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Be Honest With Your Diving Doc

Dive industry ‘fixer’ Rosemary “Roz” Lunn discusses the Recreational Scuba Training Council’s (RSTC) new consensus diver medical form and the bad things that can happen if you’re not honest with your diving doc. It’s not nice to fool (with) Mother Nature!

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by Rosemary E. Lunn

Header image courtesy of DAN Europe

News has broken in the last couple of days that probably one of the most important documents in sport diving has been revised. We now have a new Recreational Scuba Training Agency (RSTC) medical declaration form, and the notes for physicians have been thoroughly reworked too. 

The process has taken three years and involved the likes of Nick Bird M.D., Oliver Firth M.D., the late Professor Tony Frew, Alessandro Marroni M.D., Simon Mitchell M.D., Associate Professor Neal Pollock Ph.D., and Adel Taher M.D..

The resulting document is succinct. The 30+ questions have been cut to 10 with the aim of reducing unnecessary and avoidable referrals, while doing a better job of screening those medical issues truly associated with diving injuries. 

It certainly demonstrates a willingness by the diving doctors and relevant bodies to make this key document work for our global community.

This international collaboration of volunteer diving experts also demonstrates that, in the main, hyperbaric doctors involved with diving are ardent fans of our sport. Probably their most common complaint is that they dive a desk more often than they would wish, but I think we would all say that too. When a patient walks into their consulting room, the last thing they want to do is inform the patient “I am very sorry, but you cannot go diving”. The doctor wants you to leave with a medical that enables you to embrace diving. In rare cases, however, they have ended up signing what is effectively a death warrant, because their diving patient has been less than truthful with them. That’s really not big, clever, or funny. 

Now I can understand divers getting frustrated with their local doctor, a General Practitioner or Family Practitioner when it comes to diving medicine. Although I am not medically trained, I do have a far greater knowledge of diving medicine than personnel at my local surgery. I am not boasting, just lucky I get to work with some extraordinary professionals who have improved my education in this field, and I am a curious cat by nature. I always want to know more. 

“A GP saying you should or shouldn’t dive again ain’t worth squat in most situations. A proper dive doctor that does a dive medical is much more relevant”

Post, ScubaBoard 10JUNE 2020

A classic case in point about the lack of diving medicine education springs to mind. A friend of mine took an unprovoked hit. The chamber medical staff thought he might have an undiagnosed PFO (patent foramen ovule) and recommended that he get this checked out before he thought about recommencing diving. The diver toddled off to his GP and asked to be referred to a cardiologist to check if there was a shunt or perhaps a hole between his right and left atrium. His doctor responded with “what is a PFO”? My friend was aghast. Yup. Scary stuff. So I can understand a diver being a tad reticent about discussing dive medicine with their local doctor. 

This doesn’t give anyone carte blanche to be economical with the truth when consulting their diving doctor though. It can have fatal consequences. We had a tragic case in the UK where a 70 year-old was taking a rebreather class at an inland quarry. 

Neal Pollock, Ph.D examining a diver prior to conducting a field research trial. Photo by Rosemary Lunn

The Coroner’s Report stated that a diver “was undertaking a `re-breather’ course with an instructor and was diving at Stoney Cove, Stoney Stanton in Leicestershire on the 25 September 2018 when his instructor noticed that something was wrong with the diver. They made an emergency ascent to the surface and attracted the attention of centre staff who immediately pulled the diver out of the water and called the emergency services. Unfortunately, after resuscitation attempts failed, the diver was declared deceased at the scene. He was an experienced diver and had been diving since about 1992.” 

It transpires that the diver had cut short a dive in 2015 because he had experienced breathing difficulties. He had therefore been investigated by a consultant cardiologist for symptoms of immersion pulmonary edema. The conclusion was that the diver should not dive again “not only for the sake of his safety but for the sake of the safety of the rescuer”. The cardiologist confirmed this in writing to the diver’s GP on 27 December 2017. 

