I was sleeping on a couch in Berndeane's hospital room when her choking woke me around 2:00 AM. She made motions as if talking, but no words came out as she tried to cough something up. I went for the nurse who went for the head nurse who went for the respiratory therapist who prepared for a tracheal suctioning, which would pull out whatever was blocking Bernie's breathing. But it all took too long. Bernie's oxygen level dropped below 90 percent, which is considered okay, to 80 percent to 60 percent to 40 percent. Nurses and doctors poured into the room with more on hand in the hall as she went into cardiac arrest.
Bernie had breast cancer for ten years, during which she'd lived well for the most part, but she'd fallen into a decline we couldn't stem. She stopped being able to drive, then to leave the house on her own, then to walk without a walker, then to get to the bathroom on her own, then to leave the bed.
It all seems inevitable now, but I was fighting for her life with all my heart, and believing in her turning a corner, gaining strength, returning to herself, was central to that fight. I never once approached her bed to check her or clean her or just love on her without that belief. So when she dropped out of consciousness for the last time before my eyes, I was utterly unprepared.
We'd agreed to what's called Partial Code, which specified that if needed, Bernie be resuscitated with an Ambu bag, which is placed over the nose and mouth to restore breathing when the person can't on their own. But no chest compressions to restart the heart, and no intubation, in which a tube is inserted into the trachea to keep the airway open and assist with breathing. These are both considered invasive and even inhumane for someone with little chance of recovery.
But at that moment, with dozens of people crowding the room poised for instruction, the lead doctor turned to me. Through Colonel Sanders mustache and beard, he asked me in an oddly sarcastic tone, what I wanted done, as if he didn't give a shit or couldn't let himself sound like he did. In a bizarrely bored drawl, he explained if they didn't perform full CPR at that moment, Bernie would die. So despite our agreement, with no hesitation whatsoever, I told them to do it.
Bernie being Bernie, warrior of life, lover of all it entailed, eager hard worker, enthusiast of accountability, transcender of hardships, bringer of blessings, light of my life, Bernie responded. Her heart restarted and she was intubated and moved to the Intensive Care Unit.
But there was no coming back from this, and I stayed by Bernie for hours as she lay intubated and unconscious, and I wept. I wept like my ancestors wept when their Temple was destroyed, because Bernie was sacred to me and now lost. It is a testament to the potency of cancer, and to our woefully inadequate ways of treating it after decades of research and billions of dollars of invested, that it could take Bernie from me, and our love, which was great, could be rendered so ultimately inconsequential in the face of it. She didn't want to go. I didn't want to lose her. But cancer took her.
When Bernie went into cardiac, I texted our housemates Jim and Lana, closer than family, who were sleeping with phones off because I was at the hospital. We finally spoke around 6:00 AM when they saw the text, and they were as shocked and unprepared as I'd been. But in those three hours, I'd begun reformulating Bernie's final months and weeks in the reality of her end, rather than the determination of her recovery. I started to see plainly the intolerability of her suffering, and how shattering that would be, even to an exalted spirit such as hers, and how hellish and probably hopeless these months must have been for her. I shared this with Jim and Lana, so we could begin to accept what to us was simply unacceptable.
When I walked out of the ICU, I cried out knowing I would never see Bernie again. Our friend Deb, a doctor who had fought for Bernie beside us, had seen my text in the night and joined me there. We delayed in the hospital parking lot for a few more minutes, bound to this last site of our struggle, to the love of Bernie that had sustained that struggle, before breaking away finally, each to our own cars and leaving her.
At home Jim, Lana, and I sought to process the devastation, talking freely, crying freely, but of course, Bernie was everywhere there. In photos in our bedroom; in the piano she had played now silent; in the perfect placement of plants, books, figurines, the fine cherry wood rocking horse she'd bought for our living room; in the clarity of our home and order of our life, there was no escaping Bernie.
How exactly the subject of cryonic suspension came up, I don't recall. Cryonic suspension involves preserving the human body immediately after death at extremely low temperatures with the intention of using radical technological advancements in the future to revive the person and cure them of what had killed them. We knew about cryonics through our involvement in the longevity community, in which some consider it the last longevity treatment when all else fails.
It's technological resurrection, and I tended toward skepticism, not so much about future technology, which seems likely to alter everything, including mortality, but about relying on today's technology to initiate the process, and how insufficient it probably is. When the subject came up, we shrugged, but Lana posed the question: why don't we preserve Bernie?
Death of those we love leaves no good options. A hole in the ground. Cremation. Above ground crypt. We may seek some measure of comfort in saying "rest in peace" or a popular one now, "rest in power," but no one is really resting, least of all we the survivors. Why don't we preserve Bernie?
