Radiolab - How to Save a Life

Starting point is 00:00:00 You're listening to Radiolab. Radiolab. From WNYC. I'm Lula Miller. And I'm Lut, if not, sir. This is Radiolab. How do we, how, how should we start? Uh, I mean, you probably should lead with the big news from yourself.

Starting point is 00:00:18 Okay. The big news, which I'm sure you've heard of. The big news, which I'm sureutf Nasser. This is Radiolab. How do we, how should we start? I mean, you probably should lead with the big news from yourself. Okay. The big news, which I actually just found out is particularly big. I am very, very pregnant.

Starting point is 00:00:35 I have a extra big baby inside, I just found out at the doctor. Which means I will be one, sort of disappearing from the regular rhythm here for a little bit. Although we've preloaded some things, I'll pop in and out. But also it means that I am past my fly safe date. So I am not allowed to fly anywhere, but you just, you flew and you got to do an event

Starting point is 00:01:00 with our resident ER doctor correspondent, Virmitra, and I truly know nothing, except that I had total FOMO and authentic jealousy, because you're both so shiny and fun on stage. But we're gonna get to hear about it now, right? Right, okay, so let me set the stage a little bit. So the place we performed at was our WNYC's very own live space called the Green Space. Hello, hello, welcome everybody. I am your friendly neighborhood radio lab host,

Starting point is 00:01:27 Lethif Nasser. Basically what this came out of, okay, so you people probably remember the stories that Avere has done on this show. He did one about this mysterious epidemic of vultures dying. He did one about this miracle drug that they took out of the soil. Yeah, so he's done all these great stories, right?

Starting point is 00:01:44 But he came to me with this idea of something kind of different. Avere has been able to convince me and hopefully with some special guest friends we have, he's gonna be able to convince all of you that not only does he make saving a life look easy, that actually in this one particular way, it actually kind of is easy.

Starting point is 00:02:06 Basically, he wanted to take on in a sort of straight ahead practical way, one particular topic and show how in this one case, all of us, including you Lulu, including you listener, how you can be the difference between life and death. Like a thing you could actually do. It's a thing you could actually do to save a life. Oh okay. Okay, so you ready? Yes. Here we go. So is everybody excited? Please welcome to the stage of Viramitra. truck. Thank you guys. All right.

Starting point is 00:02:51 What are we going to do? Get going. Well, I guess I was kind of hoping we could start with a little story. Okay. Does that sound good? Sounds great. So the story goes, you know, I had, there was a patient, she was a 78 year old woman coming in from Jersey.

Starting point is 00:03:03 It was her birthday. Her family took her to see a Broadway show. Husband's with her, some kids, some grandkids. And while they're waiting in line, she sort of collapses. The family responds immediately. They lay her flat, they start fanning her. Someone calls 911, literally under a minute they call 911. Ambulance comes in record time

Starting point is 00:03:25 and the EMS finds that she's actually in cardiac arrest. So she's in cardiac arrest. She comes to the hospital and that's where I get involved in the story because I'm the resident there. And so I'm like a second year resident, which means I'm sort of, I know some things and I'm cocky about it, but I don't know what I don't know type of thing. So I'm seeing this patient come in, it's cardiac arrest and I like know my algorithms and I'm like, Oh, I got this. So we start doing everything. We're doing chest compressions where we start IV, we put a line into her shin so we can put synthetic adrenaline in there. We're shocking the heart, you know, we're putting her on a ventilator. We're doing all these things. We're working on the heart for like at least 20 minutes, maybe 30 minutes. Okay.

Starting point is 00:04:10 So I'm there and I'm just like so eager about it. So we shocked the heart. We look with an ultrasound, it's not beating. Shock it again, shock it again. And eventually all of a sudden, boom, just like that, the heart restarts. Blood pressure is normal. All of a sudden, all these vital signs that were all beeping at me start looking great. And so I was super excited. The families all around me, they're crying and now they're crying. I tell them she's back and they're

Starting point is 00:04:34 crying like tears of joy. They're like, wow, amazing. So the next step is now she's more stable. So now we have to bring her to get a CAT scan. So Veer had brought some visuals with him and at this point, he showed us a slide of a CAT scan of a healthy brain. This is kind of what a good CAT scan of a brain would look like. I know it's hard to see, but it's like a cross section of a brain. Okay. Kind of looks like how you would picture a healthy brain with,

Starting point is 00:04:59 you know, folds and everything. Got these nice black ventricles in the middle. You have all this nice brain matter there. To me, this is a beautiful picture. I don't know if you guys feel that way. But what I saw next was this. Then he showed us the CAT scan of the brain of this patient of your cousin, Mrs. W. And this is what he saw in that moment. And this sort of made my heart sink into my stomach. It's just a blob. It's just a great blob. What I'm seeing here is that this brain is dead, completely dead. And I guess in my eagerness to sort of be the guy who knows what to do,

Starting point is 00:05:36 I just sort of didn't even think about this. And now I have to go out and, you know, talk to the family. And it was, I just wanted to disappear. It was like a terrible, terrible moment for the family. And now I'm part of it. So I had to tell them and I felt terrible because now I have to tell this family that actually your grandmom is brain dead. And now I had to sort of make them withdraw life support.

