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The BBC have a news article on this: http://www.bbc.co.uk/news/uk-scotland-22015175

Damn, this sounds like a Klatskin tumor, a "rare" cancer. My father hat that kind of tumor as well. He died within 8 weeks of first developing jaundice.

Let's stop trying to make people click on cheery-colored buttons and do something about this fucking disease instead.

Getting rich and improving the economy is almost certainly the best thing you can do to combat disease, pollution, poverty, etc.
Or by doing the actual medical research that will fix these problems. Seriously, not everything is solved by money - most is fixed by smart people figuring stuff out. If all the smart people spend their time trying to make money, who is going to do the research?
Indeed. If you stand back far enough the behaviour of humanity seems completely insane. I wish I knew what to do.
Except diseases like cancer are almost exclusive to "western" society. The more affluent we become, the more cancer and other non-contagious diseases we get.

We are killing ourselves and it starts with the stuff our mothers eat, is made worse by what we eat, and is topped of by the environment we live in.

Err.... no.

It's more prevalent in some societies because we live longer and we don't any longer die of preventable infections.

Our air is cleaner than it's been for a long time. Decent nutrition has never been cheaper or more widely available. Life expectancy has never been longer.

We are not killing ourselves. OK so some are by overeating and doing no exercise, but in general you're talking nonsense.

and we've never ate so many chemical food preservatives, taste modifiers, colourants like we're eating now. we've never been exposed to so much radiations like we are now. mobile phones being the first source. and the list goes on. we definitely are doing something to ourselves.
and we've never ate so many chemical food preservatives, taste modifiers, colourants like we're eating now. we've never been exposed to so much radiations like we are now. mobile phones being the first source. yes we might be killing ourselves

This doesn't change the fact we're living longer, healthier lives than ever before.

I'm sure there's a lot more that we could be doing, I'm sure that there are things we do that we should stop doing for our own health BUT none of this supports the notion that cancer is a disease of western privilege and we're doing everything wrong. We're doing more right than we've ever done.

and yes i forgot sugar and lifestyle
Actually, you need to do cohort analysis to see the risks in different age ranges rather than generalizing.

People in older baby boomer cohorts are doing better than younger generations.

"Decent nutrition has never been cheaper or more widely available."

Sugar/fat has also never been cheaper or more widely available.

Cancer isn't even remotely exclusive to western society. You don't think there's a cancer cost to the fact that 36% of Japanese men smoke?

In Japan, their cancer rate per 100,000 is 1/4 lower than in the US, but that isn't close to the claimed exclusivity. 220 per 100k in Japan versus 300 per 100k in the US.

In S.Korea, it's 260 per 100k, for a mere 13% variance.

How come the Chinese live seven years less than the supposedly cancerous and diseased French in the west? Shouldn't the eastern lifestyle make the Chinese live a lot longer?

Your claim about exclusivity isn't supported by the data. Affluence doesn't correlate to cancer, in fact it's the exact opposite: on average rich people live a lot longer, live healthier, and get cancer less frequently than poor people. In the west, cancer has a high correlation to both obesity and poverty.

Your right. I shouldn't have said "exclusive". I shouldn't be posting when I'm sick. Mea culpa.

Instead, what I should have said is, cancer rates are significantly higher in "western" countries and certain kinds of cancers have seen dramatic increases, such as breast cancer[1] and prostate cancer[2], as countries have "westernized". As countries westernize, rates of these cancers increase.

1. http://www.independent.co.uk/life-style/health-and-families/...

2. http://www.healthandenvironment.org/prostate_cancer/peer_rev...

Or perhaps western medicine is better at detecting those diseases.
Japan is basically Eastern genetics with Eastern diet and Western medicine, right? And a few very "Western" cultural trends (lots of work/high stress, smoking, etc.).

(The irony is that smoking is more on the rise in Asia/etc. than elsewhere, so at some point smoking and related illness will be a non-Western thing, too.)

By a large margin my favourite author. The Wasp Factory was the first novel of his I read and it was great, but Consider Phlebas and The Player of Games utterly blew my mind.
Agreed. I became a fan of his after reading just a few chapters of The Player of Games, and have since read almost everything he has ever published. He is an author of extraordinary skill.
The Player of Games is one of the few sci-fi books I recommend to readers interested in the genre.
Which Banks book should I start with? I was going to start with the Player of Games after your comment, but it turns out it's part of a series, and Consider Phlebas is the first one. Does it matter?
I've read in a Amazon review that it is recommended to start with Consider Phlebas, then The Player of Games and finally Use of Weapons (as a first start into the Culture, that is).

I've bought them three myself and will read them in this order.

I will too, thank you.
I'd actually consider starting with one of the latter two. Consider Phlebas is great still, but distinctly less mind blowing than PoG or UoW..
Aha, well, Player of Games it is, then! Especially since, like ceejayoz said, they don't really depend on each other. Thanks for the recommendation.
I wouldn't start with Consider Phlebas.
Read this: http://nuwen.net/culture.html

then: The Player of Games Consider Phlebas Use of Weapons

Use of Weapons is great, but the writing is poorer than the other two.

Use of Weapons is great, but the writing is poorer than the other two.

Heh. Interesting. I'd say exactly the opposite myself. Not that I dislike the other two - PoG is one of my faves of his SF work - but to me UoW is a vastly better work of literature, both in structure and character development. Less full of SFnal goodies than some of his later work, but all the better for that in some ways.

No, it doesn't really matter. Each of the Culture novels is basically standalone. They occasionally reference events amongst each other, but more in an "this is an interesting story too" manner.
For the first 3 I agree with you, but I feel the later Culture novels expect a certain level of familiarity with the Culture universe
It's quite an interesting concept... Instead of having a recurring character in a series of standalone novels, have a recurring culture.
I'd suggest Player of Games first; I found it better as an introduction to the Culture. They're not really a series as such; his Culture novels share a setting but don't share any characters (well, almost none) or any particular plot continuity, so you certainly don't have to read them in order.

I'd suggest PoG as a starting point to explain what the Culture's about, which I think it does better than CP because the main character in that is not of the Culture. YMMV though.

Yeah, that seems to be the consensus. I'll go with that, thank you.
Actually, don't start with the books.

Read this webpage to get an introduction to the Culture. It's great, and it helps you get through some of the "rougher" edges in the earlier books.

http://nuwen.net/culture.html

I'd suggest not starting with the Culture novels. The Algebraist is more accessible because it's not constantly referring to a mysterious super-organization that's driving the plot.
The Culture books are not really a series so much as a collection of stories all taking place in a single imaginary universe. Plots and characters from one book occasionally turn up as background details in another, but there is no reason to read them in order.
To everyone who enjoyed Player of Games, I ask.. why?

I'm not suggesting your opinions are wrong, of course, but I had a much different impression. Obviously Player of Games is well regarded by many people, so I'm curious to know what I missed.

--- SPOILERS BELOW ---

My general impression was that the Empire of Azad was that its conception lacked imagination. The peculiarities of the species (the three sexes, the society built around a board game, etc) could have made for a very interesting culture, but those instead the peculiarities were mostly left untouched and the culture was recognizable as human in every way. The greatest offense, in my opinion, is that the most interesting part of the book (the game Azad) was left almost entirely undescribed. An alien species should be different. Vastly different. These were humans painted green on Star Trek.

The point of the book is obvious, once completely read. In fact it's wickedly delightful and has nothing to do with Azad.
In Player of Games, the Culture doesn't represent we humans on Earth. The Azad do. They aren't alien and different because of that.
You're missing my point. The Culture and the Azadians were very anatomically similar. That's silly and lacks imagination.
Banks explains, in one the books, how the universe somehow produces humanoids all over the place, for unknown reasons; probably it's simply an optimal shape in a certain type of gravity and atmosphere; and that this is why many of the species in the books are humanoid. It's a writer's way out, really, and a perfectly adequate one.

Banks has other weird and interesting species appearing in the periphery. But the books are ultimately not about weird aliens.

He also goes further in this explanation in another work (whose name eludes me), in so far as some races deliberately seed the galaxy with humans so that when a race such as ours breaks free of their solar system, they don't get all hegemonic because there are already humans everywhere.

This saves many nasty wars.

> An alien species should be different. Vastly different.

That is one thing you could do with an alien species. Banks has done that elsewhere quite a bit. It could be that his imagination failed him here. Or he could have made a conscious choice, seeking a specific effect.

I think it was the latter. For me, part of the point of literature is to explore what it means to be human. One of the things that comes up over and over in Banks's work is encounters between developed and primitive cultures. He uses the contrasts to examine where we've come from, who we are, and where we might go.

Player of Games in particular to me spends a lot of time looking at the desire to win, and also the desire to play for high stakes. The Culture's post-scarcity society makes bets meaningless. How does somebody with a gambler's nature fare in that context? And how does somebody raised in that context change when they become immersed in a society built around gamesmanship and gambling? The Azadians are an exaggeration of particular aspects of humanity because he's trying to explore those aspects. If they were more alien, you would identify with them less, which I think would weaken the impact.

