Sign up for our monthly newsletter so you never miss the latest from InDepth!
By Rosemary E Lunn
Header photo by Catherine Meehan. Fiona in Sodwana Bay.
One of the colorful characters in the field of diving medicine died tragically in a rebreather diving accident on Thursday, October 17, 2019. Fifty-five-year-old, Australian diving physician and anesthetist Dr. Fiona Sharp, MBBS, FANZCA, was found unresponsive on a reef at 24 m/80 f. She had been solo diving on a rebreather, and she was discovered with her mouthpiece out. Fiona was medevaced but did not regain consciousness. The incident occurred on the last day of Fiona’s diving trip to Bonaire, located in the Leeward Antilles, Carribean Sea. It was the week after Bonaire Tek. Fiona enjoyed deep rebreather diving and was known to be a bit of a maverick.
“We are shattered.” Bruce and Lynn Partridge, Shearwater Research.
The disturbing news of Fiona’s death rocketed around the world in a few hours. Many people from the diving medicine and technical diving communities expressed their dismay and distress at Fiona’s death. She was gregarious, fun-loving, irrepressible, and generous. Fiona was a friendly colleague and we had dived together a few times. I wrote a heartfelt tribute about Fiona’s bulldozer attitude to life and diving, and this was published by X-Ray Mag. It includes a myriad of voices from around the globe and amply illustrates just how well-loved she was by her colleagues and friends.
“Fiona was an individual. She did what she wanted. She did what she loved. She was very much her own person, and drove us mad at times. Fiona was down to earth, had a massive heart, a huge personality, and was very dear to all of us. She will be greatly missed.”Dr. Catherine Meehan
Fiona Sharp was born in May, 1964, in Perth, Australia, and she was bright! She attended Mercedes College Perth, where she was “Dux” in her graduating year. [Dux: from Latin for ‘leader,’ the term that is now used in Australia and New Zealand to indicate the highest-ranking student in a specific achievement).
After leaving high school, Fiona studied medicine at the University of Western Australia where she graduated in 1989 as a Bachelor of Medicine and Bachelor of Surgery (MBBS UWA). After serving an internship in Perth in 1989, followed by a year as a junior Resident in Sydney, Fiona moved to England where she gained her Diploma of Anaesthesia (DA) in 1992, whilst working as a Senior House Officer in Anaesthetics in Southend, Essex.
Fiona then returned to Australia and commenced specialist Anaesthetics training. In 2000, she flew once again to the UK where she spent five years practicing diving medicine at DDRC Healthcare (Diving Diseases and Research) in Plymouth. During this period, she was awarded a Fellow of the Australian and New Zealand College of Anaesthetists (FANZCA) Fellowship in 2004.
At the time of her death, Fiona Sharp was working at the Fiona Stanley Hyperbaric Medicine Unit (FSHHMU) in Perth, Western Australia. She had been in post since it opened in November 2014. Prior to that, she was employed at the HMU at Fremantle Hospital from 2007 to November 2014. (The department then relocated to the newly built department at FSH).
Whilst writing this, I spoke to Fiona’s family and asked: “why medicine?” They responded,
“If you are really smart at school, you are expected to be an architect, a lawyer, or a doctor. Medicine appealed to her; however, it was possible that she could have become a vet because the family did have a lot of animals.”Fiona’s family
“She was nuts, about everything. But especially about diving.”Dirk Peterson
Fiona got into diving in her late teens after trying skydiving and scuba diving. Water prevailed and she learned to dive when she was 18 years old. She was a PADI Divemaster, cave certified and qualified to dive the Inspiration, Evolution, SF2, Drager Dolphin, Mark VI Poseidon, and JJ-CCR rebreathers.
You cannot ever say that diving was her hobby. It was her all-encompassing great passion. Fiona recently told her older sister that she felt happiest when she was underwater. It was therefore natural that she would take an active interest in diving medicine, and she became a fixture at all the major diving medical or tech conferences. SPUMS, UHMS, EUBS, HTNA, as well as EUROTEK, OzTek, Rebreather Forum 3 and other diving industry events. These helped keep her current and educated in this niche sector.
