Cardiac arrest

I am a beneficiary

I have benefited from living in a rural community in Nova Scotia. My neighbours in the village and surrounding area are friends and acquaintances. For 5 years near the end of my career, I was one of their doctors. The day I was driving up Main Street, one of my neighbours^* driving in front of me happened to check her rearview mirror. She saw me veer off the road and hit a telephone pole. She pulled into the service station, announced the accident, and ran back to help out.

I am a beneficiary

A nurse^† from our hospital who had taught cardiopulmonary resuscitation (CPR) for 30 years happened to be walking by the crash site. No pulse! She started CPR. A volunteer fireman^‡ at the service station arrived and assisted with CPR. A passing snowplow operator^§ and a neighbour^‖ both phoned 911. The paramedics arrived in 3 minutes and placed the defibrillation pads on my chest: ventricular fibrillation. I was shocked; my heart rate returned to a normal sinus rhythm and I was transferred by the paramedics to our hospital.

I am a beneficiary

At our hospital, the nurses^¶ continued to ventilate me. They set up intravenous lines, placed a nasogastric tube, and put in a Foley catheter. Our doctors^# intubated me and arranged a helicopter transport to the tertiary care hospital where the cardiologists^** cooled me and put me in a medically induced coma. In that subliminal state a defibrillator and pacemaker were inserted, and cardiac medication was adjusted. As I was gradually brought back to a conscious state, I tried to escape over the rails of my bed and pull out my catheter. I was extubated and passed my swallowing test.

I can’t remember any of the events I just recounted. They are the memories of my family, those who kept me alive, and those who nursed^†† me through the confusion. My first lasting memory occurred the day after I arrived home. There was a knock on the door, and there stood Donnie Fraser. He and his family own the service station a short distance from my accident site. He looked at me and said, “The last time I saw you, you were dead. You were some lucky Hertha was right there. She just dropped out of the tree.” I gave him a living hug.

Donnie took care of my silver truck, The Lone Ranger, while I was in the hospital. It was in pretty good shape, just a small crinkle dent on the right bumper and a twin one just to the right of my front headlight (which had to be replaced). The truck had lots of time to recuperate, but I couldn’t drive for 6 months. But now it’s high ho silver as I glide by the balsam firs that lead to a dirt road to another dirt road and the wide world beyond.

Family

My father and two of his brothers died of cardiac events mid-life. Since then there has been considerable progress in cardiology and cardiovascular surgery. With cholesterol-reducing medication, acetylsalicylic acid, an exercise program, and a diet that has evolved from low cholesterol and saturated fat to low carbohydrates, my 28-year-old triple coronary bypass predicted to last 10 years is still functioning nicely. After my cardiac arrest, a pacemaker and defibrillator were implanted; a β-blocker and an angiotensin II receptor blocker were added to my medications. My previous paternal generation were smokers, exercise was sporadic, stress was never mentioned, their meals were for men who did hard physical work, and the blood thinning properties of acetylsalicylic acid were not appreciated. The only medication for coronary artery disease was nitroglycerin, coronary surgery was in its experimental infancy, and coronary stents were decades away.

My oldest daughter has also benefited greatly from cardiovascular progress. At 28, she had bacterial endocarditis and ruptured her mitral valve. Since then, she has had 2 beautiful daughters and 3 months ago she had her third successful tissue mitral valve transplant.^†† Neither one of us would have survived 2 generations ago.

Life

It is February. I’m looking out at the frozen river. Snow squalls are coming and going. An otter appears in an air hole and pops out, scampering and sliding across the ice. It repeats this scamper-slide cycle until a veil of snow obscures my view. In all seasons otters know how to have a good time.

Just underneath a fringe of red spruce trees, 5 hen and 3 cock pheasants are feeding; little flocks of juncos are shuttling between the spruce boughs and the scratched snow beneath the feeders; a few chickadees, goldfinches, and red-breasted nuthatches come to the window feeder. Three blue jays are everywhere in 30 seconds: top of the tree, bottom of the tree, hanging off of the window feeder, all for one sunflower seed. Then they bounce around under the feeder looking for the peanuts that they hid in the snow, only to be found by squirrels. I am reminded of Carl, the petty criminal in the movie Fargo, a blue jay burying money in an endless snow-filled prairie.

The wind is out of the northeast and snow wraiths are swirling down the far side of the river. They swirl, collapse, and reform in a frenzied dance to the ocean. I’m reading Lisa Moore’s tragic, bittersweet novel February. It’s about Newfoundland, winter storms, death, grieving, and a single-parent family functioning in the aftermath of the Ocean Ranger’s sinking in a North Atlantic storm on Valentine’s Day, February 1982.

Yesterday, we had a snowstorm, 10 cm, no drifting. Today, it is bright and sunny and the evergreen boughs are heavy with pristine snow. Bev and I strap on snowshoes and crunch off down along the riverbank. Cold exertion is an added strain on the heart. I have learned to pace myself, pausing to look, pausing to listen. The tide moving under the river ice makes sonar music: pings, deep groans, and sharp snaps as the edge ice cracks. We travel under snow-laden spruce boughs and come to a copse of young birch trees. They are still, brittle, and fragile in the cold. Next to the road we come to a high bush cranberry. At its top, a young ruffed grouse is feeding on the bright red berries.

Later, just at dusk, Bev and I sit by the fire and enjoy a winter gimlet (lime juice, brown sugar, rum, and hot water). Out on the river ice there is a barely discernible small white ice fishing shack. I blink and it disappears in the gloom. The challenges of ice-fishing are a pleasant memory.

Middle of the night

When I wake up at 4 AM, I don’t analyze the vivid dream or ruminate on what might have been. I get up: I read, write, send e-mails, exercise, sometimes pay bills. Existential nothingness never occurs to me. Instead, I reflect on topics like medical progress, gratitude, and attribution. I then return to bed and think of the delicious nap I’m going to have after lunch at some point between Tempo and Shift^§§ before drifting off to sleep. Blessed.