Ketamine really was a miracle drug in this situation.
It's one of the few anaesthetics that doesn't cause respiratory depression, overdosing is practically impossible, and it's also injected intra-muscularly, rather than intravenously, making it easy to apply in the dark and underwater by an untrained person.
These factors are also why it was used extensively in the Vietnam war for battlefield surgery.
Interesting that, as usual, the media has labelled it as "horse tranquilliser". It's used more extensively on humans than on animals, and is used on all different mammals, not just horses.
It's also used on dogs, but mentioning that it works on horses is more impressive since horses are known as very large strong animals. I think that's the reason it's often called a "horse tranquilizer", to emphasize that it's serious stuff.
I mean, the article makes clear that Dr. Harry is an anesthesiologist and that anesthesiology is a very serious discipline, so I don't think the author meant to suggest they were carelessly administering medication meant for animals instead of humans.
The irony is that it's actually one of the safest
(and cheapest) tranquilizers and that's why it's used on large animals. It's hard to weigh a horse, so you want something that doesn't require a very precise dose.
Benzodiazepines have a depressant effect on the respiratory system, and have a risk of paradoxical reactions. In addition you’d need a heroic dose to cause total sedation, so a benzo is usually only a component of along with an opiate to induce “twilight” sleep. For the purposes of this dive obviously respiratory depression was unacceptable, and doubling down with an opiate would have been worse.
Ketamine is very safe, and some nasty side effects are preferable to death.
Benzodiazepines require heroic doses before they start to depress respiration. At low doses, like what you’d use to keep someone calm, it’s a non-issue.
Not sure why you’d want them so sedated that they are semiconscious.
It doesn’t take much to keep someone from freaking out.
Compared to ketamine, benzodiazepines are far more likely to cause respiratory depression and arrest, as well as airway obstruction due to relaxation of muscles and soft tissues in the jaw and neck. I am a retired neurosurgical anesthesiologist (38 years experience) and used ketamine — both IV and IM — hundreds of times in the OR in children and adults.
Well you obviously know more than I do, but I guess my question is - were these kids anesthetized?
If so, I would agree ketamine is much safer. But if you’re just trying to keep them from freaking out, 5mg is diazepam will do the job and respiratory depression isn’t much of an issue.
Yes, the kids in the cave were anesthetized. Diazepam is NOT an anesthetic: it is an anxiolytic/hypnotic/sedative. 5mg of diazepam will calm some, put others to sleep, and not noticeably affect others. Variation in response is huge. With ketamine, a given mg/kg dose is far more predictable.
A psychedelic experience basically, why people take it recreationally in doses that don't quite knock you out. It's really bizarre and something best not experienced submerged in a cave.
I was taught 20 years ago that it was still given to children as an anaesthetic because it's very safe and they tend to either not experience the "trip" or are not bothered by it, thinking it's a dream.
I don't like how this was articulated because giving someone enough drugs to 'knock them out' is extremely dangerous in any circumstance.
There are so many things that could have gone wrong during that time, my god man ... random diver dudes (i.e. non medical) giving needles putting people out - this was as dangerous as anything else.
It's not for nothing that it's not the WHO list of essential drugs. It's a miracle drug in more ways that one, with it now also being used with success against depression in treatment resistant patients, to treat alcoholism etc. And of course nothing beats a good old k-hole experience.
Incredible story. Richard "Harry" Harris and Craig Challen were jointly awarded Australian of the Year on the weekend for their efforts in the cave rescue. Absolutely deserved.
In a post-award interview, Richard Harris described what he wanted to do as Australian of the Year...
"I really want to try and inspire kids to get out and about, get them off their screens... ...and get outside and build up a bit of confidence and resilience that comes with adventuring and taking a few risks."
As long as said risks don't involve getting stuck in an underwater cave and triggering an international search and rescue mission!
