hn-classics/_stories/1997/4977935.md

---
created_at: '2012-12-28T15:06:52.000Z'
title: The Cold Hard Facts of Freezing to Death (1997)
url: http://www.outsideonline.com/outdoor-adventure/As-Freezing-Persons-Recollect-the-Snow--First-Chill--Then-Stupor--Then-the-Letting-Go.html?page=all
author: BlackJack
points: 431
story_text: ''
comment_text: 
num_comments: 184
story_id: 
story_title: 
story_url: 
parent_id: 
created_at_i: 1356707212
_tags:
- story
- author_BlackJack
- story_4977935
objectID: '4977935'
year: 1997

---
When your Jeep spins lazily off the mountain road and slams backward
into a snowbank, you don’t worry immediately about the cold. Your first
thought is that you’ve just dented your bumper. Your second is that
you’ve failed to bring a shovel. Your third is that you’ll be late for
dinner. Friends are expecting you at their cabin around eight for a
moonlight ski, a late dinner, a sauna. Nothing can keep you from
that.

![Headphones](/sites/all/themes/outside/images/icons/headphones.svg)**Listen
to the Frozen Alive Podcast to Go Behind the Story with the Author**

Driving out of town, defroster roaring, you barely noted the bank
thermometer on the town square: minus 27 degrees at 6:36. The radio
weather report warned of a deep mass of arctic air settling over the
region. The man who took your money at the Conoco station shook his head
at the register and said he wouldn’t be going anywhere tonight if he
were you. You smiled. A little chill never hurt anybody with enough
fleece and a good four-wheel-drive.

But now you’re stuck. Jamming the gearshift into low, you try to muscle
out of the drift. The tires whine on ice-slicked snow as headlights
dance on the curtain of frosted firs across the road. Shoving the lever
back into park, you shoulder open the door and step from your heated
capsule. Cold slaps your naked face, squeezes tears from your
eyes.

![Headphones](/sites/all/themes/outside/images/icons/headphones.svg)**Listen
to the Frozen Alive Podcast to Go Behind the Story with the Author**

You check your watch: 7:18. You consult your map: A thin, switchbacking
line snakes up the mountain to the penciled square that marks the cabin.

Breath rolls from you in short frosted puffs. The Jeep lies cocked
sideways in the snowbank like an empty turtle shell. You think of
firelight and saunas and warm food and wine. You look again at the map.
It’s maybe five or six miles more to that penciled square. You run that
far every day before breakfast. You’ll just put on your skis. No
problem.

There is no precise core temperature at which the human body perishes
from cold. At Dachau’s cold-water immersion baths, Nazi doctors
calculated death to arrive at around 77 degrees Fahrenheit. The lowest
recorded core temperature in a surviving adult is 60.8 degrees. For a
child it’s lower: In 1994, a two-year-old girl in Saskatchewan wandered
out of her house into a minus-40 night. She was found near her doorstep
the next morning, limbs frozen solid, her core temperature 57 degrees.
She lived.

Others are less fortunate, even in much milder conditions. One of
Europe’s worst weather disasters occurred during a 1964 competitive
walk on a windy, rainy English moor; three of the racers died from
hypothermia, though temperatures never fell below freezing and ranged as
high as 45.

But for all scientists and statisticians now know of freezing and its
physiology, no one can yet predict exactly how quickly and in whom
hypothermia will strike—and whether it will kill when it does. The cold
remains a mystery, more prone to fell men than women, more lethal to the
thin and well muscled than to those with avoirdupois, and least
forgiving to the arrogant and the unaware.

The process begins even before you leave the car, when you remove your
gloves to squeeze a loose bail back into one of your ski bindings. The
freezing metal bites your flesh. Your skin temperature drops.

Within a few seconds, the palms of your hands are a chilly, painful 60
degrees. Instinctively, the web of surface capillaries on your hands
constrict, sending blood coursing away from your skin and deeper into
your torso. Your body is allowing your fingers to chill in order to keep
its vital organs warm.

You replace your gloves, noticing only that your fingers have numbed
slightly. Then you kick boots into bindings and start up the road.

Were you a Norwegian fisherman or Inuit hunter, both of whom frequently
work gloveless in the cold, your chilled hands would open their surface
capillaries periodically to allow surges of warm blood to pass into them
and maintain their flexibility. This phenomenon, known as the hunter’s
response, can elevate a 35-degree skin temperature to 50 degrees within
seven or eight minutes.

