Thursday, June 2, 2011

                                                     Long Live the Crocodile Hunter

Imagine Steve Erwin, the Late Crocodile Hunter, and an elderly librarian walking down the street. Mr. Erwin is strong, energetic, and enjoys close encounters with dangerous animals. The librarian, Ellin Klor, is a 56 year old woman from Santa Clara, CA. She is slightly overweight, a little clumsy, and normally stressing over how many things she has to do while franticly running from one task to the next. Both of these people were pierced through the heart by similar sharp objects. One of them survived and as we all know, one did not. Although, these two separate incidents have never been compared together by medical professionals, extensive research has been directed towards traumatic punctures to the chest cavity and heart. Standard, clear, and precise instructions on how to treat such injuries prior to hospital care are in wide use. Proper emergency care, given prior to patients reaching a hospital is often a critical factor in the survival of trauma patients. But before I draw conclusions from the details of these to incidents I will tell the stories.

The knitting needle that punctured Ellin Klor’s breastbone and jabbed into her right ventricle nearly killed her. She had chosen that night to attend a get-to-together with her knitting club that she had been teaching for about a year. She was really excited to share some new patterns with her friends. She arrived to find cars already parked outside the little ranch house where they gathered, so she knew some eager knitters were waiting inside. She hurriedly grabbed three bags full of books, unfinished knitting, and needles from her backseat. Turning down the little dirt path that led to the front porch she quickly jostled up the seemingly harmless steps to the front door. She could remember thinking to herself, “the scourge of a librarian, always carrying too much stuff.” Her toe caught unexpectedly on one of the steps and she was suddenly tumbling forward. She crushed into the ground chest first over her assorted bags and recalls scolding herself for trying to carry so many things. Rolling over she jumped up and gathered her bags before knocking on the door. She noticed her knee felt scraped and it hurt to breathe but didn’t give it much thought. One of the ladies in the inside answered the door and ushered her in.

Ellin was used to being a little clumsy. Falling over and banging into things was a little less than a regular habit for her so she wasn’t surprised at all she had. In the living room knitters were already getting started and Ellin was eager to join in. but the pain in her chest was rapidly getting worse and little panic messages were running from her nerves to her brain. She looked down at her red sweater and lifted it up. She will never forget what she saw. Protruding from her chest stuck a wooden knitting needle about the diameter of a number 2 pencil and almost four inches out of her chest. It was jagged and planted through her bra directly between her breasts. She whispered, “Oh my God.” Her friends immediately started to decide what should be done, should they pull it out? “No!” Ellin did not want anything to be done until she was in the hospital. This was her first life saving decision. Removing any object that has pierced skin tissue will often do much more damage as it comes out than when it goes in. It’s like pulling the plug on a drain, blood gushes out the open wound.

Note: This is the critical element in my comparison of these events. Steve Erwin was stabbed in the heart by a Bull Ray while shooting underwater film for his TV series. He immediately grabbed the barbed spear in his chest and tore it out. The experts who studied his death decided it was not the poison from the deadly fish’s stinger that killed him, but rather the damage caused by the violent removal of the serrated stinger which tore his left atrium and led to cardiac arrest.

Elinn refused to be rushed to the hospital by her friends; another life-saving decision because a slight movement of the needle within her heart could have induced cardiac arrest. She sat carefully down on the couch and noticed the irony that a wooden spear was jabbed in her chest and not a drop of blood was visible. The paramedics arrived and took all necessary pre-cautions before transporting her to the ER where she was run through a series of x-rays, scans, tests, and evaluations before being taken into the operating room. Her physicians informed her that they had removed every conceivable object from practically every part of the human body but had never seen her injury before. The needle had penetrated her sternum, the hard flat bone that lies in the center of the human chest to protect vital organs. The needle had grazed her right ventricle and internal bleeding was showing on all the scans. The doctors told her surgery was needed to stop the bleeding immediately and she gave them permission to start. Less than an hour from the needle penetrating her chest Ellin was laying on the operating bed as surgeons cracked into her chest.

