by Lynne Cox
We watched the coils turn glowing red.
I placed my arm palm down over the coils and felt it grow hot. Perspiration streamed down my cheeks.
The warmth from the heater increased the blood flow into my wrist so my veins and arteries expanded. They moved toward the surface and the blue lines bulged beneath my skin.
The cardiologist palpated them and said, “Much better,” and he wrapped a tourniquet around my arm. He then stood up and spread his feet to balance himself. He seemed a little awkward. He explained that usually he inserted cannulas into people when they were in hospital beds.
I asked him if it would help if I lay down on the floor. I wanted to make this as easy as I could and get it over with. He said that would not be necessary, but he needed me to hold my hand just above the coil so my arm would stay warm.
“You ready?” he asked.
I nodded and held my breath so I wouldn’t move.
He took a deep breath to prepare himself and leaned over my arm. He used a syringe to open the vein in my wrist and began slowly threading the cannula tubing into my vein. I watched with queasy fascination.
Sweat formed on his forehead and streamed down his cheeks.
He dabbed the blood that had pooled around the incision site with gauze and secured the cannula in place with white tape.
He advised me not to move my hand too much. He didn’t want the cannula to bruise my vein.
The cardiologist stepped back so Dr. Keatinge could see his work.
Dr. Keatinge checked my arm. He told the cardiologist he’d done an outstanding job. He explained that it took a lot of skill and concentration to thread the cannula into the vein so fluidly.
“It’s great to work with a pro,” I said and smiled.
The cardiologist was sweating hard and I was too. He asked Dr. Keatinge to move the heater aside.
“You okay?” Dr. Keatinge asked.
“Yes, but do you need to put in the second cannula?” I asked. This wasn’t fun.
“It’s crucial to the study to measure the blood pressure into and out of the hand. But if you can’t tolerate a second one, we can get by with one,” Dr. Keatinge said.
“All right,” I said.
The cardiologist hesitated. He wanted to be sure I was okay.
“You’re doing a great job. I just don’t like being stuck,” I said.
“I’ll do this as quickly as I can,” he assured me.
“Take as much time as you need. I’m okay,” I said.
He used the syringe and opened the radial artery in my wrist but could not get the cannula in. He tried and tried, and finally, on the fifth attempt, he threaded it into my artery.
I was relieved when he finished and told myself that the difficult part was over.
The cardiologist stood up, grabbed his back, and stretched it. He told me to stand up slowly so I wouldn’t feel faint and instructed me to hold my left arm close to my chest and not bump anything when I walked with Dr. Keatinge to the other lab. He would meet us in about an hour to remove the cannulas.
Time will go fast, I told myself. The researchers will get what they need. I didn’t feel as anxious as I did the first time. I thought, Everything will be okay.
4
THE DISCOVERY
Mattie and the two researchers were ready and waiting for us. They welcomed me back like an old friend and connected me to the wires. Mattie sat beside me. Dr. Keatinge made sure the equipment was functioning, then he left to take care of other work. Mattie explained that Dr. Keatinge didn’t like to see me in pain. It bothered him.
The researchers were looking at me with frowns. Mattie spoke up.
“When we tested the other subjects, they experienced some pain. They dealt with it by pounding the table, shouting, and even cursing. If you’re in pain, it’s okay if you do the same. You don’t have to be stoic. It might make this test easier.”
“Did they do anything else to handle their pain?” I asked.
“One lad from Scotland was a theological student before he was premed. He sang religious and Scottish songs at the top of his lungs. I think he was in considerable pain. His blood flow closed down more than the other subjects. We discovered that the more our subjects closed down, the more pain they experienced. That wasn’t part of the test; it’s just something we noticed,” he said.
“Did the Scottish lad have a nice voice?” I asked, smiling.
Mattie smiled back. “He sang nicely.”
“Okay, I’ll make noise if I need to.”
“Ready when you are,” a researcher said.
I took a deep breath and hoped that it wouldn’t hurt as much as before. I immersed my left hand in the bucket, and the cold was as immediate and as intense as it was the first time.
