CryoNet #33363 - #33394

CryoNet - Mon 28 Feb 2011

    #33363: Mike Darwin's Alternate Reality [Melody Maxim]
    #33364: comments re Darwin [Ettinger]
    #33365: Re: CryoNet #33358 - #33362 [Gerald Monroe]
    #33366: Secret societies? [Luke Parrish]
    #33367: Melody Maxim's Distorted Reality 1 [M2darwin]
    #33368: Melody Maxim's Distorted Reality 3 [M2darwin]
    #33369: Melody Maxim's Distorted Reality 4 [M2darwin]
    #33370: Melody Maxim's Distorted Reality 5 [M2darwin]
    #33371: Melody Maxim's Distorted Reality 6 [M2darwin]
    #33372: Melody Maxim's Distorted Reality 7 [M2darwin]
    #33373: Melody Maxim's Distorted Reality 8 [M2darwin]
    #33374: Melody Maxim's Distorted Reality 9 [M2darwin]
    #33375: Melody Maxim's Distorted Reality 10 [M2darwin]
    #33376: Melody Maxim's Distorted Reality 11 [M2darwin]
    #33377: Melody Maxim's Distorted Reality 12 [M2darwin]
    #33378: Melody Maxim's Distorted Reality 13 [M2darwin]
    #33379: Melody Maxim's Distorted Reality 14 [M2darwin]
    #33380: Melody Maxim's Distorted Reality 15 [M2darwin]
    #33381: Melody Maxim's Distorted Reality 16 [M2darwin]
    #33382: Melody Maxim's Distorted Reality 17 [M2darwin]
    #33383: Melody Maxim's Distorted Reality 17 [M2darwin]
    #33384: Melody Maxim's Distorted Reality 19 [M2darwin]
    #33385: Melody Maxim's Distorted Reality 18 [M2darwin]
    #33386: Melody Maxim's Distorted Reality 2 [M2darwin]
    #33387: Melody Maxim's  Distorted Reality 20 [M2darwin]
    #33388: Melody Maxim's Distorted Reality 21 [M2darwin]
    #33389: Melody Maxim's Distorted Reality 22 [M2darwin]
    #33390: Melody Maxim's Distorted Reality 23 [M2darwin]
    #33391: Melody Maxim's Distorted Reality 24 [M2darwin]
    #33392: Melody Maxim's Distorted Reality 25 [M2darwin]
    #33393: Melody Maxim's Distorted Reality 26 [M2darwin]
    #33394: comments re Darwin [M2darwin]

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Message #33363
From: "Melody Maxim" <[email protected]>
References: <[email protected]>
Subject: Mike Darwin's Alternate Reality
Date: Sun, 27 Feb 2011 10:45:03 -0500

In Cryonet message #33358, Mike Darwin writes that I have made "bizarre and 
ludicrous claims that cryonics has not interacted with perfusion science and 
'Board Certified' perfusionists," and that those claims have "been shown to 
be patently false." I have never made such statements, at all, hence it's 
impossible for anyone to have proven them to be false. I did make repeated 
objections to cryonics organizations sending laymen to perform perfusion on 
their clients, because perfusion is not a task a layman is likely to 
perform, without inflicting significant harm. Suspended Animation contracted 
with qualified perfusionists AFTER I harshly, and repeatedly, criticized 
them for allowing unqualified laymen to perform their perfusion procedures.

It's Mr. Darwin whose comments have, many times, proven to be "patently 
false." For example, Mike Darwin clearly, and falsely, stated on the Cold 
Filter forum, that he had once been a "board-eligible perfusionist." Mr. 
Darwin has never even come close to meeting the requirements of being a 
board-eligible perfusionist, and I called him on it, at which time he 
stopped posting on Cold Filter and began criticizing the moderator of that 
forum. It is Mike Darwin, who never acknowledges his mistakes, (or lies). 
I'm sure he would love the moderator of this discussion group to satisfy his 
request to ban me, because I'm probably the only participant who is likely 
to recognize, and comment on, his many mistakes and deceptions.

Mr. Darwin also claims I have established a "secret forum," where I post my 
"hateful rants and...use fraud and force against cryonics." This is just 
another of Mr. Darwin's many delusions. My blog was available to the public, 
until recently, and I'm sure most of what I wrote there has been archived, 
or copied, on other public sites. Not long ago, (after the Max More 
craziness), I grew tired of the tabloid-like sensationalism, and decided I 
would convert the information on my blog into a more dispassionate plea, for 
some sanity in the conduct of cryonics organizations, to be posted on a new 
website. One would think Mr. Darwin would be happy my blog was closed, but 
no, he wants to use the closing of it as an opportunity to pretend there is 
some sort of secret cryonics-bashing conspiracy. I have not  posted even one 
word on the blog, since locking it. If Mr. Darwin, or anyone else, would 
like to read my old material, all they have to do is ask. It is Mr. Darwin 
who wants to operate under a veil of secrecy, not I. I simply want to carry 
out the discussions in a more civilized manner, but it seems Mr. Darwin 
would like to take the opposite course of action, with his name-calling and 
false accusations.

In addition to falsely claiming to have been a "board-eligible 
perfusionist," Mr. Darwin claims to have performed approximately 1,000 dog 
perfusion experiments. Does anyone really believe that? If so, where is the 
documentation of all those experiments? What valuable conclusions, if any, 
came from those experiments? Does the reporting of any such results come 
from credible sources? How many people outside the cryonics community have 
been impressed with Mr. Darwin's scientific endeavors, over the past 35 
years? Where did all those dogs come from? Where are the authorizations Mr. 
Darwin would have needed, to legally perform all those experiments? Does Mr. 
Darwin care if his outrageous behavior leads to the banning of cryonics? If 
Mr. Darwin is such a cryonics superstar, why is it the cryonics 
organizations, themselves, have so little to do with him? (Rhetorical 
question...I believe many of us know the answer to that question.)

