Lessons to be learned-Death in Palau

[Wijbrandus]

Why would you even tie this thing to you? Isn't the "standard answer" never to tie a line to your body? For the same reason we just hold onto dive flag floats, instead of tying them to us?

Seems to me if a reef hook is so useful, it should be done with a handle or a leash, so the user can release it easily.

 

[redrover]

FOOD FOR THOUGHT
PERSONAL OPINIONS REGARDING THE INITIAL AND SUBSEQUENT POSTS
Quotes are in the font of the poster, italics my own -Sorry, the formatting got lost in the pasting.


I’m replying to you detroit diver because you were kind enough to share what for me was an interesting reading experience. As I read along the thread I jotted down my strong reactions to specific issues. What follows is the regurgitation. Thank you for the sharing. If you are still in contact with the RN, please convey the loud smack of my high 5 for being in the right place at the right time and doing it right. She is commendable for applying what I’m guessing are daily skills and knowledge out side of the box.
There are three posts, big issues.

This was an excellent opportunity for education; open free flowing discussion about a number of issues.

From my experience (all not diving) as rescuer, 1st responder, event medical staff and accident/incident investigator.

-Any visible head injury indicates possible LOC (loss of consciousness) and neck injury (the nerves that control respiration are in the cervical spine) and should be treated or considered as such until proven otherwise by say witness or victim. Both are a bad thing in any environment.

-We as fellow sport participants are lucky to have a clear concise detailed account of the situation and events as provided by detroit diver’s friend. This said, a lot is missing. Judgments should be withheld when not all of the facts are known; trying to figure out what may have contributed to the outcome is a good thing. Very interesting to compare the puplished news report - different 'flavor'.

The husband or buddy had no idea. He thought she had only lost her fin…..Piecing the story together, the scenario goes as follows: The victim hooked on the reef. She lost a fin in the current, perhaps looked back to assess the situation, and lost her mask in the process. She panicked, dropped her weight belt, and tried to remove her BCD. What follows next, no one knows. She may have……… Everything that occurred was clearly visible, but no one did anything to help. Her husband was nowhere around, and witnessed nothing.

I’m not sure what is meant by the last bit. My impression is that except for the loss of the fin being witnessed, nothing else about her actions or events were witnessed up to the RN’s arrival.​

-The ROW (Rest of the World) is often full of surprises. Services and standards in isolated locations and in other countries as well as just outside our ‘neighborhood’ can be very different than we are used to. I suggest anyone venturing out into the ROW do a little research if they expect say Palau is just like home only prettier.

-If something, let’s say CPR, is not practiced or performed frequently it can be a bit difficult to remember all the details in a highly stressful situation. Just having the person you are doing mouth to mouth on vomiting into your mouth is very unpleasant. Far more so if lets say, you are a corporate lawyer that did take a CPR class once when you were coaching Jr.’s T-Ball team. When I first learned CPR it was taught only to medical professionals, considered too potentially damaging to trust to laypeople. I think one of my later instructors expressed it best when he said, “Well, ya know, Medicine has come a long way; we can fix broken ribs and flail chest. But dammed if we can fix death.
Now the chance of someone in a group having learned CPR is pretty much a given that I don’t feel I need to explain it stands for Cardio Pulmonary Resuscitation. (How about the ABC’s?) Certainly, several people with at least rudimentary knowledge stand a good chance covering more of the bases. Having administered 1 man CPR with no other equipment available for an hour, two weeks into my training, CPR being the only thing covered, I quickly learned to welcome help. My stress was always lessened by that quiet unseen voice beside me asking, “How can I help?. I am thankful most often people are willing to help.
Trauma can be quite gruesome and I’ve seen highly trained experienced teammates including Air Ambulance Flight Crews struggling to function (lots of urping in the woods and sitting down feeling woozy happening) while I was pinned stabilizing a neck and keeping the still conscious patient with a 4” compressed skull fracture from freaking out. And needing to bellow orders to manage the rescue since no one could stand to look around and see what needed to be done to get this woman ALS (Advanced Life Support). It’s a weird feeling to ask the flight crew to please get someone up here and get a line in while they can, lotta blood loss here.
I’ve given detailed assessment and status progression (crushed airway, tension pneumothorax) to helpers to radio into EMS (who wrote it down and repeated it verbatim) and had the ambulance team casually stroll over with no equipment and ask, what’s up? O2! Drive over here! Backboard! All here in the USA. Yeah, I’ve been one demanding Lady too. (Friends tell me later they were amazed at the change from my usual manner.) One thing the stuck out in my training about water is that cessation of breathing while in the water had a very poor prognosis. (Temp can help though, if you are going to drown witnessed, chose cold water.)
I have not been active in medicine for 6 years. If any of the above is incorrect or no longer valid, I apologize and welcome corrections.

