Saturday, September 26, 2009

Re-inventing More Wheels, in Cryonics

(The "bottom line" of this post is, "If you want to develop a complex perfusion procedure, you start out with the existing technology, and at least one good perfusionist.")

Aschwin de Wolf quotes below, (in navy blue italics) are from:

Aschwin de Wolf: "Where this criticism can go off track, however, is when it is insufficiently recognized that knowledge of conventional medicine is a necessary, but not a sufficient, condition to do good cryonics."

I know Aschwin means well, when he writes something like this, but it's a misconception on the part of self-taught "cryonics experts" to believe they can perform variations of existing conventional medical procedures, simply by having read about them, and/or having practiced on a couple of animals, or cryonics patients. People do NOT learn to do good cannulation procedures, or perfusion, without extensive, SUPERVISED experience. Cryonics procedures are simply variations of existing conventional medical procedures; they are not something totally new and unique.

In regard to Alcor's computerized system, they still need a qualified perfusionist to operate such a system. There's a reason why perfusion is not fully-automated, in conventional medicine, and to think it can be fully-automated in cryonics, to the point of being performed by amateurs, is extremely naive. This reminds me of a joke a friend of my mother's told me, when I was 13. A transatlantic flight had just taken off, and the following message came over the loudspeaker: Good morning ladies and gentleman. You have the privilege of being aboard the world's first fully-automated airplane. Decades of research have resulted in this state-of-the-art aircraft that will immediately adjust to any and all flight conditions. Please sit back and relax, with the knowledge that nothing can go wrong, nothing can go wrong, nothing can go wrong, nothing can go wrong, nothing can go wrong, nothing can go wrong..."

Aschwin de Wolf:""Alcor has decided to develop a system that not only uses software to record perfusion parameters (concentration, pressure, temperature, refractive index etc.) but to use the same software to control them as well. Provided that this new system lives up to its expectations, this development will be a major step towards a system that can use real-time feedback to adjust perfusion parameters in a manner that so far has only been available in small organ cryobiological research. The data that will be generated during cases can, in turn, be used to create cases reports that follow a consistent, formal standard. When these reports are used in an intelligent fashion, the prospect of developing technologies and protocols that can reduce the high variability in patient care will be feasible."

Alcor isn't doing anything new, here. Heart-lung machines have been responding to, and recording, all of these parameters, with the single exception of refractive index, for many years, now. To state that "real-time feedback to adjust perfusion parameters...has only been available in small organ cryobiological research" is extremely uninformed. This is yet another example of people in cryonics attempting to "reinvent the wheel," rather than building on existing technology, another situation in which the cryo-orgs are going to pay a bundle to a handful of individuals to attempt to do what the companies building perfusion equipment can do, and have done, better, and probably at a much lower cost than all those DIY'ers who brought cryonics the six-figure vinyl PIB liner. Three years ago, I wrote a report, for Saul Kent, and had a subsequent discussion with him, describing how we should investigate adapting a computerized heart-lung machine, to perform the ramping based on refractive index feedback, and informed him that some heart-lung machines would already record, and respond to, the other needed parameters. I don't know why my suggestion didn't go far, other than maybe it didn't involve a science fiction writer and materials from Home Depot.

Aschwin de Wolf: "One of the worst scenarios for the future of cryonics is one in which regulators impose standards upon cryonics organizations that actually increase the challenges of providing good patient care; something that has happened already in the case of the Cryonics Institute when the organization was forced to perform a complex technical procedure like cryoprotective perfusion at a funeral home."

I, totally, disagree with the situation at Cryonics Institute being a negative one. Throughout history, organizations such as Alcor and SA have allowed just about anybody off the street to perform these "complex technical procedures" that could be performed, with ease, by qualified medical professionals who are experienced with cannulations and perfusion.

More and more, each day, I am convince that regulation is the ONLY way the science of cryonics is going to progress.


Phil Ossifur said...

The argument against regulation is that the authorities either are too busy to be bothered or that they're not going to be interested in following the subtleties and new developments so that regulations correspond to what real honest cryonics would need.

Instead, my strategy is to keep exposing the the reality of the situtation. Expose, expose, expose... in this blog. The bending that occurs across time will be significant, I believe. For me, it's all about good writing, good distribution to certain email recipients, feedback, sarcasm, and of course, indexing. I can't emphasize indexing enough. Overview historical writing that includes that point about heart lung machine for example is the only way to make the reality of the situation accessible to anyone.

I think good writing becomes far more important than regulation because writing wakes people up-- and educates members like me too. From there, eventually, self-regulation would come into play--at least in theory.

Melody said...

I agree authorities are probably too busy to pay attention to something so few people probably really care about. I'm fully aware of the fact that a serious push for regulation may only be met with snickers, (okay, perhaps guffaws). However, I am tired of beating my head against the wall, and it's obvious that even the most intelligent, most honorable, people in cryonics, (such as Aschwin de Wolf), have bought into the myth that cryonics is destined to be developed by non-medical professionals who aren't even aware of existing technologies and equipment.

Phil Ossifur said...

But have you considered the possibility that dewolf is part of the network of silence on professionalism? Maybe he has NOT "bought into it" but rather has "sold out"... see the difference?