You may be wondering at this point how in the world these two events have anything substantial in common. Steve was attacked by a predatory marine animal while diving on the Great Barrier Reef. While Ellin merely tripped over some stairs and unfortunately landed on a knitting needle. The truth is from a strictly medical standpoint they both suffered nearly identical injuries. A sharp object roughly equal in length and diameter punctured their chest cavity with significant force and entered the heart. The thesis for my paper is that the decisions people make in life-threatening situations often determine whether or not they survive. At this point I have yet to shed light on the mental or emotional aspects that dictate how a person responds to dangerous and chaotic situations. And for the sake of this paper I am going to focus strictly on the comparison of these two events. Come away from this understanding that I am not here to portray any cynicism or mockery against these two amazing people. Merely to deduce from the similar tragedies in their lives what factors led to Ellin’s survival and the unfortunate death of Steve Irwin.

A Stingray’s barb is approximately 10 inches long, serrated and loaded with toxin. However, the toxin only causes excruciating pain and eventually paralysis in small sea fish. Ray’s do not use the spines to hunt but rather as deterrents against attacks from larger predatory sea life. The toxin is not lethal enough to cause the death of a human on its own as many other animal injected toxins are.* The total number of reported worldwide deaths caused by attacks from stingrays is not more than thirty; although, the accuracy of this number is questionable because no organizations are employed in recording these events specifically.* I do not believe that one individual trauma led to the Steve Irwin’s death. Instead it was the contribution of all the dynamics involved in the incident. His environment and the nature of the attack are just two examples of these.

One factor, that undoubtedly played a significant role, was Steve’s own past life experiences. Mr. Irwin hosted a TV show where he had many close encounters with dangerous animals. The mind can overcome fears when it is constantly exposed to them. Once a fear becomes familiar, a person becomes comfortable with the environment or danger and basis his/her actions around the idea that it is harmless. Because it hasn’t hurt me yet, it won’t hurt me now. It’s just like learning to drive. New drivers tend to be wary and cautious while driving because the mind is adjusting to the new threats and functions of the environment. Experienced drivers, talk on cell phones, eat, listen to the radio, and behave as if they are not performing one of the most dangerous habits in our society. So, it is reasonable to assume Mr. Irwin was too comfortable swimming with the generally mild sea creature.

Another unique element in this incident was the fact that it occurred under the water. People are not designed by nature, to spend more than seconds submerged. Although modern technology allows us to spend more than an hour at certain depths if anything goes wrong, we try to react to threats as if we were on land. It’s purely instinct. For example: divers who encounter extreme difficulty like air flow problem have a strange tendency to attempt removing their masks while underwater in panic. It is completely illogical and counter-productive to survival until you are above the surface. That’s instinct and sometimes it kills you. When the spine of the ray drove into Steve’s chest it caused an overbearing sensation of pain, panic, and confusion. He thought two things; get it out, get to the surface. He almost instantly grabbed the barb attempting to wrench it from his chest. The serrations along the spine, like fish hooks are designed to prevent removal. Steve was a very strong man, it’s very likely he was nearly successful at removing the barb despite it’s design, but the spine had entered his heart and dragging its teeth across his internal organs did devastating damage. He was unconscious seconds later, due to cardiac arrest.

Emergency personal pronounced him dead on arrival. The medical treatment of penetrating injuries is very clear and consistent. Do not remove the object until in intensive care because it helps prevent loss of blood and if not done correctly, removal of the object will cause extensive damage to internal organs. This was Steve’s mistake. He had to make the decision to jerk the barb from his chest even while submerged. Ellin adamantly refused the needle to be touched. While no can say, that had Steve not removed the spine he would have survived, medical science say’s that he would have survived longer possibly until paramedics arrived and he could receive emergency treatment.

Now, from what I have written you may deduce that I am laying the fault of Mr. Irwin’s death in his own hands. I have no desire to do that. I do believe that many people who die in traumatic accidents make decisions or behave in manner that is adverse to their survival. It is also true that most of these decisions were made because the person believed it would save his/her life. I’m as certain as anyone can be this is what happened in Steve’s case. In some instances we can pin-point exactly what caused victims to die, in others it’s multiple factors. But the most common and shocking factor of every life-taking emergency is that; if only one thing had been done differently or not at all, the victim would have survived.

I just wanted every one to know I’ve always been a fan of the Crocodile Hunter. Ellin Klor was something of a medical celebrity after her accident. The x-ray’s the surgeons used to extract the needle from her chest also revealed the early stages of breast cancer. Because the cancer was found at such an early stage the doctors were able to successfully eradicate the infection. So the needle that almost killed her, also saved her life.

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