My son Mike

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HYPERVENTILATION - A DEADLY GAME

Written by Anne Phillips and published in 'Headlines' - the Journal of the Secondary Heads Association, UK. November 2002.

"It's an adolescents' game called the funky chicken. It feels like you've been out for two hours even though it only takes seconds to come around. We used to put pillows around on the floor to avoid injury when collapsing."

"The forced exhalation causes carbon dioxide levels to drop and blood vessels to narrow, causing a grand mal seizure."

The church was crowded to overflowing. Even now I can barely recall the faces of so many acquaintances and friends. But I do remember standing in the church hall after the service and looking into the sad eyes of a woman I recognised as the mother of one of Mike's friends.

"You lost one of your sons too, didn't you? When?" I asked numbly.

"Six years ago and yesterday," she replied with a half sob, adding an invitation to call before giving me a hug and quickly turning away, obviously too overcome to say more.

Sometimes it feels as if my family's 'hell' night belongs in another lifetime. At other times, it seems like only yesterday that my teenage son attended a Halloween party from which he never returned. In truth, it was eight years ago that the coroner concluded that Mike's had been "an unfortunate, freak accident".

It was Hell night, as they call the eve of that pagan festival, when Mike and six friends decided to smoke a joint. Since the hostess did not allow such behaviour at her house, the seven found the privacy they needed at a nearby church parking lot. After the joint was consumed, one among them suggested they play a game of hyperventilation before rejoining the party. They agreed, crouched down in a circle and began the game by taking three deep breaths.

Mike was the only one who played the game well that night - so well, in fact, that when he stood up and exhaled hard, he passed out and fell backwards, hitting his head hard on the pavement.

"The blow, audible to several of his friends, knocked him out," the newspaper article later reported.

After a minute or so, Mike regained consciousness, sat up and vomited. He rubbed the back of his head, complaining of a headache and asking what had happened. One of the boys dashed off and soon returned with a car. Recognising the obvious signs of concussion, Mike's friends ignored his request to be driven home to sleep and instead drove to the hospital and admitted him with a brief explanation about slipping on some wet leaves. Having assured Mike that he would feel better after a good night's sleep under the watchful eyes of hospital staff and arranged to see him at home the following morning, his friends returned to the party, blissfully unaware that their parting promise would never be kept.

Had I been at home that evening, I could have been with son during the long night while the hospital staff frequently tested his reflexes and monitored his brain patterns. However, since I had stayed overnight at a friend's to attend my graduation ceremony later that day, it was not until early morning that the police finally contacted me with news of the accident. When I arrived at the hospital, Mike looked decidedly relieved to see me but seemed relaxed. The fact that he drifted in and out of sleep while we chatted caused me no undue concern; I simply concluded that he was tired. However, I began to realise the seriousness of Mike's condition when the doctor pointed out the dark blotches on the brain scan. He seemed perplexed over the extent of the injuries, given the boys' explanation of the fall. As I signed the permission form for an immediate transfer to University Hospital an hour's drive down the highway, the gravity of the whole situation hit home with a vengeance.

There was a short delay in the transfer, allowing me, Mike's sisters and elder brother to reach the hospital before the ambulance. As the attendants raced down the hall to surgery, I ran alongside the stretcher, but my words of encouragement and love fell on deaf ears. Mike was already unconscious.

After the first operation, the surgeons were guardedly optimistic about Mike's prognosis, but within hours his blood pressure soared. Again he was rushed to surgery, but during that second operation the doctors decided against replacing the piece of skull they had sawed through in the first, hoping to relieve the mounting pressure on Mike's bruised brain. Sadly, the procedure fell short of their expectations, and while his brain continued to bleed and swell, Mike slipped even deeper into his coma. Only then did his friends admit to the truth of the matter and the reason for the fall.

For three days, we kept our vigil. I prayed for a miracle, but on the morning of the fourth day I had no choice but to sign the final form giving permission for all life supports to be disconnected. Again I prayed, hoping against the odds that Mike's lungs would take over their life-giving task. Again my prayers went unanswered. Within minutes, his chest heaved and fell one last time. The tiny room became deathly quiet and my son's body, deathly still.

Mike was dead, and all I had left were my memories of that handsome eighteen-year-old, the third of my five children who loved life and lived it to the full. He was a selfless, willing child to whom I turned for help in our single-parent home. When I was ill, he brought me soup and tea in bed. He was the one upon whom I relied to look after his two younger sisters while I attended night lectures at university. He patiently taught me how to use my first computer and fixed minor problems on my car. We had moved often since the divorce, and among others Mike's job was to hook up the stereo and television equipment. He worked the night shift at McDonald's on weekends to relieve our family's financial pressure; at the same time he aimed for a school average high enough to earn him a place in the mechanical engineering program at the university his brother and I attended. Mike would have made a good engineer, given his curiosity about the way that things worked, his innate mathematical ability and his habit of always putting one hundred and ten percent of himself into the job at hand. And therein lies the irony; so well did he play the final game that it cost him his life.

