This week we present two stories from people who were underwater both literally and metaphorically.

Part 1: Barbara Abernathy has always felt at home in the ocean, but when she undergoes a bone marrow transplant, her doctor tells her she can't go into the water for a year.

Barbara Abernathy, PhD, LMHC, is the President and CEO of the Pediatric Oncology Support Team, Inc. (POST), a nonprofit helping children and their families cope with the devastating effects of cancer. Being a cancer survivor herself, she brings a personal touch to the children and families battling childhood cancer. She has 30 years’ experience in nonprofits, 21 of those years at POST. She has a PhD in Counselor Education and Leadership from Florida Atlantic University (FAU), Master of Education in Counseling from the University of South Alabama, A Master of Science in Biology from FAU, and a Bachelor of Education in Human Development and Social Policy from Northwestern University. She is adjunct faculty at the University of Miami Miller School of Medicine and FAU. Other professional experience includes pediatric AIDS, bereavement, family counseling, parent education, and treatment of severely abused children. Barbara has presented as an invited speaker at many national and international professional conferences and numerous community and school settings. Her interview with Heal magazine was published in the Spring 2018 issue under the title: “Surviving Survivorship.” She has authored three scholarly peer-reviewed articles. She was awarded the Giraffe Award for women “who stick their neck out for others” by the Women’s Chamber of Commerce of Palm Beach County. She also won the 2017 Heroes in Medicine Award presented by the Palm Beach Medical Society and the 2018 MPN Heroes award given by the American Society of Hematology in December.

Part 2: With only two days to find and extract a sample from one of the oldest coral colonies in the world, Konrad Hughen finds himself at the bottom of the ocean with a broken drill bit.

Konrad Hughen is a Senior Scientist in the department of Marine Chemistry and Geochemistry at Woods Hole Oceanographic Institution (WHOI). He received a double B.Sc. in Biology and Geology at the University of California, Santa and was awarded a NASA Graduate Research Fellowship, leading to his Ph.D. at the University of Colorado, Boulder. Konrad was also awarded a NOAA Climate and Global Change Postdoctoral Fellowship, which he pursued at Harvard University before joining the scientific faculty at WHOI. As a geochemist and paleoclimatologist, Konrad’s research interests involve the development and application of proxy indicators for reconstructing climatic and environmental change, focusing on materials from modern coral tissues to centuries-old coral drill cores. His investigations have taken him all over the world, including recent expeditions to Micronesia, Red Sea, Maldives, Indonesia, Vietnam, Philippines and Cuba.

Episode Transcript

Part 1: Barbara Abernathy

Five years ago I was standing on the jetty in Florida looking out at the Atlantic Ocean and just drinking in its beauty because that was the moment that I had to say goodbye to the ocean to go have a bone marrow transplant.  The transplant doctor had told me that, for a year, I wouldn’t be able to get into the water because of all the treatment and it makes you immune-compromised.  It would be risky to get in the water with a compromised immune system and be susceptible to bacteria and just don’t count on it. 

I’m a scuba instructor.  I love the water.  I've grown up around the water.  The water is just such an essential part of me, of who I am.  It’s my happy place.  It’s my joyful place.  We all have that safe, joyful place that we go to and it just represents who we are. 

So that day I got in the water and I just was like, “Okay, let me just hold on to every memory of how this feels, the water against my skin holding me up, just the warmth of the sun,” just that moment drinking it in. 

And as I turned to leave, I said out loud, “All right.  This is goodbye for now but I’m going to be back.  Don’t go anywhere.  Give me a year.”  And I went to start my bone marrow transplant journey. 

But my story starts back in 1996 when I was diagnosed with polycythemia vera.  Google didn’t exist.  The internet barely existed.  It was almost impossible to get information.  When I was diagnosed, the doctor said to me, “Your grandmother had leukemia when she was in her 70s and she died.  Your father was in his 50s when he had leukemia and he died.  You're in your 30s.  You do the math.”  He said, “Don’t plan to be here to celebrate Christmas.” 

So I stopped planning my life and I stopped planning for the future.  I just lived for now, which it helped me function.  There was no real MPN community.  There were not people around that I could talk to, that I could go to with questions.  So I went through years and years of different treatments and, by 2013, a doctor said to me, “Your disease has changed lanes.  You now have myelofibrosis and it’s transforming into acute leukemia and you need a transplant immediately.” 

