X-Message-Number: 33264
From: "Melody Maxim" <>
References: <>
Subject: In Response to Mike Darwin's "Automated Data Collection" Post...
Date: Sat, 22 Jan 2011 15:31:09 -0500

It is absurd for Mike Darwin to maintain that cardiovascular perfusion is 
"very simple to automated compared to some of the unbelievable complex and 
exactly manufacturing processes (he's) seen automated it can be surprisingly 
difficult, even if you have you have experts, and enormous computing power 
at your disposal." [sic] (*Note: Mr. Darwin refers to cardiovascular 
perfusion as "cardiovascular bypass," terminology that might be confusing to 
some, as indicated by Perry Metzger's Cryonet response to Mr. Darwin, in 
which Mr. Metzger appears to be asking if Mr. Darwin is referring to 
automating an entire cardiovascular surgical procedure. (Cryonet message 

It's nonsensical to assert that something "very simple" is at the same time 
"surprising difficult," even in the hands of experts with unlimited 
technological resources. Even more than that, it is preposterous to compare 
the manufacturing of a specified component, or device, which requires the 
same, precise, repetitive steps, time-after-time-after-time, to the 
perfusion of human beings.

Responding to Mr. Darwin's automated airplane/perfusion analogy, it doesn't 
matter WHY the wind blows, or WHY the terrain rises, it only matters that 
the plane must maintain its center of gravity and stay above the terrain. 
However, it DOES matter why venous return to a heart-lung (perfusion) 
machine diminishes. Did the patient's blood vessels dilate, resulting in 
more volume remaining in the patient, and less returning to the machine? If 
so, the proper response might be administering vasoconstrictors. Is the 
surgeon pulling the heart over, so that he can work on the posterior side, 
temporarily interfering with the venous return to the machine? If so, the 
proper response is to temporarily adjust the flow rate, provided that doing 
so does not result in the patient being inadequately perfused. Has something 
happened, which resulted in an unexpected loss of blood, from the patient, 
or perfusion circuit? If so, that situation needs to be recognized and 
corrected, immediately, and volume must be added to the system, to replace 
that which has been lost. (This discussion is simplified, and intended to be 
for an audience of laymen. There are many factors, in regard to both the 
causes, and the responses, to such a situation.) If the returning volume is 
suddenly depleted, does the computer have discussions with the anesthetist 
and the surgeon, to determine the cause of, (and, therefore, the proper 
response to), such a situation? This is only one example of MANY issues, 
which perfusionists must respond to, on a case-by-case basis; a situation 
that precludes the use of fully-automated perfusion systems. There is 
nothing in the perfusion process, similar to the precise manufacturing of 
components, or devices, no matter how complex that manufacturing might be!

Perfusion IS automated, to a large degree. Perfusionists can program their 
machines to respond to various parameters, in a variety of ways. For 
example, the machines can be made to automatically adjust flow rates, in 
response to pressure; or to turn off a pump and clamp the patient lines, in 
the event of inappropriate pressures, or air in the lines. But, what happens 
after that? Someone, who knows how to assess the situation, and produce the 
proper response, must be operating that machine. I find it quite arrogant, 
for Mr. Darwin to claim he has tried to automate perfusion systems and has 
found it difficult. Does Mr. Darwin think he compares to the scientists, 
perfusionists and engineers, involved in equipment development, with the 
major manufacturers of perfusion equipment? While I'm sure Mr. Darwin has 
toyed with primitive perfusion equipment, at cryonics facilities, he is not 
a perfusionist, or an engineer, and he certainly does not have resources 
comparable to those of companies, which specialize in perfusion equipment, 
such as those mentioned here: 

Mr. Darwin wants to argue that such automation could require less-skilled 
personnel, something I find disturbing. Someone who does not routinely 
assemble and operate perfusion equipment is very unlikely to be able to 
assess, and correct, problems that might occur with an automated-system 
failure. Would Mr. Darwin like someone who has memorized the contents of a 
dozen aviation textbooks, but never flown an airplane, to be sitting in the 
cockpit of his commercial airliner, when the computer goes out? I find his 
argument for "knowledge without reflexes" being "sufficient," (in regard to 
cardiovascular perfusion and flight), to be absolutely ludicrous.

Mr. Darwin's remarks about a market not existing, for automated perfusion, 
resulting in "no economies of scale...that further drives up the price and 
drives down the reliability of any system you do develop," is just as 
ridiculous as most of his other observations and speculations. The perfusion 
disposables I used two decades ago, cost approximately $1,600; today, the 
same disposables are around $500. I'm not a financial expert, but the 
machines, themselves, seem not to have increased more than that due to 
ordinary inflation. If there has been an increase, it has probably been due 
to the developments in the computerization/automation features! Salaries 
also seem not to have risen, other than increases due to inflation, over 
time. Never before has perfusion been so technologically-advanced, 
reasonably-priced, or safe. It is much more likely that heart surgery will 
eventually be performed, without the use of perfusion, than with the use of 
fully-automated perfusion, as evidenced by an ever-increasing number of 
"off-pump" procedures. (Of course, this has nothing to do with cryonics. 
Heart surgery can sometimes be performed, without the use of perfusion, but 
the vitrification of human bodies cannot.)

The fact that Mike Darwin is one of cryonics' greatest "superstars" should 
be quite telling. How many cryonics projects have been directed, on the 
advice of Mr. Darwin and others like him? How many of those projects were 
based in ignorance of existing equipment and technology? For so long as 
people like Mr. Darwin and his peers are considered to be "experts," in 
cryonics experiments, there is likely to be nothing more than ample 
misdirection and false promises. It seems a very small group of 
self-interested people have made, what could be an interesting scientific 
experiment, a total sham. (By "self-interested," I do not mean people who 
are interested in extending their own lives; I mean people who are primarily 
interested in maintaining their over-inflated egos and/or bank accounts, by 
maintaining control of experiments and/or projects, which they are not 
capable of leading.)

Melody Maxim 

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