Erick Itoman, Pittsburgh, PA – 33 at time of event (2006)
On May 13, 2006, I suffered what is known as “shallow water blackout.”
At the time of the accident, I was in the middle of an Internal Medicine Resident at the University of Hawaii. There were three of us that day. Greg Sakamoto an Internal Medicine Prelim Resident (who is now doing Dermatology at Harvard), Kalani, an experienced diver (friend of Greg), and me.
We were spearfishing off the North Shore of Oahu. The water was blue and clear, and the winds were light. We had already speared Mahi Mahi, Jawfish, and a number of other prized fish, when we arrived at our final diving spot. As soon as I jumped into the water, there were schools of fish around me. I quickly shot an amberjack, then focused my attention on a red goatfish (Kumu) approximately 40-50 feet below. Each time I would dive down, the fish would go back into his hole. Up and down I dove, sometimes alternating with Greg. Due to the strong current, Greg and I got separated. Kalani was still on the boat. I began to think that it was not worth it, but I decided to dive again.
Separated, Greg was harassed by a shark. It was persistent, and didn’t scare easily. Eventually it lost interest and left, so Greg came to check on me. Hovering over, he thought, “WOW! Erick’s got great bottom time.” Then, his heart stopped as he saw my body flip face-up off the floor.
Now 60 feet below, he quickly dove down and attempted to grab me. Heart racing, he could not reach me. “Kalani… Come here!!! Erick’s in trouble.” Kalani jumped off the boat, and together they dove. Greg sacrificed his spear-gun and together they quickly stripped my weight belt off, and brought me to the surface. Greg noticed there was no pulse and no breathing. Kalani swam to get the boat. Chest compressions were started immediately. I was thrown onto the boat, and Kalani raced to the harbor. He notified the Harbormaster of the accident, and an ambulance was waiting for me at the pier.
I was raced to a community hospital where one of my medical school classmates saw me in the ER. A tear appeared, but then protocol quickly suppressed emotion as she evaluated me. I was hypothermic, cyanotic, blue, and unresponsive. Greg had notified the Chief resident at Queen’s Medical Center (QMC) of the incident, and she notified the Intensivist. Transfer was arranged to QMC, and I arrived to an awaiting team of physicians. To prevent further injury to my brain, a cooling catheter was placed and I was cooled to 33 degrees C. Ironically, this was the very ICU I was running as one of the senior residents just 3 days prior.
I was still hypotensive, hypoxic, and cyanotic. I was placed 3 different medicines to support my heart and blood pressure. I remained on mechanical ventilation for two weeks, and was in the ICU for 1 month.
In reviewing my dive watch some astonishing information was found. I had dived to 50 feet and ascended within 90 seconds. Just prior to reaching the surface I stopped and sunk to 60 feet where I remained for another 3 minutes. I suffered shallow water blackout, where when ascending from the deep I ran out of oxygen just prior to reaching the surface. It was 5½ minutes before I was brought to the surface again. It was anther 15-20 minutes before I reached the harbor, and another 10-15 minutes before I reached the community hospital.
It is an absolute miracle that I am still alive! It is a miracle that I have no neurological deficits, and can still practice medicine. There are 5 things that made a difference that day: the quick actions of Greg and Kalani, early CPR, induced hypothermia, the readiness of QMC, and divine intervention.
Can you believe that this happened 1 day prior to Mother’s day, and 2 months prior to my marriage?
Today I am the Chief Critical Care Fellow at a large University in Pennsylvania.
- Erick Itoman