Cryonics, July, August, September 1986
INTERVIEW WITH JERRY LEAF
One of the greatest dangers in life is to adopt a too simplistic view of the world. Simple explanations of life have a tremendous appeal, because they offer to boil down the whole complex panorama of existence into an easy bromide. To some extent, the "great man theory of history" is such a simplification. Men are not only shapers of their times, they are shaped by them. It is a complex interaction. Nevertheless, we, the editors of CRYONICS feel justified in saying that Jerry Leaf is arguably the most important man in cryonics since Robert Ettinger. He has shaped cryonics more completely and surely than any man who has come before him.
Almost singlehandedly Jerry has transformed cryonics, at least cryonics in Southern California, into a credible, professional operation. He has also, more than any other man improved the quality of care delivered to suspension patients. But perhaps most importantly he has brought with him to cryonics a degree of integrity and high values which were sorely lacking before. Jerry's integrity, coupled with his total commitment to the use of reason and the scientific method have forever changed cryonics and attracted the best and brightest from around the world to make their home in Orange County and to become a part of the Cryovita (and thus ALCOR) family. Both of us, the editors of CRYONICS, are here doing the job we're doing, almost exclusively because of Jerry Leaf and the values and skills he represents.
However, integrity, values, skill, competence -- while these things describe Jerry, and while they are necessary and even critical ingredients in the makings of a world shaper -- they are not enough. It takes more -- it takes sensitivity, fairness and humanity to attract and hold people and to gain their loyalty and love. Jerry is blessed with these things in abundance. Though blessed is the wrong word to use, since it implies that "it just happened." To know Jerry is to feel completely and at once that you are in the presence of a man who has taken nothing, but who has made and shaped himself completely. This interview will hopefully provide a glimpse of that tremendous sense of self control, and of the immense reservoir of concern and competence which accompanies it.
CRYONICS Magazine: Very few of our readers know much about your background, about what caused you to get involved in cryonics. Could you tell us a little about yourself and your personal motivations for involvement in cryonics?
JL: My motivations go back to the beginnings of the 1960's. They began in the jungles of Southeast Asia. I was involved in a special operations group deployed out of Western Europe. We were assigned a highly sensitive mission in South Vietnam, the kind that were eventually handled by special teams called Phoenix Groups. We were further used as a test case for operations across the border into North Vietnam. Part of what we learned was used to develop what became known as MACV-SOG, a top secret organization involving the South Vietnamese and American Special Forces and the CIA in mid 1964. It was during these missions into North Vietnam that our casualty rate began to rise, eventually exceeding 50% before our return to Western Europe.
There is a special kind of chemistry and feeling that is shared by people who face death together over a period of time. I came away from these missions with the face of death having a very specific meaning; it was defined by a roll call of men we carried out of North Vietnam. They went home; there were no MIA's. I lived because of these friends, and it was the worst feeling not to be able to reciprocate.
I left my fear of death somewhere in the jungles of Vietnam. To this day I have absolutely no fear of death, only the fear of not being able to save someone else that I care about. It's not that I don't want life for myself, because I do very much. I just don't feel anything about nonexistence. I only have the positive feeling towards life. I want more of it.
This caused me to begin to think about the fragility of life and what could be done to prevent the loss of people that you cared about. People whose lives were in extreme jeopardy -- or even beyond the ability of current medical science to recover.
When I came back (we were quietly reinserted into Germany after the Southeast Asian operations) and I was cycled back to the US for a period of time (during which time I was involved in additional covert operations here) I began to become increasingly concerned over the issue of life and death -- over the the tremendous importance and preciousness of life. I began to ask questions about life itself -- I started studying biology and philosophy in college and I became particularly interested in suspended animation. In 1966 I heard about a lecture that was being given by Robert Nelson of the Cryonics Society of California (CSC). I attended that lecture and it stimulated me to contact the cryonics groups that were in operation at that time: CSC, the Cryonics Society of New York, the Cryonics Society of Michigan and a group in France. I contacted all of them by mail and tried to keep in touch with some of them over the years when I was going to college.
I was attending college in Southern California at the time. I was married in 1965 and stayed on in Southern California for two more years at which time I completed a B.A. degree in philosophy. Afterwards I moved to Nevada to pursue a graduate education in biology. I was there almost 2 years. I left the graduate program because of inadequate instrumentation and support which I needed to pursue low temperature biology. At the time I was in a special program to get a degree in low temperature biology. The university there is primarily oriented toward ecological studies -- and still is. After awhile I began to realize that I knew more about low temperature biology from my independent studies than they did! That, coupled with the lack of equipment available for graduate research caused me to make the decision to return to Southern California.
CM: Why did you do this? Did you plan to pursue graduate studies in cryobiology here?
JL: No, I had pretty well determined at that point that the kind of research which needed to be done and which I was interested in doing would require equipment and facilities which would simply not be available to me in a University environment. No publicly supported institution would be likely to support the kind of work I knew needed to be done. The Southern California area represented a lucrative market in surplus equipment -- because of the many medical centers, high technology manufacturers and Universities in the area. I began to acquire equipment for my own use.
I began working at UCLA in the operating rooms with the idea in mind of setting up to do research myself in my own laboratory. I recontacted Southern California cryonics by attending a meeting sponsored by Trans Time. This was an attempt by Trans Time to cut into the Southern California cryonics market of Manrise Corp. At that time, I agreed to do the first Total Body Washout (TBW) of a dog, to be conducted at Trans Time's facilities in Emeryville. Shortly thereafter, I met with Fred and Linda Chamberlain of ALCOR/Manrise and agreed to help them with dog work if they were interested.
I did the first cryonics dog TBW up at Trans Time in 1977 in which the dog lived for 17 hours. All the equipment and supplies I took up in my van, except for some material which I relied on them to provide. That was partially a disastrous decision I made (laughter) because the main things I relied upon them to provide were inadequate. This was my first experience in seeing what was actually available for cryonics. I was really surprized at the inadequacy of their equipment and at their misconceptions about how to carry out extracorporeal perfusion. The degree of their isolation from the mainstream of medical knowledge was particularly surprising. They had very little insight into what was going on in clinical medicine. They had a little insight into low temperature biology and physiology, but they had essentially no equipment that I considered to be useful at the time for actually accomplishing extracorporeal circulation of blood or cryoprotective agents in a manner which would insure proper perfusion by any clinical standards.
CM: How did Cryovita Laboratories come about?
JL: After I came back from doing the experiment with Trans Time I got involved down here with Fred and Linda Chamberlain of ALCOR/Manrise and we did a study in which we carried out cryoprotective perfusion of a dog simulating the protocol which had been applied to a previous ALCOR neurosuspension patient. The purpose of this experiment was to evaluate the ultrastructural effect of the suspension procedure on the brain. Electron microscopy was later performed on the animal's brain to evaluate structural integrity.