As they say, there are no atheists in foxholes, and faced with circumstances of extreme severity, we see reality differently. The truth was, regardless of my skepticism about cryonics, at the possibility of giving Bernie more life in some undefined future, I felt a lifting in my chest where the weight of her loss had set like stone. The more we talked about it, the better I felt. The better we all felt, and the conversation morphed from general dismissal to seriously investigating the possibility of making this happen.
Jim had been the CEO of Bernie's care, constantly making calls to the institutions supposed to be supporting us, organizing nursing help, monitoring bloodwork, and strategizing with me on next moves as the previous ones failed. He could take on a demanding tone, and once I had to remind him, "Jim, I don't actually work for you, Bernie's my lover." But being a longtime business owner and operator, he couldn't help himself, and someone had to manage all the moving parts, and I had enough on my hands just caring for her, being with her, and keeping my own work life going.
Bernie had been Jim's intimate partner for years, and then his very close business partner when she and I came together. CEO-ing her preservation gave him a way to keep fighting for her and avoid, or at least postpone, the crushing finality of loss. We were both exhausted from months of struggle, but he took up his station at our kitchen bar and started making calls.
In a sense, the same optimism that drove us to keep seeking answers for Bernie until the end, we now transferred to pursuing her cryopreservation. What is the line between optimism and denial? Clearly, I could have been more prepared for Bernie's death if I had been less fixated on her recovery. But would either of us have been better off? Was I deceiving myself now by seeking to cryonically preserve her?
To get perspective on this, I spoke with a scientist well known in cryobiology circles, the broader science studying the effects of low temperatures on living organisms and tissues, of which cryonics is the still somewhat reviled stepchild. For his work in cryonics, this scientist had been threatened with losing his job, shunned socially, blackballed from events and publication. To protect himself, he requested anonymity, so I'll call him Dr. Yates. "My whole life I've had to live in the shadows because the world was not ready for it," he says.
Dr. Yates has a mild, friendly manner one might not associate with revolution, and the patient, plain-spoken intelligence of an original thinker who's had to stand up to critics many times over. He recites numerous scientific reasons to believe in the concept of cryonics and to question the irreversibility of death as we've traditionally thought of it. He says pig brains have been revived after four minutes of death and dogs after fifteen. "A cat was revived after a whole hour of brain ischemia." And there is the advancement of technology to factor in. "If you were to die in a forest in 1435, you're dead. But if you die in a hospital today, you can often be brought back with no brain damage."
Yates says his most recent work will demonstrate human brain structure can be preserved after cooling to cryogenic temperatures, which reach minus 200 degrees Celsius. He plans to publish this soon in a well-respected scientific journal, which is why he doesn't want to risk his reputation now. "Once it's published, there's no real scientific counter argument to cryonics anymore," Yates says.
Cryonics technology stands somewhere between the science fiction of yesterday and the innovation of tomorrow, between self-driving cars and the transporter of Star Trek. So while it certainly seems far out, how far out is it?
The first flight of the Wright Brothers came just 58 years before Yuri Gagarin orbited earth in the Vostok 1. Imagine being a kid on the beach near Kitty Hawk, North Carolina, and seeing the Wright Flyer catch air and soar over the sand dunes, and thinking, "In my lifetime, human beings will fly into space."
You wouldn't think that. You couldn't. But that's the kind of transformational advancement we're facing in healthcare and virtually every other area of technological inquiry. Cryonics seeks to tap this arc of advancement, presupposing if we can keep people sufficiently intact, and society doesn't collapse, there will come a day when what took their lives becomes eminently curable and they can be reanimated.
"If you suffer a medical condition, and the doctors says your case is terminal, you can accept it and die," says Yates, "or you can get a second opinion. But the second opinion you need may be from a doctor of the future, maybe 200 or 300 years from now. It doesn't matter, if you can wait to get that second opinion. That's the whole idea."
The truth is, in the hours and days following Bernie's intubation, our mind was made up: we wanted cryopreservation for her. My being on hand to have her resuscitated suddenly proved prescient. Instead of a last gasp move to postpone the inevitable, it turned into a foundational piece of our final effort on her behalf.
So when a relative objected, we were worried. The family member believed in what they called ascension, which means after death people's souls rise to some higher plane of existence. Bernie believed in no such thing. She felt, as I do, that physical life, the flesh, bone, blood that we are, is what we are, and though there are mysteries untold and untapped within us, including spirit, these all exist in our physical bodies. We had full legal power in the matter, but would they try to block us?
The family member, as well as some others who spoke up, felt cryonics somehow interfered with a vital spiritual process, which seemed odd. Isn't that the point of such metaphysics? That they don't adhere to any sort of physical reality anyway, so they aren't limited by it? If a soul can ascend from a buried body, then surely it can do so from a body suspended in nitrogen at -200 C. Ironic that people with such vaporous notions as ascension can be so fixed about them.