I was lucky enough that there was a donor.  Within a month they found a match and I went into transplant within two months and away from my beloved ocean. 

In the transplant unit, it’s so easy to lose a sense of yourself and who you are.  When you go into, like they had told me that once I entered those doors I could plan on not leaving there for at least a month.  I was going to be in the unit on isolation and that all I could do was walk from one end of the unit to the other which, as I got sicker and sicker and sicker, became further and further and further because my steps everyday got smaller and smaller as I got weaker and weaker.  Eventually, I came to know that it was about 300 baby steps from one end to the other because that was all I could do. 

I got so sick that I began to lose that sense of who I was.  I lost my hair.  I felt just so alone and scared.  There came a time where I was so sick that I didn’t know whether to pray for the strength to keep going or the courage to let go. 

But I thought about those kids that I work with and I thought, “Okay.  This is not going to be the end of my story.  I’m going to keep fighting and I’m going to get back there.” 

So I went into the bathroom and I ran water over my hands and I thought, “Okay, I need to reconnect with this part of myself.” 

I couldn’t take the shower because of the central lines and all the things that happen in transplant.  So I was in transplant for about five-and-a-half weeks and then, when I got out, I had to be in clinic every day, it was very restrictive and my life became defined by what I couldn’t do.  I couldn’t go into a restaurant and eat things off the menu.  I couldn’t go have a salad.  I couldn’t have a sub and I couldn’t… it’s just so hard to remember all the things I couldn’t do but one of the big things was not going into the ocean. 

But the day came that the doctor said to me, “You know, you're doing pretty well.  You can go do something, go a little bit further afield.  You can get more than five miles away from the hospital.” 

So I have my friend drive me to the closest beach.  I could only be in the sun for five minutes.  I got out and, immediately, I could just smell the sea air and hear the birds and know that I was back there, that the ocean was there, it was waiting for me.  I still couldn’t get in but, for five minutes, the sun was on my face and I felt like me again. 

I get back to West Palm.  Life goes on.  You get back to work and things.  You try to find a sense of yourself again, but I still couldn’t go in the ocean.  And every time I would see my transplant doctor, I would ask him like, “Okay, is it now?  Is this it or no?” 

“No.”  He's like, “You have to wait.”  And he said, “I’m trying to save your life.” 

I said, “I’m trying to live my life.” 

Finally, on January of this year, it’s more than four years after my transplant and again I said to him, “Okay, how about scuba diving?  What do you think?” 

He said, “No.” 

I said, “Well, all right.  So no scuba diving.  What if I go swimming with manatees?” 

He got really quiet and I thought, “Wait.  Okay, what is happening?” 

And there was this really long pause and I thought, “I don't know if this is really bad or really good but I’m just going to hang in there.” 

And he goes, “Yeah.  Yeah, you can do that.” 

And I was like, “Wait, what?”  I was like, “Okay, don’t break the moment because he doesn’t know what he said, and that’s fine.  So move on, move on.  Just move on.”

And he said, “You have to know that you're going to have to wear a dry suit and you can’t have any cuts on your body and you have to rinse off with distilled water and you have…”

I was like, “Fine, fine.  Okay.  Sure, sure.  You want me to stand on my head and sing Happy New Year?  Okay.  I'll do whatever it takes.  I’m in, as long as I can get back into the water and that sense of myself.” 

So I did all of those things and got ready. 

The day finally came.  I’m on a boat and I’m still like in a surreal state thinking, “Is this really happening?” 

So the boat is going out to the spring and we get there.  I slip into the water and it was such an emotional moment for me because it was like coming home but to a home that I didn’t think I would ever get to come back to.  And I realized in that moment that there had been the part of me that had held hope that I would one day get back to the person and place that I was and that I loved.  Then there was the other part of me that thought it would never happen, that feared that it was gone forever. 

And those two parts came together in that moment and it was so magical.  I think even the manatees realized that because this baby manatee swam right up to me and put his forehead against mine and I thought, “Thank you, God.” 

