden accelerations on the dewars which will be stored inside the vaults, and finds that even if each dewar was solidly mounted it should withstand forces of 2 gravities. Still, CryoSpan decided to go one step farther and will be cushioning the dewars with insulating, shock-absorbing material both underneath, above, and in the six-inch gap between each dewar and its silo wall.

Thanks to this additional insulation, which was proposed by CryoCare director Brian Wowk, less liquid nitrogen will evaporate on a day-to-day basis. This will result in more efficient storage, and in the highly unlikely event that the vacuum between the double walls of a dewar is breached as a result of earthquake activity, the insulation should prevent complete boiloff of the liquid nitrogen for up to a week, allowing ample time for action.

Construction of the vaults will require additional capital, but Paul Wakfer reports that he has already received pledges which will largely cover the cost in conjunction with funds which he will provide himself. When the vaults are completed, CryoSpan should have the safest patient storage facility not just in California but in the entire United States. Not only will the vaults provide earthquake protection, they will also provide protection from fire, acts of sabotage, or vandalism.

So far as we know, no other cryonics organization has installed this kind of protection for cryonics patients or has any plans to do so in the future.

A New Cooldown Box

CryoSpan has recently finished most of the work constructing a glass-fiber box which can be used for cooldown of patients on their way to liquid nitrogen storage. The box could also be used to house patients temporarily in an emergency, since it is big enough to hold four whole-body pods of the type that slide into CryoSpan's four-patient dewars.

Currently, CryoSpan owns one four-patient dewar and has been using a smaller unit for neuropatient storage. When the vault is complete, neuropatients will be moved into it and the glass-fiber box will be used for future cooldowns.

The box is double-walled. Its interior dimensions are approximately 7 feet long, 4 feet deep, and 28 inches wide. The interior wall is fabricated from half-inch epoxy glass fiber, separated by ten inches of special high-insulation foam from an outer wall of 3/16" polyester glass fiber. A steel frame at the bottom rests on six casters.

CryoSpan is now ready to test the unit, first by pumping nitrogen gas into it and checking for leaks. Once the integrity has been proven, the enclosure will be filled with water, which has approximately the same density as liquid nitrogen. If the walls of the unit are sufficiently rigid (as calculations predict they will be), the final test will be to fill the box with liquid nitrogen.

Plans for the box were drawn up by Mark Connaughton, a mechanical engineer, from a design by Paul Wakfer which was adapted from a configuration developed by Andy Zawacki at the Cryonics Institute in Michigan. We thank Robert Ettinger for freely sharing this proven design.

Business Plan Now Available

CryoSpan is a for-profit corporation which hopes to attract investors. While this should not be considered a formal offering, Paul Wakfer reports that he has completed a twelve-year business plan which is available free of charge. On the basis of various assumptions, Wakfer's plan predicts that CryoSpan will be profitable by the end of the 1997 financial year. Depending on growth in cryonics generally, the plan estimates a profit by the year 2006 of $141,000.

To receive a copy of the CryoSpan Business plan including its detailed assumptions and forecasts, write to

CryoSpan, Inc.
Three Christina Center
210 North Walnut St., Ste 1000
Wilmington, DE 19801

Some aspects of cryonics are harder to accept than others. Neuropreservation, for instance, rouses squeamishness in many people and is a never-ending source of fascination for journalists in search of shock value.

The advantages and disadvantages of neuropreservation have been debated for many years, and most of us have long since made up our minds on the subject. CryoCare believes that neuropreservation is a legitimate, useful option, and we are quite willing to endure any negative publicity that it may entail.

But there is another problematical issue which has been less widely discussed and is less easy to endorse as an option: disinterment.

It may seem pointless even to consider cryopreserving a person who has already been embalmed and buried. But the idea is not necessarily as foolish as it sounds. If we accept the premise that nanotechnology may be able eventually to undo individual molecular bonds, future science might be able to rescue a person whose cells have been fixed with glutaraldehyde (a common embalming agent, similar to formaldehyde).

We are certainly not advocating this as a standard protocol. But suppose we receive a call from grieving relatives who are eager for CryoCare to freeze their loved one. Suppose the person has been interred for only a day or two in a part of the world where temperatures are near freezing. Should we consider taking the case?

There are three reasons to say "yes."

1. We should be willing to consider any case where there is a chance of renewed life. That's what we're here for.

2. Each patient that we accept provides CryoCare with a small but worthwhile amount of income. The stronger CryoCare becomes, the better it will serve everyone.

