Put the Lime in the Coconut

The Phoenix Islands "Greatest Hits" highlights continue...

#6: Medical objectives and triumphs of the 2009 PIPA expedition

Some of the most incredible highlights from the trip were the things that never happened. These things are of huge concern when headed 5.5 days away from anywhere, and when engaging in high-risk activities such as repeatedly diving in shark-filled waters with sharp corals at every turn. Of course, there are always the other regular afflictions--sun poisoning, broken bones, infected wounds, parasites, disease and who knows what else. So, you can see that it is quite worth mentioning that no major medical maladies occurred on our expedition. Hoorah!

Dr. Craig Cook on SCUBA with camera in hand and no sharp coral in sight (Photo: R. Rotjan)

Despite our good fortunes, we weren't willing to risk our lives on luck alone. Instead, we placed our lives into the care of the NAI'A, and into the very capable and experienced hands of Dr. Craig Cook, who was our expedition medical doctor. Craig is no stranger to practicing medicine in high-risk, remote locations. He is the Medical Editor for Sport Diver Magazine and a referral physician for Divers Alert Network. With a background in Anesthesiology, Dr. Cook has been a consultant to the National Oceanographic Atmospheric Administration (NOAA), and is also a scuba instructor and has been actively diving for 40 years. It is with his guidance and wisdom that we hauled a Hyperlite Hyperbaric Chamber with us all the way to middle of nowhere.

Dr. Craig Cook (black shirt) demonstrating the hyperbaric chamber to expedition members (photos: R. Rotjan)

What exactly is a hyperbaric chamber? It's used to treat decompression sickness, (aka "the bends"), which can occur when diving. Basically, divers are at pressure (every 30 feet of depth is equivalent to approximately 1 atmosphere of pressure). The air we breathe is a mix of gasses, including oxygen (~21%) and nitrogen (~78%). At depth, air is compressed (more or less depending on the diving depth), but "the bends" occurs upon depressurization. As divers return to the surface, gas expands as the pressure decreases, and air (basically a mix of dissolved gasses) can form bubbles. Bubbles are usually small and eventually dissipate, but sometimes a bubble forms that is too large, or unfortunately located, and can cause illness ranging from mild to extreme severity. Its effects may vary from joint pain and rash to paralysis and death. To treat the formation of bubbles, doctors use a hyperbaric chamber to recompress a patient (simulate diving depths) while on oxygen, to re-dissolve the bubbles and hopefully prevent their reformation.

Close-up views of the chamber and pressure valves (photos: R. Rotjan)

Luckily, we never needed to use the chamber, and Craig spent most of his doctoring time trying to ease our seasickness, or treating bruises, cuts, scrapes, and allergies. Beyond that, we were all healthy and returned home safely and intact. We were prepared for much worse, however. Craig made sure that each diver was equipped with communications technology (in case we got lost or separated), a safety sausage (again to increase our visibility in case we got lost), a flashlight, a knife (to free from entanglements), a whistle (to call for help), and a tourniquet (in case of shark attacks). However, the one thing that we were all most scared of was a coconut incident. After all, there were a lot of coconut palms on some of the islands!

Coconut palms on Nikamororo (photo: R. Rotjan)

You see, one of my favorite marine biology statistics is as follows: you are more likely to get hit on the head by a coconut than to suffer a shark attack. True, or urban legend? Who knows, but to quote a 2001 journal in the ANZ Journal of Surgery entitled Coconut palm-related injuries in the pacific islands "A total of 3.4% of all injuries presenting to the [Solomon Islands] surgical department was related to the coconut palm. Eighty-five patients fell from the coconut palm, 16 patients had a coconut fruit fall on them, three patients had a coconut palm fall on them and one patient kicked a coconut palm".

"Dangerous" coconut palms 0n the Phoenix Islands (photos: R. Rotjan)

In other words - beware of falling coconuts, but if one falls, mix it with lime (full of vitamin C, it prevents scurvy!), and yell "DOCTOR!" loudly. Thanks to Craig, tropical fruit-borne fractures, scurvy, and the bends were not an issue... and we're most grateful.

Dive safe,



Facebook Comments


Post a Comment