The Perfect Storm: A True Story of Men Against the Sea

by Sebastian Junger

Water in the lungs washes away a substance called surfactant, which enables the alveoli to leach oxygen out of the air. The alveoli themselves, grape-like clusters of membrane on the lung wall, collapse because blood cannot get through the pulmonary artery. The artery has constricted in an effort to shunt blood to areas of the lungs where there is more oxygen. Unfortunately, those don’t exist. The heart labors under critically low levels of oxygen and starts to beat erratically—“like a bag full of worms,” as one doctor says. This is called ventricular fibrillation. The more irregularly the heart beats, the less blood it moves and the faster life functions decline. Children—who have proportionally stronger hearts than adults—can maintain a heartbeat for up to five minutes without air. Adults die faster. The heart beats less and less effectively until, after several minutes, there’s no movement at all. Only the brain is alive. The central nervous system does not know what has happened to the body; all it knows is that not enough oxygen is getting to the brain. Orders are still being issued—Breathe! Pump! Circulate!—that the body cannot obey. If the person were defibrillated at that moment, he might possibly survive. He could be given cardiopulmonary resuscitation, put on a respirator, and coaxed back to life. Still, the body is doing everything it can to delay the inevitable. When cold water touches the face, an impulse travels along the trigeminal and vagus nerves to the ce...