You’re Not Dead Until Your Brain Is Beyond Repair and Everything Before That Is Negotiable | Ep. 360

When we declare someone dead today, what we're actually doing is kind of making a bit of a mistake. Just like in the past when people stopped breathing, the heart stopped beating, back then we just said they were dead because we didn't know what else to do. We didn't have CPR, we didn't have defibrillation. But today, you know, we know that that boundary is a lot more blurry than we thought. So our point is that you're not truly gone until the brain has deteriorated beyond the point at which some future technology could repair it.

Hey everyone, Dr. Gladden here. I just finished a podcast interview with Max More. PhD. He's a devout transhumanism gentleman philosophically, which really is about how humans continue to expand and grow and do more and bring technology along, et cetera. Not terribly spiritual, but still expansive. He also is very involved in biostasis and cryopreservation, and it leads to some really interesting conversations around cryopreservation, where we are, what we do, things like that. So I think you'll enjoy this podcast.

He went from saving hearts as a cardiologist To rewriting the entire aging playbook. Dr. Jeffrey Gladden believes 100 is the new 30, and he's got the science to back it up. This is the Gladden Longevity Podcast.

Welcome everybody. Max, it's good to have you here on the Gladden Longevity Podcast.

Good to be here. Thank you.

So, you know, you're in an interesting space. Tell us a little bit about how you kind of evolved into transhumanism and philosophical points of view that you've developed. Where, where did that start for you? Were you always very thoughtful as a child or something you did? Yeah. PhD?

Yeah, no, this, this comes up a lot because it's a little hard to explain my interest from my background. My, you know, my family was pretty conventional and didn't really think about these ideas at all. I didn't actually have a very academic family. My grandfather on my mother's side was the only person to go to university before me. So yeah, it was a little unusual, but I got interested in, in health in a very early age and actually specifically in life extension by the time I was probably 13 or 14. I was taking supplements and exercising, which I still do. So it became very early for me and it really formed Formed part of my basic philosophy, which I call the philosophy of extropy, essentially a philosophy of overcoming limits, of continually improving ourselves. And of course, life extension and health get very much into that. So I developed a kind of philosophy of transhumanism around that and practicing life extension and biostasis or cryonics as a backup option in case, in case I don't live long enough until we reach longevity escape velocity, which at my age of 62, I'm not that optimistic about right now.

Oh, okay. Well, that's interesting. I just finished an interview with Aubrey de Grey. before I jumped on this, and we were talking about escape velocity. He thinks it's sometime in the next 10 to 15 years, so maybe sooner. So maybe there's, you know, maybe there's hope for you.

I hope so, but I'm kind of skeptical about that because I've, you know, I go back into the 1970s and '80s and see similar claims back then. And of course, Aubrey does make his claim somewhat conditional. It depends on the funding. It does seem like funding is definitely increasing a lot these days, which is encouraging. But, you know, my point is that we still haven't seen even a 1-year extension in maximum lifespan. Nobody's beaten the record from 1997. It's still 122 years or so. So, you know, it's basically asking us to believe it's going to happen all at once quite rapidly. And that's possible, but I'm also a little skeptical about the current abilities of AI to solve fundamental problems like this. So I would love to believe that because that put me into my 70s and I'd rather not get older. But I'm skeptical. I'm certainly going to work very hard at staying alive and healthy, but I also have my biostasis backup option.

Okay. Well, let's talk about your backup option because it's an option that we haven't really talked about here on the podcast before, which is cryopreservation, if I'm not mistaken. And you were involved with Alcor. Alcor, I think it was. Do you want to talk to us a little bit about cryopreservation, kind of how you got involved with that?

