TRAIL OF THE OCTOPUS -- FROM BEIRUT TO LOCKERBIE -- INSIDE THE DIA
By Donald Goddard and Lester K. Coleman
Chapter 1:
All governments lie, some more than others. To protect themselves or 'the national interest', American governments lie more than most.
The story of Washington's blackest lie in modern times began, typically, with a bureaucratic blunder. In the spring of 1988, Special Agent Micheal T. Hurley, the Drug Enforcement Administration's attache to the American Embassy in Cyprus, was given a clear warning by an American intelligence agent that security had been breached in a 'sting' operation the DEA had mounted against Lebanese drug traffickers running heroin into the United States via Nicosia, Frankfurt and London.
Seven months later, on 21 December 1988, a bomb exploded in the cargo hold of Pan Am Flight 103 from Frankfurt to New York, killing all 259 passengers and crew. Eleven more people died on the ground as the wreckage of the Boeing 747 jumbo jet, Maid of the Seas, rained down on the Scottish border town of Lockerbie.
Among the victims were at least two, possibly five or more, American intelligence agents, who had disregarded standing orders by choosing to fly home from Beirut on an American-flag airline, and a DEA Lebanese-American courier who had previously carried out at least three controlled deliveries of heroin to Detroit as part of the 'sting'.
Those involved in this operation, along with those who had authorized, condoned or used it for other purposes, recognized at once that their neglect of the warning in May had cost 270 lives, that terrorists had slipped through the reported breach in security and converted a controlled delivery of heroin into the controlled delivery of a bomb -- probably in revenge for the 290 lives lost in July when the US cruiser Vincennes had shot down an Iranian Airbus 'by mistake'.
The US government would lie about that catastrophic blunder, too, but the more immediate problem was the Lockerbie disaster. Like a woodlouse sensing danger, the Drug Enforcement Administration (DEA) rolled up in an armour-plated ball to protect its bureaucratic arse.
This worked, more or less, for two years, but the problem refused to go away. When the DEA's obduracy began to attract as many embarrassing questions as it deflected, the agency started to lie, with the grudging connivance of the intelligence community and the ungrudging assistance of the Bush administration.
It lied to the media and the public, of course, but it also lied to Congress. And the more it lied, the harder it got to keep the story straight.
For one thing, there was the problem of the intelligence agent who had warned Hurley about the disaster waiting to happen months before the downing of Flight 103. Like most of his colleagues in the Defense Intelligence Agency (DIA), Lester Knox Coleman III had found little to admire in the work of the DEA overseas.
And for another thing, there was the problem of Pan Am and its insurers, who had commissioned their own investigation into the disaster. The more they picked up about the DEA connection, the less they felt inclined to pick up what was beginning to look like a $7-billion tab.
For those watching the situation from Washington, a recurring nightmare was that these two problems might come together like match and tinder; that Coleman would meet up with Pan Am's attorneys and tell them what he knew. Because if that happened, they might between them start a fire that would blacken the reputation, not just of the DEA, but of the United States itself. If the truth came out, it would not only undermine America's role as moral and political exemplar to the world, but inflict intolerable damage on its policy objectives in the Middle East.
The risk was simply not acceptable. The 'national interest' now required the DEA sting never to have happened, and Lester Knox Coleman III not to exist -- at least as a credible witness.
It was a job for what Coleman had come to think of as 'the octopus' -- America's state security apparatus.
***
Nothing feels right at four in the morning.
He frowned at the ceiling, trying to recall what had woken him. Careful not to disturb Mary-Claude, he slipped out of bed to look at the babies.
They were sound asleep -- the seven-month-old twins, Joshua and Chad, sprawled in their crib like abandoned dolls, so quiet he bent over them suddenly to make sure they were breathing, and Sarah, curled up like a tiny blonde edition of her mother. He watched until she stirred and sighed, threatening to wake, and tiptoed away.
Still restless, he pulled on a T-shirt and shorts and went downstairs to the refrigerator. It was probably nothing -- just the usual uneasiness in the final days before a mission. And worse this time, for he had been out of it for two years, since May 1988, when Control had called him home after Tony Asmar's murder in Beirut and the row with Hurley.
After a two-year lay-off, the adrenalin had naturally started to surge again at the prospect of reentering the bloody arena of Lebanese politics, particularly as Operation Shakespeare was probably the most sensitive assignment the DIA had yet given him. Also, he was still not comfortable with the idea of using his alias on the first leg of the journey.
He had never done that before. It was a sensible precaution if the intention was not to alert the Israelis or if the general sloppiness of the DEA in Cyprus had set him up as a target, like Asmar, but it still bothered him. It was one thing to return to the Middle East as Lester Coleman, award-winning TV and radio newsman, and quite another to arrive without antecedents or connections as Thomas Leavy, American businessman.
And anyway, why couldn't Control just have given him a passport in the name of Thomas Leavy instead of getting him to apply for a real one, using his phony papers? The agency had always been good with documents.
Needing air, he opened the casement doors to the balcony. Except for a vulgar canopy of stars and the faint fuzz of phosphorescence along the beach where the waters of the Gulf lapped ashore, the night was velvet black, and so still his ears sang in the silence.
He loved this place, out of season. While waiting for a lull in the fighting in Beirut, he had decided to take the family away on holiday, renting the last in a row of beach-house condominiums at the edge of Fort Morgan National Seashore Park, a beautiful stretch of the Alabama coast, near the Florida state line. As it was only 2 May, there was no one else around, apart from a nice enough young fellow just down the street, holidaying there on his own.
He had wondered about that, too.
Disinclined to go back to bed, Coleman stretched out on the couch and reached for the file he had put together on General Michel Aoun, the Maronite Christian commander of the Lebanese Army and the country's acting President. Having persuaded Aoun to receive him and Peter Arnett in the shell-shattered ruins of the presidential palace at Baabda, he needed to be on top of every nuance in Lebanon's murderous factionalism if he was to stay on afterwards and begin to explore Aoun's constituency in the maelstrom of Beirut, the support he was getting from the Israelis, and in particular, his military alliance with Saddam Hussein against the Syrian army of occupation. Control had received reports that the Iraqi forces were getting ready to pull out, and wanted to know why.
He woke again, with a start, around seven. Somebody was hammering on the front door. It was light now, and he went through to the kitchen, which overlooked the street, to see who it was. As he looked out, a young man in a blue FBI windbreaker glanced up from below, hand on holster, and tried to hide behind a telephone pole.
Coleman pulled back from the sliding glass door, and tried to think. What now? What possible reason could there be for an early-morning visit from the FBI? Some inter-agency training gimmick to pep him up after a two-year lay-off? Some far-out psychological game, maybe to test the solidity of his cover story before the mission got started?
The hammering began again, and that made him angry. If they kept this up, they would wake the children. Whatever was going on, Control had no right to bother his family. Ignoring the commotion, he went upstairs and gently shook Mary-Claude awake. Brought up in East Beirut during the civil war, she had learned to sleep through almost anything, even artillery bombardments.
'Oh, God,' she groaned, shaking him off. 'What's the matter?'
'I don't know,' he said. 'There's somebody downstairs trying to get in.'
It was a moment before this registered. 'Oh, my God,' She sat up, wide-eyed with alarm, 'Have you called the police?'
