This is what it's like to be struck by lightning

Story highlights

  • Lightning is responsible for more than 4,000 deaths worldwide annually
  • Victims can suffer short and long-term effects, such as cardiac arrest, confusion, seizures

Sometimes they'll keep the clothing, the strips of shirt or trousers that weren't cut away and discarded by the doctors and nurses.

They'll tell and retell their story, sharing pictures and news reports of survivals like their own or far bigger tragedies.
Only by piecing together the bystander reports, the singed clothing and the burnt skin can survivors start to construct their own picture of the possible trajectory of the electrical current, one that can approach 200 million volts and travel at one-third of the speed of light.
    In this way, Jaime Santana's family have stitched together some of what happened that Saturday afternoon in April 2016.
    Jaime had been horse-riding with Alejandro Torres -- his brother-in-law -- and two others in the mountains behind Alejandro's home outside Phoenix, Arizona, a frequent weekend pastime.
    They had witnessed quite a bit of lightning as they neared Alejandro's house, enough that they had commented on the dramatic zigzags across the sky. But scarcely a drop of rain had fallen as they approached the horse corrals, just a few hundred feet from the back of the property.
    Alejandro doesn't think he was knocked out for long. When he regained consciousness, he was lying face down on the ground, sore all over. His horse was gone.
    The two other riders appeared shaken but unharmed. Alejandro went looking for Jaime, who he found on the other side of his fallen horse. Alejandro brushed against the horse's legs as he walked passed. They felt hard, like metal, he says.
    Alejandro reached Jaime: "I see smoke coming up -- that's when I got scared." Flames were coming off of Jaime's chest. Three times Alejandro beat out the flames with his hands. Three times they reignited.
    It wasn't until later, after a neighbor had come running to help and the paramedics had arrived, that they began to realize what had happened -- Jaime had been struck by lightning.
    The rain that had threatened all afternoon didn't start to fall until Alejandro and Jaime's sister, Sara, were driving to Maricopa Medical Center in Phoenix. Alejandro sat tense. "All of this way, I was thinking, 'He's dead. How do I tell her?'"
    When they arrived, Alejandro was stunned to learn that Jaime was in surgery. Surgery? There was still hope.
    Jaime had arrived at the Phoenix trauma center with an abnormal heart rhythm, bleeding in the brain, bruising to the lungs and damage to other organs, including his liver. Second- and third-degree burns covered nearly one-fifth of his body. Doctors put him into a chemically induced coma for nearly two weeks to allow his body to recover.
    Jaime finally returned home after five months of treatment and rehabilitation, which is continuing. "The hardest part for me is that I can't walk," he says from the living room of his parents' house. The doctors have described some of Jaime's nerves as still "dormant", says Sara, something that they hope time and rehabilitation will mend.
    His family have stopped asking why lightning caught him in its cross hairs that April afternoon. "We're never going to be able to answer why," Sara says. So now it's time for Jaime to start thinking about "what's next".

    A second survivor's tale

    Justin Gauger wishes his memory of when he was struck -- while fishing for trout at a lake near Flagstaff, Arizona -- wasn't so vivid. If it weren't, he wonders, perhaps the anxiety and lingering effects of post-traumatic stress disorder wouldn't have trailed him for so long.
    An avid fisherman, Justin had initially been elated when the rain started that August afternoon. But when it picked up, becoming stronger and then turning into hail, his wife and daughter headed for the truck, followed later by his son. The pellets grew larger, approaching golf ball size, and really started to hurt as they pounded Justin's head and body.
    Giving up, he grabbed a nearby folding canvas chair -- the charring on one corner is still visible today -- and turned to head for the truck.
    A crashing boom. Jolting, excruciating pain. "My whole body was just stopped," Justin recalls. "If you've ever put your finger in a light socket as a kid, multiply that feeling by a gazillion."
    A couple huddling under a nearby tree ran to Justin's assistance. They later told him that he was still clutching the chair. His body was smoking.
    When Justin came to, he realized that he too was paralyzed from the waist down. "Once I figured out that I couldn't move my legs, I started freaking out." It took five hours for the paralysis to subside.
    Describing that day, Justin traces the path of his burns, which at one point covered roughly a third of his body. They began near his right shoulder and extended diagonally across his torso, he says, and then continued along the outside of each leg.
    He shows me his hiking boots, tipping them to reveal several burn marks on the interior. Those dark roundish spots line up with the singed areas on the socks he was wearing and with the coin-sized burns he had on both feet. Justin's guess is that the lightning hit his upper body and exited through his feet.
    Socks worn by Justin Gauger when he was struck by lightning.
    Although survivors frequently talk about entry and exit wounds, it's difficult to figure out precisely what path the lightning took, says Mary Ann Cooper, a retired Chicago emergency physician and long-time lightning researcher. The visible evidence of lightning's wrath is more reflective, she says, of the type of clothing a survivor had on, the coins they were carrying and the jewelery they were wearing.

