My wetsuit is at waist-level as I hear the cries for help.

Darting across the dirt road towards Half Moon Bay beach, I scan the dock, the beach, and the water for the source of the shouts of distress. A handful of people stand on the dock, pointing excitedly at two figures struggling on the surface some two hundred meters offshore, their bodies bobbing in and out of sight amidst the rolling waves. My coworkers are charging down the dock.

This is the real deal.

I’ve been here before. With forty-seven PADI Rescue Diver certifications under my belt, I’ve simulated this situation at least as many times, but the level-headedness with which I execute my training scenarios is quickly usurped by the shot of raw adrenaline coursing through my veins. Perceptual narrowing kicks in. Time dilates.

The salty spray scalds my eyes as I stampede through the breaking surf. The sandy bottom gives out from beneath my feet. I crawl through the swells head-up with my vision fixed on the victims, nervously anticipating which rescue skills will be required of me in a mere matter of seconds. Two of my fellow Coconut Tree Divers Instructors dive off the dock, scrambling with equal intensity towards the scene.

I stress realism when I teach my PADI Rescue Diver courses. With every course I conduct, I strive to stress two key points:

1. Murphy’s Law is in effect. Emergencies are never convenient.
2. The only way to fail a rescue is to give up. Never, ever give up.

From vomiting ketchup in my students’ faces to spontaneously enacting missing diver searches at grossly inconvenient times, I aim to drive home these principles to each and every one of my students. With every simulation I teach, my overarching goal is to ensure that my students can and will fall back upon their training when faced with a real emergency. Before I scribble my signature upon any certification card, I must have confidence that my students are capable of providing adequate care in the face of novel and potentially terrifying circumstances. But no amount of simulation can prepare you for the sheer terror of touching cold, pale skin as you turn a victim’s unresponsive body face-up in the water.

His face is white and blue. Look, listen, feel. Weak breathing. His oxygen window is ticking away. The next few minutes are a matter of life or death.

Jose and I hook him under the arm, towing with all our might towards the shore. Matt attends to the other girl who, though obviously panicked, has decidedly less cyanosis than her partner. The strain of pulling a completely inert body is exhausting. We are still a fair distance from the shore. Time is ticking.

Marco tosses a yellow throw-rope from the dock. It’s a perfect throw, landing just inches away. I hook the line around my right arm. Marco runs down the deck, dragging our trio of rescuers and victim towards shore at a speed far faster than our tired legs could possibly kick. Our feet strike the sandy bottom. We’re running chest-deep in the surf. We drag his unresponsive body onto the beach, carefully cradling his head and rolling him on his side into the recovery position.

He vomits a noxious mixture of seawater and half-digested sandwich. He is breathing, thank God; CPR isn’t necessary for now. The oxygen kit is brought down from the shop. He’s not breathing strong enough for the nonresuscitator demand valve. We throw together the nonrebreather continuous flow mask, opened to 15 liters per minute. He’s over-breathing the bag. 25 liters per minute. Breathing becomes a bit more stable.

The crowd gathers in a circle. Delegation is now critical. You, gather information from his friend. You, call a taxi. You, keep these pricks with video cameras away from us.

We haul his limp, sand-coated body into the cab. The oxygen kit, still delivering a continuous flow of that life-giving gas to his lungs, rests in the front seat. His head lays on my lap. As the taxi careens towards Anthony’s Key Resort, I have flashbacks of how my childhood cat passed away in my mother’s lap en route to the vet. God, please don’t let him pass his death stool on me.

We’re here. The taxi driver runs into the clinic to summon the doctors. I gently remove the oxygen mask from his face. He is a bit more responsive now, and already his skin has taken on the reddish hues indicative of a normally functioning human. We struggle to shuffle him on the stretcher. Three, two, one, vaminos!

The doctors carry him inside the clinic. After seemingly endless minutes of chaos, I am suddenly alone, coated in sand and spittle, standing barefoot on the rough gravel of the Anthony’s Key parking lot. I breathe deeply, resisting the waves of nausea from the volatile concoction of adrenaline and lactic acid accumulating in my body.

Resistance proves futile. I vomit in the bush.

As my vile upchuck settles into the soil, I recall how, a year prior, I stood in the same spot staring down upon the lifeless corpse of a freshly murdered taxi driver as liters of his congealed blood stained the earth. I remember frantically dashing into a meeting of some forty-odd PADI professionals demanding barriers with which to take the stabbed cabby’s final pulse check. I recall the sensation of touching my warm fingers against his cold skin, his flesh rigid with early rigamortis, the metallic tinge of bodily fluid tainting the night air. Emergencies are truly never convenient. I puke again.

But the training works—this I know for certain. Whatever the outcome of my present predicament, the training from the Emergency First Response and PADI Rescue Diver courses works. As my queasiness subsides, the blur of the last hours comes into focus. Minor mistakes were made—why didn’t I take off my wetsuit before the swim? how the hell could I forget to grab my fins?—but I remind myself that imperfect care delivered is better than perfect care withheld. The training works. The team worked. Whatever happens, we did all that we could to give him a fighting chance at survival.

And then he’s laughing.

I have witnessed a miracle. He’s standing, laughing, and weakly smiling. As an IV drips essential nutrients directly into his bloodstream, I am finally able to introduce myself to the man who, less than two hours ago, was floating cataleptic amidst the sea swells. He’s alive and well. The cruise ship leaves in an hour, and he will be sailing away from my little island of Roatan with one helluva story to share over the all-you-can-eat lobster dinners.

I sit on the dock as the sun descends beyond the horizon, a half-finished rum and pineapple in hand, as the aquamarine waters of Half Moon Bay become an oil-like smear of reds, violets, and greens. My body aches. My head heaves with the dull doldrums of mild dehydration. My heart rejoices. I raise my glass alongside those of my coworkers. With the clink of glasses, we tacitly salute the same thought: the training works.