A lighting strike traveled down this barbed wire fence, killing a herd that apparently thought the grass was greener on the other side of the fence. Photo by 45th Weather Squadron. Courtesy NOAA

The Why Files talked with Mary Ann Cooper, a professor of emergency medicine at the University of Illinois-Chicago, about the medical effects of lightning. Cooper, who also studies other electrical injuries, calculates that lightning kills about 120 or 125 people annually in the United States, and injures about 1,200.

Those numbers are higher than those in the standard lightning safety material because Cooper believes that 30 percent of lightning fatalities are not reported, and that nine people are hurt for each death.

But even if you use the official numbers, lightning is second only to flooding among for weather-related deaths in the average year. (Most flooding deaths happen when people are trapped in their cars.)

1994 weather casualties, and 30-yr normals.
Order is by 30-yr death rate, then 1994 deaths:

WEATHER TYPE	DEATHS PER YEAR	1994 DEATHS	1994 INJURIES
Flash flood	139	59	33
Lightning	87	69	484
Tornado	82	69	1,067
Hurricane	27	9	45

In the average year, lightning causes more deaths than any miserable weather -- except floods. Some experts consider lightning an underreported hazard.
Data courtesy 11th Conference on Applied Climatology, American Meteorological Society, 1999.

Lightning kills by stopping the heart, which, after all, runs on electrical impulses. Surprisingly, the bolts which Cooper says last 0.1 to 1 millisecond, are too quick to burn most victims. Burns may happen if clothing ignites or sweat boils and steam is trapped under clothing.

Injury: worse than death?
Although victims don't get reduced to a pile of ash, lightning can change their lives, and not for the better, as Steven Marshburn, Sr., of Jacksonville, NC, told us via fax. He was struck in 1969 while working in a bank. Although the sky was blue, no storm was in sight, a bolt entered the bank through a wire from the drive-up window.

The bolt hit Marshburn in the back and changed his life: "I suffered from severe headaches, chronic daily pain, grand malaria [epileptic] seizures, dizziness, problems with my eyes going blurry," Marshburn wrote. "Many health problems persist. I have had 20 lightning-related surgeries..."

Marshburn now receives Social Security disability payments, but he could not get over his brush with death. In 1989, he formed Lightning Strike & Electric Shock Survivors International, Inc. to investigate the medical effects of lightning and support victims and their families. He told us that members have talked 13 fellow survivors out of suicide.

A shock to the nervous system
Lightning "tends to be a nervous system injury," Cooper writes, "and may affect any or all parts of the nervous system..." The effects can be severe, long-lasting, and hard to treat.

One common syndrome includes confusion resulting from an inability to process information fast enough. The symptoms may include "difficulty in short-term memory, coding new information and accessing old information, multitasking, distractibility, irritability and personality change," according to Cooper.

Damage to the frontal lobe, the site of much higher thinking, is common, she wrote. "Many may suffer personality changes because of frontal lobe damage and become quite irritable and easy to anger.

The person who 'wakes up' after the injury often does not have the ability to express what is wrong with them...and cannot carry on a conversation, work at their previous job, or do the same activities that they used to handle. As a result, many self-isolate, withdrawing from church, friends, family and other activities."

What's going on?
How, exactly, does lightning injure or kill cells? The scanty research that exists on this key issue suggests that lightning's electrical impulse may damage pores that control the entry and exit of sodium and potassium from cells. Potassium, for example, is normally 1,000 times more concentrated inside a cell than outside, and a change in level can cause mischief.

This shoe was cooked by lightning. Courtesy NOAA

Cooper says cells may be dying for other reasons, and that some cell types continue suffering for weeks after the lightning strike. Nerve cells, she adds, seem to "spend a long period trying to heal themselves, until finally the cell body is exhausted" and the cell dies. That lengthy damage, she says, accounts for a delayed disability syndrome seen in many lightning survivors.

It's not clear why neurons are especially subject to lightning damage, Cooper adds. "You'd say neurons are susceptible because they carry electric energy, but they also have myelin insulation," which would tend to protect them. However, since some neurons are the longest cells in body (they can reach three feet or more), "They are more susceptible to electricity field injury -- they may act like giant antennas," she says.

It's easy to speculate but hard to know. "You can look at all kinds of different angles, but nobody's done research on nerve cells" and lightning, Cooper concludes.

Help at hand?
Ignorance about the mode of injury, however interesting, is less pressing than finding treatment for lightning survivors. Today, following urgent care to stabilize the patient, there's no proven way to arrest, let alone reverse, nerve damage, Cooper says.

"The biggest hole in our knowledge is having something we can do to mitigate or prevent the injury," says Cooper. The situation is analogous to stroke, where there is also no proven way to succor brain cells deprived of oxygen -- except that the stroke injury can sometimes be halted with clot-busting drugs.

Common-sense precautions could keep you out of the lightning-damage statistics.

Can you see lightning from space?