If you're reading Banks for things like detailed descriptions of fictional games, you should probably look elsewhere. He's definitely the kind of guy who likes building elaborate sets and then showing them to you. But they are there to support the drama that is performed in front of them.

I read Consider Phlebas in one go during a day off between finishing my final year project at Uni and starting revising for my finals - would have been May '88.

Left a bit of an impression on me....

My favorite science fiction author, got sucked in by Matter, then quickly proceeded to read all Culture books. Use of Weapons is my favorite, has the perfect mix between the dark character and the utopian Culture space opera.
Yep, Use of Weapons is my favourite too. Transition really stuck with me, as well.
Shit.

Amazing author. I want to live in the Culture. And I want to read new books by him forever, this is not allowed.

Gutted, incredible author. Am going to miss my Culture novels dripping through every few years. :-(
Damn. It's always the good guys :(
I never read any of the "M" banks books but i read a few of his regular ones when i was a teenager.

I remember thinking at the time, the wasp factory was a book i'd not forget, yet i can only vaguely recall the plot and some events! Espedair Street on the other hand i can recall pretty much everything. It's funny what you remember.

I was like you at the same age, and I wondered what the fuss was about.

Then I read his first Culture novel... I never looked back! They are my favorite sci-fi series ever and I have read a TON of sci-fi and fantasy in my life now (mostly sci-fi when younger).

Of all of his books I too have a soft spot for Espedair Street - Glasgow, Weird, and that utterly wonderful opening.
Indeed; I've re-read it several times. A great book.
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I am very upset about that... In my opinion he's the best living science fiction author... but not for long, I guess... :-(

I've read most of his books (all of his SF books). The Culture is an amazing universe, but the rest of his works are also outstanding.

I rank him in my top tier of writers along with John Barnes.
Excellent call-out on Barnes; he's one of the most under-rated authors out there.

If you haven't read his stuff, pick it up.

I think the only novel of his I read was Finity, and that kind of turned me off.
Not all of his work is great, but the "Thousand Cultures" series and "Century Next Door" series are the great reads.

Note: The dark anti-hero in "Kaleidoscope Century" is probably the reason he hasn't won many major awards. You can't write such a character and not piss off the various sci-fi author and fandom cliches.

Agreed. Barnes can go dark - REALLY dark.

The Directive 51 universe is really dark, but has a ton of great ideas and great writing.

I only just started reading the Culture, after the first book I was already hooked. He is a great writer.
What do you recommend as a first book to read?

(edit: never mind, sibling thread has it covered: https://news.ycombinator.com/item?id=5485695 )

Read this page first as an amazing introduction to the Culture:

http://nuwen.net/culture.html

I wouldn't. It's amazing only after you've read some of the books and familiarised yourself with it. Any teenage SF fan can come up with some kind of crazy and awesome-sounding universe, but turning it into a series of dozens of amazing novels is another thing altogether!
Consensus seems to be Player of Games but I have to say my first one was Use of Weapons, which I picked up from a book store in London on a whim, one weekday lunchtime in the late 90s. It's a fantastic starting point.
If you LOVE science fiction already, I'd go straight for the jugular and start with Excession. It's hardcore, it's full of awesome technology, it will blow your mind and forever seduce you into the world of the Culture.

If you're just a normal science fiction fan, start with Use of Weapons. It's complex and sci-fi-ish enough, but not as hardcore as Excession. The plot is amazing. To me it is one of the most memorable books of science fiction that I've read. It really made me question some basic beliefs about ... well, you'll see.

If you're a normal person, who wants a slightly softer intro into the Culture universe, or someone who's not particularly into science fiction, Player of Games is a great starting point because it is less about the tech and more about the ideas and the people, but nevertheless a great book.

Ultimately, the only one I wouldn't start with is Consider Phlebas, which is good, but imho nowhere near as good as the rest. To me, Consider Phlebas was about the same level as, say, the Reality Dysfunction by PFH - great space opera, fast paced, gripping, but not exceptional in any way. Every subsequent book (with very few exceptions) is not just great, but also unique and different from all the other science fiction books out there.

Thanks for this - I read Consider Phlebas and was very underwhelmed by it. Just now I struggled to remember much of the plot even though I read it less than a year ago. I'll check out some of your other recommendations.
> I read Consider Phlebas and was very underwhelmed by it.

Huh. Same here. I've only read CP and I honestly could not tell why everyone is so excited about Banks.

Okay then, I'll add a few more titles to my wish list. Thanks!

Consider Phlebas is more of a literary novel that happens to take place in the future. I like all of Banks' work and thinkSwombat's suggested reading order above is spot on, but I also think Consider Phlebas is by far his best work.
My fav is Look to Windward, but you needed to be entrenched in the world to get a lot out of that book.

I still haven't been able to make myself finish Matter yet.

I loved Matter. It drags on for the first half (like many of his books), but once it gets started, boy does it go!

The title is awfully well chosen, too. The full title would probably be: "Matter? It doesn't"

Silly nitpick: doesn't Consider Phlebas take place in our past?
yes. And It makes a lot more sense if you're already familiar with the Culture, in which case the perspective of CP (from an avowed enemy of the Culture) is a lot more interesting. A prequel of sorts, but one I'd almost read last.
Depends where you think humanity-on-Earth sits relative to the Culture. Since most of the Culture is human and we on Earth are as yet unaware of any spacefaring civilizations, I view it as a possible future for humanity. I would not be surprised if we encounter other life in space, but I'd be extremely startled if it turned out to be human life.
Pretty sure our present is post-Idiran-war based on the short story in The State Of The Art.

EDIT: I should specify that Contact is working on present-day Earth in that story, from what I recall.

Oh, you're right as an in-world thing. But I meant this sort of high technology described is in our future, ie I'm using 'in the future' as a proxy for 'science fiction.' Sorry about the confusion.
In cannon, Earth is an un-contacted planet and the Culture isn't our future. They are out there now.

Though, obviously, as a literary device you are right.

Not the future. The Culture books happen rougly in the present day (although across a timespan of many centuries; CP is set 800 years before the other novels, The Hydrogen Sonata several centuries after Excession), and there is even a short story about The Culture encountering Earth.
Consider Phlebas was sort of a literary lark. Start with Player of Games. Also, it all only works if you like the idea of The Culture. Really, it's the main character of all of the books. If you aren't cheering for The Culture, the books aren't going to work for you.
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This isn't a good context in which to wax lyrical about how completely I fail to get why people like Iain Banks's SF, so I'll skip the ranting, but I'd love to have someone convince me what there is to like.

A loved one loves Banks, so I've tried really hard to get it, and I've failed. I recently read Excession and got zero value out of it. Also recently read Feersum Endjin; it was alright, but suffered from the same flaws as other Banks. I did enjoy The Algebraist, though I read it a while ago so it's a bit foggy. I also read, once upon a time, Consider Phlebas and Player of Games, and remember being utterly utterly disappointed in both, but I can't remember anything more than that.

Thanks for the recommendations. I just finished The Player of Games and was about to start Consider Phlebas. Now I'll have to consider whether to tackle Excession or Use of Weapons instead.
Funnily though, I started with consider Phelbas, and it was good enough to keep me involved, the ending and the emotion it dripped has made me think about it in a different way, and far more than any of the other books, except maybe Use of Weapons.

Excession was quite a flourish, and deliciously fun.

I won't tell you which one I recommend reading first, but I would recommend reading 4 or 5 before hitting "Against a dark background".

That book is really hard on the emotions. I have a feeling it may have been a bit of an experiment for Iain as it reads a bit differently from the rest (I think I've read every book he has out currently, including "Raw Spirit"... Brilliant book)

Oh, and the top comment in the sibling thread you linked to is a very good recommendation.

Iain [M] Banks is the writer whose books I most look forward to reading.

Fuck cancer.

A UK charity is taking this approach to fund raising.

Compare these two adverts -

"Not Alone", MacMillan Cancer Support (http://www.youtube.com/watch?v=MLpS97XA5VA)

"Cancer, We're Coming For You", Race for Life (http://www.youtube.com/watch?v=GWJEmMDQXoA)

Yes, fuck cancer.

I'm not sure if you understand what MacMillan is about, but you're comparing apples and oranges here.

"Fuck Cancer" is all well and good... but MacMillan's work isn't about finding a cure, it's about easing suffering. They provide support and care to patients and their families, "Not Alone" sums them up pretty perfectly.

This is sad news. He's an awesome author, and many people will miss his great writing. 'Wasp Factory' was an amazing book.

He mentions his sore back. That's important! Most lower back pain is nothing serious, but rarely it's a sign of significant illness. He also mentions that he initially thought the pain was related to his work on a book. That's relevant for an industry where people tend to spend many hour sitting at a desk typing code. We talk about better ergonomics -nicer chairs, standing desks- but sometimes the wider health is missed.

He's a titan of British literature, I've loved his work for a number of years. What a legacy to leave behind.
As an English Brit I'd love to claim him for our own but, to be honest, I think "Scottish literature" is the only appropriate description.

