Don't breathe the water.

 It was just before noon.  My brothers had just come back from driving little water scooters around on the ocean, one brother trading places with our close friend on the lounge chair in our beach shelter tent.  Three of us went to the shoreline and began swimming for the edge of the swimming area, a floating rope out in the ocean about 50 yards from shore.

This is nothing out of the ordinary, it's a swim we do every time we go to this beach island.  Surrounded by hundreds of other tourists playing around in the water, the 100 yard swim isn't a race, it's just a fun little thing we do.

Today the sea was a little more rambunctious than usual.  Nothing serious.  No whitecaps or actual waves, just bumpy water with swells maybe a foot tall.  The waves came all the way up the beach to the first row of loungers.  Partly cloudy and warm, it was a good day for a swim.

So swim we did.  My brother and friend were perhaps 15 yards in front of me as I took an extra moment to take a picture of the surf with my phone and remove my glasses.  I joined them in the water and began to swim for the rope.

Just as I crossed the point where the water was too deep to touch bottom comfortably, I got slapped in the face with a swell while on an inhale stroke.  I stopped, flailing about coughing and sputtering in confusion before spitting out the foul tasting sea water and regaining my composure.  All seemed okay, though slightly less comfortable now that nature had thrown me a flag.  Things seemed fine though so I continued with my swim, fixed on the rope ahead.  "Keep moving" became my mantra.  It's not far, I'm almost there.

When I reached the rope, I was moving a lot slower than I would normally swim, and panting badly.  I grappled with the float and pushed it under in an attempt to get my chest above water -- surely just a little less pressure on my chest would help me breathe?  It didn't seem to help much.  My brother, already waiting at the rope, detected something was wrong and asked me if I was OK.  I shook my head violently, something was not right, I couldn't breathe, and I didn't quite know what to do about it.  I considered briefly my options.  Water's too deep, can't cling to my friend or my brother for fear of becoming an anchor.  I couldn't hold for long at the float, it wasn't doing much good holding me above water, and my breathing situation was getting worse by the second.  My brother's suggestion mirrored my own thoughts:  Roll over and backstroke back.  I wasted no time in compliance.  Struggling for air meant struggling to stay afloat, and I received plenty more slaps in the face from the rambunctiously playful waves.  I began to realize I might not be able to make it back to where I could touch.  I prayed.  Not so much a well structured neatly formatted prayer in the format given in the Lord's prayer, a more visceral direct-to-God plea.  I'm ready to die, but I'm not done with this life, please help.

I touched sand with my feet.  This gave me a much needed morale boost.  It would be wrong to call it a second wind at this point:  I had no more wind.  "Keep moving" was my mantra.  Pushing along, feeling the pull of gravity return to my legs, I realized I had barely the strength to stay upright with the water holding me afloat.  The surf's pull back out to the ocean was powerful, and I struggled against the waves which would normally be little more than an annoyance, now a force which easily pulled me back two steps with every wave.  One step at a time I managed to float-walk my way up onto the beach where I found myself on my knees in the surf.  At this point I realized forward progress required me to stand up.

I am told I did stand, and then fell over in a relatively uncontrolled crash.  I found myself laying face-up in the surf.  My first thought was this might be OK, after all you see people in this position in the movies all the time.  My second thought was to realize this was a bad plan because the next wave would probably cover my face in a fresh layer of salt water.  I needed to move, so I rolled on my side in an attempt to crawl just a little farther.

The life guard was standing in front of me.  He had seen me struggling, and apparently had been trying to get my attention for some time.  My brother was not far behind.  Our mutual friend is sight- and mobility-impaired and needed navigational help.  Once he was within his sight of the shore, my brother broke off to catch up with me and the lifeguard.  One arm over my brother and the other over the life guard I was taken to the nearest beach lounger.  The life guard was already on the radio for O2 and medical transport.  My brother asked me if I'd hurt my knee, to which I responded "No.  Can't.  Breathe."

At this point my memory is fuzzy.  I recall spitting out what appeared to me as some very red substance, I recall the life guard kindly requesting I do so on a provided towel instead of the beach.  The 4 wheel beach buggy arrived very soon after.  I was loaded into the front seat, my brother in the back, along with an O2 tank and I guess a medic who had come along?  My ability to think had quickly gone to a very limited capacity.  Breathing, staying upright, and following the simplest of instructions was about all I had left.

My brother tells me the lifeguard who helped pick me up beat us to the infirmary hut, which is impressive because the buggy was going as fast as possible, smoothly going around inattentive tourists and uninformed island staff.  I have no visual memory of the infirmary hut on the island.  I was moved from the buggy to a wheel chair, the O2 mask was adjusted to my face and someone was present to keep me from removing it (because despite all my own previous studying telling me the O2 mask is my friend, in practice it *feels* restrictive -- an awkward combination when you're operating on instinct).  I'm told the doctor in the infirmary hut actually saved my life, that I had just a couple minutes to live at that point.

The emergency being far from over, I was wheeled onto the already-loading tender and pushed to the top deck next to the gangplank gate.  The tender pilot took the smoothest route we've ever experienced and pulled right up to the ship's side without so much as a bump.  The crew sprang to action, and as soon as the gangway was safe, my nurses were full sprint into the ship, ignoring the waiting gurney the ship's crew had waiting, and brought me directly to the infirmary, where they put a CPAP on me and turned it on full blast.  I recall hearing them say something about intubation, but after a short struggle with some kind of high pressure air system the CPAP is what settled onto my face, and began to force my lungs back open.

From there, I got better.  Little by little.  The US port authorities were contacted, an ambulance pickup was arranged, my luggage was organized and packed, my brother called the airline and had my flight arrangements changed.  That evening I was changed from a full CPAP facemask to a simple nasal cannula spraying pure O2 up my nose.  The next morning one of my brothers and I left the ship, where I was transferred to a local ER.  I spent the night in the hospital.  4 chest x-rays, a CT scan, and a whole lot of antibiotics later, the doctors deemed me healthy enough to fly home... with a bottle of antibiotics and an emergency inhaler that my insurance mysteriously rejected coverage for.  I paid out of pocket rather than risk needing it and not having it.

So... that was the last "day" of my birthday cruise.  What exactly happened I can only conjecture.  A soft blap in the face with salt water turned into what the doctors and WHO term a "nonfatal drowning".  Apparently salt water is a better surfactant than the one in your lungs already, and the salt in the salt water pops your alveoli... which may or may not grow back.  My lungs got just enough to go into full defensive mode, shutting off my airways and leaving me without enough O2 to function.  The medical staff, lifeguards, and crew of the Holland America Line MS Eurodam quite literally saved my life.

For them I thank God, and am exceedingly grateful.  I could not have made it without them.