On September 1, 2023, American caver Mark Dickey was exploring uncharted passageways of Morca, one of many longest, deepest caves in Turkey. Rugged and distant, nestled deep within the Taurus Mountains, simply reaching Morca’s entrance requires 4 hours on a 4WD observe from the closest settlement.
Dickey’s expedition had arrange a base camp 1,000 meters (3,300 ft) deep within the cave. Reaching this camp from the floor necessitated roughly 12 hours of subterranean journey, a posh array of rappels, climbs, traverses, crawls, and ultra-tight squirms, generally by way of mud, down waterfalls, and throughout frigid underground streams. Briefly, accessing the decrease vestiges of Morca is like wiggling your means by way of a subterranean “Ninja Warrior” course.
Dickey and his fiancé, Jessica Van Ord, had been an hour away from the expedition’s 1,000-meter base camp, roped up in the course of a vertical climb.
That’s when issues went unsuitable.
The Rescue Skilled in Want of Skilled Rescue
This was Dickey’s second expedition to Morca. The earlier yr, he’d accomplished a 100-meter (330-foot) dome climb close to the 1,000-meter base camp. “From the highest of that climb, [I could see] a waterfall coming in from one aspect of the shaft, and a window within the ceiling on the prime, extending one other 20 to 30 meters,” Dickey advised The Outside Journal.
His return in 2023 had a number of functions, together with scouting the placement to host future programs for the Caving Academy (a nonprofit he based).
However that glimpse of additional passages had additionally enticed him. “I needed to get again over to that climb,” he mentioned, “and see if I used to be capable of get my means by way of the window, to push previous a flooded or slumped passage to see if we might get into a brand new part of the cave.”
However 80 meters up the climb, shit hit the fan. Dickey started feeling deathly in poor health. “Dizziness, nausea, needing to go to the lavatory, chilly sweats… only a complete bunch of simultaneous disagreeable signs,” he mentioned. He instantly rappelled all the way down to the bottom of the dome, and advised Van Ord he wanted one factor: “Privateness.”
The outcomes weren’t very best. Dickey had produced a wealth of “black, tarry stool.” Mixed along with his signs, it pointed to main inside bleeding. 12+ hours beneath the earth, with none bagged blood for a transfusion, this was a life-threatening state of affairs.
Relying on the way you take a look at it, it was both extraordinarily good (or dangerous) luck that this emergency hit Dickey, and never another person within the expedition. The workforce’s lead rescue coordinator was Dickey himself. The 40-year-old American is among the most skilled and revered cavers on the earth, significantly within the realm of rescue operations.
A former firefighter and EMT, Dickey dove into the caving world within the Nineties, and has now taught for the Nationwide Cave Rescue Fee for over a decade, main multi-day programs in a wide range of areas round the USA annually.
By his early 30s, Dickey was working throughout the pond, educating with the European Cave Rescue Affiliation (ECRA). He presently serves as secretary of the outfit’s medical fee. For the final a number of years, he’s additionally ranked as chief of the New Jersey Preliminary Response Crew—a SAR group overlaying the Northeastern United States.
Dickey specializes as a lead teacher for “SPAR” (Small Get together Assisted Rescue) programs. Versus exterior groups coming in to rescue cavers, SPAR programs give attention to “a small celebration rescues one among its personal members, who’s alert, oriented, and ambulatory to some extent,” Dickey defined.
(It’s onerous to overlook the irony right here. That is the precise state of affairs he was now in, deep in Morca.)
The Name for Assist
Within the bowels of Morca, bleeding his personal bowels out, Dickey managed to get again to his workforce’s base camp with Van Ord’s assist. This hour-long jaunt was an odyssey in and of itself, requiring not simply walks and crawls however climbs and vertical rope work. “My situation was disagreeable,” Dickey mentioned, “however hey, you push by way of and do what you’ll want to do.”
As soon as the pair had been again at camp and had alerted the remainder of the expedition, Van Ord ready to go up for assist. This was a necessity, as a result of their camp had no direct reference to the skin world. In contrast to within the backcountry, for instance, Dickey and his workforce weren’t capable of merely ship out an SOS on an inReach or different satellite tv for pc communicator. No helicopter might swoop in and decide them up or drop off provides.
