Survivor Says Andes Plane Crash Called Him to Save Lives

Interviewer: Tricia Ward; Interviewee: Roberto Canessa, MD

Disclosures

May 20, 2019

On Friday October 13, 1972, a Uruguayan Air Force plane chartered by an amateur rugby team crashed in the Andes mountains en route to Santiago, Chile, for a match. On December 21, two emaciated survivors, including 19-year-old medical student Roberto Canessa, appeared in Los Maitenes after hiking 44 miles and climbing peaks more than 12,000 feet high. Over the next 2 days, the remaining 14 survivors stranded in the Andes were airlifted out.

The group's ordeal was immortalized in the book Alive and the Hollywood movie of the same name. Canessa went on to become a renowned pediatric cardiologist and was the Simon Dack Keynote speaker at the 2019 American College of Cardiology meeting, where he spoke with Medscape.

Canessa in 2019 (L) and the day after his rescue (R).

The passengers were your rugby teammates or from the same village as you in Uruguay. Do you think that helped you survive, compared with if it was a commercial airline crash with total strangers?

It helped because if someone had a bad day and was very stressed, we knew that he was really a nice guy just having a bad moment, so you could calm him. Having the same education and the same religious beliefs helped a lot.

You were a second-year medical student when the crash happened; was that an advantage?

Yes, because I had some knowledge about medicine. Playing rugby, you get a lot of injuries; and besides that, my father was a physician. So I was already oriented to helping people.

Ten days after the crash, the remaining 25 survivors of the original 45 passengers heard over a transistor radio that the search had been called off and they were presumed dead. Six days later, an avalanche struck, killing eight more and almost suffocating Canessa before a teammate quickly dug an opening in the snow, allowing him to breathe. He says that the avalanche taught him that no matter how bad life is, it can always get worse.

By this point, the group had resorted to necrophagy and used the dead bodies as food. Writing of the experience 44 years later in his book I Had to Survive, Canessa explains that "we thought we had gone mad or that we had become savages. But later we realized that it was the only sane thing to do."

Did your medical background help with the decision to use the bodies for food?

Of course, of course. I knew the body was a source of protein and fat. I had the Kreb's cycle memorized. That is what I had studied in medical school.

How was it to quickly go from being hailed as heroes to being cast as—for want of a better word—villains, given the sensationalist headlines about cannibalism?

I didn't really care what they thought. I mean, they had given us up for dead and then they wanted to pass judgment. I completely accept that some people would rather die themselves than do what we did. Obviously that's not my position. My only concern was for the parents of those that died. I wanted to tell them the truth.

We had made a pact that if any of us died, the others could use us as food.

Was there ever any consideration given to lying about it?

No, no. What we wanted to do was deliver the news in the best way. It is something very delicate, very intimate. I wanted the parents of the dead to hear it first. I wanted to go to their houses and tell them. I thought they had the right to hear it from us, and we couldn't just wash our hands of that responsibility and put it in the tabloids.

Press conference, December 26, 1972; Montevideo, Uruguay

After the media uproar, the Andes survivors called a press conference where Alfredo "Pancho" Delgado equated the necrophagy to the biblical story of Jesus at the Last Supper, giving his body and blood to the apostles. It changed the public's reaction.

Did comparing the ritual of eating the bodies to the Catholic sacrament of Communion help people come to terms with it?

For some people, it did. We all had different reasons. For me, I knew that if I had died, I would have loved to have been part of the project of survival.

You said that at times you envied the dead. When you almost suffocated in the avalanche, you felt at peace. Are you not afraid of death?

I thought that dying was not that bad. I'm not really afraid of that. When I was younger, of course, I was worried about my kids because they were dependent on me. But now they're grown up and have their own lives. I have pains in my body and I've lived a life.

There are moments in your life when you feel that you are suffering so much that it would be better to be dead, and I understand this. Some people commit suicide because their life is completely unbearable. I respect that, but we should try to make them feel better so that death is not a choice.

Realizing they would eventually die if they stayed put, Canessa, Fernando "Nando" Parrado, and Antonio "Tintin" Vizintin agreed to hike for help. They were given more food rations, the best sleeping locations, and warmer clothes to prepare for their epic journey. Parrado, whose mother and sister had perished in the crash, was eager to escape, but before he departed he gave permission to those remaining to use their bodies as food.

It took them 3 days to reach the summit, and instead of signs of life, they found snowy peaks as far as their eyes could see. Vizintin went back to the wreckage site to inform the others while Canessa and Parrado persevered south. On day 9 of their journey, they saw a shepherd, Sergio Catalan, across a roaring river. Catalan tossed them a pen and paper and received a note that began, "I've come from a plane that crashed in the mountains." He returned with help. In the 2010 documentary Stranded, Catalan recalls, "They smelled of the grave; no animal would go near them."

Parrado, Catalan, and Canessa (L-R).

Right after you and Fernando Parrado were found, but before the other survivors were rescued, you were interviewed by the BBC. That must have been strange.

It was the morning after we were found. The interviewer told me I had come back from the dead. But I never died. There was a dichotomy between what the world was saying about us and what we experienced.

Some people think we survived because we ate the dead, but we survived because we were a team—because we worked together and because we walked out of the Andes. That's the real reason we survived.

You became famous from the news coverage and the movie Alive, but you were never enamored of the trappings of fame or celebrity. Why not?

It's really hollow. I used to think that I would end up like an actress who was a beauty and now she's old and taking pills because she's missing her old life. After what happened, I had to catch up on my real life, and a celebrity was not what I was meant to be.

After you returned to civilization, why do you think you escaped much of the psychological trauma that has haunted survivors of other disasters?

We didn't choose to be there. We were not in a war. We were just trying to survive and it was hell. Once I was out of there, I was out of hell.

