Yesterday, for the second time in just over two years, I came close to witnessing the death of someone close to me. Two years ago it was my father, 98 years old, who passed away of heart failure at a hospital in my presence. Though it was a difficult moment for me, I was glad to have spent the last several weeks with my him until his fragile health finally collapsed. When he lost consciousness, a team of doctors descended on his room. Against his written wishes, the team began CPR before the senior physician called a halt. His pulse was nil and his breathing never resumed despite their futile efforts. In a halting voice, I thanked the mostly young care providers for their sincere attempt to revive my father’s life.
Yesterday was another matter. Four friends, all of us in our late sixties or early seventies, were playing doubles tennis at BSC Newton, on Wells Avenue, in the early afternoon. About forty-five minutes into the match, one of the players suddenly collapsed and fell backwards onto the court. At first we all thought that he was kidding around, as we sometimes do to keep things light. His partner, a retired physician, quickly grasped the danger. He dispatched one of us to summon the club trainers, all of them CPR-certified. I called 911 while the doctor administered compressions. Our friend, alas, was initially unresponsive and unconscious- he had no pulse.
In a moment several trainers rushed over with a defibrillator while the club manager went outside to guide the EMTs to the spot. As a high school tennis coach, I am also trained in CPR, but I was relieved to be an observer. Though the ambulance arrived reasonably promptly, even before they came, the trainers had begun administering electric shocks. Fortunately, though it took several attempts, my friend responded and resumed breathing. Slowly, his consciousness returned. Once he was stable if weak, the ambulance crew placed my friend on a cart and rolled him away to be transported to Beth Israel Deaconess Hospital. I followed him there a while later.
When I arrived his two adult children and their step-mother were speaking with the attending. It turned out that one of his major arteries was blocked 100%! As our physician friend observed, it was fortunate that he was on a tennis court at a sports club with a skillful staff. Had this cardiac event occurred, say, overnight at home, then he might have died in his sleep without discovery until the morning. The crew at BSC Newton deserves praise for its prompt, efficient, and effective response to the life-threatening crisis.
Another interesting thought: my friend had no history of heart problems. A few years ago he had undergone knee replacement surgery but recovered thanks to conscientious rehabbing and exercising. Most of us tennis veterans have had issues with our hips, knees, shoulders, or Achilles’ tendons. Over the years, however, I have known only one player to collapse after a match and pass away, and he was over 80 years old.
Let yesterday’s near-tragedy be a warning to Newton’s seniors who are athletes. All of us strive to stay in good shape, and we walk or bike or swim as well as work out on machines. At a certain age, however, a cardiac event may occur despite our best efforts. We and our medical care providers must remain vigilant however healthy we may feel. When our new senior center opens, with an expanded program of yoga and exercise, well-trained instructors should be on hand. Yesterday, BSC Newton and the ambulance EMTs met the challenge and managed to save a life. Now begins a new round of rest and rehabilitation for my friend until, we hope, he returns to the courts for some doubles indoors and outdoors on the courts of Newton.
Great story with a better ending. Thanks for sharing.
Wow. Thanks for sharing that story, Bob. It’s great that the BSC personnel were so responsive and well-trained. (Having a physician as a doubles partner certainly helps.)
A 100% blockage in a situation like this occurs when a cholesterol plaque built up over many years ruptures. Platelets in the blood stream mistake the resulting rough patch as a wound, and the resulting misdirected clotting suddenly clots the artery. It can happen any time, but strenuous exercise elevating heart rate, like a sedentary person snow shoveling, can create a prime opportunity for the high twisting torque on the plaque to cause it to rupture.
If the blockage occurs such that a key portion of the heart is starved of o2, then cardiac arrest can occur due to the muscle being starved or to the electrical pacemaking misfiring. Alternatively it can lead to something like Bernie Sanders’s recent “I need a chair” type moment. Often those more subtle moments are misdiagnosed as indigestion and damage accumulates (time = muscle).
Chest compressions/CPR in the scenario Bob describes are key. While CPR can be futile/hopeless in so many situations, in this case the person’s otherwise healthy body/heart just needs o2 supply while waiting for help to arrive and eventual artery clearance. The heart has one-way valves that allow it to pump blood through the lungs and body just by the alternating pressure on the chest, which really is amazing. Defibrillators now often available in public places, like in this case, can get the heart muscles’s electrical symphony back in synchronization.
While weight control, diet and exercise can mitigate risks, genetics/family history plays the dominant role. Statins for cholesterol also stabilize plaque and reduce risk of rupture. Know your numbers.
While playing basketball at the Hyde Center a few years back, our 50 year old friend dropped into the lap of another friend sitting just under the defibrillator. Luckily that night, Brian Doo, the then trainer for the Celtics was playing with us and he began compressions. We shocked him and brought a pulse back. he had a blockage. After a few stents were put in, he was back playing with us within a few months. He literally died in front of our eyes, but thank god for the defibrillator. Everyone should get trained on how to use them because we would not have been as proficient as Brian was that night.
Thanks for writing this, Bob. Life threatening medical events sometimes happen to people who have had no warning, although some hidden problems are now identified early and treated successfully, thanks to good research. Funding is generally inadequate for studying pathology perceived as rare, but it’s possible your friend’s experience is not uncommon.