But Kerry was more interested in pulmonary edema, for that was the cause of death given by Dr. Sands. One article she found, “Fear the Squeeze” by Peter Scott, included the following passage:
The greatest danger of severe lung squeeze is that it can cause secondary drowning. Meaning instead of drowning under water, you drown in your own blood, as your blood coated alveoli can no longer exchange carbon dioxide for oxygen. Not a nice way to go.
Was that what happened to Nick? Kerry wasn’t so sure. Besides, Scott’s article was based on anecdotal knowledge of the sport. It wasn’t a scientific investigation. Another study seemed to hold at least a clue. It was conducted in 2008 by Mats Liner and Johan Andersson, at Lund University in Switzerland. They were looking at the mammalian dive reflex and its possible negative impacts on athletes.
In freediving classes, the dive reflex is pushed as a purely positive physiological response to depth. As the lungs shrink due to pressure, the blood vessels in the extremities constrict, and blood floods the thorax. This also means that pressure in the lung’s capillaries is ratcheted up, and because the blood gas barrier is so thin in the alveoli, edema is one likely outcome. A similar phenomenon can happen to mountain climbers. The Liner-Andersson study followed nineteen competitive freedivers through a competition to find out if any had edema after their dives. Six of them had fluid—blood and plasma—in their lungs hours after surfacing.
As for long-term effects, Kerry didn’t find anything at all, but the final passage from a 2005 German study, “Physiological and Clinical Aspects of Apnea Diving,” stuck with her.
Although the absolute limits of apnea diving are not yet known, it is increasingly clear that the quest by extreme apnea divers to find those limits could come at a potentially high physiologic and medical price if those limits are exceeded.
While Gilliland’s team worked on Nick’s tissue and Kerry dug for gold on PubMed, a video of Nick’s dive and the resuscitation attempt surfaced, and Kerry did not like what she saw. For weeks she’d assumed, based on what she’d heard from those at the scene, that Nick had a catastrophic lung injury, and that’s why he wasn’t resuscitated. The video that John Shedd sent her, taken with Daan Verhoeven’s GoPro camera, told a much different story.
Kerry and Steve watched it together. They rewound it over and over, and paused it here and there to vent and take notes. They were appalled to see that the doctor at the scene, Barbara Jeschke, the same doctor who had cleared him to dive, didn’t follow Advanced Cardiac Life Support procedures appropriately. The more times Kerry watched the event unfold, the more it became clear to her that Nick Mevoli should have lived.
That’s not what the AIDA report said when it was released the following January. In it, Johan Dahlstrom, a Swedish physician and former competitive freediver who finished in the top ten at the world championship in Constant Weight in both 2005 and 2009, writes that “with the wisdom of hindsight, Nick should not have been allowed to dive,” but Dahlstrom’s report does not hold Jeschke responsible for clearing him. In fact, it specifically mentions that by rule, she did nothing wrong at all. As for dissecting the resuscitation attempt, Dahlstrom writes how calm and efficient the treatment was. He points out a few problems, but also asserts that should things have gone differently, there was only a very small chance that he would have survived. Dahlstrom goes on to place cause of death as pulmonary edema.
The report troubled Kerry to no end, and she didn’t even know that Dahlstrom, AIDA’s chief medical officer at the time, had not debriefed Dr. Jeschke over the phone or in person, or that the bulk of his report was based on emails and witness reports written by safety divers and Jeschke, among others. AIDA president Kimmo Lahtinen never spoke to Jeschke about Nick’s death either. Erika Schagatay, the scientist who has published fifty papers on freediving physiology, wrote a supplemental report as well. In it, she claimed that she spoke to Jeschke, but when asked directly about their conversation, she retracted that and said she communicated with her by email. An athlete died for the first time in the history of AIDA, and nobody in a position of authority talked to the doctor.
Schagatay was less willing to concede that the cause of death was pulmonary edema until more research was complete, but both her report and Dahlstrom’s made it clear that AIDA was more concerned about the culture of squeezes within the sport and the need to reverse it than they were about trying to figure out exactly what happened to Nick, and they went out of their way to avoid blaming Dr. Jeschke for her failures.
