Doctor on Fran Crippen case: ‘No such thing as dying of exhaustion’

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The news of swimmer Fran Crippen‘s death has created an outpouring of response and raised serious questions about the race conditions and safety issues at the 10K open water event in the United Arab Emirates.

Crippen did not finish the race on Saturday and was found in the water about two hours later. Three swimmers were also hospitalized and treated for heat exhaustion -- two of them American women -- and the winner, Thomas Lurz, was quoted as saying the competition should not have taken place, citing high water and air temperatures.

(Separately, USA Swimming just announced it will commission an independent investigation into Crippen’s death, saying it will ‘examine exactly what happened to Crippen, why it happened and what can be learned to keep such an incident from happening again.’)

(Stating the obvious, it will be separate from FINA’s ongoing probe into the matter. FINA is the international governing body of the sport.)

Of the many comments posted to The Times blog item on Saturday, one in particular caught my eye. It was from noted oncologist Larry Weisenthal, founder of the Weisenthal Cancer Group in Huntington Beach. He competed on the varsity team at the University of Louisville and still swims and assists at open-water events.

He granted permission to reprint his comments from the Saturday blog item, and we spoke at greater length about the tragedy. Weisenthal took issue with contention from race officials in the U.A.E. that Crippen died from ‘overexertion.’

‘I’m a physician and there’s no such thing as dying of exhaustion,’ said Weisenthal, adding that such a thing was nonsensical.

The conversation covered a lot of ground -- he said the race never should have taken place under those conditions. What sort of measures should be taken so something like this doesn’t happen again?

‘At a minimum, I think two things that need to happen,’ he said. ‘There needs to be a little bit of scientific study to be put into this. It wouldn’t be that expensive or hard for FINA to do. I could design some studies to determine a maximum safe water temperature.

‘Also, for world-class, open-water races, each swimmer needs to have someone assigned to take care of him.’

Here was his posting from Saturday:

Having a 10K (2 hour) race in 86 degree water is criminal.

The analogy would be running a marathon in 86 degree air. Swimming is much more dangerous, however.

When a runner becomes dehydrated, two things happen. He stops sweating. You see encrusted salt everywhere. It’s obvious. Then the heat stroke starts. There is delirium. It’s very, very obvious to race observers.

These are the problems with swimming in 86 degree water.

1. Swimming at a world class pace, you start to get hyperthermic, and start sweating profusely. The Mission Viejo pool is notorious for its saltiness.

2. No one can see that you are sweating. You get dehydrated.

3. The problem with running in warm air is both dehydration and hyperthermia (heat stroke). The heat stroke symptoms are more obvious than the dehydration symptoms.

4. With swimming in 86 degree water, the hyperthermia is not nearly as bad. Even in the absence of sweating, there is still 86 degree water to cool you off (86 being warm, but much less than 98.6, and water is a much more efficient thermal transmission medium than air). So you don’t get the bizarre heat stroke symptoms. Weaving and bobbing, etc.

5. With swimming in warm water, you are killed not by heat stroke but by dehydration. More sinister than in running, where you are upright and you’ll faint/pass out in relatively early stages of dehydration, with swimming you are already lying down and can maintain blood flow to your brain. So you won’t pass out until you are so dehydrated that you essentially go into frank shock, with total circulatory collapse.

6. Of course, in a big ocean, it’s easy to disappear from view, without anyone noticing, particularly if one is trailing the lead pack.

- Larry Weisenthal/Huntington Beach, CA

-Lisa Dillman