Mr. Darwin wants to maintain that no one has been deceived by the practice 
of referring to laymen as medical professionals. Does he expect people, 
newly interested in cryonics, to visit websites where they might see photos 
of people dressed up in surgical garb, being referred to as "surgeons" and 
"perfusionists," to know those people might really be gas station 
attendants, or store clerks? Does he expect a layperson to read 
SA's/Catherine Baldwin's ridiculous case report and know that one does not 
find the femoral vessels in the femoral capsule, where Ms. Baldwin claimed 
to be looking for those vessels? Does he expect a layperson to be able to 
read between the lines of that report, filled with medical jargon that might 
be impressive to laymen unfamiliar with medical terminology, and recognize 
that Ms. Baldwin, (who referred to herself as a "surgeon"), didn't really 
know what she was doing? Isn't it likely that many people who have signed up 
for these very expensive procedures, some who have left substantial 
insurance policies, trust funds and bequests to cryonics organizations, 
might have been under the wrong impression, in regard to the quality of the 
procedures they were signing up for? How can anyone fail to see the problem 
with falsely referring to laymen with the titles of medical professionals, 
while attempting to sell services with price tags of up to $200,000? 
(Please, don't come back with the "it's all there in the small print" 
defense, as the small print needs to be front-page news, in this situation. 
Otherwise, it looks like a con-game.)

It's my position that cryonics organizations are misrepresenting the quality 
of their services to an unsuspecting public, including members of their own 
community, and I believe Mr. Darwin has played a large role in that 
misrepresentation. It is also my position that cryonics "research" of the 
last 40 years has been largely a waste of time and money, which has 
accomplished little more than padding the pockets (and egos) of a small 
handful of insiders, who have a vested interest in continuing on that 
course. Mr. Darwin can try to discredit me until the end of time, with all 
his name-calling and false information. The truth is, I'm a medical 
professional who has spent many years working with some incredibly talented 
and well-respected members of the medical community, and everyone who has 
ever worked with me in conventional medicine will vouch for my credibility 
and competency. Can Mr. Darwin say the same, or have his past cryonics 
activities made him a pariah amongst even his own peers? Anyone who really 
cares about cryonics activities should demand the cryonics organizations 
live up to a much higher standard of professional ethics than they have in 
the past, and the toxicity of "loose cannons" such as Mr. Darwin should be 
of great concern.

Melody Maxim

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Message #33364
From: [email protected]
Date: Sun, 27 Feb 2011 11:05:54 -0500 (EST)
Subject: comments re Darwin

Here I'll just touch briefly on a couple of points raised by Mike Darwin's  
recent post.
 
His analysis of the reasons for slow growth are largely unsupported and  
unconvincing, and he leaves out a moderately prominent one--viz., the 
embracing  by many cryonicists of nonsense such as uploading. econlog.econlib has a 
piece  by one writer who was turned off cryonics by an advocate who embraced 
uploading.  I don't have all the relevant figures, but it is clear (1) that 
many in cryonics  do embrace uploading etc. and (2) that these fantasies 
are easy bubbles to  prick. 
 
Then there is the assertion, more or less, that all publicity is bad  
publicity and all media coverage should be avoided. Again, what is lacking is  
supporting data. In particular, of those who have joined, what precipitated  
their decisions? If it wasn't reading an article or a book or a web site,  
what was it, and what was behind that?
 
Robert Ettinger
 

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Message #33365
References: <[email protected]>
From: Gerald Monroe <[email protected]>
Date: Sun, 27 Feb 2011 12:28:56 -0600
Subject: Re: CryoNet #33358 - #33362

--20cf307f389a9d4e3d049d47bdc8

Melody : A piece of paper doesn't guarantee that you are good at something.
 Given that slightly over 200 cryonics cases have been performed in all of
human history, there *is no* formal training pathway to prepare someone to
save the minds of the recently deceased.  I guess the closest match would be
training as a vascular surgeon, a perfusionist, or perhaps as a PhD in the
hard sciences.

All of those education paths take years to decades, and earn you a
professional license that you would be at risk of losing if you were to
participate in anything controversial.  If you read the case report in
question, an M.D. WAS present during this case.  Email me for the report.

It's funny you mention that regarding the blood clots : because Mike
actually mentioned that very issue.  He specifically explained his
observations : an instrument to visually look at the outer surface of the
cortex.  Those capillaries are the farthest from the arteries, so if they
don't visibly clot up, it's a good sign.  Moreover, he isn't saying there's
no clotting at all : Mike is saying that since the patient was preserved
under better conditions, he doesn't see the clots that were visible in most
other cases.  He is in no way claiming there is no damage at all : the hope
is that the better procedure caused less damage, leaving more information
preserved.

  The reason I believe Mike is that he's honest about a great many things.
 His reports don't gloss over things when a case goes bad, his technical
explanations are correct up to my level of education, and so on.  I've never
seen him claim degrees he doesn't have, merely that he performed the surgery
or connected the bypass equipment, etc.

Have you TRIED to contact Mike and give him advice?  Or contacted the folks
and Alcor and volunteered your services?

I actually agree with you in that there's a reason cryonics is small.  *
Partly* the problem is a chicken-egg issue : today, cryonics is too small to
have access to or to *afford* teams of full time, fully formally trained
folks in the relevant field.  The reason the teams have people without
formal training on them (and this is one factor leading to *mistakes*, as
Mike Darwin himself points out has happened a huge number of times) is
because those are the only people available for whatever the pay is (and the
need to be on call).  Read about the early days of cryonics, and you will
realize that compared to those days, Mike is a legitimate expert in the
field.

I think that when the people with wealth look at cryonics, they don't see
the trapping of an institution they want to donate to : no marble corridors
and the like.  Hospitals competing for the same donations *look* enormously
better, and they are crammed to the gills with extraordinarily well paid
employees with enormous amounts of formal education.

Yet a hospital will give you painful, futile treatments until you breathe
your last and leave you to rot under a sheet in the morgue.  *Reality* is
different from appearance.

The only way cryonics can progress is that good people have to stand up for
it.  Again, find out what it takes to join one of the cryonics teams.  They
won't accept your advice as a stranger on the internet, but if you
demonstrated your abilities in person and did a few cases you might.

 Your opinions are not unusual or even insightful : the fact that hospitals
that forcibly keep hopeless patients breathing as their brains rot
irreversibly away using hundreds of billions of dollars of national wealth
while cryonics has a paltry few million proves that.  There's a reason that
nearly all of the hundreds of millions of Americans ignore cryonics even
though nearly everyone has been exposed to at least the concept somewhere.

             Gerald Monroe

--20cf307f389a9d4e3d049d47bdc8

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Message #33366
Date: Sun, 27 Feb 2011 12:10:49 -0800 (PST)
From: Luke Parrish <[email protected]>
Subject: Secret societies?

> Recently, remarks have been made, in regard to Mr. Darwin wanting to
> make cryonics some sort of "secret society." Why might that be? Does
> he want cryonics organizations to live up to their reputation as
> being cult-like?