'No, no,' He shook his head. 'I don't know what they want, but I think it's the FBI.'
'The FBI?' She was bewildered. He had never told her he worked for the American government, and like a good Lebanese wife she had never questioned him, but she had always known he was a spy. 'Why are they here? Have you done something wrong?'
Before he could think of anything reassuring to say, the hammering at the door began again.
'Oh, my God.'
'No, don't worry,' he said. 'It's a mistake. They probably came to the wrong house. I'll take care of it.'
'We have to open up, right? I mean, maybe they'll go away.'
'No.' He pulled himself together. 'Get dressed. See to the children. I'll go find out what this is all about.'
He returned to the kitchen, dragged open the sliding glass door and stepped out on the balcony. The agent he had seen before was no longer hiding behind the pole, but before Coleman could challenge him, a woman in an FBI windbreaker emerged from the carport under the house and looked up at him, also hand on holster.
'Are you Lester Knox Coleman?' she asked.
'Yes.'
'This is the FBI. We have a warrant for your arrest.'
'Oh, really?' He took a deep breath to steady himself. 'Is this a joke? What for?'
'If you'll open the door, Mr. Coleman,' she said, 'we'll be glad to talk to you about it. Do you mind opening the door?'
'No, no,' he said. 'I'll be happy to open the door. Just wait a minute.'
He went inside again, fumbled with the locks and stood back, bracing himself as a third agent, older than the other two, flung open the door and grabbed him. Offering no resistance, Coleman allowed himself to be spun around, jammed up against the wall and patted down. His arms were then pulled out behind him and handcuffed together.
'You're under arrest,' announced the agent.
'Yes,' he said. 'So I see. Now would somebody mind telling me why?'
Joined at this point by his colleagues, the agent turned him around to face them.
'I'm Special Agent Lesley Behrens,' the woman said, 'I have a warrant here, issued in Chicago. You're charged with making a false statement on a passport application.'
He frowned, trying to cope with a sudden inkling of what the onset of madness might be like.
Thinking about it afterwards, in a filthy cell in Mobile City Jail, he could recall very little of what passed between them after that. They seated him on a stool at the bar. They asked him routine questions, to which he presumably responded with routine answers, but nothing registered.
Unable to withstand more than a split-second glimpse of such fathomless duplicity, all he seemed able to do was shake his head. The sudden collapse of every certainty in life was too much to grasp all at once. Each time he braced himself to consider his position, his mind simply tripped its overload switch.
It got going again when Mary-Claude appeared on the stairs with Sarah, who had started to cry. Trapped by her Lebanese upbringing between loyalty to the family and respect for authority, his wife smiled down on them uncertainly.
'Hi,' she said.
Then she saw the handcuffs, and all softness of manner disappeared. 'What is this?' she demanded, looking about her as though for a weapon. 'What's the problem here? What are you doing to my husband?'
'No problem,' he said easily, knowing how headstrong she could be. 'It's a mistake, that's all. Somebody's made a mistake.'
'Mistake?' She advanced down the stairs, Sarah clutching her hand and now crying in earnest. 'Why are you treating him like this? This is my journalist husband that I'm so proud of. What has he done?'
Mary-Claude's English -- her third language, after Arabic and French -- sometimes fractured under stress, but her outrage was plain enough. They all began to talk at once, except for the older agent, who gave Sarah a smile, trying to coax one from her in return.
Still passionately demanding an explanation from Special Agent Behrens, Mary-Claude suddenly noticed that in her hurry to get dressed she had left the front of her shorts undone, and stopped in mid-flight.
'I'm sorry,' she muttered, turning away to zip them up.
Her sudden embarrassment gave Agent Behrens a chance to resume command. She ordered Mary-Claude to go back to the bedroom to look for her husband's papers -- all she could find -- and bring them downstairs.
Mary-Claude hesitated, unable to catch Coleman's eye as Behrens was standing between them, then did as she was told, rather than risk making matters worse for him out of mere stubbornness.
He watched her go. Though still in free fall, he had already begun to doubt that Control had played any part in this. After months of painstaking preparation for a mission of obvious importance, that made no sense at all. Therefore, it had to be the DIA. No other agency, apart from his own, even knew of his other identity. Except the CIA, of course, which had always worked in lockstep with the DEA in Cyprus and had actually supplied him with his Thomas Leavy birth certificate in the first place.
'Oh, my God,' he said, losing his way again.
It was no use talking to Behrens and her partners. They obviously knew nothing, and he could certainly tell them nothing. It was up to Control to straighten this out. Somebody at Arlington Hall or the Pentagon had to pick up the phone and have a quiet word with the director of the FBI and that would be the end of it. Although there wasn't much time. He was due to leave in two days. If they tangled him up with all the formalities of arrest and arraignment and insisted on shipping him back to Chicago, they could blow the whole operation.
'Look,' he said, in case there was just an outside chance he could fix this himself. 'Maybe there's something I can help you with here. I mean, I can't tell you much except that something is seriously wrong and somebody is going to get into a helluva lot of trouble, but I think you might be interested in that stuff.'
He nodded toward the videotape cassette on the table, next to his file on Aoun, his passport and his wallet containing the Thomas Leavy birth certificate. He had spliced the tape together as a record of his tour of duty on secondment to the DEA in Cyprus. There was some interesting footage on Lebanese dope trafficking, some narcotic reports he had compiled, media clips on the subject, and, at the end, an audio recording of his last telephone conversation with Hurley before coming home, a conversation that not only warned him about 'the disaster waiting to happen', but clearly indicated that he worked for another government agency.
'Why don't we take that along with us?' he suggested.
'We'll take anything you want to give us,' said Behrens.
And that was interesting, too. He was getting a better grip on this now. So far, they had made no attempt to search the house, although with an arrest warrant they were legally entitled to do so, and no one had escorted Mary-Claude upstairs to make sure she didn't dispose of incriminating evidence. So what kind of charade was this anyway? They hadn't even read him his rights. Was it a DIA game after all? To see if he'd crack under pressure?
Mary-Claude reappeared on the stairs.
'I'm sorry,' she said defiantly. 'I can't find his papers. I can't find anything.'
He smiled at her, and nodded his approval.
'Are you sure?' asked Agent Behrens coldly. She advanced to the foot of the stairs. 'They're not down here. There must be something. What about his pockets? Have you looked in his pockets?'
Mary-Claude retreated a pace, afraid they would come up and search the bedroom themselves. 'All right,' she said. The twins were awake now, and screaming for attention. 'All right, I'll look again.'
'Okay.' Behrens turned back to the others. 'Take him out to the car,' she said. 'I'll be with you in a minute.'
Coleman offered no resistance as they took him by the arms. Whatever this was -- a training set-up, a DEA set-up or a bureaucratic foul-up -- the game had to be played to a finish. If the operation was cancelled or delayed, it wouldn't be his fault.
'I'll be back shortly, Mary-Claude,' he called out after her. 'Don't worry. Call the lawyer. Call Boohaker. He'll know what to do.'
Mary-Claude closed the bedroom door behind her and tried to pacify the twins, but they were hungry and cried all the harder.
'Why am I so nervous?' she asked them, getting mad. 'I am a citizen. I have my rights. This is my house. I don't have to give her anything. I must calm down and go tell her to get the hell out of here. Then I'll come back and get your bottles ready.'
