Lightning Injury Facts
Myths, Miracles, and Mirages
Mary Ann
Cooper, MD
Adapted from Seminars in Neurology, Volume 15, Number 4, December 1995
Copyright © 1995
(Permission for use on this page kindly granted by Thieme Medical Publishers Inc.)
An article about both lightning and electrical injuries
Injuries from man-made,
generated, or "technical" electricity have been reported for
only about 150 years; but injuries from lightning must surely predate written
records. Depictions of lightning affecting people or events appear in writings
and drawings from almost every ancient religion. Although such an
occurrence was sometimes interpreted as a positive sign of blessing, more often
it was seen as a sign of the god's warning or vengeance.
Priests, the earliest astronomers and meteorologists, became proficient at
weather prediction, interpreting changes in weather as omens of good or bad
fortune, sometimes to the advantage of their political mentors.
Observations of lightning and other natural phenomena were often used to decide
matters of state, the scheduling of battles or other events. Lightning from the
east was usually seen as a good omen. This is reasonable because it is probably
the end of a storm. Lightning from the west was ominous, but also meant a
storm was probably approaching.
Over the centuries, superstitions and myths have grown up about lightning that
include avoidance, protection, the types of injuries, and their treatment. In
this article, I cannot be all inclusive but will attempt to discuss some
of the more common ideas, particularly those related to the medical field, as
well as some myths about injuries from the newer form of injury by generated
electricity. I will leave discussion of appropriate lightning and electrical
protection to those who are more knowledgeable in these areas and have been
kind enough to write articles for these issues of Seminars.
Disclaimer: This article is not meant to be a scientific treatise but to be
entertaining and perhaps enlightening (no pun intended since it is a different
spelling). I am giving my best reply to these myths based on a composite of 20
years of experience, reading, and discussions with patients, families, and
professionals from many areas of expertise. I have had to reverse myself enough
times since I began investigating lightning injuries in 1977 to ever claim that
I know all there is to know about it and will be the first to encourage
research into any of these questions. It seems that everyone has a lightning
story. I hope you will have fun reading this and investigating these
areas for yourself. Lightning and electrical injuries are fascinating and the
myths that have grown up about them are myriad. I invite you to collect your
own. If you will be kind enough to send them to me, I will forever be in your
debt.
CLASSIFICATION OF MYTHS
Beliefs have grown up about these injuries that I will arbitrarily divide into
the following groups:
1. Occurrence and demographics
2. Effects of the strike/types of injuries
a. Positive effects
b. Negative effects
3. Significance of the strike
4. Prevention/ avoidance
"I will probably never treat a victim of a lightning
injury in my practice because they are so rare. "
False. It is true that injuries from electrical injuries are
probably more common than lightning injuries, especially when low-voltage
injuries are included. Best estimates place lightning injuries at somewhere
between several hundred and a few thousand per yearn 4 It is common for the
victims to avoid medical care initially, hoping that the symptoms will subside
in a few hours or days. Most are not admitted to the hospital and thus do not
become part of any state hospital admission databank. Lopez and Holle have done
some of the best studies on the epidemiology of lightning injuries and I refer
you to their articles in these issues and elsewhere. (5,6) It would be unusual
to meet a neurologist who has not had at least one patient with complaints
referable to an electrical event. Much research remains to be done into
the best treatment, the differences between these groups, and long-term
effects.
This picture illustrates the lightning distribution worldwide.
Global frequency and distribution of lightning as observed from space by the Optical Transient Detector
"I will probably never treat a victim of a lightning injury in my
practice because no one lives to talk about it."
False. In 1980, I published a study of collected literature
and found only a 30% mortality.(7) Andrews (8) repeated the study a few years
later and calculated it slightly differently at 20%. Both reviews would
overestimate the mortality, as case reports will always be biased toward the
more severe or interesting cases. Although Holle and Lopez report figures
somewhat differently, my best guess on the mortality from lightning would be
about 3 to 10% of all incidents. Projecting from numbers of between 75 and 150
reported deaths per year (and many do not get coded appropriately), there may
be as many as 750 to 5000 injuries per year.
