Twenty two minutes after leaving Short Drop-off, Jack and I once again plunged into the water. By this time, my legs were numb, weak, and totally uncoordinated. The numbness wasn't so much a tingly sensation, but rather a reversal of temperature sensation (i.e. the cold water felt warm on my legs). My arms and fingers were moderately uncoordinated, but not nearly as bad as they were back on the boat at Short Drop-off. As I descended this time, however, something was different - the symptoms did not go away. I followed the steep slope down to 80 feet, where it bottomed out into mud. The poor visibility compounded my uneasiness about the fact that my symptoms were unchanged, even at this depth. I had an overwhelming urge to remain as deep as I could until the symptoms vanished, but Jack (and my common sense) convinced me not to stay at 80 feet more than two minutes. I certainly didn't need any more nitrogen in my body! Five minutes later I was at 40 feet; ten minutes after that I was up at 30 feet. After 20 minutes at thirty feet, I began the long wait at 20 feet.

At about 7:15 in the evening (an hour after entering the water this last dive), I was down to 500 psi in my tank. Jack had long-since gotten in the boat and was waiting with the Dive Shop employee. I wanted to stay out there, underwater, as long as I could - at least until the chamber was ready for me. I surfaced and asked Jack if he had any air left; he had none. They decided to leave me there,go back to the dive shop for another tank, and then bring it back to me. They gave me a flashlight (it was night), and I descended back to the reef, 20 feet below. I was alone. Fatigue was beginning to set in. My mind began to wander. I wondered what I would do if the boat never came back. Would I be able to swim back to the dive shop? At night? Half paralyzed? What if a shark got me? What if the chamber isn't working? Will I get worse? Will I be confined to a wheelchair for the rest of my life? Am I going to die? I kept pointing the flashlight straight up. Fifteen minutes later, the boat glided to stop directly above me, and an anchor fell to the reef a few feet away. I shined the light up at the white hull of the boat, and saw that they were lowering a SCUBA cylinder with regulator over the side. They hung it beneath the boat at a depth of twenty feet. I decided to leave some air in the tank on my back, just in case I needed it later, and I began breathing off the new cylinder. I spent the next hour and fifteen minutes alone in the darkness, thinking about life in general, thinking about the ludicrous mistakes that day, and wondering what price I was going to have to pay for them. There were many thoughts of "If I had only..." and "Why didn't I just...?", and there were many, many regrets. I also thought about David Wilder...and Utrie Taie. At one point during my long wait, another boat came to a stop alongside the one I hung below. I could see flashlights moving about and pointing down at me, and it was clear that the occupants of the two boats above were exchanging information. It was nearly nine o'clock at night, and I had spent more than six hours of that day underwater. My body was saturated with nitrogen, and probably filled with tiny bubbles. I was exhausted. I freed my mind of the sobering realities of the situation just long enough to appreciate the amazing light show going on around me. The water was rich with bioluminescent planktonic organisms which would glowbright green when disturbed. Passing fish left glittering green trails of light behind them as they swam. I was momentarily bemused by the thousands of tiny sparkles of light I created in the wake of my arm as I swung it through the water. But my amazement didn't last long. When I had finally breathed the last few breaths of air out of the SCUBA cylinders, I came to the surface. Jack was still on the boat, and he asked me how I was feeling. It was difficult to assess my state in the weightlessness underwater, but back on the boat I could confirm that my condition had not improved. But it hadn't gotten any worse, either. I was informed that the recompression chamber was ready and waiting for me, and we unanimously agreed that I would be better-off in the controlled, dry, and warm environment of the chamber than I would be underwater. Besides, I was at the limits of exposure; my fingertips looked like white raisins, and my jaw and lips were fatigued from holding a regulator for such a long time.

Arriving at the dive shop, I did my best to hobble to my feet, but had to be virtually carried off the boat. On shore, and with a great deal of concentration, I was able to stand on my own and even walk the three or four yards to Francis' car. I plunked down on the back seat, and lifted my legs inside. Someone shut the door, and Francis drove off towards the hospital. During the short drive, I remembered what one of the American Peace-Corps students had told me: "If you ever find yourself sick while in Palau, the last place you want to go is the hospital. It's appalling!" Francis was driving, and I said "So I bet you think I'm pretty stupid, huh?" He only said "No, Richard, I don't think you're stupid. Just relax." I sat for a moment and said "I'm really sorry to keep you up so late at night." "Don't worry about it." he said, and we were quiet for the rest of the trip.