Yeah, so I've actually been involved with cryonics, or more generally biostasis. Let me just make a distinction here, because biostasis is the preferred term these days. It includes cryonics. Cryonics is basically human cryopreservation, but there are other methods of preservation like chemical fixation, which can be used instead or in combination. So biostasis is sort of the broader term. But yeah, I've been involved for over 40 years. I started the first cryonics organization in Britain back in 1986. I also ran the Alcor Foundation, the current largest cryonics organization for almost 10 years. And I'm still active in that area. In fact, I just wrote a book on the topic that I have an agent now looking for a publisher. So hopefully it'll be out fairly soon. It's a very complex issue, but the basic idea is pretty simple. Basic idea is that when we declare someone dead today, what we're actually doing is kind of making a bit of a mistake. Just like in the past when people stopped breathing, the heart stopped beating, back then, we just said they were dead because we didn't know what else to do. We didn't have CPR, we didn't have defibrillation. But today, you know, we know that that boundary is a lot more blurry than we thought. So our point is that you're not truly gone until the brain has deteriorated beyond the point at which some future technology could repair it. And if we jump in very early, as early as possible, like preferably seconds after legal death has been declared, and start cooling the patient, introducing various chemicals to protect the cells, and then eventually store them at super cold temperatures, the tissues are going to be unchanging, just like, you know, we have millions of people walking around today who are cryopreserved as embryos at some point. We have cryopreserved skin and heart valves and corneas and so on. So it's just more complex. We can't, we can't reverse that process today because it requires a very rapid warming, which is difficult in large bodies of tissue. But we're making progress along that way. We have some very direct evidence that under good conditions, we are actually preserving the ultrastructure of the brain in which our memories and personality reside. So it's certainly not a guarantee, and I always emphasize that it's a long shot. There's no guarantee here, no promises, but it seems like something worth doing if otherwise you're not going to continue living if you're still enjoying life.

It is an interesting point you make that everybody is familiar now with, you know, in vitro fertilization, cryo storage of embryos, right? People will say, well, I have 4 or 5 or 6 embryos in storage, or, you know, this kind of thing, right? And we really kind of take that for granted, as it's just, you know, matter of fact. It sounds like what you're saying, though, is that the difference is that it's easier to uniformly warm an embryo than it is to uniformly warm a larger body. Is that right?

Or a slice of tissue. Yeah. So currently, the state of the art in terms of reversibility, and you can see this at 21st Century Medicine in California, University of Minnesota, has repeatedly and reliably managed to cryopreserve rat kidneys and then rewarm them successfully so they function. And 21st Century Medicine done even more difficult with rabbit kidneys, which are larger. So we're talking about whole mammalian organs which have already been reversibly cryopreserved. So if someone comes along and says, well, you know, cryonics is crazy, it's impossible to cryopreserve the brain, well, they could have provided a good argument because we can see that we can already do this with organs. But to do a whole organism— Yeah, the problem is you have to rewarm at a very rapid rate. It seems strange, but there's a phenomenon called recrystallization. Essentially, as you warm up from cryogenic temperatures, ice crystals can reform and do a lot of damage. So you have to warm very rapidly. And there's various, you know, radiofrequency, nanowarming, there's a number of different methods being But that's the reason why today we couldn't bring back someone who's been cryopreserved, even if they're under very cryopreserved, under very good conditions. But it doesn't mean that, you know, in the future, as we have better repair technology, maybe some kind of medical nanotechnology, hopefully we can go in there, fix the problems. And of course, there's no point doing this until we fix the aging problem, because if you get cryopreserved when you're 90 years old, you're obviously not going to last too long. So you would have to await till we actually beat the aging problem too.

Sure. Well, it is interesting. If you're heating them up, they would go through a phase where they would develop the ice crystals, whereas with the preservatives you have, they're kind of in just a static state. I can imagine if you overheated them too, you might vaporize water also, potentially, or—

Yeah. Well, you've got to, you definitely got to optimize the rate. Yeah. But, you know, we're getting a lot of, a lot of knowledge because there's a lot of research going on to this area. If we could reliably cryopreserve human organs, for instance, it would save, you know, tens of thousands of lives a year, at least maybe it's in the hundreds of thousands, just in this country alone, because right now it's very hard for you to get a kidney or a heart or a liver across the country rapidly, keeping it cool in time to be transplanted. But if you could actually cryopreserve them, keep them in a cryobank in the hospital, pull them out as needed, that will be, you know, a massive benefit. So we're relying on the same kind of research that's advancing that. So it's, you know, it's, it's, it's very much part of the mainstream. It's just that we have a bit more of a vision of how we could apply this to the whole person.

Yeah, you're probably familiar with the company Extherma.

Yeah.

It's involved in preservation of organs for transplant and stem cells and things like that.

Yes, I know Shaozhe, I think, is one of the leading people in that company.

Yeah, that's right.

Yeah, that's right.

Yeah. So that's interesting. They're working in that area. So tell us a little bit about your philosophy of continued expansion for the human. I don't know what you know about us, but our view of longevity is that it represents the greatest opportunity that humanity has ever had to actually upregulate or upgrade the human experience. It's not just extra years, right? So the goal for us is, you know, to develop a 30-year-old body and a 300 or a 3,000-year-old mind. Yeah. Right, with all the wisdom, insight, perspective, etc. That goes along with that. Tell us a little bit about your philosophy of continued improvement. How does that kind of play out for you?