Starting point is 00:06:02 And, you know, and I felt like I wanted to save her life. And what I ended up doing was making her sort of die twice. Well, how did the family take it? What? They were very gracious about it. They were very nice. They were kind. They were like, you did everything you could, but it just sort of shook me out of this sort of, immature kind of cockiness I had in the emergency department at the time. Right. So that that sort of stuck with me forever, I guess. I think about that case a lot. But like what what went wrong? Like why did it like yeah, what did you do something wrong? Like what happened?

Starting point is 00:06:38 Right. Well, let's table that because if we do a good job tonight, I think by the end, you guys will know exactly what went wrong there. Okay. So we'll get there. But yeah, I guess that's sort of the impetus from why I wanted to do the show because I was thinking in our society, we worry about so many things. Wake up in the morning, start doom scrolling and we're worried about climate change. We're worried about gun control. We're worried about climate change. We're worried about gun control. We're worried about terrorism. But really the reality is the majority of human beings

Starting point is 00:07:11 die because of heart problems. It's not sexy, but it's just true. This is across the world. So at this point, we're all looking at a graph of the leading causes of death worldwide. So of all the deaths that happen on planet earth. And number one is heart disease and heart failure. The number two is not even close.

Starting point is 00:07:30 Far and away, like down here we have terrorism. We have all climate change. I'm not putting any of these things down. Like they're real, but fires, suicides, murders, HIVs, somewhere on this list, but cardiovascular disease, it's just insane. We should like allocate government budgets based on this graph. Right.

Starting point is 00:07:50 But we do it based on what's the scariest looking, you know? And in America it's a little better. It's only just one in three people will die of heart problems, so I don't know if you guys want to look to your right and to your left. Figure out which of the three of you is dying from your heart. It's one of the three. I'm just glad there's only two of us on stage. Right. So, okay. So when hearts do stop, you know, if a heart stops and eventually when it stops, it can happen slowly or quickly, right? So if your heart starts to die slowly,

Starting point is 00:08:20 that's good in a way because at least you can, you know, get your way to a hospital, see a doctor, make an appointment. When you say slowly, how slowly are you talking about? I mean, I'm saying like, it's almost like if you're driving a car and the check engine comes on. You know you need to take it into the shop, but you can wait a couple hours, maybe you can wait a couple days. Right. Okay. All right. But sometimes your heart stops quickly. Like one minute it's working, the next second it stops

Starting point is 00:08:45 working. And when that happens, we call that cardiac arrest, basically, your heart arrested. And the thing about a heart stopping is basically that means you're dead. So like when we pronounce a death, we'll listen with a stethoscope to the heart. I'm sure you've seen that on TV and stuff, but actually this idea that a dead heart is a dead person kind of goes back as long as humans have been around. This is going to sound weird, but I was just reading Gilgamesh for some reason. Great book. I don't know. How do you have time to read? I don't get it. Okay. Audiobook. It was an audiobook.

Starting point is 00:09:17 Okay. All right. Audiobook of Gilgamesh. I highly recommend it. Gilgamesh turns out is the oldest story that we know. It's like the first written story. And even in Gilgamesh, they sort of reference, they say, what is this, you know, someone dies in the story. What is the sleep which has seized you? You've turned dark and do not hear me. He touched his heart, but it beat no longer. So even then I was listening to it and I was like, oh wow. Like even then, 4,000 years ago, they knew that when someone doesn't have a heartbeat, they're dead. And as long as humans have known that, we've been trying to restart hearts. So there's this sort of been this practice of like reanimation, bringing a heart back

Starting point is 00:09:55 from the dead that we've been working on for thousands of years. The oldest reference is actually, and we don't have to read the whole quote, but is in the Old Testament here. There's actually this guy, Elisha. Elisha? Does anyone know what Elisha? Okay. So this guy, what, was he a prophet or a, he's a prophet.

Starting point is 00:10:14 So he did this, so there's this story of when he goes into someone's house, a boy's house, and he goes and sees that he's dead. So he goes in, closes the door behind him, prays, and then lays on top of the boy, puts his lips on the boy's lips, eyes to eyes, and just lays on him. And then the boy's body grows warm. The boy sneezes and comes back to life. He sneezes? Yeah.

Starting point is 00:10:37 I mean, OK, I didn't learn this technique in medical school. OK, all right. But I guess it were. I mean, in the Old Testament, they say it worked. So who knows if this really happened? I don't know. Did you think it really happened? It says that he was alone with the boy in the room. Yes. And with the door shut. So who knows? Oh boy. True New York skeptic right there. All right. Yeah. So that. Who knows? But in the modern era we've been trying to do this for a long time. Actually, I don't know if any of you guys have seen this picture.