Can someone else explain the story with "Ben"? Did he offend someone and thus get kicked off the rescue squad? I couldn't follow the reason why he was stuck sitting in a chair outside the cave.
From searching online the answer isn’t clear. Ben Reymenants gave interviews during the run-up to the rescue that may have pissed someone off; on the other hand, it was never clear that the signage was legitimate.
Basically the entire rescue operation sounds like it was conducted under a fog of war. No one was ever officially in charge, no one was legally authorized to do what they did (such as the medication of the boys).
Narongsak Osatanakorn was put officially in charge of coordinating rescue efforts even after his term as governor had ended. I don't know how involved he was with facilitating communicating between the teams but at the very least he seemed to be their official liaison with the outside world (although of course unofficial lines existed as well).
I found it a bit odd that the author differentiated between Britons and Europeans. Britons are Europeans!
I wonder why Europeans were so well represented. I wouldn't have necessarily imagined that would be the case. Is it simply because most European countries are relatively wealthy?
Definitely an odd wording. However, I have some speculation as to why it is this way.
Maclean's is a Canadian publication and I think many Canadians have a special interest in the UK, and I think the demographics of Maclean's readership likely reinforces this.
Additionally, I would guess that this is some semantic ambiguity introduced via morphological clipping where the author is using European as a shortened form of Continental/Mainland European. It's a fairly common device used to remove excess verbiage especially when reusing the same terms over and over. Pragmatically, when in context being contrasted against Briton, it becomes more clear that the author means Europeans other than Brits.
A similar example could be "all squares have equal sides whereas rectangles do not". It is pragmatically more likely that I mean _non-square_ rectangles even though my wording is ambiguous or straight up incorrect taken at face value.
So I'd guess it's attributable to the psychological primacy of the UK amongst the readership of this publication, semantically confused via a common morphological device, and ultimately disambiguated by the pragmatics of contrasting a part with its whole.
Yeah - I'm a Brit, I read it as a shorthand for continental Europe. Just a shorthand way of differentiating a team of Brits from a team of other Europeans (and Canada).
I've heard this usage in Australia; I can't find a free Australian dictionary so no citation. Australian English maintains more British-isms than American English. I imagine Canadian English may be the same.
It’s pretty common in British English, and so I guess Canadian English as well, to say European and to mean continental Europe. That’s not any kind of political statement, something recent, or anything to do with Brexit, it’s just a shorthand of speech.
Id say it comes down to the way cave diving in Briton is largely different from that of mainland Europe. So even on site the British cave divers would see the approach as different to the Europeans
In Briton cave diving is largely done to move between flooded sections of dry cave, so most cave divers are dry cavers first, and diving is just used to bypass sumps.
Also most British cave diving is done solo (so without a buddy that most systems recommend.) in quite tight conditions.
Caves in mainland Europe tend to be larger and the diving philosophy is different. There you will find team diving prevalent.
The distinction between UK/EU was obviously made among the teams themselves.
There happened to be a UK crew, and then another crew of Europeans, so 'team UK' 'team Europe' makes sense. If they were event eating/living apart, then the distinction was made on the ground, not by the author.
If there were a bunch of Swedes (Thailand is a disproportionately popular destination for Swedes) it might have been 'Team Sweden' / 'Team Europe' as well.
"I wonder why Europeans were so well represented."
Because Europe is considerably more advanced in many ways than a place like Thailand - and also bigger and richer. The 'talent pool' for these things is going to be massively larger'.
To compare: Thailand is 70M people with 7K GPD per capita. It's kind of poor, not 'technically developed' is my nice way of saying they don't have all of the civic, academic, social, industrial foundations that other, richer countries do. And so a lot people in villages do not create the surpluses that say, a European IT consultant has to adventure in their spare time. I think also, that 'different sports for different cultures' - it might just be that 'caving is not a thing' in Thailand or he region.
