And more than mediocrity, this seems to be a deliberate withholding of the best care that could right now be given to cryonics patients. See the article by Aschwin de Wolf:
In this article he emphasizes the importance of rapid cooling immediately after pronouncement of death, and that there is no better mechanism for delivering it than liquid ventilation. He points out an Alcor case where it was used, 6 years ago, with nothing apparently since then, even though Alcor had prototype equipment then that was capable of doing the job. He points out that Suspended Animation has equipment capable of doing the job. Yet apparently neither organization is willing to deliver this service to its patients at this time??!!
Is the problem that they are waiting for the perfect systems to be developed? Or is it merely that neither organization wants to put capably trained personnel on their standby teams, qualified to use the available equipment?
I've held field vitrification up as a goal for cryonics companies, but liquid ventilation is certainly a step along the way that must be taken, towards getting patients the best and fastest service, in the hope of saving lives as is supposedly the goal and rationale of all cryonics organizations.
Personally, I think even primitive methods of cold lung lavage with saline, (which is probably a lot easier to get, and transport, than perfluorocarbons), would be of great benefit to cryonics patients, (given that the primary goal would be the benefits of rapid cooling, not oxygenation).
I wrote this in a blog entry, back in December: ...from the February 2000 issue of Life Extension Magazine (note the year "2000"):
"The most recent breakthrough made at The Critical Care Research Project is an Automated Liquid Ventilation System that can lower whole-body temperature extremely rapidly with a (sic) an automated system that introduces cooled liquid perflurocarbon into the lungs without causing lasting injury. What remains is to make the system portable, so that it can fit into an ambulance for use at the scene of automobile accidents, heart attacks and strokes."
Charles Platt was working on this project while I was at SA, (perhaps even before I arrived on the scene, in March 2006), and no doubt it's one of the projects at his new LEF-funded workshop, in California. Are Bill Faloon and Saul Kent paying any attention, at all, to the lack of progress at the LEF-funded organizations of CCR and SA? Seriously. What has been going on, for the last eight years, at CCR? Does anyone know?
I can't think of any logical reason to delay bringing this technology to the field. To argue "lung damage" would be ridiculous, since cryonicists expect future technology to cure existing disease and repair all other types of damage. A good percentage of cryonics patients are neuros, who are expecting a whole new body, anyway, so what's a set of lungs?
I hope Alcor isn't letting the Wowk, Harris, et al., patent hold them back, as there are too many ways around it, in regard to rapid cooling via lung lavage. While a company might patent a specific device that is superior to other devices, in some proprietary fashion, there is simply too much "prior art" in regard to lung lavage to get a monopoly on it. There are papers on liquid ventilation, dating back to the 1920's, and experiments were carried out during World War I; it is not a "new" concept. The Wowk, Harris, et al., patent was filed eight years ago, which means, at the rate they are going, it may expire before the device is ever brought to the field. I suppose this patent made people (including Bill and Saul) think something was actually being accomplished by the LEF-funded facilities, but it seems like just more wasted time and money, to me. In fact, it may have been detrimental to progress in cryonics, by instilling some sort of fear of patent infringement liability on other cryonics organizations interested in this technology.
My guess is, at least a few consultants and employees of the LEF-funded organizations have already "earned" tens of thousands of dollars on this project, and I have no doubt they're willing to keep working on this project, for many years to come, perhaps under the guise of striving for that "perfection" FD mentions. Is it possible some people may be more motivated to making endless modifications to this project, than to completing it?
Maybe Saul Kent will reply to this personally here?
May 9 2008, 11:14 AM
Since Charles Platt, his usual conduit, has taken a leave from CF posting..
These are indeed serious questions. Why isn't liquid ventilation, after all these years, by now a standard part of standby/stabilization practice? What has CCR been doing all this time?
Although my name appears as sole author of the case report referenced in Aschwin's article, I should emphasize that almost all my data about the procedures preceding the transport to Scottsdale were derived from the team leader in this case. This person asked not to be named, for reasons that I can no longer remember. Perhaps (s)he'll be willing to post some clarifications here.
The report that I wrote mentions a "bolus" of perfluorocarbon liquid administered twice to the lungs. This is rather different from repeated cycles of infusion and suction, with perfluorocarbon passing through a heat exchanger. I believe this could not be achieved at the time. Thus it is misleading to suggest that the perfected technology has just been sitting on the shelf since then.
Because I have functioned only as a consultant in the development of liquid ventilation during the past couple of years, I have no authority to write a public update.
Re-reading my own report made me feel embarrassed by the emotional content, yet pleased by the amount of detail. A report of this kind may be unduly subjective, but does give the reader some idea of what actually happened. I regret that no one at Alcor seems to have time to do that these days.
Although I've learned elsewhere who the team leader was in the Alcor case, I will not divulge who it is either, since that person apparently has desired confidentiality. Perhaps now many years later any such concerns are no longer relevant, and that person, who has posted to CF before, might tell us more here of the progress since then on liquid ventilation and what has hindered it from becoming a standard part of standby/stabilization for all companies who provide such service.