The Long Road to Recovery

At the hospital, Francis helped me out of the car, and semi-carried me through the entrance and down a long hallway. We cam the room with the recompression chamber. It was a yellow cylinder, about six feet long and two feet in diameter, with a number o pipes, valves, and miscellaneous other contraptions fastened to its sides. About a dozen SCUBA cylinders were lined up along one end, the first connected by a high-pressure hose to the chamber. I was placed on a stool and given a quick physical to evaluate my condition. After answering a few questions, they asked me to undress, wrapped me in a sheet, and asked me to try to walk over to the chamber. With a lot of concentration, I was able to walk, one uncoordinated and shaky step at a time, all the way over to the chamber. I climbed in and they closed the big round metal door. As they were pressurizing the chamber I looked out the small round window above my head and could see Francis reading the owner's manual. Although this seemed a bit disconcerting, I was really too tired to care. I remembered how Boota Taie, one of the divers from Christmas Island, was bent to about the same degree that I was, and he almost totally recovered after extensive treatment. I never allowed myself to believe that my prognosis was any different. The chamber was only capable of simulating a depth of 165 fsw, and it required the air from several SCUBA tanks to pressurize it that much. I don't remember the exact profile they treated me with, but it involved breathing pure oxygen through a mask for four twenty-minute bouts (with 5-minute air breaks) at a simulated depth of 60 fsw, and the full treatment lasted over six hours. I remember hearing voices outside: Jack was telling the doctors what had happened, and insisted that he should pay the bill. John Kraemer visited me and gave me a great deal ofmoral support. Other, unfamiliar voices discussed possible plans of action. I talked over the microphone system and recounted all of the dives I had done that day. After that, all I could do was lie and wait. About an hour into the treatment, my legs began to feel very tingly. At first I thought that in the cramped quarters in that steel coffin, the blood circulation to my legs had been constricted and my legs had fallen asleep. But I soon realized that the sensation was obviously bends-related. I didn't worry much about it, I decided that it must be due to fatigue. I was extremely tired. When the treatment finally ended at 3:15 in the morning, more than twenty hours after I had awakened the previous morning, I could barely keep my eyes open. I was so tired that I could think of nothing else besides sleep. I've never been more physically and emotionally exhausted in my life. I was too tired, even, to care that I was by that time unable to move my legs, and could only barely move my arms. I only wanted sleep. When I awoke at 10:30am, I was in a room full of other patients with a wide assortment of maladies from broken legs to burns to cancer. Otherwise, I was alone. I could just barely wiggle my feet slightly, and both arms were numb and uncoordinated. There was a clear demarcation in feeling across my chest just below my collar bone. My entire body below this demarcation felt the way my lower lip feels after my dentist fills a cavity - numb. I had lost all bladder control, and had been hooked up to a urinary catheter. It was difficult to breathe lying down because my diaphragm was non-functional. When my chest muscles expanded my lungs, there was nothing to prevent my other organs from filling the space, and I had a hard time fully ventilating my lungs. John Kraemer came in and sat by the bed. I told him how it all happened, and I wasn't quite sure whether or not he was really pissed-off at my irresponsibility. He told me that once word had spread of my accident, someone broke into my apartment and stole an airline ticket and $400.00 in cash, along with my brand-new speargun. (The nerve of some people!) John was dressed up because he was on his way to the government building to meet with the Foreign Investment Board regarding our permit to do business. I was supposed to attend that meeting, but I had to cancel - health reasons. Jack stopped by on the way to the airport and offered more moral support. He had to leave, but he would contact me after he returned to Hawaii. Francis also came by and asked me for a detailed description of how I felt. He told me they were preparing the chamber for another treatment, and I should be ready to go back in that afternoon. I told him I hadn't made any other plans, and that I probably wasn't going anywhere, seeing as I couldn't walk and all. The second chamber treatment lasted eight hours, and was generally uneventful. There was neither any improvement in my condition, nor did I get any worse. Francis told me they had made arrangements with a Coast Guard C-130 to take me up to Guam, where there was a more fully equipped and staffed recompression chamber. John came by again and told me the Foreign Investment Board had flatly refused our permit to do business. He said it had nothing to do with my accident, but rather was some sort of political thing. He was going to try again, but I was clearly out of the picture.

