X-Message-Number: 15441 Date: Tue, 23 Jan 2001 23:52:19 -0500 Subject: Mr. Grimes Goes Public From: Mr. Jeff Grimes, receiving two personal emails from me, noted that I did not specifically tell him that they were personal and confidential. So he chose to post certain selected passages in public. It would have been kind of polite to ask first, and he did not. I think people who write to him in the future might bear this in mind. He noted (without attributing the passage to the sender) that someone wrote: "Personally, I would be perfectly happy with a straight freeze. The primary concern I have is to cool the body rapidly and even this may not be all that critical. All this 'cryoprotectant' stuff will probably prove to be a waste by the time we are at the place where resuscitation becomes possible." The person whose private letter he is quoting from also without permission? is not me, though Mr. Grimes has left that fact unsaid. Although I do in fact think that a straight freeze, done rapidly, would be sufficient (my reasons are elaborated in some hundreds of pages by Dr. Ralph Merkle available through http://www.cryonics.org/links.html), I also think there is no doubt that standard forms of perfusion produce much less damage, and that damage at some point (burning in a fire, for instance, or extremely long bouts of ischemia) does become irreparable. How long? We don't know and can't say; which is why I personally think we should, for the sake of cryonics patients, assume that time to be large. It would be a shame to say, No, two days of ischemia is too much , only to find oneself refuted by developments 70 years later. It would also be a shame to say straight freezing produces irreparable damage, when we don't know that that is the case, and when current nanotech scenarios clearly imply that it is not. My position, nonetheless, is that cryonics organizations should minimize damage if and as much as they can. Said Mr. Grimes: As I mentioned here before, I swapped some email with David Pascal at Cryonics Institute. Since he said that his answers to my many questions (sorry there were so many, David) were NOT private, I hope he won't mind if I quote some of his statements I did not state anywhere in my letters that they were NOT private , and I was not asked whether I minded if he might quote some. I do mind. If he wishes to make my personal mail public, I am not particularly sorry since I stand by what I say. But I do *not* think people should post other people s personal email without asking permission. If people think every last remark they make off-the-record will get posted in cyberspace, that will produce a air of suspicion and mistrust and self-censorship that will kill dialogue. I myself got an email recently in which a long-held and contemptibly inaccurate charge against CI was revealed to be pure rubbish; I suggested the writer to post his remarks publicly. The writer didn't. I respect the person's decision, though I do not greatly respect the person for making it. I have corresponded with any number of people from Alcor, CryoCare, and ACS, and not a single one has made my private remarks public without asking, nor have I done so with theirs. They were acting politely and properly and in everyone's best interest. I am quite disappointed with Mr. Grimes, and I will not be sending him any personal email in the future. I do not suggest that anyone else does so either. So. To put my remarks -- posted out of context as well as without permission -- into context: Says Mr. Grimes: First, the time it takes for someone to move from the deathbed to CI. I asked how long recent cases have taken to reach CI, on average. David answered: "We haven't worked it out to the minute (perhaps we will once we get our expanded database set up), but our recent record has been pretty good." But he also said: "Alcor's last four patients were reached in 38 hours, 30 hours, `more promptly' than 30 hours, and `more than' 30 hours, respectively." This makes Alcor sound pretty bad! On the other hand it is another example of the habit which I am beginning to find irritating, where CI wants to give me precise information about Alcor, while it provides only vague information about itself. If David doesn't know how long the last four patients at CI took to get there, surely someone else does. Anyone? "our recent record has been pretty good" doesn't tell me anything. First, let me quote the entire paragraph I wrote, rather than Mr. Grimes artful selection: We haven t worked it out to the minute (perhaps we will once we get our expanded database set up), but our recent record has been pretty good. Two of our recent patients died at home under hospice care and there was no delay at all in beginning treatment, even though one was a death-bed sign-up. But of course, circumstances, luck, and planning are all factors. When J.E. [I've omitted the name out of family considerations], a long-time CI officer, died some years ago, he was home alone when a heart attack took him, and his wife didn't find him until maybe two hours later, with a further delay of about an hour until the medical examiner cleared him for us. In hospital cases, the delay before releasing the patient to us is usually not over an hour or two, and cooling may begin before then. On the plus side, it looks like eventually we will have automated personal monitors with remote signal capability it looks like you can actually put your heart beat on the web nowadays (I think it s mentioned on out electronics newsletter at http://www.egroups.com/egroups/group/long_life), and when we manage to be able to