She marched downstairs, pointedly ignoring Special Agent Behrens, and picked up the phone.
'Who are you calling?' Behrens asked.
'I'm not going to give you anything,' said Mary-Claude. 'And I'm not going to answer any of your questions. I'm calling my lawyer. I don't know what's right, what's wrong, and I want my lawyer's suggestion. '
'Okay.' Behrens considered her for a moment. 'Okay, don't bother. I'm going now.'
As the door closed behind her, Mary-Claude put down the phone. She could not think straight, what with the shock, the twins bawling for food and Sarah pulling at her shorts, asking 'Where did Poppy go?' In an unfamiliar house, in a country she hardly knew, thousands of miles from her family, with her husband suddenly taken away, and three babies to care for, she had never felt more lonely and frightened in her life.
She was so rattled she used the wrong measuring cup for the twins' formula and had to mix it all over again. Then, after each had finished his bottle, she paced up and down, waiting for them to settle before she called Boohaker, who was shocked to hear what had happened. He promised to do the best he could and to call her back when he had some news.
Rather than sit around watching the telephone, she got the children dressed and put them in the car, with the idea of going to the market to buy a few things they needed. She was about to drive off when, as an afterthought, she went back into the house for Coleman's papers, in case the FBI decided to break in and get them while she was away.
By the time Mary-Claude returned from the market, about an hour later, the idea of keeping his papers from prying eyes had become an obsession. If the FBI was so eager to have them, it could only mean they would do her husband harm if the agents got hold of them. She put her now sleepy children to bed and, except for Coleman's clothes, carried everything of his she could find into the bathroom.
With no way of knowing what was harmful and what was not, she tore all his papers into shreds, including his Federal Communications Commission (FCC) broadcast engineer's license, and chopped his ID cards into pieces, hurting her hand with the scissors. Not sure what to do next, she then made a heap of everything in the bathtub and set light to it.
Watching the smoke rise, she felt that even the war in Lebanon had been easier to live through than this. In a war, you knew that anything could happen at any time, but you also knew there was nothing you could do about it. Now, for all she knew, her husband's fate might rest with her. She wrung her hands and was still trying to decide if there was anything else she ought to do when the smoke set off the fire alarm.
'Oh, my God, what is this?'
She rocked back and forth in despair until she realized what she had done. Jumping up to shut off the alarm before its noise woke the children, she turned on the shower to put out the flames, and in a tearful fury flung the sodden remains into the toilet and flushed them away. Only then did she notice the marks that the fire had left in the bathtub. As she scrubbed away at them hopelessly, that seemed like the saddest thing of all somehow.
Meanwhile, Coleman was still grappling with bewilderment in the back of the car. Within days of leaving on a mission of national importance, an operation that might well affect the whole course of US strategy in the Middle East, he was riding into Mobile between two FBI agents to answer a trumped-up passport charge? It was crazy.
'You want to share the joke with us?' Behrens asked.
'No, I don't think so. It's only funny if you know the whole story.'
'Then why don't you tell us about it? You got a passport already. Why in the world would you want another one? In another name?'
'Hell, I don't know. I'm a journalist, right? Maybe I was researching a story about how easy it is to get false identification.'
'Well, now you know it's not that easy,' she said. 'If that's true, you should have got authorization first.'
'Yeah. And you should have read me my rights first.'
The older agent sighed. 'Okay,' he said tiredly. 'Read him his rights.'
'Fine, but why don't we all get more comfortable?'
Coleman handed them the handcuffs. For an amateur magician of his calibre, it was a simple enough escape trick. You just had to flex your wrists in a certain way as they were fastened on.
The government was not amused. Its agents put the handcuffs back on. Tighter.
'Oh, come on,' said Coleman. 'You know this is bullshit. What's it all about?'
|
Trail of the Octopus Chapter 1
The cold hard facts of freezing to death
The cold hard facts of freezing to death
By: Peter Stark
When your Jeep spins lazily off the mountain road and slams backward into a snowbank, you don't worry immediately about the cold. Your first thought is that you've just dented your bumper. Your second is that you've failed to bring a shovel. Your third is that you'll be late for dinner. Friends are expecting you at their cabin around eight for a moonlight ski, a late dinner, a sauna. Nothing can keep you from that.
Driving out of town, defroster roaring, you barely noted the bank thermometer on the town square: minus 27 degrees at 6:36. The radio weather report warned of a deep mass of arctic air settling over the region. The man who took your money at the Conoco station shook his head at the register and said he wouldn't be going anywhere tonight if he were you. You smiled. A little chill never hurt anybody with enough fleece and a good four-wheel-drive.
But now you're stuck. Jamming the gearshift into low, you try to muscle out of the drift. The tires whine on ice-slicked snow as headlights dance on the curtain of frosted firs across the road. Shoving the lever back into park, you shoulder open the door and step from your heated capsule. Cold slaps your naked face, squeezes tears from your eyes.
You check your watch: 7:18. You consult your map: A thin, switchbacking line snakes up the mountain to the penciled square that marks the cabin.
Breath rolls from you in short frosted puffs. The Jeep lies cocked sideways in the snowbank like an empty turtle shell. You think of firelight and saunas and warm food and wine. You look again at the map. It's maybe five or six miles more to that penciled square. You run that far every day before breakfast. You'll just put on your skis. No problem.
There is no precise core temperature at which the human body perishes from cold. At Dachau's cold-water immersion baths, Nazi doctors calculated death to arrive at around 77 degrees Fahrenheit. The lowest recorded core temperature in a surviving adult is 60.8 degrees. For a child it's lower: In 1994, a two-year-old girl in Saskatchewan wandered out of her house into a minus-40 night. She was found near her doorstep the next morning, limbs frozen solid, her core temperature 57 degrees. She lived.
Others are less fortunate, even in much milder conditions. One of Europe's worst weather disasters occurred during a 1964 competitive walk on a windy, rainy English moor; three of the racers died from hypothermia, though temperatures never fell below freezing and ranged as high as 45.
But for all scientists and statisticians now know of freezing and its physiology, no one can yet predict exactly how quickly and in whom hypothermia will strike--and whether it will kill when it does. The cold remains a mystery, more prone to fell men than women, more lethal to the thin and well muscled than to those with avoirdupois, and least forgiving to the arrogant and the unaware.
The process begins even before you leave the car, when you remove your gloves to squeeze a loose bail back into one of your ski bindings. The freezing metal bites your flesh. Your skin temperature drops.
Within a few seconds, the palms of your hands are a chilly, painful 60 degrees. Instinctively, the web of surface capillaries on your hands constrict, sending blood coursing away from your skin and deeper into your torso. Your body is allowing your fingers to chill in order to keep its vital organs warm.
You replace your gloves, noticing only that your fingers have numbed slightly. Then you kick boots into bindings and start up the road.
Were you a Norwegian fisherman or Inuit hunter, both of whom frequently work gloveless in the cold, your chilled hands would open their surface capillaries periodically to allow surges of warm blood to pass into them and maintain their flexibility. This phenomenon, known as the hunter's response, can elevate a 35-degree skin temperature to 50 degrees within seven or eight minutes.
