On a warm June night in New York City, I had an acute
cardiac arrest on the sidewalk across from the Staten Island ferry. I had lived well that evening walking across
the Brooklyn Bridge to join my wife and daughter for dinner and helping a sick
woman in a subway as we returned to Manhattan.
I lived the next twelve days of my life in an induced coma with
intervals of wide delirium. During my rehabilitation, I asked my wife and
family a thousand questions about how I survived.
A cholesterol deposit within the
wall of the blood vessel which nourishes the right side of my heart, suddenly
broke off of its base immediately after I climbed the stairs coming up from the
subway. The turbulence in that blood
vessel set off a chain reaction causing blood flow to slow throughout my heart
because I also had other multiple blockages. My heart suddenly lacked oxygen and could not
generate its life sustaining and rhythmic electrical charge which excites each
heart beat. The heart was too weak to
push oxygen dissolve in my blood to my brain. I lost consciousness. My wife’s
scream for help brought an African American to my side who was a medic and Sergeant
in the United States Army. His powerful hands methodically pushed on my breast
bone which propelled blood out of my heart and up into my brain. His effort
accounts for the fact that I am still the same person I was before all this happen.
The Sergeant’s wife called 911. In about four minutes two New York City
firemen were there. They cut my shirt up the middle and applied the paddles of
a defibrillator to my chest. The devise discharged
three increasingly powerful jolts of electricity. With the third shock, my upper
body jerked violently for an instant and then I lay motionless. One of the firemen put his fingers into my
groin, searching for a deep pulse as a sign of life. The signal from the paddles showed a straight
line and my wife thought I was gone. But deep in the cells of my heart the flow
of sodium ions in tiny channels disrupted by the loss of oxygen, had been restored by the
shocks. As electricity flows in a wire,
an ionic signal mysteriously developed in the specialized circuitry of my heart
and instantaneously electrified my heart muscle. The heart reacted like a hand
suddenly becoming a quenched fist. The
blood in my heart chambers rushed out into my brain, lungs and abdomen. The
fireman’s finger tips finally detected an impulse. The wondrous electromechanical
pumping action of my heart had resumed and preserved my life.
I was transferred to the Columbia
Presbyterian Medical Center where I was cooled to the low nineties. Low
temperature retards heart and brain damage. I required a pulsating balloon
inserted into my aorta to augment my heart’s pumping. I developed a vicious pneumonia requiring two
antibiotics. A respirator was necessary to aide my breathing. I had to be kept
deeply sedated because when I was allowed to become awake I was a delirious
wide man who pulled out the tube in my wind pipe connected to the respirator. My
family was advised that I required open heart surgery to bypass multiple
coronary artery blockages. Considering my general condition, they worried that I
would not recover from surgery.
My wife and daughter studied their iPad at my bedside
looking for a patient in a similar crisis. They found the names of three
cardiology groups who had treated patients like me without open heart surgery.
These groups inserted multiple tiny springs called stents into the left main coronary
artery which is a blood vessel so critical to the heart’s circulation,that only
open heart surgery was done to repair it.
Stents are usually threaded into the heart’s blood vessels from the same
blood vessel in the groin which signaled that I was alive to the firemen. The cardiologists who were pioneering risky
stent operations were in Seoul and Milan but a name in the third group was
familiar. He was in New York City!
Dr. Michael Collins had performed my
cardiac catheterization to define my multiple coronary artery blockages. He had recommended open heart surgery. He
advised my family that I could die if he made an error trying to insert
multiple stents into the left main coronary artery and the blood vessels
downstream. However, my family sensed that he was capable and confident and
asked him to do the procedure. In the
time my wife and I were married, 41 years earlier to the day, five stents were
positioned and sprung open in my main coronary arteries. My heart’s pumping power increased by one
hundred percent that afternoon. I was taken off the respirator in five days as
I regained consciousness.
Seven months later, Dr. Collins
and I met again in the heart catheterization room to determine if the repaired blood
vessels had remained patent. He and I looked at the images of my coronary
arteries on the computer screen as the dye he injected rushed unobstructed into
the big pumping muscles of my heart. Michael
Collins stood back one step from the table. “I really had a good day the last
time we were here.” I have seen two grandchildren
enter my life since my collapse. I have resumed caring for hundreds of
patients. When I close my eyes to sleep
each night, I think of my days in coma, unaware of the vigilant family at my
bedside. I recall the pain in my ribs and the burn marks on my chest when I became
aware of my survival and I think of the men, the system and the science which
have given me my continuing gift of life.
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