There may be solely a small cadre of cavers with the expertise to securely attain these depths, a lot much less get somebody out of them, and a number of other of them had been down there in Morca, sitting round a debilitated Dickey making an attempt to determine the way to assist him. For all intents and functions, they might as effectively have been in outer area.
By this level it was nearing midnight, and the workforce had already operated all day lengthy. Dickey satisfied his companion and one other caver going up along with her to sleep for a couple of hours, see how he felt within the morning, and go for assist then.
The next morning, with Dickey seemingly comparatively secure, Van Ord and the opposite caver started climbing. Earlier than they’d made it up two pitches, Dickey was violently vomiting blood. It was clear that issues had been severe. Earlier than she made it out of the cave, Dickey’s vomiting had elevated to a major quantity, requiring one other workforce of two cavers to climb out with this up to date information, whereas the ultimate two cavers stayed behind with Dickey.
“Two or three deciliters of recent blood had been misplaced in a single occasion of vomiting,” Dickey mentioned, talking of his personal near-death virtually as if he was describing a medical state of affairs from a textbook. “So this was now a life-critical state of affairs. Medical care is instantly obligatory and relying on how issues go, it’s applicable to begin a rescue response even when it will get known as off afterward.”
Dickey paused. “I knew that this was going to be, a technique or one other, a really large occasion.”
A Worldwide Response
Van Ord hoped she’d solely need to make half of the 12-hour climb to get in contact with the crew topside. As one of many workforce leaders, Dickey had ensured that communications traces had been run all the way down to 500 meters (1,640 toes) of depth earlier than the expedition descended, however between the final examine of the cellphone on the floor and Van Ord arriving on the 500-meter camp two hours later, the battery within the floor cellphone had died.
“Comms was non-functioning precisely in the intervening time that Jessica arrived there,” Dickey mentioned, forcing his fiance to go all the best way to the floor to succeed in assist.
Up prime, Van Ord contacted ECRA and caving medical doctors utilizing a medical chat Dickey had began two years prior. Groups from all around the world started flying in: Hungary, Bulgaria, Croatia, Italy, Poland, Slovenia, and the USA.
These weren’t simply cavers flying in for knowledgeable rescue although. They had been coming to assist a buddy.
Out of the 200-odd individuals who got here collectively from 9 completely different nations to assist within the rescue effort, Dickey mentioned he knew near half, and a big proportion of these fairly effectively, many from instructing them personally in cave rescue. Nearly all of these flying in had heard of Dickey, as one among ECRA’s main medical officers.
The primary individual Van Ord known as, late on the night of September 2, was Dr. Nagy Dénes Ákos, workforce chief of the Hungarian Cave Rescue Service. Ákos instantly handed the phrase to fellow Hungarian physician and cave rescue professional Zsófia Erzsebet Zádor, an in depth buddy who first met Dickey and Van Ord in 2015, throughout an ERCA expedition in Montenegro. Zádor was in the course of a 24-hour hospital shift however dropped every part to fly to Turkey and assist.
After choppering into the mountains to succeed in the cave mouth, Zádor was dismayed on the infrastructure. “There was little or no to facilitate a rescue,” she mentioned. “A small kitchen, a restroom amongst some rocks, no gear for doing something technical, like further rescue ropes. There was additionally no electrical energy, only one little photo voltaic panel.”
By the point Zádor arrived, Van Ord had already secured provides from the floor and was making her means again all the way down to Dickey with fluids and drugs to mitigate his blood loss.
His situation was quickly worsening. “I had transitioned from talking in full sentences and with the ability to journey to the lavatory to speaking in phrases, vomiting right into a bucket, peeing right into a bottle, and utilizing a rubbish bag for shitting,” Dickey recounted. “Finally, my communications had been all the way down to single phrases. My pulse was getting progressively weaker.”
