Generation Cryo: Fighting Death In The Frozen Unknown

Generation Cryo: Fighting Death In The Frozen Unknown

In a vat of liquid nitrogen on storage platform 17, the youngest person ever to be put into cryogenic storage has been waiting for the future for one year and eight months.

Matheryn “Einz” Naovaratpong was two when she was diagnosed with a rare form of terminal brain cancer. “She showed fighting spirit since she was born,” her father Sahatorn Naovaratpong tells me. “Her cry was the loudest in the nursery.”

Einz died shortly before her third birthday. Her parents preserved her at the Alcor Life Extension Foundation in Arizona shortly after. They were accused, over and over, of partaking in a bizarre and misguided form of grieving, and clinging to false hope.

Sahatorn and Nareerat Naovaratpong — both of whom hold PhDs in science and engineering — argue that cryonics is a misunderstood branch of science “at the edge of human limitation,” as Sahatorn says. The parents insist that they preserved Matheryn not for themselves, but for her.

“Einz might have an opportunity to live in the future, but for me, I have lost someone,” Sahatorn says, remembering Einz’s last evening, in the bedroom where she was raised since birth. Sahatorn gave his dying daughter a final dose of anesthesia and turned off the life support system himself.

“Her pulse started to beat faster, and finally came to rest. We were actually apart,” he reminisced. “We didn’t just give Einz to Alcor’s staff and then walk away. We stayed to help, applied cardiopulmonary support, cleaned her body, lowered her temperature, helped with the operation, removed her teeth, and stitched her wounds until 2 a.m. We carried Einz and put her down into an extremely cold capsule. We said goodbye and closed the seal ourselves… It will be very difficult for us to meet again, even in heaven.”

It seems like a rather futile attempt to stave off the inevitable — preserving chilled human remains in a stainless steel dewar and hoping that some future civilisation will develop the technological know-how to revive them. Or further yet, wishing, as Sahatorn Naovaratpong does, that your family “will reunite in a life where diseases and death are no longer in existence.”

Cryonicists are often dismissed as wasteful, selfish, and narcissistic, and the practice itself is often viewed as an eccentric indulgence for wealthy people with a profound fear of death. And genuine concern exists about the feasibility and viability of cryonics. But as more and more families take the leap into the frozen unknown, there are practical concerns — legal rights, money, consent. And lurking beneath the surface, there is a different fear — that cryonics might just actually work and that signing up for cryonics might be the most insanely rational decision you will ever make.

The hot, arid climate of Scottsdale, Arizona, might seem an unlikely setting for a modern version of the fountain of youth. But amidst the cacti and scorpions, in an inauspicious building in a light industrial park with a dusty desert garden out front, is Alcor, a company that’s been cryogenically preserving people since 1976.

Alcor is your basic run-of-the-mill office space, except for the operating room and a rather unusual storage area out back.

Longtime futurist Max More, Alcor’s current president and CEO, is sheepish about the facility’s austere appearance. A tall and imposing figure, More speaks with a slight English accent. He says he hates the current grey flooring, and that he’s like to get it painted a dramatic, bold colour. He worries that the facility is “too industrial looking” and not quite “science fictiony” enough.

To make up for any perceived cosmetic deficiencies, More installed blue floor lighting in the Alcor Patient Care Bay to give it a cooler, sleeker look.

Generation Cryo: Fighting Death In The Frozen Unknown
Dewars in the Alcor Patient Care Bay.

Dewars in the Alcor Patient Care Bay.

The Alcor Patient Care Bay is a kind of shrine — a small warehouse where people often come to visit loved ones. Visitors to the facility are immediately greeted by a recursively reflecting “infinity mirror.” Framed photographs line the wall commemorating the 148 human beings — and 33 unwitting animals — who have opted for a chance to live again, with about one to two new members added each month.

Eventually the surface of each dewar — the tall stainless steel vats (More calls them “giant thermos flasks”) in which the bodies are kept — could be equipped with a video screen displaying pictures and video of the people contained within, but More admit’s that’s just a thought. He’s even toying with the idea of having soft, funeral home-like music play in the background.