I don't think anyone suggested the technology was perfected 6 years ago, as Charles mentions. The point to me is: Isn't 6 years long enough to perfect it, probably in several versions? What has CCF been doing? Why have the cryonics patients since that time had to receive treatment inferior to what they could have had?
This isn't just a liquid ventilation issue. Alcor has demonstrated great reluctance to use SA equipment generally. I'm told that they air-transported a complete standby-stabilization-transport kit to Florida not so long ago, and I believe they then brought it all back to Scottsdale. Of course any standby team will naturally want to use equipment that it knows rather than equipment that it doesn't know. On the other hand if I were in their position, with virtually no local capability east of Arizona, I would have *found out* what SA had available. During the Alcor training session that was held at SA in, I think, 2006, Tanya Jones seemed quite uninterested in this. Of course this was the same occasion where two Alcor personnel drove the Alcor vehicle all the way from Scottsdale to Florida, to show it off to Florida Alcor members as if the vehicle would satisfy all their needs without any local capability. Fortunately no emergencies occurred in Arizona or California while the vehicle was making its 5000-mile detour for the sake of this PR exercise.
Just to add to the ironies, when Todd Soard decided to end his agreement with Alcor, and he wanted somewhere to park the Alcor equipment and medications that he had been storing for them, he moved everything to SA--with Alcor's knowledge and consent, of course. This equipment included an Alcor ATP and ATP support kit, two more Alcor Pelican containers, and a small plastic laundry basket full of medications. I would guess that all this stuff is still being stored at SA, and I would further guess that Alcor may have forgotten it was there when they airlifted their equipment from Scottsdale.
Comes now "Finance Department" wondering why new rapid cooling equipment developed entirely outside of Alcor has not been used on Alcor patients. I see this as being secondary to some more fundamental questions about policy relating to regional standby work and equipment developed outside of Alcor.
A couple of years ago, I suggested to Steve Van Sickle that SA and Alcor could have annual or biannual technology-sharing meetings, to swap opinions on each others' work in progress, suggest ideas, and avoid unnecessary duplication of effort. Van Sickle rejected my proposal, stating that he didn't believe SA had anything worthwhile to offer. What puzzled me at that time was that he didn't actually *know* what SA had to offer.
Charles is trying to shift the focus to Alcor, but I believe the million dollar question is why the LEF-funded facilities of CCR and SA have spent such an enormous amount of time, (and, no doubt, an equally enormous amount of money), and have yet to bring this technology to the field. They claimed all it needed was "to be made portable," eight years ago. Somebody must be laughing all the way to the bank. I believe it's a relatively simple project that could have, and should have, been completed years ago.
I strongly suspect that if the truth ever comes out about the development of LV, it will have at least as much to do with the desire of the patent holders of certain aspects of its development to control its use and extract income from it, as it might have to do with employees milking the system for years on end designing new bells and whistles.
Alcor ain't talking, so far at least. Probably because they're too lazy and luddite to be interested in undertaking a project that might move right up front of the patent holder's faces, sticking their tongues out at them, or most certainly in one they would actually be willing to pay for the use of.
Kent ain't talking, so far at least. He's about the only corner we hear less from directly here than Alcor management/directors. I'm surprised Steve Harris hasn't chimed in - he usually can't resist, and he would be at least on paper a most appropriate voice from the Kent corner, being both in charge of CCR and a new director at SA. I didn't think we'd hear from Charles Platt, who said he was taking a leave from CF so I didn't bother to ask him about it, and whose words can often be taken as a communique from Kent but you always have to guess when. So far though since he has been back he has skirted around the subject of why the Kent group has not yet developed and is not yet using LV in standard practice, I suppose it is another one of those big secrets.
FD: I strongly suspect that if the truth ever comes out about the development of LV, it will have at least as much to do with the desire of the patent holders of certain aspects of its development to control its use and extract income from it...
This doesn't make sense, to me. I think we've already established that the immediate, primary goal for cryonics would be the benefits of cooling, not oxygenation, and I don't believe it is possible for any cryonics organization, (or anyone else, for that matter), to prevent others from performing cold lung lavage. There are ways to do it that are not proprietary.
FD: ...as it might have to do with employees milking the system for years on end designing new bells and whistles.
The fact that CCR and SA have spent all these years, and a ton of money, on the liquid ventilation project, without ever mentioning, (as far as I can see), the underlying questions regarding oxygenation and rapid cooling only strengthens my opinion that certain parties just find something to design and build, and then milk the situation for every penny they can. It probably helps to have a good journalist with computer graphics skills on your side, if you want to convince someone to "build things" without properly addressing known issues, beforehand. CCR's "liquid ventilation" work has been just more "smoke and mirrors," as far as I can see.