I got back on the boat and that’s when I realized that it wasn’t my moment.  That it belonged to everybody who was there that day.  There was this sort of sacred silence.  There was a hush on everybody who was there.  I think they realized how momentous this moment was for me and that they felt honored to be able to bear witness to that moment.  It was a moment of shared humanity, of people just coming together to bear witness to someone who had gone through some struggles, some hard times, walked through some darkness and had gotten to find light at the end of the tunnel. 

So for me, what I learned was that even in brokenness we can find wholeness.  And that joy may look different than we think that it’s going to but that hope has to live in all of us.  And that hope may look different than we planned but that it’s always there and it’s waiting for us.  Thank you.

Part 2: Konrad Hughen

I’m kneeling on a coral.  I’m literally on my hands and knees, alone underwater on top of a giant coral colony.  I’m surrounded by my equipment but nothing is happening.  Everything is quiet.  Justin is up on the boat and I’m down in the lagoon trying to figure out what’s going to happen next. 

I study climate change.  I’m a paleoclimatologist.  And I was leading an expedition to Micronesia to study the West Pacific Warm Pool.  The warm pool is a giant blob of hot water that the trade winds blow into the Western Equatorial Pacific and all that heat eventually has to flow to the poles and so it drives a lot of the ocean and atmosphere circulation around the world. 

I've always pictured it as a beating heart.  It’s fluctuating with the seasons and it is driving circulation out into the far reaches of the world.  And understanding how it’s changed in the past, whether or not it has predictable beats, rhythms of its own, it will tell us about, potentially, if we know how it has behaved in the past then we know how it may respond to human-induced climate change in the future. 

And to study past climate, I use drill cores from coral colonies.  Corals look like brightly-colored fuzzy rocks or maybe branching trees but they're actually colonies of millions of tiny polyps in a thin skin over a limestone skeleton that they have secreted continuously as they grow.  And as these corals grow, they deposit density bands that are just like tree rings.  So when we take a core, we can count those layers back through time and determine how old they are.  Then we do chemistry on the limestone and that can tell us about past temperature and past salinity and river run-off and lots of different things. 

I know that we are not supposed to touch corals.  And if you do touch corals, especially in the same place day after day then, yes, you can do damage and you can kill those polyps on the surface.  But we don’t spend a lot of time on the coral and we do take a core, and those polyps unfortunate enough to be living right in the circle that we take home will find their maker. 

But we do plug the holes that we drill with cement corks, with cement plugs and the corals will grow back over those plugs, four inches across, in a year-and-a-half.  Those scars will be healed completely and you'd never know that we were there. 

In this case, because of the logistics this trip to Micronesia, we weren’t able to make it to the most important site until the very end of the trip.  Kapingamarangi.  I love saying that.  Kapingamarangi Atoll.  Kapingamarangi is the southernmost atoll in Micronesia and it is closest to the center of the warm pool and that was our target site.  We had gotten some good cores from other sites before this but none of them were that large.  In some cases, there were not big colonies that we could find.  In some cases, the colonies had been deeply undercut on the sides or they had dead patches on top or they had crevices and cavities inside from burrowing worms and clams.  There's a lot of things that can mess with what would be a perfect coral record and so I was really, really nervous about getting…

We needed a record from Kapingamarangi.  It was key to the scientific mission of the whole expedition.  I was really nervous about whether we were going to find something.  We only had two days.  Finding colonies is actually one of the hardest parts of all of this work.  I’m pretty good at psyching out where corals - how they think - and I can usually find the patch of giant corals in a given area.  But it can take me days so we always, if it’s possible, we always invoke the help of the local fishermen.  They know the reefs like the backs of their hands.  Many times, I've had individuals point and say the largest colony on the island or in the country is right there.  And it is.  We motored over it in order to come to the village and talk to them, so that’s always a huge help. 

And in Micronesia, every single island that we came to, I would go and meet with the elders and meet with the chief and ask for permission to study their coral reefs.  And they were incredibly helpful.  They were open and friendly and they were excited that we were working on the corals.  They wanted the coral reefs to be studied.  They were incredibly sophisticated in their knowledge.  These are islands without metal or concrete, in many cases. 

And they knew about climate change and they knew that sea levels were rising and they had been observing erosion on their own islands.  So that was a big deal. 

