When Cooling is Heart-Warming

Via Newsweek, Jerry Adler offers a fascinating look at the ever-shifting line between life and death primarily through the story of one man who "died" and yet lived to tell the tale. The article, aptly titled Back From The Dead, follows 61-year-old Bill Bondar who experienced cardiac death while unloading his car on May 23, 2007. In cases of cardiac death, states the article:

Without CPR, their window for survival starts to close in about five minutes. Life or death is mostly a matter of luck; response time to a 911 call varies greatly by location, but can exceed 10 minutes in many parts of the country. In rough numbers, they have a 95 percent chance of dying.

In Bill Bondar's case, the odds were slanted in his favor for a number of reasons. His wife, who found him soon after he collapsed, had some residual knowledge of CPR training she'd taken a decade ago. She pushed on his chest to get a trickle of oxygenated blood to his brain and called 911, after which help arrived within a mere two minutes. Bondar's pulse was restored through use of a defibrillator, and though comatose and at serious risk, he was at least no longer clinically "dead".

The rest of Bondar's tale begins with a move into the intriguing realm of medical hypothermia. Per Mrs. Bondar's suggestion, he was taken to Penn University Hospital, one of about 225 United States hospitals equipped with hypothermia-inducing machines. There, he was injected with chilled saline and wrapped in a network of plastic cooling tubes that circulated chilled water about the outside of his body. Then, continues the article:

Bondar was kept at about 92 degrees for about a day, then allowed to gradually return to normal temperature. He remained stable, but unresponsive, over the next three days, while Monica stayed at his bedside. She finally went home Sunday evening, and was awakened Monday by a call from the hospital that she was sure meant bad news.

"Guess what?" said the voice on the other end. "Bill's awake."

Bondar made a full recovery and was sent home -- a happy ending for him, his wife, and the doctors who worked diligently to save him. One such doctor was Dr. Lance Becker, who directs Penn Hospital's Center for Recusitation Science. Becker, who noted that most documented exceptions to the "five minute survival rule" for cardiac death patients involved individuals who had been cooled to low temperatures (e.g., following a fall into an icy lake), has been investigating the potential clinical applications of this data toward very promising ends. In particular, the article discusses the potential roles of cell death, oxygen, and mitochondria in the processes of bodily death, physiological damage, and recusitation.

It is genuinely refreshing to see a mainstream article acknowledging things like the fact that "[c]ell death isn't an event; it's a process. And in principle, a process can be interrupted.", and that "[f]ive minutes without oxygen is indeed fatal to brain cells, but the actual dying may take hours, or even days." It is easy to see how archetypical imagery like the robed, scythe-bearing personification of death managed to proliferate before these scientific facts were understood; in the past, if someone had a heart attack and collapsed, the finality of the event seemed immediate, certain, and complete. Understanding that this is no longer the case -- that as knowledge of human physiology grows more extensive, we can better parse the process of death into stages -- is critical to the shift in consciousness that will ideally play out in the form of more support for effective longevity medicine and "stopgap" measures such as cryonic suspension.

Speaking of which, Back From The Dead also offers a surprisingly sympathetic look at cryonics as the natural extension of lifesaving medicine; the Alcor Foundation is mentioned and some of its methods and speculations about the future of suspension and reanimation are described:

The Alcor Foundation, in Scottsdale, Ariz., has signed up about 825 prospective patients, and has preserved 76 of them, including Ted Williams. These aren't all whole bodies; some people opt for just their heads, which, apart from being cheaper, freeze faster than an entire body, reducing the danger of frost damage to the cells. Of course, we are a long way from knowing how to reanimate a frozen body, let alone just a head. One possibility, according to Tanya Jones, chief operating officer of Alcor, is to take a cell from the head and clone a new body to attach it to. The other is to scan the entire three-dimensional molecular array of the brain into a computer which could hypothetically reconstitute the mind, either as a physical entity or a disembodied intelligence in cyberspace. This, obviously, is not for the impatient. The physicist Ralph Merkle, an Alcor board member, has used this idea to popularize a fourth definition of death: "information-theoretic" death, the point at which the brain has succumbed to the pull of entropy and the mind can no longer be reconstituted. Only then, he says, are you really and truly dead.

Though the article wanders off into some mild fluff near the end in its discussion of "near-death" out-of-body experiences, overall I have to say that this is by far one of the best recent mainstream treatments of the shifting, evolving definition of death that I've come across.

While cryonics is often joked about even in optimistic circles as being "a mildly expensive funeral" or "the second worst thing that can happen to you", I have long theorized that despite the notoriety it gained a while back due to previous media treatments of the subject, it might actually end up becoming one of the first novel death--defeating technologies to gain widespread approval. The fact that we can already cool the comatose and use this low-temperature state in lifesaving strategies bodes very well for the increasing acceptance of medical cryonics.