Well, I call it the philosophy of extropy, which is a term that my friend Tom Mill came up with, which just fit it very nicely because, of course, in physics you have the idea of entropy, which means in a closed system when there's no energy coming in from the outside, that system will tend to decay and fall towards disorder. Of course, the Earth is not a closed system because we have The sun coming in. That's why we have life here. But yeah, so it's not meant as a technical term. It's sort of, it's not a technical opposite of entropy, but it basically is sort of a metaphor for increasing energy, vitality, intelligence, all the good things in life. And it's essentially, you know, it's a philosophy that says we should question these limits. Just because we've always had aging and death in the past doesn't mean we always will in the future, right? We always had slavery for thousands of years too. We didn't have democracy for thousands of years. So things do change. And, you know, very much what the perspective you put forward, we can do something about aging. We should, because imagine having a life where you remain Absolutely vital and perfectly good health, perhaps even better health than we have today possible. But you're acquiring knowledge and wisdom over hundreds or thousands of years and becoming what I like to call an ultra mature person. You're not going to be static because we're going to be changing and improving ourselves in various ways. And a lot of people just kind of scratch their heads about that because they have a very static view of life. They seem to think that you know you're going to run out of things to do. I recently debated this guy Ezekiel Emanuel. I don't know if you've come across this fellow. He was one of the architects of Obamacare. He's a The most widely cited bioethicist, apparently. And he wrote a piece for, I'm not sure if it was Time magazine, one of those magazines, basically arguing that we should let ourselves die at the age of 75. And I debated this guy earlier this year. It's just a very strange view to me that, you know, my wife is already 76, so she takes offense at that suggestion.

Mm-hmm.

I'm not that far away. People seem to have this very narrow view of life and possibility. Like, you're not going to run out of things to do in 100 years or 1,000 years. I could right now, right now sit down and write down things to keep me busy for, you know, many hundreds of years. And by then there'll be many new things to do. So I really find it strange that unless someone's, you know, really depressed or unhappy or disappointed in their life, why would you not want to carry on living, given we're talking about good health? Because people would make that mistake. They think we're talking about keeping people alive in misery. No, it's not what we're talking about at all.

No, that's right. Yeah. It's interesting when you ask people, do they want to live to be 100? Most people say no, because their concept of what it would be like to be 100 is, you know, not a pretty picture, right? So, but if you say, what would it be like if you could live like you were 30, you know, for the rest of your life? And everybody wants that, right? Everybody wants youthfulness. And we can relate to that. We know what that is. You know, it's interesting. I think we're coming to an interesting point around purpose and meaning, right? I think the reason, and maybe AI will have an impact on this, if jobs are removed or things like that, there could be a crisis of meaning for many people because for many people, their job, their families, raising their kids, those provide meaning for them. It sounds like for you that you found a sense of purpose and meaning beyond the routine things. I don't know if you want to speak to that at all.

Yeah, I'm actually fairly optimistic. I think that, you know, people like to argue that AI is different than everything else, but there've been lots of technologies throughout history that have displaced people from various jobs. But we've never actually, you know, but we always get new activities. There's no fixed amount. It's kind of an economic fallacy. There's a fixed amount of stuff that we want or a fixed amount of labor. Right. So I think as long as we're flexible and willing to do some different things, there's no particular reason why we shouldn't have work if we want it. It may be that, you know, AIs, if they are super productive and super intelligent, which I don't actually see happening in the near future with the current forms of AI, but even if they are, It may be that we don't have to work if you want a decent standard of living, but people will still want to. And I think there'll be plenty of room for people to collaborate with AIs to do much greater work than they could do alone. So, and also the current figures, you know, despite, I think, head of Microsoft or one of the top people at Microsoft said a while ago that by 2028 or something, like half of workers in these industries will be unemployed. So far, there's absolutely zero sign of that happening. I mean, there's no increase in unemployment. So, you know, we've heard these kinds of fears for a long time. I tend to take a bit more optimistic view as long as we're flexible.

Yeah, I know that some companies actually let a bunch of people go and then brought a bunch of people back because they realized that AI couldn't do what humans could still do, right, in a way. Nonetheless, I think humans are kind of at their best when they're creating, either creating or co-creating, right? And so if you have something that you find to be a creative outlet, I think this is key in going forward, whether it's music or sports or art or writing books or thinking about things or connecting with people, creating adventures with other people, all those things kind of factor into this creation process. But if you're, if you're listening to this and you're wondering, well, geez, you know, if I lose my job and I'm going to live a long time and be youthful, well, what's the meaning of life? Well, I think it's, it's about finding ways to create and contribute. I think that provides a lot of meaning for people.