3. When relatives pay for the cryopreservation of a loved one, they acquire a very personal interest in cryonics. This field needs as many members--and as much help--as it can get. We are not yet big enough to turn away possible supporters without regret.

But there are also three reasons to say "no."

1. Disinterment has ghoulish associations which could create negative, damaging publicity if details of the case reach the national media.

2. Disinterment usually occurs only in last-minute cases where people have failed to make prior arrangements. Last- minute cases are notoriously risky. Relatives who are desperate to cryopreserve a loved one may be so grief- stricken that they are liable to make a rash decision which they will later regret. They may even decide, some time in the future, that the cryonics organization took advantage of their grief. A law suit may result. Also, relatives may have trouble paying for cryopreservation with a lump sum of cash, and as a result, the cryonics organization will feel tempted to offer a discount or accept a nonstandard method of payment. This, too, can have repercussions.

3. The possibility of reviving a patient who has been embalmed with glutaraldehyde seems relatively remote. It may be unethical for a cryonics organization to accept money for such cases.

Overall, at CryoCare, we tend to feel that the disadvantages of disinterment outweigh the positive factors. In fact, we have already turned down one case where disinterment would have been involved. At the same time, those of us who participated in that decision felt some misgivings. It's very hard to say "no" to someone wanting to buy extra life for a loved one who died too soon.

If you have any opinions on this subject, we'd like to hear from you. CryoCare does not, at this time, have a rigid policy on disinterment, and the subject is open for discussion.

Evaluating Cryonics Freezing Protocol

Using the facilities co-owned by Twenty-First Century Medicine and CryoVita Laboratories, BioPreservation's emergency standby team has been participating in ground- breaking research of direct relevance to cryonics.

Some of this research focuses on the brain damage that may be caused by freezing despite modern cryopreservation techniques of the type now practiced at BioPreservation and Alcor after initial development by Jerry Leaf, Mike Darwin, and others. Mike Darwin, Steve Harris, MD, and Sandra Russell have been pursuing a long-term study perfusing and freezing dogs using the same protocol that would be applied to a human cryonics patient. In some animals, a short period of cardiac arrest was followed by resuscitation with CPR, followed by blood washout, followed by cryoprotective perfusion and freezing. In other animals, cardiac arrest was omitted to eliminate injury caused by ischemia, and different experiments were designed to distinguish any injury caused by glycerol perfusion from injury caused by freezing and thawing.

Tissue is also being viewed in the frozen state using a technique called freeze substitution. Samples are being sent out to a specially equipped laboratory where they are encapsulated in plastic and evaluated under an electron microscope.

"We are trying to tease out each variable which causes confusion about the source of injury," reports Mike Darwin. "Is injury being caused by thawing, when melting water creates osmotic forces and other stresses? Or are we seeing injury caused by the freezing process itself, or even as a result of perfusion with very high concentrations of glycerol? These are the kinds of questions which we hope to answer."

The team is not yet ready to disclose definitive results but hopes to publish them within six months to a year. The report will include all data about the methodology, enabling other teams to replicate and verify the work if necessary.

So far, dogs perfused with the standard BioPreservation protocol (as was used on Jerry White in 1994) have reperfused very well at a capillary level. Using a marker consisting of a carbon particle suspension in a fixative, it has been shown that even small capillaries are intact and vascular resistance is little different from before the animal was frozen. No leakage has been observed (as would happen if blood vessels were ruptured), and no cracking has been seen, even when the animal was mechanically stressed during freezing by a load of 50 pounds between two widely separated supports. Mike Darwin sums up: "No fractures or cracks were visible by the naked eye, by light microscopy, or by electron microscopy in animals that were perfused with 7.4 Molar glycerol and cooled to -90 degrees Centigrade. Even when we rewarmed the animals by plunging them directly from -90 degrees Centigrade into a bath of liquid at zero degrees and rewarmed at a rate of 10 degrees per hour, we saw no signs of cracking."

Better Brain Monitoring

Another ongoing area of concern has been the need for better ways to predict legal death and protect brain function in patients who suffer slow, wasting disease such as cancer or AIDS.

Mike Darwin comments: "People who die very slowly seem to experience failed perfusion of blood to the cerebral cortex. I strongly suspect that we're seeing a failure of cerebral perfusion long before legal death is declared. The overall blood pressure in such dying patients is extremely low for long periods. There may be a mean arterial pressure of 40 to 50 millimeters of mercury for four to eighteen hours before death. And the patient's pupils often become fixed in mid-position, half dilated, which is clinically considered a sign of brain death."