"Nowadays most lightning injuries occur on the
golf course. "
False. Indeed, a large number are work-related. These
include injuries to postal and construction workers and persons using
telephones that have not been properly grounded. (5) The numbers of farmers
injured has decreased farmers to work larger fields in better-protected
vehicles. Injuries during recreation have increased. They occur to joggers,
hikers, and campers, as well as golfers. In addition, a significant number of
people are injured while participating in team sports.
"Some people can attract lightning."
Some have called themselves "human lightning
rods," claiming that thunderstorms would change course to find them or
that they had been struck multiple times. Given my experience with lightning
victims, I must say that, although some may suffer little injury from a single
strike, the majority have some type of sequela. When one claims to have been
hit 20 or more times, the odds of being able to talk about it decrease
logarithmically. Would any reasonable person not have enough sense to learn to
avoid lightning after the first couple of hits?
EFFECTS OF LIGHTNING STRIKE/ELECTRIC SHOCK
These effects are what these two issues of Seminars in
Neurology are all about: we have tried to address most of the questions that
arise about electrical and lightning injuries, and the differences between
lightning and electrical injuries and their treatment have been discussed in
other articles.
Because so little has been studied in these injuries, it is often difficult to sort out the complaints that are real from those that are metaphysical, compensation-related, or due to normal aging. As discussed in the article by Engelstatter and Primeau, (9) a marginally compensated individual may see the injury as the precipitant for all subsequent problems in life. Although the physical and cognitive complaints are sometimes vague and often do not show on standardized testing, nevertheless, they present a consistent complex that is difficult to disbelieve after listening to them for 15 years from people who have nothing to gain from their disability. Even the complaints that we can objectify often have no good treatment, frustrating both the patient and the physician.
Among the claims of positive effects of lightning strike (and sometimes electrical injury) are the cures for persons who have been blind, deaf, or had serious illnesses. A few years ago there was a very well-publicized case of an elderly gentleman who was cured of his blindness and deafness by a lightning strike. Those of us who were consulted on this knew that these were hysterical complaints suffered as a result of a truck accident many years before but forbade the press to quote us out of respect for the gentleman.
I have had one call from another gentleman who asked if lightning could cause "hyper sexuality" because after his lightning injury he could not seem to get enough sex. While there is a neurological injury that can cause hyper sexuality, more commonly lightning and electrical injury causes impotence, as a result of either direct nerve or spinal cord injury or depression. There is one published claim of improved intelligence on psychological testing after a prolonged cardiac arrest in a pediatric patient. A woman in southern Illinois became psychic after suffering a lightning strike while asleep in bed. Reportedly, her powers have been used by police agencies in locating missing persons and solving cases.
If remissions or cures of serious illness have occurred, as some have claimed, praise God, and I am happy for them and will not dispute their conclusions, but I cannot explain it by any medical literature, only supposition.
The medical literature and medical practice are resplendent with examples of myths that grow out of misread, misquoted, or misinterpreted information and that then continue to be propagated without further investigation, particularly when the author is an individual well-respected for other accomplishments. Not the least of these is the tenet that lightning victims who have resuscitation prolonged for several hours may still successfully recover. This belief seems to be grounded in the old idea of "suspended animation" the concept that lightning is capable of shutting off systemic and cerebral metabolism, allowing rescuers a longer period in which to resuscitate the patient. This concept, credited to the only article that Taussig ever wrote on lightning, actually first appeared in an article that was published quite some time before hers. The case recounted by Taussig that is the basis for this myth, when searched to its source, was a case reported by Morikawa and Steichen, F. While it does show a somewhat longer resuscitation period than usual, it is not as miraculous as reported in her paper or as propagated in subsequent references to it.