Cryonics, on the other hand, required us to deal with several all too physical issues, which we were getting increasingly nervous about. Now that we'd decided to do this, the clock was running. Bernie was still on life support in the hospital, which gave us some time. But it also added to my anxiety, knowing she was lying where I'd left her, a terrible image of stricken vulnerability seared in my mind. I could see how people prefer their rituals of burial or even cremation. These at least bring some release from the devastating corporal presence of a person too fragile to sustain life.
While Bernie waited, there were numerous obstacles to overcome. The first was money. Most people sign up for cryonics years before they need it and pay for it through an insurance policy that comes to a manageable monthly payment. But we hadn't planned this. The lump sum costs are prohibitive, especially after all the money we had expended on Bernie's care.
We live outside of Phoenix, a half hour from where the best-known cryonics organization, Alcor, is headquartered. But Alcor charges upwards of a quarter of a million dollars. The Cryonics Institute, located in suburb of Detroit, charged less than half that, but still more than we could pay.
We were connected to Aaron Drake, who does what is called Standby, Stabilization, and Transport, which amounts to getting the person to their cryonics container, or dewar, as intact as possible. The term "dewar" is named for Sir James Dewar, who invented the first vacuum flask, which is the basis for how these containers are designed.
Originally from Nebraska, Drake has a talkative, easy going Midwestern manner, which belies his unique skillset and role; Drake has helped invent and implement the processes to make cryonics as it is currently practiced possible. He was also, I found out later, an alternate on the 1984 Olympic swim team in the 100 meters breaststroke.
Drake had worked as an advanced paramedic in Lincoln, Nebraska, for 15 years. "I enjoyed it immensely, the challenge of trying to save peoples' life," he says, "but it brought some level of frustration. Some people you can't save, and even if you do, they may have a lot of brain damage or other disability." He saw cryonics as a way of taking his lifesaving work to a higher level. When I asked him how many he'd performed, he answered with unhesitating specificity: One hundred and three. Each one counted to him.
In several phone conversations, Drake explained the Cryonics Institute's window for receiving the body, or the patient as they said, used to be 72 hours after death, assuming they were packed in ice. But they had scaled back to 24 hours. This meant that from the moment Bernie died after being removed from life support, there would only be 24 hours to get her to Detroit. Which was not much time, "when you think of the regulations for funeral homes, TSA, cargo handling, and all that," Drake said.
The risk of Bernie reaching the Cryonics Institute in Detroit and getting turned back for being too late made me extremely uneasy. It felt like being denied some piece of critical care by the healthcare system.
As Drake explained it, there are three levels of damage he seeks to prevent in preparing the "patient" for preservation. The first is ischemic damage from oxygen deprivation, like that caused by heart attack or stroke. This is done by restoring oxygenated blood flow through the body using chest compressions and a ventilator, so blood is circulating while lungs are oxygenating. They also administer medications to maintain PH balance and keep blood pressure up.
The body is cooled to slow metabolic function, so the second level of damage prevention is to avoid freezing. Ice takes up 15% more space than water, so if ice crystals form, they would expand and crush cell structure. To avoid this, a process called profusion is performed. Profusion is when they wash out blood and other bodily fluids and replace it with a cryoprotectant fluid, which Drake calls "medical grade antifreeze."
The third challenge is to prevent decomposition, which is why the body is cooled. At about -100 degrees Celsius, the antifreeze hardens into a glass-like consistency, which Drake likens to "a kind of acrylic," in which everything becomes solid inside. Stored in liquid nitrogen at -196 Celsius, metabolism stops, and the body can be maintained indefinitely, until the right "second opinion" becomes available.
While Bernie lay in hospital, we tried to line up the logistics. Fortunately, we found a longevity charity we had supported in the past that agreed to help bear a significant part of the cost. But the funeral home Drake knew in town was balking at a quick turnaround. They had several burials and cremations that weekend and wouldn't prioritize Bernie. Drake wanted to find another funeral home that would be more helpful, but could he do it in time?
We also worried about the objecting relative. However little legal standing they had, any court action could cause delays that would make preserving Bernie impossible. Then there was the hospital. They still had Bernie on life support and wanted to know what we planned to do. We told them we expected out of town relatives to come see her, but it was an uncomfortable arrangement. These issues became like life or death for us, again, even though death was already unavoidable.
Several days had passed since Bernie went into cardiac arrest. Over a few conversations with the objecting relative, Jim had been able to explain that what we were doing was in alignment with Bernie's wishes to do everything possible to live. And in any case, her spirit could ascend from a cryonics dewar as well as anywhere. So that seemed settled, but we couldn't be certain until Bernie was interred at the Cryonics Institute. Could Drake get it done?
