How we drown
We think we know what drowning looks like. But what if you can be watching, paying attention, and still not know that someone is going down?
August 8, 2010
By Keith O’Brien
THE SCENE in the popular imagination is almost always the same. A swimmer in the water – typically a child or a young woman in a bikini – calls out for help, splashing and screaming for a lifeguard. The swimmer is drowning. Of this, there is no doubt. And depending on the narrative, one of two things happens next: After more splashing and screaming, the swimmer will drown. Or the lifeguards will hear the person’s calls for help and make a daring rescue.
It’s a dramatic, often horrifying, moment, depicted in television and film again and again. And thanks to these pop culture portrayals, it’s what we look for while we’re at the beach or the pool. We think we know what drowning looks like. Surely, we’d be able to spot the signs. But what if we’re wrong? What if it’s possible to be an attentive parent and still not see that a child is drowning? What if the reality – the truth about how a drowning victim really goes down – is far scarier, and more silent, than we’ve been led to believe?
Four decades ago, Francesco A. Pia – then a young lifeguard on one of New York City’s busiest beaches – began exploring that very idea and came to some startling conclusions. He paid a student to train a 16mm movie camera on his beach, filming near-drownings and rescues. When he analyzed the results he found that Hollywood’s version of what happens in a drowning was complete fiction. And far more alarming than that, he found that water safety experts had it wrong, too. There is, in fact, almost never any shouting or waving involved with a drowning. Quietly and quickly, usually without a word to anyone, people struggling to stay afloat slip beneath the surface of the water – gone, sometimes, in cases involving children, in 20 seconds.
“It’s the rule rather than the exception,” Pia said, “that a drowning person is often surrounded by people who are unaware that a drowning is taking place. We had one case where a boy was drowning – he was probably about 12 years old – and there was a man side-stroking right in front of him. You can see the boy’s eyes tracking him as the man is swimming and he just keeps going by. This is not a case of the side-stroker not caring. He simply did not know that the boy was drowning.”
Pia’s findings, released in an instructional video called “On Drowning” in 1971, didn’t initially revolutionize water safety. One longtime expert said Pia’s views were so unorthodox at the time that many dismissed both him and his film. But in fact his conclusions echoed an earlier study which looked at 248 near-drownings. That study, done in 1966, reported that in nearly one-third of the cases the victims provided the lifeguards with little or no sign that they were in trouble. And ultimately, the water safety industry came full circle on Pia. In recent years, he has literally written the textbook on preventing drownings. Today his findings are widely accepted as fact, and he is considered the go-to expert on the topic by organizations like the American Red Cross.
But despite Pia’s efforts to spread the word over the years – first to lifeguards and later to the public – most beachgoers and parents still have no idea how to spot someone struggling in the water. Raised on the movies and, of course, “Baywatch,” we’re often looking for drama, thrashing, and panic. But the truth is, Pia said, we could be looking right at someone who’s drowning, even a loved one, and not think twice about it.
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It is every parent’s summertime horror and, this summer, it has come to both Lynnfield and Brockton. Last month, twin sisters, not even 3 years old, drowned in Lynnfield after somehow managing to slip unnoticed into the family’s backyard swimming pool. And just last week, 4-year-old twin sisters in Brockton did the same.
Such tragedies, according to studies by the Consumer Product Safety Commission, account for more than 200 deaths every year. And parents, seeking to assure themselves that such a thing could never happen to their family, tend to blame inattentive parenting as the real cause.
Certainly, that’s a key issue. But even parents who believe they are paying attention while their children are swimming spend too much time texting or talking to friends, according to longtime water safety consultant Gerry Dworkin. And even if they are engaged and watching, he said, they are often watching for the wrong thing.
“They may be looking for somebody who’s actively struggling in the water, with the victim calling for help, waving for help, and so forth,” said Dworkin, vice president of Lifesaving Resources Inc., a New Hampshire-based water safety consulting and training company. “And drowning victims don’t look like that. To an untrained observer, a drowning victim looks like they are playing in the water when, in fact, they’re engaged in a life or death struggle.”
