Between Life and Death

When you're life's on the line, instinct takes over.

Every year, thousands of sportsmen find themselves suddenly thrust into extreme situations, even life and death ordeals, with brains and bodies forced to make equally sudden reactions. It turns out that many of our initial physical responses are actually instinctual. A good thing, too.

"The human body's a very efficient, very smart computer," says Dr. Mahmoud Ahmed, M.D., a psychiatrist at Marshfield Clinic, in Eau Claire, Wisconsin, who treats many patients with high-stress encounters in their pasts. "It does not wait for us to tell the computer what to do. It's able to function independently, automatically."

Much of the automatic reaction by the human "computer" is routed through the brain's amygdala. According to Amanda Ripley, in her book, The Unthinkable: Who survives when disaster strikes, the amygdala is, "an ancient, almond-shaped mass of nuclei located deep within [the]…brain's temporal lobes that is central to the human fear circuit. In response [to fear or extreme stress], the amygdala set off a cascading series of changes through [the]..body….without any conscious decision making" on our parts.

Those changes include the release of hormones into the bloodstream, chief among them adrenaline and cortisol. The impacts are near-instantaneous: blood pressure and heart rates shoot up; extra blood's pushed to our muscles and organs; reflexes quicken; we're suddenly stronger; wounds, even broken bones, don't hurt, for a time, anyway.

"Your pupils dilate, so you're able to see your environment better," Ahmed adds.

However, "Not all extreme situations are the same," says Dr. David Goldstein, a clinical researcher with the National Institute of Health, who specializes in the body's reaction to stress. "So, for instance, somebody who falls out of a boat and into ice cold water is going to have a different response, a different outlook, from somebody who is trapped in a jungle and is running away from a lion. And both of these are going to be different from somebody who is starved or deprived of water…"

The body seems to know what's needed. It will, for instance, push extra blood to muscles when we need to fight back against an aggressor. But if we're suddenly immersed in very frigid water? The body can automatically draw blood from our extremities and siphon it into the brain and other organs of need.

Yet what of our thinking, our emotions, when faced with fear, pain, and possible death? How do they react? Those are the big wild cards in the whole equation. In her book, Ripley documents numerous disasters where people respond surprisingly well, folks without even the most basic training in stress or survival. They fight through their fears, do the next right thing, and save themselves and others.

Yet other people in the exact same time and place completely lose their minds, flail around, and make the exact wrong decisions. A fair percentage are unable to react at all.

"Some people become so paralyzed, they can not talk," says Ahmed. "This is very different [from a good survival reaction]. Which one will we do? We cannot predict."

No, we can't predict. But we can observe. And those observation suggest that when the chips are very down, those of us who make it possess a combination of positive personalities and solid survival instincts, good brains, strong wills, and little of that old-fashioned luck.

A Montana Pheasant Opener: ****_Birds, Hunting Buddies, and a Bear
_It was a fine pheasant hunting opener, October 15, 2007. Brian Grand, 39, a carpenter from Missoula, and three friends hunted the rolling wheat fields and creek bottoms west of Valier, Montana. They knocked down a few birds in the morning, had a nice lunch, then began hunting back toward their trucks. Grand entered a thick, brushy creek bottom, heard some rustling but figured it was deer. A moment later, he spotted the grizzly bear, just 30 feet away.

"That bear probably had three leaps, on his dead run, and he was on top of me," Grand remembers.

Grand estimates it took the griz three, maybe four seconds to cover that distance. In that snapshot of time, "You're thinking, Holy shit!," Grand says. "You're processing [it's] a bear. But you're almost not believing it. But you are, and you're processing: do you/don't you shoot, where do you shoot? Do you run, do you fight--what do you do?"

And then the bear was on him, a relatively young male, seven feet long and maybe 350 pounds.

"Why I did it, I don't know. It's not like I read it or have been taught it," but Grand instantly dropped into the fetal position. "I naturally did it, and stuck to it."

Good thing, too. The grizzly wanted to expose Grand's soft belly and rip into it.

"I was rolling over, putting my back to the bear and trying to bury my face into the dirt," says Grand. "What he was doing was basically clawing and biting. He's trying to roll you [over], and when he releases you to get ahold of you in a new place, you roll yourself back [into a ball]. I probably did that, I'm going to say five or six times."

