Survivor miracles: nail in the head, shark attack, lightning strike--impossible to survive? Read three tales that defy all odds. (Life Science/Biology).

NAILED!

A PATIENT WALKED CALMLY INTO THE EMERGENCY ROOM AT BEN TAUB GENERAL Hospital in Houston, Texas No bleeding or screaming--but something was very wrong. The man's lower left eyelid was pinned open by a nail--its spike jammed 7.6 cm (3 in.) deep in his head.

The carpenter had been at a building site when a co-worker on the floor above shot a nail gun at a board. The nail split the wood and flew one floor below, straight into the carpenter's eye socket--just missing five vital areas. "An eighth of an inch in any direction would have killed him," says Dr. Anne Hayman, the Baylor College of Medicine radiology professor who X-rayed the man last year. Believe it or not, Hayman says, "the nail entered the man's eye socket with surgical precision" (see diagram, right). It followed the exact path surgeons take to reach tumors at the base of the brain, penetrating alongside his left eyeball just below the tear duct and stopping at the skull base, millimeters from the brain stem. Surgeons removed the nail, and the carpenter walked out of the hospital unscathed. "We call him the luckiest man in the world," Hayman says.

1 EYE

The nail struck between the eyeball and its bony socket, bypassing two muscles--inferior rectus and inferior oblique--which move the eyeball up and down. It also missed the optic nerve, which carries visual signals to the brain.

2 CRANIAL NERVES

Next, the nail almost grazed the oculomotor, trochlear, and abducens nerves, which control eye muscles, eyelids, and pupil dilation. In all, 12 pairs of Cranial nerves sprout from the brain.

3 CAROTID ARTERY

The nail missed one of two carotid arteries, a pair of blood vessels that carry 1 liter (2 pints) of oxygen-rich blood from the heart deep into the head every minute. Had it struck one, the man would have bled to death.

4 PITUITARY GLAND

The nail just bypassed the pituitary gland, which controls the body's entire endocrine (internal secretion) system. Endocrine glands secrete hormones. chemicals vital for many body functions.

5 BRAIN STEM

The nail nearly lodged in the brain stem which controls vital functions like breathing and heartbeat, Had the nail struck the brain stem, death would have been instant.

SHARK!

THE SHARK ATTACKED AT DUSK, AS 8-YEAR-OLD JESSIE ARBOGAST SPLASHED IN KNEE-DEEP SURF ALONG FLORIDA'S Gulf Coast. Suddenly he screamed: "He's got me! Get him off!"

In a flash, Jessie's uncle Vance Flosenzier wrestled the boy's mangled body from the jaws of a 91-kilogram (200-pound) bull shark. But Jessie's right thigh was already shredded--his right arm gone. Nearly all blood was drained from his body, usually a sign of imminent death. When paramedics from Baptist Hospital in Pensacola scooped Jessie off the beach, one asked, "Where's his arm?" All eyes turned to the shark, still thrashing on the beach. A park ranger shot it and pried open its jaws, while a lifeguard drew out Jessie's arm. They packed the arm in ice and rushed it to Baptist Hospital.

An emergency room nurse inserted an IV (hollow needle) into Jessie to deliver type O-negative blood, the universal donor. At this point he'd lived without blood for 30 minutes; less than 1 percent of victims survive when major blood loss starves organs and tissues of the oxygen-rich blood they need to function. How much blood can a person lose and live? "Typically not as much as Jessie lost," says Dr. Ian Rogers, a surgeon who helped save Jessie. "You can lose half your blood and still make it." But Jessie hung on due to multiple blood transfusions--in all nearly 6 liters, twice the normal amount in the body of a 36-kg (80-lb) boy.

Even more amazing: The teeth that nearly killed Jessie enabled doctors to smoothly reattach his arm. "I've seen shark bites before, and I've never seen a nice clean amputation like that," says Rogers. While Dr. Jack Tyson repaired Jessie's right thigh, where the shark had chewed off two hamstrings (muscles that bend the knee) from the rear thigh and three quadriceps (muscles that extend the knee) from the front, Rogers began to reattach Jessie's arm (see diagram, right). Examining the arm and stump, he marked the corresponding muscles, blood vessels, and nerves in each. Orthopedic (bone) surgeon Dr. Juliet DeCampos trimmed the humerus (upper arm bone) by an inch to screw in steel plates to brace the limb. Then Rogers sutured (sewed) the biceps muscle, which flexes the arm; the triceps, which extends it; and the brachialis, which allows the arm to twist.

With hair-fine nylon thread, Rogers repaired three major nerves--radial, ulnar, and median--with 10 stitches each. "I repair nerves before blood vessels," Rogers says. "You can see nerves better if blood's not flowing in them." He then repaired the cephalic and brachial veins with 12 tiny sutures each. To fix the brachial artery, he transplanted a piece of vein from Jessie's thigh.

Afterward, the surgeons anxiously waited for blood to flow in the arm. "Finally," Rogers says, "the arm pinked up, the vessels pulsed." The bite wounds started to bleed. Closing the cuts required 200 stitches and three more hours.

After a month-long hospital stay, Jessie returned home to continue his recovery. "Probably in 12 to 18 months we'll know how well his arm functions," says Rogers. Already Jessie can twist his forearm and bend his elbow--hints that his recovery could be as miraculous as his survival.

STRUCK!

ONE CLOUDY AUGUST AFTERNOON, SABRINA X (NAME WITHHELD BY REQUEST) HIKED WITH HER PARENTS AT THE GRAND Canyon. "It was raining lightly on and off," recalls the 13-year-old. "Then clouds rolled in and it started raining really hard."

