E-Mail a Lifeline for Sailor Forced to Operate on Himself

Crouched over the navigation table in his tiny cabin, the exhausted sailor plunges the scalpel into his arm.

He cuts fast and deep, just as the doctor instructed.

Pus and blood spurt everywhere, and he gasps at how far the infection has spread.

The boat heaves, shoving him against the side. Above, the wind shrieks through the sails. For a second, he worries as much about his yacht’s chances of survival as his own.

Focus, he tells himself. Focus.

He pulls a 4-inch stick of gauze from his medical kit and pushes it hard into the wound.

The pain would make most people scream or pass out.

But no one will hear Viktor Yazykov if he screams. And if he passes out, he knows he will probably die.

Alone in the middle of the South Atlantic, the 50-year-old Russian is 1,000 miles from shore. His autopilot is broken, he has lost power and his only light is a miner’s lamp strapped to his forehead.

He has been at sea for 40 days, on the first leg of a grueling 27,000-mile solo sailboat race around the world that began in Charleston, S.C., in September and will take competitors to Africa, New Zealand, around the treacherous Cape Horn to South America and then back to Charleston.

The eight-month odyssey is called Around Alone. In the churning ocean darkness, Viktor Yazykov has never felt so alone.

He has tried to follow the 14-step surgical procedure the doctor from Boston e-mailed him hours earlier. But he can’t stop the bleeding, and he’s afraid he is losing his arm.

Slumped against the bulkhead, he sips wine. The waves are banging so hard against the thin carbon fiber hull, it feels like they are sloshing around in his brain.

With his good arm, Yazykov reaches for his laptop.

“Have been sitting on the bloody cabin floor almost completely naked all covered with blood with right arm lashed up and watching as my lifeblood drop by drop leaving me,” he types.

Who will find me here, he wonders, as he closes his eyes. Who will see this terrible mess?

Hurtling downwind into the dark, Yazykov’s yacht would set a record that November night, covering a total of 239 miles in 24 hours.

But would Yazykov survive?

Medicine on the High Seas

Thousands of miles away, in the heart of Boston, Dr. Dan Carlin had spent the day in his cozy, crimson-colored office at the New England Medical Center. A 39-year-old former ship’s medical officer, he runs a practice called WorldClinic that provides emergency care, through computer technology, to people around the globe.

His specialty: how and why people die at sea.

Carlin, a sailor himself, was the doctor assigned to Around Alone. He met all the competitors and fitted their boats with emergency medical kits: scalpels and staplers, antibiotics, dental cement.

He expected calls during the race. Sailors get banged up stumbling about their boats, dodging booms, climbing masts, fixing rudders and keels. Sometimes they suffer from dehydration or hypothermia. Fatigue is a constant.

The race, which takes place every four years, has a history of medical emergencies and high seas rescues. Hurricanes. Icebergs. Dismastings. Death.

Carlin was sure there would be an emergency in this race too. But not six weeks into the race, not when skippers and their vessels should be at their fittest.

So on that crisp November day, the last thing Carlin was thinking about was Around Alone. In fact, he was looking forward to skating with his wife and children on the Boston Common after work.

E-Mail Worries Race Officials

The call from race headquarters in Charleston interrupted his daydreaming. Officials were worried by an e-mail from Yazykov.

“My right elbow does not look good. After a day I have spent working on the mast . . . it became red and even bigger . . . it feels like it’s dead.”

Carlin frowned. Patients don’t come any tougher than Yazykov, a former Soviet commando with a chiseled body and piercing blue eyes. Yazykov had sailed oceans alone, fought in Afghanistan, helped clean up Chernobyl. Not the kind of guy to complain about a minor infection.

Clean the wound, Carlin wrote, typing into his computer. Make a sling. Start antibiotics.

But he wondered: Was something more serious going on?

*

Yazykov’s boat, a graceful 40-foot sloop with sleek white lines and a distinctive canting keel, is one of the smallest in the race.

He is proud of the yacht he built with his own hands, proud of the way she slices the waves, smooth and clean at speeds of up to 20 knots. He talks to her every day, his soft voice filled with emotion, as though talking to a lover.

“Perfect,” he tells her. “You are just perfect.”

