Shocked

by David Casarett

  However, the Society produced: This helpful advice is provided by Charles Dickens in his Dictionary of the Thames, from its Source to the Nore, and attributed to the Royal Humane Society (London: MacMillan & Co.), p. 57.

  Actually, I learned later from an authoritative source: Mickey Eisenberg, Life in the Balance: Emergency Medicine and the Quest to Reverse Sudden Death (Oxford: Oxford University Press, 1997), 63. However, the Society Web site indicates that it was demolished in 1954: Royal Humane Society, “History,” royalhumanesociety.org.uk/html/history.html [accessed January 10, 2014]. Personally, I prefer to believe that the Germans viewed the house’s stash of feathers as a weapons stockpile that needed to be destroyed.

  William Tebb, an English businessman: William Tebb and Edward Perry Vollum, Premature Burial and How It May Be Prevented, with Special Reference to Trance, Catalepsy, and Other Forms of Suspended Animation (London: Swan, 1905).

  “Charles Walker was supposed to have died”: Tebb, Premature Burial, 101.

  “ALMOST every intelligent and observant person”: Ibid., 98.

  the case of Anne Green: Mickey Eisenberg’s sleuthing unearthed the following example and he highlights it as the first clear case of a near miss: JT Hughes (1982) “Miraculous deliverance of Anne Green: An Oxford case of resuscitation in the 17th century,” British Medical Journal 285: 1792–793.

  3: The Ice Woman Meets the Strange New Science of Resuscitation

  When she was twenty-nine years old: “Frozen Woman: A ‘Walking Miracle,’” February 11, 2009, cbsnews.com/2100-18564_162-156476.html [accessed January 10, 2014].

  “I think it’s amazing that I’m alive”: Ibid.

  “However . . . after the experiment”: Peter Christian Abildgaard, Tentamina electrica in animalibus, Inst Soc Med Havn. 1775; 2:157-61. This source and its translation come from two physicians, Dean Jenkins and Stephen Gerred, whose tireless work to teach the art of reading EKGs is exceeded only by their passion for the topic’s history. And by their inexhaustible sense of humor regarding experiments like this one. See: “A (not so) brief history of electrocardiography,” ecglibrary.com/ecghist.html [accessed January 10, 2014].

  Birds seem to have borne: Charles Schechter, Exploring the Origins of Electrical Cardiac Stimulation (Minneapolis: Medtronic, 1883), 361. I found this titillating reference to Humboldt in Mickey Eisenberg, Life in the Balance (Oxford: Oxford University Press, 1997).

  But the physician and historian Mickey Eisenberg: Eisenberg’s history is, for my money, about the best one there is. It helps enormously that Eisenberg himself is a highly respected researcher in this field, and that his account is eminently readable. See Eisenberg, Life in the Balance.

  The next decade saw: Charles Kite, “An Essay on the Recovery of the Apparently Dead,” Annual Report 1788: Humane Society (London: C. Dilly, 1788), 225–44. A more accessible and detailed description of Kite’s work can be found in AG Alzaga, J Varon, and P Baskett (2005) “The resuscitation greats. Charles Kite: The clinical epidemiology of sudden cardiac death and the origin of the early defibrillator,” Resuscitation 64(1): 7–12.

  The next big breakthrough came in 1947: Eisenberg, Life in the Balance, 188.

  As Beck was ending the operation: CS Beck, WH Pritchard, and HS Feil (1947) “Ventricular fibrillation of long duration abolished by electric shock,” Journal of the American Medical Association vol. 135: 1230–233.

  “It is well known that human beings”: The experiments on groundhogs, monkeys, and “mongrel dogs of medium size” described here are from: WG Bigelow and JE McBirnie (1953) “Further experiences with hypothermia for intracardiac surgery in monkeys and groundhogs” Annals of Surgery 137(3): 361–65.

  “I was interested in cooling”: D Bigelow (1997) “Dr. Wilfred Gordon Bigelow named to Canadian Medical Hall of Fame,” The Forge: The Bigelow Society Quarterly, 26(4): 68.

  dogs could survive fifteen minutes: WG Bigelow, JC Callaghan, and JA Hopps (1950) “General hypothermia for experimental intracardiac surgery; the use of electrophrenic respirations, an artificial pacemaker for cardiac standstill and radio-frequency rewarming in general hypothermia,” Annals of Surgery 132: 531–39.

  This is a success rate: Bigelow and McBirnie, “Further experiences,” p. 365.

  “more akin to man” . . . “He appears normal”: Ibid., p. 361.

  “We feel, however, that cooling dogs”: WG Bigelow, WK Lindsay, and WF Greenwood (1950) “Hypothermia; its possible role in cardiac surgery: an investigation of factors governing survival in dogs at low body temperatures,” Annals of Surgery 132: 849–66.

