He made superficial attempts to cut into his arm with the multi-tool’s blade during these days, testing whether the tool could accomplish what he was beginning to understand would be necessary. It could not. The blade was too dull to penetrate the skin effectively. Even if it had been sharp enough to cut through skin and tissue, it could not have managed what lay beneath: the bones of the forearm, the radius and the ulna, which would require something more than a knife to address.
By Tuesday, April 29 — day four — Ralston had run out of water. He was also exhausted, weakened by diminishing nutrition, and facing the specific physical deterioration that dehydration accelerates. His arm, meanwhile, was undergoing its own processes: without blood flow, the tissue below the point of entrapment was dying. The arm that he had been trying to free was becoming less viable with every passing hour. Doctors who later reviewed his case told him that even if he had been freed without self-amputation, the arm would likely have been lost due to the severity of tissue damage from prolonged compression.
He began to drink his own urine, a last-resort hydration measure that extends survival time by some margin while introducing its own risks. He was managing his body’s decline as rationally as someone in his condition could manage it, applying whatever knowledge and discipline he possessed to the problem of staying alive long enough for the situation to change.
The question that haunted these hours was not whether something had to change, but what.