Other human adaptations to the cold are more mysterious. Tibetan Buddhist monks can raise the skin temperature of their hands and feet by 15 degrees through meditation. Australian aborigines, who once slept on the ground, unclothed, on near-freezing nights, would slip into a light hypothermic state, suppressing shivering until the rising sun rewarmed them.
You have no such defenses, having spent your days at a keyboard in a climate-controlled office. Only after about ten minutes of hard climbing, as your body temperature rises, does blood start seeping back into your fingers. Sweat trickles down your sternum and spine.
By now you've left the road and decided to shortcut up the forested mountainside to the road's next switchback. Treading slowly through deep, soft snow as the full moon hefts over a spiny ridgetop, throwing silvery bands of moonlight and shadow, you think your friends were right: It's a beautiful night for skiing--though you admit, feeling the minus-30 air bite at your face, it's also cold.
After an hour, there's still no sign of the switchback, and you've begun to worry. You pause to check the map. At this moment, your core temperature reaches its high: 100.8. Climbing in deep snow, you've generated nearly ten times as much body heat as you do when you are resting.
As you step around to orient map to forest, you hear a metallic pop. You look down. The loose bail has disappeared from your binding. You lift your foot and your ski falls from your boot.
You twist on your flashlight, and its cold-weakened batteries throw a yellowish circle in the snow. It's right around here somewhere, you think, as you sift the snow through gloved fingers. Focused so intently on finding the bail, you hardly notice the frigid air pressing against your tired body and sweat-soaked clothes.
The exertion that warmed you on the way uphill now works against you: Your exercise-dilated capillaries carry the excess heat of your core to your skin, and your wet clothing dispels it rapidly into the night. The lack of insulating fat over your muscles allows the cold to creep that much closer to your warm blood.
Your temperature begins to plummet. Within 17 minutes it reaches the normal 98.6. Then it slips below.
At 97 degrees, hunched over in your slow search, the muscles along your neck and shoulders tighten in what's known as pre-shivering muscle tone. Sensors have signaled the temperature control center in your hypothalamus, which in turn has ordered the constriction of the entire web of surface capillaries. Your hands and feet begin to ache with cold. Ignoring the pain, you dig carefully through the snow; another ten minutes pass. Without the bail you know you're in deep trouble.
Finally, nearly 45 minutes later, you find the bail. You even manage to pop it back into its socket and clamp your boot into the binding. But the clammy chill that started around your skin has now wrapped deep into your body's core.
At 95, you've entered the zone of mild hypothermia. You're now trembling violently as your body attains its maximum shivering response, an involuntary condition in which your muscles contract rapidly to generate additional body heat.
It was a mistake, you realize, to come out on a night this cold. You should turn back. Fishing into the front pocket of your shell parka, you fumble out the map. You consulted it to get here; it should be able to guide you back to the warm car. It doesn't occur to you in your increasingly clouded and panicky mental state that you could simply follow your tracks down the way you came.
And after this long stop, the skiing itself has become more difficult. By the time you push off downhill, your muscles have cooled and tightened so dramatically that they no longer contract easily, and once contracted, they won't relax. You're locked into an ungainly, spread-armed, weak-kneed snowplow.
Still, you manage to maneuver between stands of fir, swishing down through silvery light and pools of shadow. You're too cold to think of the beautiful night or of the friends you had meant to see. You think only of the warm Jeep that waits for you somewhere at the bottom of the hill. Its gleaming shell is centered in your mind's eye as you come over the crest of a small knoll. You hear the sudden whistle of wind in your ears as you gain speed. Then, before your mind can quite process what the sight means, you notice a lump in the snow ahead.
Recognizing, slowly, the danger that you are in, you try to jam your skis to a stop. But in your panic, your balance and judgment are poor. Moments later, your ski tips plow into the buried log and you sail headfirst through the air and bellyflop into the snow.
You lie still. There's a dead silence in the forest, broken by the pumping of blood in your ears. Your ankle is throbbing with pain and you've hit your head. You've also lost your hat and a glove. Scratchy snow is packed down your shirt. Meltwater trickles down your neck and spine, joined soon by a thin line of blood from a small cut on your head.
This situation, you realize with an immediate sense of panic, is serious. Scrambling to rise, you collapse in pain, your ankle crumpling beneath you.
As you sink back into the snow, shaken, your heat begins to drain away at an alarming rate, your head alone accounting for 50 percent of the loss. The pain of the cold soon pierces your ears so sharply that you root about in the snow until you find your hat and mash it back onto your head.
But even that little activity has been exhausting. You know you should find your glove as well, and yet you're becoming too weary to feel any urgency. You decide to have a short rest before going on.
An hour passes. at one point, a stray thought says you should start being scared, but fear is a concept that floats somewhere beyond your immediate reach, like that numb hand lying naked in the snow. You've slid into the temperature range at which cold renders the enzymes in your brain less efficient. With every one-degree drop in body temperature below 95, your cerebral metabolic rate falls off by 3 to 5 percent. When your core temperature reaches 93, amnesia nibbles at your consciousness. You check your watch: 12:58. Maybe someone will come looking for you soon. Moments later, you check again. You can't keep the numbers in your head. You'll remember little of what happens next.
Your head drops back. The snow crunches softly in your ear. In the minus-35-degree air, your core temperature falls about one degree every 30 to 40 minutes, your body heat leaching out into the soft, enveloping snow. Apathy at 91 degrees. Stupor at 90.
You've now crossed the boundary into profound hypothermia. By the time your core temperature has fallen to 88 degrees, your body has abandoned the urge to warm itself by shivering. Your blood is thickening like crankcase oil in a cold engine. Your oxygen consumption, a measure of your metabolic rate, has fallen by more than a quarter. Your kidneys, however, work overtime to process the fluid overload that occurred when the blood vessels in your extremities constricted and squeezed fluids toward your center. You feel a powerful urge to urinate, the only thing you feel at all.
By 87 degrees you've lost the ability to recognize a familiar face, should one suddenly appear from the woods.
At 86 degrees, your heart, its electrical impulses hampered by chilled nerve tissues, becomes arrhythmic. It now pumps less than two-thirds the normal amount of blood. The lack of oxygen and the slowing metabolism of your brain, meanwhile, begin to trigger visual and auditory hallucinations.
You hear jingle bells. Lifting your face from your snow pillow, you realize with a surge of gladness that they're not sleigh bells; they're welcoming bells hanging from the door of your friends' cabin. You knew it had to be close by. The jingling is the sound of the cabin door opening, just through the fir trees.
Attempting to stand, you collapse in a tangle of skis and poles. That's OK. You can crawl. It's so close.
Hours later, or maybe it's minutes, you realize the cabin still sits beyond the grove of trees. You've crawled only a few feet. The light on your wristwatch pulses in the darkness: 5:20. Exhausted, you decide to rest your head for a moment.
When you lift it again, you're inside, lying on the floor before the woodstove. The fire throws off a red glow. First it's warm; then it's hot; then it's searing your flesh. Your clothing has caught fire.
At 85 degrees, those freezing to death, in a strange, anguished paroxysm, often rip off their clothes. This phenomenon, known as paradoxical undressing, is common enough that urban hypothermia victims are sometimes initially diagnosed as victims of sexual assault. Though researchers are uncertain of the cause, the most logical explanation is that shortly before loss of consciousness, the constricted blood vessels near the body's surface suddenly dilate and produce a sensation of extreme heat against the skin.