The next morning I was put aboard the Coast Guard plane and flown in a pressurized cabin over to Guam. The attendants were incredibly kind and helpful, and I never really had a chance to thank them. The flight was long and grueling - there were no windows near me. For my in-flight meal, I was fed intravenously. In Guam, I rode inside a military ambulance to the U.S. Navy Hyperbaric Facility. Iwas greeted by an assortment of very friendly military personnel, most of whom were officers. I was given a thorough examination, and tested carefully for various reflexes and sensory responses. It was there where I was first introduced to the "wheel of death", as I call it - a shiny stainless steel wheel of very very sharp needles, attached to a short metal handle. The idea behind this simple torture device is that a doctor could roll the needle wheel over a person's body to locate exactly where the demarcation between normal and impaired sensory perception was. The doctors determined that the line of sensory impairment was a few inches above my nipple-line. Below that line, the wheel of death felt like the wheel of a toy motorcycle. It was then when I really began to realize the extent of my injury. Sharp pain was entirely absent from most of my body, and an ice cube on my foot felt like a hot coal. But when the doctor tickled my toes with the tip of a feather, I could feel it just fine - as though there were nothing was wrong with me at all. I was even able to feel a tiny ant crawling across my big toe. After a great deal of poking, prodding, questioning, and swapping tasteless paraplegic jokes, I was again put inside a big steel chamber. This chamber was very different from the one in Palau: it was about 4 feet in diameter and twelve feet long, and had two beds and all sorts of instruments inside. I was accompanied this time by two attendants who took care of my every need (emptying catheter bags and whatnot) and continuously monitored my condition. This time I was initially pressurized to a simulated depth of 165 fsw, and brought to the surface again over an eight hour period. Afterwards, I was placed on a cot in the middle of the commanding officer's office floor. The doctor in charge was Dr. Cy Severns. Although he knew a great deal about treating DCS cases, he was not the resident expert. The real "bends Doc" of that facility was out of town, and the general consensus among the half dozen military officers who kept me entertained was that I should be flown to Hawaii. I watched as they made a long series of telephone calls to various places - including the Pentagon - to make arrangements to fly me out to Hawaii. After a while, they brought me a telephone and asked me if there was anyone I'd like to call. I decided that it might be a good time to break the news to my parents, and a few minutes later, I heard my mother's voice over the receiver. She already knew about the accident because the doctors in Palau had called. She had answered the phone when it rang, and she heard the voice say "Yes, hello, this is the Palau Hospital calling concerning Mr. Richard Pyle...is Dr. Robert Pyle there please?" My mom replied "This is Mrs. Pyle, I'm Richard's mother..." After a long pause, the doctor said "Uh, I think I'd better speak with his father..." With that, my mom solemnly gave the phone to my dad, went in the living room, and told my sister "That was the Palau Hospital...I think Richard's dead." For half an hour, she and my sister sat in silence, listening to my dad say "Uh huh...Uh huh...Yes, I understand..." Although my dad told her that I was alive, she was nonetheless exceptionally pleased to hear my voice over the phone when I talked to her from Guam. After a second chamber treatment in Guam, my condition was reassessed and we were all delighted to find that the numbness demarcation line on my chest had dropped to several inches below the nipple line. I was asked to sign a form saying that the military could, should they so desire, send me a bill for the flight (although they never did), and I was taken by ambulance to the military airfield and put aboard a humongous jet bound for Honolulu. If the two hour plane ride from Palau to Guam seemed bad, this ten hour excursion from Guam to Hawaii was going to be a living hell. It was. Again, no windows, no movie, and intravenous dinner. But seriously, those men and women of the 8th MASwere truly a fantastic bunch of people, and I am eternally grateful for their help and encouragement throughout the long and boring flight. After we finally arrived in Honolulu, I was loaded onto yet another ambulance and rushed to Kewalo Basin, where the Hyperbaric Treatment Facility is located. As they opened the ambulance door, I could see that the place was exactly as I remembered it from the times I had visited David Wilder. There was Dr. Overlock, the same doctor who treated David, looking me over as they brought me off the ambulance. "Hi" I said, "remember me?". "Yes" he said, "I sure do." He repeated many of the same tests that were given to me in Guam, and he finally asked me to try to sit up. I could barely lift my head, so he helped prop my torso upright. Within seconds, I began feeling very light headed and I started to faint. They carefully laid me back down and I regained consciousness. They took my blood pressure - it was 40 over 17 (no kidding). Apparently, because of the paralysis, all of my veins and arteries had completely dilated; so I was basically just a big sack of Jell- o. Thus began the long series of treatments at the Honolulu recompression facility. The first few treatments were 12 hours in duration, but most of the rest were standard eight hour "Hyperbaric Oxygen" ("HBO") treatments. These consisted of an initial "spike" to a simulated 220 fsw, a slow ascent to 60 fsw breathing a special enriched-air nitrox mixture, four 20-minute periods of breathing pure oxygen (with 5-minute "air breaks" in between) at 60 fsw, a long haul on pure oxygen at 30 fsw, then a very slow ascent to the surface. I was given one such treatment per day, then taken to a nearby hospital to spend the night. I had many visitors at the hospital. Besides my parents, Jack Randall came by several times to check on my progress. Many other friends visited as well. Between visits, I became involved with an assortment of television soap-operas - there really wasn't much else for me to do. I was subjected to a series of tests to determine the full extent of damage to my body. For one of them, numerous electrodes were attached to my scalp, and electrical probes were fastened to my toes and fingers. I was administered a rapid succession of fairly painful electrical shocks which were detected by the electrodes on my head. That test revealed that there was permanent damage on my spinal cord - scar tissue - which would have unknown permanent affects. Slowly, day by day, I began to recover. I wasn't able to stand on my own for a full week after the accident. I could barely walk on my own another week later. My legs were still very weak, and I still had no feeling of sharp pain or hot/cold below my waist. The treatments themselves were not exactly an exercise in comfort either. As you can well- imagine, breathing pure oxygen at three atmospheres absolute for extended periods is quite toxic, and can cause any number of a wide variety of side-effects. Fortunately, I never had any problems with CNS (acute) oxygen toxicity - I never convulsed. But after a week or so, I began feeling the effects of cumulative oxygen exposure and pulmonary or "whole-body" oxygen toxicity. My fingertips lost all feeling, and I would get terribly nauseous. Every day I entered that chamber, I would succumb to extreme abdominal discomfort, and I would inevitably vomit (you can imagine how the fine aroma of puke can quickly permeate the air inside a steel can). Also, each day I came out of the chamber, I was nearly deaf for several hours. I never understood why breathing high partial pressures of oxygen could lead to deafness -I suppose it's possible that Dr. Overlock tried to explain it to me, but I probably couldn't hear him. Day by day, I continued on. Despite the physical troubles I was having from theoxygen, I was eager to go into that chamber each day; because each time I came out, I could detect a small improvement in my condition. Also, breathing hyperbaric oxygen has some other good side-effects too. During several of my treatments, I was joined by another patient, a woman who had taught SCUBA for many years, who was suffering from severe osteoporosis. Before she began the HBO treatments, she had been confined to a wheelchair because of her problem. But after a few months of one treatment per week breathing hyperbaric oxygen, her condition improved dramatically - she could walk with only a moderate limp. Also, a nasty gash on my leg I had received in Palau refused to heal for weeks. But within days of starting the HBO treatments, the wound healed right up. There were two notable incidents during this long series of treatments in the chamber. The routine of each treatment began with a fairly rapid pressurization of the chamber to a simulated depth of 220 fsw. Just like filling a SCUBA tank quickly, the chamber would get warm on pressurization, so as soon as we reached maximum depth, the outside tenders would ventilate the air inside to cool it down. These ventilations were incredibly loud inside the chamber. After a minute of ventilation, the inside tender would give me the mask which delivered the EAN mixture, and I would put it on and breathe from it throughout the rest of the treatment. After many such treatments, the process became routine. On one occasion, just after initial pressurization, I habitually reached up and grabbed the mask and put it on. The tender, who was a medical technician rather than a seasoned diver, was understandably influenced by the nitrogen narcosis, and had no qualms about me putting the mask on - he even assisted by handing it to me. For a full minute, throughout the ventilation process, I breathed from that mask without problem. It tasted fine, I felt fine, everything was okay. When the roaring sound of the ventilation stopped, a voice from the outside tender came over the speaker: "Uh, did you verify the hook-up on that mask?" The insider tender, a bit bewildered and somewhat under the influence of nitrogen narcosis, said "What...what do you mean?" The voice on the speaker came back "Did you check to make sure the mask was hooked up to the right gas supply?" The tender looked around, and all of a sudden realized that he hadn't checked, and that I was breathing pure oxygen at a simulated depth of 220 fsw! That's an oxygen partial pressure of about 7.7! Needless to say, the problem was immediately corrected, there was a lot of yelling going on outside the chamber, and I never even noticed the difference. After that, we always waited until the ventilation process was complete before I breathed from the mask, and we always verified which mixture it was connected to. Another time, again just after initial pressurization, the tender waited for the completion of ventilation, verified that the mask was connected to the correct breathing mixture, then handed the mask to me. I took hold of the mask and brought it towards my face. When it was about half an inch away, I was horified as the mask suddenly grabbed my face like some terrible monster and instantly sucked all the air out of my lungs! The mask clung to my face with incredible strength. Its hose was accidentally connected to outside ambient pressure, and the simulated 220 fsw pressure inside the chamber was trying to force my lungs out my throat!! I frantically pulled and tugged at the mask trying to tear it off my face, but it wouldn't budge. It gripped my face with a