After reading the AIDA response, Kerry, Steve, and John Shedd filed a rebuttal. They singled out Jeschke for allowing Nick to dive. Shedd had benched divers in the past, and they were unwilling to accept AIDA’s premise that the absence of an explicit rule giving the doctor the right to suspend an athlete prevented Jeschke from doing the right thing. They also went into great detail about when and how Jeschke diverged from basic and advanced life support practices. (Dr. Jeschke declined several requests to be interviewed for this book.)
Kerry and the others were also troubled by the cause of death being listed as pulmonary edema so quickly. Nick had been given CPR for almost ninety minutes by the time his death was called. That alone can produce pulmonary edema. Kerry believed there must have been some underlying reason why he went into respiratory distress after getting to the surface under his own power and breathing on his own for nearly a minute. She met with Dr. Moon, at Duke, and showed him the video.
“This is not a hypoxic death,” Moon said, “because he was communicative for what looks like about a minute after he surfaced, and you’d expect his oxygen levels to rise.” Moon also doubted edema was the proper cause. “He wasn’t spewing out blood, his lungs weren’t full of blood, so what could it have been?” Moon believed it had to be an embolism—an air bubble that leaked from the lungs into the bloodstream and got lodged in his heart, causing arrhythmia and sending him into cardiac arrest. If that were true, he would have needed a defibrillator to shock his heart back into rhythm. Jeschke didn’t have access to a defibrillator on the platform, so perhaps there was no saving him, after all?
Kerry was polite in the room, but doubted Moon’s theory. Afterward, she stood on the roof of a parking structure, stared over Duke’s modern and gleaming medical complex that put ECU’s to shame, binged on gummy cola bottles, and chewed on the case. Dr. Sands had specifically tested the heart and brain for embolism—submerging them in a bucket of water to look for bubbles—and found none. She also reported no damage to the heart, which should have occurred had there been cardiac arrest. Moon was wrong, and Kerry was more convinced than ever that only Nick could help solve this medical mystery, but it wasn’t until October 2014 that she saw slides of his lung tissue.
Then again, it was perfect timing. Dr. Gilliland’s call helped her forget her troubles and reignited her passion to find the answers. The next morning she pulled herself together and drove her Toyota Tacoma past Greenville’s historic brick facades and the towering southern live oaks that shade East Carolina University, and arrived at the hospital before her shift. Early enough to spend some quality time with her favorite forensic pathologist.
As Kerry put her eye to the microscope, Gilliland slid a thumbnail slice of lung tissue into the light and pointed out macrophages. Macrophages are cleanup cells. After an injury, they report for mop-up duty to digest red blood cells. That’s how the human body heals. Each successive day, the macrophages eat more red cells, and as days pass, the macrophages digest and accumulate more iron. Gilliland had added dye to the slide in order to reveal the iron in a given piece of tissue. She was hoping to determine how fresh each injury was, and her dye stained those cleanup cells several shades of blue. The blood from his final dive was never mopped up, so the lightest blue macrophages were determined to be from the Friday dive, and yet there were additional macrophages dark enough to mean he’d had similar injuries several days before that. The cellular trail suggested that Nick had been squeezing and diving injured for weeks.
Gilliland kept pushing new slides under the microscope and she and Kerry kept taking turns looking for macrophages as well as interstitial fibrosis, or scar tissue. Scar tissue is denser, less permeable tissue created by repetitive injury, and if present in the alveoli (air sacs) can impede the exchange of carbon dioxide and oxygen. If Nick had that, it would mean his string of injuries dated back a lot farther than a few weeks, and it would also mean that freedivers who suffer repetitive injuries may be damaging themselves at a level they’ve never imagined, and could be putting their lives in jeopardy. It didn’t take Gilliland long to find collapsed tissue, a telltale sign of fibrosis, but there also looked to be ample healthy lung tissue in his alveoli.