Starting point is 00:11:07 So this is like a, it's a drawing, like an old drawing you'd see in like an old medical atlas or something. There's someone lying on the ground naked on their side. And then there's someone else sitting over top of that person. And this guy puts a tube up this person's rectum. Does he know you can't really get to the heart from there? You know, I'm not sure what they're thinking. But he takes a big drag of a cigarette or a cigar and blows the tobacco smoke into the

Starting point is 00:11:40 rectum. This was called a tobacco smoke enema. And it was... What's the logic Like, why do they think this is... All right. I did spend some time trying to put myself in this guy's shoes. Okay. And the best I can come up with is nicotine is kind of a stimulant. Okay. And the rectum has a lot of tissue. So maybe just blowing a bunch of nicotine

Starting point is 00:12:01 and a bunch of tissue with thought to work, you know? Great. Sure. But it, you know, no surprise to anybody here, it didn't really work. Actually, the phrase blowing smoke up your ass, that's where that came from. Right. And from the guy next to him when he's like, this is working, right? And he's like, yeah, for sure it's working. After a couple of centuries or, you know, a couple of decades of this, it just became, yeah, I'm blowing smoke up my ass. I get it.

Starting point is 00:12:26 But we've tried other things even more recently. So like all things that I love in science, an answer kind of came from probably the most bizarre place that you could ever think of. This guy, Rudolf Bohm. He's a German guy. And this is 1878. So this guy is a pharmacologist and he's studying chloroform. I mean, this is the guy, the big bushy beard, this is kind of the guy that you've expected. Yeah. And I don't know why they invented chloroform, but he was experimenting on it.

Starting point is 00:12:57 And the way he would experiment on it is to take cute cats and chloroform them. I know. Just for fun. Just for fun. I mean, today he would be labeled a sociopath. Okay, all right. Okay. Okay.

Starting point is 00:13:13 But you could do that back then. So he would just kill these cats or he would chloroform them. And the thing about chloroform is if you don't use enough, it really doesn't do anything. If you use too much, it kills the person. You got to get that happy medium. Right. And so, I don't know if this is true, but this is what I think. He was spending too much money getting all these cats. You know, he kept killing cats. So he's like trying to figure out how can I like, you know, work on my budget here.

Starting point is 00:13:36 He's trying, he's trying to reduce, reuse, recycle kind of thing. Exactly. Right. Okay. So what he sort of, by doing this over and over again realizes is that if he chloroforms his cats too much He could start sort of start squeezing the cat's chest for a few minutes and then the cat would survive Wow, and that's the guy that this is the guy how we figured this out So that happened he publishes this and then lo and behold 20 years later a young surgery Resident is in the hospital one of his patients dies and he

Starting point is 00:14:06 somehow heard about this and just tries it on a patient. Is this in Germany again? No, this is in, I think this was in the US. Okay, yeah. So he, or maybe England, I can't remember where it was, but this is 20 years later. So early 1900s, he just randomly tries it on a patient and lo and behold, it works. Wow. So these are the first times that we were able to bring people back from the dead.

Starting point is 00:14:28 And since then we've progressed a very extremely long way. Now we have so many ways to do it. We almost take it for granted. We can shock people back into a normal rhythm. We can give super strong medicines. We even have machines that will pump for the heart when the heart can't pump. I mean, it's, we're so used to it, honestly, that in the OR and places, people will induce cardiac arrest just to test the heart so that they know what causes it to bring it back on certain patients.

Starting point is 00:14:55 Wow. It's like such a, like, it's now like a standard miracle. Like it's like an expected thing. It's like, yeah, cardiac arrest, let's bring it back. So I have a little video here that I think is cool. I don't know if you guys will think it's cool, but this is a heart. We got the music too. So this is them in the OR and this is a normal heart that's beating in a weird rhythm. And all of a sudden it goes into cardiac arrest. You'll see right here, they induce cardiac arrest. Now the heart is dead.

Starting point is 00:15:21 It's dying as we speak. Okay. And then you hear a shock charging. They shock the heart and now it's back. And you can hear it by the way they're casually playing Bon Jovi in the background. This guy's living on a prayer. I mean, it doesn't feel like... I couldn't have said it better myself. But basically it's like standard. This is no big deal. Right. So you would think at this point, cardiac arrest would be like, no, no big deal. Like you go into cardiac arrest, we got you.

Starting point is 00:15:48 Unfortunately, that's just not the case. Turns out that if you suffer cardiac arrest outside of a hospital, on average, your chance of surviving, of living is 8%. 8%? Yeah. 8%, which look at that another way. If you, if your heart stops quickly Anywhere in the world outside of a hospital you basically have a 92% chance of just dying then and there

Starting point is 00:16:12 Wow, and that's that means that like I don't know It's like you never had a chance to see a nurse see a doctor It's like you had died a hundred years ago or a thousand years ago It's really no different and that's a lot of people are still dying But is that a thing is that just a thing about the heart? Like the heart is, it can only be revived 8% of the time or something? Right. Yeah, exactly. You could think, you know, is there something inherent to the heart? 8% turns out no, because it turns out there's a place in the world where you can have a

Starting point is 00:16:39 cardiac arrest and you'd have like much better outcomes. So I don't know. Do you want to take a guess where it is? Like what's the ideal place to have a cardiac arrest and you'd have like much better outcomes. So I don't know, do you want to take a guess where it is? Like what's the ideal place to have a cardiac arrest? Yeah, maybe we should ask, yeah, like do you guys have any, if you had to have a cardiac arrest? Hospital. Hospital. Where was that? I would think like a nursing home maybe?