Hearing the commotion, Grand's hunting buddies rushed to the scene, and the griz broke off its attack. Though the assault last less than a half minute, Grand suffered extensive damage, including: over 30-inches of open wounds, with deep bites to his left hand, both forearms, his back, and both thighs; bites to both elbows, with the right one flayed open to the bone; bites to the left side of his face, including a griz eye tooth puncturing his left eye socket at the tear duct; and, tissue ripped out between his right thumb and forefinger, with a broken bone in this hand.

Grand remembers the attack itself very clearly. In fact, as he's telling the story, he's back there in time.

"I have a vivid memory of actually seeing the blue sky…the sun's hitting me directly in the eye, and then a complete blackout, where my face is into the bear."

However, "That's one thing I do not have any [memory] of--smell," Grand says. Wildlife officials went to the attack scene shortly afterwards. "They said that it just reeked something fierce, of bear and bear scat. But I have no sense of it."

He also has no memory of his 20-gauge shotgun going off, though it did, with Grand holding it tight for the duration. Yet, "I could hear the growling roar of the bear," Grand says.

"During the whole attack, no, I didn't have any pain," Grand adds. He was carried to a dirt road, maybe 70 yards away, and laid down. Friends rushed to their vehicles. "That's when the pain started," Grand says. "The pain was the break in my [right] hand. That was pain like I've never felt before. But that was the only pain I felt throughout," even hours later at the hospital. "As much morphine as they were giving me, that still hurt."

His numerous other wounds? Some minor discomfort. In fact, until he got to the hospital, Grand didn't even realize his legs were bitten through and through.

Today, Grand still hunts, though he admits he's a bit more careful about where. He doesn't have nightmares, though "bits and pieces" of the event surface in some dreams. He'll feel some general anxiety during the day. Smaller inconveniences that once bothered him? He lets them go. At the same time, personal relationships are more important to him, and he tends to live more in the moment.

"You look at things a little differently."

Analysis:
Facing life or death, human instinct is usually "fight-or-flight" inclined: we either fight back with everything we've got or beat feet--fast. However, "If you're in an extreme fight-or-flight situation, and neither will work, then another possibility is defeat or [to] faint," says Goldstein. "And they might work!"

Goldstein speculates that Grand, with no escape or chance of fighting back, instinctively took option number three: defeat via the fetal position.

While under attack, says Ahmed, "The senses are going to be completely re-arranged. You need to see more, to hear more. But smell and taste are not a big deal." Which explains why Grand's sight became very sharp and precise, while his sense of smell cut out altogether. Grand could also hear the bear, very important to his survival, but not the shotgun blast. As Ripley writes, "Most people [facing life-and-death stress] also get a muted sort of tunnel hearing. Certain sounds become strangely muted; others are louder than life."

It's no surprise Grand felt so little pain. With hormones like adrenaline and cortisol surging through your bloodstream, "Your ability to endure pain becomes very high," Ahmed notes. "Your body is saying, We'll feel the pain--later on!"

No doubt, strength from that hormal surge helped Grand push away from the terrifically strong grizzly as it was trying to get at his belly. Those hormones, "in particular cortisol and adrenaline," Ripley notes, give our muscles "a sort of bionic boost."

Survival Is In The Details
Jackson Fox had become a human luge, rocketing down a snow-covered mountainside on the north side of Zachar Bay, Kodiak Island, Alaska. Not by choice. Fox, 27 and an environmental manager with the city of Fairbanks, shot a nice goat, and it rolled downslope and then dropped out of sight. While he and hunting partner John Wisniewski made their way to the goat, Fox lost his footing and started sliding. He purposefully kept himself on his back, arms spread and feet first, to avoid a crazy tumble and serious injury.

Didn't quite work out.

Fox shot over a rock ledge, a 20-footer, slammed onto his back, human-sledded to the next ledge, and hit the steeply sloped ground beyond. Even though he was picking up speed, "Everything's going slo-mo now," says Fox.

Still hurtling forward and down, Fox's left boot heel caught a rock, and busted his lower leg all to hell.

"I broke my fib-tib," says Fox. "It flipped my leg [up] backward, and my toes hit my knee."

Fox's left fibula, the rear bone of the calf area, was cleanly broken just below the knee. The tibia, though, the front bone, was completely shattered just above the ankle.

"The 'pop!' was really loud," Fox remembers. "It wasn't really like breaking a stick. It was more the sound of hitting an animal with a bullet. Whap!"