Yeah. You know, throughout most of our history, we've been sort of used to getting meaning from roles that we're basically born into. You know, you're born as a farmer or as an artisan or as a feudal lord or whatever it is. And it wasn't really a lot of choice. So you had to sort of make meaning out of that. But today, because we can, we have far more choice in what we do, our occupation is, our interests, our hobbies. So yeah, I agree, find something that really engages you and push at that. And it doesn't mean it has to be easy. I think, you know, part of our problem with our current culture is everybody wants things to be easy. You know, we don't— people shouldn't face any consequences. They shouldn't have to, you know, work hard. They shouldn't have to exercise. There's a lot of unhealthy thinking. I'm a little more Nietzschean in my philosophy. I think it's, you need a vigorous life, you need challenges, you need to push against those challenges to grow. And that also gives life meaning. Yeah. So I'm not favoring a life of sort just retirement and doing nothing and just being waited on by AIs. I don't think that would be very meaningful.

Yeah, exactly. So are you in a community of people where you kind of share these same principles? Let's call them the transhumanism principles. Is there like a community of folks that you're connected to?

Yeah, well, we had, we used to have Extropy Institute, but we closed that down quite a while ago, though currently we're thinking of restarting something because we had so much interest from people looking back to the 1980s, early '90s, when we had a lot of people together. So we've people filming documentaries over here. So we'll probably start something, but you know, there's a whole bunch of sort of informal network. There's Humanity Plus that my wife pretty much runs, which is a transhumanist organization. There are, you know, our blogs and so on. So we discuss these ideas quite a lot, but most of the, there are also conferences, quite a few conferences happen internationally, both on transhumanism and in the biostasis space. When you're biostasis, people tend to be transhumanists because it wouldn't make sense not to be really, if you're going to live that long. So yeah, it's a pretty strong community. I've spent most of my time right now writing, doing podcasts, getting the book published. So I very much, you know, think about the ideas and communicate them. But I'm right now I'm preparing for a debate in in Qatar on October fifteenth, where we'll be discussing the Pope's views on AI. Interestingly enough, that Pope wrote the encyclical on AI as like a forty thousand word statement. So I'm studying that right now, making the usual kinds of objections that I think are largely mistaken. But yeah, I think the future is going to be really interesting and generally probably quite good. It's not just that people think of ill health and reject the idea of life extension because of you know assuming ill health. I think another major factor is. The culture and the media have promoted this view of the future as a horrible place. AI is going to hunt us down, or there'll be overpopulation, or there'll be too much pollution or too much global warming. But throughout history, we've solved more problems than we've created. We're better off, we live longer, we're healthier, we're freer. And there's no particular reason why that should end, in my view. People tend to take a very narrow view of things, don't understand how economics works, how technology works. And these are problems that— there are problems in the world, but we overcome them. And there's no reason to think that life is going to be The kind of dystopia you see in so much science fiction.

Yeah, no, it's an interesting point. Well, there certainly are dystopian possibilities out there. There's no doubt. I mean, an asteroid could hit us or, you know, things like that. A volcano could change the weather in a big way, or a series of volcanoes, earthquakes, things like that. To your point, life is resilient. You know, if it's ever been proven to be one thing, it's actually incredibly resilient. I think it'd be almost be difficult to exterminate life from the planet apart from the planet being swallowed by the sun, right?

Yeah. A lot of people talk about extinction risk these days or existential risk, which I think is largely overblown. It's kind of, it's like people are trying to one-up each other that they've got the biggest crisis and this one is going to destroy everybody completely.

But

as you say, I think that's actually quite hard to do. I particularly find it implausible that AI would try to do that.

So what are you finding to be some of the ways in which you're challenging yourself right now? What challenges have you laid out for yourself?

Well, writing the book was a challenge actually. That took sustained work.

So that was a challenge.

Yeah, you know, pretty much every day challenge myself at the gym. I like to work out pretty hard. I've always been fond of doing resistance training, but I'm doing more aerobic exercise, which I don't particularly enjoy, but doing sprints is actually not so bad. And I realized I was getting stiff. I hadn't really taken care of my flexibility. So I spend more time stretching now too, which also is not particularly fun, but I need, I know I need to do that. I spend a lot of time looking at the longevity evidence. You know, what can we actually do to not die so early, even if we can't extend maximum lifespan right now? And of course, that's, that's a very difficult issue, as I'm sure you're aware. There's a lot of Conflicting evidence, people making claims, it could be hard to assess. But one thing I did a little over 10 years ago, which I don't know if you've had anybody on the show talk about this, you might want to do so if not. I was in the, what are called the TRIM trials.

