Did a hypothermic, clinically dead boy revive in response to prayer defying "every expert, every case history, and every scientific prediction"?

Question

The Impossible (a 2017 non-fiction book) and Breakthrough (its 2019 movie adaptation) purport to describe a case of miraculous healing.

Quoting the book’s webpage:

When Joyce Smith’s 14-year-old son fell through an icy Missouri lake one winter morning, she and her family had seemingly lost everything. At the hospital, John lay lifeless for more than 60 minutes. They asked themselves, How could God do this to us? But Joyce was not ready to give up on her son. She mustered all her faith and strength and cried out to God in a loud voice to save her son.

Immediately, her son’s heart miraculously started beating, again.

In the coming days, her son would defy every expert, every case history, and every scientific prediction. Sixteen days after falling through the ice and being clinically dead for an hour, John Smith walked out of the hospital under his own power, completely healed.

According to Wikipedia's plot summary of the movie:

After John is transferred and placed in a medically-induced coma, Garrett warns his parents that he has little hope for John's recovery, and that if he were to pull through, he would likely live in a persistent vegetative state.

I looked at the Wikipedia article about hypothermia and its lead states:

One of the lowest documented body temperatures from which someone with accidental hypothermia has survived is 13.0 °C (55.4 °F) in a near-drowning of a 7-year-old girl in Sweden. Survival after more than six hours of CPR has been described.

The paragraph about prognosis elaborates:

Survival with good function also occasionally occurs even after the need for hours of CPR. Children who have near-drowning accidents in water near 0 °C (32 °F) can occasionally be revived, even over an hour after losing consciousness.

It would therefore seem that revival from severe hypothermia may be possible even after the initial prolonged lack of response to treatment. Despite this, the book's webpage still maintains this particular case is, for some reasons, unique:

“We have spent the last two years searching around the world to see if there is another case like John’s and we have found one that has some of the same characteristics. John is the only person we can find who has survived and come back 100 percent in the world that we know of.”

―Dr. Jeremy Garrett, Cardinal Glennon PICU Doctor Area expert on drowning and Hypothermia

All of this, I believe, warrants me to ask:

• Was this case indeed unique, ie are there no registered analogous cases of revival and healing?
• Was this revival and healing inexplicable by contemporary science? Would most experts predict the boy would not survive and even if he survived he would not fully recover?

Answer 1

A quick Google search found a list of similar cases:

Tipton, M. J., & Golden, F. S. C. (2011). A proposed decision-making guide for the search, rescue and resuscitation of submersion (head under) victims based on expert opinion. Resuscitation, 82(7), 819–824. doi:10.1016/j.resuscitation.2011.02.021

This was published in 2011, so it seems implausible that an expert in the field in 2017 would not have been aware of it, still less that two years of searching would not have found it.

The paper has a list of 43 cases (plus one review paper of other cases which may overlap) listing the ages of the patients and the outcomes. Many made full or nearly full recoveries after prolonged submersion in icy water. The most extreme case seems to be a 2.5 year old female submerged for at least 66 minutes in water at 5 degrees C. She made a full recovery. Factors correlated with successful resuscitation were:

if the water is very cold; if the duration of submersion is short; if the victim is a child or small adult; if the submersion is into freshwater.

Also, this isn't a case of drowning, but the BBC reports that a woman with hypothermia was in cardiac arrest for 6 hours and has since made an "almost full recovery".

According to a local newspaper story about the incident:

John Smith, who was under water for about 15 minutes before he was rescued [...]

So this case matches all the criteria given above: 14 years old, very cold fresh water, short submersion. In short it is neither unprecedented nor inexplicable.

As for the dramatic scene described in the original post:

She mustered all her faith and strength and cried out to God in a loud voice to save her son.

Immediately, her son’s heart miraculously started beating, again.

It seems likely that a woman of faith would have started praying as soon as she learned of her son's accident. Why attribute his recovery to the most recent prayer and not to the skill and persistence of the doctors?