Statistically speaking, drowning is a rare occurrence. In 2007, the last year with complete data, the Centers for Disease Control recorded 682 drowning deaths among children under age 15. And yet, drowning is the second leading cause of accidental death among children in that age bracket, just behind car accidents. Among children under the age of 5, drowning is the leading cause of accidental death, according the CDC, far more likely than other things that parents routinely fear: fires, suffocation, poison, even guns. And on Pia’s beach in the Bronx, drowning wasn’t all that unusual. By the Fourth of July every summer at Orchard Beach, he said, at least two people, maybe more, would have drowned.
Pia had been taught to spot potential drowning victims, he said, by looking for “convulsive agitation” in the water. But he soon realized that most near-drowning victims agitated very little whatsoever, and rarely called for help. Instead, they exhibited something that he called the instinctive drowning response.
In his grainy, color footage gathered at Orchard Beach, the victims time and again flap their arms at their side, as if trying to use the surface of the water as a platform. They go vertical in the water, straight up and down, angling their airways toward the oxygen. And the goal, he pointed out, is not yelling for help – that almost never happens – but something far more primal: just breathing for as long as possible.
“They are trying to avoid suffocating in water,’‘ Pia said. “And the elegance of this particular theory is that whether they’re male or female, old or young, heavy or thin, African-American, Caucasian, or Hispanic; whether they’re drowning by themselves, drowning with another person, drowning with three people, or even, in one case, we had four people on film drowning – the same arm movements are there, the same body position, the same activity. So this is instinctive. Hence the term ‘instinctive drowning response.’”
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These days, from the shores of American beaches to the offices at the CDC, lifeguards and policy makers know better what to expect from a drowning victim. Even if they are not taught the term that Pia coined, instinctive drowning response, they are taught the central idea: that drowning victims will not likely wave or yell for help; that they will look like they are “climbing a ladder” in the water; and that the struggle, much to a parent’s horror, will not last long.
“Most children don’t even understand what’s happening to them, particularly young children,” said Dr. Julie Gilchrist, a pediatrician by training and a medical epidemiologist at the CDC. “And that’s why we warn parents of young children that drowning occurs very quickly and very quietly. Descriptions from children who have survived a near-drowning say, ‘I went underwater and I went to sleep.’ They just don’t understand what’s happening.”
This knowledge, Gilchrist said, helps explains the typical response we often hear in the aftermath of a drowning: “He was there one minute and I turned around and he was gone.’‘ Victims, especially young children, can drown in 20 to 60 seconds, Dworkin said, and it’s not only parents who fail to see that someone’s drowning. Sometimes, Dworkin said, trained lifeguards sitting right there miss it, too.
“I’ve had several major cases where the victim has been in distress – and you can see it on the security video camera footage,” said Dworkin, who also works as a forensics expert in drowning cases. “But after the distress, the victim has been unconscious at or below the surface of the water for six or eight minutes, and the lifeguards failed to recognize that there was a problem.”
One such case involves a 4-year-old named Jonathan “Yoni” Gottesman. In August 2005, he attended a day camp at an athletic club outside Santa Barbara, Calif. Near the end of his first day there, he and other campers hit the pool, where, according to grainy security tape footage shown at the civil trial and posted on Yoni’s memorial page on the Internet, one counselor dunked Yoni and other children multiple times.
As the counselor and the other children swam away, continuing the game, Yoni swam toward the pool’s edge, but could not make it and soon stopped swimming altogether. For the next eight minutes, no one in the crowded pool noticed the limp body of the little boy floating face down in the water. Not his fellow campers, not the counselors, not even the lifeguards – negligence that is almost inexplicable, and which led to Yoni’s death and, just last year, to a $16 million jury verdict against those charged with watching him that day.
But lost in the shocking outcome is a moment that is subtler, but almost as frightening to a parent. It comes in the video footage as Yoni tries to keeping swimming, to keep up with the others. One moment, the 4-year-old appears to be paddling, pushing through the water and toward the wall, toward safety. And the next moment, literally a few seconds later, he’s not moving at all. Just like that, the little boy stops breathing and begins to drown.