However when the diver went for a diving medical on 30 January 2018, he was passed fit to dive by a highly experienced doctor. This was not the fault of the doctor because they worked with the data they were provided with. This doctor is an Occupational Health Physician, a UK Sport Diving Medical Referee and an HSE Approved Medical Examiner of Divers. In other words, a doctor educated in diving medicine. The doctor passed the diver as ‘fit to dive’ for two years based on the information given to them by the diver in the medical questionnaire and the doctor’s physical examination of the diver.  They did not have access to or knowledge of the cardiologist’s letter. 

As a direct result of the diver being less than honest with the truth with the diving doc, he contributed to his own death. 

And then there is one case I remember while I was working in the Red Sea as a fulltime dive pro. I would regularly get to visit Dr. Adel Taher at the Sharm-el-Sheikh hyperbaric centre with potential divers. 

The first thing that is completed on any diving course is the paperwork, and part of that is of course the medical declaration form. It was quite normal for at least one student to need to get a medical signed-off prior to training. 

One morning I took a family to the chamber. The parents and their offspring were due to start an open water course. One of the children had a medical issue. I got lucky because on that particular day the diving doctor on call was a pediatrician. (Dr. Adel does employ some remarkable staff at the chamber). This man wasn’t just a normal child doctor, he was a consultant at one of the Cairo hospitals. A rare thing, and just the combination of medicine expertise we needed in this instance. 

The pediatrician is a kind and knowledgeable man. After examining the child he thoroughly explained in a very gentle manner to the parents that “at this time he could not sign off their child as ‘fit to dive’. However, the good news was that he thought the child would grow out of the condition, and in two to three years the child would be ok to dive. He recommended that at that point, the family consult a diving doctor for a medical.”

The family took me to one side and asked if I could arrange a second opinion because they believed the doctor was incorrect and didn’t know his stuff. I was a bit stunned to say the least. You can’t just pull, as if by magic, a diving doctor who is also a consultant pediatrician out of a hat. This experience has stayed with me, and I have pondered about it over the years. 

In hindsight, I have come to two conclusions, and I could of course be wrong in my private thoughts. Either as a white English family they saw a dark-skinned Arab and were prejudiced in their thoughts, or they saw an Egyptian doctor and considered his training and knowledge to be third world. “What does he know about my child’s condition? How can he think they cannot be fit to dive?”

I was embarrassed and angry, and put in the horrible position of diplomatically explaining to the parents that the diving doctor was not out to ruin their holiday. He was not out to spoil their fun. He was in fact giving the very best advice he could to keep their daughter safe and well. And he gave them positive advice for the future. They just didn’t want to hear any of it. 

Rule of diving: Diving docs are not out to ruin your fun. They also don’t want to sign your death warrant. Just be honest with them and they will keep you as safe as they can. 

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RSTC Medical declaration Form


Dive industry “Fixer,” Rosemary E Lunn (Roz) is Business Development Director at The Underwater Marketing Company. This British firm specializes in providing marketing, communications, social media and event management for the tecreational and technical diving industry. Rosemary is a PADI IDC Staff Instructor, BSAC Advanced Instructor, Trimix and CCR diver. Before moving into the public relations field, she worked as a professional recreational instructor in the United Kingdom and abroad, on History Channel and National Geographic documentaries, and as a safety diver and model underwater.

She established TEKDiveUSA and organised Rebreather Forum 3 on behalf of AAUS, DAN and PADI. In 2008 Rosemary co-founded EUROTEK, the European advanced and technical diving biennial conference. She has organised the last six events: 2008, 2010, 2012, 2014, 2016 and 2018. Roz is a respected and prolific diving author, an Associate Member of the Women Divers Hall of Fame, and an SSI Platinum Diver. She takes an active role in the scuba diving industry and sits on the SITA Board (Scuba Industries Trade Association) and the BDSG (British Diving Safety Group). 

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The Top Stories of 2022

We kick off the New Year with 10 hand-curated stories from our growing sea of content. They represent some of the most read, important, and fun stories from the last year. We hope you will enjoy them!

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Header image by InDEPTH art director SJ Alice Bennett. Two Dirty Dozen rebreather divers exploring a sunken armored tank at Chuuk Lagoon.