All you know is that you're burning. You claw off your shell and pile sweater and fling them away.
But then, in a final moment of clarity, you realize there's no stove, no cabin, no friends. You're lying alone in the bitter cold, naked from the waist up. You grasp your terrible misunderstanding, a whole series of misunderstandings, like a dream ratcheting into wrongness. You've shed your clothes, your car, your oil-heated house in town. Without this ingenious technology you're simply a delicate, tropical organism whose range is restricted to a narrow sunlit band that girds the earth at the equator.
And you've now ventured way beyond it.
There's an adage about hypothermia: "You aren't dead until you're warm and dead."
At about 6:00 the next morning, his friends, having discovered the stalled Jeep, find him, still huddled inches from the buried log, his gloveless hand shoved into his armpit. The flesh of his limbs is waxy and stiff as old putty, his pulse nonexistent, his pupils unresponsive to light. Dead.
But those who understand cold know that even as it deadens, it offers perverse salvation. Heat is a presence: the rapid vibrating of molecules. Cold is an absence: the damping of the vibrations. At absolute zero, minus 459.67 degrees Fahrenheit, molecular motion ceases altogether. It is this slowing that converts gases to liquids, liquids to solids, and renders solids harder. It slows bacterial growth and chemical reactions. In the human body, cold shuts down metabolism. The lungs take in less oxygen, the heart pumps less blood. Under normal temperatures, this would produce brain damage. But the chilled brain, having slowed its own metabolism, needs far less oxygen-rich blood and can, under the right circumstances, survive intact.
Setting her ear to his chest, one of his rescuers listens intently. Seconds pass. Then, faintly, she hears a tiny sound--a single thump, so slight that it might be the sound of her own blood. She presses her ear harder to the cold flesh. Another faint thump, then another.
The slowing that accompanies freezing is, in its way, so beneficial that it is even induced at times. Cardiologists today often use deep chilling to slow a patient's metabolism in preparation for heart or brain surgery. In this state of near suspension, the patient's blood flows slowly, his heart rarely beats--or in the case of those on heart-lung machines, doesn't beat at all; death seems near. But carefully monitored, a patient can remain in this cold stasis, undamaged, for hours.
The rescuers quickly wrap their friend's naked torso with a spare parka, his hands with mittens, his entire body with a bivy sack. They brush snow from his pasty, frozen face. Then one snakes down through the forest to the nearest cabin. The others, left in the pre-dawn darkness, huddle against him as silence closes around them. For a moment, the woman imagines she can hear the scurrying, breathing, snoring of a world of creatures that have taken cover this frigid night beneath the thick quilt of snow.
With a "one, two, three," the doctor and nurses slide the man's stiff, curled form onto a table fitted with a mattress filled with warm water which will be regularly reheated. They'd been warned that they had a profound hypothermia case coming in. Usually such victims can be straightened from their tortured fetal positions. This one can't.
Technicians scissor with stainless-steel shears at the man's urine-soaked long underwear and shell pants, frozen together like corrugated cardboard. They attach heart-monitor electrodes to his chest and insert a low-temperature electronic thermometer into his rectum. Digital readings flash: 24 beats per minute and a core temperature of 79.2 degrees.
The doctor shakes his head. He can't remember seeing numbers so low. He's not quite sure how to revive this man without killing him.
In fact, many hypothermia victims die each year in the process of being rescued. In "rewarming shock," the constricted capillaries reopen almost all at once, causing a sudden drop in blood pressure. The slightest movement can send a victim's heart muscle into wild spasms of ventricular fibrillation. In 1980, 16 shipwrecked Danish fishermen were hauled to safety after an hour and a half in the frigid North Sea. They then walked across the deck of the rescue ship, stepped below for a hot drink, and dropped dead, all 16 of them.
"78.9," a technician calls out. "That's three-tenths down."
The patient is now experiencing "afterdrop," in which residual cold close to the body's surface continues to cool the core even after the victim is removed from the outdoors.
The doctor rapidly issues orders to his staff: intravenous administration of warm saline, the bag first heated in the microwave to 110 degrees. Elevating the core temperature of an average-size male one degree requires adding about 60 kilocalories of heat. A kilocalorie is the amount of heat needed to raise the temperature of one liter of water one degree Celsius. Since a quart of hot soup at 140 degrees offers about 30 kilocalories, the patient curled on the table would need to consume 40 quarts of chicken broth to push his core temperature up to normal. Even the warm saline, infused directly into his blood, will add only 30 kilocalories.
Ideally, the doctor would have access to a cardiopulmonary bypass machine, with which he could pump out the victim's blood, rewarm and oxygenate it, and pump it back in again, safely raising the core temperature as much as one degree every three minutes. But such machines are rarely available outside major urban hospitals. Here, without such equipment, the doctor must rely on other options.
"Let's scrub for surgery," he calls out.
Moments later, he's sliding a large catheter into an incision in the man's abdominal cavity. Warm fluid begins to flow from a suspended bag, washing through his abdomen, and draining out through another catheter placed in another incision. Prosaically, this lavage operates much like a car radiator in reverse: The solution warms the internal organs, and the warm blood in the organs is then pumped by the heart throughout the body.
The patient's stiff limbs begin to relax. His pulse edges up. But even so the jagged line of his heartbeat flashing across the EKG screen shows the curious dip known as a J wave, common to hypothermia patients.
"Be ready to defibrillate," the doctor warns the EMTs.
For another hour, nurses and EMTs hover around the edges of the table where the patient lies centered in a warm pool of light, as if offered up to the sun god. They check his heart. They check the heat of the mattress beneath him. They whisper to one another about the foolishness of having gone out alone tonight.
And slowly the patient responds. Another liter of saline is added to the IV. The man's blood pressure remains far too low, brought down by the blood flowing out to the fast-opening capillaries of his limbs. Fluid lost through perspiration and urination has reduced his blood volume. But every 15 or 20 minutes, his temperature rises another degree. The immediate danger of cardiac fibrillation lessens, as the heart and thinning blood warms. Frostbite could still cost him fingers or an earlobe. But he appears to have beaten back the worst of the frigidity.
For the next half hour, an EMT quietly calls the readouts of the thermometer, a mantra that marks the progress of this cold-blooded proto-organism toward a state of warmer, higher consciousness.
"90.4...
"92.2..."
From somewhere far away in the immense, cold darkness, you hear a faint, insistent hum. Quickly it mushrooms into a ball of sound, like a planet rushing toward you, and then it becomes a stream of words.
A voice is calling your name.
You don't want to open your eyes. You sense heat and light playing against your eyelids, but beneath their warm dance a chill wells up inside you from the sunless ocean bottoms and the farthest depths of space. You are too tired even to shiver. You want only to sleep.
"Can you hear me?"
You force open your eyes. Lights glare overhead. Around the lights faces hover atop uniformed bodies. You try to think: You've been away a very long time, but where have you been?
"You're at the hospital. You got caught in the cold."
You try to nod. Your neck muscles feel rusted shut, unused for years. They respond to your command with only a slight twitch.
"You'll probably have amnesia," the voice says.
You remember the moon rising over the spiky ridgetop and skiing up toward it, toward someplace warm beneath the frozen moon. After that, nothing--only that immense coldness lodged inside you.
