Alcor vs. Cryonics Institute

I found the Thiel-Gilder debate.

Thiel's list of fields where "innovation in stuff was 'outlawed'":

• petroleum engineering
• nuclear engineering
• electrical engineering
• chemical engineering
• mechanical engineering
• bio-engineering

I can believe that changes in the law and the legal-political climate have hampered innovation in at least some of those fields, but by "outlawed" Thiel seems to mean "a bad career choice", judging from what he says at 42:17.

Edit: Thiel does not just mean "a bad career choice"; he gives some examples of what he does mean at about 9:50 of this July 16 2012 debate with Eric Schmidt:

I think it's because the government has outlawed technology. We're not allowed to develop new drugs with the FDA charging $1.3 billion per new drug. You're not allowed to fly supersonic jets, because they're too noisy. You're not allowed to build nuclear power plants, say nothing of fusion, or thorium, or any of these other new technologies that might really work. So, I think we've basically outlawed everything having to do with the world of stuff, and the only thing you're allowed to do is in the world of bits. And that's why we've had a lot of progress in computers and finance. Those were the two areas where there was enormous innovation in the last 40 years. It looks like finance is in the process of getting outlawed, so the only thing left at this point will be computers [...]

[nuclear engineering] has horrible job prospects, so it might as well have become illegal.

That's not a very accurate way to think about legal problems. For comparison, PhDs in English Literature have horrible job prospects, but that's not evidence that English Lit is becoming illegal.

If cryonics is outright prohibited, then the first part of the conditional is very unlikely to obtain...

Just to be clear, what I'm skeptical about is the idea that cryonics adopters are in fact generally seeking to maximize the expected value of their continued information-theoretical identity after their cells die.

I certainly agree that there's stuff outside my brain that contributes significantly to the construct I'll label "TheOtherDave" for convenience, including but not limited to the enteric nervous system. (Indeed, much of that stuff is outside my body as well.)

Not that this makes me a skeptic about post-mortem person reconstruction, particularly. I'm perfectly prepared to believe that something could be extracted from my properly-preserved body that would be similar enough to me for it deserve the label "TheOtherDave" about as well as I do. Ditto for my properly-preserved brain; in that I'm not at all confident that the extracranial stuff is necessary when it comes to distinguishing plausible "TheOtherDave" candidates from implausible ones.

To be honest, though, I'm not convinced that my brain is necessary either. Constructing a plausible "TheOtherDave" candidate from information outside my body (e.g, my writings and relationships and demographics and so forth) probably isn't that much harder than doing so from information inside my body; given a system capable of doing the latter, it's likely less than a few centuries of progress until we have a system capable of doing the former. (Actually, I'm not entirely convinced that former is harder than the latter at all.)

Yes, unquestionably some of the "information" that constitutes your person hood is in your gut, your glands, your immune system and your peripheral nervous system. However, your position would seem to imply that these things, and things much more central to your identity, such as your brain structure, are like unchanging books or artifacts on a museum shelf. They aren't. In fact, by the time you are 80, you will have lost roughly a third of your brain mass and your brain will be a tattered "remnant" of what it once was. You're now losing roughly 80K neurons a day. The practical consequences of this will be a massive transformation of your personality and of your functional capabilities. If that change were to be imposed on you all at once, you would not only be horrified, you likely wouldn't even recognize the resulting individual as the same person. More likely, you'd consider that individual to be a cruel and sadistic parody of yourself.

The point is that your "identity" is a dynamic thing which is badly degraded over time by aging. This is important information to keep in mind, because it provides context for what I'm going to say now. I have known a good number of people who have no stomach or intestines. They could not eat food of any kind. They stayed alive by virtue of total parenteral nutrition (TPN) which provides for all their fluid and nutritional needs intravenously. These people did not undergo any perceptible change in memory, personality or person-hood. At least three such people I've known have also had kidney transplants. That's even more interesting, because we now know that many patients with successful, long term grafts become chimeric with the donor! Donor immune and stem cells colonize the patient! Similarly, any mother is chimeric for each of her fetuses. In fact, in animals, if you injure the mother's heart or brain during pregnancy, the fetal stem cells are the ones which repair the damage - massively remodeling the damaged organs. This chimerism seems to be an evolutionary adaptation to protect the mother against injury during pregnancy.

To my knowledge, no one is upset at the idea that a significant fraction of the stem cell population in such people is ALIEN. And those stem cells are genetically and functionally different from the native ones. Maybe more than the gut, the immune system is an extension of the brain - they interact dynamically and the immune system can and does profoundly effect mood and behavior.

