The Boys in the Cave

by Matt Gutman

  The impending mission was, in fact, kept so secret that many U.S. officials working closely with the American team had no idea it was about to commence. This explained the cases of reportorial whiplash journalists like me had just suffered. I’d received multiple reports from trusted sources that were so utterly contradictory that we elected to report none of them.

  And as we waited, so did the parents. They had been informed that afternoon that a rescue dive would begin the next day, and were instructed to keep it secret. They were furnished with no details about the plan itself—not a single one of them knew the boys would be sedated. It wouldn’t have mattered anyway. The Thai government was not asking for their permission, it was informing them what would happen with their sons. It was the only way it could have worked. There was no time for debate or dissent.

  There was still work to do that Saturday night. The Chiang Mai rock-climbing team had to take a second look at its calculations and ropes. They hadn’t managed to finish everything and needed to go back in the morning to tension some ropes and drill in bolts for hand lines that rescuers would be using to steady themselves along the uneven terrain.

  But eventually everyone called it a night—Sunday was the big day. Rope rigger Mario Wild was nervous. Diver Jason Mallinson lay in bed mentally rehearsing the next day’s movements. Thanet wondered if all his toil trying to wrestle northern Thailand’s bountiful water into a more forgiving state for diving would pay off. Vern—whose knowledge of the cave had been seminal in helping map out the rescue plan—and his partner, Tik, lay in bed in their bungalow, with the Sleeping Princess a dark shadow beyond the dimly lit valley. The same questions rattled around his brain over and over: “What is happening with the water levels? Will it be pissing rain outside in the morning? Will it rain long? Can they do it? Will the divers even be able to get in?”

  Anderson trudged back to his hotel on Saturday night, exhausted. He’d spent the evening trying to manage expectations. He still had no idea if this concept would work. They had practiced and they had prepared the best they could; now it was out of his hands. He had about five hours before he had to be up again, so he scarfed down some pasta and racked out.

  Vern was up shortly after 5 A.M. He had only slept a little over three hours. It had rained early that morning—not a monsoon punch, but a steady rain accompanied by a distant growl of thunderclaps that lacquered Mae Sai and its surrounding jungle in a shiny shade of emerald. Pretty, but not the start the divers had hoped for. Vern and Tik drove from their home to the 7-Eleven to pick up coffee for Stanton, Vollanthen, and Harper. As they sipped the convenience-store lattes and ate some packaged food at Stanton and Vollanthen’s hotel in Mae Sai, they talked logistics and the rain, which had started to slacken.

  Reviewing it once more with Vern, Harper, and Vollanthen, Stanton felt confident about their logistical plan and comfortable with the group they would be working with. The forecast for the rest of the day looked decent: no major rain was predicted aside from the expected sprinkle. A veteran of six major international rescue-and-recovery missions, Stanton mentally girded himself for the day ahead and the likelihood that at some point his water-pruned hands would be carrying a dead child. It would hardly be the first corpse he’d handled, and he’d necessarily grown philosophical about the unpleasantness inherent in rescues; he explains in his characteristically blunt way that he cherishes life and would risk his own to preserve another’s, but once a human expires, “I just treat it as a lump of meat. The human ceases to exist. It’s just a shell the human once occupied.”

  Human corpses had never really bothered him. Even before he had joined the UK Fire Service in 1990, he’d come face-to-face with one of those shells “the human once occupied.” It was May 1986, and he was a twenty-five-year-old who had been called to Yorkshire, where cavers had become stranded in a near-vertical cave named Rowten Pot, a giant hole in the ground atop a nearly bald hill covered in tweedy grass. Rowten Pot has a deep section that requires a complicated abseiling descent past a jet blast of water from a stream careening off rocks as it crashes down the hole. Two cavers had gone missing, and the area’s Cave Rescue Organization was called in to save them. One of the rescuers was David Anderson, who had apparently slipped during his descent and fallen into a gully. The water came up so fast that he was trapped on his rope and drowned. And there he remained for the next several hours until Stanton and members of another rescue team rappelled down to recover his body. By the time they arrived the flash flood had subsided, and Anderson was found slumped in his harness in full kit. For the next several hours the team had to manhandle the inert body up several hundred feet of rope. They had come into unusually close physical contact with a dead person—one Stanton had known personally. It was the first corpse he had ever seen, yet he was mostly unmoved.

  At the Tham Luang cave that morning, head park ranger Damrong, the man who had initially found the boys’ bags more than two weeks earlier and had since overseen the registry of over one thousand journalists, would now have a hand in banishing them. Clearing the mud pit members of the media called home was the mission’s first action. A sparsely attended “press conference” featuring a lone police officer had started, but it was poorly attended and conducted entirely in Thai. The intent became patently obvious when soldiers started helping journalists fold up tables and take down tents. ABC’s internal WhatsApp page began crackling with warnings: “Dude, all the local media are packing up. Tents and everything. It sure looks like this place is being evacuated.”

