This is a difficult article to sit with. Not because the science is complicated — it isn't — but because the tragedy at its center is preventable. A 39-year-old mother died. And the mechanism wasn't cold water. It was a broken information ecosystem that told her cold immersion was safe, simple, and universally beneficial.
Kevin Bass frames it bluntly: misinformation killed her. I think that's right. And I think people who genuinely believe in the power of cold exposure — people like me — have a responsibility to take that seriously rather than get defensive about it.
The benefits of cold exposure are real and well-documented. Reduced inflammation, improved cardiovascular markers, enhanced mood through norepinephrine release, accelerated muscle recovery. The 2014 Kox et al. paper — the Wim Hof PNAS study — showed measurable immune modulation through cold and breathwork protocols. These are legitimate findings, replicated across multiple labs.
But here's what the wellness influencer circuit consistently strips out: the cold shock response. When cold water hits your skin unexpectedly, or without adequate acclimatization, your sympathetic nervous system fires immediately. Heart rate spikes. Blood pressure surges. Breathing becomes gasping and involuntary. This is not a bug in the biology — it's a feature. Your body is trying to survive. The problem is that in open water, that gasp reflex introduces water into the lungs, triggering a drowning cascade that is extraordinarily difficult to reverse once initiated.
Two reported deaths in official ice swimming competitions — events with trained observers, medical staff, and participants who know exactly what they're doing. That number should inform how we talk about this practice with beginners.
The cold exposure community — and I include myself in this — has a pattern of celebrating the dramatic transformations while minimizing the failure modes. We share the stories of people who did cold plunges and felt reborn. We don't share the stories of people who panicked, hyperventilated, and needed rescuing. Selection bias isn't just a research problem; it's a storytelling problem.
Experts are not actually in disagreement about whether cold exposure can be dangerous. They are in disagreement about how dangerous it is relative to the benefits, and for whom. Cardiac patients, people on certain medications, those with autonomic nervous system dysregulation — these populations face meaningfully elevated risk. The influencer content that reaches them does not make that distinction.
If you are new to cold exposure, start with cold showers. Not ice baths. Not open water. Cold showers. Stay in control of your environment, your breathing, and your exit. Build acclimatization gradually over weeks, not days. Never do cold water immersion alone, especially outdoors. And if you have any cardiovascular history at all, talk to a doctor first — not a podcast.
There's a pattern across every high-benefit practice in this knowledge base: the dose-response curve has a steep edge. Sauna overuse suppresses immune function. Fasting too long breaks down muscle. Exercise without recovery causes injury. Cold exposure, pushed too fast or without proper context, can kill you. The practices that make you most resilient are the same ones that can cause serious harm when the information conveying them is stripped of its nuance. That's not a reason to avoid them. It's a reason to learn them properly — with respect for both the power and the threshold.