Right after coming to a stop (he slid an estimated 300 feet), Fox felt no pain.

"I'm fairly clear-headed at that point," Fox says. "But my leg's folded in half, so I'm thinking there might be some bones sticking out. So I pushed my right heel into the ground, and pushed up, just to straighten my [left] leg." Fox shimmied out of his snow pants, then unlaced his left boot, though he didn't remove it.

"I knew my [lower leg] was going to swell, and it needed some room to swell," Fox explains. "If I'd kept my boot as tight as it was, it would've turned itself into a tourniquet."

Then the agony. "It was the worst pain I ever felt in my life," says Fox. "It was horrendous. Just shooting pain, all the way up from my ankle to my hip."

"I kept getting these warm sensations in the bottom of my boot," he adds. "It felt like there was blood pouring out of my calf there [at the break] and filling up my boot." Fox thought he might bleed out.

"And I panicked, for about five seconds," Fox says, got very light headed. "I started yelling, 'John! You need to get down here--fast!' And all of a sudden, that sensation [of blood flowing out] stopped, and I calmed down. I took a bunch of deep breaths, tried to take ten deep breaths in a row, and I was back to normal."

It took Wisniewski an hour to get to Fox. The two were hunting with a larger group, and they assembled a few hundred yards below Fox, where the slope leveled off. They also used a satellite phone to hail a Coast Guard helicopter, which got to Fox some four hours after he'd originally broken his leg.

During this time, and despite the intense pain, Fox was able to function. In fact, he forced himself to. Fox read up on bone breaks, from the first aid book in his pack. He and Wisniewski talked over the pros and cons of splitting his leg, and various scenarios if he had to spend the night outdoors. He used his GPS to try to figure his coordinates, and got constant updates from the other hunters below via two-way radio.

"It kept me focused, not on my leg, but on, We need to get ourselves out of this situation," Fox says. "Having a friend there definitely helped keep me level headed, too."

The Coast Guard chopper lowered a crewmember on a basket. The slope was so extreme, though, the basket wouldn't lay flat. So the crewmember and Wisniewski held the basket as level as possible, the chopper bouncing in the high winds. Fox had to load himself.

"I was able to scoot down and get my butt in [the basket]," Fox says. "Then I had to lift up my broken leg and flop it over. Oh, man, that was painful. I screamed pretty bad."

Doctors used a titanium rod to stabilize Fox's left leg, attaching it with ten screws. Surgery late in 2009 will remove the rod, so hunting isn't possible until the 2010 season. But that's okay.

"I have enough [wild] meat in my freezers to get me through next year," says Fox, who promises, "I'll be back hunting the year after that!"

Analysis:
Fox focused on getting himself out of his dilemma, and it aided his survival immensely by keeping panic to a minimum. As Ripley writes in The Unthinkable, "Again and again, studies have shown that people perform better under stress if they think they can handle it….If the brain concludes that the stressor is indeed under its control, the brain blocks some of the more devastating effects of extreme stress," like the bounding fears that can lead to terribly bad decisions.

So Fox's many small tasks gave him a feeling of control and well being. He was taking action, assisting in his own rescue happen, and in the process making it all less scary.

Fox's "work" also shifted his attention from his throbbing leg. Such distractions help alleviate pain, says Ahmed, who notes that marathon runners purposefully listen to iPods. "It's a way to divert them from paying attention to the pain, the discomfort, the agony their bodies are facing," he says.

Fox tried deep breathing during his momentary panic (when he feared he was bleeding out) because he'd read about it. It was exactly the right thing to do. "By consciously slowing down the breath, we can de-escalate the primal fear response that otherwise takes over," Ripley notes.

Survival literature is filled with people who experience the slow-motion phenomena, like Fox's slide downslope seeming to take many, many minutes, when it fact it was probably over in 60 seconds. As Ripley writes, "trauma creates such a searing impression on our brains that it feels, in retrospect, like it happened in slow motion." 67

Slo-mo may also be the brain's way of making the event, as it occurs, seem less overwhelming. True, it all happens in real time. Yet the brain's slo-mo reaction to the stress seems to give us a bit more time, another moment or two of consideration, before we need react.

Minutes to Live, Minutes to Death
Roy M. Goodwin knew that he, his son, and his grandson only had a handful of minutes before the very cold waters of Narragansett Bay, Rhode Island, would kill them.

