Accidents Do Happen
August 5, 2004
In the Golden Days of Sail, cruising wasn't a particularly healthy activity. When sailors weren't wasting away from scurvy, they were being washed overboard in storms or blown apart in sea battles. The crew who accompanied the renowned 18th century explorer James Cook on his three voyages of discovery experienced a relatively low mortality rate because their leader stuffed them full of sauerkraut, a good source of vitamin C. But even a healthy diet wasn't a guarantee of long life. Captain Cook died at age 51 when he was clobbered by an irate native in Hawaii after a dispute over a missing dinghy. Accidents do happen.
Cruising nowadays is less hazardous to one's health. Onboard meals are generally not limited to hardtack and salt beef. Accurate weather forecasting means you can usually avoid being schmucked by a hurricane. And reliable charts (thanks to Captain Cook and others) should keep you off the reefs. In fact, we generally feel safer when we're out at sea than when we're ashore. The only potentially serious injury we've sustained in ten years of living aboard occurred on the hard in a boat yard in Virginia when Eileen stepped off the deck, missed the top rung of the ladder, and did an impressive face plant in the dirt next to "Little Gidding". She was lucky she suffered only a black eye, several bruises, and a mangled pair of glasses (David found the more he insisted, "it was the ladder; really, it was the ladder," the more people gave him dirty looks).
"Risk management" are favourite buzz words these days. When you go cruising you can minimize your risk of injury or death by being properly equipped and acting prudently. This, of course, applies to life on land as well. Don't expect to live too long if you have a penchant for high speeds and haven't checked the brakes on your car for a while. But as Captain Cook discovered, even the best prepared and most cautious sailors occasionally find themselves in the wrong place at the wrong time. Unfortunately, an accident at sea can often have more disastrous implications than its terrestrial counterpart. The guy who misses a curve on the interstate and overturns his SUV will probably be assisted by emergency workers within minutes. The cruiser who piles his inflatable into an unlit breakwater at night on a remote island might not be found for hours, if he's found at all.
Our friend Pat on the sailboat "Illusions" had a serious accident this past winter in George Town, Bahamas. He lost control of his dinghy, fell overboard, and was chewed up by his outboard engine's prop. His jaw was crushed and his head severely lacerated. Luckily, the incident occurred in daylight in a popular anchorage with several people close at hand, including a cruiser who was a physician. Pat was rushed to a local clinic on shore, temporarily patched together, and flown to Nassau. When his condition stabilized, he flew to Canada for reconstructive surgery.
Pat's accident shook us up. Shortly after it happened, we left George Town and for the next couple of months we cruised the Jumentos archipelago and the north coast of Cuba -- a fairly empty stretch of islands and shoreline. We encountered very few settlements and only a handful of other cruising boats. Many nights we anchored alone. Although we enjoyed the solitude, we were also aware that help was far away if we ran into trouble. "Let's take a first aid course this summer when we're back home visiting," Eileen suggested. David agreed, but got nervous when she muttered something about performing an appendectomy with his Swiss army knife.
A little while ago Eileen had some music performances scheduled in Toronto, so we signed up for a two day first aid and CPR course offered by the city's Emergency Medical Services department. Both of us had taken similar courses in the dim distant past -- Eileen as a life guard and swim instructor and David as a scuba diving instructor -- but we were pretty rusty. "I've heard that bloodletting isn't acceptable medical practice anymore," David remarked as we entered the community recreation centre where the course was to be held.
Our instructors were Michael, a moonlighting professional actor, and Alex, a lifeguard. Most of the 17 students were participating in workplace safety programmes or wanting to add credits to their job and education resumes. We were the only ones taking the course out of personal interest. Apparently, this is a typical class profile. Michael told us, "In a perfect world, 100% of all adults would have current training in CPR and first aid; in reality, only about 5% of North American adults have had this training. Eighty percent of students who sign up for courses like this are doing it out of work or school reasons. Only about 20% do it for their own interest. Personally, I would like to see those proportions reversed."
It was an intensive course. Over the next two days, we listened to lectures, read a 170-page manual, watched videos, and -- most important -- practised lifesaving techniques over and over again. We learned how to deal with amputated fingers, sucking chest wounds, and throat blockages. We took turns wrapping each other up in bandages and splints. We got to resuscitate deathly looking dummies -- both adults and babies (the baby dummy could have been a prop in a sci-fi horror flick). We simulated accident scenes where safety and prevention of further injury were key concerns ("Didn't you notice the victim was lying on an electrical cord? Sorry, you just became a casualty yourself").
We gained important knowledge of rescue techniques, but just as significant, we learned a lot about our own limitations. The premise behind most first aid practices is that help is on its way. In a remote anchorage or in the middle of an offshore passage, this may be wishful thinking.
One of the true-or-false questions on the written exam for our course was, "CPR must be performed on a flat, level surface." Michael insisted that the correct answer was "true". David argued, "There's not one flat, level surface on our entire boat. Does that mean I shouldn't attempt CPR if someone suffers a heart attack onboard?"
But the unfortunate reality of the matter is that CPR, even when practised under ideal conditions, is still only a stopgap measure. Few cruising boats (and certainly not "Little Gidding") carry defibrillators. Last year, a cruiser in Black Point, Bahamas, died from a heart attack despite the heroic efforts of other boaters who performed CPR on him for over an hour. He may well have died even if he had keeled over at the entrance to the emergency ward of a well equipped hospital, but in a location several hours from any medical facilities, his chances of survival from the outset were close to zero.
All of this is pretty sobering stuff. We've promised each other that we'll continue taking first aid courses (it's recommended that students take a refresher CPR course annually and retrain completely every three years). And when we get back to the boat, we're determined to do everything possible to avoid having to put into practice what we've learned.