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    Alcor's ​cryogenic tanks, or dewars, contain the dead. Images by the author

    The Art of Not Dying

    Written by Daniel Oberhaus

    Given the ubiquity of the phenomenon known as death, it is no surprise that people throughout the ages have gone to great lengths not only to describe it, but also to prescribe the proper way to approach it. This was the impetus behind a host of ancient funerary texts, including the Egyptian Book of the Dead, Bardo Thodol, and the lesser known Ars Moriendi, a medieval Christian book whose Latin title translates to "the Art of Dying Well." 

    If a philosopher were to attempt a guide to dying and the afterlife now—that is to say, in an age when death is increasingly described in some futurist circles more as a terminal illness than as the finality of finalities—where would he or she begin? To answer this question, I decided to go on a search for modernity’s antidote to death. That quest brought me to a non-descript building tucked away in a light-industrial area in Scottsdale, Arizona.

    The building belongs to Alcor Life Extension Foundation, and behind the several inches of Kevlar and reinforced concrete that make up its walls, Alcor is home to 129 patients who are cryopreserved in vats of liquid nitrogen, waiting for the day when technology has advanced to the point that they can be revived to roam the Earth once more.

    A patient in the operating room. Image: Alcor

    Alcor froze its first "patient," as it calls its customers, in 1976; there are currently 1005 people signed up to be preserved by the company when they die. They pay an annual fee of about $770, and then, at the time of death, $80,000 to preserve just the brain and up to $200,000 to do the whole body. There are teenage members of Alcor waiting to be frozen, in some cases with their dogs; there is said to be a growing customer base in China. Perhaps the most famous Alcor patient is Ted Williams, baseball Hall of Famer, whose head is kept in one of its smaller vats. (Allegations about the abuse of his head were at the center of a 2009 tabloid-friendly book that has since been discredited as full of fabrications).

    The door to the facility was unlocked for me by Dr. Max More, a futurist and philosopher who since 2011 has served as Alcor’s CEO. More looks like the sort of guy who could snap you in half without much effort, but despite appearances he’s gentle. He is careful with his words and when he does vocalize his thoughts, they are layered in a mild British accent, the product of his upbringing in Bristol and education at Oxford. 

    Max founded the first biostasis organization in Europe, called Mizar Limited, and launched what would eventually become the Extropy Institute in 1988 before moving to the United States where he taught philosophy and completed his dissertation at the University of Southern California. He married his wife, Dr. Natasha Vita, who is another notable figure in the field of transhumanism, in 1996 and eventually moved to Austin, Texas in 2002. After a tour of the facility, Max and I sat down to talk about the art of dying in a future without death and how the business of raising the dead is going.

    So, how's Alcor doing?

    It's growing, but much too slowly. I think it's just baffling that we're not massively larger because we've been around for 42 years. We've had periods of higher growth, so in the late ‘80s and early ‘90s we had a growth rate of 25-30 percent. It's just dropped after that and gotten into the low single figures. We actually stopped growing a year or two ago and I think it's because the dues were raised too high and the economy was doing badly. The [Alcor] board wanted to reduce dependence on donations by having higher membership dues, but they went too far. We've brought them down since then, we've made two reductions and now there are student discounts and discounts for long time members.

    How much does it cost to get frozen indefinitely? 

    There are the main membership dues which are $530 per year and $180 per year on top of that for the Comprehensive Member Standby plan, which basically means that’s money that you pay into this fund and in turn we guarantee that wherever you are, we'll be there. We just introduced a new policy which says if you provide $20,000 in addition to the $80,000 or $200,000 [that it takes to cryopreserve your head and body, respectively], then we'll waive the CMS fee. This really helps younger members because an extra $20,000 in life insurance is really very little for them, whereas $180 per year actually feels a lot worse.

    I gave a talk a few years ago called "Join the .00004%" (because that's how small we are) and that's ludicrous to me. There are plenty of crazy ideas out there with much less backing that get much more support, and we have actual evidence for what we're doing! We've been around for almost 43 years and only have 1008 members—that's not very many. So why is that? Obviously, there is some expense to it, but I don't think that's the main thing.

    Max More surrounded by frozen dead people. 

    If we were trying to get rich, there would be far better ways of doing it; this is the hardest thing in the world to persuade people of. 

    What's the main hurdle?