Wind of Change, he named her, built as she was during the tumultuous changes that swept through Russia in the early 1990s. She has a spirit, he says, a sense of the sea.

Other racers, the 60-footers in Class 1, have heaters, toilets, satellite phones--and hundreds of thousands of dollars in professional sponsorships. The inside of Yazykov’s smaller boat is stripped bare; everything, down to the paint work, is designed to make her as light as possible. Competing in Class 2, Yazykov depends on volunteers and goodwill.

This boat, this race, is his dream.

“Boat, boat, boat, all these years,” sighs his wife, Ludmila. “Nothing but boat.”

But his dream has come at enormous personal cost, including a bitter fight with the American partner who helped build and finance the yacht. The two haven’t spoken since the start of the race.

Other things have gone wrong too. A hurricane delayed his arrival in Charleston and forced him to start the race six days behind everyone else. He contracted food poisoning. He broke a tooth. The elbow he bruised on the way to Charleston swelled badly. The autopilot broke, and so did the engine.

Still, he was enjoying the rhythm of the race, the solitude. He celebrated his 50th birthday on Oct. 29 with a candle-lit dinner of fried eggs and wine and a letter he had carried with him from Ludmila.

His celebration was short-lived.

On Nov. 7, Wind of Change slammed into a storm with a sickening crack. One of the shrouds, thin metal rods that stabilize the 60-foot mast, snapped.

Yazykov spent five hours clinging to the mast, working on repairs. He fixed the shroud. But he had another problem. His right elbow, which had ached since he left Charleston, had swollen to five times its normal size. It didn’t hurt anymore. It didn’t have any feeling at all.

*

“I think we might have a problem.”

Race officials were on the phone from Charleston again, with the latest e-mail from Yazykov. His elbow had blown up like a soft pillow and he wanted to cut it open.

Carlin started typing immediately. Clearly and concisely, he laid out a memo, telling Yazykov how to cut, drain and dress the wound. He had to be brutally clear, conveying the pain of surgery while reassuring Yazykov that it was safe. There was no anesthetic and he couldn’t let his patient be affected by a painkiller until the operation was over.

So he told the sailor how much it would hurt. And he told him that he had no choice.

* “Make your incision rapidly. It will hurt less if you do.”

Swirling through Carlin’s brain was a picture of the medical kit, the cramped cabin, the heaving sea.

Fingers on a keyboard: Tap. Tap. Tap.

* “It hurts a great deal when you insert the gauze. . . . Get it down into the depths of the wound as much as possible.”

Carlin was conscious of the time: Yazykov’s engine hadn’t been working properly, and he was using solar panels to charge his batteries. He would lose power after dark. Carlin was conscious of the language barrier: Yazykov’s English was good, but was it good enough to fully understand medical terms? Most of all, Carlin was conscious that if the arm was not treated properly, the infection could spread, meaning loss of the arm, or worse.

Tap. Tap. Tap.

Carlin pictured the wound, the infection pouring out, the sailor wincing in pain. He knew Yazykov wouldn’t cry out.

Focus, Carlin told himself. Think of what could go wrong. Have you covered everything?

* “Take the squeeze bottle that is full of water and iodine and gently rinse out the pus pocket. The rinsing out will cause you pain.”

For an hour, Carlin typed and thought and typed some more. He told Yazykov to rest after surgery, to take a painkiller, to apply heat compresses. He reassured him that doctors would be waiting in Cape Town.

And when he couldn’t think of anything else to say, he signed off:

“Good luck.”

So Much Blood, Dripping Everywhere

Yazykov is frightened. He has done everything Carlin instructed. But something has gone wrong.

The doctor never said there would be so much blood, and now it is everywhere, dripping over the table and the medical kit, soaking his pants, flowing into a red pool on the floor where it rolls with the motion of the boat.

Remembering what he learned as a soldier, he grabs two bungee cords and strings them together. Using his teeth and his good arm, he ties them around the wound, seven times, as tight as possible. Then he hooks the cord to an overhead handrail and pulls as hard as he can.

The bleeding stops.

So does all sensation in his arm.

Yazykov doesn’t hear the wind howling anymore, hardly feels the pitching of the boat. The tiller is lashed down and Wind of Change is steering itself, racing through the darkness, surfing down 15-foot waves.

Softly Yazykov talks to his arm, in the same soothing tone he reserves for his vessel.