All of this brought into sharp focus the need to develop real facilities for research. At that time I was operating out of my garage. There was so much equipment stuffed into that two car garage that any kind of meaningful work was impossible. Also, in order to do animal research I realized I would need to be licensed by the Department of Agriculture. That meant M-2 zoning for the facility, so I moved from my garage into the industrial facility which Cryovita and ALCOR currently occupy, in 1978.
I established Cryovita as a corporation for licensing purposes and for tax purposes -- and of course for common sense reasons of limiting my liability. The fundamental motives were to provide a more adequate environment for research operations and for patient perfusion services that I perceived as being unavailable through Trans Time or Manrise.
Shortly thereafter I agreed to do perfusions for Trans Time. In the interim, Manrise, the Southern California "for-profit" entity had been sold to Trans Time by the Chamberlains. I ended up being the subcontractor to Trans Time doing perfusion's for both ALCOR and the Bay Area Cryonics Society.
CM: Since Manrise had merged with Trans Time at that point, why didn't you merge with Trans Time too?
JL: Well, I decided that rather than merging with Trans Time I should remain a completely independent entity capable of making my own decisions about who to become involved with, who to remain involved with, and to have the ability to make decisions in protocol with more influence on Trans Time. If I were just a stockholder in a larger corporation controlled by many stockholders -- even if I were the principal stockholder -- I wouldn't have the ability to influence the Trans Time board in what I considered to be technical decision making in areas in which they had no expertise and I did.
CM: Do you have any regrets about having made that decision and about having taken on the tremendous personal and financial load which Cryovita has represented to you?
JL: No. As a matter of fact I think the decision to remain independent has proven to be the correct one. For a number of years I enjoyed a considerable influence on what the perfusion protocols and level of technical expertise would be in perfusing Trans Time patients -- which was essentially all the patients being done over that period of years. It was an opportunity for me to influence the technological developments during those years and introduce substantial improvements in patient care. It also provided me with an opportunity to be involved directly in the perfusion of cryonics patients and to become involved in training people to do suspensions. It was a tremendous educational experience for me, and it provided me with an opportunity to provide trained people down here in Southern California who would be directly in support of patient care and research. It was essentially an ALCOR team direct by Cryovita Laboratories. The nucleus of that team is still doing research at Cryovita.
CM: Up until about a year ago Cryovita was providing services to TT. What caused the contract not to be renewed.
JL: We were expending over $20,000 per year to operate Cryovita with most of that money going solely in support of patient perfusion operations. Trans Time had always plead poverty and compensated Cryovita for these services in modest amounts of money, but mostly with stock. The last three years of the contract with Trans Time we were paid entirely with stock because I was concerned that they wouldn't have enough cash flow to keep their doors open.
I was happy to provide them with help during these rough times. For years I accepted this arrangement because I wanted to see them make a go of it. But then I began to notice that windfalls and benefits which came their way as well as research money and other cash flow was not trickling down here. Not even in small part. It became clear that they were content to let me and the other Southern California people absorb the tremendous cost of providing perfusion services to them -- indefinitely. So, when we said that these services were going to cost something, about $3,500 a year, not even enough to begin to cover their share of the costs, the negotiations began to linger. We finally agreed upon a combination of cash and equipment, but never signed the contract.
CM: Why not?
JL: As I said before, the technological decisions as to how to treat suspension patients were largely left in my hands, and they were very sensitive to any input I had. However, there were some people in Northern California who were not happy with this. They felt that the quality of perfusion was secondary to taking some kind of immediate action -- even if that consisted of walking into a grocery store and buying table salt and culinary ingredients and pumping these through someone with an embalming pump! If someone wants to do something exclusive of cryobiology and the medical sciences, they don't need my services. I offered to provide training for Trans Time/BACS personnel, but they would not provide even the modest levels of funding required. Capability was set on the shelf for future consideration.
CM: Surely you must be joking about the grocery store scenario?
JL: No. This is something which had existed as a matter of contention in cryonics for a number of years before I came along. I just brought that difference into sharp focus because I represented a greater extreme of technical accomplishment than the others who had held this position previously. I think these background issues of cost vs. quality were partly responsible for their decision not to pursue services with Cryovita.
Some real differences between Trans Time's operations and what I considered Cryovita's proper operation began to gel when we had difficulties with relatives who had placed a patient into suspension. They seemed not to be aware the nature of the process and what kinds of injury and damage these patients would be subjected to as a result of the preservation process. In one instance Trans Time failed to notify a relative about a serious error they made in the care of a patient and that information was communicated second hand, and many weeks after the incident.
As a consequence of an inability to communicate with people in a way that was mollifying of their doubts they began to incur litigation and threats of litigation. This resulted in the loss of at least two of the core team members here in Southern California with these people stating that they could not justify continuing to participate in suspensions if it jeopardized their livelihoods and the the livelihoods of their families. Of course, the Nelson disaster in Chatsworth only increased tensions and concerns over litigation. It also caused me to become increasingly sensitive to the issues of informed consent and public image.
CM: Why was this?
JL: I had given interviews to the press during this period in an attempt to show the difference between Nelson's operation and the rest of cryonics. These interviews were edited in such a way as to make them useless to defend the difference between existing cryonics organizations and Nelson's CSC. This problem was only made worse by the misuse of photographic and video materials that were taken here at Cryovita Laboratories, with my permission, for the use of Trans Time in promoting cryonics when the TV news people discussed the Chatsworth disaster while showing images of a modern cryonics laboratory.
What occurred was that Trans Time had been selling these materials -- in the beginning they sold them with inadequate controls to people not only in the mainstream news media, but people who were making documentaries on whatever. . . The consequence was that material depicting Cryovita was used in a "film" entitled FACES OF DEATH. This was a film I considered to be of an extremely negative character in as much as it packaged human death, misadventure and death related procedures in a vulgar and exploitive way. It showed cryonics as one of those death related procedures in a context which I found completely unacceptable. It showed cryonics patients inadequately covered in terms of their privacy, which I considered unacceptable for surviving relatives to see. It didn't cover their nakedness for example, it identified them by name, and it showed team members both in Northern and Southern California whose permission was not obtained for this kind of thing -- including me. I considered that to be totally inappropriate to the purposes for which I allowed Trans Time to make video recordings and photographs in my facilities.
Consequently, before any contract could be signed between Trans Time and Cryovita, I required that I have control over any material, photographic or video, made at my facilities. I agreed to to allow Trans Time to use this material for promotion on an individual, case by case basis. I further asked that they not release any of the material which had been previously made at Cryovita to anyone without first contacting me for my permission. Apparently, Trans Time decided that they had made so much money from the previous sales of video material produced at Cryovita that they were unwilling to release that control. So, there was no longer, at that point, the possibility of my signing a contract with them.
