Shock new details of Thai cave rescue
On Saturday, June 23, after their weekly soccer match, 12 members of the Wild Boars Academy Football Club set out with their coach - 25-year-old Ekapol Chantawong - for a trip to Tham Luang caves, north of Chiang Rai in far northern Thailand.
It was one of the many adventures the tight-knit group - the youngest boy was just 11, the eldest 16 - had together.
The caves are off-limits in the monsoon season from July to November but the group had no concerns about wet weather and had hoped to walk the 10km to the end of the cave system to scrawl their names on the back wall. But when they turned to leave about 5pm, they found themselves cut off by flooded passages.
Over the next two weeks, the world watched as hundreds of experts from around the planet descended on the small Thai village of Ban Chong and set about one of the most intrepid rescue efforts the world has ever witnessed.
This is an edited extract from The Cave, a book by ABC South-East Asia correspondent Liam Cochrane, who was there for the rescue.
FIRST, A SECRET PRACTICE RUN
In order to give their plan every chance of success, the rescuers prepared in every way they could think of. The rehearsals started at a school 10km from the cave, in Mae Sai town. It was Saturday, July 7, the morning after the dive option had been decided upon.
The pool had been taken over by a select group of Thai Navy SEALs and US soldiers, as well as the British divers, for a secret practice run. In these controlled conditions, the team would simulate the most dangerous part of the operation - putting a child underwater and swimming them out.
Standing around the pool were three boys of small, medium and tall builds - roughly the same sizes as the boys trapped in the cave. The boys had volunteered for the job.
The rescuers put each boy into a wetsuit, put a buoyancy vest on them and, finally, strapped an air tank to their fronts. To do this, the divers had modified a harness, adding a handle on the back to carry the boy, and bungy straps to the front to attach the cylinder - known to cave divers as a "bottle bra".
They added a lead weight to a pocket in the front. The theory was that if something went wrong and the boy somehow separated from his chaperone, the weight of the lead and the tank would drag him to the bottom of the cave, still face down. With luck, he would remain there - breathing - until the diver could find him again.
The practice run was a success. The team had proved they could put a young non-diver underwater using a full-face mask and a front-mounted tank, and move around. But this was in the relatively pristine environment of a school swimming pool. Would it work in the dark, flooded tunnels?
DR HARRY HAS HIS DOUBTS
The arrival of anaesthetist Dr Harry [South Australian cave diver Dr Richard Harris] might have suggested that perhaps some kind of sedation would be involved in the rescue.
But, at the time, this was a closely guarded secret. In a testament to the old adage "never believe something until it's officially denied by the government", Thailand's Prime Minister, General Prayut Chan-o-cha, denied claims the boys would be unconscious.
But in fact, a powerful sedative would be used to knock the boys out during the rescue. They would be unconscious; it was their only chance of getting out of the cave alive.
For Dr Harry, the question was: what cocktail of drugs should he use? What do you give malnourished boys so that they stay still, and aren't traumatised by being dragged underwater through a hostile cave environment?
This kind of rescue had never been attempted before, so there was no rule book. Dr Harry consulted widely, seeking the opinions of other medical experts in Thailand and abroad.
In the end, the anaesthetist came up with a combination of three drugs. First, he would give them a 0.5 milligram oral dose of alprazolam, an anti-anxiety drug better known by its trade name, Xanax.
Giving the boys a tablet of this while they were still with their friends would hopefully take the edge off any fear they had as they prepared to leave.
Next, he would inject ketamine into a muscle in one of their legs - this would be the main sedative. A powerful drug originally developed as an animal tranquiliser, it has also been used as a painkiller for humans and, in more recent times, as a recreational drug by partygoers. It was also known to knock out memories - perfect for the job inside Tham Luang.
Dr Harry would use five milligrams of ketamine per kilogram of body weight, to put the boys to sleep. Ketamine acts fast but doesn't last long - about an hour.
The rescue, however, would take several hours.
This meant that Dr Harry had to instruct each of the recovery divers how to re-administer the drug using a syringe pre-loaded with a top-up dose of 2.5 milligrams for every kilogram of body weight. The divers would carry the drugs and needles in pockets in their dive wetsuits.
The last drug, atropine, was to reduce the amount of saliva in the boys' mouths. This would also be injected into their leg muscles.
The divers knew that a leak in the seals of the full-face masks could be fatal, but the Australian doctor thought of something few had considered - that excess saliva could drool into the face masks and become a drowning hazard for the semi-conscious youths.
Dr Harry had carefully considered the types of drugs and dosages that would be used, based on his years of experience and the advice of other experts. Still, he was not at all confident.
"Personally, I thought there was zero chance of success; I honestly thought there was no chance it would work," he would later admit. \
"So we set up a system for some feedback to come back after the first one or two kids, and if they hadn't survived that first sump [a passage in a cave that is completely submerged], which was the longest one, although not the most difficult one, then I was going to say, 'Well, that's all I can do', [and] walk away at that point."
WHO WANTS TO COME OUT FIRST?
By Saturday [July 7], the Wild Boars team had been inside the cave for two weeks. The energy gels, food and company had restored their strength, but the wait was dragging on.
When the British divers had first popped up and told them the SEALs were on their way, the boys thought that meant they'd be getting out immediately. Five days later, they were well and truly ready to leave.
At about 8.20am on Sunday, the divers gathered for a briefing. There were more than 100 people involved in the operation and they all began their final preparations.
About 10am, the four recovery divers entered the cave. They were followed by Dr Harry and the support divers. The rescue operation had begun.
Outside the cave, there was much speculation about who would be brought out first. There were two main schools of thought.
Some believed the strongest boy would go first, as a test, to give the rescue workers the best chance of success.
