High drama, near death and an uncertain future.

Bigger machines that go bing.

15th March 2023

Georgetown, Grand Cayman – Georgetown, Grand Cayman via Doc Poulson, Grand Cayman

Most days run like clockwork on Ruffian. We wake up in an idyllic location and make a plan where fun and adventure are the central activities. Tired from our exploits we then end the day with the sun setting before Ruffian rocks us gently to sleep and the trade winds cool us. Never do we plan high drama, near death and an uncertain future.

Waking in Grand Cayman the day was full of opportunities. The sun rose over George Town into a cloudless sky and shone through the clear water that Ruffian sat on, lighting up the reef and waking all the fishies. This was perfect diving weather and we had a scuba dive planned with wrecks, reefs and underwater sculptures all within a single swim.

Picking up one of the dive balls that litter the coastline the water was so clear that we could see the wreck sitting under Ruffian and the reefs that wrapped around us. Full of excitement we followed our usual routines of prepping our kit, checking each other for safety, jumping in and giving the a-ok. The water was warm, the surface flat and everything was working perfectly. Our usual clockwork plan was being executed, even after the difficult dive three days previously.

Signalling we were good to descend, the blue water surrounded us as we let the air out of our BCDs. Descending slowly our ears adapted to the change in pressure and we grew accustomed to this new environment as the delights of the deep came closer and closer.

The wreck was alive with life as large groupers hung in the cabin, sergeant majors investigated us and sleepy barracudas waited for darkness in the shadows. As we swum around, we stayed close, checked air levels and ensured each other’s well-being. This is when Fiona signaled something that you never want to see while near the seabed. She was in trouble and we were aborting the dive.

The colour drained from Fiona’s face with every passing second as we followed all the surfacing rules. Once surfaced she gasped for air but no matter how hard she tried air wasn’t getting in and her condition was deteriorating. We were in big trouble.

Iain towed Fiona to Ruffian’s stern so that Fiona could scramble onto the back deck.  Instead of offering sanctuary, onboard Ruffian, our predicament seemed even more precarious. In the moments when she wasn’t gasping for air, she was coughing up blood and mucus and all the while she could feel her life draining away from her and Iain could see it.

Getting on the VHF Iain called for ‘immediate medical assistance’ and the port security harbour patrol boat instantly responded. It felt like an age for it to hove into view with blue lights flashing, sirens wailing and its 150hp engines screaming. At 40 knots the miles from Georgetown flashed by in seconds, but those seconds dragged like no time ever before.

Taking the last of her energy Fiona boarded the boat and was whisked away. ‘Harbour patrol’ took charge, ordering ambulances, issuing emergency care and ensuring that Fiona, near to death, wasn’t going to get any closer.

Following in the medi vac’s wake Iain drove Ruffian home and Harbour Patrol kept him updated on Fiona’s movements. She went from the care of harbour patrol, to the care of paramedics to the care of doctors, nurses and specialists in A&E, and with every breath of pure oxygen she moved further away from death.

In the hospital machines pinged, monitors showed all her vitals and she felt like a pin cushion as bloods were taken and tests run. She was taken through x-ray machines, cardiograms and CT machines examining the operation of her insides in an effort to get a diagnosis and create a prognosis. All we were given however, were puzzled expressions and relief that her vitals were looking better and better.

As day drew towards night although Fiona was feeling better all the signs were not looking good. X-rays showed infiltrates in both lungs, her heart was racing and her blood pressure was low, her white blood cells where high and a blood test for blood-clots was off the scale. Worried faces paraded around the ward and in the early hours of the morning she once again found herself in the back of an ambulance to be transferred to a specialist cardiology hospital.

Now in a bigger medical facility with even more machines, that made even bigger bings, things started to stabilize. Time after time we recounted the story of the dives to cardiologists, pulmonologists and pretty much anyone who had a passing interest and the consensus started to coalesce around observation, re-hydration, oxygen assistance, rest and relaxation.

After 24 hours we left the hospital and observation, rest and relaxation were the order of the day on Ruffian. Follow up appointments were booked and we counted the hours to see if there are any long-lasting implications from this scary drama that resulted in a near death experience and which could result in us having a very uncertain future.

After a full dose of R & R on Ruffian the colour had returned to Fiona and we made our way to the appointment that would spell our future. Once again Fiona was hooked up to cutting edge technology where we could see her heart beating, her valves flapping and her arteries all performing perfectly. Dr Ravi studied all the evidence and as he gave Fiona a clean bill of health, relief washed over us, but we were still perplexed.

Dr Ravi went on to explain that during the long surface swim after our tricky dive three days previously, he felt that Fiona had ingested so much water that she’d had a near drowning experience. Our subsequent dive with the changes in pressures and the stress on the body had simply pushed her over the edge, some alveoli in her lungs, weakened by the water, had burst and this led to her body trying everything to get back on an even keel. This accounted for everything from her off the scale blood clot results, to her racing heart and fluctuating blood pressure.

This was not a day, or a even week, that has run like clockwork and was certainly not ‘fun or adventurous’. In future we are going to try and avoid anything that involves high drama, near death and an uncertain future, but at least we’re both alive to tell the tale.


We never felt comfortable with the near drowning diagnosis. After doing more research we feel it is more likely Fiona suffered from SIPES (Swimming Induced Pulmoary Edema). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340429/

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Author: Iain & Fiona Lewis

8 thoughts on “High drama, near death and an uncertain future.

  1. OMG. What a relief you’re ok. Yes, try for less drama or certainly less trauma in your travels. I occasionally read your blog from the UK with much envy. At least I’m getting some excitement daily this week on a Hobicat on holiday in the Dominican Republic but I rarely get to sail so I’m always wowed by your travels. I used to work with Ian at CV/Prime/PTC (Can’t remember which exactly 😩).. Good luck for the rest of your global wanderings. Chris R

  2. Holy moly!! Thank goodness you managed to get to help as quickly as you did

    So glad you’ve recovered – massively scary

  3. Wow! So glad that you are both ok. – I imagine Iain was worried to death too!!! Stay safe and look after yourselves xx

  4. Great news, glad to hear you’re feeling better Fiona, SIPES is the same as near or secondary drowning, the aspiration of the water is the key as if it is taken in it can sit in the alveoli and become a problem later. Glad to hear you hacked, coughed, splurged it all out

  5. We are at the Marquesas nuku hiva where we met Steve and Helen and they updated us on yr situation. We could not believe the amount of bad luck. It’s a relief to read about the clean bill of health of Fi. Gosh what an experience.

  6. We heard about this just recently from Steve and Helen, reading the details here makes it clear to us how bad it really was. Horrifying. So glad it all ended well. Luckily good medical care was so readily available, might have ended different had it happened in a more remote place, like here in the Tuamotu’s. All the best, take care and stay safe!

  7. Hi, so sorry to hear of your near death experience !! It must have been so scarey for you both. Thank goodness for the prompt response from emergency services and their expert care. You can enjoy many more adventures in and on the high sea’s. I will look forward to reading about them all. Take good care both. xx

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