The second hand on the pace clock was moving slowly, like the first test.
“Are you okay, Lynne?” Mattie asked.
“I am. How are you?”
“People never ask me that. I’m doing quite well,” he said.
“Glad to hear it,” I said and felt myself tumbling into the pain cycle. I remembered that during cold swims, I ignored the cold. I didn’t think about it, so I didn’t give any energy to it. I tried to do the same during the test by watching the second hand and biting my cheek. Then I tried stomping my foot. It got the researchers’ attention, but the distraction didn’t help at all. I realized I needed to focus on the second hand and see my progress, even if it was one second at a time.
A shiver raced up my spine. It wasn’t because I was cold. It was because I realized this test was going to be as difficult as the first one, and if I went through it the way I did the first time I would experience the same amount of discomfort. I needed to change something.
“Lynne, would you like me to hold your right hand? Sometimes that helps,” Mattie said.
I’d love to hold your hand, I thought. It would be a nice distraction. Instead I asked, “Do you think your hand is warmer than mine? If it is, it could affect the test results, and I don’t want to repeat this test.”
“Hadn’t considered that. I don’t think it will affect the test if I hold your hand for just a few minutes,” he said.
“Are you sure?” I asked.
“I’m sure,” he said.
“Okay, yes, please do that,” I said.
He leaned over and held my right hand. His hand was the same temperature as mine. I was relieved. I felt myself relaxing, and then something magical happened. The pain in my left hand in the cold water was cut in half. The human connection made all the difference. This was my epiphany. This was why I repeated the test. I needed to understand that it is the human connection that helps you deal with pain. That was what I needed to learn.
I looked at the second hand on the pace clock. It seemed to be moving faster.
I looked at him. He knew there had been a change in me. I think I was breathing more normally, and my body was less tense.
The minute hand moved. Two minutes passed.
“You can hold my hand a bit longer if you’d like,” he said.
“No thank you,” I said, but I dreaded letting go.
When I did, the pain increased. But I felt a little calmer.
With five minutes remaining in the test, Dr. Keatinge returned to the lab and checked on me. “You’re almost done,” he said.
When I removed my hand from the bucket I hoped the rewarming phase wouldn’t hurt as much as it did after the first test, but it did.
I told Dr. Keatinge I needed to leave the lab and jog through the hall. I thought that if I could warm my core it would warm my hand from the inside out, and the pain would diminish.
Dr. Keatinge told me to do whatever I needed to do but cautioned me to be careful with my left hand, to make sure I didn’t hit anything with it. He didn’t want the cannulas to slip out and damage my vein, artery, or tissues.
After jogging in the hallway for twenty minutes, my hand was warmer, and I returned to the lab and put it under cool water. Matti
e and Dr. Keatinge stood beside me.
Mattie asked if I wanted to hold his hand.
I reached out and took it.
“I can’t believe holding your hand makes such an enormous difference. It makes the pain dissolve,” I said.
“It’s effective. I use handholding all the time with my patients,” he said.
When my hand was warm, we walked to the room where the cardiologist was waiting for us.
“How did the test go?” he asked. He had been Dr. Keatinge’s colleague for years, and he enjoyed contributing to his studies. He was always eager to discuss the team’s findings.
“It went well. The cannulas showed that the blood flow in Lynne’s hand wasn’t regulated at the wrist level; it was regulated at the fingertips,” Dr. Keatinge said.
“That is exciting, something I’ve never heard before,” the cardiologist said.
“It’s extraordinary. We need to take a closer look at the data, of course, but I think this may change the way we look at blood flow into the hand,” Dr. Keatinge said.
The cardiologist assured me that it would be easier to remove the cannulas than it had been to insert them. He carefully removed the tape and slid a long tube from my wrist, applied heavy pressure to the vein with one hand, covered the incision site with gauze, and secured it with tape.
His face was red and he was sweating.
I was relieved one cannula was out.
He steadied himself, pulled the second cannula out of my artery, applied heavier pressure, and bandaged the incision site.
