Me and My A.E.D.

“Everyone should have BLS training. . . we’ll all be better off because of it”     -Me.

I arrived at my designated gate at Chicago’s O’Hare Airport.  The run there kept the adrenaline level up in my system, though the hubbub was now well behind. I pulled the crumpled boarding pass out of my pocket as I caught my breath. No that’s a hotel receipt. Check the other pocket, there it is, Zone 3, that can’t be that bad; I thought,  there’s gotta be, what maybe 6 or 7 zones, right? “Welcome aboard American Airlines flight to Flint, Michigan” the gate attendant announced. We welcome our platinum medallion, gold medallion, silver medallion, bronze high-flyers, copper star club, as well as plastic fantastic, and purple star members, followed by zones one and two” The last of the passengers was already through the jetway. “Now boarding zone three, welcome aboard”.

After handing over my crumpled boarding pass for scanning, I made my  down the jetway and onto what appeared to be a small but fairly packed little jet. Passengers on each side of the aisle eyed me as I walked past, a few noticed that my jeans were soaked from the knees down. Some caught the odor that  trailed behind, a light of recognition igniting in their eyes as they realized what it was. Does he really smell like that? Is he the one that’s dragging that awful scent through this cabin?

6 hours earlier things had been going very differently for me. My colleagues and I had just given a well received talk at the annual Chest convention. I had reconnected with old friends that I hadn’t seen since training.  I had just personally  thanked Kevin Pho (of KevinMD fame) in the hotel coffee shop for giving our keynote address and getting our membership fired up about the future of medicine and social media. It was with this sense of excitement and renewed enthusiasm that I boarded my plane to catch a connection at O’Hare.

I also distinctly recall that, at the time, my pants were absolutely one-hundred percent completely dry.

But that apparently wasn’t to last. As I made my way from one gate to the next at O’Hare,  I stopped to buy a cola. I spent a minute drinking it in before making the turn towards the terminal where my gate was located. After making my way through the circular hub towards my terminal, the call, faint and distant, came out. . “Doctor?” At that time it barely registered in my brain. “Doctor?” I think I heard that, but it sounds like it’s coming from the television in the bar I passed.

Is there a doctor, we need a doctor!” That’s no television. I wheeled around, walked quickly toward the sound, I saw a man laying  face down on the floor, and then my walk became a run.

A large, elderly man lay face down, un-moving, and not responding to my voice. I tried to turn him over but he must have been 400 pounds. All I succeeded in doing was sliding him on the tile floor. For about 30 seconds I tried, while being vaguely aware of someone taking a video on their phone. Just then a security person arrived, big and burly, we turned the man over easily.

“Sir, are you O.K?, can you hear me?!” I turned to the security guard, “call 911 and get me an AED!” A bystander arrived and felt for a radial pulse in the man’s wrist.. “I think I feel a pulse” he said. Which was strange as I did not feel a carotid pulse in his neck. I checked the other side of the neck and the other wrist. Nothing. “Are sure you feel a pulse there?” I asked.

He looked at me sheepishly “Well maybe not, I’m not really sure”

The man’s shirt had already torn open as we turned him. His face was ashen and quickly taking on a bluish tinge. On the chest.

“One, two, three. . . “ I started chest compressions.

A woman arrived, her calm, purposeful demeanor suggested that she worked in the medical field, or at least watched a lot of medical dramas.The fallen man was large enough that his dangling head didn’t even touch the floor. Even if he could breathe, he probably wouldn’t be able to breathe effectively with his head at that angle. She gently raised his head with her gloved hands.

Wait, where did she get those gloves from? I thought. “Twenty-five, twenty-six, twenty-seven!”  I completed a set of 30 compressions, but nobody was giving breaths, so I just kept going.

I’m the one with the bare hands on his bare chest, shouldn’t I be the one that gets the gloves? “Six, seven, eight!”  

More security had arrived, they cleared some space. An irate man was yelling at whoever was taking a video on their camera. “Nineteen, twenty, twenty-one!”

“Here’s the AED” I heard one of the security people say. Boy, really woulda been great to be wearing some gloves right now, I wonder why she didn’t offer me any?  “Twenty-eight, twenty-nine, thirty! Get that AED hooked up!”

The woman with the gloved hands now starting placing the AED pads, working around me. “Seven, eight, nine! Ok holding compressions while the AED analyzes rhythm. ‘Analyzing rhythm’” said the machine. “Shock advised” Awesome!, maybe this guy’s got a chance!

I got back on the chest while the machine charged. “twenty-six, twenty-seven, twenty-eight!”

“Press button to deliver shock” said the machine in it’s soothing male voice.

I moved back from the man, still on my knees.

“Sir can I have your I.D? said one of the security guards. Another chimed in, “We can’t shock him while he’s in that puddle”

“Ya, no problem!” I replied as I reached for my back pocket. Wait, what puddle? Was he talking to me?

“Sir you’re going to have to move back a bit to get out of that puddle”

“Ok, everybody clear!” I said,  I stood up from my knees, moving back from the man “Here’s my driver’s license” I motioned to the gloved woman to give a shock. Did somebody say something about a puddle?

The AED delivered the world’s most uneventful shock, nary a sound from the device or jolt in the victim. I knelt back down to my knees again and checked for a carotid pulse.

“He’s got a pulse!” I said.

“I feel it here, too!” said the sheepish bystander confirming a radial pulse

“Ya, real classy, asshole!” said the irate man, still chiding whoever continued to take a video.

Holy shit! This guys’s back! I think he’s going to make it!

I stood up again, my legs had fallen asleep after crouching in an awkward position to do compressions, and as the feeling raced  back into my legs, I felt something peculiar. My shins were soaked. I looked down to find out why, and there it was.

I had been kneeling in a puddle of piss.

If ever there was a time that the word “urine” was inadequate, this was it.  This was a well  demarcated puddle of yellow, filthy, stinky, festering piss. A puddle that I alone had not managed to avoid. There was nothing I could do, my other pants were in my checked baggage. And in any case, I was out of time, I could hear my flight being called overhead as the EMT’s arrived.  I sought out  the security guard who had my license, he had given it to another guard. He introduced me to the man’s daughter who was traveling with him.

“He was hurrying to catch his flight” she said. I explained to her that his heart stopped, and the AED brought him back, hopefully the doctors at the hospital would be able to help him. Planes don’t usually have AED’s, if this had happened once he had boarded, he might have never made it back.

After grabbing my carrying-on, and finally finding the security guard who had my license, I headed  for my gate.

I got home just after midnight. After chucking  my jeans in the washer, and chucking myself into the shower, I settled into an empty bed. Earlier that afternoon my wife had flown out of town to a conference of her own. I hoped that her trip was uneventful, and that when she returned her jeans were dry.