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Lost at sea

Mar 30, 2011

Drug interactions cause a crewmember to lose touch with reality and force a retirement from the Marion Bermuda Race

Of the many experiences one might expect in an ocean race, the crew of Corsair, a 1981 C&C 40 could not anticipate the medical event that created an unusually challenging passage during the 2009 Marion to Bermuda Race.

Among the decisions made by owner David Risch prior to the race, the easiest was selecting his crew. After asking his son, David, 18, a student, to come along, his next choice was his neighbor, Ron Chevrier, a 75-year-old retired executive. Also included were good friends Jeffrey Hallahan, 66, a local businessman, Bob Kostyla, 55, a scientist, and Bob’s son Chris, 23, a CPA.

Prior to the start, some people respectfully shared concerns about Ron’s participation in the race, but David had no doubts. A distinguished man cutting a formidable figure at 6 feet 3 inches, 200 pounds, Ron is soft-spoken yet sharp. Twenty years ago, David, 48, a financial advisor, moved to Marion, Mass., right next door to Ron. “Ron has always been there literally and figuratively, as a friend and a life mentor,” David said. Loyalties aside, David was confident about Ron’s inclusion as an invaluable crewmember.

David and Bob crewed in three previous Marion to Bermuda races aboard Ron’s boat, Seaflower, and David knew he could benefit from Ron’s experience preparing for the race. Bob shared David’s confidence in both Ron’s physical and mental condition and remembered Ron as a meticulous captain with a sound boat.

Having won the 1997 Bermuda One-Two Race on the return leg, David found the elements of ocean racing to be the most exciting experiences he’d had in 40 years of sailing. He looked forward to a similar experience in this race.

A rainy start
The rainy, blustery start on Friday was followed by light air and it was a challenge to keep the boat going only 3 knots for the first couple of days. Prior to the race, David requested Ron put together a watch schedule. When asked to produce the schedule, Ron had not yet completed the task. “I couldn’t figure out why it wouldn’t work!” recalled Ron. After two or three more queries, David finally had Chris create the schedule.

Ron did not avail himself of the chartplotter, choosing instead to use dead reckoning to plot the course. Jeff recalled his concerns when they were just past Cuttyhunk and Ron said, “I don’t think we’re going anywhere.” He’d put four or five plots around a buoy and said, “They’re all coming out in the same spot!” Jeff showed Ron the waypoints displayed in the GPS. Ron realized his mistake and casually shrugged it off as “just one of those things.”

During the first two days, David discovered that Ron’s navigational skills had increasing gaps. “Ron’s assignments were not being fulfilled as crisply as usual; he wasn’t doing logistics and strategy as needed.” David also found that Ron was not maintaining the log.

“We entered the Gulf Stream where I wanted and the exit was good, but farther east than I planned,” David said. “It was a tactical error.” Unbeknownst to Ron, David quietly took over. It was too late however, to take advantage of some critical eddys, which were now adversely affecting them.

Bob recalled Ron’s sentences weren’t making sense, “There was no change in his mild-mannered demeanor, but intermittently his behavior was odd.” Even more alarming, Jeff elaborated, “Ron had talked about people floating below without faces.” There was foul weather gear hanging above the saloon table. Jeff showed a jacket to Ron. Even after handling it, Ron looked puzzled.

Sunday night Ron slept for four hours and seemed better Monday morning. Jeff made an optimistic evaluation suggesting, “Ron has re-booted!” but this improvement was short lived. Over time he became increasingly disillusioned, yet still had moments of complete clarity. With no visible signs of injury, the crewmen were all trying to assess Ron’s condition; perhaps it was just fatigue, anxiety or stress. To add to the confusion, Ron was in particularly good spirits.

Calling Ron’s wife
As Corsair’s medical officer, Bob put in a ship-to-shore call in to Ron’s wife, Lu, awaiting their arrival in Bermuda. Bob didn’t want to alarm Lu about the hallucinations, but felt compelled to inform her about Ron’s condition and wanted to access an envelope with info about Ron’s medical history. When Ron was aware Bob was talking to Lu, he insisted on speaking with her. “I’m not sure what they want from me, but I’m sure they want some money,” Ron stated unemotionally. He also shared his hallucination about people floating about the cabin. Lu took in Ron’s story and joked, “What have you been drinking?” Ron persisted in what was perceived as deadpan humor and Lu kept waiting for the punch-line. In spite of Bob’s sensitive approach to Lu, her conversation with Ron spoke volumes.

