Connect
MJA
MJA

Crevasse fall in the Antarctic: a patient's perspective

Raina K Plowright
Med J Aust 2000; 173 (11): 576-578.
Published online: 4 December 2000

Raina K Plowright

As a veterinarian working on an Adélie penguin research program, I was to spend six months on an island off the coast of Mawson Station in the Australian Antarctic Territory. During a field training exercise on my third day at Mawson, I fell into a crevasse with my four-wheel-drive quad bike and was crushed between the bike and the crevasse wall six metres below the rim. I had hypothermia and abdominal injuries, and underwent two emergency surgical procedures at Mawson Station. Sixteen days after the accident, I was evacuated by helicopter and ship. Here, I describe my experiences.

The Antarctic plateau is a crevasse-riven mass of ice rising steeply behind Mawson Station. While riding across sastrugi (ridges in the ice formed by frozen accumulations of blown snow) on the plateau, I slowed to avoid skidding on a snowdrift that was barely visible in the glare. The front wheels of my quad bike reached the other side of the drift, but spun on blue ice. There was a deafening sound, like shattering glass, then ice and metal rushed past me as I plummeted down the walls of the crevasse and was crushed into the ice by the oppressive weight of metal. When everything stopped, I opened my eyes and found I couldn't breathe. I was wedged vertically in a narrow part of the crevasse, pinned between the bike and the ice wall 30 metres from the bottom. The 250 kg bike was crushing my abdomen and thorax against the ice, my chest flattened by the seat, the petrol tank against my lower body.

Photo of quad bikes Four-wheel-drive quad bikes being driven across sea ice. (Photograph courtesy of Kym Newbery)

At that moment death seemed violently and terrifyingly close. The enormous weight of the bike was squeezing the life from me and I thought that I had only minutes to live. I knew something was very wrong where the bike was crushing my abdomen. Warm urine dribbled down my freezer suit and I could no longer feel my legs. The possibilities that crossed my mind included spinal injury and paraplegia, but I was unafraid, as a chance of life as a paraplegic was preferable to dying.

Photo of Westbay Westbay and the area where I fell into the crevasse: a view from Mawson Station. (Photograph courtesy of Kym Newbery)


Rescue

By the time rescuers descended into the crevasse 90 minutes after my fall, I thought that I couldn't manage the extraordinary effort of moving air into my lungs any longer. As the bike was lifted off me I was crushed back into the ice and a white curtain of unconsciousness descended. It took six people over 15 minutes to haul me out of the crevasse using a "Z"-pulley rigged with ropes secured to an oversnow vehicle.

I recall lying in a stretcher. Madeleine Wilcock, the station doctor, was peering down at me and asking what day it was, an oxygen mask was placed over my face and I was breathing rapidly, gulping for air, and I remember thinking, "I'm breathing! I'm breathing!". The stretcher was lifted onto the back of a utility, which started bumping over the ice, while I stared at the blue sky thinking, "I'm still breathing, I'm alive".


Triage

I have vague memories of painful needles being pushed into my arms and abdomen, uncontrollable shaking from the ice at my core and nausea that suddenly swept over me causing me to vomit a liquid like coffee grounds. I knew this was altered blood, but my mind refused to make the next logical step and question why I would be vomiting digested blood. There was a frantic effort to find Jason the electrician, as he was the only one of the 44 expeditioners on station who shared my Rh negative blood type.

When Bryan Walpole walked in, with his cheerful hello, the relief of his familiarity was so overwhelming that Madeleine noticed a drop in my highly elevated pulse rate. Bryan had been the ship's doctor on my voyage to Antarctica on the Aurora Australis. The ship was still within helicopter range, and Bryan had been rushed 140 nautical miles over the sea ice to Mawson. It was extremely important to me, and for my morale, to see someone familiar taking control over a situation in which I had none.



"We have to operate"

The next morning Bryan announced that they had to operate. The thought of postoperative pain on top of discomfort and nausea I could already barely tolerate was devastating. I didn't even know if the station had surgical facilities, or if Madeleine or Bryan had surgical experience. It did not occur to me to ask them why I needed surgery. However, my haemoglobin level had fallen from 140 g/L to 100 g/L overnight, my pulse rate was rising, and I had developed abdominal pain. The only diagnostic tools available were haematological and biochemical tests, and x-rays. Thus, it was necessary to open me up to see if there was continued bleeding. There was also concern that I may have had a perforated gut, as I had been vomiting altered blood.

It was a lonely and daunting experience being wheeled into an empty, sterile room under bright surgical lights. At least the lights indicated that they had an operating theatre. My anaesthetist, his beard covered in a mask, sat at the head of my bed. I had met him just two days previously; he was an electronics engineer with only two weeks training in anaesthetics at The Royal Hobart hospital 12 months earlier. My nurses were a carpenter and a diesel mechanic. I recall being terrified -- too sick and narcotised to interact or understand; the situation was completely out of my control.

I remember someone explaining that the anaesthetic was being injected and a mist washed over me and I couldn't see or breathe. I could hear instruments being dropped onto metal trays and people talking around me, but I felt unable to breathe. My neck had been cranked to one side and the discomfort was excruciating. Then something was placed down my throat, and the air that I was desperately craving flowed into my lungs. I needed another breath and I strained to inhale, but my body wouldn't respond. I realised that I was paralysed and experiencing anaesthetic awareness and the doctors were about to operate while I was still conscious. I started screaming and screaming but I couldn't open my mouth to make a sound. With the most enormous effort I tried to move my arms and open my eyes to show them that I was fully conscious, but nothing I did made me move.

