A Brief History of Drowning - Pacific Standard

A Brief History of Drowning

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Drowning has been a common cause of death since the Middle Ages. How do we prevent it when humans were likely never meant to swim?

By James McWilliams

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(Photo: Chuck Espinoza; Model: Elaine Rensing; Stylist: Mark Starr; Make-Up: Gaby Ramos Torell)

It’s later afternoon at the Town Lake YMCA in Austin, Texas, and a man in Lane Two is gliding through the pool with fearless perfection. His movements are languid; breathing metronomic; pace effortless. He completes lap after lap with such ease of motion that the only word that keeps coming to mind as I watch him move down the lane is natural. That’s a natural-born swimmer.

In fact he’s nothing of the sort. No human being is a natural-born swimmer. To confirm, I need only look over to the YMCA’s instructional pool, where the whole notion of being a natural-born swimmer is quickly disabused by a clutch of six physically fit adults milling anxiously in waist-deep water around Dena Garcia, a swim instructor.

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This story first appeared in the May/June 2016 issue of Pacific Standard.

They’re participants in a TOW — “Terrified of Water” — class, and the contrast with what’s happening in Lane Two illustrates something important. At some point in time (probably very early in life), the impossibly elegant lap swimmer had to do exactly what these courageous adults were now doing in the instructional pool: confront his fears by gripping the edge and kicking, placing his face in the water and making bubbles, and allowing his body to float while avoiding a panic attack.

Exactly why we don’t instinctively swim is a mystery. But as Daniel E. Lieberman, professor of human evolutionary biology at Harvard University, explains, “It is possible that some of our ancestors swam or occasionally waded into marshes to collect sedges, but there is very little evidence that natural selection acted much on human abilities to swim.” He calls humans “slow, inefficient, and awkward as swimmers.”

Which is strange. Given that Homo sapiens and our hominin ancestors lived near water for millions of years, one might expect that we’d have evolved the rudimentary ability to swim, if only enough to get us out of trouble. But a survey of evolutionary accounts of how humans became nimble, vigorous bipeds shows that swimming would have been a waste of evolutionary energy. We were born to run on the savannah, not swim in the ocean, and to have done anything but run would have been to misallocate precious energy resources. Swimming, in short, is a very unnatural activity for a hominin.

Of course, academics being academics, and the fossil records of early hominins being frustratingly incomplete, a renegade interpretation posits the “aquatic ape theory,” which suggests that humans evolved in a more amphibious way than is generally recognized. The vast majority of evolutionary biologists don’t even entertain the notion, but the idea not only has its adherents, it has its own conference — one that, in 2013, even attracted David Attenborough, the famous naturalist.

But whatever the precise evolutionary explanation, swimming is not, by any common scientific understanding, natural to humans. And that is cause for trouble.

We drown easily and often. Drowning is the fifth-leading cause of “unintentional injury death in the United States” and the second-leading cause for those between the ages of one and 14, ranking just behind vehicular deaths, according to the Centers for Disease Control and Prevention. Eighty percent of fatal drowning victims are male; a disproportionate number are black; and children from the ages of one to four are the group most at risk for drowning fatally (as opposed to non-fatal drowning, which is a thing). Factors that contribute to drowning include not only poorly developed swimming skills, but also the failure to wear life jackets, inadequate supervision, the inability to recognize when a drowning is happening, and the lack of proper safety barriers, most notably four-sided isolation fences around backyard pools, which is where most one- to four-year-olds die.

“There are lots of hospitalizations for many other injuries. But not for drowning. It’s either quick intervention or death.”

The frequency of drownings is at least partially explained by history. Take an activity — swimming — that we’ve never done particularly well (drowning was a common cause of accidental death in medieval Europe); create the expectation that we should do it well (as happened in the early 20th century with the advent of formal swim lessons); fail to provide broad access to aquatic instruction (it appears to be mostly wealthier white people who enjoy that privilege); introduce swimming as a common form of recreation (there are now 5,061,000 residential in-ground pools, 309,000 commercial pools, and over 1,400 water parks in the U.S.); and you have created a recipe for disaster.

By learning to swim a little we may have learned to drown a lot.

How to confrontthe problem of drowning is a remarkably difficult question to answer. Elizabeth Bennett, director of community benefit at Seattle Children’s Hospital, and co-founder with her colleague Dr. Linda Quan of an anti-drowning program called Stay on Top of It, laments that there’s “no single governmental body for preventing drowning.” The Coast Guard nods at boating safety, the Army Corps of Engineers addresses water safety, and the Consumer Product Safety Commission touches on pool safety. But there’s no equivalent of the National Transportation Safety Board for swimming accidents. When it comes to our swimming abilities, the government assumes a laissez faire approach.

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(Illustration: Elias Stein)

That might have something to do with the geography of drowning. Traffic safety is generally confined to roads and licensed drivers, but the risk of drowning applies to everyone everywhere — infants and elders, bathtubs and oceans. It’s also possible, as Bennett suggests, that open-water drowning is downplayed as a public safety hazard because it so often happens off the radar. “There are lots of hospitalizations for many other injuries,” she says. “But not for drowning. It’s either quick intervention or death.” In some circumstances, it’s even difficult to assess why a trained swimmer drowned. “Fatality rates are [so] high,” Bennett says, “that you don’t get to ask what happened.”

