Medical Chronicle

I'm so tired

Yann Eliès (Quéguiner-Leucémie Espoir)
© Alexis Courcoux

You take a look at the rankings and the position of the boats around you to try to find some motivation and to tell yourself that there’s still something to play for. “Time to get back to work. You wanted this. You chose to do the Vendée Globe. You’re lucky to be here, even if you’re not up at the front. Get a move on!” But I spite of that, your brain cells find it hard to turn on. Finding the right route is not easy and it all gets confusing. You feel like you’re working at slow speed. You can’t think straight and it’s hard to remain focused. It’s all such an effort. You suddenly became aware of that today. But it’s been a gradual process over the past few days and weeks. Apathy. Why bother? The first sign was when you didn’t wake after two hours of sleep. At that point, you thought it was fine being able to sleep without losing any speed. Why worry? But that lack of attention to what is going on should have alerted you. Are you on your way to a burn out?

There was so much to do in the race, communications with those ashore, looking after the boat… That didn’t give you any time to think about what was happening to your body. But it’s lurking there in the background ready to pounce with all the stress and demands of this incredibly long race. So gradually, you feel the tiredness. You start to feel exhausted without any warning. You don’t feel like going outside to carry out manoeuvres, or stacking or going outside to take the helm just to gain a few extra miles. Occasionally you start to forget things and that can cost you. You forget to change your clothes, wash or brush your teeth.
There are other signs, such as the typing mistakes, when you send messages back. Tiredness, fatigue, exhaustion is waiting in the wings. All you see now is the tip of the iceberg. But it is the nine-tenths that lie under the water that is the most dangerous. You can easily make mistakes, get things wrong and that can have dramatic consequences.

Those watching from the outside can see it happening. On the phone or radio sessions, we can see that you are not as enthusiastic. You have fewer things to tell us. It all turns to platitudes. So are you on your way to a burn out? Not necessarily. But you are extremely tired in a hostile universe, where the body struggles to adaprt all the time. Many of the skippers will tell you about it after the finish. It will take them weeks to recover. Looking at the purely physical aspects, everything is fine. Your hands are suffering, but the cuts and bruises are healing. Your fingers are not as swollen and your skin is back to a more normal colour. Your boots have been washed and are drying. It feels great to be able to walk around in sandals! It is pleasant outside and inside. Yesterday, the weather was fine. You found the energy to take a shower in a squall and give yourself a good rub-down. You don’t have a mirror there to look at yourself, but you can see your thighs have shrunk and your legs look thinner. That is not surprising. It was to be expected, in spite of your daily exercise regime. You physical trainer told you that you needed to look after your legs to be able to climb the mast, if necessary.

Ocean racing is a sport that is often done sitting down. That makes it more comfortable. When you’re standing up, you have to compensate for the movement of the boat all the time. That is physically and mentally demanding and has no real purpose. So when you’re aboard, you prefer to remain sitting down on comfortable seats, particularly at the nav desk, where you spend several hours a day. In the cockpit, some remain standing, but then, it is not that demanding for the legs. You need to run or walk. You might go around the deck a few times, if it’s fine, but that means just a few metres. You think of getting back to Les Sables and your first steps ashore, rather like an astronaut after a long stay in space.

So far all the medical problems have been dealt with by the skippers themselves. You know that if there is a serious incident, your friends are out there and will come to your assistance. They could offer some sort of support, even if that is about it, as it is extremely hard or even impossible to get two IMOCAs alongside each other. The masts would touch each other and break. Tossed around by the waves, the fragile carbon hulls would shatter. Two boats to rescue instead of one. Or in any case a risky operation. If required, other rescue means are available. The Maritime Rescue Coordination Center (MRCC) at Cape Gris Nez can put in place a rescue operation alerting the nearest MRCC. If it is a medical problem, the incident is dealt with in collaboration with the Race Doctor and the Medical Centre based in Toulouse. Cargo ships in the area have to go to their assistance and the operation is dealt with by whoever has the best means possible. This can often mean military vessels, who can offer the best guarantees with a doctor onboard. So far, there haven’t been any incidents like that in this Vendée Globe. Health problems are under control. There is however, still a long way to go for the tail-enders. They need to ensure they grab each opportunity to rest, dose your physical and mental efforts before you have to deal with gales in the Northern Hemisphere. The Forties in the North may not be roaring but at this time of year, things can change very quickly and the sea can easily turn nasty.

Dr Jean-Yves CHAUVE

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