Oh, you were in TRIM? Yeah. Yeah, I know, I know Greg Fay.

Yeah, so I was actually patient number 1 there. I did the first TRIM trial, which basically meant taking growth hormone for a year along with metformin and DHEA. Right. And we had our, I went to Stanford Medical School and had our thymus scanned and indeed the cortex actually regrew, regenerated. So presumably my immune system is now doing pretty well. I never caught COVID, so maybe that's a sign of that.

Yeah, let me interrupt you for a second. So for the audience to understand, the TRIM trial was set up by Greg Fay, and his hypothesis was that a lot of aging is related to involution of the thymus gland, which is this gland that sits below the mediastinum here in the center of your chest, at the base of your throat. And that when that involutes, then, you know, the immune system has trouble producing new T cells, thymus cells, if you will. And so then you're left with an aging immune system, and what you've got is what you've got, and eventually it runs out. So his theory was that if he could rejuvenate the thymus gland, then it would enable the immune system to rejuvenate as well and be more youthful. What they demonstrated was that they turned back epigenetic age. I think it was a year or a year and a half.

Year and a half.

Yeah. Within one year of giving growth hormone, DHEA, which is a precursor hormone, and then metformin to counterbalance any blood sugar issues brought on by the growth hormone. It also activates AMPK, which has a longevity benefit in and of itself. So, and counter Interacts the the mTOR activation by the growth hormone. So anyway, it's kind of a balanced biochemical approach to to trying to rejuvenate the thymus and the immune system. And we know that one of the one of the main reasons that we die is from immunosenescence, where the immune system is no longer capable of responding to new challenges, either clearing out taking out the trash, natural killer cells can't prune senescent cells properly, or you can't respond to the next virus that might show up on the planet, right? Or you can't kill off the mutation in the cell that could turn into cancer.

So yeah. Well, you break a leg, go into hospital, broken hip, whatever, and you catch an infection in the hospital and you have no immune system to fight it.

Yeah, exactly. So you, so you did TRIM 1. Did you do TRIM 2 also?

No, not yet. I think it's been quite expensive to follow up. I got in when it was relatively inexpensive early on. But I would, the interesting thing, you know, you mentioned the, the aging clock reversal. Yeah. So a few years after the trial, Greg sent the blood samples to Steve Horvath, a leading expert in aging clocks. And he said, yes, you've got like a year and a half younger over the course of the year. Which is quite remarkable. That was all in the last 3 months. So if I do this again, I would like to talk about maybe doing it for 18 months instead of the 12 and see if we get a larger age reversal and if that was repeated. But that was, that was a very nice bonus.

Yeah. Well, we're able to get much bigger epigenetic age reversals now just with things that we do here in the clinic. So it kind of paved the way for that kind of thing. It is interesting to think about rejuvenating the thymus. And I wonder if you've had your another follow-up MRI to see if the thymus is involuted again or where it might be.

I haven't, no. Actually, I'm thinking about doing a whole body MRI. I'm kind of debating back and forth as to whether I want to do that or not, but I don't know if that will be sufficient. I may need a more special MRI. I know at Stanford Medical School, it was a, it wasn't just a regular MRI. It was, um, you know, special expertise needed for that. But yeah, that would be good to know if it's been maintained because it's been over, it's been, how long is it, about 11 years now?

4 or 5 years?

No, it's been like 11 years. It was like 2015 or '16, I think I did this.

Yeah, got it. Yeah, yeah, very cool. What else are you doing for your own longevity?

Well, you know, I think the main things you do right now are the boring old things that take a lot of work. It's the exercise, it's diet, it's good sleep, you know, controlling stress. That's probably the thing I'm worst at. But I make sure I get my sleep, my exercise, diet, because even diet is controversial as to which is the best diet. That's something I'm constantly questioning and trying to work out. But to me, it's pretty, pretty clear that avoiding a lot of of sort of junk foods and empty sugar and empty calories, empty carbs. That's a pretty good idea. Whether it should be high protein or not, that's more controversial. Whether you should eat meat or not is also more controversial. A lot of the anti-meat stuff seems to me to be based on processed red meat rather than, you know, grass-fed steak, which is actually extremely nutritious. But that's, you know, that's a controversial issue. But I think just by getting rid of the junk and controlling calories makes a huge difference in itself.