“My poor arm,” he says, trying to massage some feeling back. “You have worked so hard for me all my life, and now I cannot save you.”

No response. No feeling. Just cold and white, like a lump of rubber.

Yazykov stumbles over to the laptop. It’s nearly 10 p.m. and the ocean is dark. He prays that there will be enough power for his message to reach Charleston.

“I did it, but was something unexpected. I could not stop bleeding,” he types. “Please, what should I do before too late. Viktor.”

Doctor’s Worst Fears Are Confirmed

Carlin has spent the day pacing the office. He hasn’t heard from Yazykov in six hours. What is going on in the Southern Ocean?

Crawling home at rush hour, cell phone by his side, he gets the call. The message from race headquarters confirms his worst fears. Yazykov is killing his arm.

Over the din of Boston traffic, Carlin yells into his cell phone: “Tell him remove the shock cords immediately!”

In Charleston, a race official starts typing.

Carlin’s head is spinning. Why so much blood? He had diagnosed an abscess. Had he been wrong?

Aspirin. Yazykov had been taking aspirin for weeks for the pain and it must have thinned his blood, preventing it from clotting after surgery.

“Tell him not to take any more aspirin,” he shouts into the phone. “Tell him to put the arm in a sling and not to use it for several hours.

“Tell him,” he searches for the right words, “that it is not, repeat not, likely you can bleed to death from this.”

At 5:21 p.m. Charleston time, Carlin’s instructions are e-mailed to Yazykov.

Still clutching his cell phone, Carlin goes home to his family and prays.

In Charleston, race officials sit by their computers and wait.

They are all sailors here--some of them former solo racers. They know the sheer impossibility of steering a boat through stormy seas when you are crippled and alone.

They think of others who have been lost: Harry Mitchell, the irrepressible 70-year-old Briton, lost in the Southern Ocean during the 1994-95 race; Mike Plant, the 41-year-old American whose yacht capsized in the Atlantic during a race in 1992.

Carlin remembers them too.

Tucking his children into bed that night, he asks them to say a special prayer that God will keep Viktor safe. Then he turns to his wife. “I might lose this guy tonight,” he says.

No Word From Patient

* “Viktor. Dr. Carlin has some questions. Did the feeling in your arm and hand come back? Can you feel your pulse? Can you move all your fingers?”

6 p.m. at race headquarters, an hour since the last message to Yazykov, and still no word.

* “Viktor. Did you get the message?”

* “Viktor. Dr. Carlin is waiting for the answers.”

* “Viktor. Are you OK?”

All night they pound the computer keys, sending e-mail after e-mail. They might as well be trying to contact the moon.

There is no other way to reach the stricken sailor, nearly 1,000 miles from Cape Town. They can’t send a helicopter that far into the ocean, and the nearest boat is days away.

Morning dawns in the Southern Ocean. Nighttime in Charleston. Still they keep typing.

* “Viktor. Please send a message telling us how you are.”

The words pop up on the computer at 3:07 a.m. in Charleston. It’s 8:07 a.m. in the ocean, 12 hours since Yazykov performed surgery, nearly 10 hours since his last desperate plea. He has just awakened.

* “I AM OK.”

* “The hand is still very sleepy. Getting strength back very slowly. Thank you very much for your help.”

In bed, in Boston, Carlin gets the call he has been waiting for.

*

On Nov. 16, 45 days after leaving Charleston, Viktor Yazykov sails into Cape Town to crowds and cheers and champagne.

He hugs Ludmila tightly. He waves his bandaged arm. When a radio station hooks him up with Carlin, he tells the doctor that they are brothers for life.

Then he turns and gazes at his boat.

“Wind of Change is the real hero,” he says. “She’s a great little boat.”

Viktor Yazykov set off on the second leg of the race, from Cape Town to Auckland, New Zealand, on Dec. 5. His arm appeared healthy and almost completely healed. He is expected to arrive in Auckland this month. The third leg of the race, from Auckland to Punta del Este in Uruguay, begins on Feb. 6. The race ends in Charleston, S.C., sometime in May.

This story is based on interviews with Dr. Dan Carlin, officials of Around Alone and Viktor Yazykov. It also draws on e-mail messages between Yazykov and the doctor.