Try being a white New Zealander. You technically don't class as European but sort of get described as being of European descent and then on a technicality you are from an island in the Pacific Ocean so you could claim you are a Pacific Islander only that's not what a Pacific Islander is as they are all brown and from Fiji, Samoa, Tonga etc.
So I dunno... sometimes categorization is complicated.
We just refer to the lot of us as Kiwis after the small and the flightless native bird. What the hell does that have to do with anything I don't know.
Even though the Elon's submarine idea wasn't used, at least one little known piece of American engineering was used in the rescue - the "Sked". It's a stretcher that can rolled up for storage and transportation, then unrolled for loading, and then partially rolled up again to protect the patient on every side.
Speaking of Elon, did we ever get to the bottom of his pedophile claims? I don't see many people talking about it so i assumed he apologised and gave them a free model 3?
It's Musk, so he refused to apologise, doubled down on the assertions, got threatened with a lawsuit, grumpily withdrew the allegations, saw a slightly unflattering Buzzfeed article, blew his lid, sent the journalist a rant about how all the original allegations were true and Buzzfeed was a pro-pedophile publication for not agreeing with Musk 100% on everything (...not making this up), the journalist gleefully published it (because Musk was way too angry to, eg, get an agreement that the conversation was off the record), and the diver promptly sued him.
There's still zero evidence that any of Musk's claims are true, and I believe a few of them have always been trivially falsifiable, eg, Musk mentioned a child bride, but the diver's partner is 40, which isn't really what I'd consider a "child". And so on.
The court cases are ongoing, and unlikely to move fast. But at this point the best Musk can hope for is a procedural win I think, and that's iffy.
A procedural win would be if Musk can convince a court that they don't have jurisdiction (eg, the diver should have sued somewhere else), or that there's some other reason to throw the suit out.
I believe his lawyers were recently advancing the argument that the First Amendment lets you lie about people on twitter, so it doesn't matter if all the twitter claims were lies. If that argument works, that would be a procedural win, aka "it doesn't matter if I did it, because X".
The U.K. has some serious anti-libel and slander laws, and it’s pretty much a foregone conclusion given all Elon has said on the record that he has no chance in hell to win. I would guess there will be a settlement at some point, unless Unsworth wants to draw it out... which he might.
The amusing thing about Musk is, assuming he loses and has to pay a couple millions in a settlement...
...it still won't be the most expensive time he ran his mouth on twitter, said false things, and had to pay a big settlement that year.
(Musk had to pay a $20m fine to the SEC for making fraudulent statements on Twitter. Musk is on record that the fine was "worth it". And I guess if you're billions, maybe a really satisfactory tweet really is worth a few million.)
Yeah, but Musk presumably does travel a lot, and again presumably can’t afford to never show up in the U.K. again. Practically speaking if he loses, he’ll have to pay.
No extradition for civil judgments, so no. In principle, the successful litigant could seize any assets Musk had within reach of the UK to pay the judgment. Not sure how straightforward that would be, as it'd depend on how Musk's finances are structured and how much he travels.
That's right. Truth is not a defense at all in defamation cases. If your intent was to embarass or defame then even if what you said was true you can be convicted and do time.
Not sure if the case could be filed in Thailand. But if it was, Musk would be convicted for sure. The rescuers are all heroes in Thailand and what Musk said was very offensive and designed to do nothing other than defame the rescuer. Nothing would come of a conviction as long as Musk never visited Thailand again since nowhere would extradite him.
I really liked the story, and it's well worth telling it, and highlighting the heroes (and anyone who was there is a hero in my book). But the writing style was kinda hard to follow. It reads more like a stream-of-thought piece rather than an organized story.
Jumping back-and-forth in time, repeating side stories again and again, introducing new characters, and then re-introducing them, skipping major parts in the middle, only to come back to them later (or not).
All in all, it's a story well worth a good Atlantic article, or even a movie script - but I'dthink long and hard before putting time in the future to reading an "article" by this "journalist".