This is awful news. I've not been a big fan of his later SF works. But Feersum Endjinn and Espedair St are tremendous and who knows, maybe the later works will grown on me. I hope he lives to see his latest book on the shelves.

(Edit: Not that I'm claiming he's not a Titan)

I'll agree with that actually, he's in favour of an independent Scotland as his dream of a socialist Britain is unlikely (from a Guardian article he wrote a while back).
Terrible news. If you're not familiar with Iain's work you owe it to yourself to drop everything and start reading the Culture series[1] right now.

[1] http://en.wikipedia.org/wiki/Culture_series

I absolutely love the Culture series. Although it doesn't delve into the Culture universe proper, Use of Weapons is one of the best books I've read. Would highly recommend checking out this book. The two narrative flows and the conclusion at the end, wow, just wow.

Definitely very sad news.

Use of Weapons is maybe the best (or at least top 5) sci-fi novel I've ever read. Amazing stuff - and a turn that genuinely changes the whole story.
Terrible news. If you're not familiar with Iain's work you owe it to yourself to drop everything and start reading the Culture series[1] right now.

In fact go give all of his books a try (hey - we're allowed to read non-SF here too aren't we ;-)

Iain's non-SF work is wonderful, and often so very Scottish. In particular, I love the opening to Espedair Street:

"Two days ago I decided to kill myself. I would walk and hitch and sail away from this dark city to the bright spaces of the wet west coast, and there throw myself into the tall, glittering seas beyond Iona (with its cargo of mouldering kings) to let the gulls and seals and tides have their way with my remains, and in my dying moments look forward to an encounter with Staffa’s six-sided columns and Fingal’s cave; or I might head south to Corryvrecken, to be spun inside the whirlpool and listen with my waterlogged deaf ears to its mile-wide voice ringing over the wave-race; or be borne north, to where the white sands sing and coral hides, pink-fingered and hard-soft, beneath the ocean swell, and the rampart cliffs climb thousand-foot above the seething acres of milky foam, rainbow-buttressed.

Last night I changed my mind and decided to stay alive. Everything that follows is . . . just to try and explain."

Totally agree. Last year I decided to give Bank's non sci-fi a go. He draws such great characters. Espedair Street was my favourite, but The Steep Approach to Garbadale and Complicity were also great. Complicity is a really good intro to Banks; it's a nice Scottish thriller and an easy read.

He is a good literary writer, and I think that is what makes him such a good sci-fi writer. I had never read any sci-fi like it when I first read him. There are still very few good writers in sci-fi.

Very few indeed. Have you read Gene Wolfe? One of the few writers in the genre I truly admire as a literary writer. A good starting book is "The Fifth Head of Cerberus".
No I haven't. Thanks for the reference, I'll look for him next time I'm at the library.
Cool. The other thing to check out is The Book of the New Sun, which is his masterpiece. A very deft and literary subversion of the fantasy genre (though it's really SF).
My uncle died from a brain tumor two weeks ago. This week my aunt will have one of her lungs removed because of lung cancer. Last year my friend's wife had to have both of her breasts removed. And now one of my favorite authors will probably die to this shit. What a vile disease.
He shouldn't just accept this. There has to be something to be tried. With his notoriety, the option to try some experimental new treatment should at least be considered.
I've seen my grand mother die from gallbladder cancer. Weeks leading to her death she was miserable, she didn't have a minute of rest. Since then I understand why some people choose to end it early instead of prolonging the suffering...
Spot on. There's no heroics in hanging it out.

Sorry for your loss.

Nonsense.

He knows it's terminal (it's spread all over the place), and if he chooses to live the rest of his life on his own terms and not enduring the significant side effects of chemo, then it's his choice and good luck to him.

My grandmother refused chemo (cancer in bowel, liver, lymph nodes) and I think she made the right choice.

He doesn't have a chance of lasting more than a few months, most of which will be painful and with rapidly decreasing functioning. With the type and severity of his cancer, an experimental new treatment will simply ensure that his last days are more painful than they need be.
Sometimes it just isn't worth fighting. it'll just ensure suffering. Make every minute of your life count and you can live with this outcome.

Cancer sucks worse if you put everything in your life off.

The BBC article (http://www.bbc.co.uk/news/uk-scotland-22015175) states that he may undergo chemo once his jaundice clears up, so it doesn't seem like he's planning to just go entirely quietly, but the reality is that he has to make a tradeoff between possibly making his last months or year (or hopefully a bit more, if we're lucky) total agony to extend it by what is unlikely to be more than months, or try to be comfortable for as long as possible.

Cancer treatments is still ridiculously primitive, unfortunately, largely boiling down to doing lots of damage while trying to keep the patient alive longer than the cancer.

Most physicians that I have talked about all agree that quality of life is more important than the quantity in this types of cases. Every treatment of late stage cancer is very invasive and rarely successful. If he wants to spend a month as healthy as possible with his widow to be instead of two vomiting and feeling miserable that is his choice and the correct one in my opinion.

There are few things that prolong life, most of them prolong the suffering and increase the emotional drain on the loved ones.

I wish him to make the most of what he has left.

Sorry, but there is a lot of assumption and ignorance in reply to your comment.

1. Modern supportive care means that chemotherapy does not involve constant vomiting, pain and torment. Some patients work and look after their family in between having chemotherapy. For example, in a large study on the efficacy of chemotherapy in biliary tract cancers including gallbladder cancer the rates of severe vomiting were only 5% (http://www.nejm.org/doi/full/10.1056/NEJMoa0908721). And when it does happen, it doesn't go on for 'months'.

2. If you shrink the cancer people feel better ie treatment can improve quality of life, that's why we do it.

3. Some cancers are indolent. This means that people can live for a long time with them, whether they have treatment or not. See Stephen Jay Gould's essay for example (http://www.cancerguide.org/median_not_msg.html)

4. Participating in clinical trials is a standard part of cancer management. You don't have to be famous to receive experimental therapies if you want them.

Having said all that, chemotherapy IS primitive and doesn't work as well as it should, and hopefully we won't still be using the same stuff we are now in 50 years. But it can help people, and trying it is not crazy or hopeless, and an extra couple of months might mean a lot to a particular individual.

It depends completely on which chemotherapy you get, which cancer you have, and sheer dumb luck. Both "chemotherapy" and "cancer" are blanket terms covering a multitude of radically different things.

Best case: your cancer is contained to a single organ and susceptible to antibody therapy. Practically no side effects, and you'll most likely be healed.

Worst case: your cancer has spread to multiple organs, requires the use of cytotoxics and your body reacts badly to those. You're better off setting yourself on fire - at least then you'll have to endure at most a few days of excrutiating pain before you die. No, that is not an exaggeration.

Source: my girlfriend who works as a nurse in a cancer ward specializing in chemotherapy.

Most importantly: make that decision yourself while you can! Don't leave it to the doctors (who only learn ways to keep patients alive at all costs, not ways to decide whether it's better to let them die) or your relatives (who'll tell the doctors to do everything humanly possible to assuage their feelings of helplessness and guilt).

"You're better off setting yourself on fire -"

That plainly isn't true. Why come to HN to make hyperbolic generalisations about cancer therapy? There are many people with advanced widespread disease who choose to have treatment. Are you suggesting that they are all foolish or coerced by doctors? Really? Would you be happy to come down to my cancer hospital and tell the 33 year old woman with 2 young children that she is better off "setting herself on fire" than having chemotherapy?

Your last statement also is incorrect. I spend just as much time talking about stopping therapy and options that don't involve chemotherapy as I do about giving chemotherapy.

Source: I'm training to be an oncologist.

> That plainly isn't true. Why come to HN to make hyperbolic generalisations about cancer therapy?

That was not a generalization; I explicitly labelled it as "worst case", but what actually happened to one of my girlfriend's patients is that as a reaction to the cytotoxics, his entire skin started to dissolve. This may have been an extremely rare special case, but it did happen, and the doctors in charge didn't stop the therapy even then. The patient died after suffering effectively as a burn victim for 2 weeks.

It's great to hear that you are willing (and presumably trained) to consider non-therapy as an option as much as whatever the newest miracle cure is, but that's definitely no the case for all oncologists everywhere.

You should read a little more carefully. He is not suggesting anything like what you read into it.

Having seen a bad reaction to chemo up close, I can confirm that it is pretty awful, and that I'd certainly have to think before choosing between a bad chemo reaction and setting myself on fire.

I reccomend you read the "How Doctors Die" article and comments posted here a while ago: https://news.ycombinator.com/item?id=5104430

Going through chemo isn't free of suffering. And in cases like Iain's it's often a question of having a "normal" 6 months of life or a miserable 8 months via chemotherapy.

Wow this got a lot more responses than I expected. I say this for two reasons:

My dad died in 1990 when I was 10 from cancer. He fought until the end. I spent 2 years from the time I was 8 till March 1990 watching this man do what he could to survive. I've sworn that if I ever develop cancer, I too will do whatever I can to survive. The point is that if there's a remote chance of me beating it, I can deal with temporary suffering for long-term survival.