    There are major cultural and psychological barriers that have to be overcome and I think eventually they will be. Open heart surgery, that had a lot of resistance early on and the same thing with anesthesia—people made up ridiculous excuses. They didn't want to use anesthesia in childbirth—you couldn’t do that because women are supposed to suffer in childbirth, it's punishment for your sins. It's amazing what people rationalize.

    Cryonics is especially hard to convey because it's complicated. You've got to look at the evidence for it and you've got to think about death, which is very uncomfortable to many people. What's worse is that we don't give you a nice, comforting answer. We don't say, like a religion, "Oh, sign up with us and we guarantee we'll bring you back." That's dishonest, we can't guarantee that. It depends on how well preserved you were in the first place and we can't really guarantee the technology that will be developed. There are a lot of uncertainties and we've got a contract that has pages of uncertainties, trying to tell people how it could go wrong, basically. People don't want that. They want to be sure they’re definitely going to make it or to be sure they're not, so they can kind of adjust their thinking to that.

    Seems like either way your odds are a hell of a lot better than if you get cremated or put six feet under.

    Yeah, it should be a no-brainer, but that's not the way psychology works unfortunately. I always find it irritating when people say, "This is a scam; you're just trying to get rich." If we were trying to get rich, there would be far better ways of doing it; this is the hardest thing in the world to persuade people of.

    Alcor headquarters

    Could you get rich by doing this?

    We're a 501(c)(3) non-profit organization, so no one directly profits from that; people get a salary and so on, and the board is not paid anything. So no one directly benefits from big profit margins, but that does help the organization because we want to build up resources.

    In terms of where the revenue goes, there's two main parts to that: there's the patient storage and operations. In terms of operations, we've been doing okay, actually. We're buoying up our resources, we have a reserve fund which is good because we might have legal battles—fighting off government regulations, that sort of thing. So it's good to have resources, but we don't want to make fees too high and lose members—there's a balance there. We really don't have too much money for patient care trust funds because we don't know how much it will cost to bring them back. 

    We do, however, have a pretty good idea of what it takes to keep them in there. So, out of the $200,000 paid by a full-body patient, after spending money on the surgeons, the standby, the chemicals and everything else, $115,000 of that goes into the patient care trust fund. That can only be used for patient care and that gets managed by a separate board of directors, the Patient Trust board. It's very well protected and it's unique—no other organization does that.

    The idea is that the $115,000, the capital, is never used: we just use the interest earned. If we don't touch the capital and invest it well, even with a small return in light of inflation, that should grow over the years. So if we can bring people back, hopefully there will be quite a bit of money to pay for that.

    We have no idea what that will cost; it might be really cheap if robots are doing everything, or maybe really expensive. With the money in the patient care trust fund, since we're a non-profit organization, we cannot divide that up and say, ‘this is your part, this is your part,’ and so on—it's a common pool. We have private trust funds as well, if our patients want one. Actually, we recently had a patient with several million dollars who didn't leave us anything really, but he said if you bring me back, I'll give you a million dollars—sort of an incentive for us I guess.

    Alcor’s Operating Room. Image by the author

    So what’s new in cryonics?

    Alcor is looking into intermediate temperature storage. The idea is to store people at a slightly higher temperature, like -130C, to prevent fracturing. I don't think it's that big of an issue, but for some people it is. It's more expensive because it requires an active system to heat up the liquid nitrogen. So that's something we don't really offer. We have three people stored that way, more for research purposes, but that may be an option in the future. We're also trying out liquid ventilation, which hasn't really been deployed yet.

    What's liquid ventilation?

    Have you ever seen that James Cameron movie The Abyss? They're breathing in these fluorocarbons instead of oxygen, which is actually a very efficient medium for heat transfer, and it’s like that. There is a system that's being researched to accelerate the body’s cooling process and we actually circulate this fluorocarbon liquid inside your lungs. The lungs have so much surface area, there are all these tiny little vessels that branch out over this massive surface area—it's like a football field if you spread it out, so this process really accelerates the body's cooling.

    What about bringing people back?

    In terms of the revival end of things, it's a long way off. [Alcor] isn't doing a whole lot of research there because it's too much of a cap on what we can do. There is a startup company that I can't really talk about that that's doing that, trying to grow tissues, grow organs. The whole field of regenerative medicine is really relevant to what we're doing. 

