It's what Dr. Jean Romagnoli doesn't know about the health of the 33 trapped miners that worries him.
As chief medical officer of the team rescuing the miners stuck underground since Aug. 5, Romagnoli has been monitoring their health and preparing for their reentry to life above ground, which could happen as early as Wednesday. Once rescued, they will receive immediate attention at a makeshift clinic near the mine entrance and then two days of treatment at a hospital in nearby Copiapo.
Romagnoli already has an idea of the maladies the men are suffering from because of the peculiar conditions of their confinement: 90-plus-degree temperature, high humidity, a lack of sunlight and limited exercise. The medical team is ready to treat the men for fungal diseases, partially collapsed lungs from shallow breathing, eye damage from the darkness, and vitamin D deficiency.
Talking to reporters Sunday, Chilean Health Minister Jaime Manalich said the men also could suffer from dizziness or fainting spells during the rapid ascent, and possibly panic attacks prompted by the stress of the rescue operation. Ascending in the capsule, miners will "for the first time in several weeks be completely alone," he said.
Romagnoli said that, to his knowledge, miners have never been confined for so long underground.
"We're looking at some unknowns," Romagnoli said in a recent interview at the mine in the Atacama desert. "If we can't measure it, we can't manage it."
Officials said Sunday that engineers had begun inserting metal tubing into the top 300 feet of the rescue shaft to guard against a cave-in. The rescue team expects Monday to start constructing the winch that will lower and raise the 26-inch-diameter rescue capsule.
The capsule, called the Phoenix, is equipped with an oxygen mask as well as medical instruments, a radio and a video camera so rescuers can monitor each miner's condition during the ascent.
The rescue of all the men will take two full days, Mining Minister Laurence Golborne has said.
The miners have been doing aerobic exercise for three weeks to maintain their cardiovascular condition, improve muscle tone and burn off body fat to ensure that they will fit into the rescue capsule. They are being given daily aspirin doses to thin their blood and guard against clotting that could result from weakened lungs, Romagnoli said.
During their workouts, they have worn a belt called the Zephyr BioHarness made by a company in Annapolis, Md., that provides similar equipment to NASA astronauts. This half-pound "lab on a strap" monitors heart and lung activity, caloric expenditure and posture. The measurements are stored in a memory device that is sent to doctors via the 4-inch-diameter hole that reached the miners Aug. 22.
"We've been keeping track of their health since August," Romagnoli said, noting that one of the men has high blood pressure and diabetes. "Except for some fungal diseases … and dental complaints for their inability to brush their teeth as they'd like, they seem to be in pretty good shape. But we won't know for sure until we see them."
Romagnoli said the miners were put on a "special diet" after suffering malnutrition from being trapped for 17 days without contact with the surface in August. Just before the rescue begins, they will be fed a liquid high-protein diet to minimize the possibility of nausea during the ride up. The liquid food was recommended by NASA scientists.
For the ride up, the men will be given special sunglasses that have been donated by Oakley, based in Orange County, to protect them from sunlight and falling debris. They will keep the glasses on until they reach the Copiapo hospital, where they first will be treated in darkened rooms.
In interviews with local journalists, Manalich said that the men's psychological "re-adaptation" is a matter of concern to authorities, and that the men have been promised a minimum of six months of follow-up counseling.
"At their exit," Manalich told reporters last week, "they will have to confront the press, fame and their families. They won't be the same they were before they became trapped. All 33 could have psychological problems and traumas.
"They will all have difficult adaptation, and for that they will require constant support."
Manalich said the miners have been divided into three groups for rescue. First to be hoisted up will be those in the best mental condition, to provide rescuers with an idea of the condition of the rest of the men, as well as to be able to cope with any unforeseen difficulties at the outset of the operation. Then come a group of four or five with medical problems. The physically strongest will be last.
"When we told them about the order of the rescue, that started a fight," Manalich said. All wanted to be at the end of the line, rather than the beginning. "That's an indication of the comradeship they feel."
Kraul is a special correspondent.