The second reason is more that Ian Banks is one of my favorite authors. My imagination has been shaped by the worlds and stories he's created ever since I was a boy. I was introduced to his Consider Phlebas while my dad was sick and have read nearly all of his work since then. For me, this is all closely tied together emotionally.

Either way, I can respect his choices. They won't be my choices, but I can understand why.

I wish to god this news had arrived 2 days ago on April 1st :(

Ian (M) Banks is amazing and will be sorely missed.

I can't believe there won't be any more Culture novels.

FWIW, I've ordered the first three novels of the Culture series. I didn't know of Iain Banks until today and his terrible news.

I just wish he'll live the most playful last months of his life with his soon-to-be wife. We cannot wish for anything less.

Oh to be reading them again for the first time. I envy you.

This is a lamentable loss indeed. It really grieves me that my shelf of Culture novels will likely never grow again.

Fuck this fucking disease. It really makes me angry. The lives cut short, all those possibilities lost. We need to fix this bug and soon.

Does anyone know his financial situation, too many authors (two examples, RAW and PKD) seem to end up dying while having to eat dogfood if that, and unable to pay the rent and other bills. Not that its fun to die if you're rich, just that he shouldn't have to eat dogfood in addition to the stress of the disease. If he's in bad financial shape I could easily buy a couple more of his novels in kindle form (not that I need to buy them in yet another form, but if he needs some cash, well now's the time...)
I don't know of his situation either, but instead of buying a copy for yourself, it'd be even wiser to gift a copy to good friends or simply spread the word of his great work here and elsewhere.
I guess what I'm getting at is if he can't pay the electric bill today, if I finally get around to reading his 5th culture novel in 2015 that's unfortunately going to be a bit too late to help him out. So he's better off if I buy a copy today even if I don't read it for awhile. On the other hand if he's very "comfortable" then there's little point in my accelerating my purchase. I'm enough of a fan to have read and liked some books but not enough of a fan to have crawled up into his financial life, for all I know he's the richest author in the UK. I just don't want him to have to eat canned dogfood like PKD supposedly had to.
He lives in a country with socialised health care. What that effectively means for someone with an aggressive/incurable disease is that instead of leaving your family bankrupted by heroic but statistically futile treatments you get high quality palliative care courtesy of the state. Amongst developed countries I think sick people resorting to dogfood is extremely rare.
Last I heard he is quite well off. He's a relatively obscure/niche author in the US, but enjoys broad popularity in the UK.
> enjoys broad popularity in the UK.

I think he enjoys broad popularity just about everywhere in SF fan circles.

Perhaps, although he doesn't seem as well known, even among SFists, in the US as some other authors. However, when I say broad popularity in the UK, I mean in the entire literate population, not just SF, as his non-SF books are also highly regarded there, while fairly unknown in the US.

If you go into an American book store, you may find a couple of Banks books in the SF section, if it's a large and intelligent store. In my brief experience trying this, if you do the same in a British book store, you'll generally find his entire bibliography, SF and non.

> you'll generally find his entire bibliography, SF and non.

Ditto in my bookcase, and I'm in NL, not the UK...

Another person that might be cryopreserved [1], but probably won't be, much like the 150,000 who passed in the last day or so [2]. Many sorts of terminal case can actually lead to better quality cryopreservation under present legal restrictions [3], in comparison to the drawn out and uncertain end of aging, precisely because they are more rapid and certain in time.

(Or might be plastinated [4] in the alternate history thread in which people actually got up and started to do something about death in the late 1930s [5], when the chemical industry started to be up to the task of building a mass plastination concern).

If you've made no preparations but still have $200,000 or so sitting around, then the certainty of oblivion is still your choice, even at the last minute. (Most people who are cryopreserved fund it through life insurance taken out decades earlier). No judgement on that choice is offered, as the right to vanish is a good right, just judgement on the fact that while other options do exist, they might be far more available for everyone and better thought of were the world just a little bit different.

[1] http://www.fightaging.org/archives/2002/11/cryonics.php

[2] http://www.fightaging.org/archives/2002/12/death-is-an-outra...

[3] http://www.fightaging.org/archives/2011/02/to-die-in-order-t...

[4] http://www.fightaging.org/archives/2009/04/plastinate-everyo...

[5] http://www.fightaging.org/archives/2011/05/when-did-we-becom...

If the world was just a little bit different, this would be upvoted instead of downvoted. It'd be nice if someone could convince Iain to be cryopreserved, and give him that small but non-zero chance of being revived and one day seeing a civilization better than his Culture.
I would donate money to a "Cryo-freeze Iain Banks" fund - though I'm sure he has more than enough funds himself.
I'm pretty sure he would be against cryo:

"Firmly restating his atheism, Banks spoke of his belief that death is an important 'part of the totality of life', to be treated realistically, not feared."

http://en.wikipedia.org/wiki/Iain_Banks

I really wish this were higher in the comment thread.
Sounds like Stockholm Syndrome to me.
Hmm...except that cryopreservation is still, as of this point, a complete crock of shit. Trying to find a necromancer would be more productive.

As an ex-biologist, I can assure you that horrible cellular damage is being committed to these "preserved" people. I used to flash-freeze all sorts of cells, ranging from bacteria (e. coli) to animal (IMCD3 and MDCK kidney) to human (Human Embryonic Kidney, Primary cortical and hippocampal neurons).

These protocols are pretty simple. Pellet and re-suspend a small vial of cells to dilute out the media, replace with a special preservation media then dunk the entire 5mL vial in a big pot of liquid nitrogen for a few minutes. Then it goes into the deep freezer (-80C).

Sadly, even though this is a tiny aliquot that is frozen almost instantly, cell death on thawing and resuspension is immense. Like, it's a good day if 50% of the cells live. It usually doesn't matter, since these cell lines are immortalized and they just start growing again, but it illustrates the point. Despite the most ideal circumstances, cells hate to be frozen.

Now, imagine you are trying to flash freeze an entire body. They do this by perfusing preservation media through your blood, relying on your body's circulatory system to get the media in all the right places. This takes time. Perfusing a small mouse with formaldehyde takes at least 5-10 minutes. A human body? Practically ages I would guess.

All the while, cells are dieing left and right because they are no longer getting a steady supply of oxygen (and instead a bath of relatively cytotoxic preservation media). When the body is finally perfused fully and dunked into liquid nitrogen...flash freezing isn't immediate. The outer layers freeze much faster than the inner layers.

Ok, so just freeze the brain? Same problem as before, just on a slightly smaller scale.

Ignoring all the cell death that has been happening for the last hour, how about thawing? Well, let's pretend its a "good day" and 50% of your cells live. That might be ok for your skin, liver, or spleen - they are going to be unhappy but still alive. But 50% of your neurons dieing? Hmm. Also take into account that neurons don't regenerate. You just killed half your brain. Even super optimistic numbers, 70%-80% survival rate, still leave a lot of your brain as goo.

This is all just biology. I'm not even touching the morals and ethics of companies that are under no obligation to actually do what you paid them to do (since you are dead).

I'm assuming that as an author of fairly hard sci-fi Banks would not mind overmuch if he was resurrected as a "mere" upload. The point of cryo is once the initial damage is done, no additional information loss to entropy occurs, so you can afford waiting for far-distance supertech to see if your neural behavior is at all reconstructable.
Thirty centuries from now I can imagine someone boarding a starship:

'I am the Iain (M) Banks,' the ship said, through the drone.

'That's a weird name. How did you end up calling yourself that?'

The remote drone dipped one front corner slightly, its equivalent of a shrug. 'It's a long story . . .'

That's fair enough, although it should be noted that proteins/molecules are still active at -80C, just very slow. Things still break down, some enzymes are still active, etc.
The cell damage inflicted by the cryo process is readily acknowledged by its proponents. They argue that the neurological damage is not so large that the original brain can't be reconstructed either by scanning it while still frozen or by repairing it with nano-bots. Much like data from a wiped hard drive can still be recovered by digital forensics.

As for the problem of outer layers freezing faster than inner layers, I think this is mostly addressed by filling the brain with anti-freeze first.

Now, I'm rather skeptical of the whole process myself, but the crynoics guys understand biology 101.

No they understand how to fleece gullible people.
Including themselves?

They're not making any money off this, Alcor is a non-profit and the wages of the personnel involved are fairly low.

> ... is not so large that the original brain can't be reconstructed either by scanning it while still frozen or by repairing it with nano-bots.

You might as well argue that nano-bots will be able to reanimate a body that has decomposed, and save money on all the freezing equipment. Perhaps that will be the case if given enough time, but we seem to be a long way away from that technology.

The business model seems to be "give us money now, and the technology that could make this work will probably be invented soon enough. Probably".

>You might as well argue that nano-bots will be able to reanimate a body that has decomposed, and save money on all the freezing equipment. Perhaps that will be the case if given enough time, but we seem to be a long way away from that technology.

No, you might not as well argue that. If you think you can, then please argue how you can retrive information from a completely decomposed brain. On the other hand, it's pretty reasonable to assume that a cryopreserved brain preserves a lot of the information in the brain.

Why is it reasonable to assume that? Its fiat on both examples and both examples currently are impossible.
alphaoverlord understands the point I was making.