I have to believe their motivation was never high, and when this issue was raised it was the end. As far as I know, this issue of public image and how you are represented to the media is something that no organization will give up -- and Cryovita is as sensitive about that as they are. I felt I owed an ethical responsibility to team members, the relatives of patients, the patients themselves and of course to myself, to protect the use of film footage and photos made at Cryovita. So long as Trans Time would not agree that I would have equal control over my images -- the same control they would have over their own -- there could be no contract.
CM: A mutual veto on use of images was unacceptable to them?
JL: That's correct.
CM: As you know, ALCOR has undergone quite a metamorphosis and change since the days when you first became involved. You have been a very active participant in that change. To what do you attribute those changes?
JL: The way things were divided up between Trans Time and Cryovita for patient services and support was as follows: Trans Time subcontracted perfusion services to Cryovita with the understanding that whenever it would be feasible to transport a patient to Cryovita that would be done. Over that period there was only one case where a patient was perfused in Northern California -- a case where the patient lived relatively close to the Emeryville facility and there was plenty of notice for Trans Time to prepare for that case. I flew up to Emeryville to do the surgery and direct the perfusion.
Cryovita did not develop rescue/response capability to any great degree. There were no full time people available down here at that time, and the overall level of activity was very low. It was all I could do to maintain readiness at Cryovita to handle perfusions -- and this was all I was obligated to do. All our work in training was focused on getting team members some level of skill in perfusion techniques.
Until the Northern California patient I alluded to earlier came along there was little training for transport operations in either Northern or Southern California. In 1980 I had the occasion to make personal contact with Mike Federowicz, who I had corresponded with before. Mike had transported a Trans Time patient to Southern California and then stayed on to help with a second suspension which came on the heels of the first. Mike had been working in a cryonics group in Indianapolis, Indiana for a number of years. At that time I tried to open the door as far as doing what I could to persuade him that Southern California offered an attractive alternative to the difficulties he was experiencing in Indiana. I needed someone else out here to work with who had a background in clinical medicine, such as Mike did, and he himself had begun to move toward clinical models of perfusion -- using roller pumps and so on. I felt that he and I working together would allow us both to accomplish a lot more than if we were working alone. He was the only one else in the world who seemed to be aware of the fact that something needed to be done to upgrade the level of care -- and to realize that that meant medical technology.
When Mike came out here in 1981, (he remained "signed up" with his own organization, the Institute for Advanced Biological Studies which he had brought with him from Indianapolis) he came into closer involvement with ALCOR. He began to question the adequacy of services being provided by ALCOR. There was no one in the presidency of ALCOR who understood clinical medicine or who had the time to actually promote growth of ALCOR.
Since ALCOR was totally dependent upon Trans Time for services at that point, Mike began to urge changes at that level. Up at Lake Tahoe, shortly after his arrival here, he lobbied Art Quaife, unsuccessfully, for the Trans Time purchase of an A-2542 storage dewar. Mike felt that neuropatients should be stored in such a dewar for reasons of safety, economy and logistics. He also strongly urged institution of regular training for transport and perfusion, as well as a better communications system for emergency responsiveness.
I think the beginning of the shift came shortly after the 1981 Lake Tahoe Conference when an ALCOR member, who was also a Trans Time client and who was dissatisfied with Trans Time's services, proposed that he purchase the A-2542 and that ALCOR pursue his father's care at Cryovita.
CM: Was Trans Time responsive to these requests for increased levels of training and services?
JL: Mike and I felt that we needed to have a truly complete capability in Northern and Southern California. We needed to have people locally who had rescue skills and we needed liquid nitrogen available locally to allow us to conduct low temperature biological studies on freezing viability and ultrastructure.
Since we hadn't developed patient storage and transport capabilities here in Southern California it was perceived that ALCOR was really not able to respond in the event of an emergency. Also, it had already been shown that there was an inflexibility in Trans Time's storage of patients -- since they owned the patient dewars and thus had a "lock" or "hold" on the patients. It was Trans Time's policy to charge an amount of money during the initial phase of cryonics services which was equal to the purchase price of the dewar space used by that patient -- but not to let the ownership interest pass to the nonprofit organization which actually had responsibility for the patient. In order to move the patient the nonprofit organization would have to come up with thousands or tens of thousands of dollars to purchase storage equipment which, in a real sense they'd already paid for! It became crystal clear that the non-profit organizations, who had final responsibility for patient care, could not move their patients from one service company to another, regardless of the possibility of finding less expensive or better services elsewhere, unless they owned the patient storage dewars.
There was always a lot of talk about the importance of having free market competition and more than one cryonics service company so that if one company went out of business others would be there to provide the needed services. But the actual practice of BACS was to destroy their own ability to use the free market to secure alternate services. There was a situation with interlocking directorates between Trans Time and BACS and it certainly reeked of a conflict of interest with regard to patient storage. I believed that the patient's interest should always come first.
Mike felt that in order for it to be economically feasible for ALCOR to control its own patients, and to pursue services elsewhere if necessary, ALCOR had to own the dewars. That was impossible with Trans Time and that was a major factor in ALCOR's deciding to provide its own patient storage.
There was also an inadequate amount of money being spent by Trans Time to train transport teams down here. In fact there was no money being spent. There was also no money being spent to maintain suspension team training. So ALCOR, I think largely as a consequence of Mike's frustration over these issues -- and I supported him a lot in that -- decided that they would increasingly have to take over the responsibility for emergency response services and storage services. If they were going to do that, it was only a matter of time before it came to everyone's attention that they might as well have their own independent contract with Cryovita for necessary perfusion equipment and services.
CM: Why was this so?
JL: Well, at that time ALCOR was paying Trans Time for emergency responsibility and perfusion services, but ALCOR was essentially providing those services. It didn't make sense that we should have all of the responsibilities and none of the benefits of emergency responsibility fees after costs. There wasn't enough cash flow to support two facilities. I never expected Cryovita Laboratories to be supported through cryonics, but to have no plan to support activities in Southern California was a bit too much. So, when Mike was made president of ALCOR he moved to change that relationship from one of dependence on Trans Time to one of complete independence for ALCOR.
At that time, as now, Cryovita was completely independent so that it could provide perfusion services to ALCOR or to any organization that it chose to deal with. At that time that included Trans Time and the Cryonics Society of South Florida.
CM: I'd like to change subjects for a little while and discuss your "professional work." You work in the Thoracic Surgery Research laboratory of UCLA Medical Center with Dr. Gerald Buckberg. A number of fascinating papers and research results have been flowing out of that laboratory in the past few years -- much of it of direct relevance to cryonics. Can you tell us a little about your work there?
JL: Sure. I've been at UCLA for 15 years now. I was originally attracted to the Thoracic Surgery Division because I realized that the techniques of perfusion using extracorporeal circuits and artificial oxygenators to support patients in deep hypothermia was exactly the kind of technology that would be required in doing suspended animation research and procedures.