offer that to members, rapid care will be even more assured. Not to bash the competition, but Alcor's last four patients were reached in 38 hours, 30 hours, more promptly than 30 hours, and more than 30 hours, respectively. This number isn t a secret the figures are available on earlier Cryonet posts. In getting members rapid care I don t think any one beats CI, owing to their use of local funeral directors. The rough answer to your question essentially is: if you die, and someone is aware of it, how long will it take your local funeral director, prepared by us, to get to you? And after that, how long will it take for your body to arrive at CI facilities in Michigan. Comparatively speaking, I don t think anyone can equal CI in this regard. I may add that I wrote in the previous paragraph, which Mr. Grimes failed to quote: I have to tell you that although I myself opted for CI, that the people at Alcor are not villains, but serious and commited people too. You, or perhaps you and your family, would be well served by signing with either. I think you ll be better off with CI, but the only way to be sure is to not to trust, but to investigate and study. The statements about Alcor's times above are are not intended to make Alcor 'sound pretty bad!'. The times, in and of themselves, sound pretty bad, and are public knowledge, verifiable (most honorably) by public posts from Alcor officials. (My description of Alcor people as serious, committed, and my recommendation of it to Mr. Grimes and his family, if any, is my personal opinion, based on the Alcor people whom I have read of, corresponded with, respect, and like). I stated them to demonstrate what is accessible to anyone with simple common sense: that it is just plain *obviously* true that a local funeral director can get to a person faster than an assemblage of four people cross-country plus equipment, and that CI can therefore get there quicker than Alcor, and that therefore it usually does. Is it not *obvious* that, unless you re living outside Alcor HQ in Scottsdale, a funeral director a few blocks away can get to you more quickly than someone cross-state cross-country, if you happen to live outside the US? In the most recent cases I am aware of -- and I really have to tell people what I told Mr. Grimes, that I am not any sort of technical spokesman or information clearinghouse for CI, but just a guy who found all these things out simply by reading the available information and asking -- in the most recent cases, CI was there at once, and Alcor was there more promptly than 30 hours in one case, and more than 30 hours in the other . I do not say and I did not say that this is due to any incompetence on the part of Alcor. I attribute it to the inherent difficulties of the traveling team approach to cryonics, which I have criticized before. It s simply and intrinsically a poor system, and the record shows that it just does not work well, not because of any malfeasance on the part of the teams or the organizations, but despite their genuine and serious best efforts. I mean suppose you have a heart attack in the street. Who do you want to come and get you? The ambulance down the street? Or do you want to wait till Dr. Christian Barnaard is flown in from South Africa, complete with operating theatre? I will concede that Dr. Barnaard is better than the average ambulance attendant. But the attendant can get to you and save you, and if you wait for Dr. Barnaard, you will end up dead. What is there about this that is hard to grasp? Is it not transparently plain that CI must and will continue to get there earlier? Mr. Grimes quotes me again: "I should add that we have traveling team services now too, although we don't recommend them." I didn't know that there is a team. Why don't you recommend them? What does the team do? Does it have anyone with medical training? How many people are in the team? How many cases have they handled? Where are they based? What equipment do they use? How do they get it to the site? Can anyone on the team prescribe drugs? Does the team travel overseas (I assume it doesn't)? If these answers are online, just point me to the PAGE on the web site (not the whole site, it's too big.) Thank you. Do not thank me too quickly. While I try to be polite to the extent of sending private email to folks, selected portions of which end up by surprise in public I really think you would be better off doing some actual reading rather than simply coming up with questions at random and then asking me for the specific location. If the information is there, but you simply don t want to bother to look for it, preferring instead to take up space on Cryonet asking for pointers, well your focus of interest will begin skewed and end up skewed. To respond anyway -- out of courtesy, a dying art -- if you would bother reading CI s What s New page, you would know that there is a team. The reasons CI doesn't recommend them are available -- again -- at the Comparing page, which you have quoted from in your previous posts but selective parts of which you seem to have missed (and the reasons CI does not recommend them have to do, again, not with questions of competence, but with the simple tactical difficulties of arranging plane flights, etc. Funeral directors can simply get their a lot quicker, and where ischemia is an issue, that is critical.) The team prepares and cools the patient, and can do a full perfusion on the spot. Like the vast majority of all travelling teams, they do not have formal medical training. Unlike the vast majority, the members have each performed well over a dozen suspensions