“Hi! The wound is at the top of the finger, it is bleeding.”
- Where is it situated, exactly? Is it deep? Try to look at it...”
The reply is reassuring. It is important to check it out.

« Can you answer questions 454 and 564 of the medical Guide?»

Caution is the watchword
You never know as the wound could have affected a nerve or a tendon. It needs to be checked. In the list in English of symptoms, it is up to him to note down those, which correspond to what he feels. This is safer than the spontaneous expression of his symptoms, which are often difficult to interpret:
«Call me back or send me an email after the check. OK, I will send you an email, and if it’s possible, a photo»
By e-mail, he notes down the code for his symptoms. It’s simple, quick and sure. When I receive it, I can see what the codes mean immediately. This procedure avoids misunderstandings, inappropriate interpretations or the incorrect use of words, which can lead to a poor diagnosis.

His e-mail arrives. 454 A-E-K-P-R 564 B19-N. Looking at the codes that means the wound is not very deep and at the tip of the middle finger, on the front of the hand. It is bleeding a lot. I reply giving the codes for the first aid: 36-1 then 34-3. Each reference number corresponds to the right procedure presented step by step with pictures in the book. He can read it, reread it and look at the various sketches. This procedure is more reliable than instructions by phone, which can be misunderstood or simply forgotten.

Today, he is going to have to stop the bleeding, then apply sticky strips to close up the wound. Just to be sure, I add information in the e-mail about where the strips are in the medicine chest. Compartment D in the medical kit, product n° 514. Easy to identify. Some products have similar names and by phone that can lead to confusion. Using a number reduces the risk.

If it had been any worse, I would have told him to stitch it up, but with one hand that is not easy, even if you have trained. Being alone is not simple, when you have to carry out such a procedure on yourself. No worries. He should get over it. It’s not a serious problem and we have seen much worse. In this long-distance relationship, he has to be my eyes and hands. My eyes to observe, feel and describe the injury or the trouble, my hands to carry out the act for me. The medical guide approved by the ISAF (International Sailing Association Federation) is the basis of this long-distance medical dialogue. As a doctor far from his patient, it was my turn to be patient waiting for an update. So, there I am in my waiting room, separated by an ocean and ready to reply day and night to a call or e-mail.

January 1993, off the Kerguelens.

Gales. Bertrand de Broc is at the helm. Violently thrown off his feet by a wave, the boat changes tack. The mainsheet flew across the cockpit and hit him in the face. He felt a violent pain immediately. A bitter taste in the mouth. It was blood and a lot of it. He had cut the tip of his tongue. It was a clean cut and a deep one. Bertrand remembered his grandmother killing chicken by cutting their tongues. He thought he would end up like them. So he had to act quickly. There was no phone on board. The only solution, a message sent by fax. That took some time, half an hour or so.

Finally, it arrived and I read, « Cut through my tongue. Bleeding a lot. Bruise under the right eye and it hurts. For the tongue 5/6 mm deep on either side, 2 cm wide. Bye, Bertrand.»

The best solution was to stitch it up. This recommendation would no doubt surprise him. In front of the mirror, I simulated the movements to ensure I did not forget anything. I wrote it down and sent the reply hoping he would get it soon. Then, I had to wait. After two hours, Bertrand informed me that he had sewn up the tip of his tongue, simply because he had to.

Just as others later on would be capable of moving around with a broken femur or living in an overturned hull.

In the next Vendée Globe, the telephone was used to transmit pictures and this year we have videoconferences. In 1993, I could have helped and advised Bertrand with his stitches as he carried them out.

This « telemedicine » is about to affect each and every one of us. Imagine. You find yourself sick in a country where you cannot speak the language. How do you find a doctor? How do you explain what is wrong and reply to his questions? What skills do you have? It can quickly become a worrying situation. But in your pocket, you have your phone and the number of your GP. Saved!

Hearing their voice reassures you and he knows all about you. The problem is that from a distance, you have to explain and it is not easy being his eyes and hands. You feel as far from your doctor as a Vendée Globe competitor does in the middle of the Pacific.

With digital technology, this distance is no longer a problem. Symptoms, pictures audio and other signals allow you to communicate perfectly with your doctor, who can then understand your precise problem from a distance. This project called RCA (Remote Control Aid). Set up by Europ Assistance and SMI, it was trialed during the Vendée Globe and will shortly be available to all those, who find themselves alone.

I have often met up again with Bertrand de Broc. When you listen to him, you get the impression he has something on the tip of his tongue, but he reassures me that there is no trace of his problem. The stitches were well applied and he entered the history books, for showing such exceptional ability, like so many of the other solo sailors.

The Vendée Globe is truly a crossroads where sport and human endeavour come together and has shown itself to be an exemplary real life laboratory benefiting us all.

Dr Jean-Yves Chauve