 

[redrover]

-I had the good luck of being immersed in a sport many consider death seeking with world class companions and the agony of making my own decisions about participating. Many a time I was encouraged by their confidence in my ability to handle the conditions yet chose not to. The desire to play with the boys in a male dominated sport, trust their judgment, earn their respect, further my skills and accomplishments, and enjoy the good part was intense. I had long conversations with myself about what I wanted from this sport. I concluded; I just wanted to have fun. Someone along this thread referred to the solo aspect and I agree, having assistance is nice, but ultimately I am responsible for my decisions. 90% of the time there was no way anyone could come to my aid. Any time I hesitated, say at a new site or one requiring more advanced skills I would pause and consider as many factors I could think of. The first was always – Do I want to do this? If so, then I would count the potential negatives. I got tired of prolonged agonizing and the temptation to make a snap decision so I set a rule for my self that if got to three it was a no go. This has continued to work well for me in many aspects of 'the pro's and cons'.

-Trust. One definition is ‘to place confidence in’. Any time I feel I would be trusting my life in another’s hands I give it extra thought. I think of it along the lines of something my mother taught me when learning to drive. She said, ‘Its all well and good that you have the right away, but if in the end you are dead, what does that matter. I don’t do ‘blind trust well’ well at all. I want to know just what exactly am I trusting them to do and/or not do, weigh the pros and cons, evaluate the probabilities and identify priorities so I can accept responsibility for my actions. I firmly believe they have the right to offer their goods and services and I have the right to accept or decline them.

 

[redrover]

-Quite frequently, when I’m in a group type of instruction I am the only one asking questions. I’m somewhat embarrassed as it appears I’m the only one that is not sure all information I need to know has been provided and/and I don’t understand something everyone else gets. And quite frequently one or more people thank me later for having asked the same questions they had. I was in a work meeting recently and said, “I seem to be the only one that feels this way, but I think that is offensive.” 40% present chimed in agreeing.

