I hadn’t envisaged myself as a diving historian when I enrt search for the first victims of decompression sickness for the book Between the Devil and the Deep: One Man’s battle to Beat the Bends.
Martin Robson’s epic tale of survival after being paralysed by decompression sickness while still underwater is set in the here-and-now of technical, deep-water exploration using the most advanced diving technology, rebreathers.
Early in the writing process, I decided to aim for the widest possible readership. To non-divers, the phrase ‘the bends’ is the one sure thing they know about diving. When it comes to details, most people’s understanding wanes beyond a vague notion that it has something to do with bubbles in the blood caused by ascending too quickly. I wanted to present them with the real story of decompression sickness. And I wanted to do so without overcomplicating it with dry science, in much the same way as Sebastian Junger introduced readers to the history of deep water fishing when telling the story of the tragic loss of a trawler in The Perfect Storm, and Tom Wolfe had revealed the history of test pilots in his book about the Mercury program in The Right Stuff. I also wanted to put the disease into context: yes, it was a dangerous affliction for those early, pioneering divers, but it is now a low-probability event for today’s divers. (People are more likely to turn up at hospital emergency departments with injuries suffered while ten-pin bowling than decompression sickness).
To accomplish those two goals, I needed to find the human stories of those stricken by the disease, and those who tried to prevent it from happening. After building a timeline of the key moments in the scientific understanding of the disease, I headed into the archives. I made the first of many research trips to the National Archives at Kew, in London, in the summer of 2015 in search of documents that would give me a better sense of the pioneers whose suffering led to the development of diving techniques that continue to keep us safe today.
The earliest recorded cases of decompression sickness can be found in the reports concerning the first large-scale salvage operation attempted by divers. Between 1839 and 1843, a team of Royal Engineers led by Colonel Charles William Pasley used the first diving helmet to clear the wreck of the Royal George from an anchorage in Spithead, Portsmouth.
Back then, there was no training for underwater operations like this, and the only manual was a tiny pamphlet written by the designers of the diving helmet. So, the men just jumped in and found their way. They descended thirteen fathoms (24 m, 78 ft) four, five or six times a day to place their demolition charges on the wreck. After the explosions, they went back down to clear the timbers and cannons.
Spending hours slinging a ship’s worth of timbers off the sea floor was punishing work, but men began succumbing to something far worse than fatigue. The National Archives holds the original copy of The Medical and Surgical Journal of HMS Success for 12 June to 28 October 1840 by J. J. W. Roberts, Assistant Surgeon, (ADM 101/121/1). The handwritten account contains amazing details about the salvage operation and its effects on divers. In a flourish of blue ink, Roberts noted the “health of the divers employed … seemed much affected by the sometimes long immersions to which they were subject”.
“It is more fatiguing and difficult to be long down in deep water than the same period in shore,” he wrote. “The diver on coming up suffers more from depression of spirits ... weariness and exhaustion almost approaching to fainting.”
Given what we now know, it is fair to say these divers were suffering from decompression sickness. At the time, though, Roberts didn’t think the symptoms were of “sufficient interest” to note in detail. Unaware he was witnessing a new phenomenon, he diagnosed the malady as rheumatism.
Roberts recorded each case of rheumatism in the neat columns of the ship’s sick book, sandwiched between sailors diagnosed with colica, diarrhoea and ulcers. On May 4, 1840, a twenty-eight-year-old diver named Fullegard was diagnosed with acute pains and was taken ashore for treatment. Three months later, diver George Hall went on the sick list with the same complaint. He was only allowed back on duty when the pain had eased. During the remainder of the season, divers Skelton and Symonds were also struck down. Corporal David Harris, so ambitious to earn fame as a diver, was twice laid low by the illness.
Roberts suggested one of the reasons for the attacks of rheumatism was from divers partaking in a “longer continuance below than customary, attended with greater exertions”. Considering what we now know, this comment was prescient indeed.
In the History of the Royal Sappers and Miners, Volume 1 (of 2), author T. W. J. Connolly detailed how men would often ignore the issue to continue diving. “Even of the seasoned divers, not a man escaped repeated attacks of acute rheumatism and cold; and it was not a little surprising to find them returning to the work even before they had ceased to complain of their ailments,” he wrote. “Harris, Rae and Williams were really martyrs in suffering; but, nevertheless, they continued to labour at the bottom, even when the sea was high, the weather bitterly cold, and their hands so benumbed, that they could scarcely feel anything that they slung.”
Col Pasley offered a fuller description of the effects of the mystery disease when on December 7, 1843, he wrote to the Admiralty about one of his divers, Private Philip Trevail, who had been pralysed while diving. In a letter to the Rt Hon. Sidney Herbert, the original of which is held at the National Archives, Kew (Admiralty, and Ministry of Defence, Navy Department: Correspondence and Papers, in various, reference ADM 1/5528), Col Pasley asked the Admiralty to waive Trevail’s medical expenses. He explained Trevail had been “severely injured whilst diving, not by any accident, but from his extraordinary zeal, which induced him to overexert himself and remain too long underwater, which caused him a sort of paralysis of one side”.
While Pasley couldn’t have known it, his letter was arguably the first reliable reference to decompression sickness. Trevail remained in hospital for thirty-six days but never fully recovered from his injuries.
If Trevail really was the first diver seriously injured by decompression sickness, I wanted to know more about him. The Archives hold the service documents of soldiers (but not officers) who became in- or out-pensioners of the Royal Hospital Chelsea. That is where I found Trevail’s discharge papers (reference WO 97/1152/91).
The form revealed Trevail was born in the village of Luxulyan, (spelled Luxullion) in Cornwall, an area famous for its china clay quarries and granite deposits. Trevail had worked as a miner before joining the Royal Sappers and Miners on November 11, 1939, aged 22. On October 13, 1846, three years after being injured, he was discharged on the grounds of: “injury and enlargement of the left knee joint, weakness of his lower limbs.”
Af
ter his discharge, Trevail headed to Canada with his wife Harriet Jane. He worked for a short time as a sapper with the Canadian military before he bought a piece of land in Oshawa, Ontario, and became a farmer. A father of seven, he died in September 1864.
Neither he nor his family would have known that his suffering would be a crucial milestone in our understanding of the disease and the development of dive tables that we use today to keep us safe. Thanks to the National Archives, we now have a better sense of Philip Trevail, the first victim of decompression sickness.
Between the Devil and the Deep, available from Barnes & Noble, Waterstones, Amazon and all good independent bookshops now.