Yeah, I think those are all important things. Sleep is a big big deal. Of course, I think stress management is really, really foundational. We see that all the hallmarks of aging are actually accelerated by stress. And they're decelerated when people can go into a more flow state, Zen state, kind of live their life from that perspective. Do you bring any of that into your, into your practices, any meditation or stress management things that you do?

Not as much as I should, honestly. I'm not a very good meditator. I'm not very patient. So I actually tried Transcendental Meditation when I was I think 11 or 12. My Latin teacher at school was an instructor and 2 of us decided to do it, but I was never very good at it. I just can't sit still that well. But, you know, I think exercise is very good for stress. Whenever I'm feeling worked up, I go for a good workout. I feel better. So that really helps. But yeah, I could, I could probably do better along those lines.

Is there anything that you're looking to, for the audience to understand more about, you know, preserving people when they die, things that they should be aware of if they're interested in pursuing that, or things that you caution them about or encourage them about? What are your thoughts there?

I would point them to the to our blog biostasis.substack.com where we discuss this in considerable details, everything from basic stuff to dives into research into many different topics. But what I would suggest is it's worth looking into, especially as you get older and your risk goes up. You know, we've had people cryopreserved in their twenties and thirties. You just don't know when things might happen. A lot of people don't look at it closely because they they've you know the media tends to present it as something for rich people, like you have to be a millionaire to do this, which is not true at all. I started as a poor graduate student and I still do it. Most people use life insurance to pay for it, and there's quite a lot. There's a lot of different options. There's the relatively high-cost options like Alcor whole body, around $220,000. You can just do the brain, $80,000 to $100,000. There are other options actually less expensive than that. So it's not, you know, if you're paying with life insurance, it's not actually something only rich people can do. So I would disabuse people of that mistaken notion. And it's really, to me, it's just an extension of emergency medicine. Just like today, when someone's heart stops, they stop beating, we defibrillate them, we do CPR and so on. We don't want to give up on them. So our view is that when someone is declared legally dead today, they're not truly dead in an informational sense. We need to preserve them, stop them getting worse. and give more advanced future technologies a shot at repairing the problem and giving them more life. So it doesn't seem to be particularly radical from that point of view. It's actually kind of conservative medicine. We're not throwing away the person. And I think, you know, in the future, we'll look back on the present and see people who just put people in the earth to be eaten by worms and bacteria or incinerated them and just scratch our heads and go, why, why did you do that when you could have given them a chance?

Yeah, it's interesting, right? It's like people would go back and say, why did they cut that limb off when it could have been salvaged today? Right. But it was the only option that people really were familiar Yeah. Yeah.

And I would also suggest that, yeah, if people are interested in this, they should not only read about it carefully, but go visit the organizations like, you know, Alcor, Cryonics Institute in Michigan, Alcor's here in Arizona. They both welcome people to do tours. You can see how it works. You know, there's nothing hidden about it. You can read the case reports. It's all very open. So, you know, if people are not familiar with it, think it's kind of a strange thing, I think educating yourself, going to visit, I think will answer a lot of those questions. And it's not an excuse. It's not an excuse not to be healthy, by the way. You know, It's, there are some people who make arrangements for cryonics and think, oh, that's it, I'm, I'm taken care of. But no, you've gotta take good care of yourself still, not only because you want to put off being cryopreserved as long as possible to enjoy life, but because the longer you can put it off, the better the process is likely to be. You know, we learn as we go along, we get better at cryopreserving people. Sure. So if you can buy another 10 years, you'll be in better condition. Plus, when, if you actually do, you know, legally die, you really want your vascular system to be in good shape. 'Cause we have, we're gonna have to remove all the blood from the body, replace it with a cryoprotectant solution. And if you haven't taken care of yourself, if your vascular system is blocked up and no good, we're not going to perfuse the brain properly. And there's going to be a lot of ice crystal formation, which is going to do damage. So there's a very strong reason to, you know, not just sit back happy and satisfied, but to take care of your health.

So you want to be in great cardiovascular health in order to be cryopreserved. Yeah. Yeah.

I'll give you, I'll give you an example. For instance, Fred Chamberlain, who was the co-founder of Alcor back in 1972, he was living in Florida. He got prostate cancer and it was, you know, it was too advanced and metastasized. So we were able to get him over to Arizona with some difficulty, get him on the plane. He checked into the hospice there and we watched him for several days as he refused food and water, because that's any way you can legally, you know, end your life here. And then we got him cryopreserved and he got a really good perfusion because, although he'd had cancer, you know, which had ravaged his system, he'd always taken really good care of himself. He was lean. Mm-hmm. His vascular system was in great shape in his 70s. And he got a very good cryopreservation, which we know because we do CT scans of patients. And we can actually, through the CT scan, we can see how well We've removed the blood and fluids from the brain and replaced it with a cryoprotectant solution. And his looked really good. And that's not always the case.