Starting point is 00:16:59 Nursing home. Anywhere else, just name places, who knows? What's that? Denmark. Denmark, okay, that's good. Denmark. The gym maybe? Just name places. Who knows? Denmark. What's that? Denmark. Denmark. The gym maybe? He knows something. Okay, so I'm going to shatter all your beliefs.

Starting point is 00:17:13 The best place to have a heart attack is a casino. And why is that? So, you know, it turns out that it's the perfect practice space for cardiac arrest. You have a lot of older, elderly people at a casino. They periodically lose a lot of money and get very stressed. Yeah, no kidding. And they often manage that stress by doing potentially unhealthy things like smoking cigarettes or drinking alcohol.

Starting point is 00:17:45 Okay. So cardiac arrest happened a lot at casinos and everybody there is on camera and everybody in who works there like the dealers, you know, everybody they're all trained in CPR. So as a result, the arrest, the survival rates of cardiac arrest in casinos is actually 53%. Oh! It's unreal. I'll count your life, but take your shirt! Yeah. Yeah.

Starting point is 00:18:13 Wow. Sorry, residents, it's not where we work. It's not. Yeah. Wow. Yeah. So to me, that's saying we can do something. If we could do CPR, we can really increase these numbers. Because the reason the survival rate is so good in the casinos

Starting point is 00:18:29 is because there's someone right there, right in that moment, doing CPR, getting that heart beating right away. It really comes down to time. So this is a survival curve. Okay, so another graph here. So, okay, along the side, it's survival percentage, right? Zero at the bottom, 100

Starting point is 00:18:45 at the top. And then on the bottom, you have like minutes. And at time zero, that's like when your heart stops. And you can see every minute that passes, your chances of coming back just exponentially decreases. So, you know, think about in New York City, we have like the, there's an ambulance on every corner. As you guys know, it keeps you up all night and the average response time in New York city is five minutes and 53 seconds. And that's, that's great. That's great. But look at where that puts you on this graph. Oh yeah. Not good. Yeah. Not so good. You're at like between 10 and 20%. You're probably at like 15% chance of survival right off the bat. And now picture, you know, pick, I don't know, picture you're in Nebraska or some, somewhere else where a good time would be 30 minutes.

Starting point is 00:19:31 Right. So that's the problem. Right. And just to put this in context, like cardiac arrest in the U S happens 1000 times every day. No. Yeah. So this is like dismal to me, right? Like you have 92% chance of staying dead. It's happening a thousand times a day. Right.

Starting point is 00:19:53 And survival is not great. And Avir's point was, like, given that graph, the real problem is that when this happens outside of hospital, there's just not enough time, right? The key is the person or people who are right there with them at that very moment on the sidewalk or in the house or the restaurant or whatever. The only way to nudge that number is for those people to do something. We have to squeeze the heart. We have to compress that heart. So it's actually very simple.

Starting point is 00:20:19 Don't let anyone make this complicated. You have a heart sandwiched between two bones. You have a breastbone up top and you have vertebrae below it. And all you're basically doing is just sandwiching the heart between those two bones and manually pumping it. Okay. You know, and you can't do it forever, but this, this actually works. Is it fixing the problem? This is where a lot of people get confused. Is it fixing the heart? No. Is it just pumping the blood around to sort of buy you time? Yes, that's exactly what it's doing. Now, all of a sudden,

Starting point is 00:20:49 your survival goes down much more gently. You're buying yourself time for someone to come in and do something about it. Right. So I guess that brings us to like the real question is, what would you do in this situation? You know, that's the question. Because the truth is, like, when this happens out in the world, a lot of us just freeze, you know, and I can't help I'll be at work, you know, you'll be you'll be in the recording

Starting point is 00:21:16 studio. So it really just comes down to you guys, right? Like, what would you do really put yourself in that situation? Because it sounds good on paper, but like, imagine you're just walking down the street and someone collapses or you're with someone and they collapse. So what would you do, Lulu? If I saw someone collapse, and I mean, I would call 911. I would say, does anyone here know what to do?

Starting point is 00:21:41 And I mean, I'd be really scared to do the wrong thing. And I'm probably so frozen, I'm probably just calling 911 and waiting and hoping and searching for someone who knows what to do. Yeah, and I mean, that's fair, right? Because most of us haven't taken the CPR course, it's a little bit scary, feels maybe dangerous. But here's the thing about this whole event that actually felt really new and actually shook me, right? Okay, so because according to Avere, there is a new way of thinking about and doing CPR that is completely changing the game.

Starting point is 00:22:17 And when we come back from break, we are going to have a couple of very special guests come up to the stage and tell a story That is on the one hand completely heroic But at the same time when you hear it you realize Just actually how easy stepping up to a moment like that can be hmm. So just stick around. We'll be right back Lutif, Lulu, and we are back from break where Avir and I were on stage in New York City. We are now about to bring up on stage a couple. They are called the Glaucam Fleckins. Glaucam Fleckins? Is that their last name? Glaucams? No, it's sort of their like nom de TikTok.

Starting point is 00:23:05 We're bringing Will Flannery and his wife, Kristen Flannery out to talk to us. Now I know about him because of this guy's TikTok channel. He makes comedy videos for healthcare professionals that literally are like spread like wildfire. So this guy is like literally the Elvis of medical comedy. I swear. I mean, he's amazing. So I want to bring up Will Flannery and his wife, Kristen Flannery. Thank you.

