This morning, winter announced its presence with some degree (17 degrees as a matter of fact) of authority. On the upside, there was very little wind, but even at that the lowest temperature of the season so far tended toward bracing.
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Anacostia River in the Evening with the USS Barry |
I put in a pretty long day at work and walked just a touch over eleven miles today. All of that has become a matter of course, and that's not the source of this post's title. To understand that, you have to turn back the clock two years.
Two years ago today, our youngest daughter left our house in an ambulance for a trip to the hospital from which she would not return. This is an eyewitness account, and I have to state up front that it is undoubtedly inaccurate in relating some of the details. Others who witnessed the events unfold will have different recollections. This is a brief telling of what happened from my perspective filtered through time.
I was awakened by an alarm from the pulse oximeter that she wore due to some chronic health challenges. We had been advised by more than one doctor that the use of the pulse oximeter was not really necessary but it did provide a degree of comfort that we'd know if something changed while she was sleeping. False alarms were not uncommon. When I entered the door of her room, I remember a sinking feeling as I looked at the machine and saw only dashed lines where her blood oxygen percentage and pulse normally registered.
I remember calling rather loudly for help and rushing to the side of her bed where I flipped her over and began feeling for breath and a pulse. I could not find either. Help began to arrive, and an ordered chaos ensued. Someone went to the phone and called 911. Someone set up the oxygen bottle and attached it to the ambu bag. I started CPR with my wife handling respiration via an ambu bag being fed by supplemental oxygen with the regulator open to full flow. I think it was 5 L/min, but I'm not sure.
For some reason when I started chest compressions, I also started the stopwatch on my Timex. Her face had a bluish tint that pretty quickly began to get better as we progressed with CPR. The pulse oximeter that was still attached to her toe registered a pulse of 84 and a blood oxygen content that recovered to the 70% range pretty quickly and then continued up into the low 90% range. We worked on her for a little over 12 minutes before the ambulance arrived.
The paramedics responded quickly and professionally, and collectively we managed to load her onto a stretcher while maintaining CPR. The handoff lasted a little over five minutes before she was on the stretcher with the paramedics performing CPR and headed to the ambulance for transfer to the hospital. The ambulance rolled out at approximately 20 minutes from the time I started my watch. Her mom rode with her in the ambulance.
A family member had been called out of bed to stay with the other kiddos, but she hadn't yet arrived. Once the ambulance left, the police who came as well asked me if they could do anything. After I described the arrangements that had been hastily put together, the told me that if I needed anything I could call them back and they made their departure.
As I waited on the arrival of the other family member, I was at a loss. I talked to our oldest daughter who'd been so brave over the preceding half hour or so setting up medical equipment, turning on lights, getting the phone, and probably a whole host of things that I don't recall. We were both frightened.
The other family member arrived at the house and after a hasty status update and handoff, I proceeded to the hospital. When I got to the pediatric ER, the emergency medicine team was still performing CPR. I looked at my Timex and the clock was still running. It had been over one hour and twenty minutes.
It became pretty clear that the doctor in charge of the resuscitation efforts was moving in the direction of calling off the efforts and declaring our daughter dead. My insides were a dark hole of nothingness. My wife went to the head of our daughter and whispered something in her ear. I don't know what she said, but almost immediately after over an hour and a half of CPR her heartbeat returned. Dark emptiness was replaced with hope. Once established again, her heartbeat recovered nicely even though she still required respiratory support.
When she'd arrived at the first hospital, a call had been made to another hospital in a city about 45 minutes away by car that specialized in treating pediatric emergencies. Because of the weather that night, the helicopter that would have normally been used to transport a patient in our daughter's condition could not fly, so another ambulance was already on its way when her heartbeat returned. She and her mother rode the ambulance north, and I went home to get both of us some clothes and toiletries for an indeterminate vigil.
When she arrived at the second hospital a number of diagnostic tests were run, and we spent most of the rest of that Sunday waiting for results, watching the machines track her heartbeat and help her with her breathing. By the evening of the fifth of January the preliminary results were in, and although the doctors were reluctant to be definitive this early in the fight for her life it was clear to me that they were not particularly hopeful for a positive outcome. A CAT scan of her brain revealed significant swelling consistent with anoxic brain injury. At the time, all hope was not gone and the extent of the damage would be revealed over the next 12 to 24 hours. The night of 05 January 2014 was simultaneously the longest night of my life. I did not want it to end because I was afraid of what the morning might reveal, and I did not want it to go on any longer because of the crushing uncertainty. Minutes dragged on for an eternity and the hours flew by with an alarming rapidity.
That day had been a very long day.
I learned some valuable lessons that day. It was not the kind of abstract learning that you might get from books or study. It was the kind of tangible learning that comes from experience. I remember back to my classes on CPR, and I distinctly remember wondering if I'd actually be able to perform the required actions on a living person. CPR is a violent set of actions that during the practices in class felt intensely unnatural to me. Two years ago today when faced with a situation that demanded that those doubts be put aside, I learned that I could do those things required. It did not feel natural or unnatural...it just was something that had to be done.
I learned that CPR works. I'd heard the stories and read the statistics. I left all of those abstract experiences with a slight feeling of skepticism. When I saw that the pulse oximeter registered a pulse in her toe and that her blood oxygen content recovered to greater than 90%, I became a true believer in the stories I'd been told. It was as if a switch had been flipped, and seeing the quick turn of events...from a complete and total flatline to objective evidence of replacing the efforts of our daughter's heart and lungs with our own efforts...gave me hope and the feedback that I needed to press on. I'm grateful that we had that equipment. When faced with a situation like this, almost no one else will. If you're doing what you've been taught, have faith that it's working and working quickly. I saw it with my own eyes.
I learned the value of not giving up, and the value of telling the universe what you want it to do for you. Although I still don't know what my wife told my daughter, her subsequent recovery of a pulse is evidence enough for me that something much bigger than the physical efforts being exerted in that room reached down out of the ether and turned the tide of the events in that moment. Her speech to our daughter was an act of pure faith, and the universe will often respond to that kind of raw spirituality. None of that would have been possible without a great number of people to continue to act in the face of very grave odds against success, and I'm grateful to them for their tenacity and refusal to give up.
Today was a good day, and with any manner of good luck, I'll be back again tomorrow to share how the events from two years ago continued to develop. Unfortunately, you know what's coming at the end of this chapter, but like life itself the value is not as much in the destination as it is in the journey. Thanks for walking this one with me.