Greetings tekkies and mission-oriented divers,

January marks our fourth full year publishing InDEPTH, and it has arguably been our best year yet for content. In 2022, we published 113 new stories, and conducted seven surveys with our partner, The Business of Diving Institute—yes, it’s all about the data!

Rebreathers, of course, were the hot topic in 2022, particularly as helium prices continued to rise and availability was limited in some areas. In response, we offered a variety of stories on rebreather diving including in-depth looks at various units.

This burgeoning interest in rebreathers comes at a time when diving professionals from around the world will be headed to Malta this coming April for an industry, governmental and scientific symposium called Rebreather Forum 4. If you are professionally involved in rebreather diving, we encourage you to attend. 

I would like to thank our readers and subscribers, for your continuing interest and support. We want to be your number one, go-to source for serious diving content, and we will continue to work hard to win your loyalty! I also want to thank our many contributors from the global tech community, whose work and labors of love are represented here and elsewhere in InDEPTH. Thank you for your contributions! Special shout to our phenomenal, go-to picture makers and writers Jason Brown, Stratis Kas and Fan Ping! Keep your eyes on them people!

Lastly, I want to thank our illustrious sponsors, who make InDEPTH possible! Please join me in giving a big shout out to; Azoth Systems, Buddy Dive Resort, DAN Europe, Dirty Dozen Expeditions, Dive Rite, Divesoft, Extreme Exposure, Fathom Systems, Fourth Element, Halcyon Dive Systems, O’Three, OZTek, Shearwater Research, and The Human Diver. Thank you!! We hope that you will support these depth full diving brands!

In what has now become a tradition, we kick off the New Year with 10 hand-curated stories from our growing sea of content in The Top Stories of 2022. They represent some of the most read, important, intriguing and fun stories from the last year. We hope you will enjoy them!

We would appreciate it, if you would take a few minutes to complete our annual Reader’s Survey. This will help us deliver better content to your inbox. Our thanks in advance for your help!

 We have some exciting stories planned for 2023, so stay tuned!

Safe diving,
Michael Menduno/M2
Editor-in-chief

Here are the results of our 2022 surveys that we conducted with the Business of Diving Institute: InDEPTH’s 2022 Surveys .

There’s also a FREE DOWNLOAD of aquaCORPS #6 COMPUTING for you at the bottom of the page!


Divers Helping Divers: Next Stop Ukraine

June 1, 2022


1. Will Open Circuit Go the Way of the Dinosaur?

Closed circuit rebreathers have arguably become the platform of choice for BIG DIVES. So, does it make any sense to continue to train divers to conduct deep, open circuit mix dives? Here physiologist Neal Pollock examines both platforms from an operational and physiological perspective. The results? Deep open circuit dives may well be destined to share the fate of the Spinosaurus. Here’s why.

And if you’re wondering exactly, how many “deep” open circuit dives you’d have to conduct—you are using helium aren’t you?—to pay for a rebreather, training, and necessary experience dives, you’re in luck! Rebreather instructor and tech Instructor trainer Guy Shockey does the math in: The Economics of Choosing CCR Vs OC

Want a deeper understanding of how your rebreather’s scrubber works? Get a copy of John Clarke’s geeky new monograph, “Breakthrough: Revealing the Secrets of Rebreather Scrubber Canisters..” Dr. Clarke was the scientific director of the US Navy Experimental Diving Unit (NEDU) for 27 years.

Helium Technical Diving

2. The Price of Helium is Up in the Air

With helium prices on the rise, and limited or no availability in some regions, we decided to conduct a survey of global GUE instructors and dive centers to get a reading on their pain thresholds. We feel your pain—especially you OC divers! InDEPTH editor Ashley Stewart then reached out to the gas industry’s go-to helium market expert Phil Kornbluth for a prognosis. Here’s what we found out.

3. The Diving Industry Is Run By Middle Aged White Blokes. Our Future Depends on Making Them Uncomfortable.

Ahead of Women’s Dive Day, July 16, 2022 UK instructor and course director Alex Griffin examines why the industry appears to have trouble attracting and retaining divers from diverse backgrounds—and what we all can do about it. It might make you uncomfortable.

