Thai cave rescue: 'We expected some of them would die'

In June 2018, the world watched and held its breath for 17 days as an international rescue team tried to pluck a football team of young boys to safety from flooded cave passages.

In a new book, divers Richard Harris and Craig Challen tell the courageous, inside story of the rescue. In this extract, Challen reveals the emotional and mental torment he went through in the moments before the incredible rescue.

What would we do if the kids began to die? It was a brutal question, but also unavoidable. It was the question that [our partners] Heather and Fiona had asked before we'd even left Australia.

It had been haunting Harry [Richard Harris] and me from the moment we began to accept that anaesthesia was really the only practical option. If kids started dying, would we keep pressing forwards? Or would we stop and reconsider, knowing that we'd already considered every option we could think of?

How many dead boys would it take until we said no more? One? Two? Five? How many? And if we abandoned the plan we had settled on, what alternatives did we have?

If you think these are easy questions, you haven't given them enough thought.

There was, after all, a limited range of outcomes here. It was possible — unlikely but possible — that the plan would work perfectly and everyone would survive. Children and divers both.

If that happened, the only question would be . . . beer, wine or hard liquor — what would we toast ourselves with at the celebratory bash?

But on the other hand, what if it didn't go so well, as we feared it might? What if the first boy died on the way out of the cave? Would we send another boy after him? What if we did, and he died too? Could we bring ourselves to keep sending more boys on the perilous underwater journey?

It was tempting to avoid thinking about this, because the prospect was so disturbing. But Harry and I needed to prepare ourselves for this very real possibility.

Rescue divers worked under extraordinary conditions to swim free of the caves with sedated boys strapped to them. Photo / Josh Morris

I knew that Harry and Fiona had wrestled with the prospect of failure before he and I met up in Thailand. He'd told me that she had raised the thorny question of what it might mean for him to be known as the doctor who killed the Thai soccer kids. That would be a heavy burden to carry through life. Heather had raised her own dark fears about the potential for disaster. But if kids started dying while the operation was still under way, what would we actually do? Pack up and go home?

This was anything but hypothetical. It was as real as real could be. Both Harry and I and everyone else involved in this plan fully expected that at least some of these children would die. We all had the same scenarios looping through our heads: we would start on the first day with live children inside the cave. By the time the day was over, we would most likely be swimming dead children through the cave. This was never far from our minds, even as we pressed the Thais and others to give us the go-ahead.

"I have to tell you," Harry said to me in the DFAT van as we headed for the hotel that night, "if the first couple die, I might have to stop. I'm not sure I'll be able to keep sending children to their deaths, even if we're still convinced."

This was a difficult thing for Harry to say. He's a very practical and realistic person, and as a doctor he gets a special kick out of working in the most life-threatening crises imaginable, ready to do his best no matter how dreadful the circumstances or how daunting the odds. But doctors are supposed to save people, not kill them.

"I want you to know there's a limit to how far I can go," he said.
"I get that," I told him.

In a very real sense, Harry and I would be the ones making the call, Harry especially. Depending on what happened with the first few children, he would have to decide whether or not to anaesthetise the boys who were waiting to go next. Without Harry, nothing else could go forward.

"You know, I'm still not convinced any of this is going to work," he reminded me, not that I needed reminding.

Rescuers Craig Challen and Dr Richard 'harry' Harris were named Australians of the Year. Photo / AAP

He paused, struggling to articulate the fear he hadn't been able to shake. "It could be like I'm euthanising these boys." As we talked this through, I realised that we felt a bit differently about the fundamental choice we faced. Harry was grappling with the idea that he might be setting out to kill his patients, while I was focused on our lack of alternatives. Even though we agreed that the approach we'd be taking put the boys in mortal danger, could we really abandon it if it was still the best option we had?

"Harry," I said, when I saw the pained look wasn't leaving his face, "we've gone round and round, and this is the best of all the possible options. We can't leave them in there for months until the monsoon season is over. If we do that, they'll surely die. If we bring them out now, there's a chance some will survive. That might give some of them a way out."

Harry didn't seem convinced. "So if I accept it's horribly dangerous, then what?" he asked.

"At least if they die this way, they'll die asleep under the water rather than have a painful, lingering death in the cave that might take months? It's an impossible choice," I conceded. "But this part is up to you. You have to be all right with it, whatever you decide."

We sat in silence then as the van bounced along the bumpy streets of Mae Sai, each of us lost in thought. Finally, Harry broke the quiet.