Interesting. Yeah. Well, that is very interesting. So is that routine that you would do a CT scan after you've cryopreserved someone?

It is now. Yeah. It was introduced when I was president of Alcor and we started doing it then. And Alcor now has its own CTU scanner. Tomorrow Biostasis, the largest European cryonics organization, does it for every patient. Cryonics Institute does not. And we've been kind of pushing them to do that, but they're sort of the lower budget operation. So it's more difficult for them to afford it. But that's not actually— CTs can also be useful done before the procedure, because that way you can identify surgical work. Maybe people have their chest sewn up or something, which could change the surgical access. It might show you various problems you have to work around. And during and afterwards. But there are other kinds of feedback too. So we did a case with Dr. Stephen Coles 10 years ago, but it finally got published this year, in which we actually took samples of brain tissue, which of course you can do non-destructively, as people do in brain surgery. And actually, Greg Fay was involved in this work too. Along with other people, examined the brain with electron microscopy, differential scanning calorimetry, various other methods, and was able to show in published peer-reviewed work that the structure of the brain looked extremely well intact. You know, the neuropils, the neural bodies, the connections, everything looked beautifully well preserved, which is some of the first really direct evidence that we're not just hand-waving and hoping about this. We actually have very clear evidence that under good conditions, we are preserving those structures.

Have you taken— I know we talked about embryos. Have we— have you taken smaller animals, let's say, and cryopreserved them or put them into biostasis and then brought them back?

No, we wouldn't be able to bring them back. People are often saying, why don't you bring back a mouse? It's actually very difficult because, you know, different organ systems have different requirements and different warming rates. So your organs right now, we're getting pretty good at organs, but any kind of whole organism bigger than microscopic is difficult. We have done microscopic organisms. Actually, my wife, Natasha Biedermohr, was involved in this at Alcor some 10 or 11 years ago. Where we took, she took C. elegans, the little microscopic worms that have a kind of a sinuous shape. They're rather beautiful to watch. And taught it a basic task, which basically used benzaldehyde as a chemical gradient so they would know which direction to go for their food, go this way, not that way. And they could learn that task. They were then cryopreserved, kept there for a while, rewarmed, and then tested. And she was able to demonstrate they actually retained the memory, which is actually the first direct test of memory. It's a very simple memory in a simple organism, but it was a proof of principle. Mm-hmm. But now we're kind of doing other work with neural tissues. Like there's a, you might have heard about the work of these researchers who've used neural tissue to play Pong or to run a flight simulator, for instance. So one really interesting study that I think is actually being funded would be to take this neural tissue, train it to do something like that, a simple task, cryopreserve it, bring it back, and test it and see if it's retained that function, which would be a very good sign that you've preserved it. So there's a lot of evidence-based work going on to support what we're doing here.

Yeah, it goes on in nature also. I saw something really interesting about caterpillars and butterflies. that they could teach a caterpillar something about something to avoid because it was a noxious stimulus or something like that. And then it would go into the cocoon. Of course, it, you know, completely almost deconstructs itself to reconstruct itself back into a butterfly. But they showed that the butterfly had retained that memory.

Oh, really? Interesting.

Which is interesting, right? So even in nature, there's an ability for that to be—

That's kind of surprising because you said they really sort of slightly completely disintegrate and then reform. Totally.

It was very surprising, but they showed that it, that they could do that. So yeah, interesting stuff. And then of course there's epigenetic information that gets passed down, right? So it's another sort of form of memory.

And you can also, you know, back up your records because let's assume that you don't get perfectly preserved. Maybe there'll be some memory loss, which to me is not, you know, it's not that I don't have a very good memory anyway. I have to keep records of things. So some people have great memories, but if you have, uh, you know, as we're doing today, more and more photographic and video records and written records, you could even have like a digital clone, which would be a sort of a backup where you could use that to interpolate filling gaps in any memories. So that's another aspect of it too. But hopefully if you do it right, and to me that means getting preserved as soon as possible at the point of legal death.