Other human adaptations to the cold are more mysterious. Tibetan
Buddhist monks can raise the skin temperature of their hands and feet by
15 degrees through meditation. Australian aborigines, who once slept on
the ground, unclothed, on near-freezing nights, would slip into a light
hypothermic state, suppressing shivering until the rising sun rewarmed
them.

You have no such defenses, having spent your days at a keyboard in a
climate-controlled office. Only after about ten minutes of hard
climbing, as your body temperature rises, does blood start seeping back
into your fingers. Sweat trickles down your sternum and spine.

By now you’ve left the road and decided to shortcut up the forested
mountainside to the road’s next switchback. Treading slowly through
deep, soft snow as the full moon hefts over a spiny ridgetop, throwing
silvery bands of moonlight and shadow, you think your friends were
right: It’s a beautiful night for skiing—though you admit, feeling the
minus-30 air bite at your face, it’s also cold.

After an hour, there’s still no sign of the switchback, and you’ve begun
to worry. You pause to check the map. At this moment, your core
temperature reaches its high: 100.8. Climbing in deep snow, you’ve
generated nearly ten times as much body heat as you do when you are
resting.

As you step around to orient map to forest, you hear a metallic pop. You
look down. The loose bail has disappeared from your binding. You lift
your foot and your ski falls from your boot.

You twist on your flashlight, and its cold-weakened batteries throw a
yellowish circle in the snow. It’s right around here somewhere, you
think, as you sift the snow through gloved fingers. Focused so intently
on finding the bail, you hardly notice the frigid air pressing against
your tired body and sweat-soaked clothes.

The exertion that warmed you on the way uphill now works against you:
Your exercise-dilated capillaries carry the excess heat of your core to
your skin, and your wet clothing dispels it rapidly into the night. The
lack of insulating fat over your muscles allows the cold to creep that
much closer to your warm blood.

Your temperature begins to plummet. Within 17 minutes it reaches the
normal 98.6. Then it slips below.

At 97 degrees, hunched over in your slow search, the muscles along your
neck and shoulders tighten in what’s known as pre-shivering muscle tone.
Sensors have signaled the temperature control center in your
hypothalamus, which in turn has ordered the constriction of the entire
web of surface capillaries. Your hands and feet begin to ache with cold.
Ignoring the pain, you dig carefully through the snow; another ten
minutes pass. Without the bail you know you’re in deep trouble.

Finally, nearly 45 minutes later, you find the bail. You even manage to
pop it back into its socket and clamp your boot into the binding. But
the clammy chill that started around your skin has now wrapped deep into
your body’s core.

At 95, you’ve entered the zone of mild hypothermia. You’re now trembling
violently as your body attains its maximum shivering response, an
involuntary condition in which your muscles contract rapidly to generate
additional body heat.

It was a mistake, you realize, to come out on a night this cold. You
should turn back. Fishing into the front pocket of your shell parka, you
fumble out the map. You consulted it to get here; it should be able to
guide you back to the warm car. It doesn’t occur to you in your
increasingly clouded and panicky mental state that you could simply
follow your tracks down the way you came.

And after this long stop, the skiing itself has become more difficult.
By the time you push off downhill, your muscles have cooled and
tightened so dramatically that they no longer contract easily, and once
contracted, they won’t relax. You’re locked into an ungainly,
spread-armed, weak-kneed snowplow.

Still, you manage to maneuver between stands of fir, swishing down
through silvery light and pools of shadow. You’re too cold to think of
the beautiful night or of the friends you had meant to see. You think
only of the warm Jeep that waits for you somewhere at the bottom of the
hill. Its gleaming shell is centered in your mind’s eye as you come over
the crest of a small knoll. You hear the sudden whistle of wind in your
ears as you gain speed. Then, before your mind can quite process what
the sight means, you notice a lump in the snow ahead.

Recognizing, slowly, the danger that you are in, you try to jam your
skis to a stop. But in your panic, your balance and judgment are poor.
Moments later, your ski tips plow into the buried log and you sail
headfirst through the air and bellyflop into the snow.

You lie still. There’s a dead silence in the forest, broken by the
pumping of blood in your ears. Your ankle is throbbing with pain and
you’ve hit your head. You’ve also lost your hat and a glove. Scratchy
snow is packed down your shirt. Meltwater trickles down your neck and
spine, joined soon by a thin line of blood from a small cut on your
head.