With each answer more questions bloomed. How much scar tissue did Nick have and where was it located? Could that be the reason he had trouble breathing after coming up for air? And was there so much damaged tissue that his resuscitation would have been impossible under any circumstances? Was Jeschke off the hook? It was too soon to tell. They would have to keep looking.
Nick told himself it was just another dive, the natural next step, when he caught the boat from the white sand beach on West Bay to the competition zone a kilometer offshore. It was May 27, 2013, the fourth day of the inaugural Caribbean Cup, and the event had a world-class feel thanks to the presence of Will Trubridge, who had been a technical advisor, and the depth, which for the purposes of competitive freedivers, was limitless. There’s a reason that self-trained explorer Karl Stanley settled and built a submarine on Roatan. Where else could he shove off from a pier and plummet two thousand feet below into the Cayman trench, taking willing tourists and scientists along for the ride?
Less than an hour later, Nick floated above that trench in warm crystal-clear blue water, wearing a two-piece wetsuit, his legs black, his hooded top silver. Friends floated all around him. Ren was there, and so was Ashley, who was six months pregnant with Ani. Ren had been spotting Nick while he trained for the past several weeks. He and the Chapmans met up in Long Island, Bahamas, and sailed for Port Antonio, Jamaica, aboard Nila Girl, where Nick began building his depth, moving from 60 to 70 meters into the 80s and 90s. “It was a little bit cowboyish,” Ren said, and after all the lessons the sea had already taught him, Ashley hated seeing him make those big leaps, but the Chapmans had learned to bite their tongues. Nick was going to do what he wanted and there was no team element involved, no pressing reason to rein him in. If he squeezed, they thought, he would only spoil his own competition, trash another opportunity to get better. All of his training dives were in Constant Weight, and Ren noticed his kicks were smoother, his technique cleaner. It was obvious he’d spent a lot of time in the pool.
It was a brand-new year. Nick had cut his hair short, and he’d let go of all the disappointment he felt toward the end of 2012. He’d even overcome a separated shoulder, which he’d injured snowboarding in January. He looked great, he felt great, he was on a mission, and he carried that energy into his early dives in Roatan.
He dove to a personal best 92 meters in Constant Weight on day one. After turning early on a Free Immersion attempt to 75 meters the following day, he decided to put all his focus back onto his monofin and broke Rob King’s American record with a dive to 96 meters on May 25. The following day was an off day, and he spent it with Will, who was his roommate and coach at the competition. They discussed visualization and other preparatory techniques, blended smoothies, made curries and pasta dishes together, and became good friends. Although Nick had a wobble on the surface after his dive to 96 meters, he got the white card and thought it was the right time to attempt triple digits.
Will treaded water nearby as Nick breathed up. He noticed the strong current and checked the line, which fell at an angle thanks to the drift. Will figured it would take a 105-meter effort to get to 100 meters in those conditions, but if Nick made it, he would be the fastest man in AIDA history to triple digits and the first American to ever freedive to 100 meters. Nick’s trajectory had the entire sport on notice. “It wasn’t unreasonable to believe that within two to three years he could have been at the level of divers like myself and Alexey,” Will said, “challenging world records.”
Iru Balic was there too, flowers in her hair. Nick had gotten to the island early to train and in the days before the competition shared a casita with Iru in the Rasta hamlet of West End, a $1 water taxi ride away. She’d transited back into his orbit despite herself. Their relationship lines were still blurry, and he told her he couldn’t have sex because it disrupted his chi. “Fine, keep all your chi,” she snapped back. “I don’t care. You can have it.” She didn’t realize how serious he was. He hadn’t had sex in four years.
Regardless, their connection was sweet and meaningful enough to keep her interested. Although she hated his new haircut, she welcomed his fresh perspective. Nick wasn’t brooding. He was diving with joy and skill. He was an elite athlete on the rise and she adored watching him. She was in a zone too, pushing her personal bests with a real chance to win gold. Until the competition began they shared a bed and he’d make her breakfast and bring her flowers to wear in her hair every day. “He told me I shined when he did those kinds of things,” she said, “and he liked seeing me shine.”
