Sunday, April 8 Today there was a baseball game @ 2:00 that many of us planned on attending. Admission was $1,000 and, yes, they had cold cervaces. In the morning, the internet was working well, so I spent some time uploading more pictures, arranging the pictures into galleries to be more accessible, and fixing a glitch in the blog postings. All should be good now – let me know if it isn't. I had just finished lunch when Liz called frantically saying that Craig was drifting away and would I get my dinghy and get him? That didn't make a lot of sense, but I saw their dinghy drifting away from the boat so figured that was what she meant. Our dinghy was still in the davits so I had to insert the drain plug and lower it into the water before going to catch the dinghy. It was then that I noticed Craig slumped over in the dinghy. At first I thought he might be fiddling with the gas trying to get it going, but then it was obvious he was not moving. George from Silver Sea arrived about the same time I did. (One of the advantages of VHF is that EVERYONE hears your call for help in an emergency.) I maneuvered along side Craig's dinghy and transferred from mine into his. He was minimally responsive, did not seem to have any localizing signs, and had a wet spot on the crotch of his shorts. It was pretty obvious to me that he had had a seizure, but why? By then Tony from Pavo Real had arrived and we managed to get all the dinghies to our boat where Deb got my stethoscope and emergency bag for me. Unfortunately there was no shade and the thoughts of trying to get Craig as a dead weight up my stairs and into the cockpit was daunting. Instead, we dinghied over to his boat which has a very low freeboard (not good for open ocean, but great for getting a victim up out of the water). By the time we got him up and into the cockpit and shade, he was coming around. He was able to tell me that he had no known medical problems and was on no meds (which Liz confirmed). He, as expected, had no memory of the event. Nor did he remember why he was in the dinghy (he had gone to get laundry from shore) or even what he had had for breakfast – typical for either post-ictal or post- concussion. Liz said she heard him come back to the boat, heard the dinghy bump the boat softly, and then heard a “thud.” He didn't answer when she called, so she came up (she had been in the shower) and saw him drifting off so called me. I gave him an aspirin “just in case” and checked him over. The only sign of trauma I saw was on the side of his chest where he had hit the transom. No head injury I could see. His heart was regular and pulse strong. Neuro was intact. It was a hot day, but not unusually so. We had been out in the sun most of yesterday, drinking beer instead of juice or water. Perhaps he was dehydrated and fainted when he stood up to tie off the dinghy. But that really shouldn't have caused a seizure. (Seizures can happen from a faint, but usually only if the victim is forced to remain upright as in sitting in a chair.) Craig protested that the wet shorts were sweat, but I didn't really buy that. We had him drink some juice and tried to get everybody calmed down. Then he said he felt nauseous, turned quite pale (his color had come back), and we laid him down. His pulse was weak so I listened, but his heart was slow instead of fast. It did seem regular, however. Time to intervene. I knew there was a hospital in town – what sort or where I had no idea. We got a hold of Nilaya on VHF and they had Mr. Bush's cell phone number. Mr. Bush is the agent that cruisers must use when checking in or out of Providencia. He takes his job very seriously and is always available. He is also the general ambassador to the cruising community and does anything he can to help us. He is an tremendous credit to the Columbian government. He said to bring Craig immediately to the dinghy dock and he would meet us there and take him to the hospital. We lowered Craig back into my dinghy (it is the biggest) and had him sit on the sole instead of the tube. I drove him in to town and the others followed in their dinghies. Mr. Bush was there with a friend to meet us and help get Craig into the waiting car. He called the hospital and said we were on our way. The hospital turned out to be nearly across the street from his office – about a 2 minute drive and not much longer to walk. The doctor met us on arrival. He looked to be 40's maybe East Indian origin?, but he spoke no English, so probably Columbian with some Mayan. Anyway, he understood English well (as we were told by Mr. Bush) and so I gave him a concise report in English. He immediately checked vital signs, which were OK – BP a bit up (I would have expected down, but by now perhaps adrenalin had kicked in). Next he checked a blood sugar, normal @ 85, and then an EKG, also normal. Exactly the things I would have done in Keene and in the same order. He asked about aspirin and was glad we had done that. When I asked about electrolytes, he said they could not check that here, but that he thought that was likely the problem and was going to give him a couple liters of balanced electrolyte solution (their version of Lactated Ringers I assume). He did not think that Craig needed to be transferred to San Andres for further tests at this time. (This was an important decision Mr. Bush explained as the only flight to San Andres left in about a half hour and that was the only way of getting him there.) I agreed. I thought about what a nightmare that would have been. San Andres has a population of ~100,000 and a very modern hospital I am told, but getting there! Craig would have to sit in a normal passenger seat in a small twin prop commuter. Liz could undoubtedly accompany him, but didn't have her purse and therefore no credit card to pay for anything, and no time to go back to the boat and get it. They had photocopies of their passports and a little Columbian money at least. We, collectively, could look after their boat at anchor, but it would still be a major thrash for everyone. Fortunately, Craig felt much better after a couple liters of fluids, was drinking well, and was released to return to his boat. We were told that they could settle the bill with Mr. Bush later. That will be interesting. In my old ER, if we had only done those things it would have been well over $1,000. And that never would have happened, he would have gotten a head CT and maybe an echo as well as a full cardiac panel of blood tests and probably 24 hour observation on cardiac monitor, total cost at least 5 digits.) Craig drank some more juice, went to bed, and slept at least through dinner. Deb cooked a ham for Easter dinner as well as scalloped potatoes and apple brown betty. Pixie made a wonderful ratatouille, and we brought everything to Salida. Liz was beginning to relax after a couple vodka martinis and we all had a good time. I assured Liz that she could holler at us during the night if needed (we turn the VHF off because of the every 4 hour alarm feature – now isn't that a good safety thing?!) and that if Craig was still up for our island tour tomorrow, I could drive. We can also put it off for a day or two. The weather doesn't look good for leaving here for several more days (too light and too North) so he should have plenty of time to recover before a passage. And it looks like Salida, Always, and Silver Sea will all be traveling together, so there is always help nearby. We missed the ball game, but it was a very interesting day. I was impressed by the facility and the doctor here on this tiny third world island in the middle of nowhere.