Answer 2

It's an effect that's been widely described and studied.

A meta-study says:

Prolonged survival under water

Generally, drowning results in cardiopulmonary arrest within 2 min (Fainer et al. 1951). Quan et al. (2014) reported on the outcome of 1094 open water drownings; most (78%) had bad outcomes (74% death, 4% severe neurological sequelae), and of the good outcomes, 88% were submerged for <6 min. This percentage falls rapidly (i.e. 7.4% of good outcomes when submerged for 6–10 min), with the risk of death or severe neurological impairment after hospital discharge given as ‘nearly 100%’ when the duration of submersion exceeds 25–27 min (Szpilman et al. 2012).

However, if the water is cold this time can be extended, with the current ‘record’ being 66 min of submersion with near‐complete recovery (Bolte et al. 1988). In such cases, the temperature of the water appears protective, with records of submerged survival with minimal long‐term sequelae only having been reported in water <6°C (Tipton & Golden, 2011). The Q10 temperature coefficient, a measure of the rate of change of a biological or chemical system as a consequence of increasing or decreasing the temperature by 10°C, differs for different body systems; metabolic and rhythmic processes are particularly depressed by hypothermia (Q10 of ∼3), and contractile processes have a Q10 of ∼2. As hypothermia progresses, metabolic and rhythmic processes are depressed more than the rates of diffusion of different metabolites (MacLean & Emslie‐Smith, 1977). The hypoxic survival time of the brain is extended by hypothermia, with cerebral activity, and therefore oxygen demand, falling close to minimal levels at a brain temperature of 22°C (Adams & Victor, 1977).

The proposed mechanism of prolonged underwater survival involves the 2 min of drowning‐related flushing of cold water in and out of the lung cooling the heart and carotid artery blood supply to the brain, thereby selectively cooling the brain, with consequent cerebral hypothermia protecting the brain from hypoxia (Golden et al. 1997; Tipton & Golden, 2011). Evidence for such a mechanism can be found in the animal work of Conn et al. (1995), who reported a 7.5–8.5°C reduction in carotid artery temperature after 2 min of submersion, with much slower cooling (0.8°C) during head‐out cooling. The cooling rate also slows significantly after cardiorespiratory arrest (Conn et al. 1995), further supporting the involvement of respiratory heat exchange in the initial fast rates of cooling of carotid artery temperature. Although slower, continued cooling via surface cooling does add important additional protection; this helps to explain why those who cool the most by this route owing to surface area‐to‐mass ratio advantages (i.e. the young and the small) tend to comprise the small number of individuals who have survived prolonged immersion with minimal consequences. Given that the brain is preferentially cooled, other sites for measuring deep body temperature have little prognostic value in such situations (Tipton & Golden, 2011).

Therefore, in contrast to the problems caused by cold shock outlined in the previous section, in this scenario (small individual submerged in water <6°C) the hyperventilation associated with cold shock during drowning may be beneficial rather than detrimental; this highlights the importance of circumstance for drawing such conclusions. Interestingly, the same protective mechanism that can occur naturally during drowning in very cold water has been considered as an intervention to reduce ischaemic brain damage after cardiac arrest or stroke. The challenge is to find a method that can cool the brain rapidly enough to be of value (Hoa et al. 2008; Rewell et al. 2017).

Tipton, M.J., Collier, N., Massey, H., Corbett, J. and Harper, M. (2017), Cold water immersion: kill or cure?. Exp Physiol, 102: 1335-1355. doi:10.1113/EP086283

I note that the doctor quoted in the article also says this:

Garrett says while there may be a medical explanation as to what happened — that Smith's brain and body got cold before he was deprived of oxygen and his heart and circulation stopped — he still believes the teen's complete recovery qualifies as a true miracle. "Cardinal Glennon is a place where faith is valued," he said.

SSM Health patient's miraculous recovery is the stuff of movies, The Catholic Health Association of the United States, May 15, 2019