Paul Auerbach, MDWilderness Medicine
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Sharkwater

Paul Auerbach, M.D.
The oceans are our greatest wilderness. On a recent trip to Hawaii, I was in an aquatic mood and watched the recently-released DVD entitled "Sharkwater." It is a very fine production that should be watched by every person interested in marine conservation, because it describes eloquently what is happening to one of the most important species on our planet.

The story line revolves around Rob Stewart's personal interest in sharks, beginning with a brief explanation of his interest in diving and underwater photography, and culminating in his current devotion to conservation and cinematography. The tale is fascinating, and will serve a great purpose in heightening awareness of the plight of sharks worldwide.

To being, I quote from the extensive website devoted to this production, education, and shark conservation:

"For filmmaker Rob Stewart, exploring sharks began as an underwater adventure. What it turned into was a beautiful and dangerous life journey into the balance of life on Earth.

Driven by passion fed from a lifelong fascination with sharks, Stewart debunks historical stereotypes and media depictions of sharks as bloodthirsty, man-eating monsters and reveals the reality of sharks as pillars in the evolution of the seas.


Filmed in visually stunning, high definition video, Sharkwater takes you into the most shark rich waters of the world, exposing the exploitation and corruption surrounding the world's shark populations in the marine reserves of Cocos Island, Costa Rica and the Galapagos Islands, Ecuador.

In an effort to protect sharks, Stewart teams up with renegade conservationist Paul Watson of the Sea Shepherd Conservation Society. Their unbelievable adventure together starts with a battle between the Sea Shepherd and shark poachers in Guatemala, resulting in pirate boat rammings, gunboat chases, mafia espionage, corrupt court systems and attempted murder charges, forcing them to flee for their lives.

Through it all, Stewart discovers these magnificent creatures have gone from predator to prey, and how despite surviving the earth's history of mass extinctions, they could easily be wiped out within a few years due to human greed."

Again, from the website, here are the listed awards already garnered by this movie:

Canada's Top TenToronto International Film Festival
People's Choice Atlantic International Film Festival
People's Choice Ft. Lauderdale International Film Festival
Best Documentary Ft. Lauderdale International Film Festival
Spirit of Independents AwardFt. Lauderdale International Film Festival
Special Jury Award Hawaii International Film Festival
Best Musical Composition France World Festival of Underwater Pictures
Prix Planete Thalassa France World Festival of Underwater Pictures
Best of the Festival Palm Springs International Film Festival
Best International Doc Beverly Hills Hi-Def Festival
Best HD Feature AFI Dallas International Film Festival
Audience Choice Award for Best FeatureGen Art Film Festival
Grand Jury Award for Best FeatureGen Art Film Festival
Peter Benchley Shark Conservation Award Shark Research Institute
Special Jury Award15 Short Film Festival – Charlotte, NC
Must-See Award (Category: Wake-Up Films)Telluride Mountain Film Festival
Hero of Conservation – Water Category Conservation for the Oceans Foundation
Top Ten Films Cambridge Film Festival
Jameson Audience Award for Best International Documentary Encounters South African Int’l Doc. Festival
Best Documentary Film - Nominee Critics Choice Awards
Animal Action Award International Fund for Animal Welfare
Best Documentary Directors Guild of Canada
Best Of The Festival Santa Barbara Ocean Film Festival
Best Sound - Nominee Golden Reel Awards
Best Documentary - Nominee Genie Awards
Best Environmental Film of 2008 National Ocean Film Festival Alliance

The story line in this DVD is compelling, and can be distilled down to two major concepts. First, indiscriminate and/or illegal fishing is devastating marine fish populations. Second, the harvesting of sharks solely for the purpose of finning to enable production of shark fin soup is an overwhelming destructive force in the animal kingdom. Upon these two insights, Stewart drapes the remainder of the video.

There are two moving statistics printed in black and white at the conclusion of the DVD. In the 89 minutes that it takes to view the production, fifteen thousand sharks are killed. Ninety percent of the world's shark population has been depleted by man, and the remainder is at risk. What will it take for us to stop the slaughter?

The video is punctuated by moments of great storytelling, mostly surrounding the high seas adventure organized by Paul Shepherd, who is a renowned warrior in the world of environmentalism. The exposure of an international consortium designed to decimate the world's shark population in order to serve unnecessary soup for profit is disturbing to the maximum.

There are a few moments in the DVD that seem out of place, and noncontributory to the major premise. A good example is the digression describing Shepherd's affliction with "flesh eating disease." The reenactment of his hospital stay is unrealistic and amateurish filmmaking, so I wish it had not been included. Fortunately, it is possible to overlook this awkward moment and focus upon much more important aspects of Sharkwater.


If the collective mentality of the fishing industry, governments, and regulatory agencies allows marine species slaughter on the scale portrayed in Sharkwater, we will see wholesale extinction of sharks and other marine animals in the next century, and perhaps in our lifetime. I'm afraid that similar situations exist with hundreds of species in the oceans and on land, and that there will soon be an entire library of film productions devoted to life as we knew it, rather than as we should know it. Watch Sharkwater soon, and see for yourself.

image of shark fins courtesy of www.sharktrust.org


Preview the 25th Anniversary & Annual Meeting of the Wilderness Medical Society, which will be held in Snowmass, Colorado July 25-30, 2008.