We were waiting to hear back from him about the funeral home, when he called and in his affable way told us he thought he may have another option to explore, which turned out to be a new first in cryonics, a world premiere, if you will. Until now, standard procedure was to do some cryoprotection in the field for the brain, but to perform the full profusion only upon arrival at the housing institution. But Drake told us he'd been developing a new approach, which was to perform the full body profusion on site. "The sooner you get the stuff in, the better for the patients," Drake said, "so why wait until after transport?"
In Bernie's case, since her preservation had not been pre-planned, this new approach would relieve the time pressure and the risks of delays along the way. We were all for it. He called back again that same day to say he found another funeral home that was much more helpful. We were ready to move forward.
When patients are removed from life support, it can take many hours, even days for them to die. I was relieved Bernie passed in just a couple hours, ending her tragic stay in that hospital. But even after several days of anticipation, and with all our plans for preserving her in place, it was a mournful moment that drew more tears out of me.
Drake had the next steps lined up, and because he would do the full cryopreservation before transporting her, there was little chance of the process going bad. Still, one last glitch gave us pause, when Bernie was taken to Sky Harbor Airport in Phoenix, apparently too late, and missed her flight until the following day. When we finally got word from Drake that Bernie had been delivered to the Cryonics Institute and suspended safely in her sleep of nitrogen, it didn't erase my grief, but I felt relieved.
Perhaps because we are so emotionally incompetent as a culture, grieving has gotten mixed up in peoples' minds with healing. More than one person, meaning well, expressed to me they hope I'm taking the opportunity to grieve. Well, yes, indeed.
Grieving is feeling one's pain, which we certainty need to do, but it doesn't change the facts that pain me: she is gone, she doesn't get to live as she wished, as I promised her she would, as I prayed and visualized with her through the various treatments we pursued. Those facts don't change no matter how much you feel them. On the contrary, they just become more real. We grieve, because what else can we do—but not because it solves anything.
How many times have I heard otherwise intelligent people say death makes like worth living, makes us value our time alive, and the people we share that limited time with. How many movie and book plots seek to expound on this dubious proposition. Yet I have felt no such elevation of my being, no sparking of my appetite for life. On the contrary, I've had to viscerally resist over and over the downward draw into irrevocable sadness, the permanent dulling of my capacity for joy, the physical ache cresting my heart in an eclipse of pain, the compulsion to in some sense die with her.
I find no solution for Bernie's loss other than to willfully distance myself from the suffering and distortion of disease, from the brutal, senseless, ruthless end, while keeping the feeling of her, her spirit, you might say, close. And then there is the cryonics.
Betting on cryonics is a bet on technological advancement, which seems like a safe one, but also, less securely, on society's stability to sustain it. Dr. Yates is optimistic: "The probability of someone coming back from cryonic suspension is 100%, assuming technology continues to advance. The question is are they still the same person? If preserved under good conditions, the odds are very good. But even if we think we're failing to do a good job, there's still the second opinion, and you may have done a better job than you think."
Sitting with Jim in our living room one day as we plotted this last battle for Bernie, I saw a vision, like a graph rising before me, on which one angling line was the technological advancement needed to revive Bernie, and another angling line intersecting it at, let's say, a hundred years out, was my own longevity. That would put me at 157.
To make this rendezvous, we would both need to ride a wave of innovation at this moment unknown, yet in some real sense, predictable. In his seminal work, The Singularity Is Near, published in 2005, futurist Ray Kurzweil describes the accelerating pace of technological advancements, particularly in the fields of computing, artificial intelligence, and biotechnology.
"Our intuition about the future is linear," Kurzweil says. "But the reality of information technology is exponential, and that makes a profound difference."
Exponential technology is what flew us from Kitty Hawk to outer space in less than a lifetime. If I couldn't have seen that coming then, how can I be sure of what's impossible tomorrow?
For believing in a future of such exponential gains, in which I'm able to live on and Bernie is brought back, you may think I'm a fool, but what is there for me instead? No one who isn't suffering horrifically or morbidly depressed wants death. So much so, one way or another, we imagine ourselves living on, whether through actual afterlives, or more subtly, through offspring, good works, and notable achievements, or others kinds of legacies left behind. Is it more foolish to believe in technological advancement than imagined immortalities?
Will Bernie and I, by the grace of science and the force of our own spiritual will, be brought back together? The truth is, I don't know. What I do know is I've got a lot of living to do to keep that appointment, and nothing to lose. So, I'll see you in a hundred years my dear, and leave it at that.
