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We all seek immortality in some way. Death has been one of the prime terrors haunting us since humans first started realizing that every living thing dies and death is permanent. After all, no one wants to face the end of everything that one has been, is, and will be. Indeed, a key feature of many religions is a belief that death is not the end, that there is an afterlife where we will all live forever. In some religions, in the afterlife evil is punished and good rewarded. Even if, as seems most likely, death is simply the end, and the time after death is just like the time before we were born (or, more properly, before our first memories), something that seems relatively benign just thinking about it, emotionally we still don’t want it. Being human, I get it, particularly now that I’m on the wrong side of 50 and, unless I’m far more long-lived than my genes are likely to permit, have considerably less life to look forward to than the lifetime I’ve already lived. I also realize that the number of people who are remembered long after they are gone by anyone outside of their family and friends is exceedingly small—and even that memory fades rapidly among family members. As the succeeding generation dies off, direct memory of the generation that spawned it disappears. I get it. Fifty years from now, it’s likely that all that will remain of my existence will be some scientific papers and a faint memory held by my nieces and nephews and maybe, if I’m lucky, a few of my youngest readers.

I don’t, however, get cryonics.

Detroit, like many large cities, has a free weekly “alternative” newspaper, The Metro Times. This week’s issue features this cover:

MetroCryonic

Yes, it’s a cover story about cryonics. I had no idea that there was actually a budding cryonics industry around the Detroit area. Given the unfortunate decay of my hometown during my lifetime and the brutal winter we endured last year in southeast Michigan, the jokes write themselves. I’ll resist the temptation, however, other than that brief acknowledgment. I’m more interested in the article itself, “MI Cryonics Inst. freezes dead for ‘reanimation’: Souls on ice“. If there’s a movement that resembles religion in having faith in something that doesn’t have evidence to support it, the cryonics movement is it. The article opens by describing a facility in Clinton Township, a suburb north of Detroit, where the body count tops 100, not counting critters, and “nestled inside Wal-Mart sleeping bags, the bodies stand upside-down within 10-foot-high tanks resembling immense white thermos bottles”:

This is the Cryonics Institute, and the people in those tanks — “cryostats,” they’re called — after being declared dead, have had their bodies frozen in perpetuity in the belief that future science may be able to thaw them, cure their ills, and, just maybe, return them to youthful vigor. They’ve made a bet: that in a time yet to come, they’ll rise again, with “death” only a temporary and reversible embarrassment easily remedied by medical know-how.

It’s an expensive bet that is likely never to be won. What struck me most reading this article is the power of wishful thinking, which has led an industry to spring up catering to our most primal fears and desires: Fear of death and desire for immortality. Admittedly, it’s a relatively small number of people. The article itself estimates that worldwide the number of people being frozen after death is “in the low double digits” every year. Out of the billions of people on this planet and the more than 50 million a year who die worldwide, we’re looking at an infinitesimally small fraction of the population.

Be that as it may, there’s no doubt that the technology to freeze living mammals (which is what humans are) has improved greatly and continues to improve. Unfortunately, there remains that problem of revivifying the frozen meat that is sitting in all that liquid nitrogen. Basically, when a person dies, something killed him. It could be disease. It could be trauma. It could just be some unlucky transient malfunction of an organ, such as a sudden arrhythmia that might have been survivable if treated in time or that a person might have had periodically, asymptomatically, for years but that until a single fatal incident resolved on its own. It could just be old age, the “running down” of the body. Even if it were actually possible to revive a frozen body, whatever killed the person would still be there.

Believers handwave that problem away:

“We’re not trying to bring people back to life. We don’t believe they’re really dead; if dead’s final, then they weren’t dead,” says Dennis Kowalski, president of the Cryonics Institute, which claims to have 1,100 living members worldwide. Members pay yearly dues of $120, or $1,250 for a lifetime membership, then about $28,000 when actually frozen. (In comparison, the average adult funeral in the United States costs about $8,000.) For many, life insurance benefits cover the preservation costs.

And:

But death is a gray line, Kowalski says, and it’s always moving. What might have been terminal 150, 15, even five years ago is treatable today. Something as simple as CPR has saved countless lives; cardiac defibrillation — the “shock paddles” used to jump-start a stopped heart — has revived patients previously considered dead. What’s “dead” mean to medicine, other than a challenge? From that perspective, he says, a storehouse of frozen bodies is no more macabre than a heart transplant, a now-common medical procedure once considered grotesque.

It all reminds me of this classic cartoon:

then-a-miracle-occurs

The problem, of course, is that advocates of cryonics never seem to be explicit in step two.

You can see this from the utter nonsense of the example of defibrillation. CPR and cardiac defibrillation can save lives because a fibrillating heart is still alive. Indeed, the cardiac muscle cells are still contracting and have electrical activity; they’re just doing so in a disjointed way that doesn’t produce meaningful contractions of the muscle mass that can produce any pumping power. If you’ve ever actually seen a heart that’s fibrillating, you’ll notice that it’s lamely twitching. Boiled down to its essence, the idea of the electrical shock is to “reset” all the cells to allow the intrinsic electrical pacemakers of the heart to take over and get them contracting in unison again. A heart that’s just lying there is in asystole, which is a state that defibrillation can almost never reverse, so much so that cardioversion isn’t even recommended anymore in the ACLS algorithm for aystole.