In other words, a cryonics patient who is vitally concerned with protecting and preserving brain function may lose it as a result of inadequate blood circulation, long before legal death is pronounced. And this may occur in many people other than AIDS patients--for example, cases of slow death from a malignant disease where the person wastes away, becomes dehydrated, and eventually dies without a catastrophic event. Even some kinds of slow heart failure--such as congestive heart failure--result in a very slow decline marked by inadequate tissue perfusion.

As we reported in a previous newsletter, BioPreservation has pulse oximetry capability which provides some indication of the patient's condition and proximity to death. Hospitals usually refuse to monitor or treat patients who are clearly dying, because they consider this a violation of medical ethics. In a home hospice, however, and sometimes in a nursing home, a physician such as BioPreservation's Steve Harris may be able to persuade the attending physician to permit use of the equipment. Harris has authority to order use of the equipment himself in states where he is licensed to practice medicine.

BioPreservation has now acquired a cerebral function monitor made by CerebroTrac which allows terminal patients to be evaluated more precisely than ever before. Five EKG electrodes are applied to the head: one behind each ear, one on each temple, and one in the middle of the forehead. These electrodes are connected to a processor which analyzes the EEG coming from the whole brain and breaks it into a spectrum of frequencies which are color-coded in a video display. "Certain frequencies are associated with the higher brain functions," says Darwin, "and can be easily distinguished from those generated in the brainstem, which are associated with breathing and heartbeat. In an animal in shock, we have clearly seen the higher function centers drop out as a result of diminished blood flow. We expect to see a similar pattern in patients who suffer prolonged terminal illness."

Cerebral function monitors were developed originally to monitor patients under anesthesia or in intensive care, but they have obvious importance in any cryonics case where a standby team can expect to wait for several days and nights for the moment when they will have to take prompt action after legal death is pronounced. "We may see a patient unconscious and immobile in deep shock," says Darwin, "and we have no way of knowing when the heart is going to stop beating. Blood pressure and pulse may stay relatively constant in shock, right up to the moment of legal death. But using the cerebral function monitor, we should be able to observe deterioration of brain-stem function, which will indicate very clearly when cardiac arrest will occur."

This means that the standby team need not remain on full alert for days at a time. While one person monitors the situation, others will be able to rest in shifts. Also, there will be a better chance to premedicate the patient with drugs such as antioxidants or Dilantin, which can enhance the subsequent effectiveness of CPR after legal death has been pronounced.

Currently, so far as we know, BioPreservation is the only cryonics service provider equipped with a cerebral function monitor.

New Technique Minimizes Ischemic Damage

Another area of research at the Twenty-First Century Medicine facility has focussed on techniques to enhance survival after sudden death. Cryonicists have always been especially concerned about brain damage that results from warm ischemia--total lack of blood flow at normal body temperature. But the ability of CPR to maintain adequate blood circulation has been a matter of some debate.

In an urban area, an ambulance typically reaches the scene of an emergency in three to five minutes. During this waiting period, a bystander may attempt to give cardio- pulmonary support (CPR), but this will usually be less effective than the same technique applied by paramedics who are likely to be better trained, physically stronger, and able to use drugs such as epinephrine to enhance CPR's effectiveness.

The team at Twenty-First Century Medicine has simulated this kind of situation by inducing cardiac arrest in dogs for ten minutes, accompanied by total lack of blood flow. This has been followed by five minutes of weak blood circulation (simulating poor CPR) with a mean arterial pressure of less than 15 millimeters of mercury. Paramedic-level CPR has then been simulated by increasing arterial pressure to nearly 30 millimeters of mercury for another five minutes, and this has been followed, finally, by full blood circulation using mean arterial pressures of over 100 millimeters.

The precise control of arterial pressure is made possible by circulating the blood extracorporeally--through an external pump and oxygenator that substitute for the heart and lungs.

Since little or no blood passes through small vessels of the brain while the pressure is less than 30 millimeters, this test protocol is a very severe insult to the system, representing a total of 20 minutes without proper circulation. When the test was administered to dogs that were not medicated or otherwise protected in any way, all of them failed to regain consciousness. But when the team applied a mixture of specially formulated medications and other protective measures, one out of two animals recovered with minimal neurological deficit. The dog now responds to his name, will respond to commands, and has neurological scores within normal parameters. His only apparent abnormality is that he tends to circle to the left under stress.

