Extreme Medicine Read Free Page A

body’s method of buying time in the hope that something in its external environment will change for the better, not a solution in its own right.
    As it proceeds, the deep hypothermia will go on to alter Scott’s mind, making him irritable and possibly irrational. When his body’s reserves of fuel run out, the shivering will stop—a respite that will only accelerate the rate at which he cools. Like a marathon runner hitting the wall, Scott is at the end of all of his reserves. There is nothing left to draw upon. Mercifully, something that looks like sleep will follow as the electrical activity in his brain begins to fail. He will slip into a coma well before the channels in the cell membranes of his heart muscle, the gatekeepers of electrical stability in that organ, are compromised. Frenzied anarchic rhythms may follow, the heart writhing uselessly like a bag of worms before finally coming to a standstill.
    With his heart no longer beating, his body will be starved of its fresh supply of oxygen. But at such low temperatures, the rate at which Scott’s cells fail and die will be dragged out in time. Death results from the failure of the chemical processes that drive our cellular machinery. In the deep cold those processes, too, become sluggish. The normal window of a few hundred seconds when his brain is dying yet his circulation might still be reestablished will instead stretch to many minutes. This window, elongated by cold temperatures, will become crucial to medical practitioners in the years ahead.
    But for Scott there is no rescue. The seconds become minutes, the minutes hours. Scott, once a blazing furnace of life on the subzero wasteland of Antarctica, is finally no more energetic than the ice and snow that surround him.
    â€”
    L IKE ALL LIVING BEINGS, we fight against the laws that govern inanimate objects in an effort to avoid equilibrium with the physical world. Through the act of living, we maintain a level of complexity otherwise unknown in the universe: the ability to grow, to adapt, to reproduce, and as humans, the capacity for sentience and self-awareness. As fascinating and enigmatic as neutron stars and supernovas might seem, your brain is more complicated and more impenetrable to science than either. What makes us different, what sets us apart from the inanimate matter about us, is our ability to defy entropy, to avoid the thermodynamic reorganization, that would see us reduced to a simpler, lifeless state. As the decades pass, we—the human race—become better at it and expand the envelope in which life is possible.
    For all its personal tragedy, Scott’s death also contains some hints about the directions in which the envelope expanded in the century that followed his doomed expedition. Trying to conquer Antarctica forced us to confront the world’s most extreme physical conditions and understand the havoc that they wreak upon the human body. Deepening that understanding of the body allowed us to continue our explorations there. Our frail physiology, left unprotected in these hostile environments, stood little chance.
    The challenge of exploration became less about the spirit and determination of our plodding expeditionary teams and more about the challenge of how—through science and technology—we might protect them against challenges that had been fatal throughout all of human history. As the decades passed and our knowledge grew, we were able to overcome hypothermia. The answer lay in understanding our narrow limits and what our body might tolerate. With better clothing, habitats, and systems of transport, we could go further.
    But today that understanding allows us to do far more than persist in these environments: Hypothermia has become an asset to medicine, a tool for cheating death.
    â€”
    N EARLY A CENTURY after Scott’s expedition, a twenty-nine-year-old woman skiing in the mountains of Norway suffered an accident and went through the same