Oddly enough, Mike Darwin hasn't actually said he wants to make
cryonics some sort of secret society. He stated rather that certain
kinds of secret societies are "arguably" a better model for how
an endeavor like this could be achieved realistically than
laissez-faire consumerist capitalism.

He has also registered complaints to the effect that those in
charge of regulating medicine (and indeed most members of the
culture at large) simply do not have a solid grasp on the ethics
of the situation where cryonics is concerned. It is of course clear
to most that cryonics needs "regulation", i.e. professional rules
of conduct that customers can count on being adhered to. The debate
(if one can call it that) seems to be whether the rules should be
self-imposed in some fashion, or externally imposed by persons with
no interest in the success of the endeavor.

I like Mike's proposal of setting up cameras and videotaping
everything that goes on in cryonics -- a strategy which he labels
"Prosthetic Nocioception". I don't think these recordings should be
made publicly available as a matter of course, as there is known to
be a tendency among certain individuals to distort and misrepresent
everything they hear about cryonics for maximum shock value. The
purpose of videotaping everything, like that of producing highly
detailed case reports, would be for those who do have a legitimate
interest in building up the quality of cryonics care (who also
have relevant expertise from related fields) to be able to offer
constructive criticism, on a professional, not political level.
It would also be likely to deter carelessness in the first place
and provide better opportunities for self-evaluation on the part
of staff and organizers.

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Message #33367
From: [email protected]
Date: Mon, 28 Feb 2011 01:07:04 EST
Subject: Melody Maxim's Distorted Reality 1

Content-Language: en

 
No. No more answers  from me until you answer the questions asked of you 
first - and long ago. You  are a pernicious distorter of truth by your 
indecent use of dirty and degrading  statements rephrased as questions. 
Want just a few  examples, folks? Well here's one fresh from CryoNet just 
short while  ago: 
http://cryonet.org/cgi-bin/dsp.cgi?msg=33264 
"While I'm sure Mr.  Darwin has toyed with primitive perfusion equipment, 
at cryonics facilities, he  is not  a perfusionist, or an  engineer, and he 
certainly does not have resources  comparable to those of companies, which  
specialize in perfusion equipment,  such as those mentioned here:  
http://www.perfusion.com/cgi-bin/links/default2.asp?tree=558" 
Yeah, right, OK  Maxim, PROVE it, prove that the equipment I worked with in 
the 1980s and "90s  was "primitive perfusion equipment, at cryonics 
facilities"? In fact, were using  the same equipment that was being used in 
cardiothoracic operating suites around  the world - and some of that equipment is 
still, today, being used with  excellent outcomes in places that can't 
afford the latest and newest pumps...  Nevertheless, removing the pejorative 
words "toyed with" out of consideration,  DFEND YOUR ASSERTION THAT I EMPLOYED 
PRIMITIVE PERFUSION EQUIPMENT in cryonics.  And be very careful to defend 
your implication that that is ALL that I ever  employed, because as we all 
know, the only thing available to cryonicists when I  became involved was "
primitive equipment" if you count embalming pumps. Indeed,  even the Manrise 
machine (which BTW, I never used myself) was reasonably  sophisticated for 
1972.  
The you can go on to  defend these remarks by citing REAL EXAMPLES and 
PROVIDING REAL  REFERENCES: 
http://cryonet.org/cgi-bin/dsp.cgi?msg=33264 
While I'm sure Mr.  Darwin has toyed with primitive perfusion equipment, at 
cryonics facilities, he  is not a perfusionist, or an engineer, and he 
certainly does not have resources  comparable to those of companies, which 
specialize in perfusion equipment, such  as those mentioned here:  
http://www.perfusion.com/cgi-bin/links/default2.asp?tree=558 
"How many cryonics  projects have been directed, on the advice of Mr. 
Darwin and others like him?  How many of those projects were based in ignorance 
of existing equipment and  technology? For so long as  people  like Mr. 
Darwin and his peers are considered to be "experts," in cryonics  experiments, 
there is likely to be nothing more than ample misdirection and  false 
promises. It seems a very small group of self-interested people have made,  what 
could be an interesting scientific  experiment, a total sham. (By 
"self-interested," I do not mean people who  are interested in extending their own lives; 
I mean people who are  primarily  interested in maintaining  their 
over-inflated egos and/or bank accounts, by maintaining control of  experiments 
and/or projects, which they are not capable of  leading.)" 
Me and most others  on CryoNet would like to know SPECIFICALLY not only "
*how many* of those  (cryonics) projects were based in ignorance of existing 
equipment and  technology" as a result of my advice or actions, but EXACTLY 
WHAT AND WHENTHEY  WERE. Tell us! 
And when you finish with the two simple  and straightforward requests 
above, THEN you can get started on the many  questions and clarifications asked 
of you in the material below and that is to  follow. And I will post and 
repost these questions relentlessly  until: 
1) You answer these  questions succinctly and satisfactorily 
2) You are removed  from this forum 
3) I am removed from  this forum. 
You are a damaging  and destructive influence in cryonics, and there's the 
pity, because you might  well have made valuable contributions. It would be 
hard to find anyone in or out  of cryonics whose criticisms of the technical 
and ethical shortcomings of the  field more closely match my own, and those 
of a very few others, some of who you  know and with whom you might also 
have worked. Instead you have chosen to  attach, denigrate and humiliate. And 
the irony is, of the people to whom you  have directly caused distress, I am 
not one. To use the only sentence that will  do service to you and your 
words: I could frankly give a fuck about your fucking  lies and distortions 
where they concern me. And anyone who knows me will know  that is true. When 
they first came to my to attention, as a result of an email  from "Finance 
Director (FD)," I responded factually and without ad hominem until  I realized 
that you were a seriously disturbed and vindictive person who was not  
susceptible to reason, at which point I walked away and didn't give it another  
thought.  
I blew off  subsequent emails from FD attempting to alert me to your 
actions. Become any  kind of a public figure and crazy idiots will say all kinds 
of bad things about  you - most of which are lies. Hell, even you own 
associates and so-called  "friends" will lie salaciously and foolishly about you. 
The reasons for this  execrable behavior as varied as they are impossible to 
correct, or to control.  You either get used to it, or you go mad. And 
since I've long been the latter,  that left me nowhere to go but on with my 
life. It was not until I was forced to  realize that your vile babble was 
actually hurting cryonics that I was moved to  action. Because when you started 
harming cryonics you started fucking with two  things I do care about - my 
only reasonable hope of personal survival, and one  of the few things I've 
loved without reservation. Maybe it's better that way,  because my response is 
as mechanical, as relentless and as inevitable as the  secondary fusion 
reaction of a hydrogen bomb.  
Mike  Darwin


