I was just involved in a fatal snorkeling accident.

[Aloha Joe]

Talking this over over a beer or two... or... with a good buddy / companion that you can do that with... may help putting things in perspective.
There is nothing wrong with feeling some guilt or questioning and wanting to improve once actions after the fact if only one could. That's normal. There is nothing wrong with learning from it or getting motivation from it. But there is a lot wrong with letting it eat you. Don't let it!
I am not saying at all that you made a mistake, but I am saying that only those that do nothing make no mistakes. I think you are already thinking the right things. You seem to plan to keep doing and to learn how to get better at the doing and that to me is the right thing. Infinitely better than deciding to be done with doing. So, keep doing...

Addendum: I bet it helped some to write this up here on SB, but it also took guts to do that. Kudos.

I think part of why this is so hard is that this is a solo trip. I visited a few dive shops and told a couple people what happened and it helped a little to talk...until the scene repeats in my head.

 

[Bubblesong]

You wish you could have helped more, but don’t assume they would have accepted your help if they felt embarrassed. I just took CPR/AED/First Aid class again, and I took Rescue but they told us that people often are too embarrassed to ask for or accept help. For example people starting choking, or having the beginning of a heart attack often head to the bathroom to try to sort themselves out, then they are alone when things get critical!
In this case that elderly couple just wanted to get away fast, but likely the woman had already aspirated some water, and she should not have snorkeled another inch! If you tried to insist they wait for help, they would have fought you off!
In all my experience of life, the only way to save this woman was to have three determined crazy people: two to hold the woman and block any attempt to snorkel her back to shore on her or her husband’s foolish pride, and a third to swim to lifeguard and bitch slap them for not seeing you wave like they get paid to do.
I am one crazy, determined, SHAMELESS busy body, I have taken all the safety classes and i could not have saved these two from themselves.
I do hope you take all the classes, it will help in some situations.

 

[joe10540]

As an ER nurse I can tell you that you will never get to a point where watching someone pass from one form of existence to another ever becomes easy, even when it is expected. If you saw foam come from her snorkel without her coughing and attempting to pick her head out of the water, she may have already been experiencing a medical crisis when you first got to her and nothing would have changed the outcome. Your actions were far more clear headed than most people would have been, witnessing someone in distress. Take some time to process everything that happened and greive appropriately there is nothing wrong with that but also know that you did everything that you could and despite your best efforts she was freed of her earthly existence.
Call your loved ones, hug them when you have the chance and appreciate every day that is given to you. Life is a gift that’s why today is also called the present.

 

[Aloha Joe]

Thanks Joe.

 

[woodcarver]

Time is a good healer. Sounds like your instincts were good. As others have pointed out, your after incident reactions are normal. Taking a little time and talking to someone about it can really help.

Read this! Post-Traumatic Stress Disorder in Recreational Dive Rescuers - Shearwater Research

What he talks about are very real issues that good samaritans and even trained professional emergency responders can experience after an event. His advice is very sound and should help you work through the after affects of the unfortunate event you were part of.
While it is a natural response to second guess yourself after a traumatic experience, it is important to recognize and accept that you did the right things based on the training and skills you have.
And I'll second what @Schwob said, it took some guts to put this out here. Sorry you had to go through this. Hopefully the rest of your time there is like a trip to Hawaii should be.

 

[Aloha Joe]

Thanks everyone. All of your comments have been helpful. One of them in particular has helped me get to a different place and I’m feeling much better. I did reach out to my old therapist and she’s ready to talk if I feel like I need it, I told her I’d check in with her tomorrow.

I wanted to post about this for 2 reasons: the first is because I’m traveling alone and needed to talk, and the second is because I felt it’s an important reminder, particularly to new divers, that events like this happen.

 

[RayfromTX]

I am grateful that you had the willingness and courage to post here about your experience. These things can be very powerful in our life both immediately but also much later. I'm glad you are taking it seriously and recognizing that reaching out is strength and not weakness. Finding a group there that is dealing with ptsd may help with the isolation that you are feeling.

 

[Neilwood]

Aloha Joe - posting as you did took a lot of guts (almost as much as that required to actually help in an emergency).

Do not beat yourself up - even if the person had had that incident in an emergency room with highly trained people around, it is not guaranteed that she would have survived. You did everything you could in the situation that presented itself.

What I would advise is picking up the phone (or having a skype/FB/whatsapp call) to your best mate/family and having a long conversation about it. If that isn't an option, discuss it with a group or therapist as @RayfromTX suggests. The sooner you can chat things through the better. You are suffering very normal survivors guilt but that will get better in time. Don't be in too much of a hurry to get back in the water - take your time and ease yourself back.

Would better skills have helped? Maybe but no one ever knows that. This might push you towards getting further first aid skills (doesn't have to be dive related) or doing rescue but do that in your own time when your head is in the right place.

 

[PatW]

To me, the foam coming out of the snorkel is a really bad sign. I think she had some other issue that caused the event. A normal person who sucks a little water down their snorkel does not need anyone to tell them that. They will pop up and cough and hack like no one's business. The fact that she did not respond was really unsettling. Also, the fact that the lifeguards got to her quickly and performed CPR and she still expired indicates to me that there was some other issue.

She probably had a serious underlying condition. The exertion of the snorkeling probably triggered a fatal cascade but it was not the underlying cause.

My wife, an inactive scuba instructor, has told me that if I see someone having an an extreme underwater emergency to consider them already dead. You cannot make them any deader. In many cases, the rescue attempt is doomed. Given your level of training, I believe that you did virtually everything right.

 

[Rollin]

Oh man, feel sorry for you. But don't be hard on yourself. Long, long time ago, my best friend died in my arms while I tried to get him to the side of the pool when he was suddenly too ill to swim.
Once laying on the white tiles, people from the fire department (who were training there at the same time), tried to revive him. With no succes. It all took less then a couple of minutes for him to pass away. They did cpr for more than 30 minutes though.

As it was my best friend, I was well informed afterwards about the cause. An underlaying, non-visible medical condition was to blame. Me nor anybody else could have helped him, otherwise than being his friend or help at the very last moment.

You will probably never know what caused this lady to die, and that's a pitty. But often in such cases, nothing can be done. People just die, and when it happens at old age, snorkeling in Hawai, they can be considered lucky in some way. I hope it will happen to me when my time has come, but I hope it won't ruin the vacation of the young lad who tried to help me.
I'm sure the lady would whish you the same thing: have a nice vacation young boy, and thanks for trying to help me.