(An excerpt from May 2008 issue of Scuba Diving Magazine, as contributed by Genieking Pestolante, Founder of the Royal Scuba Divers International)

*A head-spinning ear injury causes an abandoned diver to lose his only route to survival.*    

*By Michael Ange*

The pain in George's ear went from uncomfortable to excruciating as dizziness and nausea washed over him. The wide,

comfortable tunnel seemed to collapse in all around, and his lungs tightened. Several deep breaths helped clear his

head and stave off the encroaching panic, but he knew he could go no farther. He signaled his partners that he was

turning the dive and beat a rapid retreat toward the exit, which was only a few hundred feet away but still out-of-

sight. Along the way, vertigo struck with a vengeance, dizziness clouded his mind and he lost contact with the

guideline--his only connection with the outside world.

*The Divers*

George was part of a three-man team of qualified cave divers. All three were in their early 30s, in reasonably good

health and had experience diving these local caves.

Each of the divers was properly equipped and certified to dive this particular site. 

*The Dive*

The dive team planned for a maximum depth of slightly over 150 feet, penetrating the cave to between 2,000 and 3,000

feet depending on their air supply. The divers arrived mid-morning, assembled their equipment and entered the water.

They were comfortable as they did their final equipment checks and safety drills before dropping down and squeezing

through the mouth of the cave. Visibility was good as they tied off their line and swam down the dark tunnel.

Everything was going as planned until George felt the jab of pain in his ear.

*The Accident*

Working his ear and clearing forcefully, George managed to descend a few more feet, but the pain came back more   

intensely, along with a wave of nausea. He signaled to the rest of his team, and they stopped the dive to give him a

chance to acclimate. As the problem got worse, George decided to call the dive. He signaled his decision, waited for

confirmation and turned around. George's buddies figured he was close enough to the exit that they could continue

the dive without him. Heading back alone, George's disorientation apparently intensified, and at some point, he lost

contact with the guideline. He probably swam frantically searching for the exit or line because when his buddies

swam back through the area nearly two hours later, they noticed extreme silting. They saw no signs of George,

however, and had no reason to believe he wasn't at the surface waiting for them. After their decompression, the

divers climbed out of the water and were stunned to find no sign of George or his gear--his car was still locked and

sitting where he left it. They notified local authorities who organized a search and rescue team. The searchers found

George wedged in a tiny alcove. His gear was out of place, and there was very little air left in his cylinders. He

drowned trying to fight his way out--almost within sight of the entrance.   

 *Analysis*

No one can say for sure what happened, but when he was found, George clearly showed signs of struggling. A medical

examination revealed a severe inner-ear injury, and whether the descent pressure or his forced equalization caused

the rupture, the injury almost certainly caused vertigo, a debilitating condition causing severe disorientation. In a

cave system, with no natural light reference, and walls that look the same no matter which direction you turn, vertigo

can be truly life-threatening. It deprives the diver of any sense of up and down, sometimes inducing nausea and

severe anxiety. George probably fought some or all of these feelings as he tried to find the exit.

It's unclear whether George told his teammates to continue their dive or if he signaled for the whole team to

terminate it, as he should have. However, it is clear that this was planned as a three-man buddy-team dive, and no

part of the plan indicated that the team would split up. With his buddies providing additional reference, George could

have made it through this accident with little more than a painful ear injury and a good story for the local dive bar.

On his own, George's story proved much more tragic.

 *Lessons For Life*

*Dive your plan.* A dive plan provides a template to follow in case something goes wrong--violating it invites disaster.

*Stay with your buddy.* You dive together so you'll have help in times of need. Be there for each other.

*Never leave injured or disoriented divers* to fend for themselves. Certain medical problems and massive disorientation

can leave even very experienced divers in need of assistance.

*Never force equalization.* Clear your ears often, well before you feel any discomfort. If you feel pain, ascend until all

discomfort is gone and try equalizing again before descending.