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Message #33368
From: [email protected]
Date: Mon, 28 Feb 2011 01:19:23 EST
Subject: Melody Maxim's Distorted Reality 3

Content-Language: en

 
Melody Maxim writes:   
When the flow  transducer would not work with CI's solutions, I attempted 
to persuade Ben to  allow me to find another way to measure the flow. There 
are other ways, and I  felt the safety of the centrifugal pump, (it makes it 
virtually impossible to  pump air to the patient), far out-weighed the 
inconvenience of finding an  alternative for measuring flow. I did not try very 
hard to convince Ben, because  I sensed he was uncomfortable with the pump, 
and I felt certain there was no way  for me to make him comfortable with it, 
in the three short days I would be  there. He seemed quite happy with the 
occlusive (roller) pump I had helped him  acquire, so I volunteered to 
purchase the centrifugal pump back from CI. I told  Ben I wanted to do some 
experiments with the pump, and I did, but the main  reason I wanted to buy the pump 
back from CI was that I did not want them to be  out $1,800 for a pump they 
purchased on my advice, but would not be using. I  even paid for them to 
ship it to me.  
Mike Darwin: This a  good example of something learned over two decades ago 
by professional  cryonicists through experience. Had Ms. Maxim established 
a dialogue with me  this information would have undoubtedly been quickly 
passed along. Flowm eters  on earlier clinical centrifugal blood pumps do not 
work on either asanguineous  solutions or on low ion content solutions 
(including washout solutions such as  MHP and mRPS-2 used by CI) because they are 
electromagnetic (EM) flow meters. EM  flow meters work by measuring the 
distortion in the magnetic field created as  ion containing fluid moves through 
that field. There are two sources of ions in  blood: the dissolved salts of 
metals such as sodium, potassium, magnesium, etc.,  and the iron present in 
the oxygen carrying protein hemoglobin. It is possible  to recalibrate EM 
flow meters for asanguineous solutions that have ion levels  reasonably close 
to that of blood, but these flow meters do not perform  accurately or at all 
in some cases, if the ion concentration in the solution is  much lower than 
that of blood (or other body fluids).   
TBW solutions are  designed to inhibit the cell swelling that normally 
occurs in ultraprofound  hypothermia due to inactivation of the cellular ion 
pumps that normally control  cell volume (and ion content). This is done by the 
expedient of replacing most  of the ions that are permeable to the cell 
membrane with other, larger molecules  that cannot enter the cells. Typically, 
what has been used as impermeant species  to replace the ionized species 
normally present in blood are sugars (glucose,  lactobionate, raffinose), a 
sugar-alcohol (mannitol) or (in the very early days  of organ preservation) the 
phosphate salts of sodium and potassium (e.g.,  Collins' Solution).  
Even  non-perfusionist cryonics personnel, such as Fred Chamberlain, wanted 
to use  centrifugal pumps, and indeed, as I previously pointed out here, 
the first  purpose-built cryonics perfusion equipment was executed using 
centrifugal  pumping technology. However, the problem of flow measurement had no 
ready  solution even though many things were tried. To name a few: in-line 
paddle wheel  flowmeters, differential pressure manometer flowmeters and 
falling ball  flowmeters. Sure, it was possible to get accurate flows with all 
of these  techniques, but only for perfusates of a fixed viscosity which 
meant that both  the composition and the temperature had to remain constant.   
Clearly, this is a  problem in cryoprotective perfusion where increasing 
concentrations of  increasingly viscous CPA(s) result in dynamically changing 
perfusate viscosity.  However, it was also a problem in recirculating CPB of 
cryopatients prior to  cryoprotective perfusion. This was so because the 
character of the recirculated  perfusate changed radically as its ion content 
changed (equilibration with the  large store of ions in the patients 
tissues) and as its water content changed  due to movement of water (usually edema 
fluid) from the interstitial space of  the patient into the vascular 
compartment where comparatively hyperoncotic and  hyperosmotic perfusate was 
circulating.  
Recent generations  of centrifugal CPB equipment use ultrasonic Doppler 
flow meters. These flow  meters work using a phenomenon first discovered by 
Christian Doppler in the  1840s. He noticed that a stationary observer 
perceives a sound to have shorter  and shorter wavelengths as its source approaches; 
and longer wavelengths as the  source recedes. The classic example of this 
phenomenon (i.e., the Doppler  Effect) explains why we hear a rising pitch 
in the sounding horn of an  approaching automobile and why, when the car 
passes by us and recedes into the  distance, the pitch drops. Ultrasonic Doppler 
flow meters use this frequency  shift to work with so-called dirty liquids, 
fluids containing acoustical  discontinuities such as suspended particles, 
entrained gas bubbles or turbulence  vortexes.  
When ultrasound is  beamed through a pipe or tubing containing flowing 
liquid with particles, such a  red blood cells i blood flowing through it, the 
ultrasonic beam (or pulse)  reflects off of the cells with an alteration in 
frequency that is directly  proportional to the flow rate of the liquid in 
the tubing. The ultrasonic  Doppler flow meter then calculates the flow rate 
from the velocity of the red  cells, rather than from the velocity of the 
plasma or other (particle  suspending) liquid.  
Ultrasonic Doppler  flow meters are ideally suited for many applications 
where there is dirty,  particulate rich water (such as sewage) or where there 
are lots of particles or  bubbles such as in slurries, crude oil, and, of 
course, blood. Ultrasonic  Doppler flow meters typically require suspended 
solids or bubbles of at least 5  microns or larger in size to be present in a 
concentration of ~100 parts per  million or higher. Doppler-shift measurement 
doesn't work in liquids with  particulate concentrations exceeding ~45% w/v 
or with high concentrations of  very fine bubbles. Particles or bubbles in 
these size ranges attenuate the  reflected signal until it is 
indistinguishable from tubing background noise.   
>From these  considerations its is pretty obvious why neither ultrasonic 
Doppler flow meters  or electromagnetic flow meters were usable in the 
perfusion of cryopatients.   
Why is knowing flow  so important? Obviously, it is important to know 
crudely what the flow through  the patient is. It would be pretty frightening to 
have no idea whatsoever of  what the flow rate is during perfusion. But, how 
much precision is necessary and  for what reasons?  
In clinical  perfusion flow is one of a number of critical determinants of 
both oxygen and  substrate delivery to the tissues. Beyond these 
physiologically critical point,  flow, when considered in the context of arterial and 
central venous pressures  (i.e., the systemic vascular resistance or SVR) 
provides a wealth of information  about the condition of the patient with 
respect to vascular tone, vascular  compromise (from edema or capillaries blocked 
to flow) and it provides a  necessary context for meaningfully evaluating 
critical physiologic parameters  such as the measured gas exchange, pH and 
blood ion content. In cryonics TBW  knowing the flow is important for these 
reasons and for others which are unique  to cryonics.  
Clinical CPB is not  performed in patients who have suffered long agonal 
periods with profound  perimortem systemic ischemia such as that experienced 
by cryopatients. The  impact of such systemic ischemia can be profound and 
may (and usually does)  result either in conditions of very low flow at normal 
physiological pressure  (70 to 90 mm Hg) or conversely astronomically high 
flows at well below such  pressures. The former (we think) results from 
cellular edema compressing  capillaries, intravascular clotting (both macro and 
micro) and perhaps from  vasospasm. The latter (we think) results from 
massive systemic vascular  dilation; perhaps as a result of the production of 
large amounts of nitric oxide  (NO) or, in patients with ischemic times of ~30 
min or more, due to substrate  exhaustion in the smooth muscle that controls 
vascular tone. Early attempts in  the late 1960s to place cadavers on CPB 
for organ retrieval failed due to shear  injury from very high blood flow 
rates at barely tolerable physiological  pressures (i.e.,~40-60 LPM at 40 to 60 
mm Hg!). I have seen both of these  phenomenon in both experimental animals 
(dogs) and in human cryopatients. So,  for purely practical reasons, it is 
important to know the flow during CPB in  cryopatients. 


