Using Cardiopulmonary Resuscitation (CPR)

I gave CPR to someone I just met. In 2001 I found myself giving cardiorespiratory resuscitation, or CPR, to my good friend’s life-long buddy. My friend and his friends were a little older than me, in their early 50’s. For this story, I will change the names of those involved for privacy reasons.

James and I had been friends for close to three years and we spent time together at least once a week. James owned a martial arts school, and I was taking classes there. We also visited and talked outside of classes. I had asked James if I could stop by for a short visit. I knocked at the door and heard him say come in. He and two of his friends, Paul, and Kevin, were in his kitchen installing a new dishwasher. After I entered the kitchen James began the introductions, “Cathy, this is Kevin. This is Paul.” Paul was lying on the floor hooking up the dishwasher and when James introduced us, Paul rolled over to say hello but instead the words that he uttered were “Oh, James.” Then he slumped down, lying face-down on the kitchen floor.

Paul and James had been friends for decades. They met in college and maintained their friendship through marriage, divorce, kids, jobs, and all the ups and downs of life. Their friendship lasted longer than I had been alive. Paul had blood sugar issues for years and James knew that sometimes Paul needed to eat a snack to keep his blood sugar under control.

As James began to attend to Paul, Kevin motioned for me to follow him into the living room to provide some privacy for Paul who we all assumed was going to be fine. From the living room, I could hear James offer an energy bar, but Paul did not respond. Suddenly James ran into the living room in search of the cordless phone. He rushed back to the kitchen, and to Paul, speaking to the 911 operator who was now on the phone. “He’s turning blue” James said. James called for me and Kevin to come into the kitchen to help turn Paul over onto his back. The 911 operator asked James if he knew CPR. He did. James handed the phone off to Kevin and Kevin talked to the 911 operator on the phone for the remainder of the event. I knelt on the floor opposite where James was kneeling while he gave Paul rescue breaths. Kevin had gone outside to the front porch to find the house number while James was busy providing air for his lifetime friend. I remained seated on the kitchen floor next to Paul.

After what seemed like a few minutes, Kevin returned to the kitchen with the phone glued to his ear. The 911 operator had asked Kevin to check and see if Paul had a pulse, so Kevin felt Paul’s wrist and while heading back to the front door to wait for the ambulance, he stated that, yes, there was a pulse. This triggered a memory from past college anatomy classes and other health related science classes I had taken when I learned that it was possible to still feel a pulse in the wrist even after the heart stops beating. Since Paul had not moved the entire time, I decided to put my ear to Paul’s chest to see I could hear a heartbeat. There was no heartbeat. With my ear still to Paul’s chest, James blew more air into Paul’s body and with this puff of air I heard fluid gurgling inside Paul’s chest. With a tone of voice that I did not recognize I said loud and clear, “there’s fluid in his lungs”. James looked me in the eye with an expression that indicated he understood we were losing this fight. He asked me to take over the rescue breaths while he began chest compressions. We both got up and switched places so now I was on the left side of Paul’s body and James on the right side. I do not know why we didn’t just scoot to our required positions on the same side we were already on, but we didn’t; we actually got up and switched places.

As we cycled through the chest compressions and rescue breaths my perception of time changed. It was as if time did not exist. In talking about the event later James and I both agreed that we had no idea how long we spent cycling through the CPR steps. We had both been trained in CPR several times although neither of us had ever performed it in real life. Our training kicked in automatically. Even though we both took separate CPR classes, at separate times in our lives, and even in different parts of the country, we were able to use our training to work together without any confusion. We knew all the steps to take but no one ever tells you that your concept of time can disappear while performing CPR. I have no idea how long it took for the ambulance to arrive.

We continued CPR just as we were taught. Through it all, Paul never responded, never moved.

I held Paul’s jaw open with my left hand, held his nostrils closed with my right hand, and made sure to cover his entire mouth with my mouth as I breathed into his body. At one point, while breathing my air into Paul’s mouth, fluid came rushing backward into my mouth and I gagged, nearly vomiting. James looked over at me and asked me whether I could continue. I looked him in the eye and said “yes”. I was not going to leave James alone in this endeavor. I could muster through. We cycled through many more chest compressions and rescue breaths. How many times? I have no idea.