"I think I have to go ahead with it," he said, almost in a whisper, as if he were really talking to himself. "At least if they drown, they'll be anesthetised. When it happens, they'll be asleep. They won't know anything about it at all."

I waited a moment, not sure how to answer. "Look," I said, "we reckon we've already thought of every possible plan. If the first one or two kids die, I think we'll still have to push forwards. If there's something obvious going wrong that we can address, we will, but the equation won't have changed. The first one might die and then the next twelve might be successful. The first two might die and the next eleven might be successful. Unless we've got new information, there won't be any reason to change what we're doing.
The kids will still be trapped there. We can't just leave them to what we agree is certain death if they stay in the cave. They still deserve the best shot at survival, whatever that is.'"

The rescuers used syringes to sedate the boys before swimming to safety. Photo / Josh Harris

I can't say Harry and I really found an answer to this question. It was probably unresolvable. We ended at what you might call a respectful impasse with reality. We'd been as plain as could be with each other. We had recognised and acknowledged the arguments on both sides. We would face the issue if and when we had to — but we desperately hoped we never would. Until then, it was just a horrible question hanging in the air.

It wasn't the only one, of course. There was also the question of who should be told if the children started to die during the extraction.

Outside the cave, Thai government officials would announce whatever they chose to announce and at whatever speed. That was up to them, and we couldn't control it. But given the constant swarm of foreign media, it was hard to imagine how the news could be kept secret for long. If kids lived or kids died, that would leak out in a hurry. I had no doubt about that.

But for me, the more difficult question was this: if children started dying, what should we say, if anything, to the other boys, to the coach and to the Thai Navy SEALs looking after them?

"Your friends Mark and Pong just drowned on their way out of the cave — are you ready to go now?"

Harry would receive a report from me after the first boy had arrived in chamber 8, letting him know when it was safe to send the next one, but we would have no idea of the outcome of the first rescue attempts until the end of the day. There was no real communication from outside the cave. The only way to get a message through was to send it with a cave diver — and all of them would be in the cave already, participating in the rescue.

If a boy died after leaving chamber 8, we wouldn't know it until that evening. If our estimates were right, and each dive took three or four hours, we'd already have sent the next unconscious boys on their way, possibly to their deaths.

That was chilling to me.

But eventually, we would know. We would know before the second day of the rescue — assuming we were going to proceed.

Harry with Titan, one of the boys he saved, in hospital after the rescue. Photo / Supplied

What then? Should we tell the other children? Should we tell the SEALs? Should we duck the issue? Should we lie?

I came to a tentative conclusion that surprised me. Against my better judgement, and despite the high value I have always placed on openness and honesty — I was inclined to lie. I would say to the remaining children, "Everyone's okay," even if they weren't.

I couldn't believe I was thinking like this, but I was.

If I had to do that, I knew it would trouble me deeply. But what else could we do? If any of their friends had perished and we had decided to press on, telling the full truth would make things drastically worse for all the remaining boys.

And besides, even armed with the truth, what position were they in to judge the best available course? They were children in a vulnerable situation that they had no control over. They lacked experience and full knowledge of the facts. We had both, and it was up to us to make that decision for them.

Harry and I kicked this question back and forth between us. We tried to look at it from all directions, but he ended up in much the same place I did. Reluctantly, he said he might have no real option but to lie.

"I'm not sure I'm actually capable of telling a lie like that," he said. "It obviously doesn't feel right. But saying 'your friends have died' seems even worse. I just hope we never have to decide. I'd hate to be tested on this."

Craig and Harry visited six of the boys they rescued and the coach nine months after the incredible feat. Photo / Supplied

Harry and I didn't talk about this with anyone else at the cave, including the British divers. Other people might have been having the same conversation — I don't know. I assume they were. But that's about where we ended up, reluctant but resigned.

There's so much emphasis today on people making informed choices about their own destinies. I believe in that wholeheartedly. I know Harry does too. Where there's uncertainty, people should be given all the information so they can make their own well-informed choices. That concept is at the core of living in a free world. Generally speaking, it's hard to argue against.

Then real life intervenes. A group of children are stranded in a flooded cave. Everyone wants to help them, and everyone has a plan to save them. They can't possibly know which plan is best. All they know is that they want to get out alive.

We forget that sometimes that whole beautiful concept — full disclosure, risk assessment, informed consent — it's not really applicable or desirable for the people who are the victims. Sometimes, somebody just needs to take charge. This time, we would be the ones to assume responsibility — to decide, uncomfortably, on their behalf.

Against All Odds is out now, RRP $40.