Were you aware of it? vol. 22: Back from the dead

As heard on Fresh Air Monday October 12, 2009

DAVE DAVIES, host: Well, Sanjay Gupta, welcome to FRESH AIR. I thought we'd begin with this remarkable story that you tell early in the book of this Norwegian skier who takes a plunge in the mountains and gets trapped in freezing water for something like two hours and manages somehow to recover. How?

Dr. SANJAY GUPTA (Associate Chief of Neurosurgery, Grady Memorial Hospital; Author, "Cheating Death: The Doctors and Medical Miracles that Are Saving Lives Against All Odds"): It is a remarkable story, even for someone like me who's been studying this for a couple of years, who's had the opportunity to travel around the world and talk to the foremost researchers in hypothermia, in extreme survival. This story is sort of the pinnacle of even that. This was a woman who has, I guess, the dubious honor of being the coldest-ever human being who subsequently went on to live. This is a woman who was declared dead in a hospital in Tromso, Norway, and now is a practicing physician at that same hospital.

She was found after she fell into a stream, a sort of frozen stream on a very cold place, and this is Tromso, Norway, which is north of the Arctic Circle in one of the northern-more points of Norway. What we know now is that she struggled for around 30 minutes or so. She was probably getting pockets of air, which is why she could last that long. And then she just stopped, and by the time they got her out of that frozen stream, she was dead. She had no spontaneous respiration. She had no spontaneous heartbeat. She had no blood pressure. Her pupils were dilated, indicating that her brain had become swollen. She was dead, and it was at this point that I think that a critical decision was made. The decision was to go ahead and leave her cold. The idea was that this cold could somehow be protective. It could somehow stimulate an almost hibernation-like reflex in the body. We know that there was no oxygen traveling through the body, but because she was cold, the body wasn't really demanding oxygen, either.

DAVIES: How cold was she? How cold was her body?

Dr. GUPTA: She was 13.7 degrees Celsius, so right around 55 degrees or so. And again, that's the coldest recorded temperature of someone actually surviving, someone surviving.

DAVIES: And how long did they decide to leave her in this hypothermic state?

Dr. GUPTA: Several hours. They did not warm her up at the scene, which is what often happens, even with blankets, and then warm saline and things like that. And they did not warm her up right away when she finally got to the hospital. They waited a few hours and then slowly, very slowly started to re-warm her using these temperature gradients, so just a few degrees at a time.

DAVIES: And what happened?

Dr. GUPTA: What happened is that, you know, they got her in there, and they realized that, you know, she really had no heartbeat. And sometimes you can't tell in the field, you know, it's tough to check a pulse, but now they have - they're doing an echocardiogram, directly looking at her heart, and she really has no heartbeat. So now they're very concerned, and they say we're going to slowly start to re-warm her, and we're also not going to give her any extra IV fluids.

One thing they learned is that when you start to go into this hibernation-like state from cold, from hypothermia, all your blood vessels become very leaky. They just leak fluid. So if you give a lot of fluid, that fluid starts to leak, and if it leaks into the brain or into the lungs, that can cause death.

So they gave no fluids, slowly re-warmed her, and then there was just this great moment where all of the sudden the heart, which was doing nothing - you had true, what's known asystole, that flat line on EKG, and all of a sudden it started to come back. And it was a magical moment as they described it to me when I was visiting them in Tromso, but I think they were still concerned that her brain had gone for too long without oxygen. How could the body tolerate this? But as I said, you know, she slowly recovered. At first, she was paralyzed, almost, in her entire body from lack of oxygen to her brain, but over a period of time, she continued to recover, finished her medical school, which she was a medical student at the time, and is now a doctor in that same hospital.