Starting point is 00:23:31 Yeah. Thank you. Okay. Thank you very much. Hi, everyone. So, yes, I am a internet-based, I'm a computer-based, I'm a computer-based, I'm a computer-based person. I'm a computer-based person.

Starting point is 00:23:39 I'm a computer-based person. I'm a computer-based person. I'm a computer-based person. I'm a computer-based person. I'm a computer-based person. I'm a computer-based person. I'm a computer-based person. I'm a computer-based person. I'm a computer-, yes, I am a internet comedian ophthalmologist, which I swear is a real job. I made it up, but it's still a real job. If you don't know what an ophthalmologist is, though, I am an eye surgeon.

Starting point is 00:24:03 So that means I went to med school and I learned everything there is to learn about the human body, the entire human body. And then I said, I don't wanna do any of that. It's like, I'll just devote my career to the eyeball. And that's what I did. So now I'm a practicing ophthalmologist and Kristen has been with me since the beginning. Not since birth.

Starting point is 00:24:26 We're not siblings. Not too far after. We met in college and I went on to med school. Kristen went on to grad school. We were at Dartmouth. But our story really starts in, well it starts a long time ago, but we're going to go to 2020. The pandemic hit and when the lockdown occurred, my practice shut down.

Starting point is 00:24:46 I couldn't see any patients. So I had all this free time on my hands. I did start making TikToks around that time. But there were also, there were a few times where I honestly thought I might get redeployed to the hospital to help out. And do you know how bad a public health emergency has to be? For someone in the ICU to be like, are there any ophthalmologists we could get up here? Now, fortunately, it didn't happen.

Starting point is 00:25:18 Like, there were plenty of more qualified people than an eye doctor to go help out. But I had all this free time on my hands making all these videos, trying to do virtual ophthalmology, which is as hard as it sounds. And then on Mother's Day in 2020, we had a wonderful day. We were at my in-laws' house. We had a nice meal out in the backyard. Social distancing from my parents.

Starting point is 00:25:47 It was very weird, but it was nice. We had a water balloon fight in the backyard. And that day, Kristen took a lot of photos. And those were almost the last photos that were ever taken of me. Because later that night, I had a cardiac arrest in my sleep. At around 4.45 in the morning, me because later that night I had a cardiac arrest in my sleep. At around 4 45 in the morning I woke up to him making some very strange sounds. Fortunately they were loud and I'm a mom so I'm a light sleeper.

Starting point is 00:26:19 All you moms know exactly what I'm talking about. And I woke up and I thought he was snoring. I was still really groggy. I'm not in medicine. I studied cognitive neuroscience and then education and marketing and basically everything but medicine. Bodies are gross. And so I thought he was snoring.

Starting point is 00:26:40 I did the thing that you do, you know, like, quit it, you're waking me up. And like tried to get him to turn over and stop snoring, but he wasn't responding. And he was just something about the, how he wasn't responding, kind of raised a red flag, like, whoa, that's weird. And I couldn't put my finger on why,

Starting point is 00:26:59 but it just didn't seem right. And so I tried a little bit harder, still nothing. And so then I started to get a little freaked out, and so I started kind of slapping his face a little bit and yelling his name, and then he still wasn't responding, and I had no idea what was happening, but I knew this isn't right, this is very bad, and so I just did the only thing I could think of to do,

Starting point is 00:27:26 which was I called 911. And it was the most bizarre period of time in my whole life. I sort of, part of me, part of my brain was like in the moment and just like really focused on like what needs to happen and just in emergency mode. And then another part was just sort of, it was almost an out of body experience.

Starting point is 00:27:54 I wasn't the one dying, but I was the one having an out of body experience just sort of watching myself and this scene unfolding and just feeling like What you know, like this is just so wrong he went to bed perfectly healthy I Take that back. You were not perfectly healthy. He had survived testicular cancer two times Before that so like he's used up three of his nine lives so far, but hopefully. I had a little bout of cancer a couple times.

Starting point is 00:28:26 But that wasn't anything, you know, we had moved past that. He had been completely healthy, cleared, all these things. And it just seemed so wrong that anything would be wrong with him. He doesn't have a family history of any cardiovascular incidents really. He didn't have a personal history.

Starting point is 00:28:43 So it was just the most bizarre thing. And I was leaning my head over his chest as I was calling 911, and I was sort of noticing, like I don't hear anything. There's no heart beating in here. But it was just kind of like, huh, that's interesting. I couldn't really fully process that at that time, but I remember taking note of that. And so then the dispatcher came on and they asked what the emergency was and I said, my husband won't wake up.

Starting point is 00:29:15 And the dispatcher asked me what I have since learned. I did not know this at the time, but I have since learned there's only two questions that you need to know the answer to, to know that it's time for CPR. And that's, is he responding to you? And of course the answer was no. And is he breathing normally? And that word normally is very important because I would have said yes, he's breathing. In fact, I think I did say, yeah, he was breathing. In fact, I think I did say yeah He was breathing kind of like taking these weird gasps and then he would stop for a bit and then he started breathing again I've learned since then that's called agonal respiration. It's the body's last ditch

Starting point is 00:29:58 unsuccessful attempts at Breathing in air, but it's not real breath And so that second question, is he breathing normally? The answer to that was no. So because he was not responding and he was not breathing normally, she said, I'm gonna walk you through CPR. And I said, what?