  The Safar Center did several experiments: There are many published articles resulting from these experiments. A few are listed here: A Nozari et al. (2006) “Critical time window for intra-arrest cooling with cold saline flush in a dog model of cardiopulmonary resuscitation,” Circulation 113: 2690–696; X Wu et al. (2008) “Emergency preservation and resuscitation with profound hypothermia, oxygen, and glucose allows reliable neurological recovery after 3 h of cardiac arrest from rapid exsanguination in dogs,” Journal of Cerebral Blood Flow & Metabolism 28: 302–11; C Kovner et al. (2006) “Mild hypothermia during prolonged cardiopulmonary cerebral resuscitation increases conscious survival in dogs,” Critical Care Medicine 32: 2110–116; A Nozari et al. (2004) “Suspended animation can allow survival without brain damage after traumatic exsanguination cardiac arrest of 60 minutes in dogs,” Journal of Trauma-Injury Infection & Critical Care 57: 1266–275; W Behringer et al. (2003) “Survival without brain damage after clinical death of 60–120 mins in dogs using suspended animation by profound hypothermia,” Critical Care Medicine 31: 1523–531.

  “custom-bred, male hunting dogs”: A Nozari et al., “Critical time window,” p. 267.

  News reports, for instance: The quotes that follow are from “Blood Swapping Reanimates Dead Dogs,” June 25, 2005, foxnews.com/story/0,2933,160903,00.html [accessed January 10, 2014].

  They found a 16 to 25 percent absolute increase: The Hypothermia After Cardiac Arrest Study Group (2002) “Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest,” New England Journal of Medicine 346: 549–56; SA Bernard et al (2002) “Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia,” New England Journal of Medicine 346: 557–63.

  In one large study: J Nielsen et al. (2009) “Outcome, timing, and adverse events in therapeutic hypothermia after out-of-hospital cardiac arrest,” Acta Anaesthesiologica Scandinavica 53: 926–34.

  4: Science Fiction, Space Travel, and Suspended Animation

  On October 7, 2006: BBC News, “Japanese Man in Mystery Survival,” December 21, 2006, news.bbc.co.uk/2/hi/asia-pacific/6197339.stm [accessed January 10, 2014].

  “First known human case”: Justin McCurry, “Injured Hiker Survived 24 Days on Mountain by ‘Hibernating,’” Guardian, December 20, 2006, guardian.co.uk/world/2006/dec/21/japan.topstories3 [accessed January 10, 2014].

  “decline the trouble of migration”: Aristotle (350 BCE), Historiae Animalium [The history of animals] D’Arcy Wentworth Thompson, trans., book VIII, part 16, classics.mit.edu/Aristotle/history_anim.8.viii.html [accessed January 10, 2014].

  “If you prick out the eyes of swallow chicks”: Ibid., book VI, part 5, classics.mit.edu/Aristotle/history_anim.6.vi.html.

  “That the golden hamster”: CP Lyman and PO Chatfield (1955) “Physiology of hibernation in mammals,” Physiological Reviews 35(2): 403–25.

  “Concentration of urine”: ML Zatzman and FE South (1975) “Concentration of urine by the hibernating marmot,” American Journal of Physiology 228(5): 1336–340.

  “The unique maturation response”: WA Wimsatt and FC Kallen (1957) “The unique maturation response of the graafian follicles of hibernating vespertilionid bats and the question of its significance,” Anatomical Record 129(1): 115–31.

  This area of research got a bo
ost: F Smith and MM Grenan (1951) “Effect of hibernation upon survival time following whole-body irradiation in the marmot (Marmota monax),” Science 113(2946): 686–88.

  When scientists first began to examine: BR Landau and AR Dawe (1958) “Respiration in the hibernation of the 13-lined ground squirrel,” American Journal of Physiology 194(1): 75–82.

  Specifically, researchers focused on an area of the brain: E Satinoff (1965) “Impaired recovery from hypothermia after anterior hypothalamic lesions in hibernators,” Science 148(3668): 399–400.

  During the winter of 1967–68: AR Dawe and WA Spurrier (1969) “Hibernation induced in ground squirrels by blood transfusion,” Science 163: 298–99.

  Alas, subsequent attempts to replicate: B Abbotts, LC Wang, and JD Glass (1979) “Absence of evidence for a hibernation ‘trigger’ in blood dialyzate of Richardson’s ground squirrel,” Cryobiology 16: 179–83.

  They act as a class of opioid receptors: CV Borlongan et al. (2009) “Hibernation-like state induced by an opioid peptide protects against experimental stroke,” BMC Biology 7: 31.