The team finds no precedent in the medical literature for any experiment in which consciousness was regained after such a long period of warm ischemia. Following further tests, the protocol may be used to minimize brain damage in cryonics patients when blood circulation stops or is maintained at an inadequate level by weak CPR.

Sponsors of this research are expected to seek patents, so we are unable to give more specific details of the protocol at this time.

Redundancy at BioPreservation

BioPreservation's core team has acquired a lot of practice and experience doing these experiments. As a result, if necessary, the core team of Mike Darwin, Steve Harris, MD, and Sandra Russell can now carry out a complete cryoprotective perfusion, including all data acquisition, without any additional help. Dr. Steve Harris has performed the thoracic surgery needed to set up the bypass circuit that is used in cryoprotective perfusion, and two human patients have been handled without need for a contract surgeon--though additional assistance will still be used where necessary.

Mike Darwin feels he is now close to the point where other members of the team can handle his own case if it becomes necessary. Larry Wood (a biochemist who has been donating a lot of time at the facility with his wife Candy) has learned all the details of perfusate preparation, and Larry, Sandra, and Steve have had experience setting up and priming the heart-lung machine circuit in Mike's absence.

This is good news not only for Mike but for CryoCare members. BioPreservation's team has acquired a new level of expertise and is no longer so totally dependent on Mike Darwin's unique set of skills. As in any emergency system, greater redundancy means greater security.

Several members have asked why they haven't seen our newsletter during the past seven months. Some people have been concerned that the lack of communication might mean something bad about CryoCare. In fact, the opposite is true: we are doing better than we originally expected. The hiatus in newsletter production has been due to a mixture of personal factors in my own life and other tasks in cryonics which claimed my time. I do apologize to everyone for not maintaining our original publication schedule.

When I first committed myself to CryoCare, I assumed newsletter production and PR would be my primary task. In practice, however, it has been the smallest part of my job. I've been active in areas ranging from designing a database for our patient records to building a model prototype of a new portable ice bath.

Like everyone else working for CryoCare, I'm donating my labor while the organization continues through its initial phase of growth. In due course we hope to employ people to do some of the routine work, but for the next year or so it seems likely that we will continue on an all-volunteer basis. (Most cryonics organizations are staffed this way.) Inevitably, some jobs will be done sooner than others, although our highest priority will always be to maintain the reliability and stability of our service. In this area, there have been no compromises.

Speaking personally, there are periods when my career as a writer leaves me with relatively little time to pursue cryonics. I have just emerged from one of those periods and can now make a firm commitment to produce this newsletter on a reliable quarterly schedule for the next year at least. Issues will be dated April, July, October, and January, and will appear in the preceding month.

Thanks for your patience.

--Charles Platt

CryoCare has been very busy the last few months. Our activities have included attending and hosting several events. We could not have done so had it not been for the generous help we have received from the following individuals.

For their valuable help at the November Cryonics and Life Extension Conference in Ontario, California, I thank Saul Kent, JoAnn Martin, Eric Klien, Marce Johnson, Allen Lopp, Ben Best, Bill Falloon, John and Carol LaValley, Arlene Pappan, Larry and Candy Wood--and Dave Kurzdorfer for the beautiful CryoCare banner. I also wish to thank the directors and officers of the CryoCare Foundation, the Independent Patient Care Foundation, CryoSpan, and BioPreservation for their attendance and for their support.

For the Second Annual Conference on Anti-Aging Medicine and Biomedical Technology, held in December in Las Vegas, I'd like to thank Saul Kent, JoAnn Martin, Ben Best, Paul Wakfer, Eric Klien, my father Bob Peters for countless hours of hard work, Larry Sharp, Judy Sharp, Dr. Steve Harris, Sandra Russell, Bill Falloon, Dayna Dye, and the officers and directors of CryoCare, Life Extension Foundation, and CryoSpan for their support.

For the CryoCare November meeting in Florida, I thank our hosts The Tupler Family for their consistent hospitality. Thank you to Dayna Dye and David London for your patience as witnesses to paperwork. Thank you to Saul Kent and Bill Falloon, as always for your support.

Thank you to cryonicists all over the northeast for your support and attendance at the CryoCare holiday party held in Manhatten in December. Special thanks to Janet Pinkney and Curtis Henderson for encouragement and support.