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Message #33369
From: [email protected]
Date: Mon, 28 Feb 2011 01:23:09 EST
Subject: Melody Maxim's Distorted Reality 4

However,  beyond these immediate practical considerations flow, in the 
context of pressure  and other variables of the case, provides critically 
important insight into the  pathophysiology of the cryopatient. We want to 
understand what is causing these  things, why they happen, and how they respond to 
our interventions. Does SVR  improve when we use a hyperoncotic perfusate, a 
hyperosmotic perfusate or a  combination of both during TBW? Is this 
improvement lasting and does it come  without adverse effects? Are 
vasoconstrictors such Neosynephrine or vasopressin  effective in cases where the SVR is 
extremely low and the flow rate is  astronomically high: and yet acceptable 
(i.e., required) physiological perfusion  pressure cannot be obtained? How much 
actual capillary perfusion is occurring in  such cases as opposed to flow 
that is shunted around the capillary beds?  

Beyond these examples it is important to understand that accurate  
measurement of as many physiological parameters as is possible leads to  
fundamentally new insights; often insights into important phenomenon which we  did not 
even know existed. If we dont collect the data we will not be able to  learn 
and make progress. The history of scientific, evidence-based medicine is a  
testimony to the criticality of vigorously collecting data which is 
consistently  and ACCURATELY collected. That means precision in quantification. Ms. 
Maxim  seems not to grasp this. 

Roller pumps are heavy, bulky and shed  particles of tubing (spallation) 
into the blood or perfusate they pump. They are  also harder on blood (more 
damaging to the cells) and they cause more activation  of immune-inflammatory 
cascade (IIC) than the latest generation of centrifugal  pumps. Depending 
upon the design of the system they unequivocally carry a  greater risk of 
macro air embolization. Everyones preference in cryonics was to  use centrifugal 
technology. However, a number of factors argued against this:  

1) Knowing flows with precision and accuracy (indeed knowing them at  all!) 
was critically important. It is absolutely essential in cryoprotective  
perfusion because flow rate is the primary perfusion parameter that determines  
cryoprotective agent equilibration in the patient. Flow is also the primary 
 determinant of cooling rate (along with heat exchanger efficiency and the  
temperature of the wall water) during in-field CPB of cryopatients. Knowing 
when  the patient will be cold enough to come off the pump is often really 
important  since it can mean catching or missing a commercial flight. Roller 
pumps give a  very consistent flow regardless of temperature, pressure, 
viscosity or perfusate  composition. RPM can be converted directly into flow. 

2) It is  possible to design TBW systems so that no macro air can be 
perfused using roller  pumps. This was done with the ATP. The ATP, properly set-up 
(a given in any  system including centrifugal circuits) cannot pump macro 
air. The ATP was NOT  designed for extended closed-circuit operation and ALL 
of my advice to SA was in  the (stated) context of simple open circuit flush 
of the patient. 

3) The  notion that centrifugal pumps cannot cause physiologically 
devastating  over-pressure injury is incorrect. While centrifugals cannot generate 
an  infinite head of pressure under occluded conditions as can roller pumps, 
the  static pressure of most medical centrifugals under no-flow (occluded 
arterial or  venous line) conditions varies from ~500 to well over 700 mm Hg. 
Such pressures  will NOT rupture the extracorporeal circuit (i.e., explode 
oxygenators, filters,  or blow apart circuit connections) but they can cause 
tremendous damage to  patients. Just try occluding the venous (outflow) line 
on a CPB circuit  employing a centrifugal pump on a human (or animal) and 
wait until the flow goes  to zero from back pressure. You will have one very, 
very dead patient. The much  touted safety against over-pressure with 
centrifugals in CPB is primarily to  the circuit and thus indirectly to the 
patient because if the arterial leg  of the circuit explodes due to a clamped 
line, bypass is interrupted until a new  circuit can be brought on-line and the 
patient is now virtually guaranteed not  only ischemic time, but very 
likely the need for transfusion as well (with all  its attendant risks). 

4) No cryonics patient, to my knowledge, has ever  been air embolized 
during in-field TBW due to a roller pump or due to pumping  the venous reservoir 
dry. When in-field air embolization has occurred it has  been due to 
improper connections on the arterial line: between the arterial line  and the 
cannula (Venturi effect) or due to failure to de-bubble and aspirate the  
arterial line and arterial cannula/vessel prior to going on bypass. 

5)  Low level and bubble detection equipment with auto-shut-off and 
line-clamp  features are highly effective at prevent air embolization and should be 
used on  ALL CPB circuits. 

6) Loss of prime on centrifugal pumps in the presence  of high molecular 
weight colloids creates large numbers of very stable and  difficult to remove 
micro-bubbles. This also often happens during priming when  air is 
enrtrained into the pump. 

