Don’t Ignore that Dive Injury

February's article, "Bad Stories about the Bends," about divers who came down with decompression sickness and the professions who were supposed to treat them, got me wondering: Have you ever suffered an injury on a dive trip and either been in denial about it, or found that the crew was reluctant to get you medical help?

Bret Gilliam, a veteran dive professional and regular Undercurrent contributor, has operated recompression chambers for over 40 years. He says that, while DCS is a statistical inevitability in diving, "what concerns many of us in the business of treating divers is the unfortunate mindset of the sport diving population that consistently denies the possibility of DCS. A certain stigma to reporting symptoms has developed, and this trend flies in the face of all common sense and logic. Why would any intelligent adult ignore symptoms with the knowledge that DCS manifestations are progressive in nature?"

Intelligent dive managers do err on the side of safety, and even if their admonitions annoy you, you shouldn't wave them off. Back in the day, I dived with Peter Kragh, a top underwater cameraman who has shot footage for BBC's Planet Earth and various IMAX films, when he was a young dive guide on the Undersea Hunter at Cocos Island. Not then understanding the short decompression advantages of diving with fixed oxygen in a closed-circuit rebreather, Kragh strongly believed that I must have gotten bent after the long dive. (I would have been if I'd been using traditional scuba gear.) So just to allay his fears, I breathed therapeutic oxygen on the boat and spent another good hour hanging on a rope under the boat that night, breathing oxygen. (Kragh is a devoted rebreather user now.)

Cocos is a long way from hyperbaric treatment, and a bent diver would have ruined an expensive trip for everyone else on board, so in the light of his beliefs regarding deco at that time, Kragh made a brave decision, despite my insisting I was perfectly OK. However, denial is one of the common symptoms displayed by someone who is bent, so Kragh was taking no chances.

The flip side of that is when a diver is mysteriously taken ill after a dive in a remote spot, and the commercial pressures on the crew make them reluctant to call the trip and head for medical safety. That may have been a factor in the John Cody case we wrote about in "Bad Stories about the Bends," in which he thought he was bent but the crew of the Palau Aggressor disagreed. Cody was lucky to get back home to Saudi Arabia and get hyperbaric treatment without further damage to his nervous system. However, he did suffer DCS, due in big part to a massive hole in his heart known as patent foramen ovale (PFO).

I was on a boat in Egypt when one of the passengers was taken ill during the first dive of the trip. Despite my insistence that the man should be rushed to the hospital, the European cruise director preferred to wait to see if he got better. After a downward spiral of suffering, the poor guy was finally evacuated after three days. It turned out he'd suffered a stroke and could only fly home after some months of recovery. Back on land, the boat's owner was appalled when I told him what had happened.

When you've got a full boatload of passengers who've paid a lot of money to dive somewhere remote, canceling a trip and returning to port early can be an expensive exercise when it comes to compensating them. Should a passenger get injured in some way, no matter who is to blame, the crew will always be inclined to treat them where they are, continue with the cruise, and be spared the perceived wrath of the owner at the loss of revenue. It's not always that bad, but ultimately, who will suffer the most are the divers who aren't given the proper treatment or shrug off symptoms because they want to keep on with the trip that they paid and flew all that way for.

"Historically, denial of symptoms and treatment delays have been the rule in sport diver DCS injuries rather than the exception," Gilliam says. "The enlightened diver of the 21st century hopefully will be pivotal in reversing this head-in-the-sand mentality. We have to remove the stigma of blame so improperly associated with DCS reporting."

You Tell Us: Have you been injured in some way or taken ill during a trip, and what did the crew do about it? Write us your story and send it to BenDDavison@undercurrent.org.

-- John Bantin