On the other hand, in a study of lightning survivors, Andrews has shown increasing prolongation of the QT interval, bringing up the theoretical possibility of toursades as a mechanism for the suspended animation reports.' Theoretically, if lightning hit at the right instant of the QRS interval, a toursades type of rhythm might occur, not only supplying minimal cerebral perfusion, but also perhaps resolving spontaneously. Toursade certainly has a better prognosis than fibrillation or asystole. There is new evidence from animal experiments to support the teaching that respiratory arrest may persist longer than cardiac arrest. (13,14) This study, in which Australian sheep were hit with simulated lightning strokes, showed histologic evidence of greater damage to the respiratory centers than the cardiac center in the medulla. Prolonged assisted ventilation may then, in some cases, be successful after cardiac activity has returned.
Among the myths about negative effects is the "crispy critter" myth.(3) This is the belief that the victim struck by lightning bursts into flames or is reduced to a pile of ashes. In reality, lightning often flashes over the outside of a victim, sometimes blowing off the clothes but leaving few external signs of injury and few, if any, burns.
Two other myths held by the lay public as well as many physicians that are particularly harmful to the lightning survivors are, "If you're not killed fly lightning you A be OK" and, "If there are no outward signs of lightning injury, the injury can't be serious.(8) The medical literature, by lack of follow-up case reports, implies that there are also few permanent sequelae of lightning injury. However, in the last few years, it has become apparent that permanent sequelae may and often do occur. In addition, both lightning and electrical victims with significant sequelae may have no evidence of burns. While the effects of amperage and voltage have been studied in animals, the effect of frequency, radio waves, and body impedance, as well as other effects, have not been elucidated well enough for us to be able to explain many injuries.
A myth that is still prevalent today is that the victim of lightning retains the charge and is dangerous to touch, since he is still "electrified " This idea has led to unnecessary deaths because of delaying resuscitation efforts.
Many
patients, particularly those without external signs of injury, have been told,
most often by medical professionals, that they have "internal burns"
that are the cause of their problems. This is both a misnomer and an
oversimplification for the cellular, vascular, biochemical, or other types of
damage they may have incurred. So many questions need to be investigated in
lightning and electrical injuries.
"Lightning is a sign from God. "
I can claim no inside track on this one. Ancient Romans saw
Jove's thunderbolts as a sign of condemnation and denied burial rites to those
killed by lightning. Andeans hold similar beliefs and may ostracize the victim.
In some cultures, medicines are made from stones that are believed to be a
result of lightning strike. Roman, Hindu, and Mayan cultures all have myths
that mushrooms arise from spots where lightning has hit the ground.(5)
In the
poly-ethnic United States, belief in "fate" or "God's will"
may affect how family, friends, or coworkers relate to the victim or how the
victim feels about himself and his recovery. Some patients may have already
consulted a healer before finally seeking the advice of a physician and in rare
instances it may be difficult to treat a patient unless the help of a shaman or
priest is employed to address the religious issues while the physician
addresses the physical ones.
Several Roman emperors wore laurel wreathes and sealskin,
which were believed to be protective. Pliny taught that a sleeping person was
safe from lightning. Some of the references at the end of this article detail
even more curiosities and myths.
"Wearing a rubber raincoat (substitute sneakers or other forms of clothing here) will decrease my chances of being hit." Conversely: "Wearing cleated shoes increases my chances of being struck."
False, and
probably false. The first is easy to dispel: if lightning has burned its
way through a mile or more of air (which is a superb insulator), it is hardly
logical to believe that a few millimeters of any insulating material will be
protective. The second is a subject of contention but I tend to believe that
there would be little effect from whatever is on the bottom of your feet.
Certainly metal on the bottom of the feet can heat up and cause secondary
burns, but it is unlikely to "draw" lightning to the person.
"I am safe in a car because the rubber tires protect
me."