“Fiona loved the diving, diving medicine, and the camaraderie around the bar. She was regularly first up and last to bed. Most often, Fiona could be heard well before she was seen on land and underwater!! She was well-loved by her colleagues at these events and, as many have said, the SPUMS Conference won’t be the same without her. I think she attended at least 17.”Dr. Neil Banham, Fiona Stanley Hospital
Fiona’s first South Pacific Underwater Medicine Society (SPUMS) Conference was at Layang, Layang island, in Malaysia in 1999, a venue well suited to her type of diving because it was deep. It was at a later SPUMS, in 2008, that Fiona’s diving would change. Dr. Catherine Meehan takes up the story.
“I met Fiona at a SPUMS meeting about 20 years ago. In 2008, I chartered the ‘Golden Dawn’ liveaboard. Ten of us flew into Alotau in Papua. New Guinea. and we sailed and dived our way across to Kimbe Bay, West New Britain, to join the SPUMS annual scientific conference. There was a rebreather on board and Fiona had a guided rebreather dive. She enjoyed it so much that she dived with it for the rest of the week. I believe this was one of her earliest experiences rebreather diving, and I think that she embarked on her passion for diving rebreathers shortly afterward.”
Catherine and Fiona would regularly dive together, at least two or three times a year, all over the world.
“We did a lot of conferences and diving together. We were most recently in South Africa diving Sodwana Bay. She was dressed in her vibrant orange drysuit so it was easy to see where she was, doing her own thing. It was tough cold water diving, but she was very hardy and didn’t miss a dive, even when her suit leaked. It is a good lasting memory of her.”
“It was like she had been shot out of a cannon when she entered a room.”Joanna Mikutowicz, DiveTech
Fiona Sharp never did anything by halves, and this is amply demonstrated by a classic Fiona story that her older sister Donna regaled to me.
“Many years ago Fiona rang me up and said, ‘I have got two tickets to the rugby game on Friday night, do you want to come with me?’ I thought, ‘Why not?’ One of our kids plays rugby at school. I rocked up at the game and she said to me, ‘Here is your ticket. Don’t worry about paying. And by the way, these tickets are not just for tonight’s game. They are season tickets’.”
She goes on:
“We ended up supporting the Western Force, a professional Perth-based rugby team, for the next twelve years and watched them play Super Rugby against New Zealand and South Africa. What I found ironic was that I went to nearly every game. I think Fiona missed more games than any of us because she was away diving so much.”
“Fiona Sharp drew no quarters when it came to life and diving. I only met her a few times, but she left an aircraft carrier shipwreck-sized impression on my psyche and we remained in contact.”Laura James, Environmental Campaigner, Underwater Cinematographer
Many divers have been generous with their Fiona stories. Todd and Tiffany Winn of Silent O Solutions reached out to me with another classic Fiona tale and said I could share it. When Fiona decided you would be friends, the recipient really didn’t stand a chance.
“Fiona’s reputation as ‘difficult’ preceded her, and our first encounter with her was memorable, to say the least. It was in San Diego for an in-water recompression symposium and training event in 2014. She exceeded my expectations. I believe she only told me I was completely mistaken two or three times. I conceded two of three and agreed to disagree on the third. She had an uncanny ability to defuse my ire with a wry smirk. As she had already decided we’d be friends, I had little say in the matter.”Tiffany Winn
“Tiff liked Fiona immediately and loved her unflinching honesty and authenticity. Fiona threatened to visit us on Maui on one of her transits across the globe, but unlike nearly everyone else she called and texted for a month straight, ironing out the details, and sure enough, one day, showed up. We loaded up our little boat for its maiden voyage, and Tiff and Fifi had a girl’s day rebreathering all by themselves. We had a beautiful day and a fabulous sunset. We will remember her fondly and often, and will miss her dearly.”Todd Winn
It is only right that I leave the last words to her family. I was told that Fiona had wanted to climb Mount Everest, but she suffered so badly with altitude sickness, that she just about made it to base camp and no further. Fiona was always willing to take a risk, and push herself. Apparently she competed in triathlons in her early 20’s, and she liked challenges. Everyone who came into contact with her soon found out she had a very dry sense of humor.