Both of these things are impossible, at the current level of tech.

One or both of them might become possible through the use of sufficiently advanced technology.

> On the other hand, it's pretty reasonable to assume that a cryopreserved brain preserves a lot of the information in the brain.

See, I don't think it's reasonable to assume this.

I believe that both of these things are equally possible - that is, not very possible at all.

>I believe that both of these things are equally possible - that is, not very possible at all.

I believe it's incorrect to claim that the probability that a cryopreserved brain has some information about the brain structure is equal the the probability that a fully decomposed brain has after decades of decomposing (which is the scenario I have in mind).

I just don't understand how someone could make such a proposition. If we dig up a decomposed brain, it's just pretty much completely destroyed (e.g. fully decomposed) if we look at it with a microscope. I'm assuming that we're not talking about rare niche cases of fossilization etc.

To have an idea of how much information vitrification preserves, you should know that a kidney can be frozen and thawed, and replanted to a live animal.

We can also look at neural tissue after vitrification, like here: http://www.alcor.org/Library/html/braincryopreservation1.htm...

After you've looked at this probably new evidence presented to you, do you still seriously claim that it's exactly equally as possible to retrive information from a cryopreserved brain as it is from a decomposed brain?

I don't believe you actually think that. I think that you've made the mistake to take two extremely unequal yet different and small probabilities to mean exactly the same.

If you assume that the probability that cryopreservation is 0.1%, then you should think that the probability to retrieve information from a decomposed brain to be lower than 0.001%. They're both really small, but they're not unequal.

Do you think that the probability is exactly the same? I rate such beliefs as not only wrong, but ignorant of empirical evidence.

nawitus, I can't reply to your other comment, which is probably a good thing :-)

You are taking me literally, when you shouldn't - I was being flippant. Of course it is unlikely we will ever make the technology that can take the dust that, decades ago, used to make up a human brain, and somehow retrieve information from it.

The point I am making is that you said:

> On the other hand, it's pretty reasonable to assume that a cryopreserved brain preserves a lot of the information in the brain.

I flippantly argued that if your argument is "it's reasonable to assume science will solve the problem for us", you could apply that to essentially anything.

It used to be reasonable to assume that the world is flat, or that the world was the center of the universe.

I do not think we will somehow invent a machine that turns dust in to a working brain.

I do think that "it's reasonable to assume" is faulty logic when talking about something that is beyond the current reach of science, and should be questioned at every possible opportunity.

Now, you might say "but Mike, I provided links that back up my assumption" - and if that's the case, you are no longer "reasonably assuming" that this is true, but basing your belief of the scientific literature that outlines how such a thing is done. :)

>I flippantly argued that if your argument is "it's reasonable to assume science will solve the problem for us", you could apply that to essentially anything.

Well, I don't believe that anything is reasonable, that applies merely to reasonable things.

>I do think that "it's reasonable to assume" is faulty logic when talking about something that is beyond the current reach of science, and should be questioned at every possible opportunity.

Just because it's beyond the reach of technology, doesn't mean it's faulty to talk about it. It's clear that it will be possible in principle to travel to other planets, cure aging etc., but we don't have the technology for that yet.

If we draw something like an air-field on sand, it is reasonable to believe that the planes will start to land again...

Sounds like that "cargo cult" variety of science.

So your argument is that if someone believes something to be reasonable, he is wrong because there exists some other unrelated non-reasonable beliefs?
> On the other hand, it's pretty reasonable to assume that a cryopreserved brain preserves a lot of the information in the brain.

No! That's not at all reasonable. We understand very little about brains. We understand even less about deep-frozen brains.

From what we do know, it's actually very reasonable. We know e.g. that memory survives hypothermic loss of electrical activity. So it is probably structurally based.
No, we do not know any such thing. Again, you personally were told this by someone who works with this stuff: http://lesswrong.com/r/discussion/lw/8f4/neil_degrasse_tyson...
Not at all what was said. In fact, the whole criticism you linked to is about structure, and ways in which it is supposedly altered beyond repair. The notion that we are transient electric fields that fade the moment the brainwave goes flat is long discredited.
They don't!

If someone could freeze at least a small insect brain after it "learned something", unfreeze it and prove that it retained what it learned, I might have at least a grain of faith in this. Even getting an insect ganglia out on a feeder plate with electrodes, training it to respond in a way to a certain sequence of input electrical impulses and proving that after thawing and reanimation it still preserves that memory would light a spark of faith, but we don't even have this!

Understanding "biology 101" means understanding that biology is about experiments, everyth is empirical (and will be for quite some time I guess), nothing can be said that "it works" in biology or medicine until you experimentally prove it does. Maybe in a few centuries we'll have cool equations describing life and have something like "theoretical biology" that will be like theoretical physics is to physics (no, what we call "theoretical biology" nowadays is not that!). Show me some equations (derived from experiments, of course, and that can predict other experiments of course) describing the amount of information relevant to a human's personality that can be recovered from a frozen brain! If you can't, prove it experimentally. If you can't... bad luck! With the kinds of probabilities involved in biology, "good things" (like being lucky to be able to revive a frozen human brain) don't happen by chance!

"Nature"/"The universe"/"God" is NOT on our side on this path, so there's no room for optimistic thinking, we can only rely on cold (literally) hard science and math!

So your argument is that until it's "proven" that we can cryopreserve and then restore brains, the probability of success is zero? If you agree that the probability is non-zero, then you agree with the cryopreservation advocates. In addition, if you agree that it's non-zero, you must agree that it's better than doing nothing (which clearly has a zero chance of revival).

Cryopreservation advocates do not claim that the process is proven to be work, they claim that the chance may be small, but it's non-zero.

>"Nature"/"The universe"/"God" is NOT on our side on this path, so there's no room for optimistic thinking, we can only rely on cold (literally) hard science and math!

I don't even know where you're going with this discourse. If you're a utilitarian rationalist you can estimate the chance of success for cryopreservation and revival. It's quite easy to show that if the probability is non-zero, then it's beneficial to make such a bet, as the possible positive utility can be huge if the cryopreservation is succesful.

If you think that probability estimates are "not science" and therefore "irrational", you don't know what you're talking about. If you think that current scientific evidence shows that the chance of revival is zero, then you're clearly wrong (and that would contradict your own claims, as zero chance would mean there's no need to make any new experiments).

"Cryopreservation advocates do not claim that the process is proven to be work, they claim that the chance may be small, but it's non-zero."

They implicitly claim that not only is the chance non-zero, but that it's large enough to be worth the opportunity cost of actually freezing people. I agree that a non-zero chance seems obvious, but this claim definitely does not, and needs a lot more substantiation than there actually is.

That's a good point.

You can look it this way: life after rewarming can last for hundreds of years, easily a thousand as medical technology will have advanced at that point. People are currently willing to pay $100k in medical bills to extend their life by about one year with 50% chance, which means that the cost is $200k per year.

Cryopreservation also costs about $100k (slightly more in real life I guess, I'm rounding numbers for simplicity).

If cryopreservation has a 1% of success to extend life by 1000 years for $100k, then they will "buy" 1 year for $10k. Of course, you can change the numbers (in any direction), e.g. 100 years of life would come out to $100k per year, still cheaper than what most people are willing to pay today to live slightly longer. The 1% success rate is rather pessimistic, too.

If you take quality of life into consideration, the argument starts to favour cryonics quite heavily (we can assume that life is a lot better in the future thanks to advancement of technology).

> The 1% success rate is rather pessimistic, too.

Where do you get that? From what little I understand, 1% seems highly optimistic, given how destructive the freezing process is at the moment.

It's my own estimation based on the evidence I've seen. There's plenty of detail when you look at neural tissue using a microscope: http://www.alcor.org/Library/html/braincryopreservation1.htm...
That is not peer-reviewed research, and therefore I treat it about as seriously as I treat any other comment on the internet: at best incompetent, at worst maliciously deceiving. Considering its published by a company that makes money from freezing people...probably the latter.
By all means, please, show us peer reviewed sources that contradict it.
(comment deleted)
It so, so doesn't work like that. You don't get to make a spurious claim and then defy anyone who objects to find evidence it's false. You personally were told this in excruciating detail on http://rationalwiki.org/wiki/Talk:Cryonics .

Cryonicists really just don't get burden of proof.

My gut estimate is that the chance is somewhere in the 1-10% range. I've been thinking about it for around 5 years. Part of why that number is so high is the relative lack of coherent and nuanced counterargument that demonstrates the critic at least understands the issue (not just one aspect, but the whole huge convoluted topic) well. I may end up becoming such a critic myself, eventually, but so far things aren't looking so bad for cryonics.

It is true that chances can't just be "non-zero" and be rational, nor simply based on faith, because that's basically Pascal's Wager. However I think my 1-10% gut feeling is something that I could probably be talked out of if it were really arbitrarily low like people keep assuming.