Starting point is 00:30:21 It didn't make any sense, but I just said, okay. And I followed her instructions and she told me, she asked me if I could move him off the bed. We were in bed. It was the middle of the night. And so I said, well, I can't move him. I don't know if anyone's just listening to this. You can't see this.

Starting point is 00:30:39 But I have heels on. He's got a good 13 inches on me and probably a hundred pounds. And more than that I had had neck surgery four months prior that I was still recovering from and I said I can't move him off the bed and she said okay if you can't move him we're just gonna do it where it is and I'm so glad I did not know this at the time but that was bad. That was, you're, you need a hard surface. Preferably, if you can get the person to a hard surface, do that. But I could not. And so thankfully we do have a very firm mattress, thanks to my neck. So that was good. But I did, she told me, you know, put, put your

Starting point is 00:31:22 hands on his chest, lace your fingers together, put your hands on his chest in the center of his chest, between his nipples, and just push hard and fast. And she just counted with me, one, two, three, four, five, six, seven, eight, nine, 10, just over and over and over and over for 10 straight minutes. It was May of 2020, and we lived not far from the station that responded to my 911 call, but they were in full hazmat gear.

Starting point is 00:31:55 They had hoods, shields, the whole suit, gloves, everything. everything and so they had to wait outside of our door put all the gear on and then try to get in the door which turned out to be locked and so they had to kick it down never been so happy to have structural damage to our house that's right I will take it any day if that's what it means and so they finally you know we're able to do all of that. But in the meantime, you know, that was 10 minutes of looking over my husband and the father of my two children,

Starting point is 00:32:34 who were eight and five at the time and were asleep in the very next room. And I was thinking, they cannot come in here. They cannot come in here. Because I didn't want them to see what I was thinking, they cannot come in here. They cannot come in here. Because I didn't want them to see what I was seeing. Because you can never unsee that. And they were so young. And I was watching him turn blue and then purple.

Starting point is 00:32:59 He stopped making those noises eventually. And by the time EMS arrived, he was gray. And I saw them take him off the bed, carry him downstairs, and lay him down on the hardwood floor, and hook a bunch of things up to him. And, may not have medical training, but I have watched television. And I heard things that should be beeping. I knew this. They were making a flat, solid sound and a flat line. And I knew what that meant. And so I turned around.

Starting point is 00:33:42 I remember this really distinctly, unfortunately. I turned around to go back up the stairs because I wanted to check to make sure that the children were still in their beds and weren't trying to come out. And I didn't wanna see what I knew was about to happen because I saw them take out the paddles. And I, as I went up the stairs

Starting point is 00:34:03 before I could even get halfway up, I heard them deliver that first shock. And I heard the way that his six foot, four inch, all arms and legs body just slammed against our hardwood floor in a really unnatural, weird way. And from there I just went up and I was trying to figure out anything useful

Starting point is 00:34:31 that I might be able to do, or just a thing to keep busy to keep from breaking down. And so I packed him a hospital bag. And I called into his clinic to tell them, I don't think he'll be in today. You might want to reschedule his patients. And I called both of our sets of parents. And you know during that time some of the paramedics, one of them was coming up and down the stairs and giving me updates. And he told me that what had happened was Will's heart

Starting point is 00:35:05 had gone into ventricular defibrill, no ventricular fibrillation, did I get that right? Okay, which is what you saw on the screen where when they stopped the heart it just sort of shakes like this but it doesn't actually pump any blood anywhere. And the sounds that I had heard were those agonal respirations and that meant that his heart had stopped and But thankfully they were able to Get his heartbeat back after they shocked him five times they didn't give up on him and their hoods and shields were fogging up and they would have to switch off and It was such an effort and a team effort to get him back. And they didn't give up on him.

Starting point is 00:35:48 And they did get his heartbeat back. And they took him to the hospital. And I went into my children's bedroom. And I asked them what they would like for breakfast. Just to put a little bit of a different context on that from a health care professional, 10 minutes of chest compressions, that's an eternity. Like two minutes you're supposed to pass off to somebody else

Starting point is 00:36:10 because it's so hard to continue doing effective chest compressions after two minutes. And even I know that as an ophthalmologist. And so I still don't know how she did 10 minutes. Oh I know we had just gotten a mortgage and we had two young children. You were not getting out that easily. That's why. Come back here sir. And so they took me to the hospital and from my perspective you know I went to bed one night I woke up in the ICU two days later didn't have any underwear on I didn't know what the hell was going on and I had all the testing done in the world. And we still, to this day, don't know what caused my cardiac arrest, which is not unusual

Starting point is 00:36:51 for young people that have an out-of-hospital cardiac arrest. Often we don't have a good answer for why it happens. And as a physician, I never once thought to myself, like when this happened, I had been a physician for like seven years. I never once thought, Hey, maybe my wife should know how to do CPR. Hey, my family members, because if something happens, I'm usually there. I'll be the one to help. We never thought about it happening to him.