“Fiona didn’t like cheap champagne or wine. It had to be good quality and lots of it, and she always brought home two bottles of whiskey from every trip for her father.”Donna Sharp
Fiona was close to her family. She is survived by her mother, three sisters, a brother, and 18 cousins. She was an “oh so very proud” aunt to 13 nieces and nephews. Typically big-hearted and kind, Fiona had planned to take a nephew to Antarctica this November. You mad as a box of frogs lady, you will be missed.
The author is very grateful for the assistance of the Sharp family and Dr. Neil Banham, Director of Hyperbaric Medicine at Fiona Stanley Hospital in writing this tribute.
Dive industry fixer, Rosemary E Lunn (“Roz”) is the 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, safety diver, and underwater model underwater and appeared on the History Channel and National Geographic documentaries. She established TEKDiveUSA and organized 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 is a respected and prolific diving author, an SSI Platinum Diver, an Associate Member of the Women Divers Hall of Fame, and sits on the SITA Board (Scuba Industry Trade Association).
A Perspective on Teaching Cave CCR
Veteran Irish cave and CCR instructor cum sports psychologist Matt Jevon explains how he teaches divers to become competent underground rebreather divers who “err safely” and thus are likely to return home at the end of the dive.
by Matt Jevon
Header image courtesy of Marissa Eckert
“To err is human” Alexander Pope
In his “Essay on Criticism,” Alexander Pope wrote “To err is human, to forgive divine.” However, if you are not prepared to err safely in cave or rebreather diving, you will come face to face with your preferred divine being, begging for forgiveness.
Stratis Kas’s book, Close Calls, a compilation of stories from a roll call of “who’s who” in diving, attests to the fact that the very best of us can and do make mistakes, or err. That they are still here to share these lessons with us affirms the huge amount of training, preparation, and experience required—and, as many will admit, no small amount of luck.
Gareth Lock, author of Under Pressure, is fond of the phrase “fail safely,” and with good cause. As he puts it, and I paraphrase; the human in the machine is at the heart of likely outcomes. In my own experience as a psychologist with expertise in human performance, the best systems, processes, and technologies are often outwitted by an unwitting fool or an arrogant wise man.
Today there is a surge of divers wishing to become cave divers, perhaps because it is perceived by some as the pinnacle of diving—in skill and status—or perhaps because it is seen as more accessible. Certainly, social media has given access to the incredible and beautiful environments that were once the playground of a select few. Divers are discovering that cave and modern diving practices, equipment, and training are making it a much safer environment until they start exploring virgin caves. Closed circuit rebreathers (CCR) are now mainstream and in wide use by many divers. In cave and deep dives, I would say they have become the primary tool; the limitations of open circuit scuba are seen as making it inappropriate for most “big” dives.
By the time a diver reaches their CCR cave course, they will, or should be, a knowledgeable, skillful, and competent diver on a CCR. Perhaps the odd one will find a shortcut, but it is the exception rather than the rule. In addition, the majority will already have some open circuit cave training, at least to intro level if not to full cave. The pathway from zero to hero in the cave is much longer and more difficult to shortcut than, say, open water to instructor status. Starting cave diving on CCR from cavern to full cave is, and should be, a much longer route.
[Ed.note: There are arguments against allowing a student to pursue any form of diving before gaining open circuit experience. Some argue that one should first become competent on open circuit in the relevant environment and THEN train in that environment on RB/CCR. This argument asserts that RB failures will find a diver on open circuit, requiring them to be proficient on this equipment in the relevant environment. These factors may be progressively more relevant with more complex environments.]
So, the CCR cave instructor is not dealing with an inexperienced CCR diver; nor, if they are as careful in their acceptance of students as most are, will they be dealing with an adrenaline seeking-junkie. See “Why We Cave Dive” (video) for reasons why some divers seek out the karst realm, as well as examples of divers we hope to encourage into the sport and those we prefer to avoid it.
The job of a cave CCR instructor is not to prevent all errors or mistakes. It would be both arrogant and foolish to believe that instructors can overcome human nature and the situational factors found in closed circuit cave diving. The instructor’s role is to lessen the frequency and severity and to mitigate the consequences of those errors as, and when, they occur. The instructor must do this in the course, ideally exposing students to likely errors or challenges in controlled conditions and embedding appropriate solutions. Students should acquire appropriate and controlled emotional, cognitive, and behavioural responses.