"We're trying to get a little warmth back into you," the voice says.
You'd nod if you could. But you can't move. All you can feel is throbbing discomfort everywhere. Glancing down to where the pain is most biting, you notice blisters filled with clear fluid dotting your fingers, once gloveless in the snow. During the long, cold hours the tissue froze and ice crystals formed in the tiny spaces between your cells, sucking water from them, blocking the blood supply. You stare at them absently.
"I think they'll be fine," a voice from overhead says. "The damage looks superficial. We expect that the blisters will break in a week or so, and the tissue should revive after that."
If not, you know that your fingers will eventually turn black, the color of bloodless, dead tissue. And then they will be amputated.
But worry slips from you as another wave of exhaustion sweeps in. Slowly you drift off, dreaming of warmth, of tropical ocean wavelets breaking across your chest, of warm sand beneath you.
Hours later, still logy and numb, you surface, as if from deep under water. A warm tide seems to be flooding your midsection. Focusing your eyes down there with difficulty, you see tubes running into you, their heat mingling with your abdomen's depthless cold like a churned-up river. You follow the tubes to the bag that hangs suspended beneath the electric light.
And with a lurch that would be a sob if you could make a sound, you begin to understand: The bag contains all that you had so nearly lost. These people huddled around you have brought you sunlight and warmth, things you once so cavalierly dismissed as constant, available, yours, summoned by the simple twisting of a knob or tossing on of a layer.
But in the hours since you last believed that, you've traveled to a place where there is no sun. You've seen that in the infinite reaches of the universe, heat is as glorious and ephemeral as the light of the stars. Heat exists only where matter exists, where particles can vibrate and jump. In the infinite winter of space, heat is tiny; it is the cold that is huge.
Someone speaks. Your eyes move from bright lights to shadowy forms in the dim outer reaches of the room. You recognize the voice of one of the friends you set out to visit, so long ago now. She's smiling down at you crookedly.
"It's cold out there," she says. "Isn't it?"
By: Peter Stark
May 2, 2004
When your Jeep spins lazily off the mountain road and slams backward into a snowbank, you don't worry immediately about the cold. Your first thought is that you've just dented your bumper. Your second is that you've failed to bring a shovel. Your third is that you'll be late for dinner. Friends are expecting you at their cabin around eight for a moonlight ski, a late dinner, a sauna. Nothing can keep you from that.
Driving out of town, defroster roaring, you barely noted the bank thermometer on the town square: minus 27 degrees at 6:36. The radio weather report warned of a deep mass of arctic air settling over the region. The man who took your money at the Conoco station shook his head at the register and said he wouldn't be going anywhere tonight if he were you. You smiled. A little chill never hurt anybody with enough fleece and a good four-wheel-drive.
But now you're stuck. Jamming the gearshift into low, you try to muscle out of the drift. The tires whine on ice-slicked snow as headlights dance on the curtain of frosted firs across the road. Shoving the lever back into park, you shoulder open the door and step from your heated capsule. Cold slaps your naked face, squeezes tears from your eyes.
You check your watch: 7:18. You consult your map: A thin, switchbacking line snakes up the mountain to the penciled square that marks the cabin.
Breath rolls from you in short frosted puffs. The Jeep lies cocked sideways in the snowbank like an empty turtle shell. You think of firelight and saunas and warm food and wine. You look again at the map. It's maybe five or six miles more to that penciled square. You run that far every day before breakfast. You'll just put on your skis. No problem.
There is no precise core temperature at which the human body perishes from cold. At Dachau's cold-water immersion baths, Nazi doctors calculated death to arrive at around 77 degrees Fahrenheit. The lowest recorded core temperature in a surviving adult is 60.8 degrees. For a child it's lower: In 1994, a two-year-old girl in Saskatchewan wandered out of her house into a minus-40 night. She was found near her doorstep the next morning, limbs frozen solid, her core temperature 57 degrees. She lived.
Others are less fortunate, even in much milder conditions. One of Europe's worst weather disasters occurred during a 1964 competitive walk on a windy, rainy English moor; three of the racers died from hypothermia, though temperatures never fell below freezing and ranged as high as 45.
But for all scientists and statisticians now know of freezing and its physiology, no one can yet predict exactly how quickly and in whom hypothermia will strike--and whether it will kill when it does. The cold remains a mystery, more prone to fell men than women, more lethal to the thin and well muscled than to those with avoirdupois, and least forgiving to the arrogant and the unaware.
The process begins even before you leave the car, when you remove your gloves to squeeze a loose bail back into one of your ski bindings. The freezing metal bites your flesh. Your skin temperature drops.
Within a few seconds, the palms of your hands are a chilly, painful 60 degrees. Instinctively, the web of surface capillaries on your hands constrict, sending blood coursing away from your skin and deeper into your torso. Your body is allowing your fingers to chill in order to keep its vital organs warm.
You replace your gloves, noticing only that your fingers have numbed slightly. Then you kick boots into bindings and start up the road.
Were you a Norwegian fisherman or Inuit hunter, both of whom frequently work gloveless in the cold, your chilled hands would open their surface capillaries periodically to allow surges of warm blood to pass into them and maintain their flexibility. This phenomenon, known as the hunter's response, can elevate a 35-degree skin temperature to 50 degrees within seven or eight minutes.
Other human adaptations to the cold are more mysterious. Tibetan Buddhist monks can raise the skin temperature of their hands and feet by 15 degrees through meditation. Australian aborigines, who once slept on the ground, unclothed, on near-freezing nights, would slip into a light hypothermic state, suppressing shivering until the rising sun rewarmed them.
You have no such defenses, having spent your days at a keyboard in a climate-controlled office. Only after about ten minutes of hard climbing, as your body temperature rises, does blood start seeping back into your fingers. Sweat trickles down your sternum and spine.
By now you've left the road and decided to shortcut up the forested mountainside to the road's next switchback. Treading slowly through deep, soft snow as the full moon hefts over a spiny ridgetop, throwing silvery bands of moonlight and shadow, you think your friends were right: It's a beautiful night for skiing--though you admit, feeling the minus-30 air bite at your face, it's also cold.
After an hour, there's still no sign of the switchback, and you've begun to worry. You pause to check the map. At this moment, your core temperature reaches its high: 100.8. Climbing in deep snow, you've generated nearly ten times as much body heat as you do when you are resting.
As you step around to orient map to forest, you hear a metallic pop. You look down. The loose bail has disappeared from your binding. You lift your foot and your ski falls from your boot.
You twist on your flashlight, and its cold-weakened batteries throw a yellowish circle in the snow. It's right around here somewhere, you think, as you sift the snow through gloved fingers. Focused so intently on finding the bail, you hardly notice the frigid air pressing against your tired body and sweat-soaked clothes.
The exertion that warmed you on the way uphill now works against you: Your exercise-dilated capillaries carry the excess heat of your core to your skin, and your wet clothing dispels it rapidly into the night. The lack of insulating fat over your muscles allows the cold to creep that much closer to your warm blood.
Your temperature begins to plummet. Within 17 minutes it reaches the normal 98.6. Then it slips below.
At 97 degrees, hunched over in your slow search, the muscles along your neck and shoulders tighten in what's known as pre-shivering muscle tone. Sensors have signaled the temperature control center in your hypothalamus, which in turn has ordered the constriction of the entire web of surface capillaries. Your hands and feet begin to ache with cold. Ignoring the pain, you dig carefully through the snow; another ten minutes pass. Without the bail you know you're in deep trouble.