    We benefit from a lot of other fields of research, like nanomedicine and the people trying to cryopreserve organs. They've actually managed to cryopreserve a rabbit kidney, keep it there for several months and then rewarm it, implant it in the rabbit and have it function. That's been hard to replicate actually because the exact chemical, the crucial chemical they're using in the solution, is made by one company that ceased to exist, and nobody else could get it just quite right. Apparently that's been solved and they think they're going to be able to replicate that study. That would be great because that's really the first time they've cryopreserved an organ and been able to bring it back.

    You can do it with all kinds of single tissues—it's very common now to cryopreserve corneas, sperm, eggs—there are dozens of tissue types that can be cryopreserved and then rewarmed. Going from a single tissue to a whole organ is much more difficult.

    Are we anywhere close to understanding how to warm up brains?

    What we would imagine is that the brain would actually be repaired cell by cell, which is why we want to minimize the damage we do because there are a lot of neurons to be fixed. We do know that under good conditions we are preserving brains very well—we can look at vitrified brain tissue from animals under an electron microscope and it looks great. You can see the membranes are all intact, the neurons are all connected, it looks perfectly preserved.

    It looks worse if we can't perfuse the brain and get ice crystal damage, but it doesn't mean it’s destroyed. It's going to look bad to us, but in our view, we look at it like, the functional ability of the brain's been destroyed, but function is not really crucial. What really matters is that you're storing enough of the structure that some future technology can look at it and say “this membrane's been damaged really badly, but we know how to put it back together.”

    CT scans from Alcor’s neuro patients indicate their cryogenic state. Image by the author

    we need to have a third category where the dead have rights... Right now, the patients are our property basically; they have no separate legal status. 

    Why is the structure rather than the function so important?

    Everything we know about personality tells us that it’s stored in physical changes in the brain. Apart from very short term memory where the last few minutes is all electrical activity, anything longer than that is stored in changes in the neurotransmitter connections in the brain. That's what we're preserving under good circumstances. We're not just being speculative and taking a leap of faith. We’ve started a program of doing CT scans of our neuro patients. We can't do full body patients because they're too big to go through the scanners. People just assume that the CT scan won't work through an aluminum can, but it turns out it does. We can get really good readings of people's brains and see how we're doing.

    What does death mean to you? Cryonics seems to abandon the traditional binary, where you're either dead or you're not. For the patients in Alcor, is either label fitting?

    The first thing that is important to realize is that the criterion of death changes with time. People think that dead is dead, but it’s not that simple. If you go back 50 years or so and someone in front of you just falls over because they stop breathing or their heart stops beating, we would've said they're dead—that's it. Today we say we have to do something about this, and we can with CPR, defibrillation, and so on. In many cases they come back to life. So were they dead? Not really. There have been people that have been clinically dead for hours that have been brought back to life, especially children, because they cool more quickly than adults. They fall in cold water and their circulation and metabolism drop quickly, kind of the same principle as what we're doing: it slows down the damage and they can be revived.

    There's legal death, which is really just when a doctor declares you dead; there's clinical death, which is when your heart stops beating and you stop breathing; and then there's biological death, which is where the cells really die and that takes time. But even that is not really death, in the sense of being irreversible, until you’ve passed the point beyond which it’s impossible to repair you—say, if you're incinerated. If there's enough structure left, then you're not really dead. It's kind of like someone who is in a very deep coma where there's metabolism but no brain activity; it's like that but even deeper. 

    I think we need to have a third category where the dead have rights, where it's not okay to dispose of them, but where they still don’t have the ability to enter into contracts or something. Right now, the patients are our property basically; they have no separate legal status. That's got to change at some point. We regard our patients as people, potential people, but the law doesn't—they're organ donations and tissue samples.

    So if the dead aren't actually dead, what's a better way to think about death?

    I think the information theoretic criterion is good. If there's sufficient structure left, enough information about the structure, the brain cells in particular, that you could repair the brain, then you're potentially recoverable.

    The analogy I like to use is, let's say you wrote down a bunch of stuff on a piece of paper and then you think “wow, that's really embarrassing or illegal,” or whatever, so you decide to shred it. You think now I'm safe, I've destroyed that information. Trouble is, you'd be wrong. The NSA, for example, could take that paper, scan it, and run it through an algorithm and recover that information. So you may think you destroyed it, but it's actually much harder to destroy information than most people realize.

    Something analogous would apply to the brain. Even if there is a lot of damage done to the brain, there'll be some point beyond which you can't bring it back, but it’s not clear what point that is. You can do a lot of damage and as long as we have some similar program to reconstruct the brain, you're not really gone. It'd be hard to retrieve, but not necessarily irretrievable. It's hard to say when someone's truly dead because it depends on what capabilities and information we have to reconstruct them. I think you can safely say if you're ashes, then that's it.