each. There are two people in the team (possibly assisted by the local funeral director and his crew). The team has never yet received a call -- CI members (wisely, in my opinion) have opted for the traditional funeral director approach. CI headquarters has a back-up of not one but five funeral directors trained to perform full suspensions in their absence. The team is based in Michigan. The team can travel overseas, although in European cases, it would be superfluous, since CI has trained Barry Albin to do full perfusions there. Mr. Grimes: " David continued: "Well, we do have a team (as I said) but we've found that it's far better in practice to train a funeral director and have him there on the spot." Quicker, obviously, but "better" in what sense? If a funeral director has never done an actual case before, and the team has some experience and specialized equipment (at least we hope it does) I would have thought a team would be "better." (a) This question is a trifle odd, since CI offers both travelling team services and funeral director approach. Yes, our travelling team has both experience and equipment and would likely do a better job, and, yes, it could still have to make flight arrrangements, get stuff together, take a flight, get through traffic, etc. We think that the member would suffer far less ischemic damage using the funeral director approach, so we greatly recommend it. Where it comes to ischemia, quicker is by definition better. Thirty hours of ischemia, as in recent cases, is tough to reverse. Or does Mr. Grimes feel that waiting for 'future scientific developments' will take care of such problems? (b) While some funeral directors may have never done an actual perfusion before although some, like Mr. James Walsh, have done more than twenty funeral directors are degreed professionals who perform a procedure (embalming) that is not markedly different from perfusion, ie that involves removing the patient s blood rapidly to avoid decay and replacing it with a preservative fluid. No, the procedures are not exactly the same, but it is obviously easier to teach someone who can do a related technique, just as it is easier to teach someone who can ride a bicycle how to ride a tricycle. I do not know how many people Alcor has actively standing by in various traveling teams. There are no published figures on how many of them have ever performed an actual perfusion. There are no published figures on how many of them have ever assisted on a full perfusion. There is no listing of how many actual team members are physicians, and there is no listing of how many have in actual cases have dropped their dropped their practice and current patients or hospital duties to go cross-country for an unspecified length of time. In the most recent suspension, it is my understanding that only one suspension team member showed up, and that he or she was assisted by unnamed 'contract consultants' from an unnamed company. There is no detailed description on the Alcor web site or in print about their specific training or certification requirements. I'm told (perhaps wrongly) that it consists on a a few hourly sessions over the course of two or so days, once annually. In one recent period, there was a space of time in which no Alcor patients died for two years. How 'experienced' can a travelling team member be if he's not an MD, has never performed a cryonic perfusion even if he is an MD, and gets no practice for two years? To say nothing of those other team members who may not have worked on a patient for for four years, or five, or ten? What is the actual number of perfusions fully performed by *each* such member, and when did each last perform it? I answer Mr. Grimes questions, but who answers mine? There is simply no reason why a veterinarian or a software engineer, who may never had any experience performing a perfusion on a human patient, can be called a 'certified cryotransport technician', while funeral directors, certified by government officials, with experience treating hundreds of bodies, are held to be by definition incapable of grasping what it is to perform a cryonic perfusion. Are we to understand that if a funeral director were to take an Alcor Cryotransport course, he would remain incompetent simply because he's an experienced funeral director and not a sociology major? Funeral directors in contrast to *all* travelling team members, yes, and virtually all doctors too may perform cryonics-like techniques on actual people every couple of days. It is absurd to consider them intrinsically inferior -- particularly when you factor in the ischemia avoided simply by having them there far more rapidly. Again, this is not to bash Alcor. A company is not restricted to any one particular practice, and this particular practice, in my opinion, should go. Problems are just an inherent part of the traveling team approach. If no one dies for two years, no one gets any real-life practice for two years. Funeral directors, by contrast, may deal with over a hundred bodies in that same amount of time not to mention have a well-practiced system of shipping the bodies, and years if not decades dealing with local doctors and local police and local bureaucratic officials and distraught family members. *Obviously* they can do some things better than traveling teams, and *obviously* someone doing a cryonics-like procedure can adapt to cryonics procedures more easily than a Linux programmer or a stockbroker or even an EMT or MD who simply is not taught cryonic suspension or even enbalming as part of their trade. You cannot simply assert an ideal situation