Alcor is the first and largest cryonics firm in the world. Its only true competitors are the Cryonics Institute located near Detroit — a 7,000-square-foot facility that currently hosts 100 preserved individuals — and CryoRus near Moscow — the world’s first cryonics firm based outside the United States, and home to 51 corpsicles. More has bigger plans. His team is currently planning an expansion that would allow Alcor to store over 1,000 preservations.

Futurist Robert Ettinger came up with the idea of cryonics in the 1960s, but it was Frederick and Linda Chamberlain who formed a nonprofit organisation in 1972 dedicated to cooling recently deceased people down to liquid nitrogen temperatures, and maintaining their bodies until it was possible to “reanimate” them. They called their new California-based organisation the Alcor Society for Solid State Hypothermia — “Alcor” being a faint star in the Big Dipper.

After dealing with some uncomfortable political squabbles and bureaucratic hurdles in California, the organisation moved its operations to Arizona in 1990. Arizona offered a stable environment, free from earthquakes, floods, and other natural disasters, and state laws that were more amenable to Alcor’s unconventional activities. The institute has been in Scottsdale ever since. Mayor Jim Lane attended Alcor’s most recent conference, and in 2004, Secretary of State Michelle Reagan helped Alcor defeat a proposed bill that would have placed it under the regulation of the Cemetery board.

Alcor may be a not-for-profit 501(c)(3), but it needs to be profitable to survive, and to ensure the long-term prospects of those preserved at the facility. The core staff of Alcor — all of whom are signed up — have a vested interest in the success of the company. More says, “We want this for ourselves.”

Registering with Alcor comes at a price. A whole-body preservation costs upwards of $US200,000 ($262,018), while a head-only preservation costs $US80,000 ($104,807). Membership dues are $US525 ($688) per year. About half of all members have opted to have their brains preserved following clinical death, figuring that the scientists who revive them will provide them with a new body. For some, it’s only the brain — the seat of our memories and personalities — that really matters.

To help pay for it, most clients take out a second life insurance policy and name Alcor as the beneficiary. To ensure that Alcor can take possession of the deceased, clients donate their bodies to the organisation for scientific study.

But not everyone can afford life insurance, and life insurance companies have a habit of staying away from people with terminal illnesses. In 2013, Kim Suozzi, a 23-year-old neuroscience student, was diagnosed with terminal brain cancer. “I want to be cryogenically preserved when I die from brain cancer but can’t afford it,” Society for Venturism launched a fundraising campaign on Suozzi’s behalf, and Alcor eventually took it on as a charity case.

“We want to combat this idea that we’re freezing dead bodies,” More says. Alcor’s patients are “basically in a deep coma, but without any metabolism,” he explains.

And yet, very few people are actually ready to go the distance. Around 2.6 million people die each year in the United States. Alcor, the world’s leading cryonics institute, has only 1,569 full members after four decades — and that includes the 148 patients currently in cryostasis.

Undaunted, More says that there will be a tipping point, that cryonics will “eventually be the norm” and even “a regular fixture of medical care.” He sees hospitals of the future having the expertise and facilities to perform their own cryopreservations. He compared the slow buy-in to the length of time it took germ theory and open heart surgery to be accepted.

“The current problem is that it’s hard to sell something without a guarantee,” he says. “We make absolutely no promises about our offering — and in fact, we even provide our clients with a lengthy list of all the things that could go wrong.”

A surprising number of things can and do go wrong, from the moment death is declared to the lowering of a body into the shiny dewar.

Generation Cryo: Fighting Death In The Frozen Unknown
Prior to cryopreservation, a recently deceased patient is placed in an ice water bath, and blood circulation and breathing are artificially restored by a heart-lung resuscitator (HLR). This image shows a model that’s used to demonstrated the process.

