Adventures in Bringing Back the Recently Dead
David Casarette, MD 2014
Interesting but flawed book. Doctors are by nature conservative - "first do no harm" - but as the many animal experiments described in this book demonstrates, our traditional methods of learning about biology are destructive. The easiest way to learn what an organ or system does is to break it and carefully observe the results. But since systems get broken all the time, nature adapts, and frequently all this kind of experiment reveals is how the backup system behaves.
The backup system for death is reproduction, which this book does not pay much attention to. When the old never again contribute to the survival of the young, they are surplus to requirements. But with intelligent, creative human beings, sometimes old people make surprising contributions late in life, so blind biological processes cannot determine when the old are useless. Was keeping FDR alive and demented in 1944 useful? Historians disagree, but his entourage and ultimately the American voters thought so. So Roosevelt's doctors kept him alive, and kept the public myth of his health alive also. The tools we have developed (and will develop) to extend the human lifespan will preserve saints and scoundrels alike, as well as the 99% of ordinary people in between. Some of those ordinary old people will never make a discernable contribution, but we are a social species, and our vast network of connections conveys unacknowledged value between unrelated individuals and between generations. This is why we keep old people alive, when it is often cheaper to invest in young or disadvantaged people.
Dr. Casarrett smirks a lot. Perhaps this is to distance himself from the pomposity of the expert, but he editorializes instead of investigates on some things. Like most people, he occasionally observes devices like Automatic External Defibrillators (AED) or training dummies that use information technologies to do amazing things, but he does not draw the dotted line into the future, where information technology will be vastly more capable, and substitute for labor, expertise, and broken biological systems.
This is most glaring when he entirely misses the point of cryonics, "freezing the dead".
Think "film preservation". There are those who want to keep old archived films ageless, the physical object intact forever - which is thermodynamically impossible. Others want to use very good optical systems to make copies onto better designed film stock, which will last longer but still not forever. The "information way" is to scan the films into digital media, which can be duplicated and will persist forever. There are two forms of this, first,"good enough", which preserves the sense of the images and reconstructs artifacts like DVDs from them. The second form, becoming more viable at Moore's Law rates, is a microscopic 3-D examination of the film reel artifact, extracting not just the optical image but the broken-down chemistry that produces it, enabling an extrapolation to the original image before decay, and perhaps to the original 3D physical scene that the cameral and film imperfectly captured. This last examination would provide the most information to film reconstructors, but to really do it right, the scanning would probably be destructive, reaching down to the chemistry within the decaying film.
Cryonics is about preserving information, not about somehow preserving a physical object that can be poked and prodded until it comes back to life. Of course the latter is impossible - the cryonics patient died because they were nonviable, the disruption of metabolism causes further rapid decay before cooling slows it down, and even a perfectly healthy person cannot survive any form of freezing and never will. We are not our atoms - the atoms and molecules are continuously replaced - but a pattern imposed on those atoms, and a robust one. Einstein is Einstein whether he eats kale salad or lamb chops, but his biochemistry (and his health) is very different. While kale Einstein may outlive lamb Einstein, but both will die in the "natural" course of events, probably long before the non-genius centenarians warehoused in nursing homes do.
What about "digital" Einstein? If the Einstein "pattern" can be imprinted on organic molecules from many different sources, can it be imprinted on a younger human body, or a "human 2.0" body engineered for repair and immortality, or perhaps even an electronic "body"? We can imagine a vast set of options, and as we master the atoms of electronics and biology, we will discover many more. If there are a billion possibilities, and 99.9999% of them do not work, a thousand options remain.
We do not have those options today. We will surely have those options, if there are options, within a century of rapid progress. With billions of people working away on those options, no one person can be expected to prognosticate an exact and testable solution in 2015; Dr. Casarett cannot predict what he will eat over the course of a week five years from now, but it is very likely he will eat something.
But to enable those future reconstructions, we need to preserve enough information. We still don't know what is "enough" - personalities change over time, memories are lost or revised, new memories are added or refreshed from documentation. Those of us who save our old writing (and computers make this much easier) are surprised by both the wisdom and the stark idiocy of our youth. Our relationships grow also.
We still do not know with certainty how information is stored, in our brains, in our bodies, in the artifacts we surround ourselves with. Eric Kandel thought (and may still think) that memories are "stored in DNA" (which makes no sense to me!). Gary Lynch at UC Irvine thinks memories are stored in synapses shaped by kinases. This makes more sense, but suggests that mechanical shear on synapses will alter their shape and spacing, and the memories they encode. The severe differential stresses caused by freezing may leave synapses "optically intact", still there at the micrometer scale but irreversably modified at the nanometer scale. Until cryonics researchers look at the "nanomechanics" of synapses, we cannot be sure we are preserving the information image, and cryonics protocols may need to be modified to do that. Different chemistry? Sectioning the brain before freezing? Who knows? We might be lucky, but we do not yet have the measurements.
In a decade, the cost of a transistor drops 1000x. There are more transistors in the $20 USB flash drive in my pocket than existed on planet earth when I was a teenaager, and Apollo 11 landed on the moon. In a decade, the cost of sequencing a genome has dropped 1000000x, and the quest to understand and treat cancer (a DNA disease) will drive the costs down another 1000000x, because we will be sampling and modeling whole patients. Restoring brains after strokes, restoring mobility, hearing, and sight, communicating with locked-in victims, curing cancer, and many other information-driven cures will combine molecular machinery and information science to vastly increase medical capability. That will never enable us to restore a frozen cadaver to life, but it will provide tools that may enable us to extract memories from that cadaver and restore them into an artificial mind, whether biological or computational.
My bet is on the latter. We must not only recreate the mind, we must recreate the environment the mind was adapted to, then evolve that environment towards the fast-changing world we hope to integrate it with. The 200 terawatt biosphere strains to support 7 billion biological humans, but there is 380 trillion terawatts of solar system power to support digital minds. But that is for the future to decide.
But these are speculations about the future, a guide to engineering, not a description of the past and present of resuscitation medicine. Dr. Casarett's book, if you can get past the "entertaining" sneers, is a useful look at the evolution of current techniques, if not a good map of the future.