Interesting how I missed the sedation part till now. The way I rembembered it, they trained the boys to dive, right in the cave. But that must have been a plan that was later abandoned but stuck with me.
A friend of mine is an engineer at Lockheed, and used to work for NASA some 17 years long. He explained to me the whole thing was more of a photo-op and ability to over-engineer to show who's got the bigger balls, than actually to quickly rescue people.
He basically told me one of many training astronauts have is in a long dark corridor that is submerged underwater of course to simulate low gravity. However the whole thing inside is wrapped in a plastic bag, for lack of better explanation. Just imagine huge condom big enough to fit people in it. When the shit goes down, you push emergency button and whole thing fills in with air in less than 90 seconds. Since its inside cave/corridor, air has no way to push the condom outside/up, so whole water is flushed out quickly.
He told me all they had to do is put a thick foil underwater, glue 2 sides together, making long sealed condom, and then pump the air in, making a way for kids to crawl through, with no need to dive or know how to swim, almost like they have those tubes on children's playgrounds. That's all.
Because that idea is totally gonna work in a real world environment where there may be:
1. strong current messing with your construction
2. vertical sections and obstacles that will make your tunnel impossible to crawl through
3. corners, sharp outcrops etc. that might cause damage to it
4. sections that are too long for your construction to be stable even in good circumstances
If you managed to somehow solve all of the above with your design, you're still left with a construction job in an environment where people died just trying to traverse it.
There's like a myriad reasons why this is a bad idea and will much more likely result in awkward failure or even death instead of a success.
Let's not even talk about getting this assembled out of sturdy-enough materials before everyone is dead anyway.
And even if you manage that: One tear in that construction and you can guarantee the death of any child still in it.
If I had to choose I'd go with the professional cave divers and on-scenes experts rather than the dreams of some guy a thousand miles away with questionable, hardly-relevant credentials.
And particularly, the results of any damage to an air tube -- cold, opaque water rushing in.
Which sounds like a great recipe for panic and death.
And if you're protecting for that (e.g. by walking through the tube with breathing equipment), you're just making the situation more difficult and less like anything anyone has experience with.
Everybody else has done a great job at explaining why this plan had a very low chance of working, but there's one big reason why it would be a bad idea even if it had a half decent chance of working: it's completely binary — It either works, and you rescue everybody, or doesn't, and everybody dies. There's precious little room in between.
The plan they enacted, even if it might have had a lower chance of success (and I don't know that it did), was much more resilient.
One of the really important things the article explores in detail (but never calls out explicitly) is how many backups and fallbacks there were. Air tanks spread across the whole cave, multiple support stations with extra people. There were many opportunities to adjust to changing conditions. Even if getting one kid out went wrong, attempts at rescuing the others were mostly independent. All of this adds up to a pretty damn good chance of at least partial success.
Interesting use of the term "all they had to do..." and "That's all."
Given that:
a) there was continuous pumping to remove incoming water that would be overwhelmed if there was additional rain,
b) the location was remote,
c) "pushing the water" out would have flooded the location where the boys were when the non-existent tube was inflated,
d) the path to the boys was so treacherous that one very experienced diver died while replacing oxygen tank replacements,
e) after the last person was rescued (the coach), the Thai and other divers still in the cave almost died as the pumps failed while they were making their exit, and,
f) no such "thick foil... making long sealed condom" was either available locally or offered by anyone.
In other words, typical "Monday morning coaching".
Have someone tried this method in other place? Does it work when the walls have sharp edges, sharps turns, and there are water currents flowing at high speed around it? (I guess NASA might be using that method inside a pool.)
What does it mean "glue 2 sides together"? Underwater? For 800m? Completely air and water tight?
Does untrained people be "confortable" to craw in a dark tunnel for 800m or the children would have freak out in the middle?
Are you saying the kids could have been sealed in plastic/latex bags that are flexible enough for the kids to move on their own, and filled with air? What about punctures, buoyancy, &/or suffocation, to name a couple of hurdles?