in which the travelling team is ready, competent, practiced, on time, unopposed, etc., etc., when in practice the results have been so very bad. Yes, one can gamble that all the chips will fall the right way, and indeed they just might, just as one can sit down to a card game and bet one's life savings on drawing a royal flush. But people who do will almost always lose. Mr. Grimes: "David says that "Once a member joins, we locate the funeral director closest to the member, or let him look about and find one he prefers." Well, okay, but this is not clear. Which actually happens? Does CI find a funeral director, or does CI just wait to see if the member asks? To quote myself in the letter from which Mr. Grimes only seems to have read certain selected sentences: Once a member joins, we locate the funeral director closest to the member, or let him look about and find one he prefers. Mr. Grimes: "David wrote that: When we settle on a director, we first immediately send him a set of written instructions to familiarize him with the procedures." That sounds good. I wonder if those written instructions are available for members and prospective members to read. That would be really interesting. I cannot find this info on the web site. Ah, selective quotation. God's gift to Cryonet. To quote the unstated part: "We then follow up written instructions with telephone consultations with our team of five cryonics-trained funeral directors in the Michigan area till the funeral director has a good grasp of what's expected." What I did not say -- imagining myself to merely be speaking casually and not publicly -- was that on occasion the director in question will visit the CI facility for hands-on discussions and instruction, as is the case with Mr. Barry Albin, who has visited CI HQ on several occasions. As for the written instructions, try looking at the Funeral Services Articles, where they are summarized. (Does Alcor have any written instructions on its techniques? A perfusionist s manual? A training prospectus? Does Mr. Grimes ask? Does he care?) Mr. Grimes: "Now about undertakers compared to perfusionists, this part is quite confusing, since it suggests that the undertakers pump in the cryoprotectant, which I assume is the glycerol solution: "(You should understand, incidentally, that funeral directors are degreed professionals who, in performing their normal function, regularly do procedures that closely parallel cryonic suspension protocols. It's not that we're instructing them in something totally new and different. The replacing of blood with enbalming fluid and the replacing of blood with glycerol perfusate, for instance, are very similar procedures, which is why we've had success even with last-minute cases.)" But the funeral director (which seems to be the same thing as an undertaker doesn't perfuse the patient with glycerol, does he? And wouldn't a trained perfusionist be offended by your suggestion that his job is not so different from a mortician with an embalming pump? I am not trained in medicine, apart from some EMT instruction, but I would imagine that perfusion and embalming are very different indeed, bearing in mind that perfusion is a medical procedure for living people, while embalming obviously is for people who have died. Perfusion is a medical technique for living people ? Forgive me, but I am not aware of any living person who has been perfused in the cryonics sense. Cryonics suspension takes place after you have died, and can only take place legally after you have died. It is odd that someone with EMT training in Britain? May I ask what this semi-EMT training consisted of, and where? -- does not know this. To answer, however: some funeral directors, like Barry Albin, are completely trained and able to do full perfusions. CI is thinking about providing similar training to an Australian service to provide full perfusions there for the general area. Generally, though, funeral directors do not do full perfusions. CI in Michigan is centrally located and many patients can be brought there by plane or even car in a matter of hours. If a patient can be brought to CI quickly, CI may have the patient receive an anticoagulant on the spot and be brought to CI for full perfusion. If not, the funeral director may do the washout and perfusion at the funeral home, or a travelling team may be sent, if requested. It depends on whichever circumstances best favor the patient under actual circumstances. Mr. Grimes: "It's work on the part of the funeral director to keep the refrigerated solutions and equipment on hand and to regularly practice the procedure, so they're generally paid an modest annual retainer, usually by the member." I wonder how many morticians receive this annual retainer. Does CI have a lot of morticians who are equipped and trained like this? How many? I assume Albin in England is one of them. You assume correctly about Albin. I do not know whether the morticians in question (like cryobiologists) want to be named or have their fees mentioned publicly. I don't know the exact number. If a member joins, a funeral director in that area is found and trained. If a family of six join, the director covers all six. I find it odd that someone purportedly interested in CI procedures wants to know exactly how many there are, since the number has no direct impact on procedural technique. For what it's worth, CI has shared its databnase of funeral directors with ACS, which returned the gesture. It offered to share them with Alcor, free of charge, and got turned down. Mr. Grimes: "David says, "We don't use a 'moving solution' (apart