On September 4 Zádor, too, started descending into the cave with two Hungarian comrades. They left the cave mouth at 10:00 am, carrying 5 rucksacks of provides, and eventually reached the expedition base camp at 11:00 pm, 13 heinous hours later.
By the point she reached Dickey, Van Ord, and the others, the previous had stopped vomiting recent blood, and his situation was considerably secure, helped by fluids and proton pump inhibitors offered by Van Ord upon arrival Blood packs arrived the next day, and the workforce started a transfusion, additional stabilizing Dickey’s situation. At this level, there was not a direct menace to his life. The brand new mission was getting him out.
Van Ord, who has been coaching in cave rescue since 2016, credit a speedy early response from the Turkish authorities with saving her fiancé’s life. “The federal government acquired fluids there, they acquired blood there, and issues we could not have completed on our personal,” she mentioned. “There have been at the least three events when the bleed restarted and Mark would have died with out the IVs.”
“I used to be astonished that it truly occurred immediately,” she added. “Individuals have died as a result of they did not know the way to ship folks right into a cave. There have been horrible outcomes from cave rescue up to now.”
Climbing Out of Morca
Even as soon as the world had been alerted and provides had been despatched, and Dickey had been stabilized, there was no easy crusing. They had been nonetheless within the depths of the earth.
“Working at 1,000 meters, your circadian rhythm completely disappears,” Van Ord mentioned. “Lots of people will begin staying awake for 20 hours, after which ultimately they’re waking up at 5:00 PM. So as a substitute of getting 5 days, they’ve 4 more and more lengthy ones. Your physique clock can get fairly fascinating…”
An alpine cave, Morca can be fairly chilly (4°C/39°F). This offered an ever-present hazard of hypothermia for Dickey. The flip aspect of that’s this was the best temperature to maintain the bagged blood refrigerated, Van Ord mentioned, however then it truly needed to be warmed up by physique warmth earlier than it was administered. Zádor recalled how she slept with blood in her sleeping bag to heat as much as give it to Dickey the next morning.
In a couple of means, the Morca rescue was uncharted territory. However maybe most significantly, a rescue had by no means been tried at this depth.
On one hand, there couldn’t have been a greater affected person to behave as a “first” for this groundbreaking state of affairs than a veteran cave rescuer like Dickey.
On the opposite, it was extraordinarily irritating for him to be relegated to the function of a affected person.
“Even when persons are speaking in a international language, over comms, I might decide up technical phrases,” he defined. “I might overhear all of the conversations as a result of camp is just so large and every part is simply skinny tent partitions. I do know what provides are in camp. I do know what provides are being consumed. It is fully unattainable to isolate me from that info. And it was a disturbing surroundings for me, as a result of all of those rescue actions had been occurring and I used to be caught being a affected person.”
“After all, I had no questions as to the integrity and the targets of those folks,” he mentioned. “It was simply onerous being solely the ‘affected person,’ as a result of primarily based on my background expertise, I felt that there was helpful enter that I used to be capable of provide to the rescue.”
By the point Dickey started transferring out of the cave, it was September ninth, over every week after he’d fallen in poor health. All through the ascent, medical personnel stayed by his aspect. However this isn’t only a lengthy hike up a steep shaft. It’s passageways and tunnels of all angles, shapes, and sizes. Climbs. Rappells. Crawls. Tyrolean traverses.
Rope programs needed to be rigged. Passageways needed to be blasted with explosives to make them massive sufficient for Dickey’s litter to be pulled by way of. In complete, he spent 29 hours in a litter getting hauled out of the cave, transferring by way of over 70 completely different re-belays.
“You don’t simply take one rope, connect it to the litter, put a bunch of individuals on that rope and pull,” Dickey defined. “You might be dynamically transferring the affected person mid-air from anchor to anchor to anchor with each being an unbiased haul system, you must coordinate every part.”
Zádor recalled how throughout the well-known Tham Luang cave rescue, when a children soccer workforce was trapped underground in a flooded Thai cave, a lot of her non-caving medical colleagues had been glued to the display, however perplexed, asking her inane questions like, “Why don’t they only come out?” “I used to be taking a look at them like, ‘Are you fucking silly or what?’” she recalled, laughing. “It’s extraordinarily tough to elucidate how complicated it’s to function in caves like this.”