I have yet to be convinced that oxygenation would be beneficial to cryonics patients, and I believe it may actually be harmful. Mike Darwin, and others, agree this is a complex question. I think there's also a question of whether cooling at the rates CCR and SA are proposing is of any benefit, during the initial stages of cryopreservation. (This doesn't mean I think cooling via lung lavage is a bad idea; I think it's a great idea. I'm just questioning the rates that are being suggested.) In heart surgery, perfusionists adhere to a 10-degree, or less, gradient between the temperature of the perfusate, and the temperature of the patient's blood volume, because past studies indicated rapid cooling could be detrimental to the patient. (Harris claimed to have never read any of these studies. The papers are abundant, but I certainly believe Harris never read them. He did admit CCR's perfusionist adheres to this safety margin, in heart surgery.) Recent studies show the dangers of rapid cooling may have been over-estimated, but why not err on the side of caution, or at least address the issue? When I questioned rapid cooling, during one of my first days as an SA consultant, I was told rapid cooling was required, due to the toxicity of cryonics solutions at high temperatures. The person telling me this neglected to mention that the washout solution is non-toxic.
FD: Alcor ain't talking, so far at least.
I'm not so sure Alcor's relative silence is such a bad thing. It may be better to keep your mouth shut than to constantly spew out empty promises and propaganda.
FD: Kent ain't talking...
I think it would be difficult for Saul Kent to admit he's been wrong, at this point, but I don't see any logical justification for the lack of progress at SA and CCR. It appears, to me, Kent has allowed his organizations to waste many years, and many millions of dollars, while accomplishing very little. He seems to have his head turned by design and fabrication projects, without really questioning whether they are appropriate for the intended use, or if they are cost-effective.
What was it Charles wrote about the lighting in the van? I think it was something like "it's really cool." Yes, it was "really cool," but it was a tremendous waste of time and money, paying personnel to drill those "more than 200" (from the SA web site) little holes and putting in those teeny-tiny LED's when one person could have bought a couple of inexpensive fluorescent tubes and installed them on the ceiling, in minutes. After they got through with the "really cool" LED's, they had to install additional lighting because the LED lighting was inadequate.
Charles also wrote on this forum, in a response to Pancake, that SA only spent about a week on the ramps, (sometime after August 2006, because I was an SA employee at the time), and made it sound like the ramps were less expensive than lift gates, but that was very deceptive. Charles was actually working on the ramps, prior to January 2005, as evidenced in this post: http://www.network54.com/Forum/291677/message/1162512312/bulletins There were probably some expensive design hours billed for, before that initial test, and the cost of those design hours and the man-hours for that test alone probably approached the price of one lift gate. Even if Charles, Gary, Ken and Piotr had only spent a week on the ramps, (and I think it was much more than that), SA would have saved a ton of money, (not to mention a little face!), by having two lift gates professionally installed on their vehicles. Anyone who can't see that the leveling system for the ramps was as dangerous as it was ridiculous is just plain blind. You don't balance a patient container on two wheels, for any reason, much less with the flimsy leveling device SA was using. When we used it at a training session, some of the elevated wheels weren't even over the ramp. If the person holding the leveler had tripped, the contents of the PIB, (including the patient), could have been spilled to the ground. The entire project was really intellectually insulting. How many very-expensive man-hours did Kent pay, for the design and fabrication of something that defied common sense and now appears to have been cast by the wayside, in favor of the lift gates Mathew Sullivan suggested before this project began? It appears the "liquid ventilation" project parallels this, and other LEF-funded projects. Someone just draws up the design, and starts building...puts it to the side for a while...drags it back out and works on it some more...and, in the end, cryonicists either get something ridiculous, or nothing at all.
Why does Saul Kent keep approving of these projects, many of which not only are unproductive, but make everyone associated with them look foolish? Why does he keep relying on the same people who have taken him no where, (except maybe to the cleaners), for many years now? At what point is he going to wake up?
Charles Platt: Thus it is misleading to suggest that the perfected technology has just been sitting on the shelf since then.
As FD points out, no one suggested the technology was perfected. I believe FD was suggesting that cryonics patients are being deprived of the technology, while it is taking an UNBELIEVABLE amount of time to complete this project. I was suggesting that the project was going to be "researched and developed" to death, when it could possibly be of great benefit to cryonics patients, even in a simplistic form. The real question is: What the hell has CCR been doing with this project all these years? As far as I can see, Harris and Platt, and perhaps a few SA and CCR employees, are the only ones benefitting from this ongoing project, (and I believe "ongoing" is a gross understatement).
FD's suggestion that someone might be striving for "perfection" is hilarious. Let's face it, for the most part, cryonics patients aren't being offered even mediocrity, in regard to procedures, equipment and personnel. As I've stated, many times, there is nothing new about cooling patients, performing chest compressions, inserting IV's, intubating patients, or perfusion technology; all these things were perfected, for the most part, decades ago, in conventional medical settings. Yet, SA's primary focus still appears to be design and fabrication projects, many of which seem rather ill-advised. How many more ramps and level detectors does Saul Kent need, to see the light? Creativity is a grand thing, but at some point, common sense and practicality have to prevail.