    The operating room at Alcor. Image: Alcor

    If you do have religious beliefs though, I think there's no incompatibility whatsoever. Who turns down a process for a radical surgery that might save you from cancer or heart disease?

    Do people have funerals or memorial services at Alcor? You can’t really do ‘open casket’ with those big metal containers.

    We don't do anything, no, but it’s up to the patient's families what they do. It's probably different if you don't believe it's going to work and you'd probably just treat it like a regular memorial. It's a bit trickier if you do think it's going to work: you're kind of saying good bye, but hopefully more of a “see you later.” So you have to emotionally deal with the fact that you're not going to see this person for a long time, but you don't want to completely let go. If it's your brother or sister or spouse or something, you might want to write to them once a year. We keep records for people so when they come back they can catch up.

    The vast majority of our members are not really religious, for obvious reasons—if you really believe in a religion then you believe in an afterlife, and it might seem less important to come back. You figure, why bother struggling on Earth when I'm going to go to a nice easy place. Although I don't know how people think they know what heaven's like, really. It's not really well described anywhere; it sounds pretty boring to me. Laying on a cloud playing the harp or basking in God's glory seems pretty dull.

    If you do have religious beliefs though, I think there's no incompatibility whatsoever. Who turns down a process for a radical surgery that might save you from cancer or heart disease? Christian Scientists maybe, but pretty much everyone else is going to do it. 

    It seems like in order to do this you have to believe the future is a place you'd want to be. There's some inherent optimism there, but it's kind of weird to be optimistic about death.

    Things just keep getting better. Think of sometime in the past when you'd prefer to live instead of today. I know for me there isn't one. People don't realize we have less violence now than we've ever had before, fewer people are starving. Life is getting better and people are living longer. There are ups and downs, but in the long-run life is getting better, so why would that not continue? So my view is that if we get good at this and bring people back, it's going to be in a world at least as good as today's, probably better.

    The main objection is that people are terrified that this will work. They're afraid they'll come into this world, not know anybody, their skills will be obsolete and I think that really divides people who go ahead with us and people who don't. If you have friends and family coming with you, as many of us do, then you won't be alone. As this gets more popular, it's entirely reasonable to think there might be people trained to reintegrate you into society, like a combination of a psychologist and social worker, or they might just implant the requisite knowledge. It's not that big of a deal. If people have an adventurous mindset, they're not too worried about it.

    DEATH's the end of creativity, of loving—they're all gone, and that's why it’s bad, not because there is anything inherently bad about it.

    If these people come back, will they be the same person?

    My view is inspired by the work of Derek Parfit at Oxford. His basic approach is a refinement of some earlier approaches. John Locke proposed that you're the same person over time if you have memory over time and I thought that was partly right, because what exactly does memory mean? You have declarative memory, procedural memory, and so on.Parfit was saying if you take these various psychological aspects, memories, dispositions and values, we can consider you the same person over time if there are enough connections between you in 2004 and you in 2014, for instance. If there's enough overlap at any particular time, although the exact criterion can be a little messy, then you are a continuous individual. 

    You might have a car accident and your head gets bashed in, and you might lose your memory or your personality drastically changes—we might still legally call you the same person, but you’re not. Being the same person is a matter of degree. It's not your body—that's not who you are.

    So when you say "I", what are you talking about?

    You're a collection of all your psychological traits, memories, values, all those things that cause you to act in various ways. There's no soul that I can see, I have no use for the concept of a soul. That's really a peculiar idea that no one has ever really made any sense of to me. What use is a soul?

    So in the event of information theoretic death, what do you think happens to "you"? Are you afraid of that kind of death?

    I'm not there. It's hard to even say I'm dead then, because I'm not at all. One thing I think people get wrong about death is that they think it’s kind of a conditional state. I'm not afraid of death. That doesn't even make sense to me, how could I be afraid of death? Death isn't anything, it's just the lack of being. 

    What I don't like about death is not that it's something to be feared or a bad experience, what's bad about it is that it's the end of experiences. It's the end of all the things I enjoy—it's the end of creativity, of loving—they're all gone and that's why it’s bad, not because there is anything inherently bad about it. So I really don't fear death in that sense; I fear dying. I fear dying a miserable, horrible death where I'm suffering, but I don’t fear being dead. That's incoherent, it doesn't make any sense.


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