Into the Mild of Day
29 hours being hauled by way of muddy cave shafts in a litter is an expertise Dickey has no want to repeat. “Belief me, it was not nice. It downright sucked,” he mentioned, chuckling. “However I’ve spent far more hours in complete throughout my life in a litter than simply that. And an enormous quantity of that’s in coaching environments the place persons are studying about transferring a litter.”This expertise and information meant that it was far much less disturbing than it could have been for the common affected person. “I used to be comfy, in that sense,” he mentioned. “I used to be being moved by skilled groups. Due to my expertise and information, my arms could possibly be free, I might talk with them. In the event that they wanted help, I would offer help the place I might simply stabilize myself. In the event that they requested me to do one thing, I used to be capable of do it and I understood precisely what was occurring at any given second.”
Over 24 hours after he started transferring out of the cave, and every week and a half after he’d fallen in poor health, Mark Dickey was hauled out of Morca cave, accompanied for the final leg by a workforce of Turkish rescuers. “We completely needed the Turkish Cavers to have that remaining honor of bringing me up within the mild of all the media,” he mentioned, “to indicate that we had complete respect for his or her capabilities and that this was their dwelling turf.”
What adopted was a media hurricane. The Morca rescue was the deepest profitable cave rescue operation in historical past. It comes simply forward of the 2014 Riesending rescue in German Bavaria, which recovered a affected person from 950 meters [tk ft], took a workforce of 700 folks over 11 days, and price practically €1 million.
The transfusions given to Dickey, as effectively, had been among the many first and solely blood transfusions administered underground, the deepest, and by far concerned the most important quantity of blood. “It’s a loopy surroundings to render medical care, and preserve a medical presence of medical medical doctors all through ten days,” Dickey mentioned. “It’s a rare accomplishment.”
Again Underground
The response to Dickey’s emergency was by all accounts unprecedented. His stature within the caving group might have performed a job, however what it actually got here all the way down to was Turkey’s quick response with the required medical provides to stabilize his situation, and ECRA’s immense connection to cave rescue groups throughout Europe. “ECRA is sort of a thoughts hub for European cave rescue,” Zádor mentioned. With out ECRA’s assist, she, Dickey, and Van Ord agreed that the method would have been way more tough.
The important thing message Dickey has to convey is the significance of supporting cave rescue organizations—all of whom are nonprofit and privately funded—in order that they will proceed to avoid wasting lives. His associates have organized a GoFundMe to assist repay the varied rescuers who got here to his help. Readers are inspired to donate.
Van Ord seconded this, including that it was a principal instance of the significance of correct training. “Caving isn’t one thing that you simply do alone, and it isn’t one thing you must do with out correct coaching,” she mentioned. “ It’s a complete sport in and of itself. Individuals should not learn to rock climb simply by ‘figuring it out,’ proper? They search out somebody who is aware of the way to climb, to correctly place safety, look after ropes, tie in, what harness to make use of, belay gadget… All of that exists inside caving as effectively.”
For People like herself, Van Ord really helpful coaching with caving golf equipment underneath the Nationwide Speleological Society. “Elsewhere, hunt down the caving golf equipment inside your nation and study from them,” she mentioned. “You possibly can’t think about how essential correct coaching is.”
Dickey’s final medical analysis was an ulcer subsequent to a vein—which had already partially healed by the point he was evaluated in a hospital. “Statistically we are able to most likely say it was a bacterial H. pylori [Helicobacter pylori] mixed with stress, but it surely was completely unknown,” he mentioned. Earlier than the incident, “I had no signs, no indicators, no cause to imagine this existed.”
When The Outside Journal spoke with Dickey a few weeks after his rescue, he mentioned he was again to about 60% well being, and feeling higher by the day. The truth is, he’d already been again inside a cave, as a part of a Hungarian Cave Rescue Service coaching occasion.
He was fast so as to add: “However it was solely a horizontal cave, and I used to be 5 minutes from the doorway.”