I'm in the Department of Surgery, Division of Thoracic Surgery, attached to the UCLA School of Medicine. My primary responsibility is in the research laboratory. However, I've worked on the clinical open heart team in the Operating Rooms, and I'm a Board Eligible Cardiopulmonary Perfusionist. I've been through the ECMO (Extracorporeal Membrane Oxygenation) training program at the University of Michigan as well. The research has required me to acquire competence in thoracic surgery techniques. I'm involved in training neophyte thoracic surgeons in the laboratory environment as well as participating in research. My expertise in low temperature biology has been useful, since most of the techniques for protecting the heart involve hypothermia. You could say that I've had something more than a graduate education in cardiac physiology. I've been functioning as a scientist and have been co-author of over 25 papers coming out of the UCLA laboratory. This is a distinction usually shared only with MD's and PhD's. I've also set up the entire aortic valve/conduit storage program at UCLA, which involves the cryogenic storage of human heart valves and arteries for transplantation into children. But let's go on to the research and its clinical applications.
Most of the research focus when I began work at UCLA was aimed at protecting the heart during operative procedures. At that time the heart was arrested so that surgery could be performed on it -- it is almost impossible to carry out delicate surgical procedures on a heart when it is beating normally in the chest -- by electrically fibrillating it and applying topical hypothermia (ice slush). One of the first discoveries that was made just previous to my coming there was that electrical fibrillation caused the heart to consume 300% more energy than it would use in the beating empty state -- where the heart would be contracting but not pumping blood. Dr. Buckberg asked a fundamental question: "Why are patients going home after we correct what's wrong with the heart and they're coming back five years later in worse condition than when we got them and corrected the problems that they had at first?"
He began to try to answer these questions by doing basic physiology on the heart; what were the blood flow requirements, oxygen requirements? What did hypothermia do? What did then currently used methods of achieving cardiac standstill during surgery do to the heart long term?
Buckberg began to re-examine the technique of pharmacological arrest, a technique where you use potassium to depolarize the heart's nervous system so that the heart cannot contract. You can further reduce the ability of the muscle fibers to contract by using a low calcium perfusate, and that's one of the things that we looked at also. Ten years previously a surgeon named Melrose had thought that an obvious technique for stopping the heart would be to introduce potassium into the circulation of the heart and depolarize the neurons to inhibit contraction. This was a sound principal, except that he didn't determine how much potassium was needed -- and he used such high doses of potassium that it caused fatalities. As a consequence of his suggestions employing such high doses of potassium, the technique was assumed to be inappropriate and was abandoned for ten years. Our laboratory, and a couple of others, reassessed this method, called pharmacological arrest, and determined that if the proper dosages are used, this technique is far more physiologic and results in far less injury to the heart than the electrical fibrillation and direct icing which had been widely used before. The pharmacological solutions used to arrest the heart are now called cardioplegic (heart paralysis) solutions.
A natural extension of this work was to try to optimize the cardioplegia solution -- to make it as supportive and nondamaging as possible. We decided that the best vehicle to use for the potassium was blood itself -- the body's own best perfusate. We systematically developed blood cardioplegia to stop the heart quickly, to maintain it hypothermically with no injury and then to provide it with metabolic substrate while in the hypothermic arrested state. Along the way we discovered the importance of maintaining an alkalotic pH during hypothermia, such as poikilotherm animals (turtles, frogs, and so on), do.
Recently our attention has been focused on providing adequate support for hearts that have been subjected to ischemia, to no blood flow as a result of atherosclerosis or heart attack. We began to look at patients who were coming into the emergency room who had completely occluded coronary arteries in which segments of the left ventricle, which does the real work of pumping blood to the body, were beginning to fail. We had already demonstrated that we were able to restart cardiac metabolism after periods of time which would have previously been considered hopeless.
CM: Why was this work undertaken? What was the reason you made this discovery about being able to "jump start" so called "dead" hearts?
JL: The reason that we looked at periods of normothermic ischemia was because there were always cases in the operating room where the patient would have an area of his heart that was so poorly perfused or not perfused at all because of infarct or narrowing of a coronary vessel, that when you gave your cardioplegia and arrested the heart, the cardioplegia solution couldn't reach the flow restricted area. So, that area was subjected to a total arrest of blood flow without being metabolically protected and without being cooled by the cardioplegia solution. Often it was 45 minutes or more before good flow to that area could be re-established with a graft. And those were the areas of the heart that needed protection and metabolic support the most! So, you'd have warm ischemia in those areas until you got the grafts in.
About this time the concept of reperfusion injury was coming to the fore. There was work by Denton Cooley at the Texas Heart Institute, and others, which indicated that the precipitation of calcium in the mitochondria in the cells was a key cause of damage when circulation to an ischemic area was restarted. This occurred because the cells were metabolically exhausted and unable to regulate their ionic content. The important realization here was that the actual injurious event came after the re-establishment of blood flow -- it was an indirect, not a direct result of lack of oxygen and nutrients.
The natural question to ask was "What would happen if you gave the cells time to recover to the point where they could once again handle the reintroduction of normal ion levels?" We had, early on with our research with blood cardioplegia, found it necessary to develop techniques for controlling the level of calcium in the blood we were delivering to the heart -- since in hypothermia the heart also cannot regulate its ionic milieu very well. We reduced the available ionic calcium level in the blood using citrate. Later on of course, we used calcium channel blocking agents in conjunction with that.
This was only the first and most obvious reperfusion injury. It was characterized as the calcium paradox. You need calcium for normal contraction of the muscle, but paradoxically if you reintroduce calcium before the cells are able to regulate its level, you kill the cells.
This began to raise other questions about reperfusion injury. If calcium is a problem are there other problems that can be addressed and solved? Since we had demonstrated that controlling ionic calcium could redefine myocardial death, at what point is the heart beyond recall? At what point should we give up trying to salvage a heart? We don't know.
CM: What are the clinical limits right now? How long after an infarct has occurred and the tissue has been deprived of flow is it possible to intervene and restore function?
JL: Actually measuring the blood flow in an area of the heart which has suffered an infarct is a difficult thing to do in a clinical situation. We have done it in the research lab in dogs. In a clinical situation, the advance of disease has usually been slow and the tissues have had time to compensate for it metabolically by the development of collateral flow. So, it's hard to directly compare the dog work with the human work. It's easy enough to measure blood flow through an occluded artery and find there isn't any, but it is far harder to rule out the presence of collateral flow -- flow from vessels feeding adjacent areas of the heart. When you have one area of the heart's blood supply cut off you can have such low pressure in that area of the heart that a trickle of blood from adjacent areas can continue to flow through the infarcted area.
CM: What is the limit in the laboratory using the dog model where complete absence of perfusion has been established?