As lightning struck all around, they took shelter in a small side canyon until the rain and thunder stopped and they saw patches of sunlight. What they didn't know at the time: lightning can strike miles from a storm, seemingly out of the clear blue sky. As they headed up the trail toward their car, lightning struck suddenly nearby. Electricity surged through their bodies. "I felt a shock," Sabrina says. "Then I was really tingly, like when your foot's asleep, but a hundred times stronger."

A lightning bolt has enough power to illuminate a 100-watt light bulb for three months! The energy could have blown them off their feet--or worse. Lightning is the second-largest storm-related killer in the U.S., after floods. Cardiac arrest, in which the heart stops beating, is the major cause of lightning-related death. But lightning isn't good at killing people; in fact, 90 percent of the 500 or so people struck each year in the U.S. survive.

"Skin is a good insulator," says Dr. Mary Ann Cooper, an emergency-medicine specialist at the University of Illinois. So instead of frying people to crisps, lightning zips over skin faster than you can blink, a process called external flashover. "I think that lightning just isn't around long enough to cause significant burns in most cases."

Still, lightning can inflict devastating injuries (see chart, right). "People are walking bags of saltwater, which conducts electricity well," says Cooper. Electricity from lightning can shoot through a person, causing a full-body muscle spasm that flings the body through the air. Human nerves are bundles of fibers that naturally transmit electrical impulses from the brain or spinal cord to the body, or from the body to the brain. And because nerve cells are surrounded by and filled with ions (electrically charged particles), a jolt of lightning can overload the nervous system, paralyzing nerves and muscles needed for breathing and heartbeat. To be safe, says Sabrina, "if you hear thunder, find cover--and stay put!"

Cross-Curricular Connection

Math: You can calculate the distance from you to a lightning flash with this ratio: 5 seconds: 1 mile. When you see lightning, count the seconds until you hear thunder. Divide the number of seconds by five to calculate the distance in miles from you to the lightning. To find the distance in kilometers, divide the number of seconds by three.

Did You Know?

* Keeping a severed limb cold--but not frozen--lets doctors reattach the limb for up to 12 hours after an injury has occurred (up to 24 hours in the case of a finger or toe).

* Injuries claim more children's lives in the U.S. than all diseases combined, according to the Children's Safety Network. The top five causes of injury: pedestrian accidents, drowning, bike accidents, falls, and burns.

* Generally, if you can hear thunder, you're in danger of being struck by lightning. If the sound of thunder follows a lightning flash in 30 seconds or less, you should promptly seek shelter in a sturdy building or hard-top vehicle.

[CHART OMITTED]

Survivor Miracles

Directions: Answer the following questions in complete sentences.

1. The carpenter, accidentally punctured in the head, survived because the spiking nail missed five vital areas. Cite at least three areas and their functions.

2. Jessie Arbogast had severe blood loss from a shark bite. Why were his chances' of survival so low? What saved him?

3. How did doctors reattach Jessie's arm? Incorporate the definition of the following vocabulary words into your answer: humerus, biceps, and triceps.

4. Even though rain and thunder had stopped and the sky was partly clear, why was Sabrina X's family struck by lightning?

ANSWERS

Survivor Miracles

Answers will vary but should include the following points and definitions.

1. The nail entered between the eye and its bony socket. It bypassed the inferior rectus and inferior oblique, muscles that move the eyeball up and down. Also missed: the optic nerve, which transfers visual signals to the brain. The nail missed the following cranial nerves: oculomotor, trochlear, and.abducens nerves. They control eye muscles, eyelids, and pupil dilation. The pituitary gland controls the body's endocrine system. The brain stem controls vital functions like breathing and heartbeat. The nail missed one of two carotid arteries, blood vessels that carry a liter of oxygenrich blood from the heart to the head per minute.

2. Jessie lived without blood for 30 minutes. Less than 1 percent of victims survive when major blood loss starves organs and tissues of the oxygen-rich blood needed to function. Jessie survived through multiple transfusions of type O-negative blood, the universal donor.

3. To attach the arm, first, the humerus, or upper arm bone, was trimmed by an inch to screw in steel plates to brace the limb. Then arm muscles including biceps, which flex the arm, and triceps, which extend it, were sutured. The nerves were repaired next, then blood vessels.

4. Lightning can strike even miles from a storm.

National Science Education Standards

Grades 5-8: structure and function in living systems * personal health * natural hazards * transfer of energy

Grades 9-12: the cell * natural and human-induced hazards * personal and community health * matter, energy, and organization in living systems * interactions of energy and matter

Resources

Visit Sabrina's Lightning Safety for Kids Web site: www.azstarnet.com/~anubis/sabintro.htm

"Jessie's Arm" by Stefano Coledan, Popular Mechanics, November 2001

Descartes' Error: Emotion, Reason, and the Human Brain by Antonio R. Damasio, M.D., Grosset/Putnam, 1994; HarperCollins, 1995

EFFECTS OF LIGHTNING
ON THE BODY

BODY      EFFECTS
PART

BRAIN     Lightning damages the
          cerebral cortex (the
          brain's folded, grooved,
          outer layer), centers that
          control breathing,
          heartbeat, and other vital
          functions.

EYES,     Lightning zips into the
EARS,     body through these
NOSE,     openings; they're wet
MOUTH     and conduct electricity.
          The heat and bright flash
          can cloud vision, rupture
          eardrums.

HEART     Lightning may paralyze
          the heart muscle and
          interfere with brain
          centers that regulate
          heartbeat.

SKIN      Lightning follows sweat
          on skin, leaving fernlike
          burn marks in its path.
          Cuts and bruises result
          when lightning throws
          the body into the air.

NERVES,   Electrical surge causes
MUSCLES   all the nerves to fire and
          all muscles to contract at
          once. The result: major
          system overload.

BONES     The explosive force can
          actually break bones.