“There, I’m finished,” he said.
“Well done,” I said with great relief.
An hour or so later Dr. Keatinge and I walked to his car parked a few blocks from the university. I was more exhausted than after the first test. It was difficult to walk at Dr. Keatinge’s pace. His strides were long and he was deep in thought. He stopped walking and asked if he could look at my arm.
I pulled my sleeve up. It was purple and blue from my wrist to my elbow. He touched it gently. It was swollen.
“Do you think I should put ice on it?” I said to make him laugh, but he thought it was a good idea. And he asked if my hand was more numb than after the first test.
It was.
He shook his head and said I probably had some nerve damage. It would take two or three months for the nerves to regenerate. He said he would never ask me to repeat that test. But he would ask me to participate in other tests, and I was eager to do so. We were discovering things about my physiology that were surprising.
A year or so later, Dr. Keatinge asked me to return to the University of London. He led the way into the lab, where three researchers were checking monitors. Off to the side of the room was a plastic Jacuzzi the size of a large bathtub.
The Jacuzzi jets were turned on high. The room was filled with the sounds of bubbling, gushing, and gurgling water. The air flowing around the Jacuzzi was damp and chilly.
Dr. Keatinge asked me to sit in the water for as long as I could tolerate it. He said that they knew I could maintain my core temperature when I swam in cold water, but they wanted to see if I could maintain it if I sat in cold water.
He explained that they had to make sure the water circulated around my body. He said that if the water was still, my body would give off heat and warm a thin layer of water around my body. That would keep me warm and help maintain my core temperature. But he wanted to see the effect of the cold on my body, so he needed to make sure the water was moving around me.
I dipped my hand into the Jacuzzi. “Feels like ten degrees centigrade,” I said.
Dr. Keatinge looked surprised.
“I’ve always been able to put my hand in the water and feel the temperature. Doesn’t everyone do that?”
“No, most people can’t do that,” he said.
“It’s probably from all my years of swimming. When you spend a lot of time in the ocean your body becomes more aware of changes in water temperature, buoyancy, and salinity. You feel a big difference when the water temperatures changes just one degree,” I said.
I was wired up like I had been for the first cold-hand test.
I gathered the leads and handed them to a tall researcher with brown hair and light brown eyes. Dr. Keatinge introduced us, but I didn’t hear his name or those of the other two researchers assisting him. I was nervously adjusting my swimsuit straps.
Dr. Keatinge instructed me to climb into the Jacuzzi and sit in the water for as long as I could tolerate it. He said this test would be a lot easier than putting my hand in ice water.
I nodded, took a deep breath, climbed over the Jacuzzi ledge, and sat down. The cold water bubbled around my neck and shoulders and the jets shot icy water onto my skin. I felt the hairs on my arms stand up.
“Is it okay if I move my arms?” I asked.
“It’s okay if you move around a bit, but we don’t want you to move much. Your muscular activity will create heat, and we want to see your response to the cold when you are sedentary,” he said.
That was going to be difficult. Cold water stimulated me to swim fast and create heat to warm my core. I fought my urge to move, and my urge to shiver. Tightening my muscles and jaw, I imagined closing down blood flow to my arms and legs and pushing the blood into my core to keep my brain and vital organs warm. It took a lot of focus and energy to fight the cold.
“Lynne, are you okay?” Dr. Keatinge asked.
“I am,” I said.
I had sat in a hot-water Jacuzzi, but not one filled with cold water. My mind anticipated relaxing heat, but my body experienced exhilarating cold. It was so strange. I laughed.
“Okay, I’ll need to leave for a while, but I’ll be back to check on you and see how the team is doing,” he said.
It was a lot easier sitting in cold water than putting my hand in ice water.
A few minutes later I heard a researcher talking. I couldn’t tell what he was saying, but he and the two other researchers were standing by a monitor, staring at it, and then glancing at me.
A tall researcher walked over and checked the Jacuzzi jets. He stuck a pool thermometer in the water and waited a few minutes. He walked to his colleagues and showed them the thermometer.