7) Centrifugal pumps are not acceptable  for CPA perfusion and personnel 
MUST learn how to reliably and safely use roller  or other occlusive positive 
displacement pumps. This can only be achieved by  extensive didactic and 
hands-on training in a feedback driven model. Translated,  that means you must 
pump living animals under demanding conditions (i.e., that  produce major 
physiological derangements) with SURVIVAL as the outcome and with  EVALUATION 
of the quality of that survival (i.e., end organ function,  neurological 
outcome, etc.). 

I (and Jerry Leaf when he was alive) have  been saying this for 20 
years!!!!!! 

Melody Maxim writes: 

"The  misunderstandings that are going on, here, are one of the inherent 
reasons  medical professionals should be used to perform medical procedures in 
cryonics.  We never had these types of disagreements, when I worked in 
heart surgery,  because we all had the same basic educations, with our 
specialties layered on  top that. In other words, we "spoke the same basic language," 
and we had all  been educated regarding each other's specialties, to some 
degree. (All of the  perfusionists in my class did hospital rotations 
assisting the anesthesiologist,  and scrubbing in with the surgeons, and we had 
classes related to every aspect  of heart surgery, not just perfusion.) 
Mike Darwin: This is quite true and,  in point of fact, neither Jerry nor I 
had any such problems with the many  medical professionals, including 
professional perfusionists, with whom we  interacted or collaborated with over 
the years. In fact, Ms. Maxim is the first  such person with whom Ive had this 
difficulty." 

Melody Maxim writes:  

"These questions are not pertinent to the situation at SA. SA is not  
starting out with blood, and they are not using cryoprotective perfusate of  
varying concentration. The last I heard, they are washing out the patient's  
blood with a specified volume of washout solution that has a consistent  
concentration." 

Mike Darwin: See my extensive comments above.  

Melody Maxim writes: 

"Precisely measuring the flow is nowhere  near as important as preventing 
the introduction of air to the patient. An  occlusive pump will continue to 
pump at the set rate, regardless of whether the  tubing is filled with fluid, 
or air, while a centrifugal pump will not."  

Mike Darwin: This is true, but it is not the whole story (see above).  The 
solution is to have *only properly trained/skilled personnel perform TBW*.  
Clinical perfusionists are the ideal (with additional training) but the fact 
is  that any intelligent, motivated person with the right temperament and 
reflexes  can be trained to operate an open circuit TBW system (with the 
proper  safeguards) with a high degree of safety. That does not mean a weekend 
of  training but rather extensive, outcome-based training using the identical 
system  that is to be employed in the field. The reality is that in much of 
the world,  and for the foreseeable future, cryonics is going to be 
performed by  non-perfusionists. There was a time when that was done both safely 
and  effectively (if you count me as a non-perfusionist). But it was NOT done 
easily.  

In fact, actual real-world experience has demonstrated that I am even  more 
conservative on this point than is Ms. Maxim. I refused to provide CI with  
a more complex circuit absent extensive training to a level where I was  
satisfied that the personnel using the system would be reasonably safe. Every  
additional complexity in the procedure or the circuit design creates  
distractions with the potential for error (absent through training and vetting).  
There was a time in cryonics (1981 to 1997) when at least in SOME cryonics  
operations these standards applied and in those operations *air was never 
pumped  to any cryonics patient (with no exceptions and no qualifications)*.  

Meklody Maxim writes; 

"An equally critical, related issue,  (which isn't even being discussed by 
Mike), is the importance of maintaining  proper patient pressures. After 
reading SA's "CI-81" case report, I accused SA  of over-pressurizing a patient 
whose cerebral vasculature was already  compromised. The occlusive pumps 
that have been used in cryonics are NOT  sensitive to pressure and will 
continue to deliver the selected flow rate, no  matter how high the patient's 
pressure gets. (In other words, an occlusive pump  will continue to pump at the 
same rate, in the presence of increasing pressure,  until something blows 
apart.) A centrifugal pump will respond to increasing  patient pressure with a 
decreasing flow rate, and to a decreasing patient  pressure with an 
increasing flow rate, at a constant RPM. 

Placing an  amateur behind an occlusive pump is almost certain to result 
in: 

a.) Air  being introduced to the patient 
b.) Inappropriately high perfusion pressures  that may result in vascular 
insult to the patient 
c.) Inappropriately low  perfusion pressures that may result in the 
inadequate perfusion of the patient's  tissues (some of the patient's tissues won't 
be perfused with the cryonics  solutions) 
d.) Any combination, or all, of the above" 

Mike Darwin:  Countless CPB cases have been pumped worldwide with roller 
pumps with a  microscopic incidence of air embolism due to the presence of the 
roller pump,  per se; and with excellent outcomes. This was true even 
before the introduction  of safety features such as macro/microbubble detectors, 
low-level detectors and  arterial line clamps. Of necessity, neonatal and 
adult ECMO are STILL carried  out using compliant bags with these features 
(plug a push-plate type bag volume  sensor/controller) and I believe many 
canters still use roller pump for this  days to weeks-long CPB procedure. The 
fact is that BOTH systems are used  clinically with acceptable safety and 
excellent outcomes. 

Outside of  cryonics, in the world of clinical medicine, I have almost no 
doubt that  centrifugal pumps will become the standard of care and, what is 
more,  that minimal CPB using integrated centrifugal pump-oxygenator- heat  
exchanger-cardiotomy and venous reservoir systems is the future of CPB (and 
that  eventually, when/if true membrane hollow fibre oxygenators are 
manufactured,  this will be the case for extended duration ECMO, as well). These 
systems are  compact, have less immune-inflammatory cascade activating surface 
area (and the  surface area that is present can be better treated to 
minimize such activation),  and are less damaging to both the formed elements of 
the blood and to the plasma  proteins than are conventional CPB circuits 
andthey require less priming volume  thus conserving blood and reducing the need 
for transfusion. They are also just  more elegant and aesthetically 
physiological: in the body the heart is not  positioned in the pelvis, but rather is 
adjacent to the lungs with the shortest  possible lengths of connecting 
tubing (blood vessels). 

Whats more, if  the flow problem can be solved I believe that minimal CPB 
systems will be ideal  for use in cryonics cases including cases where 
prolonged (8 to 24 hours)  extracorporeal support is indicated. Of course, this 
presupposes they are  affordable. Much of what we actually used in cryonics 
from day one was a  function of what we could gain access to - and that was in 
large part a function  of money. (The righ 'connections' and favors also 
played a critical role). SA is  an other-worldly affair subsidized by LEF and 
not, as far as I can tell,  sustainable in its current form. 