Others said it would be the weakest boy, because he'd need medical attention the most urgently. In fact, the choice had nothing to do with the relative strength of the teammates.
"I talked with Dr Harris," said [Thai army doctor Lieutenant Colonel Dr Pak Loharachun], who was caring for the boys inside the cave with the Thai Navy SEALs.
"All of them are healthy, no complications whatsoever. Everyone is more or less the same strength. We talked about how we are taking them out, the small one out first, or the bigger one, or other criteria. Dr Harris told me, 'It doesn't matter who is out first'."
So the question was put to the boys: whoever wants to go first, raise your hand. Many hands went up. Dr Pak decided to delegate the decision to Coach Ek, the one who knew the boys best.
"The SEALs asked me to make that decision," explained Coach Ek.
"So, [I decided] the first set would be those who come from [the village of] Ban Wiang Hom, for the reason that they live further away. What we planned was, once they were out, they would ride their bicycles home and let the other families know that the rest of the boys would be out tomorrow. And they would ask them to please cook some food for us."
The coach's reasoning showed how little the Wild Boars understood of what was happening outside. They had no idea that their rescue had become the biggest news event in years and that the whole world was transfixed by the dramatic operation.
FIRST, WE TAKE NOTE
Note was the first Wild Boar to go. The 14-year-old was already wearing a wetsuit, a welcome layer of warmth in the cool cave. But the wetsuits were ill-fitting and hypothermia remained a real risk during the several hours they would spend in and out of the water.
Note walked down the slope to Dr Harry, and sat in his lap. The Australian anaesthetist was known for his calm, reassuring bedside manner. He prepared two syringes and eased them into each of Note's legs. Note was quickly unconscious.
He was then put into the rest of his diving gear - a buoyancy vest, the modified harness with a handle on the back, and an air tank strapped to his front. They chose not to use helmets for the boys because it interfered with the fit of the masks, but they placed packing foam inside the wetsuit hoods to give their heads some protection.
The air was turned on and the all-important full-face mask was fitted.
The divers carefully checked and re-checked the silicone seal to make sure it was tight against Note's face. It took about 30 seconds for Note to start breathing normally through the face mask.
Then, they did something that wasn't revealed to the public. They tied cable ties around Note's wrists and clipped them behind his back.
It was a final measure to secure the child and make sure that if he did wake up from his ketamine slumber, he wouldn't try to rip off his face mask, endangering both his life and that of his rescue diver.
It must have felt strange to handcuff the sleeping boy, but it was for his own good.
Then it was time for Dr Harry to do the final check - a nerve-wracking leap of faith.
"When I did my first test of pushing their face in the water - which … feels very wrong, I can tell you, the first time you do that - [there was] about a 30-second gap and they'd start breathing again."
[British diver] Jason Mallinson volunteered to be the first recovery diver. He took hold of the harness strap on Note's back and carefully submerged.
He held the boy close, in roughly the same position as a tandem skydiver and an instructor, strapped together. Mallinson watched for bubbles in front of him as he began swimming cautiously through the first flooded tunnel.
The first dive was a long one, about 350 metres.
When Mallinson surfaced in Chamber 8, [Perth vet and cave diver] Craig Challen was ready to conduct a quick medical check. [British diver] Rick Stanton was also there. Challen and Stanton helped carry Note through the dry section. They brought Note out of the water and placed him on what they called a "drag stretcher", which they would use to transport him across to the next sump.
The dry section was around 200m, long enough to require removing his diving gear. With the tank and lead weight, the boys were just too heavy to easily manoeuvre. And the divers didn't want to risk the heavy tanks bumping into the unconscious children and injuring them as they struggled over the rocks.
Satisfied that Note was stable, they placed his diving gear back on, again paying attention to his full-face mask, ensuring it was tightly sealed around his face.
Then Mallinson was on his own again, completely responsible for the life in his hands.
Once at Chamber 3, Mallinson's job was done. At about 4.50pm [nearly seven hours after the rescue had begun], he handed Note over to the US military team to do a medical check. All good. The boy was loaded onto the stretcher.
The Chiang Mai rope team pulled him up to the top of what Chinese rescue worker Li Shuo called the "little mountain". The stretcher travelled along the zip line, down to the American and Chinese men below.
The rescue workers used the large orange water pipes installed in the cave as a rail for the hard plastic stretcher to slide on, carefully guiding it over the boulders.
From the end of the zipline to the entrance, the terrain varied. The stretcher was carried, floated through a 3m sump, carried, floated through a 10m sump, and passed on again.
There were more than 100 people involved in this high-stakes game of pass-the-parcel - one slip of a rescuer's boot could bring the whole thing undone. At every moment, arms stretched out, waiting to carry or to catch Note.
This was truly an international effort, with the boy lifted to freedom by rescuers from Australia, the UK, Finland, Denmark, Canada, Belgium, the US, Thailand, China, Singapore and possibly other countries.
Political and personal tensions dissolved in the darkness, as the big, messy world focused down to one thing: keeping that boy alive.
"Once he was handed over to us, we were down at his face mask, just listening for that breath," said Senior Constable Matthew Fitzgerald of the Australian Federal Police. "He was breathing - there was instant relief."
All the while, Note lay unconscious in his stretcher.
The full-face mask remained on and an air tank was strapped into the stretcher, pumping the special mix of oxygen-rich air.
As he reached the entrance of the cave and was passed over to the Thai medics, a cheer went up among the rescue workers.
This cheer spread backwards, like a wave, through the tunnel, a moment of happiness and relief. They'd done it.
Now, just 12 more to go. ■
Edited extract from The Cave by Liam Cochrane (ABC Books, $30), published today