Starting point is 00:37:18 I was the one that needed it. And, uh, I'm sure those of you here who know CPR probably have a family or friend who doesn't. And we need to support people who do it. And so we want to thank you all for being here and listening to our story. So thank you all. Please thank the Glockenspacken. Thank you.

Starting point is 00:37:41 Thank you so much. Thank you. Thank you. Thank you so much for sharing with us. Thank you so much for sharing with us. Thank you so much for sharing with us. And I'm going to bring back out Avere. Thank you guys. So what you just heard is literally an 8% type of outcome.

Starting point is 00:38:02 That is very rare what you just heard. But Avere says the reason it did go well, it did become an 8% type of outcome. That is very rare, what you just heard. But, Avir says, the reason it did go well, it did become an 8% outcome, is because of what Kristin did. Those 10 minutes of keeping that heart going while she waited for the EMTs to show up, that was the crucial first step that made it possible to bring Will back and to bring him back without any brain damage.

Starting point is 00:38:26 I'm thinking about the weird restraints about not jumping in to do a thing. And I do feel like, didn't Radiolab once even do a show where doctors themselves were like, I wouldn't want a stranger doing CPR on me because of the potential risks, which again, wouldn't be necessarily everyone's call, but that there were a bunch of doctors who... Right, right, right, right. So, okay, so that episode, oh, it's, I've heard it recently, it's called The Bitter End, totally holds up.

Starting point is 00:38:53 Yeah. Okay. But it's a slightly different what they were talking about. What they were talking about was that was, those were doctors talking about, let's say you're already in bad shape and something goes wrong. And if you do it in that circumstance, or even if you do it, if you do it late, if you're waiting a lot of minutes and then, and then you start doing it, that's when it leads to way worse outcomes.

Starting point is 00:39:17 So, so it does have some risk, but if your point is like, you know, there, there are, you know, downsides to it and there and you got to think about it this way, like out of hospital cardiac arrest, you want to do CPR to bridge that person to get to a hospital. So for me, if it's out of hospital cardiac arrest, like I want CPR done to at least get me to a hospital. And then if they think there's nothing that could be done, fine, you know. So at this point, the conversation sort of turned back to like the reasons why people

Starting point is 00:39:44 don't step in to do CPR. And they've done studies on this. People are afraid you're doing something wrong. Maybe they're afraid of getting sued. But one of the other big fears is the fear of infection, of putting your mouth on someone else's mouth, like a stranger's mouth, right? That brings us to what Will and Kristen were talking about, which is sort of a new form

Starting point is 00:40:06 of CPR that's trying to make things a lot simpler and it's just hands only CPR. So normally, you know, CPR, it's like 30 compressions, two breaths. Yeah, that's all I remember from what learning it in high school or whatever. It's like, yeah, it's like counting the breaths and counting the pumps. Which like I can't even, I do this for a living and I don't understand, I don't know where those numbers came from. And like you said, you gotta take a class,

Starting point is 00:40:30 you know, it's expensive, you gotta get a card. Like we don't have time for that. So what they sort of invented because they knew no one was really doing CPR is hands only CPR where it's literally just push hard and fast on the chest, that's it. Oh, you don't gotta do any lip to lip, mouth to mouth action. None of that.

Starting point is 00:40:48 Just push. Okay. Huh. And they were saying, well, maybe they thought maybe this will do, you know, it won't be as good, but maybe it'll be something. And actually when they found out what they have been studying it now for a couple of years, head to head trials, this is producing the same outcomes as the big fancy CPR. Just pushing hard on the chest. Whoa! Yeah, the breath counting. Just screw the lips?

Starting point is 00:41:09 Just forget all that. Just literally pump, pump, pump, pump, pump, pump. And the reason is, you know, when you're pushing on someone's chest, you're kind of squeezing their lungs a little bit. You know, you're getting a little bit of everything. And that feels a little less scary to do. Way less scary. So hands-only CPR. That's

Starting point is 00:41:25 kind of where we're going to be at because I want to teach you guys how to do hands only CPR. So if we can have Al come up. We, yes, give it up for Al. From the Red Cross everybody. They're from the Red Cross. They sponsored this. They're bringing all these amazing dummies. So we're going to show you guys how to do hands only CPR right now. So what do you want to tell them? I want to basically demonstrate CPR, hands-only CPR, and give them step-by-step instructions on how to do it. So you demonstrate. So you're going to put one hand over the other. Okay. Do it in the middle of the chest. And then you're just gonna push hard and fast down on the chest. You want to go about two inches. It's harder than

Starting point is 00:42:10 it is on the movies. Well you can see that right there. That's good CPR. Another thing to notice is he's not moving his arms because that you could do it. It's just tiring. So what he's doing is sort of moving his hips like this. Use your hips as a fulcrum and go up and down, like just like that. Does that make sense? Awesome, all right, thank you, Al. Basically you just do that. Woo!

Starting point is 00:42:32 Woo! Woo! Woo! Woo! Woo! Woo! Woo! Woo!