Ms. Maxim speaks of inappropriately  high perfusion pressures in 
cryopatients. I concur, but would go further and ask  these questions of her: 

1) What are the safe and appropriate pressures  to use in cryopatients 
during both blood washout and subsequent asanguineous  recirculation? Please 
explain why you have chosen the value(s) you provide.  
2) What are the absolute and relative medical contraindications to in-field 
 TBW for cryopatients? 
3) What are medical indications and contraindications  for extended (> 1 
hour) asanguineous extracorporeal support of cryopatients?  What are the 
likely complications and how should they be managed? 
4) What  are the expected pressures (MAP & CVP) and flows in both acute TBW 
and ECMO  treated cryopatients? 
5) What colloids can be used in TBW/ECMO of  cryopatients and for what 
reasons? What colloids are known to be contraindicated  and on the basis of what 
evidence? 
6) What FiO2 should be used during TBW  and/or ECMO in cryopatients? Why? 

Melody Maxim writes: 

"Mike  Darwin: "So, again, I ask: has SA done the simple experiments 
necessary to  validate the SCPC flowmeter? An easy place to start is to pump tap 
water from a  reservoir and measure the flow/min by capturing the pump output 
in a graduated  cylinder while using a stopwatch to determine elapsed 
time." 

I've been  waiting all day for someone to ask the obvious question, but it 
seems to have  slid right past everyone on this forum. Since Mike claims to 
be concerned with  the accurately measuring the flow of SOLUTIONS USED IN 
CRYONICS, why is he  suggesting using TAP WATER for the experiment, rather 
than the actual washout  solution??? This makes no sense, whatsoever. 
Regardless, as Mike, himself,  points out, it is simple to determine whether the flow 
transducer is accurate  for SA's washout solutions, and I'm quite sure the 
perfusionists associated with  SA learned this simple task, (just as I did), 
in perfusion school. 

Mike  Darwin: I suggested tap water because it is cheap and readily 
available. If the  flowmeter reads tap water flows accurately then it is worth 
proceeding to test  it with perfusate (really expensive) under real-world 
conditions. I suggested  tap water for the same reason you used it in training 
circuits: it is a cheap  liquid which you can pump and which behaves enough 
like blood for the purpose at  hand. If the SCPC flowmeter gives an invalid 
number for tap water, particularly  if it is misleadingly close to a believable 
flow, then you should proceed with  real caution if you proceed at all. CPB 
ultrasonic Doppler flow meters and  electromagnetic flowmeters will NOT 
read water or TBW asanguineous perfusates at  all. This is a blessing in that 
you are not likely to mistake a random number  generator for a truly accurate 
flowmeter. If a flowmeter reads tap water with  reasonable accuracy (or can 
be calibrated to read such) then there is a good  chance it will read 
perfusate accurately; after all, we know for sure it reads  blood accurately and 
tap water is one extreme of a continuum between distilled  water and blood, 
with perfusate being in-between in terms of viscosity and ion  content. 



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Message #33370
From: [email protected]
Date: Mon, 28 Feb 2011 01:28:13 EST
Subject: Melody Maxim's Distorted Reality 5

Content-Language: en

 
Melody Maxim writes:   
Mike Darwin: "Your  remarks about unreliable and malfunctioning in-house 
fabricated circuits  certainly don't apply to my experience of nearly 25 
years. I have never had a  circuit fail - never. I have had an oxygenator fail, 
but that is really the only  mechanical failure I've ever had on CPB. One 
qualification is that the Sarns  venous reservoir bags did not have a rigid, 
internal fenestrated intake line.  This meant that under high flow conditions 
the bottom of the bag around the  orifice feeding the pump would sometimes 
collapse and cut off flow. This problem  was remedied by switching to the 
Gish/Terumo bags."   
One of the key  figures in the perfusion group SA is said to be working 
with is a prominent  figure in the perfusion community. He's the co-author of a 
book that can be  found in the lab coat pockets of a large percentage of 
clinical perfusionists,  and is required reading material for many perfusion 
students. At the risk of  being rude, I doubt his perfusionists need Mike's 
advice, regarding which  reservoir bags to use. I believe Mike's persistence 
in naming as many specific  perfusion devices he can, and remarking on 
things like "internal fenestrated  intake lines" to be a major distraction from 
the REAL issues the amateurs  working in cryonics, or the people reading this 
forum, need to be concerned  with, (like the basics of maintaining proper 
perfusion pressures and preventing  air embolization). Given that SA starts 
with a known volume of solution, it  should be easy to determine, (even 
during a case), if the flow rate is  approximately accurate. For the washout 
procedure, would it really matter if the  flow were actually 3.2LPM, when the 
flow meter was reading 2.9LPM? For as long  as you have good patient pressures 
and no air is getting pumped to the patient,  the proper answer to that 
question would be a definitive, "No.""   
Mike Darwin: These  remarks are not so much rude as ignorant. I'm glad SA 
has such a fine  perfusionist. But, no matter how good this man is, he will 
almost certainly not  have expertise unique to and essential to proper 
extracorporeal management of  cryopatients. How could he? No patient presenting 
for clinical CPB even  approximates the average cryopatient presenting for TBW 
and/or asanguineous  ECMO. Even within perfusion there are areas of 
specialization that require  additional knowledge and training: extended ECMO, 
emergency fem-fem CPB,  neonatal and pediatric CPB, and normothermic CPB, to 
name a few. What is so  extraordinary about the idea that cryonics should be 
the same? As just one small  example, Ms Maxim had no idea how or why 
conventional CPB flow meters worked, or  that they would not work in cryonics. That 
comparatively trivial lack of  knowledge resulted in the following (quoting 
Ms. Maxim):   
When the flow  transducer would not work with CI's solutions, I attempted 
to persuade Ben to  allow me to find another way to measure the flow. There 
are other ways, and I  felt the safety of the centrifugal pump, (it makes it 
virtually impossible to  pump air to the patient), far out-weighed the 
inconvenience of finding an  alternative for measuring flow. I did not try very 
hard to convince Ben, because  I sensed he was uncomfortable with the pump, 
and I felt certain there was no way  for me to make him comfortable with it, 
in the three short days I would be  there. He seemed quite happy with the 
occlusive (roller) pump I had helped him  acquire, so I volunteered to 
purchase the centrifugal pump back from CI. I told  Ben I wanted to do some 
experiments with the pump, and I did, but the main  reason I wanted to buy the pump 
back from CI was that I did not want them to be  out $1,800 for a pump they 
purchased on my advice, but would not be using. I  even paid for them to 
ship it to me.  
To summarize, the  costs of this lack of existing knowledge were at least 
as follows:   
1) Time and effort  lost acquiring a pump that was not useable.  
2) Any time and  effort lost trying out others methods of determining flow 
that have already been  explored and found unworkable.  
3) Money expended  needlessly on the system and on shipping it to and fro.  
 