Prior to cryopreservation, a recently deceased patient is placed in an ice water bath, and blood circulation and breathing are artificially restored by a heart-lung resuscitator (HLR). This image shows a model that’s used to demonstrated the process.

With advance warning of death, a standby team is dispatched to wait until clinical death has been declared. Within seconds, the patient is placed in an ice bath to start cooling, and a mechanical respirator is used to restart circulation. The goal is to maintain normal bodily processes, even after “clinical death” has been declared. Decomposition starts almost immediately.

The team then administers 16 different kinds of medication, including propofol to suppress consciousness in the event that cardiopulmonary support unintentionally revives the patient. Even at this early stage in the process, the line that divides life and death is blurred. The other medications work to reduce metabolism and stave off other problems that occur when the body stops functioning. The idea isn’t to freeze the body, but to take it down to slightly above the freezing point of water to prepare it for transportation to Alcor.

This is the ideal scenario, but there can be catastrophically long delays. Each passing hour or day following clinical death means preservation will be that much lower in quality. As Alcor likes to say, “Time is trauma.”

Sometimes, disapproving family members deliberately refrain from alerting Alcor that one of their clients has passed away, in direct violation of the recently deceased’s wishes. In an attempt to resolve this recurring problem, the company has crafted a Relative’s Affidavit — a family member’s promise to cooperate and support the preservation process to the best of their abilities, and not sabotage the wishes of their departed.

If a person was crushed by a streetcar, there may not be much left to preserve. Likewise, an autopsy will almost certainly result in a seriously compromised cryopreservation. And if the person died of an aggressive brain tumour or neurodegenerative disorder, any memories or aspects of personality that were damaged by the disease will almost certainly not be restored at a future date. Memories are data on a floppy disc. Future scientists may be able to restore the cognitive functions of a disease-ravaged brain, but any memories that were lost during the course of the disease will be gone forever. It’s akin to losing photographs in a fire.

Once the body arrives at Alcor, it’s quickly taken to the operating room, where surgeons drill burr holes into the skull to assess the quality of circulation. For whole-body preservations, surgeons connect all the major blood vessels of the heart to a heat exchanger (a device that lowers the patient’s body temperature to a few degrees above the freezing point of water), and a perfusion machine, which delivers chemicals to the body. The idea is to wash out the body’s blood and other fluids as quickly as possible, and replace them with a cryoprotectant. This high-tech gel is gradually added to the body to prevent ice crystal formation — the mortal enemy of biological sustainability. Ice crystals are like tiny knives that stab away at cells, disfiguring their shape and disrupting the connections required for normal organ function. Cells that have been severely damaged by ice crystals basically look like useless piles of mush. Cryoprotectants prevent this. When the body is lowered to liquid nitrogen temperatures, the gel causes the patient to become “vitrified,” which means they have been transformed into a glass-like state, and free of ice crystals.

The quality of this process varies according to the state of the patient. Things tend to go smoothly for people with a fully-functioning circulatory system, but for others, who have had prior surgery or other conditions, this can lead to less than ideal conditions. Aneurysms and bleeding in the brain are not good.

Neuropreservations basically involve the same procedure, but the head is removed from the body on the operating table. Then the head is placed in a holding chamber that looks like something from a medieval torture lair. From an upside down position, all fluids are removed, and a cryopreservant is added.

After this stage, the body (or head) is transported to the Patient Care Bay in preparation for cryostasis; each dewar can accommodate four whole-bodies and five “neuros.” Whole bodies are lowered head down into the dewars, and the neuros are placed in a vertical row along the center of the cylinder. Liquid nitrogen is slowly added to bring the body down to optimal temperatures.

Generation Cryo: Fighting Death In The Frozen Unknown
Alcor’s Operating Room.

Alcor’s Operating Room.

After that it’s a matter of maintenance. The “thermos flasks” don’t require any electricity and are strong enough to withstand gunshots. The dewars are topped up with liquid nitrogen once a week, but they could actually sustain a body in cryostasis for six to eight months without any replenishment or external intervention. To ensure that Alcor can continue operations in a power outage, a backup generator provides 30 hours of electricity.