  Everyone was ordered to be out by 9 A.M. By 8:30 A.M. the main paved road leading to the rescue site, the only road in, was blocked by military checkpoints. Minutes later a graphic with a map popped up on many journalists’ phones, asking them to congregate at a donation center on Route 1 over a mile from the cave site. At the hotel thirty minutes from the cave where we were staying, a call to quarters sounded. Producers, reporters, and translators started scrambling to decipher what this all meant. Our coordinating producer, Brandon Baur, caught the eye of our team’s lead driver, Nop—a big lug of a man with a long, sloping forehead and a head shaved bare. Nop was watching something intently on his phone. Baur tried to ask him what was going on. Nop started waving his hands and saying, “big news, big news!” ABC correspondent James Longman grabbed his phone, opened Google Translate, and put the phone to the driver’s mouth. He rambled on excitedly in Thai for a full minute. He finally stopped, and Longman pressed Translate. Suspenseful silence. And then the phone spoke: “Never again, alpaca.” They all started cackling. The tension was broken.

  Something was afoot, and it wasn’t an alpaca. The thousand members of the media mustered from their guesthouses and hotels. By 10 A.M. I was at the local government offices, which had been turned into a donation site, waiting for a press conference. A dais had been set up with four chairs under the eaves of one of the buildings. Hundreds of reporters clustered around a collection of blue tents with semicircular awnings, scrapping for chairs and space. Dozens of cameras targeted the little dais. There was no sign of Narongsak and the other speakers—it would be a while, a local official warned me. With time to kill, I walked around the little square. The kitchen crews had set up camp, doling out rice bowls crammed with vegetables and savory pork, energy drinks, and water. I walked through the government building, where industrial refrigerators held sacks full of pork parts. Out back, a platoon of elderly women hacked away at bok choy, onions, and garlic.

  Over an hour later, this new journalist camp jolted to attention. Governor Narongsak arrived, flanked by Rear Admiral Apakorn and two other commanders. He sat down and talked—a lot. Anticipating something enormous, possibly the seminal moment of the rescue, ABC’s executive producers back in New York had scrambled to prepare for a live special report. I was in front of the camera; crouching beside me was one of our translators, struggling to keep up with Narongsak. My job was to distill his translation and repeat it into the microphone for the folks in New York. The suspense wa
s torturous.

  Narongsak’s preamble began: “We have been preparing for the main mission in every single way possible, and today is the same. It is the fifteenth day of the operation. . . . The search was like finding a needle in a haystack, but the rescue is proving much harder because the conditions we face are not normal. Nowhere in the whole world have people ever faced conditions like this before.” He then discussed the mighty international commitment, the foreign divers, the NGOs, the regular volunteers.

  “People outside would never understand the difficulty,” he said, launching into an explanation of the continuing work on top of the mountain. “First we found the kids and now we need to get them out to the cave entrance. We are still discovering cavities; we are always drilling, and I can officially say that we have drilled more than one hundred cavities and dug into eighteen cavities with potential [but with no success].” There was discussion of the diminishing oxygen levels and the rising levels of carbon dioxide. Time was running out.

  “We are still in a state of war against the water. All the plans must not have any holes in them, but there will always be margins of error.” Waiting until December or January, after the monsoon season, he said, was now impossible. The next best thing would be reduced water levels, allowing an operation to commence. “So today there are only two plans, but many methods. We’ll choose the best method to move forward with.” At this point the reporters there were completely mystified. Producers in New York started asking in my ear: “So no rescue? What’s he saying? They haven’t decided which plan to go with yet?”

  And finally it came out: “Today is D-Day.” The rescue mission had begun at 10 A.M.—two hours earlier.

  Wait, what? It started already? Two hours ago!?

  Chapter Seventeen

  Like an Egg in a Rock

  The secrecy on the part of Thai and American officials had been complete, even if the governor’s description of the mission had not. Narongsak and the generals told reporters that a buddy team of two international divers would extract each boy, and that this would take two to four days—that part was in fact correct. Regardless, the divers, the SEALs, the Americans, the rope specialists, the water-management specialists, the Australians, and the Chinese gathered at the mouth of the cave early that Sunday morning enjoyed the quiet. The journalists and some of the other auxiliary volunteers had been flushed out. It was now just them, the boys, and the mission.

  A few hours earlier, before the press conference that had initially confounded the media, the day’s mission had gotten under way. Up at headquarters—the old park ranger cabin—Hodges and Anderson had led a team briefing. The first part had included the whole group: the governors, the interior minister, the generals, the Thai Navy SEALs, the Chinese rescuers, the climbing teams, the U.S. pararescuers—everybody. For about forty-five minutes they walked through the concept again and asked if anyone had questions. Then all were dismissed to begin gathering the tons of gear that would be needed that day. The twelve divers, Anderson, and a few others split off for a smaller meeting. Dr. Harris had them sit around the conference table where thirty-six hours earlier Hodges and Anderson had managed to convince the Thai interior minister to initialize the mission.

  Dr. Harris had something for them; each of the divers got a small pack filled with syringes and needles. He had spent the previous night tinkering with the right mixture of drugs for the sedation, jotting down notes and conferring with Thai doctors. He also had had a long conference call with Australian anesthesiologists and pediatric psychiatrists. Together they had agreed on a cocktail of drugs, beginning with Xanax, which would be administered about half an hour before the boys walked down to the water’s edge; once there they would get two injections, ketamine and atropine. The former is a fast-acting sedative frequently used in pediatrics, and the latter would be administered to dry up the boys’ mouths and lungs so they wouldn’t choke on their saliva or mucus.