However, I must have lost consciousness, as I felt no pain during the surgery, and my next memory was of regaining consciousness on a wave of nausea. Someone was holding a bowl to my mouth, and as I vomited I felt a sensation like sutures ripping through the tissues in my abdomen. The surgery was over and I was wheeled back into my hospital room.

During exploratory laparotomy, they found a mesenteric tear with some bleeding vessels, which were ligated, and a large retroperitoneal haematoma, about which they could do nothing. There were also crushing injuries to my small intestine.

Photo of Dr Madeleine Wilcock Dr Madeleine Wilcock putting an oxygen mask on me immediately after the first operation. (Photograph courtesy of Jason Reinke)



My care team

The next seven days were a blur of unbearable suffering, surrounded by the extraordinary compassion and dedication of Madeleine Wilcock, my doctor (Bryan was required to return to the ship), who understood my suffering as if she were going through it too. This was complemented by the diligence and kindness of my three dedicated (bearded) nurses, who were there 24 hours a day and would do anything for me. Their combined love and concern enveloped and helped me during those awful days.

During long sleepless nights in the care of the nurses my veterinary skills were often useful, in ways such as guiding them in fixing blocked intravenous lines or giving injections. At first I was nervous about a diesel mechanic or a carpenter trying to give me intramuscular injections, but then I noticed that they were even more terrified than I. I learned how stressful it is having to endure and anticipate multiple painful procedures each day, and would have preferred all dressing changes, catheter changes, injections and other painful events to be finished in one go. I appreciated Madeleine's efforts to relieve my pain, such as administering local anaesthetic before inserting a cannula. I decided that I would take great care to avoid inflicting pain on my patients in the future.


No visitors

Madeleine understood that I was unable to cope with visitors and allowed only Lyn (my biologist colleague, and one of only two other women on the station) to visit every day to read emails, which were important for maintaining my morale. I appreciated Madeleine's sensitivity, as I found interaction with people almost unbearable. Moving, and especially speaking, caused the nasogastric tube to irritate my pharynx and induced gagging and vomiting. I was anxious for people to leave. If they remained for any length of time, I needed their reassurance that they didn't expect me to answer or to look at them. I needed them to acknowledge and empathise with my suffering, the awful nausea, and the pain that vomiting caused me, as well as the exhaustion from lack of sleep, and the demoralising affliction of the nasogastric tube.



No medical details, please

Uncharacteristically, despite my usual curiosity and medical background, I had no interest in my medical details. I was unable to process any information. My entire focus was on existing. Until I was well again I didn't ask what the outcomes of the surgery were. I could not think about the accident, full stop. Flashbacks were immediately pushed out of my mind, and it wasn't until the nausea had subsided and the nasogastric tube had been removed that I was ready to face the full psychological trauma of the accident.



My past veterinary patients

As I lay in the white hospital room, watching the opaque grey world of a passing blizzard through my tiny porthole, I remember thinking, "My God, this is what sick people feel like". This new insight into suffering was particularly harrowing when I related it to all of those animals which had sat in the back of their cages, unmoving and unresponsive: I now understood what they may have been experiencing. I was certain that I would never work as a veterinarian again; I never wanted to face anything -- human or animal -- that felt as sick and uncomfortable as I did then.



A slow recovery

Traumatic pancreatitis -- diagnosed during further surgery after my return to Melbourne -- and recurrent forceful vomiting contributed to delayed wound healing. Eleven days after my operation my wound completely dehisced, and the next day I underwent further surgery for abdominal wall repair at Mawson Station. The Aurora Australis was turned around from its position in the Southern Ocean to bring me home. This was a major disappointment, as I was so much looking forward to recovering among the people who had cared for me and to continuing working on the island with the penguins. However, as well as the risk of further complications, supplies of drugs, cannulas, and fluid administration kits were running very low. Moreover, there was no total parenteral nutrition and my body had wasted away. Six days after the second operation I was 12-13 kg lighter than before my accident.

Photo of Aurora Australis The Aurora Australis, which turned back to bring me home (Adélie penguins in the foreground). (Photograph courtesy of Kym Newbery)

On returning to Australia, I spent two weeks at a rehabilitation hospital in Melbourne undergoing intensive physiotherapy for right lumbar plexopathy. Two months after the accident I underwent an incisional hernia repair and bowel resection because of adhesions. I have been fortunate and grateful to make a complete recovery. Madeleine Wilcock and my nurses, Garry Watson, Jason Reinke and Nick Mortimer, were awarded the Australian Antarctic Medal for their extraordinary efforts while I was under their care. I would like, once again, to express my deep gratitude for their dedicated, skilful and untiring efforts to nurse and restore me. I will always remember my journey to Antarctica by the aura of love and compassion and care that contained me during those critical days of recovery from the crevasse fall.



Authors' details

Wentworth Falls, NSW.
Raina K Plowright, BVSc(Hons), Veterinary Surgeon.

Reprints will not be available from the author.
Correspondence: Ms R K Plowright, PO Box 241, Wentworth Falls, NSW 2782.
rainapATozemail.com.au

  • Raina K Plowright


Correspondence: 

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.