Doctor of the Amazon: Sink or Swim

By Jessica Marcy, The Roanoke Times, Va.

Dr. Mateja de Leonni Stanonik believed she would die within minutes.

"I came here to save lives and I can’t die," she kept thinking as she went into anaphylactic shock in the Amazon.

After a drop of strange oil touched her skin, her torso and abdomen started itching. Then, her lips, eyes, ears and nose swelled as her neck and face became paralyzed. Soon, she was unable to speak. She began to write furiously. "Take me immediately to a hospital," she wrote.

Stanonik knew her South American adventure would be dangerous, but she never imagined she would almost lose her life. After all, she was there to treat others.

She went as the personal physician to Martin Strel, a 53-year-old marathon swimmer and fellow Slovenian. From Feb. 1 through April 7, Strel swam the Amazon River’s entire 3,274 miles from Atalaya, Peru, to Belem, Brazil. He swam with anacondas, flesh-eating piranhas, alligators and parasites at an average of 10 hours a day for 66 continuous days.

Stanonik is a neuroscientist and doctor doing her residency in medicine and psychiatry at both the Salem Veterans Affairs Medical Center and Carilion Roanoke Memorial Hospital. Fascinated by the brain, she left her native Slovenia at age 17 to study neuroscience in the United States. She speaks 11 languages, including six fluently, and serves as an honorary Slovenian diplomat to the U.S.

Stanonik was drawn to Strel’s belief in the power of the mind to conquer the impossible.

"Martin inspires me. One reason I decided to undertake this expedition is because Martin is one of those people who can conquer the impossible. Nothing stops him," Stanonik said.

Strel, who describes himself as a "professional marathon swimmer" on his Web site, has set several Guinness World Records by swimming the Danube, Mississippi and Yangtze rivers.

"I’m here to prove nothing is impossible," Strel said about why he swam the Amazon, the world’s largest river by volume.

"Some people might say I’m fat or a little old," Strel wrote on the expedition’s Web site. "Really, I’m just a simple man. I think there’s a lot of people in the world like me. People with big dreams. Dreams they are afraid to reach."

During the trip, Stanonik followed Strel in a boat more than 90 feet long that was outfitted with a medical lab and communications equipment that kept her in contact with other physicians in the U.S. The "telemedicine" link gave Strel a broad array of medical specialists on his side, who could cope with unforeseen emergencies, unusual infections and other medical issues.

Stanonik had not worked with telemedicine before the trip, but she knew that it would be a useful way to treat Strel and his team in case of an emergency. She proposed her idea to Dr. Rifat Latifi, a trauma surgeon and expert on the uses of telemedicine in the developing world.

Latifi asked her a few questions. Did she have experience with telemedicine? Did the project have money? Did she have satellites? Stanonik answered "no" to all of his questions, but Latifi was struck by her passion and dedication.

He was also excited to participate in this "human drama" and eager to have such a high-profile sports and media event bring attention to telemedicine, he said. A book and documentary film about the expedition are in the works.

Together, Stanonik and Latifi formed the Amazon Virtual Medical Team, which included 18 doctors and medical experts who could treat diseases and injuries through telemedicine during the swim. It was the first time the technology was used on such a swimming expedition, Latifi said. "It’s insanity not to have telemedicine on an expedition like this," he added.

Latifi traveled to the Amazon three times for a total of 18 days, including once to set up equipment that basically created a "high-tech laboratory on a boat." It included a mobile screen, a monitor for vital signs, a portable ultrasound machine and a satellite to ensure connectivity. Stanonik and Latifi were usually in contact on an hourly basis.

They both saw the trip as a way to promote telemedicine in the region. "I think our work will be complete when we really turn the lights on telemedicine in Peru and Brazil," Latifi said.

During the trip, Stanonik was on call 24 hours a day to provide treatment for the more than 40 members of the team, which included Strel, technicians, engineers, interpreters, the film crew and others. Strel suffered from muscle cramping, sunburn, dehydration, diarrhea, nausea and dermatitis, but avoided any serious injuries and illnesses during his swim. He also dropped to 217 pounds, down from 252 .

Stanonik also held clinics into the early morning hours to treat indigenous people who normally have little contact with doctors because of their remote locations. She treated river blindness, broken bones, malaria, yellow fever and easily preventable childhood diseases. She also saw people with active leprosy. "I treated diseases that no longer exist in our world," she said.

"As you go through villages and see the poverty and misery, one cannot feel but embarrassed because we as humans are not doing anything for these communities. … The jungle is obviously beautiful and needs to be preserved, but in the process of preservation we cannot shield them from advanced technologies and good basic health care that most of the rest of the world enjoys in abundance," Stanonik said.

She felt prepared for her trip after studying tropical medicine for six months beforehand.

But there were threats that were impossible to anticipate. One occurred when she and her crew were fired at while heading to a village to provide medical care. Another was when she went into anaphylactic shock.

Stanonik had a severe reaction to a remedy given to her by an alternative healer who had come from Slovenia to treat Strel. She now believes that his oil contained a muscle paralyzer.

When Stanonik arrived at the emergency room, she was delirious, half-conscious and in the early stages of respiratory arrest, she said.

She was fortunate to be in one of the few areas of the journey where there was a nearby hospital. During the three weeks beforehand, she was nowhere near one.

Doctors resuscitated her and successfully maintained her airway. They then made her spend the night in the intensive care unit.

"Ironically," Stanonik said, "I was the only member of the expedition who almost lost her life in the Amazon."

On the Net:  martinstrel.com amazonswim.com