Assuming that probability range, I think selling to ordinary people is pretty defensible at $50k-$500k rates, because we already spend around $5M to avoid accidental deaths via regulatory tradeoffs. If it is lower (0.1% say) and yet still not arbitrarily low, we would then need to restrict to either very rich or very desperate people (where the ratio of marginal utility of life to marginal utility of a dollar differs significantly from the norm). Arbitrarily low chances literally on level with egyptian mummification or worshipping a random god is definitely not something that should be sold to anyone (except as a novelty maybe).

Note also that cryonics storage cost is influenced by economies of scale, so mass-produced cryonics is likely to be a lot less expensive per person than the cost you see on the market today. If you could seriously measure a non-arbitrary 0.01% it wouldn't necessarily be impossible to justify even on the mass market and even to relatively death-complacent people -- it would just have to be very cheap for them. Granted, gut feelings are hard to calibrate well to reality at such extremes (hence lottery tickets) so I'm not going to seriously argue that, I'm just saying this to give you a feel for why I think there's a need for fairly strong counterargument before you can reasonably take the position that cryonics is just innately bad/fraudulent business.

I also anticipate various positive externalities from the cryonics business, such as sooner (eventual) development of suspended animation of the damage-free variety, which has potential to save a lot of lives and spare a lot of suffering. These too should be accounted for as part of a robust criticism.

Maybe a good analogy would be intelligent design. Sure, we can't say there is a 0% chance ID is false. But all evidence points to that. It's a fallacious argument to say something is possible because science hasn't proven it completely false.
What is the probability of dying and a super-natural being transferring you to heaven? It's non-zero. I've heard the same exact argument from ultra religious people.

I am all for keeping a bit of hope alive, but a non-zero chance argument on its own is not enough. What is the probability exactly, can it be proven.

Robin Hanson puts the probability around 5%: http://www.overcomingbias.com/2009/03/break-cryonics-down.ht...

The "non-zero" argument can be fixed simply by comparing relative likelihoods, or noting that while one can't ever rationally believe with 0% probability, you can use epsilon as a substitute for "it's more than 0 but I can't measure how much because it's so small". Personally I think there's enough evidence to put religious ideas of afterlife far below the probability of a single sha256 hash resulting in a new block in the bitcoin blockchain: http://blockexplorer.com/q/probability

Hanson's estimate is no better than the Drake equation. Everyone assigns different numbers to the various probabilities, multiplies them together, and gets a different result.
Sure, though the more important part of the exercise is the analysis. Same thing with the Drake Equation. And in both cases the terms aren't immune to new information, nor can you expect to honestly get away with assigning anything you want. You might have a different list of criteria or different probabilities, but the point is to lay them down and give a reason why you think it's unlikely enough not to pay the small sum of money. It also lets others argue with you over your estimates, because they might have information you don't, now or in future years. Several of Hanson's criteria can have their probabilities increase towards 1 or decrease towards 0 depending on what humanity does in the coming years.
> And in both cases the terms aren't immune to new information, nor can you expect to honestly get away with assigning anything you want.

Actually, you can get away with assigning anything you want. That's hidden in the assumption that the criteria he lists are more-or-less independent.

> You might have a different list of criteria or different probabilities, but the point is to lay them down and give a reason why you think it's unlikely enough not to pay the small sum of money.

You've got the burden of proof backward. The cryonics advocates are the ones trying to argue that cryonics will work with sufficiently high probability to make investing in it worthwhile. The grandparent cited 5% as if that figure had even one significant digit -- which it doesn't, by Hanson's own calculation.

> It also lets others argue with you over your estimates, because they might have information you don't, now or in future years.

It also lets others argue even if they don't have new information, which just wastes everyone's time. The same phenomena also occurs with the Drake equation.

Yes, I agree it's non-zero. It's a (1. benefit) x (2. probability of benefit) / (3. cost) type of reasoning, and both (1) and (3) are subjective, so everyone can choose for himself whether "it's worth it" or whether you want it.

I'm just emphasizing that this technology is not a realistic solution to anything, just as a lottery ticket is not a solution for one's financial problems. I may choose to buy a lottery ticket myself, same as I may choose to have my head frozen, but I'm not going to consider this as a real solution to any problem - just like a lottery ticket, it may have more "entertainment" value than real value (though the "entertainment" value may be enough for me to buy it).

My only point is that we should always see the difference between "lottery tickets" and real solutions, and always see the former as what they are: hope growing "entertainment" forms... I know, most people don't like this way of looking at things and label it "dark and gloomy", but it's how I see it :)

The difference is that people win lotteries every week, and so far no-one has been frozen and thawed.

As we're using analogies: we know that machine-flight is possible. But how many people broke their legs after gluing feathers to wings strapped to their arms and jumping off a barn, flapping wildly, before Kitty Hawk flew?

> Understanding "biology 101" means understanding that biology is about experiments, everyth is empirical (and will be for quite some time I guess), nothing can be said that "it works" in biology or medicine until you experimentally prove it does.

Part of this isn't really biology (as we know it) though, so I'm not sure that biologists who criticize are seeing the whole picture. Look at it like a cryptographer: Is putting a brain in liquid nitrogen a secure erasure method against all future attacks from a determined opponent with lots of resources? Would you trust your financial data to such a method of data erasure?

> "Nature"/"The universe"/"God" is NOT on our side on this path, so there's no room for optimistic thinking, we can only rely on cold (literally) hard science and math!

I like this sentiment, I wish more cryonics people took it to heart, but at the same time I don't believe that "The Force" is actually against us. There is some reasonable burden of proof on the assertion that the data is is utterly gone and out of reach of all realistic future technology.

That's complete nonsense. Nanobots cannot repair angstrom-scale freeze damages. You approach the classical limit, where protons are more wave than particle.

And what's a brain antifreeze? Even biocompatible antifreeze proteins found in arctic oceans have a thermal threshold of 269K, which is no where near cryogenic temperature.

Angstrom-scale fidelity may not be necessary for preserving memories/personality/identity. The antifreeze they use is neurotoxic, which is a known problem.
> Nanobots cannot repair angstrom-scale freeze damages.

Vitrification avoids ice. Nanobots could e.g. remove toxic compounds from extracellular areas and replace them with nontoxic solutions, and deliver yet-to-be-invented drugs that would activate upon thawing.

> Even biocompatible antifreeze proteins found in arctic oceans have a thermal threshold of 269K, which is no where near cryogenic temperature.

The stuff invented by 21st Century Medicine and used to successfully cryopreserve a rabbit kidney is a combination of the ordinary kind of penetrating antifreeze that depresses the freezing point (glycerol, EG, DMSO, and the like) with polymers that inhibit ice nucleation (functionally similar to antifreeze proteins). It has been known for a while that you can vitrify slowly by using high concentrations of the former kind of solute (depress the freezing temperature to below the glass transition temperature and the cooling rate no longer matters) but the latter lets you get away with somewhat more water in the mix, is my understanding.

There's a tradeoff when you cool things, where if you get cold enough it slows toxicity. They don't perfuse with the stuff until the brain is already cooled to near 0 degrees C, and it is ramped in concentration over time to prevent osmotic shock.

The brain is like flash memory. Sure some of the conent is still possible to get at (electrical charge stays around for a long time) but the circuits between the flash cells are all dead. The connections are as important as the state.

Not going to happen.

Alcor FAQ states this:

    “We know that secondary memory does not depend on continued activity of the nervous system, because the brain can be totally inactivated by cooling, by general anesthesia, by hypoxia, by ischemia, or by any method, and yet secondary memories that have been previously stored are still retained when the brain becomes active once again. Therefore, secondary memory must result from some actual alterations of the synapses, either physical or chemical.” — Textbook of Medical Physiology by Arthur C. Guyton (W.B. Saunders Company, Philadelphia, 1986), page 658.

    “Procedural and declarative memories differ dramatically. They use a different logic (unconscious vs. conscious recall) and they are stored in different areas of the brain. Nevertheless, these two disparate memory processes share several molecular steps and an overall molecular logic. Both are created in at least two stages: one that does not require the synthesis of new proteins and one that does. In both, short-term memory involves covalent modification of preexisting proteins and changes in the strength of preexisting synaptic connections, whereas long-term memory requires the synthesis of new proteins and the growth of new connections. Moreover, both forms of memory use PKA, mitogen-activated protein kinase (MAPK), CREB-1, and CREB-2 signaling pathways to convert short-term to long-term memory. Finally, both forms appear to use morphological changes at synapses to stabilize long-term memory.” — “Synapses and Memory Storage” by Mayford M, Siegelbaum SA, and Kandel ER. Cold Spring Harbor Perspectives in Biology, April 10, 2012, page 10.
Yes but freezing the damn thing fucks the dendrites up completely. The nervous system is dead.
If the concept only works when we're relying on full-brain scans and future nano-bots with the capability to reconstruct brain tissue, the freeze/thaw would be completely superfluous.

Why not cut out the middle-man? Just do a full brain scan and store the digital data until the nano-bots arrive? Then just recreate brains within stock bodies or some virtual/machine environment?

Clinging to the freezing and thawing, when you're forced to concede they won't actually work and then having to invent far superior technologies, but only applying them as a band-aid over the broken technology, looks an awful lot more like someone with a belief grasping for intellectual cover, rather than someone with an intellectual understanding positing solutions.