Something sounding a lot like that was already mentioned in the article:
Several options have been duly considered and politely dismissed. The kids won’t be confined to airtight metal coffins, as Elon Musk has proposed, or made to crawl through a several-kilometres-long inflatable bouncy castle tube, as one Bangkok construction company suggested.
The Thai Navy SEALs worked with incredible bravery and determination, but they simply weren't equipped to conduct a rescue of this nature. I recall seeing some of the first news footage from the scene, seeing the equipment being used by the Thai divers and thinking "oh shit, these guys are screwed". It was immediately apparent that they were open-water divers operating far beyond the limits of their training. They didn't have sidemount rigs, they didn't have CCRs, they didn't even have proper reels and lights. Frankly, it's a miracle that only one person died.
Stanton and Volanthen actually had to rescue four members of the Thai rescue team, who had fallen asleep in an intermediate chamber and become cut off by flooding. There was no lack of willing on the part of the Thai rescuers, but they simply didn't have the level of expertise necessary to coordinate a rescue of this level of complexity and technical difficulty.
Let's hope it turns out better than the movie that was made of the Chilean miner rescue ("The 33")! Following the very successful award winning book it had an all-star cast... and it sucked. It had all the drama of watching paint dry.
Interesting how the parents and neighbours didn't blame the coach. I mean in the US, he would have been sued to death the moment people learned he had survived.
There's a saying that pets look like their masters and I think the same is true for entrepreneurs and their cities. Musk is the perfect embodiment of LA flim-flam.
I get that Musk is a controversial figure and that this event was a debacle, but I dont know how you can ignore SpaceX and Tesla, both arguably the most successful companies in their fields right now by some metrics.
SpaceX is fine, although it's running at leaner margins than competitors; as long as it can scale well and beef that up, it'll be about average for an aerospace company.
Tesla is a terrible mess, and only by Silicon Valley standards can it be considered successful at all. It is not even close to being "the most" successful car company.
This is why Musk is a controversial figure; he's a Valley-style startup hype man operating in the wider world. Whether that approach is sustainable is what the fighting is about.
The operative word here is was. Everybody else was making toys. They aren't now.
Tesla might be the most impactful EV company, in that you can make an argument that what Tesla did (and, to be frank, what they talked about before they did it) changed was to is, but Nissan, GM, and Hyundai are all making EVs that are decidedly not "toys" and Tesla's advantages in the EV space (not necessarily the creature-comforts space, but a big reason why I won't buy a Tesla and am buying a Hyundai Kona EV is because I don't want a giant tablet screen as my instrument panel) are shrinking.
You realise that the Nissan Leaf predates the Model S? Before the Leaf, yes, everyone was making toys. The two most compelling were the electric Smart car and the Tesla roadster, but both were terribly impractical.
Sure his outbursts and the drama around it on social media were a farce, but how exactly is it anything less than praiseworthy that a bunch of engineers on the other side of the world attempted to solve a problem that had the potential to save a dozen lives?
In practical terms, Must and his team did an order of magnitude more than you and I for the boys, and I don't understand why you have nothing but hate for him and the effort.
The biggest argument against I've read was that the online drama took attention and resources away from the people in the cave. I find that absolutely absurd. The rescue team weren't checking their social media or waiting on Musk, or distracted in any way by the online drama.
As far as I can tell, Musk's efforts did no material damage to the rescue effort, and could potentially have saved a dozen lives if he'd been given the correct parameters to begin with.
Further, the solution the engineering came up with has the potential to work for future rescue attempts.
Are you perchance suffering from tall-poppy syndrome?
I think publicly calling one of the rescuers a paedophile without grounds sunk Musk permanently on this one, regardless of the excellent but unusable engineering solution provided by his nootropicly charged ego.
It was a horrible choice of insult, but to be fair, the rescuer was a real asshole to him for no good reason (this isn't a defence of the insult, just saying that Musk was justifiably furious).