Finally, nearly 45 minutes later, you find the bail. You even manage to pop it back into its socket and clamp your boot into the binding. But the clammy chill that started around your skin has now wrapped deep into your body's core.
At 95, you've entered the zone of mild hypothermia. You're now trembling violently as your body attains its maximum shivering response, an involuntary condition in which your muscles contract rapidly to generate additional body heat.
It was a mistake, you realize, to come out on a night this cold. You should turn back. Fishing into the front pocket of your shell parka, you fumble out the map. You consulted it to get here; it should be able to guide you back to the warm car. It doesn't occur to you in your increasingly clouded and panicky mental state that you could simply follow your tracks down the way you came.
And after this long stop, the skiing itself has become more difficult. By the time you push off downhill, your muscles have cooled and tightened so dramatically that they no longer contract easily, and once contracted, they won't relax. You're locked into an ungainly, spread-armed, weak-kneed snowplow.
Still, you manage to maneuver between stands of fir, swishing down through silvery light and pools of shadow. You're too cold to think of the beautiful night or of the friends you had meant to see. You think only of the warm Jeep that waits for you somewhere at the bottom of the hill. Its gleaming shell is centered in your mind's eye as you come over the crest of a small knoll. You hear the sudden whistle of wind in your ears as you gain speed. Then, before your mind can quite process what the sight means, you notice a lump in the snow ahead.
Recognizing, slowly, the danger that you are in, you try to jam your skis to a stop. But in your panic, your balance and judgment are poor. Moments later, your ski tips plow into the buried log and you sail headfirst through the air and bellyflop into the snow.
You lie still. There's a dead silence in the forest, broken by the pumping of blood in your ears. Your ankle is throbbing with pain and you've hit your head. You've also lost your hat and a glove. Scratchy snow is packed down your shirt. Meltwater trickles down your neck and spine, joined soon by a thin line of blood from a small cut on your head.
This situation, you realize with an immediate sense of panic, is serious. Scrambling to rise, you collapse in pain, your ankle crumpling beneath you.
As you sink back into the snow, shaken, your heat begins to drain away at an alarming rate, your head alone accounting for 50 percent of the loss. The pain of the cold soon pierces your ears so sharply that you root about in the snow until you find your hat and mash it back onto your head.
But even that little activity has been exhausting. You know you should find your glove as well, and yet you're becoming too weary to feel any urgency. You decide to have a short rest before going on.
An hour passes. at one point, a stray thought says you should start being scared, but fear is a concept that floats somewhere beyond your immediate reach, like that numb hand lying naked in the snow. You've slid into the temperature range at which cold renders the enzymes in your brain less efficient. With every one-degree drop in body temperature below 95, your cerebral metabolic rate falls off by 3 to 5 percent. When your core temperature reaches 93, amnesia nibbles at your consciousness. You check your watch: 12:58. Maybe someone will come looking for you soon. Moments later, you check again. You can't keep the numbers in your head. You'll remember little of what happens next.
Your head drops back. The snow crunches softly in your ear. In the minus-35-degree air, your core temperature falls about one degree every 30 to 40 minutes, your body heat leaching out into the soft, enveloping snow. Apathy at 91 degrees. Stupor at 90.
You've now crossed the boundary into profound hypothermia. By the time your core temperature has fallen to 88 degrees, your body has abandoned the urge to warm itself by shivering. Your blood is thickening like crankcase oil in a cold engine. Your oxygen consumption, a measure of your metabolic rate, has fallen by more than a quarter. Your kidneys, however, work overtime to process the fluid overload that occurred when the blood vessels in your extremities constricted and squeezed fluids toward your center. You feel a powerful urge to urinate, the only thing you feel at all.
By 87 degrees you've lost the ability to recognize a familiar face, should one suddenly appear from the woods.
At 86 degrees, your heart, its electrical impulses hampered by chilled nerve tissues, becomes arrhythmic. It now pumps less than two-thirds the normal amount of blood. The lack of oxygen and the slowing metabolism of your brain, meanwhile, begin to trigger visual and auditory hallucinations.
You hear jingle bells. Lifting your face from your snow pillow, you realize with a surge of gladness that they're not sleigh bells; they're welcoming bells hanging from the door of your friends' cabin. You knew it had to be close by. The jingling is the sound of the cabin door opening, just through the fir trees.
Attempting to stand, you collapse in a tangle of skis and poles. That's OK. You can crawl. It's so close.
Hours later, or maybe it's minutes, you realize the cabin still sits beyond the grove of trees. You've crawled only a few feet. The light on your wristwatch pulses in the darkness: 5:20. Exhausted, you decide to rest your head for a moment.
When you lift it again, you're inside, lying on the floor before the woodstove. The fire throws off a red glow. First it's warm; then it's hot; then it's searing your flesh. Your clothing has caught fire.
At 85 degrees, those freezing to death, in a strange, anguished paroxysm, often rip off their clothes. This phenomenon, known as paradoxical undressing, is common enough that urban hypothermia victims are sometimes initially diagnosed as victims of sexual assault. Though researchers are uncertain of the cause, the most logical explanation is that shortly before loss of consciousness, the constricted blood vessels near the body's surface suddenly dilate and produce a sensation of extreme heat against the skin.
All you know is that you're burning. You claw off your shell and pile sweater and fling them away.
But then, in a final moment of clarity, you realize there's no stove, no cabin, no friends. You're lying alone in the bitter cold, naked from the waist up. You grasp your terrible misunderstanding, a whole series of misunderstandings, like a dream ratcheting into wrongness. You've shed your clothes, your car, your oil-heated house in town. Without this ingenious technology you're simply a delicate, tropical organism whose range is restricted to a narrow sunlit band that girds the earth at the equator.
And you've now ventured way beyond it.
There's an adage about hypothermia: "You aren't dead until you're warm and dead."
At about 6:00 the next morning, his friends, having discovered the stalled Jeep, find him, still huddled inches from the buried log, his gloveless hand shoved into his armpit. The flesh of his limbs is waxy and stiff as old putty, his pulse nonexistent, his pupils unresponsive to light. Dead.
But those who understand cold know that even as it deadens, it offers perverse salvation. Heat is a presence: the rapid vibrating of molecules. Cold is an absence: the damping of the vibrations. At absolute zero, minus 459.67 degrees Fahrenheit, molecular motion ceases altogether. It is this slowing that converts gases to liquids, liquids to solids, and renders solids harder. It slows bacterial growth and chemical reactions. In the human body, cold shuts down metabolism. The lungs take in less oxygen, the heart pumps less blood. Under normal temperatures, this would produce brain damage. But the chilled brain, having slowed its own metabolism, needs far less oxygen-rich blood and can, under the right circumstances, survive intact.
Setting her ear to his chest, one of his rescuers listens intently. Seconds pass. Then, faintly, she hears a tiny sound--a single thump, so slight that it might be the sound of her own blood. She presses her ear harder to the cold flesh. Another faint thump, then another.
