END-STAGE CARE OF THE HUMAN CRYOPRESERVATION PATIENT
by Michael G. Darwin
Copyright 1994 by Michael G. Darwin. All rights reserved.
This book is intended as an educational tool primarily for those involved in the delivery of end-stage care to patients who have chosen to be cryopreserved. It may also serve as a resource to some patients, their family, and friends. I have written it in anticipation that materials, both written and video, specifically geared towards patient, family and member education on these subjects will flow out of it. Selected chapters are being presented here for criticism and comment. Typographical or grammatical critiques should be submitted in writing on hard-copy to the following address:
10743 Civic Center Drive
Rancho Cucamonga, CA 91730
A Rudder to Guide Us
"From far, from eve and morning
And yon twelve-winded sky,
The stuff of life to knit me
Blew hither: here am I
Now--for a breath I tarry
Nor yet disperse apart—
Take my hand quick and tell me,
What have you in your heart.
Speak now, and I will answer;
How shall I help you, say;
Ere to the wind's twelve quarters
I take my endless way. "
--A. E. Houseman
The unprecedented progress in medical technology has saved many lives that might otherwise have been lost; but it has also imposed on us decisions which never existed before. Fifty years ago, if a man had a heart attack, he was placed in a quiet room and given morphine while his doctor waited to see if he would recover or die. Today, there is a wide range of treatment options, involving a high degree of complexity. Is it an inferior wall infarct? Is the left anterior descending coronary artery diseased? How much heart tissue has been injured, where is the blockage, when did it first occur? Failure to answer these new questions quickly and accurately can cost a physician a large financial judgment. More significantly, it can cost the patient his or her life. We must pay a price, in anguish as well as well as money, if we fail to live up to our new responsibilities as medical decision-makers.
Cryonics, which is based on the seemingly simple concept that a patient who is considered beyond help today may be treatable using the medicine of tomorrow, now creates still more choices. The rationale for cryonics has been discussed in great detail elsewhere (1, 2, 3). Our objective here is to look not at the case for and against human cryopreservation, but at the consequences which medical personnel must deal with when a patient chooses to be cryopreserved.
Currently, physicians are not accustomed to concerning themselves with the state of a patient's brain after legal death has been pronounced. If they are unable to maintain or restore function using today's techniques, they have no further interest in the case--just as a doctor fifty years ago would not have been interested in knowing if it was the circumflex artery that was occluded in a patient who had suffered a heart attack. Doctors naturally restrict themselves to the current state of their art. Those of us who have accepted the logic of cryopreservation do not have that luxury. We believe that the pattern of atoms in a human brain determines whether that brain is potentially functional tomorrow, even though it may not be functional today. Since orthodox physicians are unlikely to share our perspective, it's up to us to make the crucial decisions that may determine whether that pattern of atoms is preserved, and whether cryopreservation turns out to be a success or a failure.
Our decisions begin before a patient dies. In fact, it is our duty to treat a patient in such a way that he or she has a "good death." That may sound like something of an oxymoron, but I assure you, it is not. It is, in fact, the primary concern of this book. To a patient who has no interest in cryonics, the "mode of dying" is of little importance. Death may be faced with courage or valor. The patient may be meticulously prepared or hysterically disorganized. It makes little difference in the long term, since the final outcome is always the same.
Interestingly, there was a time in Western history when people were much more concerned about how to die "properly." Their anxiety was based in religious belief: they wanted to die in a state that would be conducive to salvation and everlasting life. Thus, Jeremy Taylor's *Rules and Exercises of Holy Dying*, published in 1651, suggested that to die in a state of grace and peace would provide greater hope of resurrection in a land beyond. Today, the patient who wishes to be optimally cryopreserved has a similar need, though it is conceived through science rather than religion. The success of a cryopreservation will depend on many factors: finances, biology, medicine, psychology, and even sociology.
This is a difficult sea of choices. Like the mariners of the past who sailed uncharted waters, we lack precise instructions to tell us which course to take; yet we still need some sort of guide. So, like those explorers, we must proceed with a compendium of hearsay and snatches of facts and descriptions of the seas and coasts we may encounter, usually told to us by other travelers who have been only part of the way to our destination. Such gatherings of information were called "rudders" during the great age of maritime exploration, and while they were often imprecise, they could still make a difference between a journey successfully concluded and one that ended in oblivion. My abilities are limited. I cannot take you on the journey into tomorrow that you decide to make each day when you awake and go on living, and I cannot take you to the end of your life and through your death. The most I can do is offer a rudder to guide us: general pieces of wisdom, cautions about rocks and reefs to avoid, and advice on how to weather certain types of storms. I have watched and listened to many different dying people. I have held the hands of those who were happy that they would meet their loved ones in the kingdom of God, and I have cradled in my arms those who looked into my face with hope that they would meet their loved ones through my skills and the untested procedures of human cryopreservation.
I would not pretend that my experiences have taught me even a fraction of what there is to know. But I have learned where a few of the rocks are and how to get through the fog in the night without slipping beneath the waves. In this book, I will attempt to share that information--within the confines of my own prejudices and blindnesses. I share it knowing that it is far from complete, and some of it may even be incorrect. I share it also in the hope that others will correct it and add to it, so that gradually, these waters may become safer for all of us to travel.