4) Loss of  credibility that results when others learn that these problems 
had already been  extensively explored in cryonics and that that information 
was readily  available, some of it on the Internet.  
5) Knowledge of new,  scientific/industrial ultrasonic flow meters that may 
well work for cryonics  applications (but which have not yet been tested).  
Melody Maxim writes:   
Mike Darwin: "One  last point I'd like to make is that it is important to 
consider the context of  the times. SA has, by any standards in cryonics, 
vast amounts of capital and  human resources. Most of the history of cryonics 
has been one of negligible  capitalization and in most of the world this is 
still the case. The SCPC system  is lovely, but the question is, is it 
affordable for most cryonics operations  not heavily financially subsidized?"  
Now, THAT'S a damn  good question. However, it's long been my opinion that, 
if we are able to  improve the quality of patient care in cryonics, the 
science will gain a wider  acceptance, and more money will come in. (Sort of an 
"If you build it, they will  come," kind of thing.) SA has the funding to 
provide quality equipment and  qualified personnel to operate it. Would Mike 
have them remain in the dark ages  and rely on self-taught amateurs with 
makeshift equipment, just in case the  funds dry up? I think I have a better 
suggestion: SA could save hundreds of  thousands of dollars each year, by 
cutting their staff to two full-time people  managing a well-manned, 
well-maintained standby team of professionals. The  professionals would determine what 
equipment will be used, and if anything  needed to be built, it could be 
contracted out to reputable engineers who would  deliver the projects within a 
specified time- and price- range. The  professionals would be able to write 
their own case reports, so SA wouldn't have  to pay a science fiction writer 
to make them look like fools."   
Mike Darwin: I'm in  agreement with most of these sentiments, but not the 
idea that if you build it  they will come in the sense that cryonics will 
instantly or even soon be  transformed into a medical-professional undertaking. 
Here's the irony: Ms Maxim  and many others took cryonics seriously enough 
to get involved because it  APPEARED that biomedically sound perfusion 
technology was actually being used by  some extant cryonics organizations. That 
that appearance was even possible was  almost solely a result of a time in 
cryonics when such sound, medically-based  perfusion practices were in fact 
being used. When Jerry Leaf and I were no  longer present the patina of 
biomedical credibility was sustained, but NOT the  reality.  
That reality, when  it existed, used both professional medical personnel 
and in-house trained  personnel. These people were trained to do perfusion 
procedures of sharply  limited complexity to very high standards with safety as 
the core goal. No, they  could not pump a clinical CPB case, just as a 
paramedic cannot manage a patient  in septic shock in the ICU. However a 
paramedic CAN successfully manage a  patient in septic shock long enough to get him 
to the hospital ED. Paramedics  are not made in a weekend and neither were 
the (very few) in-field CPB techs we  trained. In fact, NONE OF THEM WERE 
EVER USED; either Jerry or I did or  supervised every TBW done during our 
tenure at either Alcor or BPI. The primary  (and successful) use of the in-house 
perfusionists we trained was to mind the  pump during dog research. This 
was a demanding and essential job which we could  not afford to pay 
professional perfusionist to do on a long term basis.   
In a broader sense  it IS true that if you build it they will come.' That 
sense is that IF you have  a medically sound practice of cryonics which is 
rational and evidence based,  then a few medical professionals will be 
attracted to cryonics and will not run  away in disgust at what they find. A few of 
these people will stick around and  get involved. Cryonics was lucky that 
two such people stayed around and worked  to improve things DESPITE the 
horrible state it was in. The Chamberlains, Art  Quaife, Jerry Leaf, myself and 
others are examples of this at different times in  different places and in 
different ways.  
Melody Maxim writes:   
Mike Darwin:  However, no amount of technology will protect you from 
incompetence and lack of  skill.  
I couldnt have said  it better, myself!"  
Mike Darwin: This  has been my point since at least 1978. Even very crude 
equipment can be using  with surprising safety and effectiveness if you have 
competent and experienced  personnel. Ive seen CPB done safely in the Third 
World using procedures and  equipment that would shock any Western 
perfusionist including using the same  circuit for 3 different patients (all with the 
same blood type and cross-match  compatibility) with no safety equipment 
and nothing to monitor CPB but a  manometer, an oximeter and pH meter (no 
blood gas equipment!).  


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Message #33371
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Message #33377
From: [email protected]
Subject: Melody Maxim's Distorted Reality 12

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Message #33378
From: [email protected]
Subject: Melody Maxim's Distorted Reality 13

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33379
From: [email protected]
Subject: Melody Maxim's Distorted Reality 14

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33380
From: [email protected]
Subject: Melody Maxim's Distorted Reality 15

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33381
From: [email protected]
Subject: Melody Maxim's Distorted Reality 16

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33382
From: [email protected]
Subject: Melody Maxim's Distorted Reality 17

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33383
From: [email protected]
Subject: Melody Maxim's Distorted Reality 17

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33384
From: [email protected]
Subject: Melody Maxim's Distorted Reality 19

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33385
From: [email protected]
Subject: Melody Maxim's Distorted Reality 18

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33386
From: [email protected]
Subject: Melody Maxim's Distorted Reality 2

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33387
From: [email protected]
Subject: Melody Maxim's  Distorted Reality 20

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33388
From: [email protected]
Subject: Melody Maxim's Distorted Reality 21

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33389
From: [email protected]
Subject: Melody Maxim's Distorted Reality 22

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
23 messages by [email protected] exceeds the
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Message #33390
From: [email protected]
Subject: Melody Maxim's Distorted Reality 23

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33391
From: [email protected]
Subject: Melody Maxim's Distorted Reality 24

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
25 messages by [email protected] exceeds the
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Message #33392
From: [email protected]
Subject: Melody Maxim's Distorted Reality 25

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33393
From: [email protected]
Subject: Melody Maxim's Distorted Reality 26

<<< EXCESSIVE NUMBER OF POSTS PER POSTER PER DIGEST >>>
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Message #33394
From: [email protected]
Subject: comments re Darwin

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End of CryoNet Digest
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