So how quickly can that actually occur? Let's say somebody decides to pass away in hospice. Does that mean that the team is there actually poised and ready to go the moment that they are pronounced, or—

If at all possible, yeah. So it really depends on the circumstances, but the best way to do it, As I was going to say, there's a couple of cases I know Alcor's already done in death with dignity states where basically you can— and this is what happened. I came in on Monday morning, one guy, someone was on the phone to our membership person and said that he wanted to go in 2 days' time. We said, no, no, you can't do that. We have to give us some time to plan. We've never done this before. But basically what we could do in the end, we were able to have a team on site. He took his end-of-life medications and they wait there. And as soon as the doctor declares legal death, within seconds, literally within seconds, you start, restart the whole procedure. In fact, you have to give propofol as the first drug because there's at least a theoretical possibility someone could actually return some level of consciousness even though they've been declared legally dead. Yeah. So you give that first, then you have to give blood thinners and antacids, membrane stabilizers. There's a whole cocktail based on research to protect the cells. So yeah, doing that immediately is the best thing. But we do have evidence that even if it's several hours, especially if someone's been cooled down like in the morgue or something at 4 degrees That also extends the, you know, the good date, if you like, the go-bad-by date. So it's not hopeless if it takes several hours, but it's definitely best to do it instantly.

Yeah, well, it's interesting. In the hospital, when I was doing cardiology work, you know, some people would come in and they would have sort of sudden cardiac deaths, right, where their heart would stop. And one of the things that would be done would be to— they were in the ICU— would be to cool them down very quickly. Not to 40 degrees C, but into the, into the 80s. And they showed that, you know, if they were able to fix the heart problem, whatever it was, the aneurysm that ruptured, whatever, and then bring the people back, that they had a substantial improvement in their cognitive abilities were retained as opposed to, you know, suffering brain damage per se, right?

Yeah, cold medicine has become quite popular. Actually, we had a visit to Alcor by Dr. Peter Rhee, who was Obama's personal physician, but he also did some very interesting surgery research where he actually was cooling people quite A lot more than you said, which is, you know, what you said is the standard. But he was taking gunshot wound victims and dropping them down, I think, what was he going at, about 20°C, I think. So quite a, quite a large drop. And that basically gave you about 4 or 8 times as long to operate because of the slow metabolism. Sure. So, so yeah, the same principle basically.

Yeah, I remember the stories about children that would drop through the ice and drown in a frozen lake and be resuscitated, you know, an hour later kind of thing, right? Same situation.

Yeah, an hour to hour and a half or so. There's the classic case of Anna Wagenholm in Sweden who was skiing and fell into a icy lake and basically was not, was legally dead for basically an hour and came back pretty much completely intact. It tends to be, as you said, children because they have a higher surface area to volume ratio, so they cool more rapidly. So it slows metabolism fast. So that's really the whole point is we want to slow metabolism as quickly as possible because the faster that's running, the worse things are happening. Yeah. So we do, we're doing research into ways of finding faster ways of cooling people. So it used to be people would just be put in an ice bath. That wasn't very effective. And we circulate the icy water around the patient. Now we're actually researching something called liquid ventilation, which involves pumping either a saline solution or a poly— another sort of oxygen-bearing medium through the body into the lungs because it has a massive surface area and can cool a patient very rapidly. So that's something we're hoping to introduce to accelerate the cooling.

Yeah, interesting. We were using something with fluor— I think it was fluorinated—

Fluorocarbons, I think. Yeah, they actually— James Cameron made that popular in the movie The Abyss where the divers actually were not breathing air.

They were using this, which actually you

can actually do

Yeah, we actually tried it in interventional cardiology where we would— this was back in the early '90s— we would infuse it down the coronary artery past where the balloon was occluded to protect the downstream heart muscle from ischemia, from lack of blood flow, while we were in there working with a balloon. We didn't even have stents at that point in time to try to open an artery. It never really panned out to be all that useful because in the heart there's a lot of collateral circulation and other things going on it, it just didn't make that big of a difference.

Yeah, but with the lungs, you can really, you can really make a big

difference. Well, Max, it's a very interesting field that you've been involved with. So ever onward, ever upward, and ever colder, it sounds like.

Yeah. Well, we do store people at -320 Fahrenheit or -196 Celsius. So that temperature, basically you could stay there for, you know, 1,000 years and be perfectly fresh apart from the odd cosmic ray knocking a molecule aside. You're not gonna see any change at all. So subjectively it'd be like no time has passed and hopefully you wake up one day and go, wow, I made it. I'm still going.

I'm still here. All right. Well, cool stuff. Well, thanks so much for taking time to chat with us today.

Oh, you're welcome. Thanks for having me on. I think we're on the same side.

Uh-huh. Yeah.

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