> Just do a full brain scan and store the digital data until the nano-bots arrive?

Because we don't currently have the technology to either scan or store a 3-d scan of your brain in the same resolution you can get by physically perfusing it with antifreeze and dropping it into a bucket of liquid nitrogen.

But by the time you've physically perfused the brain and frozen it, substantial cell death would have begun. So if we have to freeze until the scanning/storage tech arrives, we'll have a compromised source, at best.
Yes. Whether or not the most substantial damage occurs with apoptosis when oxygen is re-introduced, there will uncontroversially be a lot of damage even in the best case cryonic vitrification. Also uncontroversially, there will be substantially less damage than would occur with cremation or burial.

Even the lesser amount of damage may be too much. Cryonics is a bet that it is not.

But is there a scientific basis to prefer this bet to, say, death-bed religious conversion?
As a bet, its possibility of payoff is consistent with the rest of what we know about the world, as opposed to religion, which is inconsistent. Furthermore, there are cases where things similar to this were done successfully, so extrapolation of technology might lead one to believe that we may be sufficiently good at reconstruction in the future. In comparison, no prayer has ever even slightly worked.
> "its possibility of payoff is consistent with the rest of what we know about the world"

What we know about the rest of the world is that this does not work, it will cause extensive damage even if it could work, so it would not necessarily re-generate the same person even if it did work [1] and that humans are notoriously awful at projecting technological advances 50 years out, to say nothing of our track record of projections even further.

Extrapolation of current technology, from any particular point in our history, points us in wildly incorrect directions. See: the history of people proclaiming us on the verge of vanquishing death. "too cheap to meter" energy. Nuclear cars. Flying cars. Lab-grown meat. Off-world colonies in the far-off year 2000. Choose an AI prediction. Choose a cloning prediction.

The notion that some technology has worked in the past, so a particular technology has some chance of working, is as flawed as "it appeared that my last prayer was answered, so my next one has a chance". Both require selective reporting from the available data to even entertain.

[1] There are no shortage of case studies of people who've sustained comparatively minor brain trauma and been reduced to mere shadows of themselves, if not manifested new and almost entirely different personalities.

Science Fiction != Science!

(Yet.)

> Now, I'm rather skeptical of the whole process myself, but the crynoics guys understand biology 101.

Actually, they mostly understand Psychology 101, which is that people are willing to pay unlimited amounts of money for the promise of life after death. SEE ALSO: turning lead into gold.

If they really wanted to scam people, there are far better ways than suckering a couple thousand people out of membership dues, and a couple hundred people out of leaving their $30k - $200k (hardly unlimited, especially for software developers!) life insurance payout to a family member.
There's always another way to skin a cat, but you get good at one way and keep at it.
Data on a hard drive can be recovered precisely because a typical deletion does not destroy any data--only the addressing bits are erased.

If you take a HD and write over half the bits with zeroes, you will not be recovering much useful information from that with digital forensics.

>Hmm...except that cryopreservation is still, as of this point, a complete crock of shit. Trying to find a necromancer would be more productive.

No, that's not very rational. Cryopreservation may have low chances of success, but it's like a billion billion billion times better than just dying (which has zero chance of success). Nobody is claiming that cryopreservation is very probable, but it's a lot better than nothing.

>Now, imagine you are trying to flash freeze an entire body.

I don't think your critique is very relevant, when almost all cryopreservation is only done to the brain, not the whole body.

>Ignoring all the cell death that has been happening for the last hour, how about thawing?

Thawing is not relevant to be discussed at this point, because the bodies will not be thawed using current technology. If the cryopreserved brain has enough information to be reconstructed, it will be done at some point using advanced nanotechnology. Nobody will be thawing brains using 21st century technology.

> I'm not even touching the morals and ethics of companies that are under no obligation to actually do what you paid them to do (since you are dead).

Yes, there are risks. Nobody is claiming that cryopreservation has a very high chance of success. It's a lot better than nothing, though. By the way, thse cryocompanies or organizations tend to be owned and supervised by relatives of the cryopreserved people. These managers also want to get cryopreserved themselves, and want to reconstruct their own relatives. In addition, there's great scientific value of bringing 100 year old people back alive.

By the way, scientists don't refer to the cryopreversation as freezing, they call it vitrification.

> No, that's not very rational. Cryopreservation may have low chances of success, but it's like a billion billion billion times better than just dying (which has zero chance of success). Nobody is claiming that cryopreservation is very probable, but it's a lot better than nothing.

That's basically Pascal Bet (if there's God you get infinite payoff, if there's no God you get finite negative payoff (wasted time caused by being believer), so to maximize payoff you should believe in God). The problem is - there are very many possible gods, many of them incompatibile with each other. You should consider the bet with ALL gods as possible options, not just some god versus no god.

Same with the cryogenic. You should consider the possibility that freezing you with our poor technology can make you unrecoverable, while some other technology could allow you to be saved eventually.

Also I'm sorry for Mr Banks, I love his books about Culture.

>Same with the cryogenic. You should consider the possibility that freezing you with our poor technology can make you unrecoverable, while some other technology could allow you to be saved eventually.

Yes, and that's rational. If there's another preservation technology that's better than cryopreservation, we should adopt that. There's nothing irrational about that. You just need to first invent such technology, and then provide evidence that it's better than current vitrification tech.

This has happened in the past. A few decades ago the preservation method was changed from freezing to vitrification, after vitrification was shown to be better.

Cryopreservation may have low chances of success, but it's like a billion billion billion times better than just dying

I don't know about that. I have this pet theory that our minds exist in a 5-dimensional non-euclidean space for which our brains serve as mere substrates, much as a CPU is merely a substrate for the running of a software program. I'm not saying you should adopt this theory (especially considering that I don't feel like explaining it and have only tenuous evidence, so it's basically a deeply-felt hunch), but nor do I accept your contention that it's freezing or nothing with no other alternative. For that matter I'm not convinced oblivion is so awful either, but that's more of a philosophical argument.

>No, that's not very rational. Cryopreservation may have low chances of success, but it's like a billion billion billion times better than just dying (which has zero chance of success). Nobody is claiming that cryopreservation is very probable, but it's a lot better than nothing.

Ok, I'll give you that there is a non-zero chance. Other's have touched upon that in this thread, and I would contend that giving 200k to some family/friend is more useful than throwing it away, but it's your money. If you are happy with a negligible-but-non-zero chance, go for it.

>I don't think your critique is very relevant, when almost all cryopreservation is only done to the brain, not the whole body.

There is exactly zero evidence that a brain/mind is functional without it's body. And there is currently no computer simulation or interface capable of simulating a human body and its various sensory input, so this is a moot point.

>Thawing is not relevant to be discussed at this point, because the bodies will not be thawed using current technology. If the cryopreserved brain has enough information to be reconstructed, it will be done at some point using advanced nanotechnology. Nobody will be thawing brains using 21st century technology.

Bit of a cop-out, no? Is the flying spaghetti monster going to thaw you? At this point your theories are no better than saying a big bearded guy in the sky is going to resurrect you. Except he'll do it for free.

>By the way, scientists don't refer to the cryopreversation as freezing, they call it vitrification.

I guess I wasn't a classically trained biologist working in neuroscience labs for 6 years then, sorry. Also, it was before my cup of coffee in the morning.

Appropriate terminology or no, my points were and are still valid.

> There is exactly zero evidence that a brain/mind is functional without it's body.

My understanding is that head transplants actually have been done in mammals with retention of consciousness.

http://en.wikipedia.org/wiki/Head_transplant

So no, I wouldn't say "exactly zero evidence".

> Ok, I'll give you that there is a non-zero chance. Other's have touched upon that in this thread, and I would contend that giving 200k to some family/friend is more useful than throwing it away, but it's your money. If you are happy with a negligible-but-non-zero chance, go for it.

I basically agree that there's a minimal standard of evidence for cryonics working that is required for it to be worth more to an individual than giving the $200k to family and friends. However, it is not clear whether cryonics-as-it-exists exceeds that mark or not. I would think it does. Estimate $5M per life, and chances in the 1-10% range are reasonable for the cost.

>> Nobody will be thawing brains using 21st century technology.

> Bit of a cop-out, no?

Not really. There are things we can justifiably think are possible but too technically difficult to accomplish in the very near term. Comprehensively curing cancer for example. It's going to happen, but it will take a while. Likewise, machine-phase nanotech that can operate at very low temperatures to perform subtle manipulations on vitreous biological materials which improve its ability to support itself during rewarming.

The thing is, when you rewarm cells in the lab after freezing them, they incur damage during rewarming. For example, if the vitrification point is below the freezing point, that means ice will try to form if it has a chance to during rewarming. In situations where extracellular ice exists, it will melt during rewarming and thus cause osmotic shock to the dehydrated cell.