  To find out, Willis gathered: JS Willis (1964) “Potassium and sodium content of tissues of hamsters and ground squirrels during hibernation,” Science 146(3643): 546–47.

  Anti-apoptotic enzymes, which go by awkward names: C Fleck and HV Carey (2005) “Modulation of apoptotic pathways in intestinal mucosa during hibernation,” American Journal of Physiology: Regulatory Integrative and Comparative Physiology 289: R586–95.

  And they produced more bile: SL Lindell, SL Klahn, TM Piazza, MJ Mangino, JR Torrealba, JH Southard, et al. (2005) “Natural resistance to liver cold ischemia-reperfusion injury associated with the hibernation phenotype.” American Journal of Physiology Gastrointestinal Liver Physiology 288: G473–80.

  researchers removed the hearts of a bunch of rabbits: SF Bolling et al. (1997) “Use of ‘natural’ hibernation induction triggers for myocardial protection,” Annals of Thoracic Surgery 64(3): 623–27.

  The term “artificial hibernation”: S Simpson and PT Herring (1905) Journal of Physiology 32: 305.

  The challenges of maintaining body temperature: H Laborit (1954) “General technic of artificial hibernation,” International Record of Medicine & General Practice Clinics 167(6): 324–27.

  “So obvious are the advantages” . . . “One formed the impression”: JW Dundee et al. (1953) “Hypothermia with autonomic block in man,” British Medical Journal 2: 1237–43.

  Like Thomas, they didn’t: A Percy et al. (2009) “Deep hypothermic circulatory arrest in patients with high cognitive needs: full preservation of cognitive abilities,” Annals of Thoracic Surgery 87: 117–23.

  In 2005, though: KH Dausmann, J Glos, JU Ganzhorn, G Heldmaier (2005) “Hibernation in the tropics: lessons from a primate,” Journal of Comparative Physiology B 175: 147–55.

  Finally, and perhaps most interestingly: E Jerlhag et al. (2009) “Requirement of central ghrelin signaling for alcohol reward,” Proceedings of the National Academy of Sciences of the United States of America 106(27): 11318–1323.

  There’s even very limited evidence that: M Hotta et al. (2009) “Ghrelin increases hunger and food intake in patients with restricting-type anorexia nervosa: a pilot study,” Endocrine Journal 56(9): 1119–128.

  To understand what was in that injection: IS Daniels et al. (2010) “A role of erythrocytes in adenosine monophosphate initiation of hypometabolism in mammals,” Journal of Biological Chemistry 285: 20716–0723.

  So constant darkness seems to create: J Zhang et al. (2006) “Constant darkness is a circadian metabolic signal in mammals,” Nature 439(7074): 340–43.

  He pointed out that when hibernating bears exhale: H Clapp (1868) “Notes of a fur hunter” American Naturalist 1: 653.

  In 2010, Oivind Toien and his colleagues: O Toien et al. (2011) “Black bears: independence of metabolic suppression from temperature,” Science 331: 906–09.

  5: The Deep-Freeze Future: Cryonauts Venture to the Frontiers of Immortality

  Instead, it allows itself to freeze: Much of the early research to understand how frogs manage to freeze was done by the husband-and-wife team of Ken and Janet Storey. See: KB Storey and JM Storey (1984) “Biochemical adaption for freezing tolerance of the wood frog, Rana sylvatica,” Journal of Comparative Physiology B 155: 29–36.

  One of the first reports of successful cryopreservation: C Polge, AU Smith, and AS Parkes (1949) “Revival of spermatozoa after vitrification and dehydration at low temperatures,” Nature 164: 666.

  I’ve come to the fortieth anniversary conference: Alcor Life Extension Foundation, “About Alcor: Our History,” alcor.org [accessed January 10, 2014].

  The slim, petite woman: “Suspended Animation,” suspendedinc.com [accessed January 10, 2014].

  Consider the sad case of Alcor patient 113: “Alcor’s 113th Patient,” alcor.org/blog/alcors-113th-patient/ [accessed January 23, 2014].

  Inspired by those rumors: Robert Ettinger, “The Penultimate Trump,” Startling Stories 17, March 1948.

  As the weather gets colder: Storey and Storey, “Biochemical adaption.”

  What is even more interesting: JM Storey and KB Storey (1985) “Triggering of cryoprotectant synthesis by the initiation of ice nucleation in the freeze tolerant frog, Rana sylvatica,” Journal of Comparative Physiology B 156: 191–95.

  These so-called antifreeze proteins: G Amir et al. (2004) “Prolonged 24-hour subzero preservation of heterotopically transplanted rat hearts using antifreeze proteins derived from arctic fish,” Annals of Thoracic Surgery 77: 1648–655.

