What actually happens when you need us?

Most services are tested while you are there to complain if something goes wrong.

Cryopreservation is different. The moment you need us is also the moment when you can no longer call, explain what you wanted or supervise any part of the work.

That is a strange thing to buy. I get it.

It is also why the system cannot depend on you managing a medical team, finding a funeral director or understanding cross-border paperwork during your final days.

When a Tomorrow.bio member enters a critical condition, our job is to take over the operational chain. We assess the situation, deploy the team when appropriate, coordinate the people who have legal authority, perform the cryopreservation procedure and arrange transport to Switzerland.

Your job is much smaller. Tell us early, keep your information and funding current, and make sure someone nearby knows how to contact us.

Everything else starts from that.

The first step is a phone call

People often imagine the process beginning with an ambulance arriving at a hospital.

In reality, it begins with a call: who is ill, where are they, what has happened and how much time might be left?

If you receive a serious diagnosis, enter hospice care or are admitted to hospital with a life-threatening condition, contact Tomorrow.bio immediately. Our own standby guidance is deliberately blunt about this: we would rather receive a call too early than one too late.

Early does not mean that a medical team will automatically move into the room that afternoon. It gives us time to understand the prognosis, jurisdiction, family situation, local access, available staff and likely transport route.

When legal death is expected, a standby team may deploy nearby in advance. The point is simple. If the team is already there when a clinician pronounces death, stabilisation can begin with less avoidable delay.

Standby, Stabilisation and Transport is one connected response system. It is not just an ambulance.

A sudden death is harder because there was no warning and no opportunity to deploy. We still respond once notified, but time without circulation may already have passed.

No contract can quietly notify us by itself.

This is where one very ordinary preparation matters. Your partner, family, doctor or emergency contact needs our urgent number and needs to know when to use it.

The point is not to turn them into cryonics experts. They only need to make the call and provide the information we request.

A Patient Advance Directive can also help make your wishes visible if you are incapacitated. Its exact legal effect varies by country, but placing it where clinicians and relatives can actually find it is clearly better than leaving the only copy in a forgotten drawer.

Tomorrow.bio keeps the current templates on its documents page. The broader preparation is covered in important documents to keep.

Before legal death, medical care comes first. Treating clinicians remain responsible for treatment, resuscitation decisions and the legal determination of death.

We plan around that boundary. We do not cross it.

After legal death, we move quickly

Once death has been legally pronounced and the necessary authority is in place, the medical response begins.

The first objective is not dramatic. It is to cool the patient and reduce additional ischemic injury.

Circulation has stopped, so oxygen is no longer reaching tissue and metabolic waste is no longer being removed. Cooling slows many of the chemical reactions involved in this damage.

The team places the patient in an ice-water bath, begins cardiopulmonary support where the circumstances allow, provides ventilation and administers medications from the protocol.

These are preservation measures. They are not an attempt to reverse the legal determination of death.

That distinction matters because people sometimes picture our team replacing the hospital team at the bedside. We do not. Medical care has ended before our procedure is legally permitted to start.

The detailed sequence is explained in first response and stabilisation.

Then comes the technically demanding part.

The surgical team establishes vascular access, circulates a washout solution and gradually introduces cryoprotectant. The aim is to reduce ice formation during later cooling.

Gradually is important. Cryoprotectant concentration, pressure, flow and temperature are monitored throughout the procedure. The body is not a clean laboratory circuit, and prior illness, clots, trauma or long ischemic exposure can make some regions harder to perfuse than others.

This is one reason we publish case reports. A serious cryopreservation organisation should be able to inspect what happened, not simply announce that a procedure was completed.

You can read the medical detail in perfusion and cryoprotection. The important point here is who carries the burden.

You do not have to find a surgeon, buy the equipment or tell a funeral director how to work around the procedure. We coordinate it.

We handle the bureaucracy too

This part often sounds much more frightening on paper than it feels in practice.

A patient may need release documents, a death certificate, funeral transport paperwork, an airline booking, export clearance and permission to enter Switzerland. The exact list depends on the country and the circumstances.

It is bureaucracy. It is not a homework assignment for the member.

Tomorrow.bio works with the local funeral partner, authorities, carrier and Swiss side to arrange the route. We have moved patients by road and air from different European countries and from the United States.

Sometimes the documents take days. The medical clock and the administrative clock do not politely wait for each other.

Where circumstances allow, we solve that problem by completing whole-body field cryoprotection in one of our ambulances before long-distance transport. The local funeral partner can then maintain the patient on dry ice, replenishing it daily, while the remaining papers are completed.

Once the permits are in hand, transport is usually the straightforward part. Our article on logistics and transportation explains the route in more detail.

At the European Biostasis Foundation in Switzerland, the patient enters a computer-controlled cooldown. The temperature first moves quickly toward the glass-transition region and then descends slowly toward liquid-nitrogen temperature to control thermal stress.

The cooldown process is recorded through temperature sensors placed in different parts of the patient.

Before long-term storage, Tomorrow.bio also performs a CT scan at cryogenic temperature. It helps us assess cryoprotectant distribution and identify areas consistent with ice formation.

A good scan is useful evidence. It is not proof of future revival, and we should not pretend it is.

The scan sits beside the timing, temperature and perfusion records in the quality review. Our quality-check article explains what these measurements can actually tell us.

The patient then enters long-term care at EBF, Tomorrow.bio's sister organisation and the storage facility for our members. The purpose of that structure is explained in how the Swiss facility works.

What we need from you

We cannot honestly promise that every case will follow the ideal sequence.

Legal restrictions, an autopsy, an unattended death, severe trauma, delayed notification or an inaccessible location can change what remains possible. Cryopreservation is a real operation in the real world.

But the member should not have to run that operation.

Keep your funding active and independent of a relative changing their mind. Update your address, emergency contacts and important medical information when they change.

If we ask for a passport, certificate or other document, provide it quickly. We and the funeral partner will then use it to make the transport happen.

Most importantly, make sure the people likely to be present know that you are a member and know how to reach us.

This does not require their philosophical agreement. It requires one practical action at the right moment.

If your family is uncomfortable with the decision, deal with that now. Waiting until the emergency turns a difficult conversation into an operational risk.

Signing up does not automatically make the emergency instructions memorable. That is on us to explain clearly.

Here is the explanation.

Call early. Give us accurate information. Keep the arrangement funded and make the documents accessible.

Then let us do our job.

Further reading

• First response, standby and stabilisation
• Logistics, paperwork and transportation
• Important documents to keep