Starting point is 00:42:38 Woo! Woo! Woo! Woo! Woo! Woo! Woo! Woo! Woo! Woo! Woo! Woo! Woo! Yeah, are there any questions or should we just like jump into it? Do we have any questions?

Starting point is 00:42:47 So at this point we took up a couple of questions from the audience But we were basically like, you know, now's the time the show is basically over everyone's gonna stand up We're all gonna practice this we're all gonna train on how to do hands-only CPF your game we want all of you to try it Yeah, so let's have people come up and I just want to say that you know my thinking about this is like For all the modern medicine we have at the end of the day when it comes to this have people come up and I just want to say that you know my thinking about this is like for all the modern medicine we have at the end of the day when it comes to this all we really have is each other so I that's why I feel very strongly about this we got to help each other out so come on up all right everybody come on um yeah let's do it all right and it was awesome like we we got a heart-shaped disco ball down.

Starting point is 00:43:25 Oh, that's great. So it turns out the right beat for doing CPR is between 100 and 120 beats per minute. And it just so happens that the song, Staying Alive by the Bee Gees, is 103 beats per minute. Yeah, right. So it's kind of perfect. I can't act surprised because I learned this already, and I will never forget it. It's so good. It's so good. But it turns out it's not just staying alive.

Starting point is 00:43:55 There's a whole playlist on Spotify that has songs that are at that exact beat, and it's called CPR Jams. That's great. What else is on there? Here, let me look. B and it's called CPR jams. Ha ha! That's great. What else is on there? Uh, here let me look. Okay, there's like three Usher songs on here. Okay, which ones?

Starting point is 00:44:12 Yeah, Burn and Caught Up. Crazy in Love by Beyonce. Oh, Crazy in Love is? Crazy in Love, Baby Don't Lie by Gwen Stefani. Okay. Hold On by Wilson Phillips. That feels, Hold On feels like, that's right. Texas Hold'em by Beyonce. This is a newer one. Could You Be Loved? Bob Marley and the Whalers.

Starting point is 00:44:35 I Want to Dance with Somebody. Whitney Houston. Jolene. Just Want to Have Fun. Cindy Lauper. Justin Timberlake, Rock Your Body. Cause he's, I mean, what you're doing is you're rocking a body. You sure are. Never gonna give you up, Rick Astley. Oh, the Rick Roll song is? The Rick Roll song. Okay, that's the one I think I might like channel.

Starting point is 00:45:02 Yeah, that one almost feels easier. Take a Chance on Me by ABBA. Man, wow. Well, thank you, Latif. Thank you, Avere. I feel empowered to just use my hands, hands only. This is great. And if anyone does save a life because of hearing this, let us know.

Starting point is 00:45:19 Tell us. RadioLab at WNYC.org. Let us know. Yeah. Okay. Cool. That was great, Latif. Thank you. Yeah, yeah, yeah. And big, big thanks to Will and Kristin Flannery, aka The Glaucamflekens. You can check them out on their podcast, Knock Knock High, and they're actually going on a live tour starting in August. And if you go see that, you can hear more details about their story. It's called,

Starting point is 00:45:40 of course it is, Wife and Death. Thanks to The Greenspace here at WNYC's home in New York City. First of all, to Jennifer Sendro, who helped us make it work at basically every stage of the process, as well as the rest of the Greenspace crew, Carlos Cruz Figueroa, Chase Culpin, Ricardo Fernandez, Jessica Lowery, Sky Paolo Ross, Eric Weber, Ryan Andrew Wilde, and Andrew Yan Chisen. Also thank you to the Red Cross for helping us make this happen and providing the CPR dummies. And to all the CPR trainers, we had Ashley London, Jeanette Nicosia, Charlene Young,

Starting point is 00:46:16 Jacob Stable, Ty Morales, Anna Stacey, and Adithya Shaker. And by the way, you can see a video of the entire live show in its raw form on the Greenspace website, the greenspace.org, green is G-R-E-E-N-E, where you can also check out all the other awesome live events happening at WNYC. All right, that's it. That'll do it. Yeah. Take a chance on me. Take a chance, take a chance, take a chance. Yeah. Hi, I'm Rhianne and I'm from Denny-Galdon, Ireland. I'm here at the staff credits. Radio Lab was created by Jad Abumrad and is edited by Sorine Wheeler. Lulu Miller and Latif Nasser are our co-hosts.

Starting point is 00:46:56 Deryn Keef is our director of sound design. Our staff includes Simon Adler, Jeremy Bloom, Becca Bresler, W. Harry Fortuna, David Gable, Maria Paz-Cuteras, Sindhu Naan Nisambidan, Matt Keelty, Annie McEwan, Alex Neeson, Sarah Carrey, Valentina Powers, Sarah Sambach, Ariane Wack, Pat Walters and Molly Webster. Our Fat Checkers are Diane Kelly, Emily Krueger, Natalie Middleton. Hi, this is Ellie from Cleveland, Ohio. Leadership support for Radiolab Science Programming is provided by the Gordon and Betty Moore Foundation, Giant Sandbox, Assignment Foundation Initiative, and the John Templeton Foundation.

Starting point is 00:47:42 Foundational support for Radiolab was provided by the Alfred P. Sloan Foundation.

Radiolab - How to Save a Life

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