JL: At the start of our work on regional ischemia in 1980, the accepted wisdom of the time was that after three hours of 100% occlusion of the coronary arteries, those areas served by those arteries would be 100% lost. Of course there were always areas that were at risk in the perimeter of the infarct that would eventually recover, because they weren't totally ischemic due to the presence of collateral circulation.
We began using our substrate-enhanced cardioplegia to perfuse these areas. We didn't, as you might first expect, perfuse these areas with cold blood cardioplegia, because we wanted to enhance the metabolic state of the cells; and in order to do this, we had to provide substrate at a temperature at which the cells would be able to actively use it. So we used warm blood cardioplegia which was substrate enhanced; containing amino acids such as aspartate and glutamate which we had previously shown as being effective in "sparking" metabolism and restoring the levels of important high energy compounds required for operation of the cells.
Using this approach we were actually able to get hearts back after six hours, which was twice what the common wisdom would have had you believe was possible. During this same period of time we looked at some of the markers of irreversible injury, such as ATP levels and vital staining (a marker of key enzyme levels inside the cells) and we found that none of them were adequate to predict irreversible injury. Whatever marker or barometer you want to use for irreversible injury, one thing you can be sure of is that if the cells are able to function, then they are not irreversibly dead! If the heart is able to pump blood and support the life of the organism, then it's not dead. Therefore, all of the so-called accepted indicators that we had looked at were inadequate to tell if there was a state of irreversible injury. We demonstrated that what were thought to be irreversible, end-stage levels of ATP were simply false. It was analogous to saying that because you only have a sixteenth of a tank full of gas that your engine won't run. What we found is that no matter how little gasoline you have in your tank, the engine will run as long as there is some gasoline present -- providing the engine was still in working order.
What we found was that myocardial cells would function normally even if you had ATPs that were one-half of what was then felt to be the threshold of irreversible injury. Likewise, we found that vital staining techniques which rely upon the presence of myocardial enzymes (they do not stain the areas that have low levels of enzymes -- supposedly indicating "cell death") were not really predictive of irreversibility. We found that the areas that were unstained using these vital dyes were actually capable of contracting and contributing to cardiac output -- which is not possible if the tissue is dead!
We've looked at a range of other markers as well -- high energy compound levels, a range of vital staining techniques, ultrasonic crystal evaluation of myocardial cell work performance, and electron microscopy (to evaluate structural changes after hours of ischemia). What we've found, working in conjunction with Dr. Schostrand, who is the world's foremost expert on the ultrastructure of the mitochondrion, is a perfect correlation between the structural condition of the mitochondria and the functional state that the cells containing these mitochondria were able to achieve.
CM: So in other words, your basis for pronouncing a piece of tissue or a cell irreversibly injured has shifted from the rather indirect approaches represented by markers such as vital staining and ATP levels, to the much more direct criteria of structural changes?
JL: Our conception of myocardial death has evolved essentially to become perfectly analogous to the cryonics position on irreversible death. That is to say, if we look at the cells and there's nothing there -- that is to say there is no structure present in a key area, such as the mitochondria, we find a high correlation of no function. On the other hand, if we find structure there, we find that the only reason it doesn't function is that we haven't learned how to make it function yet. The farther we go, the more we learn about how to make cells function which still have structure left! The only thing you have to have is structure. In other words, if the cells exist, if their components are reasonably intact, at this point we have to say that every time we do something else (so far) we are able to restore function. There is no identifiable cell with structure that we haven't been able to adequately reperfuse and recover to function at this point. Of course, we haven't looked at cells that have had no energy input into them beyond a certain point -- in the dog model we've looked at ischemic episodes of up to 16 hours duration -- which is twice what anyone else though was possible to achieve.
We've gone on to apply these principles to the treatment of patients in the clinic. We've gone far beyond what we have developed in the dog lab. We've done many patients who've had 12 hours of ischemia and we've done some patients who've had 24 hours of regional ischemia in the myocardium. Sure enough, if you reperfuse them exactly the same way as we reperfuse ischemic dog hearts, 6 days later the patients are going home with normally contracting left ventricles. If you compare those to patients who were in better condition to begin with who've been given the standard treatment of simply re-establishing blood flow to the affected areas using streptokinase (a clot dissolving enzyme) or balloon angioplasty (to dialate plaque clogged arteries) in which you get an adequate blood supply to the ischemic areas, those patients typically come into the catheritization lab not in cardiogenic shock and they typically leave the catheritization lab in cardiogenic shock! Which is to say that they are worse off than when they arrived -- they have suffered reperfusion injury. So they've had injury added to insult and in following up these patients we've found that the infarcted areas of the myocardium scar over and suffer tremendous loss of tissue and consequently of function. That is, the structure was destroyed by inappropriate treatment, with a subsequent loss of function.
At this point in time the patients that the cardiologists are willing to hand over to us for our clinical trials are the patients who are in the worst shape. They are in cardiogenic shock and the cardiologists themselves are reluctant to try to treat them -- since conventional approaches which simply revascularize the injured area will initially only worsen the patient's condition. This is something these critically ill patients cannot tolerate. Indeed, they have lost more than a few such patients in the catheritization lab using streptokinase and balloon angioplasty.
Thus the cardiologists have increasingly begun to turn over these patients to us for controlled reperfusion in the operating room. The groups of patients that we've compared using controlled reperfusion versus those who've simply been revascularized with streptokinase and balloon angioplasty have shown a striking contrast. The ones that we've done have all left the hospital with functioning ventricles. As a matter of fact they've all shown some degree of return of function immediately after treatment. If the patients are in cardiogenic shock, or are requiring extra support such as an intra-aortic balloon pump then by the end of the procedure they usually no longer need it. By contrast the patients who are inappropriately reperfused typically experience a reperfusion injury and go into cardiogenic shock and often have to be placed on intra-aortic balloon support. So my exposure to dealing with the so-called markers of irreversible death in the research laboratory at UCLA has only served to reaffirm my previous intentions and my previous beliefs that if we knew how to treat a patient who had been without adequate blood flow we could deal with this -- in principle. In at least one organ, the heart, we have been able to deal effectively with reversing the injury due to both ischemia and reperfusion such that we have had to completely discard what were then accepted criteria for irreversible injury. I think this is a principle that may well be applied across the board to virtually every organ system in the human body.
CM: What research areas in cryonics do you feel need to be addressed in the next few years?
JL: Virtually every aspect of the procedure (laughter). We're like children standing the middle of the Hershey factory at lunch time. We've got all these goodies begging for our attention in virtually every direction that we look. It's very difficult to decide what to do first. We need to do everything. We need to do virtually everything that clinical medicine itself is beginning to look at. Namely, the causes of ischemic and cryoinjury and how to control them. How do we prevent real cellular death as represented by overwhelming loss of cell structure?