Being a cave instructor has a few significant differences from being a deep technical rebreather instructor. Here are a few:
Cave diving demands a greater equipment load. The number of backups can be summarised as “Three is two, and one is none.” So, three sources of light sufficient to complete an exit, three cutting devices, reel/spools, markers, breathing sources, and more. Before entering any overhead environment, the instructor must help students configure, become familiar with, and master accessing and manipulating their configuration. For this reason, cave divers opt for simple, easy solutions that are robust and definitely not prone to failure. This applies to their primary gear (CCR choice) and to every single piece of backup gear.
My own choices are primarily sidemount-based in the cave; the Liberty rebreather; Divesoft computers, primary reel and markers; plus O’Three 90ninety shell suit; and Apeks regulators and spools, all based on a Razor Sidemount System. In backmount I use a JJ-CCR, but I am now using the Liberty Sidemount rebreather as a bailout system. All simple, proven, tough, and each piece having substantial built-in redundancy/failure management options.
The instructor’s primary role—despite what many believe to the contrary—is, in any diving, to ensure that the students are safe and that they go home unharmed medically, physically, or mentally. Secondary to this is teaching skills, having fun, and awesome and epic dives. What a big ask in cave diving!
Progression in open water diving is more straightforward, especially using mixed gas. In the absence of narcosis, divers can build up deco time gradually and have a pre-rehearsed familiar exit/ascent permanently above them. Although not different in terms of time to exit, an open water deco ceiling somehow seems, to most, to be less of a psychological threat than several hundred tons of rock.
I have seen cave divers suddenly go from a point of being perfectly happy to being very unsettled and distressed within a few meters. There is actually a term for this: penetration stress. Penetration should be slowly built up over time with confidence in the linear distance built through many dives—some, but not all, including stressful exits (blind, bailed out, manual control, or touch contact).
To do this, an instructor needs considerable empathy. Some instructors may shy away from this and instead use a pseudo militaristic approach by battering, bullying, or belittling the student, constantly tearing off masks, shutting down gas, or more. (We are talking personality types here, not problem solving training.) Stay away from these people at all costs.
Instructors cope with a high task load. Not only do they have to monitor the group’s penetration distance, navigation, and teamwork, but they also need to monitor the students and their own PO2, decompression obligations and time to surface (TTL), bailout supply and limits, on board gas supply, scrubber durations, as well as to teach. In order to do this, a few tricks are employed. Some of these may be useful when diving in any CCR team:
- PO2 monitoring. HUDS can easily be seen reflected in students’ masks. It’s much easier than trying to read someone’s handset.
- Instructor Ghost Mode. Not just used for sneaky (pre-warned and planned) drills, the lights off/blackout ghost mode is often accompanied by pull and glide along ceilings or cave walls where no damage to the environment is possible. Instructors, especially on quiet CCRs, can get within a few centimeters of a student without their knowing, or they can shoot ahead. It is a bad practice to turn off (as opposed to cover) one’s primarily in a cave. The on-off button/switch is a weak point, especially at depth—sufficient working backups are required.
- Buddy lights on CCRs are brilliant for instructor/team monitoring, Divesoft’s show up well and Sentinels almost too well. When I was a student, my instructor found ghost mode difficult to fully pull off, since I saw this green light above me every time he tried it!
As an instructor, you want the students to develop their own robust team dynamic. If you are part of this, too often, students will always defer to your authority and default to you for leadership and solutions. So, if you do join the team to make up numbers, always be number 2, the weakest member, and play the part. Students don’t need to see how clever or skilled you are, they need to develop their own skills.
Navigation: Know the cave you are teaching in. For students’ first dives where I may not know them or their capabilities, I like to be in caves where a lost line would not be an issue for me in terms of exiting. Take Ressell in France for instance: A quick glance at the ceiling and a look at the scallop shapes in the rock, and I know which way is out.
