The Cryonics Institute’s 100th Patient
The 100th patient of the Cryonics Institute (CI) is an 84-year-old man who was a World War II veteran for the United States Air Force. The patient had been a mink farmer for most of his life, but he had a great appreciation for science and the potential of future science. He loved baseball, he loved playing the accordion, and he was fascinated by the thought of intelligent life elsewhere in space. When he developed Parkinson's disease he read every book on the subject he could find. His son would quote his father as the source of an aphorism: "Accurate knowledge is the basis of correct opinion".
The patient's son — who is currently a PhD biotechnology research scientist and entrepreneur — recounts that as a teenager he found his father to be a more fun and interesting companion than his teenage friends. The patient had been favorable to cryonics when discussing the subject with his son, although the patient had not taken the step of joining a cryonics organization. The patient's wife, son and daughter all approved of the patient being cryopreserved.
After World War II the patient had wanted to become an engineer, but schools were flooded with applications from GI's sharing the same ambition, and he faced waiting lists of one or two years. Instead, he applied an engineering approach to the farming of minks, keeping meticulous records and learning how to develop unique breeds. Growing up among so many minks, and watching their short life-cycle, the patient's son developed a keen sense of life, reproduction, aging and death. The son suspects that the neurotoxins in the insecticides his father used on the minks was a major contributing factor to his father's acquiring of Parkinson's disease.
The patient's son gave me a detailed account of the last few years of his father's life, of which I will give a very short summary. With his expertise in the biological sciences and his intimate knowledge of his father's medical history, the son developed a very negative attitude toward most physicians and the medical system in general. Father (while he was still capable) and son worked strenuously against a system that was much too ready to decide treatment is futile and death is imminent. The patient's son said that his father was given a "rap sheet" of medical history that followed his father from hospital to hospital, creating a confusing record of an increasing number of co-morbidities that could easily have misled anyone who looked at it.
In 2008 it became evident that the patient required a new heart valve. But open heart surgery was precluded when the patient developed a cold. Then lymph node inflammation led to a cancer diagnosis and removal of the cancerous node. Despite indications that the cancer had spread, it appeared to go into regression. The heart valve problem led to pulmonary edema, but an valvuloplasty resolved the problem. His father was soon walking, talking & laughing again. The patient was about to be released from the nursing home where he had been sent when a flu spread through the facility. He developed inflammation from the pulmonary infection, and he aspirated on his own vomit. The heart valve problem made it difficult to remove fluid. A physician told the son that his father would be dead within 3 to 4 weeks. When the son complained, the physician asked, "What have you got against death?" The son naturally answered, "What have you got against life?"
The son told the hospital to put his father on corticosteroids, the hospital complied, and his father mostly recovered, although still needed a ventilator. The hospital's cardiologists refused to do heart surgery, insisting that a new heart valve would be of no benefit. And the hospital resisted releasing the patient, saying that moving the patient would kill him.
The son succeeded in getting his father moved to Europe where a heart valve was inserted by pushing it up through the femoral vein (a procedure that is not approved in the US). Within two days of surgery, the patient had lost 30 pounds of edematous fluid, he no longer needed vasopressin, and no longer needed to be on a ventilator. His heart regained function dramatically. He was given a Parkinson's patch that is not FDA approved. The son concluded that the American health care system is much more prejudiced against providing good care to the elderly than the European.
When father and son returned to the US, the American hospital where the patient was sent promptly removed the Parkinson's patch. A larger feeding tube was later required in order to get the Parkinsonism pills into the patient. The patient had naturally low blood pressure (as does his son), and the son believes that attempts to elevate his father's blood pressure to "normal" levels led to kidney problems that forced the patient to require hemodialysis three times weekly. Because of a desire to monitor the patient for dehydration, he was given a Foley catheter that led to a urinary tract infection.
The son constantly struggled to get physical activity and physical therapy for his father. His father's inactivity was leading to decubitus ulcers and muscle degeneration, but hospitals were concerned that if the patient fell when walking that the hospital would be held liable.
The patient's ulcers continued to get worse, and he continued to get infections and sepsis from one or more of his medical attachments. Ultimately, the sepsis killed him. The patient's son and daughter both pressed the hospital to put ice on the patient immediately after death, but it took the hospital over two-and-a-half hours to come to a decision to allow ice. The hospital was FAXed an Alcor hospital protocol, but refused to give tPA, streptokinase or heparin. The hospital also refused to give a post-mortem CAT scan.
Once the hospital began to apply ice, they did so in generous quantities, as did the funeral director. Within 38 hours of the time of death, the patient was packed in dry ice — in compliance with CI's requirement that all post-mortem signup patients be held in dry ice at least two weeks before CI will accept them as a cryonics patient. The patient's son diligently helped his funeral director maintain his father on dry ice for several weeks. The son then drove his father to CI, arriving just before the beginning of the CI Annual General Meeting (AGM) on September 19, 2010.
Needless to say, the new patient and his son elicited considerable interest among many of those attending the AGM. Although the patient's son wished to maintain anonymity for the purpose of this case report, he was pleased to have ten to fifteen cryonics-friendly people watch the cryopreservation of his father. He also permitted photography by anyone, provided that he himself was not included in the photographs.
The cooling box was pre-cooled to dry ice temperature, and then the patient was placed in CI's computer-controlled cooling box with the new Omega controller at about 9 P.M. Sunday evening. The patient was cooled from dry ice temperature (about −80ºC) to liquid nitrogen temperature (about −196ºC) in a 24-hour linear ramp cooling. Cracking (a form of stress relief) is not an issue for a straight frozen patient that is cooled at such a rate because the frozen tissue already has micro-fissures.
|Cooling curve for the CI's 100th patient|
Cooling was finished at about 8 P.M. on Monday, September 20th. The cooling caused a ten inch drop in the liquid nitrogen level in CI's 3,000 gallon bulk tank. At about 24 gallons per inch, the patient's cooling consumed about 240 gallons of liquid nitrogen.
The patient's son watched his father be removed from the cooling box, and become the third patient to occupy cryostat HSSV−6−11. This was a rare case of a close relative being able to witness every stage of cryopreservation, from initial cooling to final insertion into a cryostat.