  The same team reported later: A Elami et al. (2008) “Successful restoration of function of frozen and thawed isolated rat hearts,” Journal of Thoracic Cardiovascular Surgery 135: 666–72.

  Fahy mentions a study of his own: GM Fahy et al. (2009) “Physical and biological aspects of renal vitrification,” Organogenesis 5(3): 167–75.

  A case in point, which is either a sign of progress or a cautionary tale: Mike Darwin, “Dear Dr. Bedford,” alcor.org/Library/html/BedfordLetter.htm [accessed January 10, 2014].

  Bedford was moved within days: Mike Darwin, “Evaluation of the Condition of Dr. James H. Bedford After 24 Years of Cryonic Suspension” alcor.org/Library/html/BedfordCondition.html [accessed January 10, 2014].

  So, how well did he do? Ibid. [accessed February 5, 2014]. All of the gruesome descriptions of poor James Bedford that follow are taken from this report.

  6: Crowdsourcing Survival

  We don’t know everything that happened: feed://radio.foxnews.com/tag/tracey-halvorson/feed/ [accessed February 4, 2014].

  “Staff at Senior Living Home Refuses”: CBS News, “Staff at Senior Living Home Refuses to Perform CPR on Dying Woman,” March 1, 2013, losangeles.cbslocal.com/2013/03/01/staff-at-senior-living-home-refuse-to-perform-cpr-on-dying-woman [accessed February 5, 2014].

  “I think anyone with any clinical training”: Dana Edelson, quoted in Judith Graham, “Amid CPR Controversy, Many Unanswered Questions,” The New Old Age Blog, New York Times, March 6, 2013, newoldage.blogs.nytimes.com/2013/03/06/amid-cpr-controversy-many-unanswered-questions [accessed February 5, 2014].

  “All of us . . . have a duty to respond”: Dale Jamieson, quoted in Ibid.

  So she truly was a bystander: KGET, “Glenwood Gardens in the National Spotlight,” March 4, 2013, kget.com/news/local/story/Glenwood-Gardens-in-the-national-spotlight/uxvuCpj170y6xQDz0bsNQQ.cspx [accessed February 5, 2014].

  Although it’s difficult to get accurate estimates: AL Valderrama et al. (2011) “Cardiac arrest patients in the emergency department—National Hospital Ambulatory Medical Care Survey, 2001–2007,” Resuscitation 82(10): 1298–301.

  Add to that the cardiac arrests that happen in hospitals: RM Merchant et al. (2011) “Incidence of treated cardiac arrest in hospitalized patients in the United States,” Critical Care Med
icine 39(11): 2401–406.

  “He sparked me into a lifelong pursuit”: P Safar, “On the future of reanimatology” (2000) Academic Emergency Medicine 7(1): 75–89.

  “In four breaths”: Mickey Eisenberg, Life in the Balance, 89–90.

  The boy survived: JO Elam, “Rediscovery of expired air methods for emergency ventilation,” in Advances in Cardiopulmonary Resuscitation, Peter Safar, ed. (New York: Springer Verlag, 1977), 263–65.

  Inspired by that success: JO Elam, ES Brown, and JD Elder (1954) “Artificial respiration by mouth-to-mask method; a study of the respiratory gas exchange of paralyzed patients ventilated by operator’s expired air,” New England Journal of Medicine 250(18): 749–54.

  Finally, when the laypeople: P Safar (1958) “Ventilatory efficacy of mouth-to-mouth artificial respiration: Airway obstruction during manual and mouth-to-mouth artificial respiration,” Journal of the American Medical Association 167: 335–41.

  Somewhere in the middle of an experiment: WB Kouwenhoven, JR Jude, and GG Knickerbocker (1960) “Closed-chest cardiac massage,” Journal of the American Medical Association 173: 94–7.

  She lived: Eisenberg, Life in the Balance, 124–25.

  After contemplating the mask he’d discovered: Ibid., 102.

  In case you, too, want some fun bedtime reading: RA Berg et al. (2010) “Part 5: Adult Basic Life Support, 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care,” Circulation 122: S685–705.

  The more compressions you do: B Abella et al. (2005) “Chest compression rates during cardiopulmonary resuscitation are suboptimal: a prospective study during in-hospital cardiac arrest,” Circulation 111: 428–34.

  In one meta-analysis of adults: M Hupfl, HF Selig, and P Nagele (2010) “Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis,” Lancet 376(9752): 1552–557.

  That’s important because: I Stiell et al. (2012) “What is the role of chest compression depth during out-of-hospital cardiac arrest resuscitation?” Critical Care Medicine 40: 1192–198.