True and False. True because there have been no
documented lightning deaths that have occurred in a hard topped metal vehicle
with the windows rolled up. However, the composite tires have little, if any,
part in this, for the same reasons as those just discussed with regard to
insulation. The safety has to do with the fact that electrical current travels
along the outside of a conductor (the metal body of the car) and dissipates to
the ground through paths that include the tires and the rainwater.
"Wearing metal in my hair increases my chances of
being hit. "
Questionable, although opinions exist both ways. Hairpins
(who uses those anymore?) may be safe; metal helmets may not. The issue needs
more study (and more publication). Kitigawa has shown fairly conclusively
with dummies that metal about the head does not increase the likelihood of
being hit (unless it projects far above the head, increasing the person's
height).
"Carrying an umbrella increases my risk of being
hit. "
True. Increasing your height by any amount increases your
chances of being hit by a calculable amount, although a prospective,
population-based, double-blind, randomized study has not been done to prove
this, nor has the composition (metal versus composite or plastic) of the
umbrella or one-iron been studied. Other dangerous things to avoid: avoid
being the highest object anywhere, be it a beach, small open boat, pier,
meadow, or ridge. Avoid being under a lightning rod (except when inside a
substantial habitable building that is protected) or standing near a metal
fence, underground pipes, or other metallic paths that can transmit lightning
energy from a nearby strike. Avoid swimming, because lightning energy can be
transmitted through the water to you. Sailboats should be equipped with
adequate lightning protection systems.
"When outdoors, I should stay away from trees."
Mostly true. Certainly you should stay away from the tallest
trees, which are more likely to be hit and side-flash or splash to you.
However, one would not want to become the tallest object in an area by standing
in a meadow, either. Making the shortest, smallest target is probably the best
answer if caught in the open. If you are in a forested area, it may be wise to
pick an area of dense growth of saplings or smaller trees, rather than either a
large meadow or tall trees. If on a ridge, get to a lower area.
Seeking shelter in a substantial building when possible is advisable. The sheds on golf courses, unless adequately protected by a lightning mitigation system, are potentially more dangerous because they offer height but little protection and lightning may splash from a hit to the shelter onto the inhabitants.
"When lightning hits
the ground nearby, it is 'grounded ' and I am safe. "
Totally and absolutely FALSE. Despite the fact that we call
the earth a "ground," it is very difficult to pump electricity into
the ground. Most "earth" is a very good insulator. When lightning
hits the ground, it spreads out along the surface and first few inches of the
ground in increasing circles of energy called "ground current." If it
contacts a fence or a water pipe or wire entering a house it can be transmitted
for quite a distance and cause injury to persons near these paths. People,
being bags of electrolytes, are better transmitters of electrical current than
most ground is, and many are injured by ground current effect each year as the
lightning energy surges up one leg that is closer to the strike and down the
one further away.
"My mother always told me to stay off the telephone (out of the bath
tub, away from windows, unplug the appliances, etc.) during a thunderstorm.
"
Good advice, if not always practical. Again, the ground
current effect of energy transmitted into the structure along wires or pipes
may find the person a better conduit to ground.(3,4) Many injuries occur every
year to telephone users inside the home. One of the biggest new areas of
consumer fraud has to do with claims of loss of "valuable" databases
on computers damaged by lightning.(5)
"Lightning only occurs with thunderstorms."
Most people know to seek shelter once the storm clouds roll
overhead. Few realize that one of the most dangerous times for a fatal strike
is before the storm. Lightning may travel as far as 10 km nearly horizontally
from the thunderhead and seem to occur "out of the clear blue sky" or
at least when the day is still mostly sunny. The faster the storm is traveling
and the more violent it is, the more likely this is to occur. Another time
underestimated for its potential danger is the end of a thunderstorm.(2-6)
"If we could just harness lightning we could use
that to power the world for months. "
Uman eloquently explains the reason this cannot be done and
is false in his book, All About Lightning.(2) He makes two points:
it is impractical to intercept a sufficient number of the lightning strikes
occurring in the world, and most of the energy in a lightning strike is
converted to thunder, heat, light, and radio waves. He notes, "If its
total energy were available, a single lightning flash would run an ordinary
household light bulb for only a few months."(2)
"Lightning could be used for a military weapon.
