The process began when they removed his gloves and he was manacled to a steel wall. The freezing metal bit his flesh. His skin temperature dropped.
Within a few seconds, the palms of his hands were a chilly, painful 60°. Instinctively, the web of surface capillaries on his hands constricted, sending blood coursing away from his skin and deeper into his torso. His body was allowing his fingers to chill in order to keep his vital organs warm. His fingers numbed slightly.
Human adaptations to cold are mysterious. They brought in a treadmill and he was handcuffed to the bar and the setting was pushed to a high level. His body temperature rose as he jogged on the treadmill. Blood started seeping back into his fingers. Sweat trickled down his sternum and spine. He felt the bite of the minus 30° air on his face. The monitors showed his core temperature was 100.8°. And then they came in with their enviro-suits and their helmets on and took him off the treadmill and chained him to the wall again. The frigid air pressed against his tired body and sweat-soaked clothing. The exertion they had put him through was now working against him. His dilated capillaries carried the excess heat of his core to his skin and his wet clothing dispelled it rapidly into the glacial wall behind him.
The lack of insulating fat over his toned muscles allowed the cold to steal that much closer to his warm blood. Within a few minutes his temperature plummeted to the normal 98.6° and then slipped lower. At 97° his neck and shoulders tightened into the pre-shiver muscle tone. Sensors within the brain signaled the temperature control center. The entire web of surface capillaries constricted. His hands and feet ached with cold and he tried to ignore the pain.
Forty-five minutes passed—at 95° he was entering the zone of mild hypothermia. His body trembled violently as his muscles contracted rapidly to generate additional body heat.
They returned and doused him with a fire hose until he was soaked. He screamed obscenities at them, but they did not acknowledge him other than to glance briefly at the monitors on the wall. He sank back against the wall, his heat draining away at an alarming rate.
Why were they doing this? Who were they? But his mind could not concentrate. The cold rendered the enzymes in his brain less efficient. With every one-degree drop below 95, his cerebral metabolic rate was falling. A stray thought told him he should start being scared, but fear was a concept that floated beyond his immediate grasp. Apathy at 91°; stupor at 90°.
He had now crossed the barrier into profound hypothermia. His core temperature was 88° and his blood was thickening like oil in a cold engine. His oxygen consumption was down by a quarter. At 87°, if a familiar face had suddenly appeared in front of him, he would not have recognized it.
At 86° his heart was pumping less than two-thirds the normal amount of blood. The lack of oxygen and the slowed metabolism of his brain triggered visual and auditory hallucinations.
He saw a room with a fireplace and heard the crackling sound of the flames. The chains fell from his wrists as he struggled to put one foot in front of the other. Hours later, or maybe just minutes, he had still not reached the warmth he craved. Exhausted, he stopped moving, deciding to rest for a moment. When he lifted his head, he was there, lying on the floor in front of the fireplace. The fire threw off a red glow. First it was warm, then it was hot, and then it was searing his flesh. His clothing was on fire!
With a body temperature of 85°, in a strange, anguished paroxysm, people freezing to death will often rip off their clothes. This phenomenon, known as paradoxical undressing, is common enough that urban hypothermia victims are sometimes initially diagnosed as victims of sexual assault. Though researchers are uncertain of the cause, the most logical explanation is that shortly before loss of consciousness the constricted blood vessels near the body's surface suddenly dilate and produce a sensation of extreme heat against the skin.
All he knew was that he was burning, and he clawed off his hoody and T-shirt and flung them away.
But then, in a final moment of clarity, he realized there was no fireplace, no room, nothing. He was still manacled and alone in the bitter cold, naked from the waist up. His discarded clothing had not come all the way off because of the chains. He tried, but could not find the strength to pull them back on.
At 0600 the next day, the men in the suits found him huddled in a fetal position on the floor, his gloveless hands shoved into his armpits. The flesh of his limbs was waxy and stiff as old putty, his pulse nonexistent, his pupils unresponsive to light. Dead.