This situation, you realize with an immediate sense of panic, is
serious. Scrambling to rise, you collapse in pain, your ankle crumpling
beneath you.

As you sink back into the snow, shaken, your heat begins to drain away
at an alarming rate, your head alone accounting for 50 percent of the
loss. The pain of the cold soon pierces your ears so sharply that you
root about in the snow until you find your hat and mash it back onto
your head.

But even that little activity has been exhausting. You know you should
find your glove as well, and yet you’re becoming too weary to feel any
urgency. You decide to have a short rest before going on.

An hour passes. at one point, a stray thought says you should start
being scared, but fear is a concept that floats somewhere beyond your
immediate reach, like that numb hand lying naked in the snow. You’ve
slid into the temperature range at which cold renders the enzymes in
your brain less efficient. With every one-degree drop in body
temperature below 95, your cerebral metabolic rate falls off by 3 to 5
percent. When your core temperature reaches 93, amnesia nibbles at your
consciousness. You check your watch: 12:58. Maybe someone will come
looking for you soon. Moments later, you check again. You can’t keep the
numbers in your head. You’ll remember little of what happens next.

Your head drops back. The snow crunches softly in your ear. In the
minus-35-degree air, your core temperature falls about one degree every
30 to 40 minutes, your body heat leaching out into the soft, enveloping
snow. Apathy at 91 degrees. Stupor at 90.

You’ve now crossed the boundary into profound hypothermia. By the time
your core temperature has fallen to 88 degrees, your body has abandoned
the urge to warm itself by shivering. Your blood is thickening like
crankcase oil in a cold engine. Your oxygen consumption, a measure of
your metabolic rate, has fallen by more than a quarter. Your kidneys,
however, work overtime to process the fluid overload that occurred when
the blood vessels in your extremities constricted and squeezed fluids
toward your center. You feel a powerful urge to urinate, the only thing
you feel at all.

By 87 degrees you’ve lost the ability to recognize a familiar face,
should one suddenly appear from the woods.

At 86 degrees, your heart, its electrical impulses hampered by chilled
nerve tissues, becomes arrhythmic. It now pumps less than two-thirds the
normal amount of blood. The lack of oxygen and the slowing metabolism of
your brain, meanwhile, begin to trigger visual and auditory
hallucinations.

You hear jingle bells. Lifting your face from your snow pillow, you
realize with a surge of gladness that they’re not sleigh bells; they’re
welcoming bells hanging from the door of your friends’ cabin. You knew
it had to be close by. The jingling is the sound of the cabin door
opening, just through the fir trees.

Attempting to stand, you collapse in a tangle of skis and poles. That’s
OK. You can crawl. It’s so close.

Hours later, or maybe it’s minutes, you realize the cabin still sits
beyond the grove of trees. You’ve crawled only a few feet. The light on
your wristwatch pulses in the darkness: 5:20. Exhausted, you decide to
rest your head for a moment.

When you lift it again, you’re inside, lying on the floor before the
woodstove. The fire throws off a red glow. First it’s warm; then it’s
hot; then it’s searing your flesh. Your clothing has caught fire.

At 85 degrees, those freezing to death, in a strange, anguished
paroxysm, often rip off their clothes. This phenomenon, known as
paradoxical undressing, is common enough that urban hypothermia victims
are sometimes initially diagnosed as victims of sexual assault. Though
researchers are uncertain of the cause, the most logical explanation is
that shortly before loss of consciousness, the constricted blood vessels
near the body’s surface suddenly dilate and produce a sensation of
extreme heat against the skin.

All you know is that you’re burning. You claw off your shell and pile
sweater and fling them away.

But then, in a final moment of clarity, you realize there’s no stove, no
cabin, no friends. You’re lying alone in the bitter cold, naked from the
waist up. You grasp your terrible misunderstanding, a whole series of
misunderstandings, like a dream ratcheting into wrongness. You’ve shed
your clothes, your car, your oil-heated house in town. Without this
ingenious technology you’re simply a delicate, tropical organism whose
range is restricted to a narrow sunlit band that girds the earth at the
equator.

And you’ve now ventured way beyond it.

There’s an adage about hypothermia: “You aren’t dead until you’re warm
and dead.”

At about 6:00 the next morning, his friends, having discovered the
stalled Jeep, find him, still huddled inches from the buried log, his
gloveless hand shoved into his armpit. The flesh of his limbs is waxy
and stiff as old putty, his pulse nonexistent, his pupils unresponsive
to light. Dead.