By satellite phone, Bob contacted George Washington University’s Doctors at Sea program. The GWU doctor thought perhaps Ron’s condition could be the result of a prescription medicine interaction between the statin drug he was taking for cholesterol (blood pressure) and the Restless Legs Syndrome medications, but according to the prescriptions, everything appeared to be in order. Prior to departure, Ron’s doctor doubled the Requip medication for Restless Legs Syndrome, prescribing the maximum dosage allowable. The doctor at GWU said to continue making sure Ron was eating and drinking so he wouldn’t be malnourished or dehydrated.

On Monday evening, Ron told the crew he recognized he was disoriented and incapable of carrying out his duties, and officially stood down as navigator. Jeff, a Naval Academy graduate, stepped into the position.

On Tuesday morning, Ron seemed perfectly content in his new role as passenger, David remembers. “He was very agreeable, not affecting the safety of himself or the boat.” Young David (D2) thought Ron seemed perfectly fine in the beginning. “After one watch, I went below and Ron asked, ‘Would you like to catch this cab with me?’” D2 chose not to play along, or give Ron a reality check. “I just tried to keep him in a stable state of mind. It was like one big dream to him,” D2 noted.

An unexpected left turn
Family and friends of Corsair tracking their progress on iBoattrack were thrilled with Corsair’s fast pace and early lead, but the boat then made an unexpected left turn. Observers could only deduce it was either equipment failure or disabled crew. They finally learned it was both. It wasn’t until Corsair arrived in Bermuda that they began to learn the unusual circumstances that delayed their landfall for two more days.

The sharp turn observed on iBoattrack was in response to a distress flare David had sighted at 2100 on Tuesday. Corsair was the nearest boat and quickly changed course to the east. They combined forces with other racers who also sighted the flare. After six hours of searching, navigator Jeff spoke directly with the Coast Guard, which had deployed a C-130 aircraft. Wednesday morning at 0900 the sailing vessels abandoned the search and motored back to re-engage in the race. The flare diversion cost them more than 12 hours.
 
They experienced more heavy weather and unfavorable currents. Nobody slept well after the flare and no one felt like eating. Ron’s condition began to further deteriorate. D2 said, “He grew paranoid that we were watching him, even when we were sleeping.” Ron wouldn’t sleep and he wouldn’t sit down. Chris recalled going below to rest while he was off watch. Within moments after settling into his bunk and closing his eyes, Ron lifted one of Chris’s lids and shined a flashlight in his eye. Ron later confided in D2 that he was being held hostage in a POW camp. His delusions ran the gamut of scenarios, but he still had one foot in the real world; when they spoke to him he would always respond normally.

Ron’s nonsensical conversations became directed at imaginary characters; his hallucinations became his reality. In one of his dreams he was observing David move cushions from fore to aft. Ron was terrified that David was readying to throw him from the boat. Ron thought Bob was on “his side,” but when he saw him helping David, he feared for his life. Both men assured Ron it would be okay. Ron remembers thinking it was ironic that he had just been accepted to the Cruising Club of America; it should have been a happy time, yet here he was about to be thrown from the boat. There was no question in Ron’s mind that these dreams were real.

Wednesday, Bob placed a second call to Ron’s wife, Lu, in hopes that she could assure Ron that everything was all right and he was with friends. Until then, the only solace the families were given was that Ron was relaxed and happy. Now, they had just been given a small window into the nightmare they were experiencing; the man they knew as Ron was no longer aboard.

Getting the patient to Bermuda
Heavily hooded lids veiled Ron’s open eyes. He began cocking his head from side to side like a blind person trying to detect a presence. As soon as David saw him in that state, he made a snap decision to bring him in. David had been so busy with the boat that until he came below to the fetid cabin, he had no idea how bad things had become. It became clear that Ron’s health was the primary concern and Wednesday evening the skipper informed the race committee that Corsair was withdrawing from the race to hasten Ron’s medical care in Bermuda.

Ron was no longer a passenger, he was a patient. At night, Chris noticed Ron peering into space with a lost look in his eyes. Chris asked if he could get him some water or a snack. “I was trying to get him to go back to his bunk and go to sleep.” Chris said. Ron replied, “I have to go to the bathroom.” But Ron couldn’t stand or walk. Chris assisted him to the head. Incredibly, in spite of not drinking, Ron made frequent trips to the head also escorted by D2 and Jeff.