So what is identity? Well, that's complicated, but one thing is clear, it is NOT static and a lot of the changes in the structures which determine it happen all the time as part of life, and you have little or no control over them. Where this intersects whole body vs. neuro is that you have the need (arguably the necessity) to decide just what parts of you are truly essential to your person-hood AND at what cost in risk to survival they can be taken along during cryopreservation.

If you are smart, cool, and rational, you'll try to determine just what parts of you are really you - are really essential to your person-hood. This would be an impossible black box of a task were it not for contemporary transplant and artificial organ medicine. There are tens of thousands of people on dialysis or who get kidney transplants. There are people with no hearts, or new hearts, and people with gut, liver, pancreas and renal transplants. There are countless people with bone marrow transplants and countless others whose spinal cord and peripheral nervous system have been functionally disconnected from their brains. Do these people constitute an acceptable degree of survival for you as persons? If so, I would suggest you delve into the logistics, economics and hard practical realities of cryopreservation that must endure over a period of many decades, or far more likely, a century or two. It is NOT easy to handle, move or care for whole body patients. They are a ball and chain and cannot be moved or evacuated quickly. They are subject to a large burden of state regulation which neuros are not, and they suffer additional injury to the brain as a result of compromises necessary to achieve cryoprotection and cooling.

If you think that those components of you identity present in your body are worth those added risks, then you should go whole body. However, my question is, where is the empirical evidence to support that belief? I've known many, many transplant patients well, and neither they nor I saw any noticeable transformation in their identity. Indeed, the transformation, such as it was, was the return to fully functioning person-hood which resulted from becoming chimeric with another human being or a machine.

Mike, let's be fair about this. Veterinary surgeons for thoracic surgery (after loss of Jerry Leaf) and chemists for running perfusion machines were also used during your tenure managing biomedical affairs at Alcor two decades ago. You trained and utilized lay people to do all kinds procedures that would ordinarily be done by medical or paramedical professionals, including establishing airways, mechanical circulation, and I.V. administration of fluids and medications. Manuals provided to lay students even included directions for doing femoral cutdown surgery.

http://www.alcor.org/Library/html/1990manual.html

The good cases that you were able to do with lay help (and being only a dialysis technician by credential yourself) are the stuff of cryonics legend. That was how cryonics was done back then. With the resources that were available then, and the need to provide cryonics response over vast geographic areas, using trained lay cryonicists was the most effective way to deliver cryonics care for many years. Some history of this is discussed here

http://www.alcor.org/Library/html/professionals.html

In the 2000s Alcor began to supplement trained lay cryonicist teams by deploying a staff paramedic to cases whenever possible. In the 2010s, Alcor began using Suspended Animation, Inc., more extensively. As announced here,

http://www.alcor.org/blog/?p=2174

Alcor policy is now to use Suspended Animation, Inc.., (SA) for all cases in the continental U.S. outside of Arizona which SA can reach in time. Local trained lay teams are now only used as first responders, bridging time between notification of emergencies and arrival of SA.

The significance of this is that SA now uses board certified cardiovascular surgeons and certified clinical perfusionists on almost all cases. I've met two of SA's contract cardiovascular surgeons, one of whom trained under Michael DeBakey. These are top-rank professionals who go out on cryonics standbys, and get cryonics patients on cardiopulmonary bypass faster than ever before in cryonics. They established fem-fem bypass on one patient last year in only 15 minutes.

http://www.alcor.org/blog/?p=2175

Another patient was placed on bypass only 7 minutes after arrival in SA's vehicle using emergency median sternotomy, never before done in cryonics.

http://www.alcor.org/blog/?p=2267

These are professional surgeons and perfusionists who do median sternotomies and cannulations so fast that in their day jobs they actually save patients who suffer cardiac arrest from fixable causes (e.g. "fatal" DVTs). This is now the level of care available under ideal circumstances in cryonics.

In Alcor's O.R., Alcor is presently evaluating and training two board certified general surgeons to supplement the veterinary surgeon and neurosurgeon who have been used by Alcor for the past 15 years. Alcor has transitioned toward utilization of professionals whenever possible or practical. There are now more medical professionals doing the work of cryonics than ever before in the history of cryonics; not just scientists and technicians, but actual clinicians.

You are also mistaken, at least partially, about utilization of animal models in training. Even though professional surgeons and perfusionists already have extensive and ongoing clinical experience, SA uses a porcine model to train its contract surgeons, perfusionists, and other personnel in the specific procedures of cryonics.