That’s why the ability of these interventions to save life rapidly declines with time after cardiac arrest. Within minutes, the heart muscle cells, deprived of oxygen-rich blood, start really dying. Once they do, no amount of CPR or defibrillation will get them working again. Basically, as soon as the heart stops, heart muscle cells start dying, and the more of them that die, the less the chance of getting the heart started again. Before defibrillation, patients only appeared “dead” because death at the time was defined as no pulse, no breathing, and no heartbeat, and the technology to get the heart going again before irreversible damage to the heart muscle occurred didn’t exist. Even so, occasionally people would “wake up” in response to a sharp blow to the chest.

The problem of the dead heart, however, is minor compared to the problem of the dead brain. The brain is highly metabolically active and is thus exquisitely sensitive to interruptions in blood flow. As soon as the blood flow stops from a cardiac arrest, the brain starts losing cells, and it only takes a few minutes before severe and permanent brain damage occurs that rapidly progresses to brain death; i.e., the death of the neurons controlling the “higher’ functions. Sadly, many are the times that patients in cardiac arrest have been resuscitated, only have severe anoxic brain injury (injury due to lack of oxygen) or be brain dead. Granting the fantastical assumptions behind the cryonics movement, specifically that dead people can be frozen and then successfully revived, what about the brain? Everything that defines your consciousness and personality comes from the function of your brain.

Look at it this way. Memory is stored in the neural network somehow through poorly understood protein changes. Freezing usually involves the formation of crystals, which could easily disrupt those changes. If the brain could be frozen without those crystals, theoretically the information might still be there (assuming, of course, that the body was frozen before the brain turned to mush from hypoxic injury). However there remains the question of recovering that information, which inevitably results in cryonics advocates, in essence, appealing to magic in the form of super future technology, most often nanobots. That’s not even counting fixing the physical damage to the brain from hypoxia that occurs after the cessation of blood flow and the freezing process itself, given the number of connections between the many billions of neurons in a single human brain.

Once that’s gone (or irreparably damaged), you’re gone. I like the way they put it in Rational Wiki: “Once you’ve fixed the body cells and the brain paths, you have a recovered corpse. Your next task is to resurrect the dead.” Just count the number of beliefs that are nothing more than wishful thinking in this paragraph:

Right now, though, cryonics is more like an in-progress medical trial. Advances in stem-cell research, nanotechnology, and therapeutic cloning give Kowalski and other cryonicists hope, but he admits there are no guarantees. Today’s frozen people are already dead, or “deanimated,” as some prefer; tomorrow’s helpful scientists will not only have to successfully thaw their “patients,” but return them to life. (And reunite them with their pets, though some are frozen out of generosity, their owners simply hoping to give their beloved animals more life.) That’s assuming, fingers crossed, that they’ve been frozen in a recoverable way, without too much tissue damage, and that they’ve been carefully maintained. Once thawed, they’ll have to be treated for being “dead,” by whatever methods would make that possible. And who wants to wake up alone in the future in a body already ravaged by time? Better to hope that a new, youthful body is waiting for you.

And if wishes were fishes…oh, never mind.

But think about it. First of all, such technological breakthroughs, even in the unlikely event that they were possible, are likely many decades, or even hundreds of years, in the future. If you were frozen and then revived, everyone you know, everything you knew in your life, would be gone. In its place would be a society where you would have no idea how to function and might not even be able to speak the language, given how language evolves over that span of time. Imagine, for instance, being transported back to Shakespeare’s time (in England, of course) and trying to communicate. You wouldn’t know anything that would allow you to make your way in the world. You’d be a curiosity to be studied at best, a burden on society at worst, all of which ignores the question of whether some future society and scientists would even want to revivify a bunch of decades- or centuries-old bodies. They might want to do a few to prove it could be done, but after that each succeeding body would just be another burden. Sooner or later, the scientific interest would wane, as would the desire to devote resources to it.

But what about the science? Cryonicists often point to the widespread freezing of embryos for in vitro fertilization (IVF), and it’s true. That works very well, and the viability rate after thawing is quite high. Of course, for IVF, we’re talking about structures that are usually only eight cells. As a biomedical researcher, I know that it’s quite possible to freeze human cells for cell culture indefinitely and revive them with only relatively small percentages of cells dying. There’s a huge difference between freezing suspensions consisting of single cells or embryos consisting of a cluster of a few cells and freezing a large mammal like a human being. It’s often pointed out that there are cases in which humans have survived severe hypothermia and been revived after warming. Such cases are relatively uncommon (most still die), and I can’t help but note that in no cases that I’ve been able to find has a “human popsicle” (i.e., a human frozen solid) ever survived and been revived.

Let’s just put it this way. Even though some small animals, particularly cold blooded animals like frogs, can survive partial freezing and some insects can survive freezing, that doesn’t mean cryonics is feasible. Indeed, lacking examples of a single decent-sized mammal being successfully frozen and revivified, I have a hard time seeing the promise of cryonics being the least bit feasible. After all, if we can’t even freeze a living animal in liquid nitrogen and revive it, what makes one think we can freeze a dead human and revive him or her? Let’s just put it this way, the plausibility of cryonics doesn’t quite reach homeopathy-level, mainly because it doesn’t require violating well-accepted laws of physics, but that’s the only reason it isn’t homeopathy-level. When Michael Shermer is quoted in the article saying “It is not impossible for cryonics to succeed; it is just exceptionally unlikely,” from a scientific standpoint he is being exceptionally optimistic.

Perhaps what’s the worst about this is that people spend incredible amounts of money, which could be used to make their lives now better or be passed on to their heirs, chasing immortality. Cryonics is not, as its advocates say, an “ongoing medical trial”. Rather, those who choose to freeze themselves are more akin to the ancient Pharaohs, who spent enormous resources constructing elaborate tombs, so that they will one day rise from the grave and live again. Instead, they are found thousands of years later and end up in museums around the world.

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Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.