Plano Profile Post By Dr. Pamela Moore, Internal Medicine PPN Physician
I thought I had a lot of important things to do Saturday. I had already caught up on some paperwork at my internal medicine practice, took my son to baseball practice, and picked my daughter up from gymnastics. As usual, she then began to pursue social engagements for the weekend. After debating a few options, my preteen daughter and I agreed that she and a couple of her friends could go swimming at our neighborhood pool in Plano. I would come with them to supervise.
As a dutiful tween mom, I took a seat in the area I decided was least conspicuous; I could keep an eye on the girls, without cramping their style. During our past visits to the pool, it had been deserted. Often, we were the only people there, and we could enjoy having the pool to ourselves. But today was different. There was an extended family preparing for a cookout, lots of children playing in the pool, a couple of high school boys tossing a football from one end to the other, and some twenty-somethings chatting poolside. It felt joyful and festive.
I sat quietly and checked for new messages on my phone while I listened to the chatter around me. There was a little bit of flirting (the twenty-somethings), a little smack talk (the teenage boys), giggling (the kids and tweens), and lots of joy in the air. Everyone was busy in their own world, enjoying the day.
“Mom, she’s been down there a while.”
After about fifteen minutes, I heard one of the tweens say, “She’s been down there a while.” She spoke louder than usual, but there was no panic in her voice. I looked up and heard another girl say, “She’s not moving.” As I rose to go and check on things, I yelled to my daughter, “What’s happening? Is someone in trouble?”
My brisk walk turned into a run as my daughter, now strenuously, says to me, “Mom she’s been down there too long!” I’m now close enough to see a dark figure on the bottom of the pool, motionless.
I see a dark figure on the bottom of the pool, motionless.
As I jump (fully clothed) towards the figure in the water, the thought crosses my mind: is this child going to pop up out of the water—giggling and joking—and make me look like a crazed maniac? But as I landed in the water and touched her arms, my fear of embarrassment turned into terror. This child was cool and not moving. It seemed she had already drowned. She was tiny, maybe about five years old, and very easy to lift—or maybe it was the work of extra adrenaline. As I pulled her out of the water, I saw her blue face. She was not breathing, and she did not have a pulse.
I began to scream frantically, “Help! Call 911! Help!” Over and over. Within a few seconds, I was able to lay her on the side of the pool, and I started CPR. I had performed CPR many times as a resident, but that was 25 years ago, in a hospital, on an adult, who was likely chronically ill, and decades older than the little girl who lay lifeless in front of me.
By now, at least two people were on the phone with 911 emergency services. A woman I later learned was the girl’s mother did chest compressions as I did mouth to mouth breathing. The experts say chest compressions should be very firm, and this mom performed CPR with fear and passion and fervor. She wailed, cried, and prayed as she willed her daughter alive with every forceful push. After a minute or two, I told her to stop because I needed to check for a heartbeat. She clearly did not want to, but she did. I checked the carotid artery, and, amazingly, there it was: a pulse. Then a breath. And the most overwhelming sense of relief I have ever had. She did not appear to be normal—she was listless, barely whimpering, breathing very slowly. But her face was no longer blue; she looked alive.
A pulse. Then a breath.
I looked around and realized the children who had been in the pool had been directed to get out and were seated on the other side. Their laughter had been replaced with crying. I wondered if their tears were because they knew this girl, or if the situation was just too intense for them. The few minutes it took for the ambulance to arrive seemed like an eternity, but we soon heard the sirens getting louder and closer. The emergency personnel asked a few questions as they strapped her barely breathing body to the gurney, and rushed her to the ambulance. And with the blare of the sirens, they were gone.
Various poolside people were left behind, stunned. We were crying, hugging, shaking, but mostly dazed. It eventually occurred to me my pants and shirt were soaking wet, evidence of my plunge into the pool. Like the whole experience that afternoon, any feeling of disbelief was overridden by proof of the truth. Our patient had regained a pulse, but her irregular breathing reminded me she was not yet out of trouble.
In the coming days, I was haunted by the silent motionless figure at the bottom of the pool, juxtaposed to the buzz of happiness around her. Thoughts of her lifeless blue face tortured me. I knew we couldn’t assume she would be okay just because we were able to feel a pulse. The most important prognostic sign in a near-drowning incident is how long the person was submerged. And we did not know—no one had noticed her until she was underwater. Questions kept invading my thoughts: How did this happen? Were we all careless and irresponsible? Did we not pay enough attention to this child? Could this happen again?
The truth is: this happened easily. And it could easily happen again. Even at our best, when we are “keeping an eye on” one another’s children, we are not looking for the child we cannot see. We are not listening for the silence of submersion. We are not monitoring the motionless struggle of drowning. It seems something as final as death, or at least the threat of it, should be accompanied by a piercing noise, or a violent action, or at least a call for help. But not drowning. It was almost peaceful; it was surreal.
We are not listening for the silence of submersion. We are not monitoring the motionless struggle of drowning. It was almost peaceful; it was surreal.
Fortunately, within a few days, I learned that the little girl had made a full recovery after a stay at Children’s Hospital Plano. I am so relieved this story has a happy ending. But the experience has changed me, taught me some valuable lessons, and made me reconsider the way I think about water and drowning and fun times at the pool.
Avoid a drowning situation
In addition to the typical safety procedures we have all heard before, here are a few other suggestions.
Discourage our children from playing the “who-can-stay-underwater-the-longest” game. It’s hard to determine if someone has been underwater too long if we are desensitized to it. And when we do suspect a problem, there is a tendency for us to wait and see if the submerged person will come up soon before acting.
Teach older kids, and remind ourselves, to spot someone in trouble and to act on it. Let’s empower them to hurry to the nearest adult and tell them forcefully that they think someone is in trouble. And when they do, we cannot hesitate. Let’s all forget about the worry of a mistake or embarrassment.
Don’t assume that children can protect each other. There is something about the silence of drowning that I think is difficult for kids to understand. It is very hard for them to grasp the urgency of getting help immediately.
Separate pool activities from other entertainment. Cookouts are cool. Family games and conversations are terrific. But while everyone is enjoying their own fun activity, inevitably there is not enough attention to the pool. Let’s all eat, and let’s all play games. Then let’s all get in the pool with the kids and be within an arm’s reach.
Recognize swimming pools as the silent killers they are. I know, this sounds extreme; we think of swimming pools as the center of good times, and they can be. But the truth is hundreds of people drown in swimming pools every year. And for each one that drowns, five more have a near drowning experience. Many of us won’t let our kids play with fireworks. We are very careful about trampolines or electric scooters or four wheel ATVs. We need to develop full respect and appreciation for the potential of quick, silent, and potentially fatal accidents in pools.
Learn CPR. I can’t imagine letting someone lay blue without a pulse while waiting for an ambulance. It truly can be the difference between life and death, or a normal life and permanent brain damage.
Pamela Moore is an internal medicine physician who has been practicing in Plano for the past 20 years. She and her husband, William Moore, have four children. When she is not practicing medicine or spending time with her family, she is likely busy in her garden.