Security is another concern. Cameras line the exterior, and More has a video screen in his office where he obsessively monitors the perimeter of the facility. During my visit in May, More asked us if the photographer and myself had any weapons prior to entering the Patient Care Bay. It seemed a bizarre question given that we were — technically speaking — about to enter a room filled with dead people.

The Naovaratpong family last visited the facility in October of 2015. They spoke with More and the Alcor staff about science and related matters for a while, and they were content to keep the conversation formal. Once they entered into the Patient Care Bay, the mood shifted.

“The staff pointed towards storage platform number 17,” Sahatorn tells us. “I brought my family to attach Einz’s picture and knelt in front of the platform. The feeling of being a scientist was suddenly gone. My hand touched the cold, flat, steel sheet. My ears were deafened. The tears ran down my face, reminding me that we are all human.”

More hasn’t had the heart to take down Matheryn’s picture. It remains the only photograph posted on an Alcor dewar.

When Einz’s father, Sahatorn Naovaratpong, was child, the air pump in his family’s aquarium stopped working, causing the fish to suffocate. Thinking quickly, his parents put the fish in the freezer to buy themselves — and the fish — more time.

“Many of the fish had stopped breathing for hours,” he says. “But we were able to revive them.”

Later, when he was less than 10 years old, he tried the same thing, but with flies. When the young Sahatorn brought them out from the cold he thought they looked like a bunch of dead insects, but many of them sprung back to life. “It’s not strange, therefore, for a kid who grew up on a path towards science to learn about cryonics and to know about an organisation like Alcor.”

As his daughter neared death, Sahatorn told his wife that they should have Matheryn preserved at Alcor. His suggestion was not received well, but Nareerat was eventually swayed by her husband’s insistence. She says it was a very difficult decision.

Once she made up her mind to have Matheryn preserved at Alcor — a decision she says was motivated purely by the power of reason — she had to explain it to the rest of the family, a process that took many months. Eventually, “everyone accepted and was prepared to be united in bringing Einz into the future.”

“We are Buddhists,” Nareerat says. “In general, we worry about life after death, which is no different than other religions. However, in the end, I decided to go with cryonics because of one particular teaching from the Lord Buddha: ‘Believe when there is a reason to believe, otherwise that belief will lack wisdom.’”

Alcor prides itself on transparency and commitment to “evidence based cryonics,” and it publishes detailed case reports for each preservation. These reports, which are freely available online, include notes about deficiencies and problems that happened during the process. Despite Alcor’s strict protocols, there’s no proof that its method of cryopreservation is actually working. For all we know, every single person at the facility is a goner.

Generation Cryo: Fighting Death In The Frozen Unknown
Alcor Max More holds a model of a dewar.

Alcor Max More holds a model of a dewar.

Alcor has published micrographs of cryogenically preserved brain cells on its website, and claim the images “demonstrate good structural preservation with dehydration artifacts, but no ice damage.” But as More himself admits, they haven’t been able to prove that the neural connections have remained intact, though he remains hopeful.

Kenneth Hayworth, president and co-founder of the Brain Preservation Foundation and an expert in the burgeoning science of connectomics, is critical of Alcor’s micrographs.

“It seems true that they don’t have ice damage, and that they show dehydration, but they also show a range of other damage,” he tells Gizmodo. “There is a reason that their methods have never been published in a peer-reviewed journal — they would be laughed at. And this is the best that their method could produce in an ideal laboratory setting on an animal model?”

By comparison, Hayworth pointed to a recent breakthrough by cryobiologist Robert McIntyre and his colleagues at 21st Century Medicine, who used a chemical compound to turn a rabbit’s brain into a plastic-like substance, and then cool it down to -211 degrees Fahrenheit (-135 degrees Celsius). The new technique, called Aldehyde Stabilised Cryopreservation (ASC), not only won the Brain Preservation Foundation’s Small Mammal Prize, but also demonstrated the feasibility of near-perfect, long-term structural preservation of an intact mammalian brain. Hayworth says that chemical fixation, in conjunction with cryonics, is the future of brain preservation, and that Alcor has it all wrong. As Hayworth said at the time, “This is not your father’s cryonics.”