In order to address that issue I think you have to look at what you do when you put someone into cryonic suspension. It's a process that starts out at some point, you go through some definitive procedures, and you end up at liquid nitrogen temperature. Let's take a look at step one. What can be done at step one, transport of the patient? What can we do to improve the chances of that patient getting through transport with the least amount of injury? I think it's of critical importance that we mobilize all that we can from clinical medicine to minimize the amount of ischemic injury the patient gets. There is a definitely a time-related, quantitative change in the structural content of the cells -- in the amount of damage done -- versus temperature and the overall treatment of the patient. That's something we can measure and get a handle on. We know that the longer a patient is ischemic the worse the injury is going to be; from the work of others and from our own experience as well. We also know that simple reduction of the temperature will go a long way toward reducing the severity of the injury.
We need to improve our responsiveness and our ability to rapidly reduce the patient's temperature while providing circulatory and metabolic support. We need to improve our pharmacological intervention to further minimize ischemic damage.
CM: Those are certainly very practical things, but they are not exactly what we had in mind as far as pure research goals.
JL: What I'm saying is that we have to start at the beginning. We need to concentrate on protecting the brain from ischemic injury. This is a problem which needs a lot of attention in terms of research and improved capability.
I'm not saying that you can afford to ignore cryobiological research -- which cryoprotective agent to use, what's the best concentration, how do we avoid cracking, and so on. We already know that no matter how good we get at cryoprotection or ischemia injury reduction, we've still got the terrible phenomenon of cracking of patients who are cooled to liquid nitrogen temperatures. As I said at the outset, there are lots of areas which urgently need attention and these areas all need attention and need it now.
I think it's very important to avoid the state of mind that people have typically had in cryonics in the past of being willing to accept any kind of injury as long as the tissue has been reduced to the solid state. That seems to have been the hallmark of success in cryonics in the past: if you get them frozen, nothing else matters. I think it's going to take more than this for cryonics to work. It's tremendously important to know that you are preserving cell structure rather than blindly proceeding and hoping that future medical and biological scientists will be able to straighten everything out. Where we have to start in accomplishing this is to do everything we know to do. If we start with the attitude: "Well, this doesn't matter, they'll figure out how to fix that tomorrow," then we've surrendered before we've started to fight.
Once we're doing everything we know to do, then we can start working on areas where we don't have any clear ideas of what we can do to improve preservation of structure.
CM: But certainly there's a cost vs. benefit ratio here. One wouldn't for instance want to apply a technique which would improve structural preservation by 1% but which would raise the cost of the procedure 1000%! How do you address that interplay between cost and quality?
JL: We don't have an adequate yardstick for making such an evaluation. In some areas we don't know what the hell the result will be. And that's a problem we've had all along. Of course, that's been a major focus of ALCOR and Cryovita's research. The work we've been doing on ultrastructural preservation, on structural changes during ischemia, and in frozen patients are critical in establishing this baseline. What we need to do is assess any changes in protocol that we make on the basis of improvements in structural preservation.
Once this correlation is established for a given procedure, it then becomes an economic and personal question, not a scientific one. Are people willing to pay for it? Do they want to pay 1000% more for a 1% improvement in structural integrity? At least we can tell them what we can do and what it is going to cost.
CM: How do you feel about offering a range of services in terms of quality? One of the reasons some people, such as many of the older CI members, have given as to why they are not signed up with ALCOR is that they can't afford the quality of the services offered -- and perhaps don't feel the extra dollars spent return a sufficient dividend in terms of structural preservation.
JL: I think that the baseline that we have to measure other techniques against is the one that we're developing and currently assessing. If someone can't afford the techniques we offer and the protocols we apply, then we are obligated, before we offer any other protocol, to quantify and qualify this in some way by doing the studies that will document just exactly what it is we're delivering. I can't allow myself ethically to be in a position of having someone who is not involved in clinical medicine, who is not involved in doing cryonic suspensions, who has no clear idea of what the impact of what they want done to them will be, to be telling me how to do cryonic suspensions. They're coming to me and asking me to do something for them which neither of us understands. They're just hoping that whatever is done will be adequate. I have to have some confidence that the procedure I'm employing will work or has a some reasonable chance of working. Everyone involved, both the patient and me, have to be informed about what's being done. Informed consent is a critical and important medical standard which should not be tossed aside.
CM: So what you're in effect saying is that a clear understanding of any proposed lower-cost protocol has to be had, or at least as clear an understanding as is present for existing protocols, and this understanding must be translated into a set of caveats or an informed consent document of some kind?
JL: Absolutely. For example, it may be possible to preserve a patient's life by amputating his leg if he has a crushing injury, or it may be possible to save his life and the limb by doing a very complicated and costly vascular surgery procedure on his leg. One patient may say "I don't have the money and I can't get it, so I'll have to go with the amputation because I want to live." It's very difficult for us to be that definitive in developing protocols to preserve structure. I think we will eventually get to the point where we'll be able to look at structure and say "This is probably adequate structure to allow for a reasonable chance at recovery of function."
They're asking for decisions based on criteria and evidence which are not yet developed. That's part of the immediate research goals that need to be developed. What is the necessary degree of structural integrity which can reasonably be envisioned to allow for restoration of function? What are the minimum protocols required to achieve that degree of structural preservation?
Our existing transport procedures are aimed at preventing ischemic injury by providing adequate circulation. If ischemic injury has already occurred, what can be done to reverse this injury or limit its effects before perfusion with cryoprotective agents? Our transport pharmacological protocol is an attempt to affect ischemic injury.
An area that begs to be studied is how our cryoprotective perfusion protocols affect cellular structure in terms of reperfusion injury to patients who have been exposed to ischemic injury. Cryoprotectant toxicity and its effects on structure is another area. We already know that freezing, with storage at LN2 temperatures, causes fracturing. We have to develop methods of low temperature storage that will avoid fracturing, which may mean higher storage temperatures for frozen tissues. The most compelling concept in cryobiology in recent years is vitrification, which avoids freezing, but requires higher storage temperatures. Whatever direction our research goes, structural preservation of cells and tissues will be our "gold standard" in the near term.
CM: You've been involved in a long-standing battle with the Society for Cryobiology over the legitimacy of cryonics and over cryonicists presenting conventional cryobiological research at Society meetings and publishing scientific papers in their journal CRYOBIOLOGY. Could you discuss your point of view on these issues?
JL: Some years ago I heard that some members of the Society for Cryobiology were totally opposed to cryonics. I've been a member since 1970 and occasionally I'd hear offhand remarks about cryonicists from a few members of the Society. Nothing very serious, just offhand negative comments which indicated that they knew almost nothing about cryonics -- usually comments made in the context of talking about other things.
It only became an issue with me during the 1982 meeting in Houston, Texas when there was a policy statement about cryonics put before the Board of Governors for approval which I considered to be inappropriate. It stated that cryonics was not scientific in nature, and while it was not the business of the Society to judge what people's beliefs should be, they nevertheless considered cryonics to be inappropriate. Basically they wanted to disassociate themselves from cryonics.