Nick had envisioned the dive several times, and as the count ticked down, he once again visualized an effortless duck dive, six strong, then six softer kicks, his arms straight as an arrow overhead. His alarm would chime at 20 meters, when it was time for his grouper call, which would bring air from his lungs into his mouth so he could equalize the rest of the way. He’d become streamlined, and with one last kick begin freefall. He would relax his gut and shoulders, tuck his chin one millimeter more, then sink soft and slow until his alarm chimed again and he was ready to kick back to life.
Nick was never so comfortable in the water as when he dove with fins, and his new monofin felt like an extension of himself. It was like having rocket boosters strapped to his ankles. With every smooth gyration of his hips, that fin cut through blue water and sent him thundering down. On the way up, his kicks felt supercharged and he knew he could make it back clean. He’d ditched the fluid goggles by then, leaving his eyes naked and burning in salt water, which he found liberating; one less item to deal with in the hypoxic fog after a deep dive. The more he visualized, the more certain he was that he would be America’s first 100-meter man, and when the time came for peak inhalation he did not delay. He sipped and packed air to the zenith, flipped, folded, and began to swim.
Though he’d made peace with his disappointing 2012 season, he wasn’t blind to the cause. He knew he had trouble controlling his urge for depth, his need to prove himself to himself, to fill a bottomless void. He also saw it as egotistical and vain, and during his long, boring Brooklyn rehab after his snowboard accident, he wondered if his injuries and setbacks weren’t signs from God that his chosen sport was too dangerous, perhaps even too sinful, to pursue?
One Sunday after church he approached Father Wlodzimierz Laz as the congregation filtered out. “Father, do you know what freediving is?” Nick asked. Father Laz loved sports, and had been an athlete back in Poland, where he grew up. These days he’s a paraglider, and in his downtime enjoys reading about extreme tales of risk and exploration. Nick had approached the right preacher man. Laz was a sympathetic ear. “I think I have a special gift from God. I can dive for over five minutes on one breath, but what I want to know is, is it a sin?”
“You want to know if your sport is a sin?” Father Laz asked.
“Yeah, because the bible says thou shalt not kill, and I’m wondering if maybe the risk is too great, and if I push too hard, if that isn’t the same thing?” Father Laz considered the question. He had long admired Nick, the way he came to church every week, and prayed so intensely. He saw the kid as a throwback to more genuine times and wished there were dozens more like him.
“Well, it’s true that when we put our lives on the edge we are only one step from killing ourselves,
” he said, “but it’s also true that we can manage risk. If you train wisely, and perform within the rules…then, no, it’s not a sin.” He told Nick about his own paragliding fix, how alive he felt when leaping off a cliff face and soaring 1,000 feet over the sea, but how he always tried to temper his desire for adventure with pragmatism. “When I go to the mountain, if I don’t like the wind or the cloud formations, I don’t fly. It should be the same for you. Do you understand?” Nick nodded, pensive. There were questions he didn’t ask. What if he couldn’t stop himself? What if the drive to win and achieve was too much to control? Would that be a sin? For once, it was more comfortable to linger on the surface than dive too deep. “If God has given you a gift,” the priest continued, “you should use it.”
Nick went home and brainstormed his goals for the 2013 season. He would study to become a freediving instructor and lure students by breaking every American depth record in the AIDA books. Along the way, he’d become the first American to 100 meters, quit production, and leave New York behind. When he was finished, he read his list and tacked it to the fridge. He started a pot of espresso, walked to his window, and looked out over his neighborhood.
Williamsburg had become a brand-new place. Once it had attracted those in dire need of coke, willing to snort low-grade snow in vinyl booths shoulder to shoulder with crooked cops in the bar two floors down. Now it attracted those in dire need of an olive oil decanter. Nick laughed at his own resentment of the great yuppie invasion that hipsters like him helped launch. Sure, he avoided Bedford Avenue at all costs, but Williamsburg was still home, and there were still corners of authenticity, and nice Polish girls like Denny around. He watched her shuffle home from her Sunday morning swim. Her hair was wet, her swim bag slung over her shoulder, as she struggled to climb her front stoop.
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