But those who understand cold know that even as it deadens, it offers
perverse salvation. Heat is a presence: the rapid vibrating of
molecules. Cold is an absence: the damping of the vibrations. At
absolute zero, minus 459.67 degrees Fahrenheit, molecular motion ceases
altogether. It is this slowing that converts gases to liquids, liquids
to solids, and renders solids harder. It slows bacterial growth and
chemical reactions. In the human body, cold shuts down metabolism. The
lungs take in less oxygen, the heart pumps less blood. Under normal
temperatures, this would produce brain damage. But the chilled brain,
having slowed its own metabolism, needs far less oxygen-rich blood and
can, under the right circumstances, survive intact.

Setting her ear to his chest, one of his rescuers listens intently.
Seconds pass. Then, faintly, she hears a tiny sound—a single thump, so
slight that it might be the sound of her own blood. She presses her ear
harder to the cold flesh. Another faint thump, then another.

The slowing that accompanies freezing is, in its way, so beneficial that
it is even induced at times. Cardiologists today often use deep chilling
to slow a patient’s metabolism in preparation for heart or brain
surgery. In this state of near suspension, the patient’s blood flows
slowly, his heart rarely beats—or in the case of those on heart-lung
machines, doesn’t beat at all; death seems near. But carefully
monitored, a patient can remain in this cold stasis, undamaged, for
hours.

The rescuers quickly wrap their friend’s naked torso with a spare parka,
his hands with mittens, his entire body with a bivy sack. They brush
snow from his pasty, frozen face. Then one snakes down through the
forest to the nearest cabin. The others, left in the pre-dawn darkness,
huddle against him as silence closes around them. For a moment, the
woman imagines she can hear the scurrying, breathing, snoring of a world
of creatures that have taken cover this frigid night beneath the thick
quilt of snow.

With a “one, two, three,” the doctor and nurses slide the man’s stiff,
curled form onto a table fitted with a mattress filled with warm water
which will be regularly reheated. They’d been warned that they had a
profound hypothermia case coming in. Usually such victims can be
straightened from their tortured fetal positions. This one can’t.

Technicians scissor with stainless-steel shears at the man’s
urine-soaked long underwear and shell pants, frozen together like
corrugated cardboard. They attach heart-monitor electrodes to his chest
and insert a low-temperature electronic thermometer into his rectum.
Digital readings flash: 24 beats per minute and a core temperature of
79.2 degrees.

The doctor shakes his head. He can’t remember seeing numbers so low.
He’s not quite sure how to revive this man without killing him.

In fact, many hypothermia victims die each year in the process of being
rescued. In “rewarming shock,” the constricted capillaries reopen almost
all at once, causing a sudden drop in blood pressure. The slightest
movement can send a victim’s heart muscle into wild spasms of
ventricular fibrillation. In 1980, 16 shipwrecked Danish fishermen were
hauled to safety after an hour and a half in the frigid North Sea. They
then walked across the deck of the rescue ship, stepped below for a hot
drink, and dropped dead, all 16 of them.

“78.9,” a technician calls out. “That’s three-tenths down.”

The patient is now experiencing “afterdrop,” in which residual cold
close to the body’s surface continues to cool the core even after the
victim is removed from the outdoors.

The doctor rapidly issues orders to his staff: intravenous
administration of warm saline, the bag first heated in the microwave to
110 degrees. Elevating the core temperature of an average-size male one
degree requires adding about 60 kilocalories of heat. A kilocalorie is
the amount of heat needed to raise the temperature of one liter of water
one degree Celsius. Since a quart of hot soup at 140 degrees offers
about 30 kilocalories, the patient curled on the table would need to
consume 40 quarts of chicken broth to push his core temperature up to
normal. Even the warm saline, infused directly into his blood, will add
only 30 kilocalories.

Ideally, the doctor would have access to a cardiopulmonary bypass
machine, with which he could pump out the victim’s blood, rewarm and
oxygenate it, and pump it back in again, safely raising the core
temperature as much as one degree every three minutes. But such machines
are rarely available outside major urban hospitals. Here, without such
equipment, the doctor must rely on other options.

“Let’s scrub for surgery,” he calls out.

Moments later, he’s sliding a large catheter into an incision in the
man’s abdominal cavity. Warm fluid begins to flow from a suspended
bag, washing through his abdomen, and draining out through another
catheter placed in another incision. Prosaically, this lavage operates
much like a car radiator in reverse: The solution warms the internal
organs, and the warm blood in the organs is then pumped by the heart
throughout the body.