During the long succession of dark days and nights that followed Mike's death, as I bounced back and forth between the inevitable stages of grief, I invariably revisited the first phase of shock and disbelief. In my numbness I often played a game with myself, rewinding and replaying the mental tapes that my confused mind had created once the facts and events of that fateful night were revealed. And in my desire to end the nightmare by constructing a different ending, I attached an 'if-only' to the beginning of each tape. If only they hadn't gone out to smoke that joint. If only he'd been facing the other way and landed on the soft grass. If only he hadn't been so tall and the patch of grass so small. If only the girls had told me that they had watched Mike and his friends play the game at our house. If only someone had warned me of the dangers of hyperventilation games. And at the very least, if only I'd known he would slip away so soon and been with him in the ambulance to say goodbye.

It wasn't until the inquest six months later that I fully understood the facts around hyper-ventilation games, more commonly called 'pass-out' or 'black-out' by the generation that plays them. As one after another of Mike's companions took the stand, we heard evidence to the fact that such activities are not an uncommon occurrence, especially among adolescent boys. I learned, also, that there are several ways to experience the high that follows the passing out.

"You bend over and take a deep breath, then stand up and have a friend push hard on your chest. Then you faint and fall down," one girl told the court after admitting to playing the game on occasion and watching it on several others. "They call it the funky chicken," she added, referring to the convulsive-like movements that result. She went on to explain that even though it takes only a few seconds to come around, it feels like two hours have passed.

The witnesses' remarks supported those I had read in an article included in the newspaper coverage of Mike's accident, compiled from a statement by a local parent who reported observing three groups of youths playing the game.

"They'd hold a child against a wall and put their hands against his neck. His whole body would go limp and shake about. Then he would get up really slowly," the woman had stated, corroborating Mike's friends' description of the convulsions.

After each witness to Mike's fall had been questioned to the court's satisfaction, a specialist in lung disorders took the stand to apprise the jurors of the medical facts. He explained the process by which a grand mal seizure occurs and, as in Mike's case, an unprotected fall: forced inhalation and exhalation lower carbon dioxide levels in the blood, in turn decreasing blood flow to the brain through the narrowed vessels. As such, the expert concluded, the game is, indeed, a dangerous one.

The juror's findings were unanimous and in the form of two recommendations on the basis of the apparent increasing incidence of injuries and/or death following hyperventilation. The first, directed towards the Ministry of Health, was that information be disseminated to the public by distribution of pamphlets, literature, displays and other media.

Secondly, information needed to be brought to the attention of all school boards pertaining to the repercussions of the dangerous practices of hyperventilation games performed by adolescents who fail to realize the seriousness of this practice. To this end, the jurors suggested that some of those who have experienced these situations might talk to students in the classrooms concerning the dangers.

Having relived, minute by minute, the events of that fateful night, I left the courthouse feeling emotionally drained. Even so, I felt a certain satisfaction that Mike's death might have some meaning if other young lives would be saved and families spared the heartache of such unnecessary loss. In that respect, the three-day ordeal had given me a sense of closure and pivotal point from which to get on with my life.

Being all too familiar with the frightening reality of the fragility of life, my daughters and I moved to a farmhouse. There the girls realised their long-awaited dream that included their own pony, two dogs and countless other furry creatures. There too I found the space and peace I needed to begin work on my first book. Simultaneously I wrote a weekly bereavement column for the local newspaper, a project that helped me as much as it did my readers to navigate the seemingly never-ending grief process.

But even as I penned the last article in the series, about acceptance and moving on, I knew I had one more story to write. During those two years, more tragic stories of death through hyperventilation hit press, prompting me to investigate further. Two meetings - one with the deputy coroner and another with a school head - confirmed my suspicions that inquest recommendations are only as good as their follow-up. In Mike's case, the file had been tied up with red tape and buried on bureaucracy's back shelf.

Once again I seek closure by sharing the facts as I all-too-sadly learned them. The playing of hyperventilation games is not unlike alcohol and drug abuse in that it is a well-kept secret - that is, until tragedy strikes. Therefore as parents and educators, we need to be informed in order to protect our children to the best of our ability. While there are no guarantees that we can keep our children safe outside of the home, we must assume responsibility by warning them of certain dangers, perhaps by relating other families' stories to them. Most importantly, we need to keep the lines of communication open between our children and ourselves and be vigilant of telltale signs of otherwise-secretive activities.

One last fact I would like to share is that the potentially deadly game is not a thing of the past, proof of which I found in a recent interview with a local youth who has played the game within the past four years on school property. He admitted that the after-effects of oxygen deprivation to his brain - mini-blackouts and temporary loss of vision - would certainly make him think twice before playing the game again. And perhaps this young man is alive and well today because he knew enough to delegate his friends as catchers before he passed out and fell to the ground. Mike was neither so knowledgeable nor lucky!

"We speak for the dead to protect the living," reads the framed motto hanging in the coroner's office. I'm betting that if Mike could speak for himself, his message would echo mine, "...If only I'd known..."