By Alice Park
May 27, 2015
TIME Health
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An Italian boy who fell into a canal in Milan is the latest “miracle” drowning survivor. The 14 year old was jumping off a bridge with friends into 6.5-foot water when he failed to come up. It took rescuers creating a human chain and 42 minutes before they could find him in the murky water and bring him back up; he had no pulse and was unconscious.

After a month in the hospital, where doctors attached him to a machine that took over for his lungs and heart to keep his body oxygenated, he woke, apparently alert and able to talk to his parents (and ask about his favorite professional soccer team).

But how did he survive underwater for nearly an hour?

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Michael isn’t the first to recover from being underwater for so long; there’s a report of a person surviving after being submerged for an hour. Other young boys have recovered after going under in frigid lakes, ponds and oceans for anywhere from 15 to 45 minutes.

Experts say it’s no accident that most of the survivors are young; the automatic reflex to drop the heart rate and divert oxygen to the brain, especially in cold water, is more robust in younger children than in adults. Keeping the brain bathed in oxygen is critical; after about four minutes without oxygen, brain damage can occur.

And the colder the water, the more likely the brain is to be sustained in this way; frigid temperatures help the body divert its resources primarily to the brain. The canal into which Michael fell was about 59 degrees.

Doctors say there is no way to fully explain how the boy survived, much less how his brain remained relatively intact. But Michael’s case, and those of the other survivors, stress how important it is to administer emergency CPR as soon as possible after a drowning.

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