Medical Chronicle

Courage and determination

SAILING - PRESENTATION VENDEE GLOBE 2000/2001 - PHOTO : PETE GOSS / DPPI INBOARD AQUA QUORUM - SOUTH ATLANTIC - VENDEE GLOBE 1997

You suddenly awake feeling completely alert. Eyes wide open, butterflies in the stomach, you await the dreaded slam.  For a fleeting moment, you feel like you are suspended in space and the impact seems to take ages to come. The hull crashes down with a huge noise hitting the water, as if it was cement. You feel breathless as you are forced back into your seat.  Everything seems to shake in this tremor.  You can feel the strain the equipment is under, as it reaches the limit of its resistance. Every part has a vital role to play in this huge jig-saw puzzle of a boat.  It must hold out.  

But already, the boat is off on the attack again as it encounters the next wave.  Worry, fear sometimes. Find something to do to get it out of your mind.  Let's think.  Tell yourself that in such circumstances you are doing your best.  Speed, point of sail, adjustments, the route... all’s well.

On the first night, the swell built up, and you had hardly any time at all to go from a land creature to a sea creature.  In these conditions, the human body is not happy and complains. The psychological pressure of the start did not help. Apathy, dozing off, headaches, no appetite, feeling down, vomiting... common troubles that are all part of feeling seasick.  Not the best way to face up to these horrendous seas.

All that is quite normal, because man lives on land. On terra firma on two legs, we stand up, but remaining vertical is not so easy when you lose your balance. It’s like turning a bottle upside down. You get an idea of the instability. Balance is controlled by the brain. It is a complicated mechanism with the vestibular system in the inner ear and its three semi-circular canals in each labyrinth. It’s a bit like a spirit level. When we move, the bubble moves in the tubes. Imagine that there are electrodes fixed in each tube. Via a nerve, each electrode touched by a bubble sends a signal to the balance system. By combining the info from the three semi-circles, the brain detects the position of the body. It is helped by what the eyes can see on a vertical and horizontal level. The ligaments located in the feet, ankles, knees and stomach inform the brain about the posture, where the body is resting and the type of ground. All this info is analysed instantaneously leading to reflex reactions with contractions or slackening of the muscles, in order to obtain the right balance. It is vital for all these signals to match each other for the system to work.

But at sea, it is more complicated. That harmony vanishes. Unlike when you are on dry land, the boat is moving all the time. The body moves with each pitch and roll. The bubbles follow these movements and transmit the information to the balance centre. But thee ligaments are not being called upon, so the info from the bubbles is not confirmed. Faced with this disagreement, the eye decides by examining the horizon or the coast.

When you are inside without that reference, it goes haywire and the info from the bubbles overwhelms the brain. You feel uncomfortable, get a headache and feel sick. There is only one way to overcome that and that is to empty your stomach. There is relief after that as the nervous system eases off. It takes time for the brain to leave to one side the info from the bubbles.

If you know what it takes to sail one of these 60-foot ocean racing boats, you can only admire these sailors, who in spite of the adverse conditions, have continued to do their best with their machines. Some hide their seasickness, but they are wrong to do so.  If you are capable alone of pushing back your limits, when confronted by the worst situations, this is a magnificent example of tenacity and determination. 

Dr Jean-Yves Chauve

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