In CryoCare's ongoing efforts to keep up with our information requests, and the manpower necessary to do so, I thank Michael Paulle, Stanley Gerber, John Perry, and Courtney Smith. And as always, a thank you to the most incredible group of officers and directors any organization could ever hope to have.

"Chiller," a suspense novel centered around cryonics, has generated a flow of information requests at CryoCare. The recent paperback edition included CryoCare's address and 800 number at the back of the book.

Author Sterling Blake is believed to be a pseudonym for a very well-known science-fiction writer who has expressed a private interest in cryonics. So far as we're concerned, the identity of the author is unimportant; we find it far more interesting that this novel portrays the cryonicists as the "good guys." This seems to be the first time that any book or movie has taken a position which is so clearly in favor of cryonics.

Strangely, the book has generated relatively little attention within the cryonics community, even though it must be one of the most positive media events in the history of the field.

Some of our members have asked us for Executor's Affidavits, Physician's Affidavits, Attorney's Affidavits, and forms to assign Durable Power of Attorney for Healthcare.

The affidavits are statements which your executors, physician, or attorney can sign, acknowledging your desire for cryopreservation and promising to respect your wishes.

The Durable Power of Attorney for Healthcare gives legal authority to a trusted friend or relative who can make healthcare decisions on your behalf if you suffer a condition which renders you incapable of speaking for yourself. Special text relevant to cryonics has been included in this statutory document.

If you would like copies of these forms, please let us know right away, and we'll be happy to send them to you.

[Since our emergency system is for use only by our members, and since our members have all received the hardcopy version of this newsletter, we have omitted from the online edition the description and instructions for using our emergency phone system.]

CryoCare is not planning to change its cryopreservation minimums, but from June 1st we are going to increase our one- time fee for processing paperwork for new members.

That's the bad news. The good news is that the increased fee can be avoided if you complete your sign-up process within the next couple of months. Even if you can't get everything done by then, there's a way for you to get a fifty percent discount.

Currently we impose a one-time fee of $100 for anyone who joins CryoCare and has not been a member of a cryonics organization before. This is because, when we decided on our fee structure, we assumed that newcomers to cryonics would require a lot of information and personal guidance. The $100 fee was supposed to help reimburse us for the time, postage, and printing costs associated with giving this guidance.

Our experience in the past year now shows that our assumptions were slightly wrong. People who switch from other organizations seem to require just as much discussion time as newcomers. They are better informed about cryonics--and this means that they naturally have many more questions.

Also, we have found that the $100 fee does not come remotely close to covering our costs in processing new members. Therefore, from June 1st, we will impose the following one-time fees for anyone who signs up after that date:

• First adult family member (non-student): $200
• Each additional adult family member: $150
• Full-time students: $100
• Children: $50

Naturally, we don't want to discourage people from joining CryoCare. Right now, however, this is not our problem! The problem is how to keep up with demands for information from people who are applying for membership.

Please note: if you complete your documents and funding arrangements before June 1st, 1995, you will avoid the higher one-time initiation fee.

And here's a special offer for anyone who has started the sign-up process but will not be able to complete everything by June 1st: If you pay us half the new processing fee in advance, we will waive the other half of the fee--so long as you do become a member of CryoCare before the end of the year.

We have no other plans to increase any of our fees for the foreseeable future.

CryoCare Report is published four times a year by CryoCare Foundation, a non-profit corporation whose main office is located at 10627 Youngworth Road, Culver City, California 90230.

President: Brenda Peters.
Directors: Brenda Peters, Brian Wowk, Peter Crowley.
Vice Presidents: Charles Platt, Billy Seidel.
Treasurer: Kevin Brown.
Secretary: Ben Best.

General inquiries and information requests may be sent directly to our president, Brenda Peters, at 300 East 59 Street,, #1105, New York, NY 10022.

Telephone (212) 832 2429 or (800) TOP-CARE.

Material intended for publication in CryoCare Report should be sent to the editor, Charles Platt, at 1133 Broadway, #1214, New York, NY 10010.

The first three issues of CryoCare Report have been free to everyone. Members of CryoCare will continue receiving the newsletter at no charge, but nonmembers must now subscribe to receive future issues.

The subscription rate is just $9 for four issues. To receive the next issue, please make your $9 check payable to CryoCare and send to Kevin Brown, Treasurer, 19-353 Dell Place, Stanhope, NJ 07874.

So long as your name and address are on the check, you don't need to enclose anything with it. Just write "Subscription" on the memo line. We'll do the rest.