from heparin" This seems odd. Why not use the stuff they they use when they fly hearts or kidneys from donors to recipients? The stuff they they use when they fly hearts or kidneys ? I don't travel around with hearts or kidneys myself (apart from my own) but -- unlike people -- severed individual organs don't have full cardiovascular systems filled with blood. Didn't your EMT training cover tiny points like this? Heparin is an anticoagulant and, since dead people have a heck of a lot more blood coagulating than one severed organ has, CI (like Alcor) favors heparin as opposed to 'stuff'. Mr. Grimes: "Please note, if anyone has replies to any of these points, I don't need more comparisons with Alcor! Personally I am not very interested in Alcor since they have no presence in the UK anymore (or so I have been told). Let's have the facts and let them speak for themselves." Facts can mis-speak for themselves. Mr. Grimes is like a person saying, Tell me every possible good thing about Hitler, and every possible bad thing about Santa Claus. Yes, I guess you can accumulate facts this way, of a sort "Adolf! Great orator! Loved operas! Doted on parakeets! An art student! Won the Iron Cross!" That Adolf -- what a jolly prince of a fellow, eh? Far superior to that fascist beast Santa: "Old! Fat! Breaks into houses! Whips reindeer! Bobs underage girls on his knee and promises them presents!" If all you look for is a certain set of facts and refuse to look at any other, all the assorted facts will get you is a severely distorted picture. Lies can be built with pieces of truth, and the way out is not to focus on and question just one side but all sides -- including one's own leanings and prejudices. Mr. Grimes: Incidentally one of the people who wrote to me suggested that I am asking far too many questions. He said that most people aren't concerned about these details. But it seems to me, if I was going in for a medical procedure, these are the kinds of questions any patient wants to know. Who will operate on me? Can he do it locally? What techniques does he use? How does this differ from other surgeons? This is basic stuff, especially in a life-and-death situation. If other people aren't interested, I have to wonder if they have blind faith in science, or at least in cryonics organizations. Personally I do not have blind faith in anything, especially a cryonics procedure, which is unregulated and unsupervised, so far as I can tell. One does not like to ascribe bad faith to people. Nonetheless, Cryonet as we all know to our grief while it has many people who genuinely seem fair and disinterested, also has one or two people who simply seem to want to ride their particular hobby horses. I have bent over backwards trying to keep Mr. Grimes out of this latter category and give him the benefit of the doubt, but I must say I am finding it increasingly tough to do so. Does Mr. Grimes tell us that I (low CI villain that I am) told him privately that Alcor people were serious, committed, that they serve their people well? No. We do hear that I pointed out that its most recent cases were not cooled down till before and after 30 hours -- a scurrilous private whisper! Which the scurrilous President of Alcor privately whispered in scurrilous public posts to Cryonet and the World Wide Web before me. And which of course has no bearing on what might have happened had a funeral director down the block instead been there, trained and prepared. Is this how we find truth? Or is this how we filter it out? Consider Mr. Grimes' example above: if I were a doctor and someone wrote me saying he was looking for a doctor and asked what technique I used in some particular procedure, well, I might take some additional time out of my schedule and write back. But when that person completely ignores every other doctor, asks questions of debatable relevance, does not bother to read available information, repeatedly suggests that my techniques are worse than others (whose techniques he does not want to examine, criticize, or even mention), when he goes to the length of publishing my personal replies unasked, and when he does all this while I am literally the only doctor in the area capable of offering him any help at all, I find myself wondering -- what is going on? Replying to one-sided stuff like this can be fun and educational, of course CI's side gets its turn up to bat, and it s certainly nice to have Cryonet running full-length arias extolling CI s virtues daily. But I have to question whether it is productive. Mr. Grimes' attack-mode approach to information-gathering can be extended forever, and never really get anywhere Do funeral directors use washout? Do they use tubes or needles? Tubes? How long? What s the thickness? What s the circumference? How deep do they insert it? What's it made of? Rubber or acrylic? Do they warm it first? What temperature? How do they heat it? Do they breathe on it or use a microwave? Do they sip tecquilas through it afterwards, or margaritas? NO don t tell me what ALCOR is sipping I DON T WANT TO KNOW! I find myself suspecting that Mr. Grimes, for all his questions, really does not want to know. This makes dialogue kind of superfluous. Perhaps the best thing to do is just answer the more obvious distortions as they arise. Specks of dust produce pearls, and continual attacks on CI produce attention, publicity, sympathy, and good solid reams of prose in defense of CI. In the short run it's kind of a pain, but in the long run it's all to the good. David Pascal http://www.cryonics.org Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=15441