Though drowning is a public safety issue that’s hidden in plain sight, advocates remain undaunted in their efforts to eliminate it from the list of avoidable tragedies. According to Alissa Magrum, executive director of Colin’s Hope, an Austin-based drowning prevention organization (named after a four-year-old boy who drowned in 2008), making swim-safety lessons available to all children is an essential first step. Rates of drowning, she tells me, drop by 88 percent for children between one and four years old who have completed lessons.

Magrum believes that the best way to usher kids en masse into water safety classes is through public schools. With the help of 4,000 volunteers, she works closely with the YMCA and other community partners to foster ongoing swimming instruction with the Austin Independent School District pre-kindergarten classes. “By giving four-year-old children in-the-water swim-safety skills,” she explains, “we are putting life-saving tools in their toolbox.” Magrum adds that the program is “replicable, scalable, and cost-effective.” She hopes to take the program nationwide.

But just as driving lessons don’t solve the problem of traffic fatalities, swimming lessons are only the beginning of a comprehensive drowning prevention plan. Beyond obvious moves such as making life jackets accessible, increasing lifeguard surveillance, and enforcing “boating under the influence” laws, advocates are thinking creatively about the subtleties of human behavior to devise solutions that honor the deeper complexities of drowning.

In this spirit, Bennett and Quan, of Seattle Children’s Hospital, have been fighting a seemingly strange battle in Washington: They want to make it permissible for citizens to wear street clothes in public pools. The reason is that certain cultural groups habitually swim in shorts and T-shirts rather than swimsuits, while some public pools require swimsuits. If turned away from a public pool on sartorial grounds, these groups are likely to seek open-water alternatives — waters with dangerous swells and currents and no lifeguard supervision. “Allowing street clothing,” Bennett says, “is really about equitable access to a safe water experience.”

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(Photo: Chuck Espinoza; Model: Elaine Rensing; Stylist: Mark Starr; Make-Up: Gaby Ramos Torell)

Another unexpected challenge of drowning prevention — perhaps the biggest — is that drowning rarely looks like drowning. The instinctive drowning response, a behavior first identified by an American lifeguard named Francesco A. Pia, excludes stereotypical drowning reactions such as yelling for help, waving, or splashing frantically — the stuff you see in movies. Instead, as Pia explained, a drowning victim will usually be “upright in the water,” unable to reach out for help (hands desperately pushing downward for buoyancy); have the head tilted back with eyes closed and mouth open; and will be gasping rather than yelling.

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(Photo: Chuck Espinoza; Model: Elaine Rensing; Stylist: Mark Starr; Make-Up: Gaby Ramos Torell)

On December 26, 2010, Dave Benjamin, an independent contractor living outside of Chicago, recognized these signs all too clearly — in himself. He was surfing the icy waters of Lake Michigan with two friends when he caught the wrong edge of a wave and was knocked under. His friends were too far behind him to notice.

“I tried to yell,” he says, “but had no breath to do so.” The water had breached the hood of his wetsuit and enveloped his bare body. Benjamin felt himself assume the telltale drowning position: vertical posture, hands pressed downward, head tilted back, mouth open, no noise — everything he’d read about. “This is it,” he thought. “I’m going to be the first surfer to drown in Lake Michigan.”

Benjamin survived what he calls his “drowning episode” (it took him about 40 minutes to reach the shore) because he managed to yank his feet upwards, allowing the buoyancy of his wetsuit to take over. But the real reason he lived, he says, “was that article.” He was referring to a short piece written in a community newsletter by the anti-drowning advocate Mario Vittone, summarizing Pia’s theory. He recalled Pia’s specific signs of drowning. And he lived.

As a nod to his good fortune, Benjamin co-founded the Great Lakes Surf Rescue Project. Part of that project’s mission has been to teach water-safety classes that ensure students know how to spot a drowning in progress. More than 15,000 people have taken the class. At least one, drawing on what he learned from Benjamin, has saved a man from drowning in Lake Michigan.

For all thetime that we spend around water, fear is a part of all swimming — and that’s not necessarily a bad thing. Staying safe in the water requires both overcoming and respecting fear — most notably, the elemental fear of your feet leaving the security of the ground and your body somehow floating above it.

Of all the people I interviewed in an attempt to better understand the convergence of swimming, drowning, and fear, Yolanda Porter, a 50-year-old African-American woman who learned to swim in 2011, expresses the phenomenon most clearly. Within years of her first lesson, Porter was competing in swimming competitions and triathlons. Even so, and even as she became an advanced swimmer, winning her age group at a few races, she never completely shook the fear that kept her out of the water for over four decades.

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(Photo: Chuck Espinoza; Model: Elaine Rensing; Stylist: Mark Starr; Make-Up: Gaby Ramos Torell)

“When you are swimming correctly and confidently, you glide through the water,” Porter says. “But when a panic attack hits, your brain overrides your fluid movements. Your brain says, ‘I shouldn’t be in the deep end.’ Your breathing goes shallow and quick. Your strokes become short and jerky. When that happens, your legs drop and you are fighting the water instead of swimming. That only increases the feeling of panic.”

“You have to work through it or drown,” she adds.

Back at the Town Lake YMCA, everyone is working through it in one way or another. The guy in Lane Two is still plowing ahead, seemingly as natural as ever; members of the Terrified of Water class now have foam flotation noodles tucked under their bellies as they jerkily stroke their way to the wall; lifeguards with strong arms and stern faces walk the tiled shoreline; and a group of children splash in the main pool, their mothers locked in conversation on a nearby bench. Fear is here, but not terror — not quite, anyway. And that’s probably a good thing.

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