Why would you attack some guy trying to help you achieve your goal of rescuing the trapped boys, and call him names on international tv.
> The biggest argument against I've read was that the online drama took attention and resources away from the people in the cave. I find that absolutely absurd. The rescue team weren't checking their social media or waiting on Musk, or distracted in any way by the online drama.
Has anyone in the cave said that some engineers on the other side of the world were holding them up or in some way impeding their efforts? I find it extremely hard to believe that some shitty twitter drama got in the way of cave rescue efforts.
I thought it was obvious, that it was a clever dig at a guy he was fighting with (as much as idiots can fight on twitter, cough trump). Something about a guy with a hard on for getting to some kids. I'm sure Elon was high. I REALLY don't understand the HN brigade trying to imagine it into more than that.
There's plenty of reason to go after some of Elon's money to keep the fame train going, but it wouldn't go anywhere in the US. In the UK? They are big on curbing particular kinds of speech and behavior. He has a good shot at getting the money.
Didn't Elon later tweet something along the lines of "He must be an actual pedo because he hasn't sued me for libel yet?" Can't say I blame the guy for suing after that.
Some of the very specific things Musk said also seem a bit too specific for just joking around. "He’s an old, single white guy from England who’s been traveling to or living in Thailand for 30 to 40 years, mostly Pattaya Beach, until moving to Chiang Rai for a child bride who was about 12 years old at the time."
How is "stop defending child rapists" not suggesting the person is a child rapist, doubling down on the initial claim? (which was in bad taste, but wouldn't have been to big a deal if he'd not stuck by it)
That's a circumstantial partial quote from an email, editorialized, that fits the narrative. That's how. I really don't understand how this is confusing. I mean, I'm willing to read the email where he makes an accusation, but you would think that would be helpful evidence in the case presented.
There are very few people in the world that can dive like these guys do. If I was that good at something, having some Silicon Valley billionaire show up to "help" with some outrageously stupid idea, that would also piss me off. Although he should have known better than to throw the first punch.
Citation needed. It was a great idea, and vastly superior to the method they actually used to get the kids out. Of course it turned out not to fit, but that just means the cave diver who was in communication with Musk gave him incorrect data in the first place.
The divers themselves said it was a great risk bringing them out and the only reason they eventually took the risk they did was because the rain continued and it was feared that the water level would rise.
You can be the best diver in the world, but have no idea how to handle panicked kids who have no dive training. Sticking them in a tube and dragging them out would have been far safer than the method that luckily worked. You and the douchebag diver who attacked Musk for offering help would both be singing a different tune right now had a couple of the kids drowned on the way out.
That douchebag diver did succeed though. There were like a dozen people involved that were the best in the world at what they do and that's the plan they came up with and it worked. US and Thai navy seals couldn't do any better. Maybe if Harry was an engineer / cave diver instead of an anaesthesiologist / cave diver they would have come up with the submarine idea.
> that just means the cave diver who was in communication with Musk gave him incorrect data in the first place
So on top of everything else, Musk has such anger management issues that he can't avoid being sued for libel and making a fool of himself in the media? You're not really helping your case.
I saw and touched Musk's "submarine" which was on display at a science expo in Bangkok I went to a few months ago. It was sort of underwhelming. It was just a metallic tube with some handles on the sides and a thick acrylic removable plate on one end that had a few air fittings screwed into it. I'm sure there was some engineering that went into it. But it certainly did not look like rocket science was involved.
It's one of the few anaesthetics that doesn't cause respiratory depression, overdosing is practically impossible, and it's also injected intra-muscularly, rather than intravenously, making it easy to apply in the dark and underwater by an untrained person.
These factors are also why it was used extensively in the Vietnam war for battlefield surgery.
Interesting that, as usual, the media has labelled it as "horse tranquilliser". It's used more extensively on humans than on animals, and is used on all different mammals, not just horses.