The slowing that accompanies freezing is, in its way, so beneficial that it is even induced at times. Cardiologists today often use deep chilling to slow a patient's metabolism in preparation for heart or brain surgery. In this state of near suspension, the patient's blood flows slowly, his heart rarely beats--or in the case of those on heart-lung machines, doesn't beat at all; death seems near. But carefully monitored, a patient can remain in this cold stasis, undamaged, for hours.
The rescuers quickly wrap their friend's naked torso with a spare parka, his hands with mittens, his entire body with a bivy sack. They brush snow from his pasty, frozen face. Then one snakes down through the forest to the nearest cabin. The others, left in the pre-dawn darkness, huddle against him as silence closes around them. For a moment, the woman imagines she can hear the scurrying, breathing, snoring of a world of creatures that have taken cover this frigid night beneath the thick quilt of snow.
With a "one, two, three," the doctor and nurses slide the man's stiff, curled form onto a table fitted with a mattress filled with warm water which will be regularly reheated. They'd been warned that they had a profound hypothermia case coming in. Usually such victims can be straightened from their tortured fetal positions. This one can't.
Technicians scissor with stainless-steel shears at the man's urine-soaked long underwear and shell pants, frozen together like corrugated cardboard. They attach heart-monitor electrodes to his chest and insert a low-temperature electronic thermometer into his rectum. Digital readings flash: 24 beats per minute and a core temperature of 79.2 degrees.
The doctor shakes his head. He can't remember seeing numbers so low. He's not quite sure how to revive this man without killing him.
In fact, many hypothermia victims die each year in the process of being rescued. In "rewarming shock," the constricted capillaries reopen almost all at once, causing a sudden drop in blood pressure. The slightest movement can send a victim's heart muscle into wild spasms of ventricular fibrillation. In 1980, 16 shipwrecked Danish fishermen were hauled to safety after an hour and a half in the frigid North Sea. They then walked across the deck of the rescue ship, stepped below for a hot drink, and dropped dead, all 16 of them.
"78.9," a technician calls out. "That's three-tenths down."
The patient is now experiencing "afterdrop," in which residual cold close to the body's surface continues to cool the core even after the victim is removed from the outdoors.
The doctor rapidly issues orders to his staff: intravenous administration of warm saline, the bag first heated in the microwave to 110 degrees. Elevating the core temperature of an average-size male one degree requires adding about 60 kilocalories of heat. A kilocalorie is the amount of heat needed to raise the temperature of one liter of water one degree Celsius. Since a quart of hot soup at 140 degrees offers about 30 kilocalories, the patient curled on the table would need to consume 40 quarts of chicken broth to push his core temperature up to normal. Even the warm saline, infused directly into his blood, will add only 30 kilocalories.
Ideally, the doctor would have access to a cardiopulmonary bypass machine, with which he could pump out the victim's blood, rewarm and oxygenate it, and pump it back in again, safely raising the core temperature as much as one degree every three minutes. But such machines are rarely available outside major urban hospitals. Here, without such equipment, the doctor must rely on other options.
"Let's scrub for surgery," he calls out.
Moments later, he's sliding a large catheter into an incision in the man's abdominal cavity. Warm fluid begins to flow from a suspended bag, washing through his abdomen, and draining out through another catheter placed in another incision. Prosaically, this lavage operates much like a car radiator in reverse: The solution warms the internal organs, and the warm blood in the organs is then pumped by the heart throughout the body.
The patient's stiff limbs begin to relax. His pulse edges up. But even so the jagged line of his heartbeat flashing across the EKG screen shows the curious dip known as a J wave, common to hypothermia patients.
"Be ready to defibrillate," the doctor warns the EMTs.
For another hour, nurses and EMTs hover around the edges of the table where the patient lies centered in a warm pool of light, as if offered up to the sun god. They check his heart. They check the heat of the mattress beneath him. They whisper to one another about the foolishness of having gone out alone tonight.
And slowly the patient responds. Another liter of saline is added to the IV. The man's blood pressure remains far too low, brought down by the blood flowing out to the fast-opening capillaries of his limbs. Fluid lost through perspiration and urination has reduced his blood volume. But every 15 or 20 minutes, his temperature rises another degree. The immediate danger of cardiac fibrillation lessens, as the heart and thinning blood warms. Frostbite could still cost him fingers or an earlobe. But he appears to have beaten back the worst of the frigidity.
For the next half hour, an EMT quietly calls the readouts of the thermometer, a mantra that marks the progress of this cold-blooded proto-organism toward a state of warmer, higher consciousness.
"90.4...
"92.2..."
From somewhere far away in the immense, cold darkness, you hear a faint, insistent hum. Quickly it mushrooms into a ball of sound, like a planet rushing toward you, and then it becomes a stream of words.
A voice is calling your name.
You don't want to open your eyes. You sense heat and light playing against your eyelids, but beneath their warm dance a chill wells up inside you from the sunless ocean bottoms and the farthest depths of space. You are too tired even to shiver. You want only to sleep.
"Can you hear me?"
You force open your eyes. Lights glare overhead. Around the lights faces hover atop uniformed bodies. You try to think: You've been away a very long time, but where have you been?
"You're at the hospital. You got caught in the cold."
You try to nod. Your neck muscles feel rusted shut, unused for years. They respond to your command with only a slight twitch.
"You'll probably have amnesia," the voice says.
You remember the moon rising over the spiky ridgetop and skiing up toward it, toward someplace warm beneath the frozen moon. After that, nothing--only that immense coldness lodged inside you.
"We're trying to get a little warmth back into you," the voice says.
You'd nod if you could. But you can't move. All you can feel is throbbing discomfort everywhere. Glancing down to where the pain is most biting, you notice blisters filled with clear fluid dotting your fingers, once gloveless in the snow. During the long, cold hours the tissue froze and ice crystals formed in the tiny spaces between your cells, sucking water from them, blocking the blood supply. You stare at them absently.
"I think they'll be fine," a voice from overhead says. "The damage looks superficial. We expect that the blisters will break in a week or so, and the tissue should revive after that."
If not, you know that your fingers will eventually turn black, the color of bloodless, dead tissue. And then they will be amputated.
But worry slips from you as another wave of exhaustion sweeps in. Slowly you drift off, dreaming of warmth, of tropical ocean wavelets breaking across your chest, of warm sand beneath you.
Hours later, still logy and numb, you surface, as if from deep under water. A warm tide seems to be flooding your midsection. Focusing your eyes down there with difficulty, you see tubes running into you, their heat mingling with your abdomen's depthless cold like a churned-up river. You follow the tubes to the bag that hangs suspended beneath the electric light.
And with a lurch that would be a sob if you could make a sound, you begin to understand: The bag contains all that you had so nearly lost. These people huddled around you have brought you sunlight and warmth, things you once so cavalierly dismissed as constant, available, yours, summoned by the simple twisting of a knob or tossing on of a layer.
But in the hours since you last believed that, you've traveled to a place where there is no sun. You've seen that in the infinite reaches of the universe, heat is as glorious and ephemeral as the light of the stars. Heat exists only where matter exists, where particles can vibrate and jump. In the infinite winter of space, heat is tiny; it is the cold that is huge.
Someone speaks. Your eyes move from bright lights to shadowy forms in the dim outer reaches of the room. You recognize the voice of one of the friends you set out to visit, so long ago now. She's smiling down at you crookedly.
"It's cold out there," she says. "Isn't it?"
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