Though Ron was certainly at risk of dehydration, Bob’s greater concern was securing Ron so he wouldn’t receive a blood or bone injury bouncing around the cabin as the boat made its way through the heavy seas. Ron wanted to come topside but the crew struggled to keep him below. To stabilize Ron they piled sail bags in the main saloon between the saloon table and settee to increase the width of his berth. Two people were required in the cabin to help him, while the rest of the crew remained on deck.

Bob placed another call to the doctors on call who prescribed 5 milligrams of Valium, the lowest dosage available. Ron calmed down a bit, but was still moving around the cabin becoming increasingly active at night, searching through their bags and poking and prodding crewman as they tried to rest. He was turning things on and off at the navigation station, once running the bilge pump dry for hours. No one could hear it because of the heavy weather.

Ron’s behavior was beginning to sabotage the safety of the entire crew.

He began breaking or taking every pencil from the nav station, trying to disassemble the compass, stashing instruments in his duffle bag and hiding charts around the cabin. A large, framed watercolor and other artwork were pulled out of the bulkhead walls.

Eight to 10 hours later, early Thursday morning Bob called the doctor again, who prescribed an additional dose of Valium. Motoring into flukey head winds, Corsair’s focus was getting Ron to Hamilton, Bermuda, as soon as possible. On Thursday morning they ran out of fuel; a faulty fuel gauge turned out to be the culprit. At the same time another front had moved in bringing 30- to 35-knot winds and 15- to 20-foot seas. While hoisting the storm sail, Corsair slid back down a steep wave unloading the steering cables. When violently reloaded, the steering cable parted. Now they were without fuel or steering. After installing the emergency tiller, the crew brought Corsair under control by steering with the autopilot controls.

Thursday morning, race officials had informed the crew’s family in Bermuda that the boat was proceeding in. The crew, however, requested help getting Ron off the boat. Ray Cullum, Beverly Yacht Club’s race liaison and close friend of David and Ron, Ray gave measured information to the extended Corsair family.

Late Thursday afternoon Corsair finally sailed through St. George’s cut. Upon entering the harbor they squeezed out the last half gallon of diesel from a jerry can and powered up to the immigration pier in St. George’s. A harried customs official presided while concerned friends and family raced down to the pier to greet the weary crew, just ahead of the ambulance.

Headed for the hospital
The group waited quietly while the ambulance attendants boarded the boat and went below. Within minutes, Ron rose magically up the companionway, effortlessly lifted by one herculean attendant. Everyone was so relieved to see Ron, a cheer rose from the group of about 20 people, “Hey Ron!!!,” they chimed. Ron’s face lit up in a big smile and he waved.

 “You have no idea about the things that went on!” Ron emphatically shared his conspiracy theories, “They took my wallet and my knife,” he continued. Jeff was glad he was there to set the record straight; Ron’s stories were mind bending. “What’s going to happen to the boat?” Ron asked. “They’re killing babies on the boat!” The doctor raised his eyebrows. Ron continued, “We were sailing up river to meet a British couple for tea,” at which point the doctor interrupted, “We’re going to admit you.”

The captain and crew of Corsair could not have been better prepared to deal with the elements of the race. However, they could not anticipate the flare sighting and search efforts that conspired to delay their arrival in Bermuda by one day, a critical window given Ron’s condition. After two days of observation in the Bermuda hospital, Ron’s diagnosis was a mystery. Ron was medevaced to Massachusetts General Hospital for a week of treatment then released to a rehabilitation center for three weeks.

Although Corsair did not finish the race, they received an award for seamanship and the bonding experience of her crew was fulfilled. Bob confirmed, “We came ashore with our relationships intact — maybe stronger.”

After several misdiagnoses, it was discovered that Ron was allergic to both his cholesterol and Restless Leg Syndrome medications. It is believed he experienced temporary acute delirium as a result of being over-medicated with prescription drugs; this triggered an underlying form of dementia. Ron is off of all previous medications, currently taking a prescription for dementia. He has no hallucinations and is sleeping through the night for the first time in years.

Diane Kelley is a sailor and freelance writer. She also owns DK Interiors, an interior design firm in Portsmouth, N.H.

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