The patient’s stiff limbs begin to relax. His pulse edges up. But even
so the jagged line of his heartbeat flashing across the EKG screen shows
the curious dip known as a J wave, common to hypothermia patients.

“Be ready to defibrillate,” the doctor warns the EMTs.

For another hour, nurses and EMTs hover around the edges of the table
where the patient lies centered in a warm pool of light, as if offered
up to the sun god. They check his heart. They check the heat of the
mattress beneath him. They whisper to one another about the foolishness
of having gone out alone tonight.

And slowly the patient responds. Another liter of saline is added to the
IV. The man’s blood pressure remains far too low, brought down by the
blood flowing out to the fast-opening capillaries of his limbs. Fluid
lost through perspiration and urination has reduced his blood volume.
But every 15 or 20 minutes, his temperature rises another degree. The
immediate danger of cardiac fibrillation lessens, as the heart and
thinning blood warms. Frostbite could still cost him fingers or an
earlobe. But he appears to have beaten back the worst of the frigidity.

For the next half hour, an EMT quietly calls the readouts of the
thermometer, a mantra that marks the progress of this cold-blooded
proto-organism toward a state of warmer, higher consciousness.

“90.4...  
“92.2...”

From somewhere far away in the immense, cold darkness, you hear a faint,
insistent hum. Quickly it mushrooms into a ball of sound, like a planet
rushing toward you, and then it becomes a stream of words.

A voice is calling your name.

You don’t want to open your eyes. You sense heat and light playing
against your eyelids, but beneath their warm dance a chill wells up
inside you from the sunless ocean bottoms and the farthest depths of
space. You are too tired even to shiver. You want only to sleep.

“Can you hear me?”

You force open your eyes. Lights glare overhead. Around the lights faces
hover atop uniformed bodies. You try to think: You’ve been away a very
long time, but where have you been?

“You’re at the hospital. You got caught in the cold.”

You try to nod. Your neck muscles feel rusted shut, unused for years.
They respond to your command with only a slight twitch.

“You’ll probably have amnesia,” the voice says.

You remember the moon rising over the spiky ridgetop and skiing up
toward it, toward someplace warm beneath the frozen moon. After that,
nothing—only that immense coldness lodged inside you.

“We’re trying to get a little warmth back into you,” the voice says.

You’d nod if you could. But you can’t move. All you can feel is
throbbing discomfort everywhere. Glancing down to where the pain is most
biting, you notice blisters filled with clear fluid dotting your
fingers, once gloveless in the snow. During the long, cold hours the
tissue froze and ice crystals formed in the tiny spaces between your
cells, sucking water from them, blocking the blood supply. You stare at
them absently.

“I think they’ll be fine,” a voice from overhead says. “The damage looks
superficial. We expect that the blisters will break in a week or so, and
the tissue should revive after that.”

If not, you know that your fingers will eventually turn black, the color
of bloodless, dead tissue. And then they will be amputated.

But worry slips from you as another wave of exhaustion sweeps in. Slowly
you drift off, dreaming of warmth, of tropical ocean wavelets breaking
across your chest, of warm sand beneath you.

Hours later, still logy and numb, you surface, as if from deep under
water. A warm tide seems to be flooding your midsection. Focusing your
eyes down there with difficulty, you see tubes running into you, their
heat mingling with your abdomen’s depthless cold like a churned-up
river. You follow the tubes to the bag that hangs suspended beneath the
electric light.

And with a lurch that would be a sob if you could make a sound, you
begin to understand: The bag contains all that you had so nearly lost.
These people huddled around you have brought you sunlight and warmth,
things you once so cavalierly dismissed as constant, available, yours,
summoned by the simple twisting of a knob or tossing on of a layer.

But in the hours since you last believed that, you’ve traveled to a
place where there is no sun. You’ve seen that in the infinite reaches of
the universe, heat is as glorious and ephemeral as the light of the
stars. Heat exists only where matter exists, where particles can vibrate
and jump. In the infinite winter of space, heat is tiny; it is the cold
that is huge.

Someone speaks. Your eyes move from bright lights to shadowy forms in
the dim outer reaches of the room. You recognize the voice of one of the
friends you set out to visit, so long ago now. She’s smiling down at you
crookedly.

“It’s cold out there,” she says. “Isn’t it?”