Phil Jaekl - Out cold : a chilling descent into the macabre, controversial, lifesaving history of hypothermia

I was out one cold January afternoon, hiking through the snow in the woods to find what I thought was an abandoned nineteenth-century farmhouse. Some months prior I had discovered it from a distance. After a couple of hours, I was tired but felt confident that it was just over the next ridge. Yet I had come to the icy waters of a creek running across my pathit appeared to be the only barrier stopping me from finally reaching my destination.

Nearby, I spotted a fallen tree that spanned the distance to the other side of the creek; heedlessly, I began crossing by balancing on its trunk. Halfway across, I lost my footing and stepped down onto the ice that partially covered the water. I broke through and sank farther as I tried to turn around to make it back to the bank. What I thought was a foot-deep waterway submerged me up to my shoulders as I struggled to get out. For the first time in my life, I felt genuinely scared. My adventure through the woods immediately turned deadly serious. I dont know how long I thrashed toward the shore. When I wasnt sinking below my nose, I tried swimming and avoiding the jagged ice around me.

When I finally emerged from the stream I knew I had to keep moving to regain warmth. I was completely soaked and dripping cold, muddy water. My hands and feet were already starting to feel numb. I followed my footprints in the snow, but by the time I reached the car I knew I was hypothermic. Luckily the drive home wasnt long. I stepped into the shower and lingered therewarmth had never felt so-o-o good. I ended up catching the worst cold Ive ever experienced.

The word hypothermia has Greek origins meaning under (hypo) and heat (therme). Its symptoms depend on the extent of temperature decline. They initially involve shivering, movement that is poorly coordinated and laborious, and disorientation. As the condition increases, heart rate decreases significantly, and forgetfulness, confusion, and apathy set in. At extremes, victims can begin to make irrational decisions and talk incoherently. For reasons poorly understood, theyve even been known to start feeling hot to the point that they take off their clothes. Before dying, they may seek confined spaces to burrow in. Many have been discovered frozen and naked.

Yet, seemingly against all logic, throughout our known history humans have also continuously sought cold for therapeutic purposes. It has been tried for conditions ranging in severity from bloody scrapes to schizophrenia and even as an indirect means for achieving immortality and time travel. Most early attempts at using cold, however, were stabs in the dark, co-opting an accessible resource that in most cases likely distracted patients from their ailments more than it actually curing them. Still, humanity has been incredibly persistent; with each new therapeutic advance, hypothermia offers a shimmering glimpse of its potential as another form of treatment.

Now, science is beginning to unlock the secrets of hypothermia in an indisputable, evidence-based manner that focuses on colds ability to effectively slow down and suspend time before tissue damage from lack of blood flow can set in, as it often does in cases of cardiac arrest, stroke, and brain injury, for example. In this book Ill tell the story of therapeutic hypothermiaa history filled with exciting but sometimes gruesome experiments, scientists, suspended animation, head transplants, prolonged space exploration, and a host of controversial attempts at harnessing the power of cold in strange and surprising ways. This chronicle often intersects where science and fantasy meet, and where the lines between life and death are blurred. Yet based on scientific evidence accrued over millennia, we understand hypothermia better than ever before, and we have numerous new lifesaving cooling techniques at our disposal. Still, a macabre stigma hangs over the field: centuries of trying in vain to harness the power of cold have left countless dead. Current knowledge, however, is overwriting the old views. To understand how milestones in therapeutic hypothermia have been reached, the following chapters will delve into a dark history from which science is now coming out on top.

It already feels like an eternity since you started walking. There are no signs of human activity or even of life around here. You feel more alone than you ever have.

Its haunting.

Theres no use in trying to hide your shivering if theres not even a remote chance of anyone seeing you. So you let loose, as loud as you can. Tutttatatut chchchch ddadduududud. Indulging in audible teeth-chattering feels good, like its going to make you warmer if you keep at it. Not only does it seem like a defense against the cold; its actually kind of amusing.

You exaggerate your movements, shaking your arms around as though you were being zapped by a lightning bolt. You ponder how absurd you must look.