The men lay frozen naked in a ghoulish pile, with mouths agape and eyes glazed over, their hair encrusted with ice and snow. They were all dead — or so the investigators on the HBO series “True Detective: Night Country” thought.
Frozen bodies are a familiar problem in this fictional Alaska town near the Arctic Circle, but this giant “corpsicle” is unusual. And so is what happens in the episode, which aired last Sunday: one of the men wakes up when his arm is accidentally snapped off by an officer.
The resurrection has sparked grisly speculation among some fans: How can a person be living, a viewer on Reddit asked, if that person’s limbs are so frozen? “They could have been flash frozen in a moment of terror” at the moment of their deaths, another speculated. Many were skeptical that the human body could survive such an ordeal and wondered if the show was straying into the supernatural.
Doctors say that it is impossible for a completely frozen person to make a recovery. But it is possible for someone who appears frozen — limbs stiff, skin cold and hard, and without a pulse or breath — to be resuscitated, depending on how long the person has been out in the cold.
“If all the tissue in your body is ice, or has ice in it, then you’re not coming back,” said Ken Zafren, a physician and a professor of emergency medicine at Stanford University, who also works in Alaska. But, he added, “I’ve seen plenty of cases in which the person really looked dead, and could come back.”
During hypothermia, an adult’s body temperature can cool well below the normal average of 98.6 degrees, Dr. Zafren said. A person’s pulse and breathing slow significantly, reducing the body’s need for oxygen. Eventually, the person may go into cardiac arrest, stopping the pulse and breathing altogether. But because the brain is cold, the lack of oxygen takes longer to cause damage, he said.
A person could persist in this state for several hours before being completely frozen, he added, noting a medical maxim: “No one is dead until they’re warm and dead.”
An account of one of the earliest recorded cases, in Scotland in 1805, describes a teenager found on a boat, who, despite appearing dead, was resuscitated next to a fire “with warm blankets, smelling salts, and massage.” In 1939, a 12-year-old boy buried for three hours in an avalanche “recovered neurologically intact.”
More recently, in 1981, a young woman was found in minus-22-degree temperatures after her car skidded off the road in northwestern Minnesota. Jean Hilliard, 19, had skin that was too hard to pierce with a needle, her temperature too low to read, and her eyes unresponsive, according to news reports at the time. But after several hours wrapped in an electric heating pad, the woman woke up, The Times reported, and she ultimately recovered with no serious lasting damage.
In some less extreme cases, a person may regain consciousness when wrapped in warm blankets, taken inside, or treated with a machine that blows hot air across the body. But once a person’s heart and breathing have stopped, the best way to revive the person, doctors say, is by using a process known as extracorporeal rewarming — taking the blood from a person’s body, warming it externally, enriching it with oxygen, and pumping it back.
Patients who survive this procedure often have little or no cognitive damage, doctors say.
Hermann Brugger, a physician and vice head of the Institute of Mountain Emergency Medicine in Bolzano, Italy, described one case in which doctors using this method were able to revive a climber rescued during a thunderstorm who did not have his own blood circulation for more than eight hours. In another case, a man buried in an avalanche for 100 minutes survived. Neither had any neurological damage, he said.
More than 100 people suffering hypothermia have survived after being resuscitated using similar techniques over the past few decades in Central Europe, according to one study.
But not all emergency medical workers and doctors are familiar with the warming technique, Dr. Brugger said. He cited one case in which a 16-year-old girl found without a pulse after hours in the cold had been declared dead before extracorporeal warming was attempted. “An emergency physician tried to resuscitate on site, but this does not make sense, because if you don’t rewarm the body, you can resuscitate as long as you wish and it’s completely useless,” he added, noting that had the girl’s blood been rewarmed externally, she most likely would have survived.
In the case of the TV “corpsicle,” Dr. Zafren said that the men appeared very stiff, but not frozen. If they had been exposed to the cold for more than 24 hours, he added, they would have had little chance of surviving, and would not have spontaneously recovered without an external source of heat.
Also, he said, the officer could not possibly have snapped through a man’s arm bone, frozen or not.
“Being mostly dead is being somewhat alive,” Dr. Zafren said. So far, doctors have been unable to pinpoint the precise point of no return, he added. “But what we do know is if you’re dead for too long, you don’t come back.”