There are shortcomings to this model. Contract clinicians are extremely skilled at specific procedures that must be done, but they are not cryonicists. For example, they don't understand cerebral ischemic injury, its mechanisms, and significance in the context of cryonics. This can hypothetically lead to difficulties understanding and managing cases with moderate periods of warm ischemia that would ordinarily be "written off" in conventional medicine. Cryonicist involvement is still essential. However on balance, as measured by the speed and competent handling of standbys and transports in which they have been involved, participation of cardiovascular surgeons and perfusionists has been very positive. I hope we can continue to afford it.

My comments about economic, social and political matters don't speak to how people should invest in the market, or to who will win the coming election. They speak to the general condition of the economy and the culture over the long haul. As I've observed in print before, plenty of people will get rich, and millions of people have gotten richer, despite the fact that diversion of wealth from the people who primarily produce it is at an all time high. I am the first to acknowledge that it has been fantastic advances in productivity that have made this possible. But that doesn't make the reality go away that the system is increasingly thwarting innovation, overspending its resource base, and appropriating vast amounts of wealth which is used inefficiently, is wasted, or is actually used for contra-productive purposes.

All I have said, in addition to these fairly mundane observations, is that, sooner or later, something's got to give. To some extent this has already happened in that many trillions of dollars of wealth have disappeared, or been reallocated to cover "bad actions" of various kinds. The situation in Europe is actually much worse than it is here, and if it becomes impossible to maintain solvency of large EU nations such Greece, Italy and Spain, then the effect will, again, be felt in the US and elsewhere.

What I have no way of knowing is how much "re-assignable" wealth is present in the system - and just as importantly, if it will be reassigned to cover "bad acts." That' difficult to assess wealth covers a huge range of goods and actions, from the quality of food people eat, to whether they use paper towels or go back to using rags! I've never claimed any special insight in those matters, and for good reason; because the data to make those kinds of "forecasts" simply isn't available.

So, my position is very much like that of someone who warns that "crime doesn't pay." It doesn't - not in the long run, because it is destructive of productivity, and destructive of effective human social interaction. But the BIG question is, what exactly constitutes the "long run?" That's not a joke, and I am mindful that the Soviet Union ground on for 70 years. That's an economist's eternity, and then some. Pepsi Cola made millions betting that Soviet Russia would continue for decades. Do I think Fidelista Cuba is doomed? Absolutely. I also think it is a miserable, oppressive place. But I wouldn't care to give any odds on how long it will survive.

Finally, if all the "non-contrarians" on this matter are concerned with or about is financial gain, regardless of the system's characteristics or "meta-qualities," then I have nothing to say to them and their disappointment in my "judgment" is as understandable as it is mutual.

As far as I can tell, Eliezer picked C.I. to minimize the cost of signaling his views about cryonics, not because he thought it was better than Alcor. See this comment.

See the comment below: My primary reason for signing up for cryonics was because I got sick of the awkwardness, in important conversations, of trying to explain why cryonics was a good idea but I wasn't signed up for cryonics.

Consider that it might actually be evidence for a different conclusion: Eliezer signed up for cryonics some years ago, when he had little income, bravely foregoing well-paid employment in favor of pursuing his core goals. (I can relate to that!) I would very much like to talk to E.Y. about whether it's time to reconsider his past decision based on current information and current finances. I'm just an email or a phone call away, Eli...

The first question you need to ask Yudkowsky (and yourself) is a damned difficult one to answer "simply," and that is what are the currently well known, well understood, and well documented BIOLOGICAL differences in outcome that are likely to pertain using the two different approaches in the reasonably optimum case. Reasonably optimum means that the member is experiencing medico-legal death under controlled conditions with competent cryonics organization personnel in attendance, My bet is that only a few people on the planet can answer that question, and that Yudkowsky isn't one of them.

Of course, if you do not believe the degree of molecular, histological or gross damage to the patient matters, within broad limits, then such differences are immaterial. For instance, if you think that several hours of warm ischemic injury, followed by 12 to 24 hours of cold ischemic injury, followed by reperfusion injury, followed by grossly inadequate cryoprotective perfusion/equilibration in the brain resulting in large areas of massively ice injured brain tissue will be easily repairable with Nanotechnology, then you will be largely insensitive to the differences between Ci and Alcor, or a well done cryoprotective perfusion and a poorly done one.

My question for such people is, "Why bother with perfusion at all? The ischemic delays are very damaging. Why not just have yourself packed in dry ice as soon as you are pronounced and get shipped off to CI? It would be about $10K to $15 cheaper and you'd only be faced with Nano-repair of cryoinjury?" No need for Nano, Nano, one Nano will do.