But those who understand cold and know that, even as it deadens, it offers perverse salvation. Heat is a presence: the rapid vibrating of molecules. Cold is an absence: the damping of the vibrations. At absolute zero—minus 459.67° Fahrenheit—molecular motion ceases altogether. It is this slowing that converts gases to liquids, liquids to solids, and renders solids harder. It slows bacterial growth and chemical reactions. In the human body, cold shuts down metabolism. The lungs take in less oxygen, the heart pumps less blood. Under normal temperatures, this would produce brain damage. But the chilled brain, having slowed its own metabolism, needs far less oxygen-rich blood and can, under the right circumstances, survive intact.
Setting her ear to his chest, one of his rescuers listened intently. Seconds passed. Then, faintly, she heard a tiny sound—a single thump—so slight that it might have been the sound of her own blood. She pressed her ear harder to the cold flesh. Another faint thump, then another.
They carried him into the adjoining room. With a “one, two, three”, the doctor and nurses slid the man’s stiff, curled form onto a table fitted with a mattress filled with warm water. They knew they had a profound hypothermia case. Usually such victims could be straightened from their tortured fetal positions. This one could not.
Technicians scissored the man’s clothes off with stainless steel shears. They attached heart monitor electrodes to his chest and inserted a rectal thermometer that flashed digital readings: 24 beats per minute and a core temperature of 79.2°.
The doctor shook his head. “I can’t remember seeing numbers so low. They kept him in there too long. I’m not sure how to revive this man without killing him.” He was aware many hypothermia victims died in “rewarming shock.” The doctor looked down at the man, compassion in his eyes. “Strap him down. The slightest movement can send his heart into ventricular fibrillation.”
“Why is that, Doctor?” The voice was young, female. She was new to his team.
The doctor had worked at a teaching hospital and obliged her with a little more knowledge. “The constricted capillaries reopen almost at once and cause a sudden drop in blood pressure.”
“78.9,” a technician called out. “That’s three-tenths down.”
The doctor rapidly issued orders to his staff. “Intravenous warm saline. Heat the bag in the microwave to 110°. Just to raise his temperature one degree means we need 60 kilocalories of heat.” Before she could ask, he supplied the new nurse with the answer, “A KC is the amount of heat needed to raise the temperature of one liter of water one degree Celsius.”
“Even with the warm saline, that’ll only raise it 30°, Doctor,” one of the technicians said.
“I know.” The doctor fought down a surge of irritation. “That’s why we have the cardio-pulmonary bypass machine. We’ll pump out his blood, rewarm and oxygenate it, and pump it back in. That’ll raise his core temperature by one degree every three minutes.”
Moments later the patient’s stiff limbs began to relax and his pulse edged up, but the doctor watched the jagged pattern of his heartbeat on the EKG machine and shook his head.
“He’s got a J line. Be ready to defibrillate.”
Over the next hour nurses and EMTs hovered around the edges of the table where the patient lay, centered in a warm pool of light, as if offered up to the sun god. They checked his heart. They checked the heat of the mattress beneath him. They whispered to one another about things they were never supposed to discuss. They were being monitored and they would be reprimanded severely by the facility head of operations if they were overheard.
Slowly, the patient began to respond. Another liter of saline was added to the IV. The man's blood pressure remained far too low, brought down by the blood flowing out to the fast-opening capillaries of his limbs. Fluid lost through perspiration and urination had reduced his blood volume, but every 15 or 20 minutes, his temperature rose another degree. The immediate danger of cardiac fibrillation lessened as the heart and thinning blood warmed. Frostbite could still cost him fingers, toes or an earlobe, but he appeared to have beaten back the worst of the frigidity.
For the next half hour, an EMT quietly called the readouts of the thermometer, a mantra that marked the progress of this cold-blooded proto-organism toward a state of warmer, higher consciousness.
“90.4... 92.2...”
E-book currently available on amazon.com. If you like, I can post other samples.