    The consequences of surviving

    Lightning is responsible for more than 4,000 deaths worldwide annually, though of every ten people hit, nine survive. But victims can suffer a variety of short- and long-term effects: cardiac arrest, confusion, seizures, deafness, headaches, memory deficits, personality changes and chronic pain, among others.
    Changes in personality and mood can strain families and marriages, sometimes to breaking point. Cooper likes to use the analogy that lightning rewires the brain in much the same way that an electrical shock can scramble a computer -- the exterior appears unharmed, but the software within that controls its functioning is damaged.
    But despite a deep vein of sympathy for survivors, there are some symptoms that strain Cooper's credulity. Some people maintain that they can detect a storm brewing long before it appears.
    That's possible, Cooper says, given their heightened sensitivity to stormy signs in the wake of their trauma. She's less open to other reports -- those who say that their computer freezes when they enter a room, for instance.
    Yet, even after decades of research, lightning experts readily admit that there are many unresolved questions, in a field where there's little to no research funding to decipher the answers.
    Some survivors report feeling like medical nomads, as they struggle to find a doctor with even a passing familiarity with lightning-related injuries. Justin finally sought out help last year for his cognitive frustrations.
    Along with coping with post-traumatic stress disorder, he chafes at living with a brain that doesn't function as it once did. "My words in my head are jumbled. When I think about what I'm trying to say, it's all jumbled up."

    Electricity and your body

    When someone is hit by lightning, it happens so fast that only a very tiny amount of electricity ricochets through the body. The vast majority travels around the outside in a 'flashover' effect, Cooper explains.
    Lightning striking east Mesa, Ariz., Friday in 2016.
    As it moves over the body, it might come into contact with sweat or raindrops on the skin's surface. Liquid water increases in volume when it's turned into steam, so even a small amount can create a 'vapor explosion'. "It literally explodes the clothes off," says Cooper.
    Cooper authored one of the first studies looking at lightning injuries, published nearly four decades ago, in which she reviewed 66 physician reports about seriously injured patients. Loss of consciousness was common. About one-third experienced at least some temporary paralysis in their arms or legs.
    Lightning's massive electrical current can also temporarily stun the heart, says Chris Andrews, a physician and lightning researcher at the University of Queensland in Australia. Thankfully, though, the heart possesses a natural pacemaker. Frequently, it can reset itself.
    The problem is that lightning can also knock out the region of the brain that controls breathing. This doesn't have a built-in reset, meaning a person's oxygen supply can become dangerously depleted. The heart may then succumb to a second and potentially deadly arrest, Andrews says. "If someone has lived to say, 'Yes, I was stunned [by lightning],' it's probable that their respiration wasn't completely wiped out."

    How it begins

    Lightning begins high up in the clouds, sometimes 15,000 to 25,000 feet above the earth's surface. As it descends, the electricity is searching for something to connect with. It steps, almost stair-like, in a rapid-fire series of roughly 50-metre increments.
    Once 50 metres or so from the ground, it searches again pendulum-style in a nearby radius for "the most convenient thing to hit the fastest," says Ron Holle, a US meteorologist and long-time lightning researcher.
    Prime candidates include isolated and pointed objects: trees, utility poles, buildings and occasionally people, though direct strikes are surprisingly rare. They're responsible for no more than 3 to 5 per cent of injuries. Still, it's likely that Jaime was directly hit, given that he was riding in the desert with no trees or other tall objects nearby.
    A snapped-off rotor blade'seen on a wind turbine near Dargelin, Germany, 17 May 2017. The damage was presumably caused by a lightning strike on 15 May 2017.
    Justin, however, believes he experienced what's called a side splash, in which the lightning 'splashes' from something that has been struck -- such as a tree or telephone pole -- hopscotching to a nearby object or person.
    Considered the second most common lightning hazard, side splashes inflict 20 to 30 per cent of injuries and fatalities.
    By far the most common cause of injury is ground current, in which the electricity courses along the earth's surface, ensnaring within its circuitry a herd of cows or a group of people sleeping beneath a tent or a grass-thatched hut.

    What to do in a thunderstorm

    So what should you do when a storm kicks up? Some guidance is available: avoid mountain peaks, tall trees or any body of water. Look for a ravine or a depression. Spread out your group, with at least 20 feet between each person. Don't lie down, which boosts your exposure to ground current.
    There's even a recommended lightning position: crouched down, keeping the feet close together.
    Still, don't dare to ask Holle about any of these suggestions. "There are cases where every one of these [strategies] has led to death."
    In his cubicle at the control center of the US National Lightning Detection Network in Tucson, Arizona, Holle has accumulated stacks of articles detailing lightning-related scenarios involving people or animals.
    Join the conversation

    See the latest news and share your comments with CNN Health on Facebook and Twitter.

    Deaths and injuries that have occurred in tents, or during sports competitions, or to individuals huddled beneath a golf shelter or a picnic shelter or some other type of shelter.
    That word whitewashes the reality, Holle says, as so-called "shelters" can become "death traps" during a lightning storm. They provide protection from getting wet -- that's it.
    Lightning safety campaigns used to promote the 30/30 rule, which relied upon individuals counting off the seconds after lightning flashed. If thunder rumbled before they reached 30, lightning was close enough to pose a threat.
    But there's no such thing as a lightning-proof guarantee, Holle states. So today, the advice is much simpler: "When thunder roars, go indoors."