These assume a whole other level of importance in cave and rebreather diving. A checklist is useful but only if you properly check everything on it. Turn backup lights on and off, breathe bailout regs at least 4-5 breaths. Fill and dump wings and drysuits. Prevention will ensure survival. It will also give students confidence, which means you are less likely to have issues, you’ll get a better response if you do, and you can actually enjoy the dive. [Ed.—Check out GUE’s Pre-Dive Sequence here]
Here are a few tricks I also like to instill:
- Link routines. For example, PO2 check and back reference. I use a hand mirror, so looking back is easy, and a quick over the shoulder is not difficult. Every time I check PO2, I look behind me. Caves often look very different on the way out and if I can, I will mentally imprint landmarks that I will see on exit. Some caves have distance markers every 100-150 m/328-492 ft on the main line, especially training caves. I’m not a huge fan of these for my own diving, as it’s a bit like graffiti; but, for trainees, PO2 plus back reference anytime you pass any navigational marker is a good routine.
- Wetnotes use. A good habit in a new cave is to make a note of time, distance, gas, and the navigation marking/direction in your wetnotes at any substantive navigation. On some dives, this will be two or three notes. Do this in some Mexican caves and you will get about 300 m/0.2 miles from the entrance and need a new Wetnotes book, so be sensible!
Finally, students will learn a lot of new skills, from what to do when you lose teammates, lose or become entangled in the line, encounter a broken line, have light and equipment failures, and more. Many of these will be done with blindfolds or blacked-out masks (mine say, “Use the force” on the front). On an open circuit, these situations can be challenging. On CCR, doing blackout drills while controlling loop content and volume, handling multi bailouts, and more, requires time both to learn and to embed. Don’t do it until you get it right, do it until you can’t get it wrong. Sometimes the lost line drill will provide unique challenges to get it right. If conducted correctly, you will probably get it wrong half the time!
Ultimately, graduating a new CCR cave diver is a moment to enjoy for the instructor—one with a need for appropriate gravitas and consideration. I have certified divers who were less proficient than other divers that I failed or asked to repeat. That was because a student’s attitude, mental strength, and sound decision-making ensured that they would likely go home safely from each dive. As the sign posted at the entrance of almost every cave reads, “Nothing in this cave is worth dying for.” There is an awful lot of cave diving worth living for, and I have been privileged to see some spectacular caves.
Barnson S.C. (2014) The Authentic Coaching Model: A Grounded Theory of Coaching. Human kinetics, Champaign, Il.
Troy A. Moles, Alex D. Auerbach & Trent A. Petrie (2017) Grit Happens: Moderating Effects on Motivational Feedback and Sport Performance, Journal of Applied Sport Psychology, 29:4, 418-433, DOI: 10.1080/10413200.2017.1306729
Swann, C., Crust, L., Jackman, P., Vella, S. A., Allen, M. S. & Keegan, R. (2017). Performing under pressure: Exploring the psychological state underlying clutch performance in sport. Journal of Sports Sciences, 35 (23),2272-2280.
The Darkness Beckons by Martyn Farr
Basic Cave Diving a Blueprint for Survival by Sheck Exley (Freedownload)
Psychological Skills for Diving @PSTforDIVING
Matt Jevon, M.Sc. F.IoD, is a Full Expedition level Trimix and Cave instructor on OC and CCR with TDI and ANDI. He is a JJ-CCR and Divesoft Liberty Sidemount instructor and dealer for Ireland. Matt’s personal diving has included cave exploration in the Philippines and wreck projects in Croatia and Ireland, and he was one of the inaugural Dirty Dozen in Truk! Matt has held accreditations as an interdisciplinary sports scientist, sports psychologist with the British Association of Sport and Exercise Sciences (BASES), and was a British Olympic Registered Strength and Conditioning Coach and invitee on the Olympic Psychology Advisory Group. Matt works in the high performance business as a board advisor and non-exec, high performance sport, and expeditionary level diving as a partner in South West Technical Diving in Ireland (), and hosts the Facebook page “Psychological Skills for Diving.”
Thank You to Our Sponsors
Why Do Divers Run Out Of Gas?
Not surprising, the answer is more complicated than simply, they neglected to look at their gauges. Here Aussie diving medical...