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Shark Attack Tragedy

Paul Auerbach, M.D.
I don’t have the complete details, but from what I know about sharks, it was bound to happen. An Austrian diver in the presence of intentionally attracted (with bait to feed) sharks was bitten by a bull shark and bled to death in Bahamian waters. Of course, our hearts go out to the victim, family, and friends. I also feel badly for the proprietor of this adventure, who certainly would never have intended for something like this to happen. No doubt, there will be finger pointing, recrimination, incredible remorse, and possible litigation.

Shark attraction and feeding for the benefit of viewing diver audiences have been going on for decades. The only safe way to do this is to have the divers observe the animals from within the confines of impenetrable (to sharks) cages, not in open water. The owners of the businesses that promote shark diving wouldn’t have been providing this service if they thought it was exceedingly dangerous. But as we all observed with the tragic stingray puncture to Steve Irwin’s heart, undersea creatures are often swift, strong, wild and above all, unpredictable, animals. Sharks should should never be considered domesticated or safe because they have been in the presence of humans. Their fight, flight, and other defensive mechanisms are guided by primitive and highly conditioned responses intended to promote their survival. They are, plain and simple, predators. When they are feeding, they are considered to be more prone to bite humans. Standard shark avoidance advice is to stay away from sharks during intense feeding activities, to avoid being mistaken for intended prey.

Sharks are fast swimmers endowed with remarkable sensory systems, and when they become disturbed, especially in the feeding mode, there is very little that a human can do to evade an attack. The usual admonition is to seek protection from behind and the sides if possible when a shark swims in an “agitated” fashion, which is what you would expect during provoked feeding of a group of sharks attracted by blood and chum in the water.

It is hard to tell what this will mean for guided shark feeding experiences. Given that it appears to be the case that this victim was bitten by a shark that was within a group being fed for show, my future recommendations are set. Although some might argue that it may still be all right to arrange out-of-cage shark feeding experiences with "less dangerous" species, I don't recommend it. Although certain sharks have less propensity to attack humans, these same animals have sharp teeth and are capable of creating severe bite wounds. It is impossible as a doctor who gets consulted about the clinical manifestations of shark attacks to advise it is acceptable for people to intentionally be in open water in the presence of a group or school of feeding sharks, particularly if they exhibit aggressive behavior.

photograph of bull shark by Howard Hall

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Myths to Debunk

Paul Auerbach, M.D.

There are many myths related to outdoor medicine. These need to be “debunked,” so that people do not fall prey to outdated and useless techniques. Here are some of the most common myths (in italix):

1. Mechanical suction, electric shock, and immersion in ice water are effective first aid (“field”) therapies for snakebite. In truth, these are not only not helpful, they may be quite harmful. Antivenom therapy is the only therapy that has been proven effective, with the possible exception of pressure immobilization for certain elapid (e.g., coral) snake bites.
2. Urinating on a jellyfish sting is an effective method to reduce pain. This is of very limited value. Some persons will cite that it was helpful in their particular case, but at least as many persons will state that it did not diminish the pain. The most effective therapy is decontamination with a specific topical compound, such as vinegar or ammonia. The decontaminant chosen depends upon the species of stinging jellyfish.
3. Applying a cold pack to a jellyfish sting is the most effective method to reduce the pain. Current information indicates that application of warmth (e.g., immersion in non-scalding hot water) may be much more beneficial.
4. Rabies shots are injected into the abdomen and are horribly painful. Not true- post exposure rabies vaccination may include a painful component as rabies immune globulin is injected into the bite site, but the subsequent vaccine, which is administered as part of the post exposure treatment, is given as a series of very tolerable injections into the arm or thigh.
5. In any circumstance of frostbite, rapid rewarming is essential. Actually, this should only be done if the body part can be relatively guaranteed to remain thawed. Otherwise, re-freezing the tissue causes significantly more damage than does the initial episode of freezing.
6. The Heimlich maneuver should be used for any victim of submersion (near-drowning) to remove water from the lungs and improve the chance for survival. The Heimlich maneuver has never been proven to be of use in humans in this situation, and may in fact increase the risk for vomiting and harmful inhalation of gastric contents. There is no evidence that it removes water from the lungs.
7. Drinking large amounts of liquids is harmful during exercise because it promotes stomach cramps. Quite the opposite – so long as the ingested amounts are prudent and don’t promote nausea from a full stomach, it is essential to replace fluids and electrolytes constantly during periods of high exertion, particularly in the heat, to avoid dehydration.
8. A person struck by lightning is “electrically charged” and may not be safely touched. This is not true. It is perfectly safe to touch such a person, and in fact the sooner that breathing can be supported, the more likely that the victim will survive with maximal neurological recovery.
9. In cold water, it is better to remain in the water where one feels warm that to pull oneself onto a rescue vessel or platform and be exposed to wind chill. Absolutely not true – one may lose heat 25 times as fast in the water as in air, so no matter how uncomfortable you feel, if it is possible to get out of the water, do so.
10. Sharks and bears are attracted to menstrual blood, so it is important for women to avoid diving and hiking during menstruation. This is a false concept, and has never been proven to be true, either epidemiologically or scientifically.

photo by Jenny Hargrove

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