-There is a line we each draw between trust or not trust. On a raft trip, I had the unfortunate experience of trusting a companion’s claim of boating proficiency and expectation of common sense and reasonable judgment. At no time have I thought he was responsible for my near drowning, and continue to think he was a total jerk.
The trip was billed a scenic drift down river with a 1 mile stretch of rapids to break up the serenity. We were offered Kayaks at the put in. Someone asked about swimming the rapids, reluctantly (it appeared to me) was allowed, with strong caution. I did not say to anyone or even think I wanted to swim the rapids.
We got two briefings by the driver and the guide separately that included what to do and expect if we ended up in the water. We were asked individually what our river running experience was. I said I had done some river kayaking, generally navigating rough water only when I could couldn’t avoid it and paddle rafted the same Class VI river good parts twice for a total of 6 days. My opinion was I was pretty much a geek compared to my friends. My companion John said he very accomplished with many years of white water experience.
I suggested we take the 2 Man vs riding in the oared raft after the guide described the river as having 2 significant but very easy to avoid spots. The guide suggested I steer which should have been a clue; these guys get a sense about these things. Another clue I should have paid more attention to was how awkwardly John entered boat.
He did not seem to have much of a clue as I toodled us around the calm water testing out the new to me ‘rubber duck’, and I was able to overpower or correct the little effort he contributed. He was new to the area and the scenery was stunning, I supposed he was content to let me have fun my way. We discussed how to run the upcoming rapids and agreed on a game plan that included avoiding the hazards we were to avoid. He agreed to not give me any grief if I wanted to chicken out a rapid.
John wanted to go look at ‘the rapid’. At some point as we approached ‘the rapid’, I could have overpowered anything he did and come no where near it. I was powering, away I thought, the guide was yelling from the raft nearby, I was restating his instructions and asking for his (John) help quite stridently, when next to the hole, John suddenly and sharply steered us exactly where the guide told us not to go.
It was a small but powerful rapid. I take responsibility for my decision to allow us to get close enough that I was unable to get us away. It never occurred to me that he would completely ignore the guides explicit warnings (three times with accompanying explanation of why) and ask for a Class IV-V toilet flush.
He choked (I suspect as turbulent water opened into gaping maw, I know I was horrified). Screaming (by now) for him to sit up as he leaned away (in terror I suspect) until finally falling off, slack, in the out side of the vortex wooshing him into calmer water. The violent rock back flipped me headfirst into the whirlpool. I was worried about him thinking he must have had a stroke or something but there was nothing I could do as it looked like I was literally circling the drain myself. Then, as I lay there pinned at the bottom; what I thought was (in this order) –I think I’m going to die here. –This sucks. –How stupid of me.
Luckily for me it was a cycling hole and I was able to surface in time to suck in a lot of water as it became just thrashing water. John was recovered quickly by raft and told the guide I said I wanted to swim the rapids. The guide went about recovering the duck before finally disregarding John’s insistence I “was having the time of my life, she loves this kind of stuff” and responded to my ‘things are not ok signaling’. However, not before I slammed thru the other place we were told to avoid at all cost, a rock I couldn’t see until I was too close to evade. At least I wasn’t pinned or break something; it sure looked to me like I would. I was kinda exhausted by then from ‘giving it all I got’ to get up out of the hole before I couldn’t keep my mouth closed any longer (the surface was a pinhole of light). And having trouble getting a full breath of air in between all the coughing out immediately replaced water for another almost quarter of a mile frequently revisiting the bottom between ‘the rapid’ and ‘the rock’.
Back on the raft I thought he didn’t apologize due to the close quarters and deep embarrassment. I was alive with no physical injuries that wouldn’t heal and stayed silently stunned. Everyone else on the raft expressed a great deal of concern, did I need to see a Doctor, pointing to rapidly swelling bruises. I was bleeding from several places, shivering uncontrollably and thought I might cough up a lung. (While loading the trailer several people came up separately and told me what happened when John re-entered the raft, there was no disparity.)
The guide asked us why we went where he told us not to go. All I could think of was, “Because John is a ****ing idiot!” It seemed cruel since that was obvious so I stifled it. John answered him with, “I thought it looked like fun and we, well, we were doing fine. Too bad something made the boat turn over but it was no big deal. I’m fine.”, and flashed a big wide grin. All I could do was turn and stare at him with very wide eyes making futile dumbfounded gestures with my hands.
Later he asked me to dinner. I went only expecting him to apologize finally and uncertain if I could accept it. After some small talk, he leant back in his chair and said, “Wasn’t that river trip a blast!” I was speechless, he continued. “That was the most fun I’ve ever had and you did too. I could tell. I know you did. You looked like you were having the best time in your life.” That was too much, I replied, “What? I thought I was going to die.” I must have spoken forcefully as the other diners noticed.
I think he was too embarrassed to face his stupidity, he was the only one there on the water that didn’t tell me they were glad to see me get back on that raft and I’m really sure I wasn’t smiling.

