X-Message-Number: 341
From att!cup.portal.com!alcor Sat May 18 15:20:31 PDT 1991
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Subject: On Joy
Date: Sat, 18 May 91 15:20:31 PDT
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X-Origin: The Portal System (TM)

On Joy
by Mike Darwin

     The Alcor members on this Net might have had less reason to express 
their distaste instead of JOY! if Quaife had started out by other than 
denigrating their efforts by way of calling them can-rattlers.

      Regarding Brian Wowk's remarks, it should be pointed out that
the information Brian brought up about the VJ suspension is a matter of 
public record since it was present in an article published in the AMERICAN 
CRYONICS JOURNAL and written by none other than Paul Segall.  Apparently 
Art not only doesn't read CRYONICS; he doesn't even read his OWN 
organization's newsletter.

     Segall reportedly withheld ventilation of the patient because he was 
afraid of "getting a lethal disease...like TB from the patient's saliva."  
I have given mouth-to-mouth to more than one hospital or dialysis patient 
when I was a dialysis technician.  Sometimes I've had to wipe the vomit 
out of the way to do so.  I am not alone in this, and I consider it the 
duty of anyone who puts themselves on the firing line in delivering health 
care.  I have also given CPR to an accident victim on the street where 
there was blood in my mouth as well as stomach contents.

     TB is a treatable disease and a curable one.  AIDS is not well (or 
perhaps at all) transmitted by saliva and in any event, an 80+ year-old 
white, middle class woman with VJ's background is hardly likely to give 
you AIDS, or TB for that matter.  And besides, how could anyone fail to 
render this aid to a friend, to someone Segall had known for years and who 
had reportedly even contributed generously to his research?

     But the point is, presumably TT knew this patient was in very poor 
condition.  In fact, Segall's account of the suspension points out that 
she had been refusing food for sometime and that she was transported to 
the hospital from the nursing home in critical condition.  If all this was 
so, why didn't Segall or someone have a bag-valve respirator, the heart-
lung resuscitator and other equipment packed and ready to go on a moment's 
notice?  Alcor is better prepared than that in Indianapolis!  What does it 
take to have a few items of essential equipment stowed in your car trunk 
or your home so that when the call comes in you are responding with more 
than your bare hands and mouth?  I assume this was what Brian was
getting at with his questions.  If you read the Segall account of this 
suspension in the ACS Journal you don't need Mike Darwin to use you as a 
stalking horse to ask them some pretty pointed questions.  You only need 
to know enough about how things SHOULD be done in order to ask questions.

     Since Quaife is promoting TT and promoting the quality of suspension 
services they offer, I don't think it is inappropriate to have such 
questions put to him -- or, what's more, for him to answer them.

     Regarding Quaife's latest posting on the Segall hamster brain work, a 
number of things need to be said.  First, I have seen the color 
photocopies being circulated.  There is no detailed explanation of the 
protocol used on either the experimental or the control (supposedly 3M 
glycerol brain).  However, a picture IS worth a thousand words.  Both 
photos disclose adjacent skeletal muscle, skin and bone which has the 
waxy, oily appearance of tissue permeated with a polyalcohol such as 
propylene glycol, glycerol, etc.  Also, the tissues are dehydrated; 
especially the brain in the lower frame which supposedly was treated with 
the new, improved protocol.

     This tells me that the animal could not have had the cryoprotectant 
agent(s) (CPA) completely or even largely removed before blood 
reperfusion.  Also, the large brain pial (surface) vessels in the 
"improved" picture show filling defects on several areas of the cortex.  
The presence of significant (i.e., visible) amounts of CPA in the tissue 
raises questions about the validity of the entire experiment.  Much of the 
art of cryopreservation involves careful removal of the CPA following 
thawing so that osmotic injury does not result from the removal protocol.

     I have another problem with this work in that the injury to the 3M 
glycerol brain looks far worse than we've seen, but more to the point, it 
is far worse than other researchers' published work indicates it should 
be, such as Suda's work with cat brains using lower, less protective 
concentrations of glycerol and cooling to even lower temperatures (Suda, 
I. et al., "Bioelectric discharges of isolated cat brain after revival 
from years of frozen storage," BRAIN RES 70:527 (1974)).  And it is 
certainly not consistent with the relatively good histological 
preservation observed by Fahy and Crane (Fahy, G.M. and Crane, A.M., 
"Histological cryoprotection of the rabbit brain with 3M glycerol," 
CRYOBIOLOGY, 21:704 (1984)) wherein the tissue WAS examined by light 
microscopy for histological integrity.  

     I agree with Max More completely: the acid test is ultrastructural 
preservation as evaluated by electron microscopy.

     It would be helpful and improve the credibility of the work 
tremendously if there was a disclosure of the detailed protocols used to 
prepare these brains.  At a minimum it would be useful (and it could 
hardly be said to be proprietary) to know the exact conditions under which 
the CONTROL brain was prepared.  Critical questions to know the answers to 
would be the method and rate at which glycerol was introduced (i.e., by 
passes of fixed concentration or by use of a "ramp" at "X" mM/min.).  The 
terminal concentration of glycerol reached in the brain, or at least in 
the venous effluent, the composition of the carrier solution (i.e., base 
perfusate), the pH, temperature of perfusion, flow and cooling rates, and 
so on.  Glycerol's penetration is critically dependent upon the 
temperature of introduction, and of course many other factors such as pH, 
and the choice of colloid can have an enormous impact on results, 
including on the integrity of the capillary bed.

     Quaife is a Ph.D. who presumably has been trained as a scientist.  He 
should know that it is not responsible behavior to make important 
scientific claims, particularly claims that involve life or death matters, 
without fully documenting the experimental work and being responsive to 
reasonable and salient questions; even if you have a personal dislike for 
the questioner(s).  Neither Segall nor Quaife is a Fermat and a "note in 
the margin" doesn't cut it where people's lives are at stake.

     Failure to make such disclosures leaves one open to a number of 
charges and suppositions, none of which are very rosy to contemplate, and 
more to the point, do little to maximize the JOY that Dr. Quaife, and the 
rest of us, want out of life.

     Thanks to Simon Levy for his vigorous support and for his 
observations about blaming the victim.  I am also a strong believer in 
never giving the "consent of the victim" either.  Thus, if I, (and perhaps 
some others in Alcor), seem a bit harsh it is only because we have learned 
the hard way that a passive approach doesn't work.

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