Alcor, on the other hand, steadfastly believes that chemical fixation is a catastrophe. The process uses aldehyde to fix the brain in place, preventing any shrinking on account of dehydration (a serious problem during the cooling process). More says this is a big no-no because it’s irreversible, and that this “destructive” form of preservation is not a true form of survival. He and others believe this process will essentially kill the individual — and all their biological bits — for all time. More admits that the resulting brain scans could help future scientists reconstruct an individual, but many Alcor members argue that it would be a mere copy of that individual. “Not a lot of people will accept that,” he says.

More insists that it’s important to preserve a person’s biological stuff and not turn it into some kind of inert material. That said, his organisation still needs to show that it’s possible to preserve a brain such that its neurons and memories remain intact. “We want to be able to say, look, we are preserving that — and we’re preserving the brain in a way that’s reversible, yet without the chemical fixation.” More says. Alcor is already doing this, but it may take years to actually prove it.

Aschwin de Wolf, the editor of Cryonics Magazine and CEO for Advanced Neural Biosciences, says it’s good that Hayworth and others are holding Alcor to a high standard, because it pushes the science of cryonics forward. Having said this, he worries that Hayworth is rehashing old misconceptions about Alcor’s techniques.

“For a long time cryonicists were criticised for causing ice formation in the brain and now that we have eliminated this phenomenon through vitrification we are told that electron micrographs do not look like controls yet,” de Wolf explains to Gizmodo. “We know this!”

He says Alcor is aware that the use of modern vitrification agents causes undesirable dehydration in the brain, but for a while it was thought that this was the price to pay for elimination of ice formation.

“This is no longer our belief,” he says. “Modern vitrification agents do not cause cerebral dehydration because of their [chemical] properties as such, but because most cryoprotectants have poor blood brain barrier penetration.”

According to de Wolf, Alcor has solved the problem of brain shrinking through the use of blood brain barrier modifiers, and it’s currently doing research to see whether such agents produce superior electron micrographs without sacrificing viability.

“Hayworth’s position seems to be that a cryonics organisation should only offer cryopreservation services if its electron micrographs are indistinguishable from controls,” de Wolf says. “That seems an extreme and ethically troublesome position to me. As long as we have good reason to believe that the original state of the brain can be inferred from the altered state, offering cryonics services is not only reasonable but an ethical mandate.”

Like the Naovaratpongs, other families are prepared to make a similar leap into the future. Among them is cryonicist and transhumanist Shannon Vyff. She, along with her husband and four children, ranging in age from three to 19, are all signed up. Aside from her 17-year-old son, who has recently developed a more cynical take towards cryonics, the family is enthusiastic about the prospect. As Vyff told Gizmodo, the kids think “it’s just what the family does.”

Vyff stresses that they’re a normal family just like everyone else. But they happen to have this “nice little thing working in the background.” She says that cryonics doesn’t offer her a sense of comfort, but she remains hopeful. What does worry her, however, is a difficult preservation in the event of an accident, or a botched preservation. “Cryonics doesn’t make anything easier about our thoughts of death,” she says.

The revelation that parents are signing their children up for cryonics inevitably brings up the issue of consent. Alcor doesn’t require informed consent from cryo-bound kids, but they become adults, they’re free to withdraw. Vyff doesn’t see this as a problem, saying that parents are obligated to provide medical care to their children and to keep them safe.

“If one of my children under the age of 18 suddenly died, I would do what I could to give them another chance,” she says. “I would like to give my kids the opportunity that future medicine has to offer.”

Vyff and her husband believe there’s a very good chance that cryonics won’t work (at least in its current form), and it’s an opinion they don’t hide from their children.