Finally, the ambulance arrived. I could hear Kevin at the front door directing someone toward the kitchen. Both James and I expected that the emergency workers would rush in and take over, telling us we could stop because they were here, they were the experts. But that is not what happened. Instead, one lone man entered the kitchen, leaned against the kitchen counter, crossed his arms, and stood there watching us. James asked, “Are you going to take over here? You want us to get out of the way?” The guy said, “No, no. You’re doing a great job. Keep going.” James and I looked at each other in disbelief. We were novices. We were doing our best but obviously not getting a response. Surely the professionals would be taking over soon and would be able to get a response. After a few more cycles of breaths and chest compressions I suddenly felt an overwhelming feeling of panic, and I looked at the man standing against the counter in the kitchen with us and between rescue breaths, I shouted “Hurry up!”. He looked at me and said in a stern voice “You need to calm down, ma’am”. James and I locked eyes again. I may have looked like I wanted to shout more things at the man standing at the counter, but I didn’t. Something about the look James gave me helped me refocus on the task at hand.

Finally, I could hear the other EMTs enter the house with the gurney. They made it to the kitchen area, several men and women were among the newly arrived. James and I were told we could stop now, and we both stood up and moved out of the way. As the EMTs worked to arrange the gurney to move Paul off the floor, it was discovered that the gurney was facing the wrong way. They needed to turn the gurney around. The kitchen was too small for them to turn it there, so they had to wheel the gurney back to the living room to turn it. During this period, no one was giving Paul rescue breaths and I almost jumped back over to him on the kitchen floor to provide more breaths, but something stopped me, almost like someone had held my hand to say no, just wait. I still thought Paul had a chance to live. It was absurd to me that the EMTs did not seem as concerned about Paul as I was. In that moment it felt like an old-time comedy sketch from an early-to-mid 1900’s movie. Except it wasn’t funny at all.

The EMTs finally turned the gurney around and reentered the kitchen. Now they were trying to lift Paul off the floor to the gurney and they were having trouble. This is when James said “Can I help you? I’m a big guy.” James had been a bodybuilder when he was younger and although he gained weight as he aged, he was still quite strong. The EMTs said yes, and James helped lift his lifelong friend off the floor and onto the gurney.

Once he was on the gurney, the EMTs put the big valve mask used by healthcare professionals over Paul’s mouth and nose and pumped the bag to send air into his lungs. Paul was still non-responsive but, in that moment, I thought there still might be a chance that he would survive.

While they were placing Paul into the ambulance, James and Kevin prepared to follow the ambulance to the hospital and call Paul’s family to alert them to the situation. I drove home. I was not familiar with Paul or his family, having just met Paul a moment before all of this began so it would have been weird for me to follow along to the hospital. I waited until later that evening to hear from James about Paul’s condition. It turned out that Paul had suffered a pulmonary embolism that blocked an artery in his lungs, rendering his lungs incapable of working correctly. In this condition, his lungs filled with fluid. The doctor at the hospital said that even if Paul had been lying on a hospital bed surrounded by doctors and nurses who knew this was about to happen and were standing ready to assist, he still would have died. There was nothing anyone could have done to save him.

I hung up the phone after hearing from James. The next day I called my parents who lived 850 miles away, and I told my dad about my experience. My dad was the first person I told outside of my home that I shared with my two teenaged daughters. Five months later, my dad died of a heart attack while at work. His boss gave him CPR until the ambulance arrived. When I saw his boss at my dad’s funeral, I saw how horribly sad he was. He was so distraught at not having been able to save my dad’s life even though he had performed CPR, as he was trained to do. I wanted to go up to him and tell him that I understood; that I had been through a similar thing and that I knew the feeling of attempting CPR but failing. In that moment, however, the emotions were too much, and I never did get to say what I wanted to say to him. I wonder how he is doing now. As far as I know there is not anyone who reaches out to non-medical personnel after they provide CPR to make sure they are ok.

As for me, James and I spoke about the incident on many occasions throughout the years. Even after I moved back home after my dad’s death to live closer to my mom, James and I would talk on the phone and sometimes discuss what happened on that late afternoon in his kitchen. My friend James died of a heart attack a few years ago. He was working at his part-time retirement job and suddenly fell to the ground. Someone nearby started CPR on him, but James was already gone.

Sometimes CPR does work, and the recipient survives and recovers. Other times, well, it is just that person’s time to go and nothing could prevent their death, even if they had been on a table at a hospital surrounded by doctors and nurses ready to assist.