At Kapingamarangi, the son of the chief took us out.  We went out into the lagoon and he took us to where he knew the large corals were, and there were many.  It was a beautiful garden of large coral colonies, and one in particular was just beautiful.  It was twenty feet tall, shaped like a gumdrop.  No cavities, no burrows, very, very smooth, perfect shape with a flat top, and I was ecstatic.  I thought we’re in business.  This is it because we found the colony that we need and we’re going to succeed.  We’re going to get what we want.  I’m going to get what I want. 

Now, don’t get me wrong.  Taking a coral core is difficult.  It’s hard work.  The drill rig is this big, steel beast like a jackhammer and we take the cores in sections so there's a lot of work and it’s heavy.  And when you're far down, when you're 10, 15 feet down the hole, you need to be using your senses.  If the core breaks and starts to crumble into rubble, that will kill the hole and you won’t be able to go any farther so it’s very intense. 

When I’m in the middle of it, and especially down deep doing this dentistry with steel bars like rebars, it’s crazy, I’m so focused I lose track of what’s around me.  I've had colleagues ask me, “Did you see that manta ray that was floating over you?”  And I had no idea.  So that does happen. 

But in this case, this core we started working with it, we started drilling and it was behaving beautifully.  It was not brittle.  Nothing was breaking.  After a while, we were pretty far down and everything was going smoothly.  I thought, again, we’re really going to get it.  This is happening and I couldn’t have been happier. 

Then the drill stopped moving.  This happens all the time.  The drill turns off and usually it’s something very short.  I stay in the water and my research assistant Justin goes up on the boat and he might change the fuel, he might make short adjustment, and then bubbles start coming out of the end of the drill again and I'll be back drilling before he can even come back down into the water. 

But I wait.  So in this case, I stay down on the coral and Justin goes up on the boat, but time drags on and the bubbles don’t come back on.  I start to realize slowly that this is going to be one of those bigger problems, which wouldn’t be the end of the world except that we have two days and so we can’t afford this kind of delay.  So I start to get this creeping dread.  My chest turns cold and I want to throw up, which is not fun underwater. 

So here I am, sitting on the coral underwater, waiting for news from above, which isn’t coming, and time is dragging on.  And, possibly, I’m underwater, I’m breathing slowly and can’t hear anything so I start to enter a meditative state.  I’m thinking about where I am, of course, and I can picture the earth and I can picture the warm pool rising expanding and contracting and changing size.  And I can see the beating heart of the earth and the warm pool and I can picture Kapingamarangi in the middle of that, right at the center of it.  And I can picture the lagoon at the heart of Kapingamarangi with this coral right at the center which is recording everything.  It’s aware of and watching and writing down everything that happens in its skeleton. 

Then things start to get weird.  The coral that I’m sitting on looks like a heart and I've got both of my hands on it thinking about the heart of the earth.  I start to feel like I’m holding the earth’s heart in my hands.  I’m holding Mother Earth’s heart and she's holding me.  I’m surrounded in this warm embrace of Mother Earth and it is completely overwhelming.  It is real.  I’m in the presence of something much, much, much larger than myself. 

And it’s not just a moment.  It’s going on and on and I realize how incredibly lucky I am to be where I am, to have had the opportunity to come to this place and see these lush coral reefs and to meet with these people, sometimes 150 people on an island, who live a life that is so different from mine.  And how incredibly important and special this opportunity was to be in this place. 

I don't know how long I sat there.  At some point, I came to my senses and remembered that I’m underwater and I’m breathing from a scuba tank.  So I slowly come back up to the surface.  I’m not worried about the drill anymore.  I am very thankful for what we've already gotten from the other cores that we've gotten.  And it’s not about the cores.  I’m grateful for the experience that we've had.  And I’m no longer worried about what’s going to happen.  I am willing to accept whatever we’re given. 

Maybe it’s because of that.  I don't know.  But of course, everything worked out.  We fixed the drill and went back the next morning.  We were able to take a core right to the bottom of the largest colony and brought back an incredible record that extended 400 years and has given us a lot of great information. 

But that coral core was not the most important thing or the most valuable thing that I brought home from that trip.  Not even close.