CM: What was the reason given for this action?
JL: They stated that they had had inquiries about cryonics from the general public and the news media and that they needed a formal way to respond to these. By directly questioning them at the time I learned that these inquiries had amounted to a grand total of three over the previous year. This is not what I would consider a nuisance level of inquiries about cryonics. I considered that the reason they were making this policy statement was not because the inquiries were a nuisance to them or likely to result in cryonics being associated with the Society in the media or public mind. Rather, I feel it was because there were specific individuals on the Board who were antagonistic to cryonics -- for reasons which were never stated.
CM: But don't you feel the Society has the right to distance itself scientifically from activities of which it doesn't approve and of which it doesn't feel are workable or ethical?
JL: I certainly think that the Society has the right to do anything that it wants in the context of its stated purposes and Bylaws. I do not feel it is the purpose of the Society to make pronouncements about activities (such as cryonics) about which they are not well advised. It has been my personal experience that they are not advised about what cryonics is about, or about what we are doing of a scientific nature -- or where the science leaves off and where aspects they would consider nonscientific begin. So, they have some sort of personal views which cause them to be antagonistic. I don't know what those views are, since I'm not in their confidence.
However, there have been statements from people such as Dr. Harold Meryman (a founder and past President of the Society) in the written form in which he has expressed the opinion that cryonics and the idea of biological immortality are mischievous in the extreme and socially undesirable. The general flavor of his written statements has been that he feels cryonics has the potential of diverting funds from what he considers legitimate research in low temperature biology. He seems to feel that if cryonics was accepted as a legitimate endeavor, then money which would go to laboratories such as the one he oversees would be diminished.
CM: The Society's initial policy statement seems fairly benign. Certainly it's one that ALCOR has no trouble with. It seems a fair policy statement and it is our opinion that Society for Cryobiology has the right to distance itself from cryonics or from other endeavors which they deem unscientific or unworkable.
JL: There was something else that occurred at that meeting in 1982 and that was a general overhauling of the Bylaws of the Society. I felt that there were a number of issues touched on in the Bylaws that reflected on the control that the Board of Governors would be able to exercise with regard to membership and the possibility of practicing exclusionary policies towards individuals who might be known to be engaged in cryonics activities.
It is one matter to issue a statement of "nonsupport" or to express your opinion about an area of endeavor, and quite another to interfere with presentation of legitimate, conservative scientific research or to interfere with access to cryobiological research by others just because you don't endorse or approve of their "nonscientific" endeavors.
CM: Why do you feel that it's important for cryonicists to be able to participate in the Society for Cryobiology and to attend meetings and become members?
JL: I think that it's important for anyone who's doing research on suspended animation and who's interested in the effects of low temperatures, cryoprotective agents and so forth on mammalian tissue to be involved with the Society as a scientist. I think that there is absolutely no conflict of interest between a cryonicist who's doing actual animal research on the cryobiology of mammals and his membership in the Society just because he also happens to be a cryonicist.
Participation in the Society offers a public platform in which an investigator can present his findings and get feedback at scientific meetings from some of the world's foremost experts in cryobiology. If an investigator is doing good work -- work they would normally accept as legitimate and be willing to listen to -- then what difference does it make if he is also involved in cryonics or if the ultimate aim of that work is to further cryonics? What they are doing is making a moral judgement about the motivations and purpose of that investigator and his work. That is totally outside the realm of their charter, their Bylaws, or accepted practice in such matters. I challenge them to show that the goal of cryonics, which is survival, is either unscientific or unethical.
CM: If the Society for Cryobiology decides to prohibit the attendance and participation at meetings and the publication of papers by cryonicists, papers which deal strictly with so called "legitimate" or "conventional" cryobiology, what sort of action do you feel should be taken?
JL: It is my understanding the a new resolution has been formulated and approved by the Board of Governors in which members can be expelled from the Society and forbidden from participating at meetings if they have a known public association with cryonics. It is my belief that my chances of having any additional work presented before the Society is minimal because they know that I am associated with cryonics.
I simply must wait to see if they prevent any more of my work from being presented. At that time I will have to consult with a lawyer and see what can be done. UCLA has paid for my attendance at Society for Cryobiology meetings for a number of years, and the reason that they did that was because our work at UCLA involves the effects of hypothermia on the heart. As a consequence we need someone in the laboratory who is current on the effects of hypothermia on the myocardium and on other tissues as well. It's important to UCLA that I attend those meetings and remain current in that area. Part of keeping current on any endeavor is the opportunity to present research and to interact with others at the meetings -- to experience peer review.
It is also of critical importance to realize that work that's being presented at scientific meetings is considerably ahead of what's being published in journals and books. It's cutting edge stuff -- and that can be essential to providing good patient care in cryonics as well as to a successful professional career. So, I would have to take real exception to being excluded from meetings and membership.
CM: Do you really feel that litigation is a constructive approach here? Do you think that people can, in essence, be forced to cooperate with you?
JL: I don't consider it forcing people to cooperate with me. I consider it trying to prevent people from taking unjust action against me. There's no loss to them as a result of my participation in the meetings of the Society for Cryobiology. But there is a personal loss to me -- professionally -- if I'm unable to attend the meetings. I'm only asking that they cease and desist in taking action against me. The purpose of a scientific society is to promote and disseminate information -- not pass judgment about people's philosophical, personal, or political beliefs.
The legitimacy of my participation, or any other person's, should be judged on the basis of my scientific work. That is the standard that is accepted in science and it is the only standard which should be applied.
CM: Litigation against the Society would be an extremely costly, time consuming, and draining affair. Do you feel it will be worth the effort considering the many other pressing issues which need to be addressed in cryonics?
JL: I think that when you take the overall effect of the kinds of actions the Society would be taking in order to exclude me from membership and meetings and to prevent scientifically valid and useful research information from being disseminated to peers and the public, then I think there are substantial ethical, economic, scientific, and personal issues at stake. Not to fight is to tacitly endorse such witch hunting. It also cuts off our access to minds which have the ability to improve the state of the art with respect to cryonics and suspended animation. I don't think the issues are just personal ones by any means. They are very practical ones as well in the long run.
As to the costs, I have limited funds and I would be willing to commit some of these to such a fight. I would no doubt need help from others: financial support, free legal advice, and so on. How far I would get would depend upon how much support I would get from others in the cryonics community who feel as I do.
CM: What do you feel is the future for cryonics as a whole?
JL: Since I've been involved in cryonics there have been ups and downs. This involves a fairly short period of time so I can't really say what the future will hold. However, there certainly has been a real growth in membership over the last few years and there certainly is more research going on than has ever gone on before in the history of cryonics. Even when we were hitting lows in membership and public interest in the years preceding these last few, the research work continued to advance. I think we're becoming more professional in almost every aspect of our operations and that bodes well for our future. The better our research base becomes, the more convincing our program will become. That should lead to greater public involvement and even faster rates of growth.
