Anna Bågenholm is no superhero, although her incredible feat of survival may have you thinking otherwise. A Vänersborg-born Swedish radiologist, Bågenholm travelled to Narvik, Norway to complete her residency. It was during this time in the May of 1999 that a routine skiing trip left Bågenholm on the brink of death.

Seconds later, her head and torso became trapped under the 20cm thick layer of ice, with only her legs, complete with skis still attached, remaining above the surface. Arriving moments later, her two friends were able to grab her legs to stop her from disappearing beneath the ice entirely, but struggled in vain to drag her back to safety. As her clothes became increasingly saturated with water, with the extra weight trying to pull her deeper and deeper, any hope of recovery seemed slim at best.A keen skier who often hit the slopes upon finishing her shift, the crisp May morning in question was no different for Bågenholm as she and two friends, Torvind Næsheim and Marie Falkenberg, headed for the nearby Kjolen Mountains armed with their skis. The trip took a turn for the worse however, as Bågenholm lost control during the descent, falling with force onto the surface of a frozen stream. The ice cracked as her back, along with her full body weight, impacted the surface, and Bågenholm was dragged head-first into the icy waters.

Seven minutes after Bågenholm first fell into the water, her colleagues called for help on a mobile phone, but it took a full eighty minutes for the rescue crew to free her. During this time, Bågenholm had fortunately managed to locate an air pocket beneath the ice, which allowed her to breathe and stay conscious for forty minutes before circulatory arrest caused her to black out.

By the time her rescuers finally managed to get Bågenholm free of the icy water she was eerily white in appearance, her blood was no longer circulating and her breathing had ceased completely. The battle to save her life, to some, seemed lost already.

Refusing to be discouraged even in the face of such slim odds, Gilbert rushed Bågenholm into an operating room and began the process of warming her blood manually outside of the body using a heart-lung bypass machine. This machine, usually reserved for major surgical applications, allowed the medical team to rapidly raise Bågenholm’s temperature while keeping the risk of further complications to a minimum. The newly-warmed blood was then reintroduced to Bågenholm’s circulatory system. Just thirty minutes later, Bågenholm’s body temperature had climbed to a much more stable 87.8°F (31°C), but the battle was far from over.The average human body temperature, and the one at which we function best, is 98.6°F (37°C). When Bågenholm arrived at the hospital, her internal body temperature had dropped to a staggering low of 56.7°F (13.7°C). As it only takes a drop of approximately 2°C to be defined as in a state of hypothermia, with further drops severely increasing the likelihood of serious injury or death, it’s safe to say the situation looked bleak. Fortunately for Bågenholm, Mads Gilbert, the doctor in charge of the resuscitation effort, refused to give up on her, citing the often-quoted mantra of “nobody is dead until they’re warm and dead”.

The problem lay in her peripheral nerves, which had been damaged to the point of failure by the extreme cold. Fortunately, unlike in cases of paralysis caused by spinal cord injuries as they usually are, Bågenholm’s nerves were able to recover over time. Following her initial six week stay in hospital for treatment, Bågenholm endured four months of rehabilitation before she could walk again. Six years on from the ordeal, following an extensive and gruelling rehabilitation effort, Bågenholm was healthy enough to return to the slopes.Despite struggling initially, Bågenholm’s heart was eventually able to recover as her temperature rose, and approximately three hours after her arrival at the hospital it began to beat independently for the first time since her frosty fall. Twelve days later, Bågenholm awoke, but the situation she found herself in was far from ideal. She was completely paralysed from the neck down.

Now that you know Bågenholm’s story, it’s about time we turned our attention to the point raised in the title of this article: just how was Bågenholm able to survive a situation which, by all logical reasoning, should have killed her?

They key to her miraculous survival was the manner in which her brain had reacted to the cold. In fact, the very same cold that had threatened her life turned out to be the one thing that kept her alive, as the plunge into, and sustained immersion in, the icy water had essentially flash-frozen her brain. In this state, her brain required much less oxygen in order to survive due to the way that cold slows down pretty much all biological processes. This meant that, even as her heart stopped pumping and her body’s oxygen supply was cut off, her brain was able to continue functioning in a somewhat dormant state.

Bågenholm’s tale of survival is truly awe- inspiring. At the time, Bågenholm had officially endured the lowest recorded body temperature ever survived. That record was broken in 2010 by a seven-year-old Swedish girl known only as Stella with a body temperature of 55.4°F (13°C), but Bågenholm still holds the record for the lowest body temperature ever recorded in an adult.

As it turns out, there is actually a scientifically-backed reason as to why young children are more adept at surviving such extremes. Basically, it boils down to their surface area to body volume ratio. With less of their total body mass held beneath the skin, the child is able to cool down more rapidly, and as a result enter a more stable state much sooner than an adult in the same situation.

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