My point is I made a lot of decisions. (The worst one was to expect rational behavior from someone I did not know well.) They weren’t made for me, pressured on me or beyond my control and contributed to a near bad outcome. Bad or good things can happen to good or bad people for preventable or unpreventable reasons.
At some point, all humans determine what level of risk they are willing to accept. There are people who cannot leave their home, the medical diagnosis is anxiety. I know of at least one man who summated Mt. Everest solo without oxygen. I know people that think a foreign film is too risky. I have been considered to my face of having a death wish, yet in my company of friends, I’m just a junior player. They ought to see me react to the huge centipedes here; slowly with frequency, I’m less hysterical each time.
-Do we want someone else to censor our enjoyment? If we think something is dangerous or high risk, we can simply just say no, not for me. I have several friends who are diving widows. The all said their spouse died doing something they loved. If I was denied getting into that rubber duck with John because I was not 100% certain he would act as I expected; you would have seen one big hissey fit.

-Don’t support activities you think are wrong. If there was no request, there would be no business. Do support youth education. I was recently appalled at the environmental attitude my very talented, hard working good all around kid niece exhibited. I’m a bit of a pro-environment zealot myself, I’ve found example and education improve otherwise unaware peoples actions. Humans do tend to be sheep (don’t ask me about political choices). Often it is assumed something must be ok because everyone else is doing it. (We all know what assume means don’t we.) What did our parents tell us when we tried that one? The environment is fragile everywhere. I’ve had the luck (desire helped a lot) to be in places appearing untouched by man. Had we not consciously policed for every flake of foil, crumb of ensolite, burnt match dropped mistakenly in the dark, misplaced nut shell and forgotten orange peel before leaving, the next visitor would not have had that extraordinary sensation.
-Do we want the government to regulate what is ok to be fun? Look at the big picture, is damaged coral or starving children worse. Contact companies, your representatives and countries to let them know, politely, your views and concerns regarding their practices, our involvement and any solutions you can think of. It’s amazing the paths a bright idea can travel.
Aloha

 

[detroit diver]

............ If you are still in contact with the RN, please convey the loud smack of my high 5 for being in the right place at the right time and doing it right. She is commendable for applying what I’m guessing are daily skills and knowledge out side of the box.
..............
O

I still see her every once in a while, mostly on Great Lakes Charter trips. This incident had a profound impact on her. I will pass along your comments when I see her next. Thanks.

 

[triton94949]

Which means you're completely S.O.L. if you drop your knife.
...

Which is why 2 knives are better than 1.

 

[detroit diver]

Which is why 2 knives are better than 1.

Or 4 knives, or an underwater power saw, or ....

Or you don't clip yourself onto something that is 40 feet below air.

 

[triton94949]

...Or you don't clip yourself onto something that is 40 feet below air.

When her mask blew off, and she did not have a 2nd mask in her B/C pocket to replace it with, nor a buddy nearby to lend her his extra, I think that is where things went awry. I would not blame the reef hook.

Not all instructors teach their students to bring along an extra mask. Maybe someday all will.

I also appreciate Mike's comment about training everyone to be as independent as a solo diver. You never know then the current or something else is going to turn your buddy dive or team dive into a solo dive.

 

[detroit diver]

When her mask blew off, and she did not have a 2nd mask in her B/C pocket to replace it with, nor a buddy nearby to lend her his extra, I think that is where things went awry. I would not blame the reef hook.

Not all instructors teach their students to bring along an extra mask. Maybe someday all will.

I also appreciate Mike's comment about training everyone to be as independent as a solo diver. You never know then the current or something else is going to turn your buddy dive or team dive into a solo dive.

Me thinks you have your priorities a bit mixed up. The mask was not the issue, nor was the buddy (although that may have helped). She anchored herself to an object 40 feet below the surface with a reef hook and couldn't ascend. You can ascend w/o a mask and without a buddy. You can even ascend without a BC and fins. But not if you're attached to a rock and can't release yourself, for whatever reason.

 

[triton94949]

Me thinks you have your priorities a bit mixed up. The mask was not the issue, nor was the buddy (although that may have helped). She anchored herself to an object 40 feet below the surface with a reef hook and couldn't ascend. You can ascend w/o a mask and without a buddy. You can even ascend without a BC and fins. But not if you're attached to a rock and can't release yourself, for whatever reason.

It would appear that the mask was the major issue. It all depends on your own perspective.