4. How Deep is Your Library?

Technical diving requires a deep body of knowledge that must be kept current. So, it seemed appropriate to ask, what books should tekkies have on their shelves? To answer that question, we turned to DAN’s nerdy risk mitigation coordinator cum cave diver, Christine Tamburri to suss out suitable tekkie tomes. Here is what she uncovered. Feed your head!

5. The Challenge for the Technical Diving Community? Connecting Divers With the Environment

While tech diving has come a long way in terms of extending our underwater envelope, enabling tech divers to truly go where no one has gone before, environmental consultant and educator, Alex Brylske, Ph.D argues that as a community there is still room for significant improvement in connecting divers with the environment. In the process, he details the results and meaning of InDEPTH’s survey of Sustainability in the Scuba Diving Industry and offers suggestions for moving forward.

6. Celebrating Wes Skiles

We explore and celebrate the extraordinary life and work of cave diving pioneer, explorer, conservationist, and underwater cinematographer/ photographer Wesley C. Skiles with a collection of curated interviews, portraits and perspectives from Fred Garth and Bret Gilliam, Julia Hauserman, Jill Heinerth, Todd Kincaid, Emory Kristof, and Bill Stone. We also feature nine essential Skiles films, some of his National Geographic photos, and a bevy of articles and content from the National Speleological Society-Cave Diving Section (NSS-CDS).

7. The First Helium-based Mix Dives Conducted by Pre-Tech Explorers (1967-1988)

More than 20 years before the emergence of technical diving, a handful of intrepid cave divers who were perilously pushing the limits of air diving, began experimenting with helium mixes for deep diving. Some succeeded, several were injured, and one almost drowned. Though some of their tales are known, no one had produced a definitive chronology until Woodville Karst Plain Project (WKPP) board member and explorer Chris Werner set out to clarify the record. Here, for the first time, are the origins of the “mixed gas” aka “technical diving revolution” that irrevocably altered the course of sport diving.

8. When Easy Doesn’t Do It: Dual Rebreathers in Extended-Range Cave Diving

Rebreather technology has enabled cave explorers to extend their underwater envelope significantly deeper and longer. As a result, a number of teams are pushing beyond the practical limits of open circuit bailout and so have turned to bailout rebreathers. But not without challenges! Tech instructor and DAN Europe editor Tim Blömeke dives into the latest research and field experience and explains what’s happening.

 9. Can We Create A Safety Culture In Diving? Probably Not. Here’s Why.

How do we improve our safety culture in diving? Is it indeed something that we as a community of divers can affect? Human factors coach Gareth Lock argues that there is no magic bullet and, in fact, that the sports diving industry needs to make a fundamental shift in how it manages diver safety if we are to improve safety. In other words, we still have a ways to go. The retired British Royal Air Force officer explains why.

And without question, the MOST FUN story of 2022, err, it actually dropped DEC 2021—we had it in the can. Call it:

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Note that InDEPTH featured a number of new shipwreck, cave and mine exploration projects in 2022, see: InDEPTH’s EXPLORATION ARCHIVES

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Download some early tech history with a digital copy of aquaCORPS #6 COMPUTING (1993) sponsored by our friends at Shearwater Research!

“Yes! I shall design this computer for you. And I shall name it also unto you. And it shall be called … the Earth.” Douglas Adams, The Hitchhiker’s Guide to The Galaxy

aquaCORPS #6 COMPUTING was published in June 1993 following the magazine’s first technical diving conference, TEK.93, held in Orlando, Florida in January of that year. The issue focused on dive computing and included interviews with nitrox computer developers Randy Bohrer (Bridge), Kevin Gurr (ACE), Paul Heinmiller (Phoenix), an interview with Karl Huggins (EDGE), and a story about commercial decompression software developed by decompression engineer, JP Imbert. Note that there were no trimix diving computers at the time.

There was also a review by Dr. RW Bill Hamilton and John Crea, of four ten newly-released desktop mixed gas decompression programs. The cover of the issue shows a visualization of decompression risk that was rendered by David Story on a high-end Silicon Graphics workstation. The issue went on to envision the future of dive computing and provided a tekkie guide to the newly emerging Internet, and its implication for diving.

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