Life After Drowning

How long can a person be drowned and recover without serious brain damage? How long should first-aiders and physicians keep up attempts to resuscitate someone who is apparently dead? There are no precise answers to these questions, but the British Medical Journal reports the remarkable case of a child brought back from the dead by the tireless efforts of resourceful Norwegian doctors. The detailed observations that were made during the boy's stormy battle for life, says the B.M.J., will help medical researchers to fill in gaps in their knowledge of how to deal with such critical cases.

The history goes back to March of 1962 when five-year-old Roger Arntsen slipped into Trondheim's ice-choked Nidelven River. By the time Dr. Tone Dahl Kvittingen (pronounced Quitting-un) arrived, the boy was apparently dead. His skin was blue-white, his pupils were widely dilated, and though the policeman who had hauled him from the water had made an attempt at mouth-to-mouth resuscitation, Roger had not responded because his mouth and windpipe were clogged with vomit. Worst of all, the Nidelven is a fresh-water river. And fresh water, when inhaled into the lungs, does far more damage than salt: it evidently dilutes the blood, breaks down red cells, overfills the heart, destroys the body's balance of sodium and potassium salts, and usually causes the heart to twitch uselessly.

Protective Cold. Paradoxically, the fact that the raw March wind was a frigid 14DEGF. and the river was close to 32DEG was in Roger's favor. When he lost his hold on the ice and fell in, he was already exhausted and chilled; he probably did not fight much for air, and as a result he inhaled less water than he might have. The icy river soon dropped his body temperature--certainly below 75DEG, but how much lower, nobody knows--so that when he drowned and circulation stopped, his brain suffered less from oxygen deprivation than it would have at normal body heat.

Roger was turned upside down to drain the dirty river water out of him, and Dr. Kvittingen began artificial respiration with a tube down his windpipe, but the boy was still in desperate plight. He had no detectable pulse, and all the way to the hospital his chest was rhythmically compressed to force blood in and out of the heart. At Central Hospital a special, electrode needle was pushed right through the chest wall into the heart, and it failed to detect any beat. External pressure was continued. A blood transfusion was started. Not until 2 1/2 hours after he had fallen into the water did Roger's heart resume a natural beat. Soon after that, he began to breathe for himself. His temperature was still only 75DEG.

He had a stormy course ahead. He began to cough up frothy blood. Dr. Kvittingen and Dr. Arne Naess concluded that his blood had been so damaged and diluted that they had to replace it all by transfusion. They cut a hole in Roger's neck to pass a tube down his windpipe, and through this they extracted more vomit. The boy's kidneys were not working. He received a whole pharmacopoeia of drugs. He had to be fed intravenously for a week.

Hungry & Blind. When the air tube was taken out and Roger was fed by mouth, he seemed to be on the mend.

Then, eleven days after drowning, he entered a terrifying crisis. The doctors still cannot pinpoint the cause of his relapse, but the boy became unconscious and uttered sudden, meaningless shrieks. He threshed around so violently that for two weeks he had to be sedated. For a month, it seemed that Roger's brain had been all but destroyed. He developed an enormous appetite and opened his mouth for food whenever his lips were touched. He went blind, and fell on his face against the bedpost when he sat up.

Then, six weeks after his accident, Roger's mental condition improved as inexplicably as it had deteriorated. He began to speak. Soon he regained vision for near objects, and later for distant ones. Detailed examinations since he was drowned show that Roger Arntsen is still a bit clumsy with his fingers, and has lost some peripheral vision, but he seems to be normal in every other way. He will start school in the fall.

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