"The biggest thing that was going in my mind is, I believed I was going to watch my grandson and my son both die in front of me, just before I died," says Goodwin, 60, a building contractor from Upton, Massachusetts. "That was going to be the last thing I was going to see. And there wasn't a thing I could do about it."

The three planned to tool out to a small island in Narraganset Bay, on the last day of the waterfowl season, the 20th of January, 2008, and bag a few eiders, scooters, and golden eyes. But engine trouble struck, and Goodwin lost control of his 14-foot aluminum boat. The wind kicked up, a glassy-calm bay was suddenly tossed by four-foot waves, and the boat swamped; three generations of Goodwins were pitched into frigid water. An experienced seaman and angler, the elder Goodwin knew the score.

"The water was 41 degrees," says Goodwin. Their life expectancy, he knew, was maybe 15 minutes, maybe, before hypothermia dropped their core body temperature so low they either died outright (when brain and cardio functions crashed) or drowned.

Now, they had a couple of advantages. The Coast Guard was called just before the boat was swamped, so the Goodwins knew help was on the way--if they could just hold on. (They were in the drink for 14 minutes). And the initial shock of the cold water didn't rattle the Goodwins too much: all three were experienced winter scuba divers, so they knew what cold water felt like. Another plus?

"I'm a stubborn son-of-a-bitch," Goodwin says. "I knew, to get the maximum amount of time in the water, what I had to do was control my breathing, and, the best I could, to control my body temperature. So what I did was, I started taking giant stride kicks and started heading for shore."

The exertion bumped up his cardiovascular system, generating some body heat. Goodwin was up out of the water somewhat, too, as he was actually wearing a life vest. (The other two grabbed their vests, but, once in the water, could not get them on.) Goodwin also snagged a bag of decoys and stuck them under one arm, for more buoyancy, jammed a floating seat cushion under the other arm.

Goodwin's feet and hands got very cold, and he swallowed some seawater. But his 18-year-old grandson was in much worse shape, screaming that he could no longer feel his hands or feet.

For his own part, "I don't think there was any time for any real terror. There wasn't squat we could do about it, except last as long as we could."

When the Coast Guard ship got on scene, Goodwin says the crew was surprised to find them alive. On shore, EMT personnel determined that Goodwin's grandson was at Second Stage hypothermia, his son in First Stage hypothermia. Goodwin himself was thoroughly chilled, but otherwise unhurt. All three were released from the hospital that day, and recovered fully.

"The people in the ambulance figured my grandson had a minute and a half, maybe two minutes to live. My son had around two, two and a half. I had probably five. If the boat had gotten there six minutes later? They would've pulled three bodies out of the water."

Today, the experience "weighs heavily" on him, Goodwin admits.

"It gave us another bond, a closer bond than we ever had before," says Goodwin. "It sounds silly, but it was a very special experience to share with close family. I'm not recommending it! But we've shared a life-altering experience no one else can really understand."

Analysis:
"When somebody falls out of a boat into cold water, there's something called a 'diving reflex,' that occurs," says Goldstein. "The body metabolism suddenly shuts down. Utilization of energy by the brain and the heart and so forth, plummets, and it's possible that a person can survive a long period of immersion in really cold water."

Oxygen consumption is lowered by a slowed heart rate and decreased blood flow to certain non-essential organs and muscles. So when Goodwin's grandson couldn't feel his feet or hands, of course that was partly a physical reaction to the cold. But the diving reflex was likely at work, too, pulling back his body's functions and waiting for the stress to go away. Goodwin himself essentially overrode the diving reflex, understood what his body couldn't: the overwhelming stress, the icy water of Narragansset Bay, wasn't going away.

While our brains and bodies may go on autopilot in a high-stress situation, as Ripley notes, "we have an outstanding second defense: we can learn from experience." So past experiences, in these cases, can have potential calming effects on the though process. Goodwin's years of deep-sea fishing and cold-water diving, for example, meant that being adrift in cold water, while scary, wasn't devastating. Strangely, too, his knowledge of hypothermia and the certainty of imminent death created a calm resignation, kept him from panicking, and allowed him to make good decisions, like grabbing the decoy bag and floating cushion.

Don't underestimate the importance of Goodwin being a "stubborn s.o.b." As Kenneth Kamler, M.D., writes in his book, Surviving the Extremes, of all the people he observed in life and death struggles, "none of them would have lived…if they didn't also have…the will to survive. Sometimes, will alone seems to get you through…"