Of course, the media have long had a romance with cryonics and I don't see that changing. So, if things continue as they have and cryonics continues to grow, I think its future looks great!
CM: What do you see as the prospects for cooperation in the future between the various cryonics groups?
JL: Well, historically the various groups have always had different individuals who had different philosophies of how to make cryonics work in terms of selling the idea to the public. Cryonics groups have tended to have a single individual which each local group has rallied around. Those were largely personal issues rather than substantive philosophical or procedural issues which determined how the various groups got along.
However, in later years there have been increasing differences based on issues rather than personalities. In particular issues involving investment in technology, doing research, safe practices of patient storage and handling, these began to evolve into real differences.
In Southern California with ALCOR we've tended to push for advancing technology both in terms of perfusion and greater safety in terms of patient storage and handling. I think these advances and concerns will stand us in good stead when we go to the public and try to interest them in cryonics. Others have taken the reverse view that if you can just get people interested in cryonics you can raise the money to pay for the technology. Well, when you're intimately involved in patient care the technological issues become more acutely appreciated.
I've been involved in doing most of the cryonic suspensions which have been done over the past few years and to me those are the critical issues, issues which have to be addressed up front. In other words, we have to show that we can do something before we can convince people that there is a degree of hope and the prospect of success.
CM: So are you saying that you don't see the likelihood of cooperation between the various groups as being good until the underlying philosophical and technical differences are resolved?
JL: I think that cryonics is a scientifically and technologically demanding process. I think it simply cannot be done without using certain minimum standards of technology. If there is anyone out there who thinks that you can rely on future medical advances to restore what you've lost by your lack of technology or effort, there will never be a unified front in cryonics which will form a basis for mutual cooperation. I certainly am unwilling to yield on the issue of good patient care. Anyone who wants to do less than I already know should be done can look elsewhere to achieve unity and political cooperation.
At ALCOR we find it impossible to wait for every cent of money to be raised for research or to do other things that need to be done. That's why a lot of us put our personal money into it. In Michigan they seem to have a point of view which relies almost completely on future technology to make up for their own inadequacies now. That is a view which I find there is no room for agreement with. It is not a view I can accept or cooperate with.
The stated reason for the differences in the level of technology between Northern and Southern California is that the Northern California group has said that when they have enough money to support high technology then they will do so. But until then, no.
CM: In fairness to CI, that's essentially the position they claim they are in. They say they have many retired members who do not have the money to afford the kind of technology ALCOR offers. They do not believe the neuro option is acceptable and they say they would rather accept the extra injury rather than go neuro.
JL: If they're maintaining that it is appropriate to maintain a low level of technology because some of their members cannot afford the higher level then what about the new members that are coming? What about the consideration that the charges being used by everyone else in cryonics are much higher than theirs? Where is their supporting information and data? Where are the case histories and technical information which offer their members the information they need to make a choice about what kind of service they want? People can't make an informed decision in a vacuum.
Their statement that they are willing to back high technology when the money becomes available is acceptable. What is not acceptable is that they are not willing to arrange a cooperative relationship with another organization which already has the technological capability to serve their members. That's a consideration that maybe they should give more thought to. When they start talking about those issues, then we can start talking in a positive way.
In regard to their position on neuropreservation vs. whole body suspension: Historically, neuropreservation has been perceived as the low cost option in cryonics. However, there are those who think that it is perhaps a safer long term method of cryonic suspension due to ease of handling patient storage and the less likelihood of failure of storage systems and so on. It's a complicated issue, but I consider it untenable of them to take the view that the neuro option is not feasible or unlikely to succeed. I've never seen them give any evidence to support their views on that. At least none that was of a scientific or technical nature. The only view I've heard them give was one of a social nature. They felt that espousing neuropreservation would be unacceptable to the public and therefore would affect their ability to deal with the public in terms of acquiring new members.
Since that is contradicted by the reality that ALCOR is able to acquire new neuro as well as whole body suspension members, to me that's a nonissue and one that represents some prejudice on the part of the leadership in Michigan.
CM: Do you have any regrets about your life? About the lives you've taken, your war experiences or about your involvement in cryonics?
JL: I'll start with the last part first. I have absolutely no regrets about my involvement with cryonics and science. I think for the most part that I've probably taken an adequate course to contribute to the history of cryonics and suspended animation. As things have evolved these are activities which are not being pursued by very many and a career in medicine would not have allowed me to pursue these things in an institutional environment. So, my involvement in cryonics has worked out better than if I had taken other courses in a professional life.
As far as my war experiences are concerned I have no regrets about my involvement in the war or the activities that I participated in. The only thing that even remotely would be considered a regret in that respect would be the effect that it has had on my life over the past two years in which I found myself returning to those memories of that conflict. Memories not of activities which I thought were not appropriate, but rather to the feelings that I had about the friends that I lost in that conflict. Secondarily, re- experiencing those losses and dealing with those emotions, which is something I didn't do completely before because of the social environment that was imposed on soldiers returning from that conflict, cost me a relationship, one that I valued very much. The loss of that romantic relationship is something that I'll probably regret the rest of my life. Even so, I do not regret having fought against an organized political system, which, even today, threatens the freedom of its own citizens and those of neighboring countries.
CM: What do you plan to do if this thing really works? What are your long term goals and ambitions?
JL: To be a free man who is allowed to pursue whatever in life allows me to contribute to my wellbeing. I've done a lot of things in the life that I've already lived. I suppose the outstanding things in my own mind about my life are things that have been adventurous in one way or another. I think the things that have impressed me the most have been things which stimulated me both intellectually and physically.
I'm probably like most people who enjoy living. I like to use all my senses. I like to see things that look good, smell things that smell good and use my body and mind to the fullest.
If I wake up in the future some time and I have to get a job on the basis of what I've already done I'd probably become involved in science and technology on some level. Although I would like to have also the romance and adventure that I've already experienced on some occasions in my life -- only more of it and more lasting in the future.
CM: That surprises us a little. We figured you more as a spacedog or soldier/adventurer, solar sail ship captain. . .
JL: I was getting to that (laughter). As a soldier, as someone who has worked in secret military operations and as an assassin I would be able to get a job perhaps as a blade runner (laughter). That would be an easy one for me because that's the kind of job that by its very nature only requires a limited amount of specialized skill and capability. It mostly requires good senses, guts, and physical ability. The environment that you operate in is the only thing that requires specialized training and that can be acquired rapidly. So, yes, when I was asked the question as to what I would be in the future at one of the Tahoe meetings I said that I would like to live long enough to become an Interstellar Smuggler -- such as Han Solo of STAR WARS. That would suit my lifestyle well. Particularly if I could find a Princess Leia out there among the stardust.
Jerry Leaf was cryopreserved in 1991.
See Jerry Leaf Enters Cryonic Suspension.