vengence. The tender quickly understood what was going on and helped me try to struggle it free. I finally grasped the edge of the mask where it formed a seal with my face, and ripped the thing off (aided by the strength of adrenalin). There was no physical harm done - after a few moments I was able to catch my breath. Again, a lot of yelling was going on outside, and the problem wasquickly corrected. After that, I was very careful whenever I put that mask on! Through intensive physical therapy, my legs increased in strength. I regained control of my bladder, eliminating the need for a catheter. I began walking up and down stairs for additional exercise. I had many long discussions with Dr. Overlock regarding the theory and practice of recompression treatment, and long discussions about the physiology of bends as well. He explained to me that my injury was analogous to a shotgun wound to my spinal cord, and he made certain that I understood that many of my nerve cells had died forever. He explained that my recovery was not a result of new nerve growth, but rather a result of my brain learning new nerve pathways to send signals to the rest of my body. He explained how I was now much more susceptible to DCS, that a subsequent hit would very likely occur in my central nervous system, and that I had used up just about all of the "extra" nerve pathways in my spinal cord. He made it clear, in no uncertain terms, that if I continued to dive I would be much more likely to get bent, and that full recovery from such a hit would be much less likely. Basically, he did his best to convince me to give up diving for good. After 28 treatments, I could walk on my own (very slowly, and with a substantial limp), although I still had no sharp pain or hot/cold feeling in my legs. The increments of improvement in my condition with each passing day had diminished to the point where I really couldn't detect them. So finally, more than a month after the accident, the decision was made to stop the chamber treatments. I was afraid that my condition would remain that way forever. True, I could walk, and I was certainly in better condition than I had been a month earlier, but I couldn't run, I couldn't jump, and my body was still suffering from some serious impairment. But Dr. Overlock assured me that the chamber treatments were yielding diminishing returns, and that only time would heal my wounds. He said the healing would continue for a couple of years, but he could not tell me how much my condition would improve. As the months passed, my ability to walk continued to very slowly improve. With practice, I was able to conceal my limp and appear to walk normally, but it took a great deal of effort. Climbing stairs was not much of a problem, but coming down them was difficult. Even stepping off a curb required a great deal of concentration. I was able to contract the muscles in my leg fairly smoothly, but I was unable to relax them at a controlled rate. Also, my legs would occasionally convulse spastically and uncontrollably. The feeling in my legs did not improve as quickly - I still could not feel any sharp pain, or distinguish hot from cold in my legs. In order for my father's insurance to pay for the bills, I had to be enrolled as a full- time student. So, in spite of my handicap, I returned to the University of Hawaii the next semester and did my best to hobble around campus from class to class. I did not dive again at all for nearly a full year. I understood Dr. Overlock's concerns about my diving again, but I knew in my heart that I could never give up diving. In fact, I knew that I could never give up deep diving. Otherwise, life slowly returned to normal. I had lost a lot of weight during the accident, and I slowly began to put it back on. I continued with an assortment of leg exercises, and my condition very slowly improved. I limited my first post-bends dive, nearly a year after the accident, to a maximum depth of 25 feet. As the months passed, I slowly increased that to 60 feet, then 130 feet; always following an extremely conservative decompression profile. On my first post-bends dive to 180 feet, I was very nervous. After a ten-minute bottom time, I decompressed for well over an hour. One of the effects of my impaired legs was that after long exposures towater, they would feel weak and numb. It was terrifying every time I surfaced from a deep dive with long decompression because my legs would feel almost exactly the same as they had felt in Palau, right after the accident. On the decompression line, I would continually monitor the coordination of my fingers by touching each fingertip to my thumb in rapid succession. Every time we returned to the harbor after a dive, I would trot around the parking lot to determine if my legs were fully functional.

Two years after the accident, I was able to walk almost totally normally, and I could even jog reasonably well. The feeling in my legs had improved, but was far from normal. By December of 1987, a year and a half after the accident, I had logged nearly 200 post- bends dives, more than half below 200 feet. In all of these, I never experienced any CNS DCS symptoms. Also in December of 1987, on Christmas day at, of all places, Christmas Island, I made my first post-bends dive to 300+ fsw on air. Decompression was scary, because an effect of extreme nitrogen narcosis for me was numbness in my legs. The numbness didn't wear off for almost an hour after the dive, and I didn't leave the water for almost two hours. But I was fine. It's now been 6 years since the accident. I've made well over fifteen hundred post- bends dives, more than two thirds of which were in excess of 180 fsw. I've also made dozens of air dives beyond 300 fsw, and I've begun using mix to penetrate depths of more than 400 fsw. In all of this deep diving, I have not experienced any further DCS symptoms. And so it continues.

Retrospective