They turned switches off and on, checked their monitors, and discussed something. They didn’t seem to be agreeing.
“We’re quite baffled. The water temperature was ten degrees centigrade when you first sat in the Jacuzzi, but within two minutes it increased by a bit more than one degree centigrade,” he said.
“That’s almost two degrees Fahrenheit,” I said.
“Yes. At first we thought there was a malfunction with the equipment. But we checked everything and the equipment is working fine. We decided to add cooler water to the Jacuzzi to bring the water temperature down to ten degrees centigrade. But a few minutes after we did that, the water temperature increased again by more than one degree centigrade,” he said.
“How’s my core temperature?”
“It’s increased half a degree centigrade—about one degree Fahrenheit. We don’t know how this could happen. When we tested other subjects in the cold Jacuzzi their core temperatures almost immediately dropped. Do you know how you’re able to do this?” he asked.
“I concentrate on feeling the warmth generated in the lower left side of my abdomen. But I don’t know how that could warm the water in the Jacuzzi.”
He looked at me, then looked down and cleared his throat. “Did you…?” He hesitated.
Suddenly I realized what he wanted to ask and said, “No, I didn’t pee in your pool.”
He looked up and tried to compose himself. He pressed his lips together.
“Gross. You think I would pee in your pool?” I asked, laughing.
He and the other researcher laughed and he said, “We couldn’t figure out how you could pee enough to warm the entire Jacuzzi. We calculated it. We realized that you couldn’t put out that much volume.”
“The things you have to co
ntemplate,” I said.
“Sorry, we need to add more cold water to bring the temperature down,” he said.
“Okay,” I said. This experiment was helping me learn how to think to warm my core. It was the first time I realized I could endure the cold water without moving. I wanted to stay in the Jacuzzi and see how much longer I could tolerate the cold, but Dr. Keatinge said he had what he needed. He was ecstatic.
Years later, I met Loree Kalliainen, a hand surgeon and assistant professor at the University of Minnesota. I mentioned Dr. Keatinge to her and she said she had read about the tests Dr. Keatinge conducted on me. She explained that the studies informed her about blood flow into the hand for surgeries and she said his work was basic medical research. It would be used by many other physicians and researchers. His findings would eventually help physicians understand how to use cold to reduce the effects of spinal cord injuries, to improve treatment following heart attacks, and for heart surgeries.
Dr. Keatinge’s tests also helped me realize that my body and mind could do things I never imagined. I would become the first person to swim in only a swimsuit more than a mile in 32 degrees Fahrenheit (0 degrees centigrade) in Antarctic waters and a quarter of a mile in 26.6 degree Fahrenheit (–2 degree centigrade) in the sea off Greenland. Science inspired me to adapt the testing process to myself and pioneer paths across distant oceans.
5
SCIENCE AND MAGIC
It was as if I had been given magical powers, and all I wanted was to test them. I began thinking about attempting swims that had never been accomplished and using swims to explore the world.
I opened my National Geographic Atlas and studied the blue spaces between the continents. I was looking to the far north and far south where the seas would be frigid and rough, where ships would have difficulty sailing.
I spotted the Beagle Channel on the map, the waterway between Argentina and Chile, and remembered reading the Voyage of the Beagle, Charles Darwin’s book about his journey of exploration and the insights that led to his theory of evolution.
I measured the distance across the strait from Argentina to Chile. In a straight line, it was three miles between the two countries. The Beagle Channel is one of the roughest, coldest, and most dangerous waterways in the world. And the timing for the project wasn’t the best. Tensions between Argentina and Chile were high. Despite the political challenges, I was able to meet with the Chilean and Argentine ambassadors to the United States and their naval attachés and I convinced them that a swim across the Beagle Channel could be a gesture of goodwill. If I was successful, the result might be the same as when I swam across the Bering Strait to help open the border between the United States and the Soviet Union and promote peace. I explained to the ambassadors that the success of the Beagle Channel swim would depend upon the navigational support and expertise of the Argentine and Chilean navies.