  At some point overnight between Saturday and early Sunday he had presented this final plan to Thai authorities and received the official green light to administer the sedatives. Without permission to sedate the boys, everyone had agreed that the mission would have to be aborted.

  But the consultations overnight had complicated the plan. It turned out that it couldn’t just be Harris administering the sedatives, because ketamine sedation wears off after about twenty-five to thirty minutes; the divers, particularly the four who were diving out the boys themselves, would have to readminister the ketamine—probably more than once during the rescue—to keep them unconscious through the entirety of their journey out. In other words, the divers would have to become amateur anesthesiologists, pronto.

  Despite the risks of deputizing the divers as anesthesiologists, this combination of drugs seemed the best option; indeed, a great deal of thought and strategy went into the drug selection. To smooth their way into unconsciousness, and to limit the possibility of cold feet or panic as they approached the water (and syringes), the Australian psychiatrists had suggested that Harris first give them the benzodiazepine Xanax.* The drug stimulates the GABA receptors in your brain—the brain’s natural antianxiety medication. By increasing the activity of GABAs, the half-milligram dose would rein in a mind whirling with fear.

  Ketamine, as Harris explained to his team, was a little trickier to administer. By guesstimating each boy’s weight, Harris would have to make a judgment call on how much to inject. There is a vast difference between a 70-pound eleven-year-old and a 130-pound sixteen-year-old. Injected intramuscularly, the drug would knock the boys out within one to five minutes, shutting down the region in the brain that notifies the body of pain. It has the additional side effect of acting as a muscle relaxer, which would limit involuntary movements of the arms and legs. Unlike its pharmacological cousin propofol—which killed Michael Jackson—ketamine would not arrest the boys’ respiratory systems. In fact, ketamine has so little effect on the respiratory system that it’s actually used in emergency rooms to treat severe asthma cases and to combat panic, turning off the spigot of emotions like fear, pleasure, and anger that are controlled by the limbic system.

  Those same properties, however, can make ketamine deadly when a patient is not constantly monitored, as would unfortunately be the case with the boys. It relaxes all the body’s muscles, including the muscles that help us breathe and those that cause us to reflexively swallow. In so doing it allows secretions to build up in the lungs. Those secretions in the lungs, plus unswallowed saliva, can be a choking hazard.

  That’s where the atropine would come in. It would dry up those secretions—an absolute necessity, for the multitasking divers would be too busy following the guideline and avoiding rocks that could brain their young wards to check on the amount of saliva and mucus building up in their mouths.

  On paper, the drug regimen made sense, but there was one sizable hurdle: the journey back from Chamber Nine would take roughly three hours, which meant that all the boys would require at the very least one additional shot, and quite possibly up to six more over the course of the extraction. If the boys woke up, Harris told them, the amateur anesthesiologists would have to knock them out again. It was crucial that they do so. An alert boy, coming out of sedation into the cold blackness with a mask tensioned on his face, would likely panic and could possibly suffer severe trauma and PTSD.

  Each diver was given a pouch with several syringes loaded with ketamine. This drug is the most commonly used animal tranquilizer, which made veterinarian Craig Challen already accustomed to administering it, but all the others would be first-time anesthesiologists. And they were getting this news mere minutes before the rescue operation was due to commence.

  Harris gave the divers a crash course in ketamine. He sat at a table, upon which were arrayed zippered nylon packs the size of small toiletry bags filled with syringes, needles, and several water bottles. He explained to the nervous divers that their mission was going to become slightly more complicated. While all of them had basic first ai
d skills, aside from the doctors only Rasmussen had practiced any kind of field medicine, when he had worked for the Red Cross years before. In a briefing that lasted about as long as it takes to read a magazine article, the divers were taught the basics of administering intramuscular shots. They weren’t going to practice on themselves—thus the water bottles. Dr. Harris did it first, instructing them that needle control and positioning are key. You have to get to the meaty part of the body—the thigh is best and most likely to have enough muscle left on it after two weeks of short rations. You don’t want to hammer it in, but you do need to achieve depth to ensure it plunges through the wet suit. Get it in the flesh, and punch down—don’t worry about gas bubbles, because this is not going into a vein—and anyway, muscle tissue will absorb any air. Each diver got to “sedate” a water bottle or two. The four main rescue divers had received a similar briefing late the night before. But that was it.

  The divers were clearly skittish. During the short training session, Harris assured them that they wouldn’t be able to overdose the children, though that was not necessarily true. According to the FDA, “Respiratory depression may occur with overdosage or too rapid a rate of administration of [ketamine], in which case supportive ventilation should be employed. Mechanical support of respiration is preferred to administration of analeptics”—but supportive ventilation, and certainly mechanical support of respiration, would not be options during the upcoming dives. It was a potent cocktail of drugs, and Harris knew that the risk of administering it to children in a severely weakened state was enormous, but there was no other choice.