"
Again, Uman (2), a professor of electrical engineering who
writes with wonderful clarity, is my source. "In view of the awesome
destructive power of modern weaponry, the military use of lightning . . . would
probably be more as a psychological than as a destructive weapon."(2)
And last but not least, "Lightning never strikes the same place twice."
In reality,
the Empire State Building and the Sears Tower get hit thousands of times a
year, as do mountain tops and radio-television antennas. If the circumstances
facilitating the original lightning strike are still in effect in an area, then
the laws of nature will encourage lightning strikes to continue to be more
prevalent there. After all, that is the reason that lightning protection
systems are required on many public buildings (including hospitals) by building
codes.
CONCLUSION
Lightning and electrical injuries are fascinating and the
myths that have grown up about them are myriad. I invite you to collect your
own. If you will be kind enough to send them to me, I will forever be in your
debt.
REFERENCES
1. Prinz: Lightning in history. In Golde RH, ed. Lightning, Vol 1.
San Francisco: Academic Press, pp1-20, 1977.
2. Uman MA. All about lightning. New York: Dover, pp 1-160, 1986.
3. Cooper MA, Andrews
CJ: Lightning injuries. Auerbach P ed. Wilderness Medicine,
Management of Wilderness and Environmental Emergencies, 3rd ed. St. Louis: CV
Mosby, pp 261-89, 1995.
4. Andrews CJ, Cooper, MA, ten Duis HJ, Sappideen C. The pathology of
electrical and lightning injuries. In Wecht CJ, ed. Forensic Sciences, release
19 update. New York: Matthew Bender & Co., 1995:23A-3-23A-165
5. Lopez RE, Holle RL, Heitkamp TA. Deaths, injuries, and property damage
due to lightning in Colorado from 1950 to 1991 based on Storm Data. In National
Oceanic and Atmospheric Administration Technical Memorandum ERL NSSL-103
6. Holle RL, Lopez RE, Ortiz R. et al. Cloud-to-ground lightning related to
deaths, injuries and property damage in central Florida. In Proceedings,
International Conference on Lightning and Static Electricity, October 6~,
Atlantic City, NJ, FAA Report No. DOT/FAA/CT-92/20,66-1-66-12, 1992.
7. Cooper MA. Lightning injuries: prognostic signs for death. Ann Emerg
Med 9:134-8, 1980.
8. Andrews CJ, Darveniza M, Mackerras D. Lightning injury a review of
clinical aspects, pathophysiology and treatment. Adv Trauma
4:241-52, 1989.
9. Primeau M, Engelstatter GH, Bares KK Behavioral consequences of
lightning and electrical injury. Semin Neurol 15:279-85, 1995.
10. Taussig H. "Death" from lightning and the possibiliq of living
again. Ann Intern Med 68:1345-50, 1968.
11. Morikawa S. Steichen F. Successful resuscitation after "death"
from lightning. Anesthesia 21:222-3, 1960.
12. Andrews CJ, Colquhoun DM, Darveniza M. The QT interval in lightning injury
with implications for the 'cessation of metabolism' hypothesis.J
Wilderness Med 4:155-66, 1993.
13. Andrews CJ, Darvenia M: Effects of lightning on mammalian tissue.
Proceedings, 1989 International Conference on Lightning and Stahc
Electricity, Sept 26 28, Bath, England, 4A.4.1-4A.4.4, 1989.
14. Andrews CJ, Darveniza M. New models of the electrical insult in lightning
strike. Proceedings, 9th International Conference on Atmospheric Physics, St.
Petersburg, Russia, 1992.
15. Lowy B. Amanita muscaria and the thunderbolt legend in Guatemala and
Mexico. Mycologia 66:188-90, 1974.
16. Ackerman L. Personal communication, Price-Hollingsworth Company.