In the concentrated solute version of vitrification like we see in cryonics, the concern is more that the concentrated solutes will interact with proteins when they get warm enough to do so. That can denature them and trigger autolysis. So prior to rewarming, picture a machine-phase manipulation that digs in and gently pulls out chunks of toxic cryoprotectant, and replaces them with something more benign for the thawing process. It could also add drugs that haven't been invented yet, e.g. a comprehensive autolysis blocker, or improved ice blocker that lets you replace some of the vitrificant with water and still take your time rewarming.

That's not getting into nano-repair, which is complex enough that I would concede it could be implausible (though I don't exactly think it needs to be ruled out at this point).

You don't seem to be all that up to date on present practice and theory in cryonics. Take some time to read up on the publications, such as by groups like 21st Century Medicine:

http://www.21cmpublications.com/

Or for a simpler starting point, the FAQs for scientists at Alcor:

http://alcor.org/sciencefaq.htm

You might also look at ongoing results from the Brain Preservation Technology Prize:

http://www.fightaging.org/archives/2012/03/an-update-from-co...

Evidence-Based Cryonics has a lot of as-unbiased-as-you're-going-to-get stuff on the perfusion and ischemia issues associated with vitrification of tissue, as well as explorations of other commonly voiced objections. Just wade through the archives:

http://www.evidencebasedcryonics.org/

Also, since we seem to be arguing from authority here, you might look at this, noting that a number of the signatories are quite well known biologists:

http://www.evidencebasedcryonics.org/scientists-open-letter-...

I don't doubt that cryonics is a valid science, but it is not a valid business model right now. The things I did in my lab were valid science, but I would be thrown in jail for ever giving those reagents to actual patients.

Like I said, the current state of "businses cryonics" is basically astrology and wishful thinking. I also don't doubt that in ten, twenty, fifty years, scientists will have figured out how to do it (much better).

But right now? I'm saying nope.

(Addendum: most of those publications listed at 21cm are about thin slices, which isn't exactly relevant. The even better ones are oocytes, which are practically tanks of the cellular world. Drosophila oocytes are so large you can see them with your naked eye and can withstand enormous punishment before dieing. Using them as case studies of vitrification is not really being honest.

This brings me back to my original point: the science is solid...at an academic level. Once you move past 50 micron tissue slices, it all goes to hell.)

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> (since you are dead).

IMHO this is the cryo equivalent of an ethnic slur. Cryophobia, if you will. It meets the "you can't change this thing about yourself so we outsiders are going to make fun of you for it, nyah nyah" pattern while being devoid of useful information content. Cryonics proponents do not readily concede the point that patients are technically dead, based on the evidence available.

The legal status (which is a fully independent use of the term "dead" and can be readily conceded with absolutely zero consequence to the technical argument) is something else, but if you are implying that cryonics companies would therefore be within their legal rights to dump their patients, that could just as easily be seen as a problem with the law (i.e. it fails to adequately protect cryonics patients). So it's not clear to me why you would think this is an innate ethical shortcoming of the choice to practice cryonics in the first place.

> companies that are under no obligation to actually do what you paid them to do

It certainly would contradict the purpose, and likely the bylaws, of a cryonics organization to fail to keep patients safe, for at least the period of time that is realistic given the limits of initial funding and uncontrollable factors world economic stability. (100 years is definitely more reasonable than a million.) Assuming the funds set aside experience real growth above the rate of inflation, the risk could actually decline over time because the financial safety net would be larger.

One possible approach if you think the time is going to be long before the needed technology is available, would be to allocate funding towards measures designed to stabilize the economy, avoid war, and/or prevent natural disasters. The other approach would be to try and create disaster-proof cryobunkers (but there's physical limits, as always).

Everyone that lives that we know of dies eventually. While I would prefer to live as long as possible I think it's important to recognize that. And trying to pitch a 200K solution to a problem that isn't really a problem but rather the nature of life strikes me as inappropriate. If you are that hellbent on this 'solution' send the email directly to the author, but your response smells like a sales pitch which makes me ill. I would downvote you if I could.
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Whole galaxies die, what to say about us poor humans, please do not offend basic physics with this "other option" thing, if there is a single certain thing in the whole universe it is the certainty of change and, as a consequence, death. We might extend lifespan greatly, it is a different thing altogether, it is worth discussing, it might even be a good thing, I don't know, but clinging to a dream of immortality will in my opinion sooner or later lead to a mental breakdown for most people who choose to pursue this path, latest when confronted with serious disease or dying.
This is the most truthful and insightful comment on this thread. Thank you.
As someone that doesn't, ever, want to die... the thought that there is no such thing as forever gives me some comfort.

Everything is temporal, we're merely surfing the entropy gradient for a while.

If you think the pursuit of immortality causes mental breakdowns, can you substantiate this with evidence from psychology journals? If not, this strikes me as unreliable folk wisdom.

There is a lot of possible change that does not involve death. I used to buy your argument, but upon reflection I've decided that it does not automatically follow from simple considerations. We need to be a lot smarter to know the answer for sure. Just as negative temperatures are possible, death-free eternities may also be possible.

Lifespan increase is certainly a stronger possibility than immortality, and is therefore a stronger motive to pursue cryonics. So why is so much space wasted talking about it every time someone suggests cryonics? The thousand year or so extension we could reasonably expect with a good aging cure and decent public safety is pretty significant regardless of eternal considerations.

I feel you.

The deathism of this thread, on a site read by technically-oriented people, where problably many agree with the computational theory of mind really makes me lose hope in the human kind.

It's not thinking that cryonics is not worth it. That's a reasonable position. I'm undecided myself. It's that response, that fighting death is somehow unethical or naive. That Death is Good, Part of the Cosmos, Don't You Dare, whatever.

Man, talk about Stockholm syndrome. Well, fuck it:

>>> DEATH IS BAD. <<<<

Yes it is. We die because we don't know how to avoid it, not because is good, natural, right or proper. Our bodies are machines that we don't know how to repair. That's all. We may invent lies to make ourselves feel better and maybe that's a natural strategy to cope with the HORROR that is death, but we are still fooling ourselves, and most likely keeping the problem from being solved.

Let's talk about the computational theory of mind. Is it bad to turn off a computer? I have a process running that will continue to do productive work forever. Is it bad to suspend it? If I resume it later, is that not bad? If I intend to resume it later, but forget, is that bad again?

There are some things that happened to my physical body that I cannot now, nor never will remember. Is that bad? There are memories I have that my physical body never really experienced. Is it bad that that person never existed? If I forget those, will that be bad?

Suffering is bad. Death is the ultimate destiny of all which was once alive. It is tempting for a brain state looking ahead to its demise to say that one or ten or one hundred years is too few, and if we had one thousand, or one million, or one million million, that would be enough. But I know no reason that should be true.

I look forward and see a descendant of humanity surviving to witness, in itself, the heat death of the universe. As every resource has been expended to maintain its consciousness, while the last holes fill in with entropy, it remembers everything that has ever happened, and it is looking forward with its dying thoughts to an infinity times an infinity as many lifetimes of nothingness which will follow, and I do not want it to weep that it will cease to be. I want it to stride boldly into oblivion, knowing that it has done its best, and with some glimmer of hope and pride for what, in some yet unconceived corner of possibility space, might be.

And I want that peace for every consciousness and form of consciousness, however transient, that experiences itself from now until then, be they animal, vegetable, or mineral.

Of course we should fight aging, with every resource we can muster, because aging is suffering. But we should not hate death, because that too is suffering.

To bring it back around... Iain M. Banks will die, very soon. Many people here are extremely distraught about this, and I am one of them. He has a choice to make, whether to make some attempt to extend his life at some expense to his remaining quality of life. It sounds as if he will choose not to. Many will, in grief, hate him for that choice. They are grieving, and it is natural, but that idea abstracted is selfish and it is evil. Iain Banks will die, and he will be fine. It is we who grieve who deserve peace, and I and others feel that peace is contained in this truth:

Death is okay.

It is not great. We do not love it. We can and will work to destroy it. But we will not succeed, and that is -- that must be -- okay.

The reason people are uncomfortable with talk of paying for immortality is that it can lead to obscene scenerios potentially thousands of times worse than the 1% debates we are having now. You think accumulation of power is bad when people pass money on to their children, think about how much worse it is if they simply live forever and accumulate it indefinitely. And now imagine what happens if only the top ecehlon gets to live forever, and the less wealthy or simply poor just die.

Immortality is not something our society can simply add to its current socio-economic make-up. Some fundamental changes would have to be made in order for the situation to be at all morally satisfactory and not utterly revolting and depressing. And no doubt any attempted change would take at least 50 years for the wild oscillations to even out.

I love people like you, who claim so fervently to be rational but still hold onto this childish, egotistical hope for immortality.

To put it bluntly, any machine becomes harder to repair over time, and some machines become so out of date as to become worthless except as curiosities anyway. People are no different. What would we ever do with 100 million nineteenth century people? The 23rd century should have as little use for us.

Galaxies die and so do we.

It was a great surprise for me to see him at the book signing event a couple of months ago in Bristol. Not a deep and mysterious person I imagined him to be after reading the books - just a great, happy guy who shared some thoughts about his imagination. He could really make the whole room laugh.
I met him on a couple of occasions many years ago and he really is great company. And he got a round in.