When I got out, my only concern was for the families of the ones that died. I went to visit them and told them what had happened. They were very supportive of us. Despite their sadness, they were helpful to our recuperation.

Did it help that you returned to medicine, a profession where you're giving back and helping people, compared with, say, a regular office job?

When we were stranded in the mountains, we just wanted to go back to our lives. We were missing them very much. When Nando and I got out, the BBC were telling us, "You're famous, you're heroes." I didn't like that life. I wanted to go back to medicine.

My aim was to go back to the life that I missed so much.

In 2016, Canessa published his biography.

You wrote that the experience in the Andes led you to pediatric cardiology. Your father was a cardiologist, so wouldn't you have ended up in cardiology anyway?

My father was a professor in cardiology, but when I was doing cardiac catheterization, a professor in pediatric cardiology started working at the same hospital. I was very interested in congenital heart diseases, and at that time, echocardiography was beginning to be used as a great tool to visualize congenital heart defects, so I got into that area.

Working with your father can be quite difficult. Once I was trying to put in a pacemaker and it was time to put the electrode in the vein. My father told me to go farther up, where it is thicker, and I didn't agree. He said, "Damn it, put it where I tell you!" and the patient said, "Please don't quarrel."

My son is also a cardiologist, but he will go into adult cardiology and I will stay in pediatric cardiology. I think it's best that fathers and sons work in different subspecialities.

How do you balance giving hope versus being realistic when talking to the parents of babies with severe congenital heart defects?

I come from an experience where there was very little hope and we made it. In the Andes, one of the things we always said was, "While there is life, there is hope." And "Perhaps tomorrow."

That is what I tell the mothers. I also teach them to accept that maybe things won't go well. We don't understand God's logic.

The day after the plane crash, when the most injured died, they were not suffering anymore. There can be a similar kind of relief when a kid passes away and he doesn't have to be stuck with needles anymore.

You wrote that you can relate to the suffering of babies with congenital heart disease because of your experience in the Andes.

To see the happiness of a mother whose child is doing well is an incredible reward. It's like having the magic of happiness in your hands, and to work on that type of project is great. We are gifted with the chance to help people.

I have a friend who works at stopping child pornography. That's a very depressing job. I think we have a wonderful job. Of course we're not Gods; some of our patients are going to die. Even if you try your best, they can succumb.

You have said that you're a risk taker. Does that play into your medical career?

A kid with congenital heart disease who will die without intervention should take their chances. It's tougher when the kid is doing well—for example, in cases of atrial septal defects.

I tell the parents that it's a very tough decision to do open heart surgery in a child who is feeling well. If the child is struggling, the choice is clearer.

I always have a plan B. If plan A doesn't work, we have plan B.

Your book includes interviews with the families of your patients. One of the mothers said that she asked you about the odds of survival for her child, but you're not a fan of such statistics.

If you are in a stadium and a pigeon craps on your head, that's 100% for you. It doesn't matter how unlikely it was to happen. Everyone has their own odds, and when there is no alternative, you must take your chances.

Why did you wait so long to write your book I Had to Survive?

Because I had to live my life. People ask, "What happened after the plane crash?" This is what happened. I couldn't have written it before I did.

The plane crash was the result of human error. Are you more or less forgiving of errors in medicine?

The pilot died for his mistake. It's not as if the surgeon will die if he makes a mistake. Although it used to happen; if royalty died during a procedure, they would kill the doctor.

You're skeptical of experts, right?

What I have said is that experts may make mistakes. They are not infallible. And medicine is not magic. If you have an expert who made a mistake, you should change the expert.

Do you think that your participation in sports helped in medicine?

Yes. Sports is very important for medicine and for life. I still play some tennis and I try to walk every day.

Of the three of us who started the climb over the mountain, none of us smoked, and the two of us who went all the way were rugby players.

Did being on a team helps with discipline?

Yes. I'm very individualistic. My captain used to tell me, "Look, Roberto, I'm the captain. I'm not the smartest. Maybe tomorrow you're the captain. But I must tell other people what to do. So you must obey me."

That was great advice. When you are in a group, you have to work together.

I would say that rugby and sports is about joy. But my life as a physician is also about joy. I like to tease my patients. I think a sense of humor is very important. Even in the Andes, we had a sense of humor. It helped relieve the stress.

What is your advice to our audience of physicians, nurses, and other healthcare practitioners?

The equation is: knowledge plus perseverance multiplied by attitude. Attitude is the most important. I learned in the mountains that the people who survived were not the bravest ones, they were not the cleverest ones; they were the ones who were able to have a smile on their face every morning.

Do you mean that they had a positive attitude?

Smiling at failure, smiling at success. Treat them both the same way. Failure is an operative cost of success. They go together.

You said that you learned that to do something difficult takes incredible effort, and to do the impossible takes just a little more.

I think you should first do what is needed. Then what is possible. And then you can try to do impossible things.

Canessa with his wife Laurie (far left) and their three children at the crash victims' gravesite, The Valley of Tears, 2001. Laurie was his girlfriend before the crash.

You frequently return to the crash site. Why?

I go there and I can see my friends teasing me. "Look at you, Roberto. Look at the belly you have. You're an old man now but we're still young."

I took my daughter there when she was 15 and she said she didn't like this place because it's so sad. But for me it has so much energy.

After surviving the Andes ordeal, did you feel pressure to really make something of your life?

I would never want the mothers of my friends who died to say, "Why did this lazy, bad person survive and my son didn't make it?" Out of respect to them I felt that I should live a decent life.

And that was the promise I made: If I get out of here, I will live a good life.

It sounds like you have.

Follow Tricia Ward on Twitter: @_triciaward

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