“It’s certainly not something I would express to my kids as a guarantee,” she says. “I still don’t know how my kids are going to turn out when they’re older. They’re their own people, and they’re going to be making their own decisions. I don’t expect all of my kids to keep on being cryonicists, but I would be happy if all of them were.”

Robin Hanson, an economist at George Mason, has been an Alcor member since the 1990s, and he says it rarely crosses his mind. “It hasn’t occupied very much of my attention or thought over the years,” he says. “It’s not some kind of part-time job that requires your constant attention.” Simon Smith, a Toronto-based digital health marketer, husband, and father of two, has been an Alcor member for nearly a decade, and he concurs. “I think it’s like a life insurance policy,” he says. “A lot of people have life insurance policies, but they don’t walk around thinking about them everyday.”

Smith is disheartened at the slow pace of technological development. An avid futurist and life extension advocate, he’d like to see more emphasis placed on technologies that will prolong human life, whether it be advances in pharmacology, biotechnology, molecular nanotechnology, or improvements to cryogenic techniques. But he remains optimistic. “The odds of reanimation being successful are better today than they have ever been and are continuously getting better,” he says, “while the odds of coming back from burial, cremation or every other alternative remain the same.”

Outside of the cryonics community, few people are behind the futuristic endeavour. In January of 2013, when io9 A row of dewars in Alcor’s Patient Care Bay.

The fact remains, however, that traditional burial and medical treatments are already expensive. The same criticisms aren’t often leveled for pursuing the latest medical treatments for debilitating and terminal illnesses.

“What about cancer?” More proposes. “If someone says they’re going to do everything they can to beat their cancer, such as chemotherapy and experimental drugs, virtually no one questions it.” He says that people resort to extreme measures to prolong life, spending copious amounts of money on health care, and that most money is spent on the last stages of life. “Yet few argue against that.”

There is a disconnect between conventional medical practices and the emerging field of cryonics. Holding onto hope before death — no matter how futile, medically speaking — is more socially acceptable.

Others worry that a reanimated patient will have no friends or family to return to, or have no financial or social assistance to help them reintegrate into society. More calls this “the big move” and compares it to immigration, or an aboriginal culture integrating itself with a modern society. To alleviate the future-shock and potential loneliness, he suggests that people “get their friends and family to join,” which is both a good point and a convenient sales pitch.

Alcor has put together a common Patient Care Trust Fund for everyone preserved at Alcor, and it’s currently sitting at about $US10 ($13) million. This kitty is accruing compound interest and it should double in size every 20 years or so. If all goes well, and assuming that Alcor is still around in the far future, More says the money will be used for the repair, revival, and reintegration of patients. It’s also possible for patients to keep their own hard-earned assets in their own name, even after death. Theoretically, they can claim this after they emerge from their lengthy slumber.

All of Alcor’s cryopreserved “patients” are technically dead. They have no rights, and are not regarded as persons. This could change in the future. If it can be proven that cryonics prevents irreversible damage to the brain so it can be revived, then a strong case can be made that the individual is still a person deserving of rights.

Such a scientific and cultural shift would be unquestionably unsettling, and it may account for much of the vitriol directed at cryonics. More says that people instinctively react against cryonics as a “psychological immune reaction” to death, having internalized mortality to the point where its presence is unquestioned.

“Any attempt to deviate from this norm — this idea that cryonics is somehow ‘unnatural’ or a kind of perversion — leads some to believe that any person who would support such a thing must have something wrong with them,” More says. He says that the effort to stave off death is “making people really uncomfortable.” The real issue, he suspects, is that people are afraid of a world where cryonics actually works.

For Sahatorn and Nareerat Naovaratpong, cryonics is just another branch of science. “In another decade, we will no longer be debating this as something that’s true or false,” Sahatorn says. “For us, although Einz’s story was sad and criticised worldwide, we did it for one of the most special children in the world — and in spite of human limitations — and for that we’re grateful, and we will love her forever.”

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