I'm in the final stages of preparing Part 3 of THE EFFECTS OF CRYOPRESERVATION ON THE CAT for publication on Chronosophere. Part 3 is the transmission electron microscopy of the tissues under different conditions of cryopreservation (Part 2 was the histology: http://chronopause.com/index.php/2012/02/14/the-effects-of-cryopreservation-on-the-cat-part-2/). You can look at those pictures of cell and tissue structure and decide for yourself which condition you'd rather be in.

Next up for discussions is the issue of "hyperonconicity." Just as cells require a certain "tonicity" (electrolyte concentration) to maintain their normal volume, tissues with capillaries require a certain concentration (and type) of large (macro-) molecules (colloid) to avoid accumulating water between the cells and becoming swollen, or edematous. Hyperonconicity refers to any solution that has more ability to hold water in the circulatory system (circulating blood or perfusate) than would be the case under NORMAL conditions. The key word there is NORMAL. The macromolecules that comprise colloids can be thought of as molecular sponges that hold water in the capillaries and prevent it from accumulating in between cells as a result of the hydrostatic pressure of perfusion.

This water holding ability is quite complex and nuanced and depends upon the condition of the junctions between the cells in the capillary, the charge of the colloid, the unique chemical properties of the colloid (poorly understood), the configuration of the colloid molecule, and so on.

Onconicity and hyperonconicity are thus in actual practice, relative terms - relative to the condition of the capillary membrane. It is quite possible to have a markedly hyperoncotic perfusate and still have massive edema due to accumulation of water and of the colloid in between the cells! This is so because injured capillary membranes do not behave the same way as healthy or intact ones do - they leak! They leak colloid and with the colloid goes water. Simply cooling the organs (or bodies) of non-hibernating animals results in increased capillary permeability and the leakage of colloid and water into the spaces between cells. There is currently not a complete understanding of why this happens, or why some colloids do not leak as much in the cold as do others. In fact, only a very few species of colloid have been shown to leak less in hypothermia.

Capillary injury and consequent leakage of colloid from ischemia is vastly worse than that induced by hypothermia alone, and no colloid has been identified which is effective at inhibiting this leak, or even reducing it enough in clinical settings to meaningfully change outcome. In the setting of serious ischemic injury in the presence of high concentrations of cryoprotectant, NO COLLOID OR OTHER MOLECULAR SPECIES HAS BEEN SHOWN TO SIGNIFICANTLY REDUCE EDEMA - INCLUDING the PEGs OF VARIOUS MOLECULAR WEIGHTS. CI's own research associates had reported this to CI prior to Ben's decision to do an ad hoc experiment on a human patient with absolutely no prior laboratory animal or even bench testing of the perfusate. The only thing more unconscionable than such an uninformed and reckless action is the continued denial that it was such, and that his "mistake did not have the disastrous consequences implied by Mike Darwin."

Here is what Ben Best says about the outcome for Curtis Henderson in terms of cryoprotective concentration at the end of perfusion:

" The refractive index of the effluent was 1.366 after six liters of VM−1 had been perfused, and was 1.3586 at the end. Intermediate values were as low as 1.3586 and as high as 1.3651, but this was a small range with no trend, and is indicative of random variation. These values are well below the values of 1.416 for 60% VM−1 and 1.4275 for 70% VM−1 — and they showed no trend."

Based on the reported refractive indexes of the venous effluent, I would estimate that Curtis Henderson had approximately 20% to 20% cryoprotectant in his brain - most of which was ethylene glycol. That would (again roughly estimating) equate to about 1.5M to 2.0 M glycerol in terms of colligative cryoprotective effect. I have not yet posted the electron micrographs (EMs) of the damage incurred when 3M glycerol is used as a cryoprotectant in the cat brain, but the histology is posted here: http://wp.me/p1sGcr-lt . I can tell you that the EM's are vastly worse than are the light micrographs.

I have provided a detailed, and I believe accurate, scientific rebuttal to Ben Best's claims. For onto a decade I have privately urged CI to either stop advertising that they are perfusing human patients under conditions which yield 86.1% viability +/- 5.8% (for a 55% concentration CI-VM-1 at - 20 deg C FOR TEN MINUTES, followed by cooling to and rewarming from -130 degrees C at 0.3 degrees C/min) brain tissue viability and ultrastructure, when in reality they are treating patients with 70% VM-1 delivered at +7 (or higher) to -7 deg C (rarely) over far longer periods of time (hours) and in the presence of ischemic insults that typically run to many hours, or even days!

This isn't about elegance of writing, it's about facts, most of which are derived from CI's own website.

This would work if one has enough people actually signing up for cryonics. As long as very few people are doing so, it isn't an option.