Anatomy Of A Drowning

Words by Jed Smith

It’s been a torrid start to the Hawaiian Winter. First, with Evan Geiselman and what can only be described as a miraculous story of survival. After making a run at a 12 foot Pipe closeout, Evan was knocked unconscious after striking his head on the reef. He spent three waves underwater. We asked a medical professional, who preferred to remain nameless, what unfolded from the moment Evan’s head collided with rock.

“When you’re hit in the head and you come to, it’s usually after a few seconds, and you will take a big breath and you can inhale water,” he says. “That’s where the problem is. You basically flood your lungs. When your lungs are flooded, the process of drowning begins.”

Bodyboarder Andre Botha was able to get to Ev as quick as humanly possible, having watched the Floridian go down and made a beeline straight for him once he failed to resurface. “At Pipe, if a surfer takes a heavy wave I look to see what’s happening, and his board was tombstoning,” Andre said. “Every other time I look to see if the board is tombstoning the guy pops up so in my mind I was expecting him to pop up and he just wasn’t popping up, so I was like, fuck man, I gotta go over there, so I started paddling in.”

Evan spent three waves underwater, in which time his lungs began to fill with liquid. By the time Andre got to him his face “was a dark blue purple colour, his eyes were back, he was foaming at his mouth.”

Evan was fast approaching permanent brain damage or death. “The problem is that the lungs are full of fluid so the veins and arteries that pass around the lungs are unable to replenish with oxygen,” explains the medic. “When there’s no oxygen in the blood, that’s when the primary injury to the brain occurs.”

There’s also the issue of lung damage. “Water can be quite toxic to the lungs and significant lung injury can result from water, especially dirty water,” says the medic. “People think salt water is clean but salt water still has a lot of bacteria in it, so you get a lot of inflammations to the lung.”

Andre thought Evan was already dead: “I was convinced the guy was dead at that point, that’s when I started blowing air into his mouth, and I got one good breath of air and water started coming out.”

That breath turned out to be the breath of life, with Evan able to be resuscitated on the beach. Though, he wasn’t out of danger yet. There was still the risk of secondary drowning.

“In the salt water we see it all the time,” says the medic. “There are bacteria in salt water so most of the pneumonia or lung infection is secondary to inflammation of the lung. An inflamed or swollen lung full of water prevents the patient from breathing, and without intensive, care they die.”

It’s estimated any one person can stand between three to four minutes underwater without oxygen. That time is drastically reduced when being ragdolled by 20 to 40 feet of swell.

When Greg Long’s inflatable vest failed while surfing giant Cortes Bank in 2012, he was condemned to a four wave hold-down that nearly killed him. Greg was under water for a lot less than three minutes, but the impact of the second wave landing on his head drained his oxygen stores, sending his body and lungs into shock.

“In that acute fight or flight response, your metabolic rate increases using more oxygen then you would if you’re still or unconscious, so in theory you’ve got less time because you’re using more oxygen,” explains the medic.

Such is Greg’s mental fortitude, he made the decision not to open his mouth, no matter what.

“My body convulsed radically, desperately begging me to inhale, but I was still deep, and made the very conscious decision that no matter what, I wouldn’t,” he told Surfing.

He eventually passed out, but without taking a breath. This sent him into a state known as laryngospasm in which the throat and face muscles spasm, shutting down the airway and stopping water from entering. This is the best case scenario, enabling a relatively quick and smooth recovery. The mental strength required to withstand the body’s deoxygenated agony, however, is what separates mortals from the likes of Greg Long and the big wave elite.

It is the injury suffered by Owen Wright, however, that has confounded the medical professionals Stab asked. Bleeding on the brain, even in mild cases, is a serious injury which can lead to death if not treated. It’s exceedingly common in the case of “blunt trauma” to the head in the form of another object, often concrete after a person has been felled by a punch. It’s a common story for the injured to opt for painkillers and to sleep the injury off rather than seek medical advice, in which case the brain continues to bleed and the injured never wakes up. But Owen’s head did not come into contact with anything, so far as it’s been reported (we tried but were unable to receive confirmation from Owen himself). The only time our medical professional has heard of bleeding on the brain without blunt trauma is in the kind of severe whiplash you get from a car accident. Which says a lot about the sheer power of the Pipeline.

“I guess if the wave hit in between the shoulder blades causing significant hyperextension of the neck, injury to your brain could occur from the brain moving inside the skull cavity but I’ve never heard of that happening without breaking your spine,” he says.