A healthy dose of preparation is the best medicine in a pinch

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“That guy’s not looking so good,” Ray says, motioning to a figure hunched over on the starboard side. Seasickness is a reality when you fish for striped bass at night, in large part because the places that have the most and biggest bass also have strong currents and pronounced bottom features. Put the latter two together, and there’s potential for sporty sea conditions.

In the immediate situation, a tide change half an hour ago has pitted a strong breeze out of the south against a south-running ebb tide at Block Island’s southwest corner.

The troughs have shortened dramatically, waves have built more than 4 feet, and suddenly the “mill pond” we’d been drifting has transformed into a massive, open-water washing machine. “Probably just a little green,” I respond, adding that I’ll go check on him. “We got any crackers, Ray? Maybe a bottle of water?”

“I don’t know if that’s it,” Ray says, looking uneasy. “Said he’s having trouble breathing.”

“Great.”

Moving up the starboard side, I collect myself. Whether or not I want the responsibility, part of my job as a mate is to convey a sense that everything’s fine. “How you feeling, bud?” I ask cheerfully, realizing immediately something’s off.

“Having … a hard … time,” he gasps, “breathing.” The man looks worried beyond seasickness. I wish I were at home, remote in hand, dinner in the oven.

Knowing the protocol, on at least a book level — let’s face it, I’m a fish guy, not a graveyard-shift paramedic — I run through quick questions and, above all, attempt to sound cool and matter-of-fact. It turns out that the man, probably in his late 20s, had a few serious asthma attacks when he was in his teens and has an inhaler somewhere in his gear. I hope the inhaler will be the magic bullet that returns order to the evening’s fishing. In my gut, I know it won’t be that simple. Rummaging through his duffel bag, I reason that this scenario started as seasickness, then went to panic that brought on an asthma attack. People unaccustomed to seasickness often attribute its symptoms to something much more serious.

After delivering his inhaler, I move swiftly up to the wheelhouse to inform Capt. Russ Benn that we may have a situation developing. I am conscious not to move too quickly while in the man’s sight, although my mind is ordering my feet to go faster. After briefing the captain, I return to the deck and discover that the situation has deteriorated. The man, now slumped over against the rail, attempts to draw air. His face contorts and his eyes flutter shut. Just when I’m sure he’ll lose consciousness, he forces in a shuddering gasp of oxygen. The inhaler has proved useless. If things don’t improve very soon, he’s going to need more than a deckhand’s medical training.

Be prepared for an emergency, no matter where you fish.

The man’s lips have faded to a steely blue-white, and he’s shaking uncontrollably. My fellow deckhand, Capt. Ben Piquette, has retrieved an emergency blanket from the forward hold, and we’ve stretched our struggling deckmate out flat on a bench seat to keep his airway open. We have, with some difficulty, taken a faint pulse and are trying to keep the terrified man calm, all the while running through worst-case scenarios and wishing we’d chosen normal occupations.

In the meantime, Benn has raised the Coast Guard on channel 16, outlined the man’s condition and begun steaming eastward in tighter to the island to stabilize the ride. As he awaits a decision from the Coast Guard, which has just deployed two boats from Station Point Judith, he steams toward home, assuming that the responders will want to rendezvous in the calmer water south and west of North Rip. Twenty-five minutes later a cutter, blue and white strobes flashing, comes tearing through North Rip, rounds up and approaches from the port side, communicating its intentions to Benn over the VHF. As we idle forward, Piquette and I prepare to help two EMTs board. I grab a paramedic’s bag from one, and Piquette receives an oxygen bottle from the other, and the two medics spring nimbly onto the deck. They head into the cabin and go to work. We stand by to help, if necessary, and a few minutes later one of the Guardsmen heads up top to consult with Benn.

The decision is made to keep the man aboard, rather than attempt a transfer to the cutter. The two Coast Guard vessels will escort us to port. Finally making it into Block Island’s Harbor of Refuge, we head into one of the fish-house docks, where an ambulance awaits. Hooked up to an oxygen pump, the afflicted man remains stable as he is carried off the boat and helped into the ambulance on the bulkhead. As we head back to our slip, we breathe a long, collective sigh of relief, silently glad that our passenger has pulled through. For a while it wasn’t looking good, though the situation probably was never as dire as my imagination had made it.

In the grand scheme of shipboard medical situations, this one has been decidedly minor. After a couple of hours at South County Hospital, our fallen fisherman is free to go, unscathed if a bit shaken.

We’ve all heard tales of draggermen maimed by winches, by cables parting under extreme tension; we’ve seen footage of hair-raising helo rescues. But with the exception of the Coast Guard, no one ever clears the inlet anticipating an emergency. In many minds, to anticipate a crisis is like asking for one: If we never even consider disaster, it won’t happen to us.

Then again, there’s the law of averages. If we spend enough years on the water, we’ll eventually face a bad situation. On the water, bad situations have the potential to deteriorate very quickly. One bad decision, born of panic, can bring on much more serious trouble. That doesn’t mean we all need to become alarmists; most of us will never face a serious incident on the water. But if for no other reason than absolute peace of mind, we should all spend some time every season running through safety drills.

Be sure that more than one regular crewmember on the boat knows how to use the VHF and how to do a security call, particularly if you routinely run at night. Be sure life jackets are stowed in an accessible location and that all on board know their location.

Ideally, the captain should not be the only one who knows how to start the boat, hold a compass course and identify the boat’s exact or approximate location using a chart or electronics. There could, God forbid, one day be a situation in which the captain is incapacitated, and it will be up to the remaining crew to maintain safety.

Go through man-overboard procedures with regular crewmembers and be sure the boat has sufficient first-aid supplies to attend to injuries. If anyone aboard has a specific medical condition — for example, is diabetic or an asthma sufferer — be sure someone knows where the medication is and how to administer it, should the unthinkable happen. Objective one in an emergency is keeping a cool head, something that’s much more easily achieved if worst-case procedures have been spelled out and practiced.

If all this preparation — which is not, in reality, all that much — never plays out in a real, live emergency, good. Consider the hours spent a small drop in a bucket to be measured against the combined weight of the best hours of our lives on a calm sea, the best sunrise we can ever remember radiating in the east, the real challenge in the day’s fishing to discover something, anything, the fish won’t eat.

June 2015 issue