Wednesday, June 13, 2007

Some people say there is no such thing as luck, or fate. This story has made me a believer.
Here, as in most US medical centers, all health workers (doctors, nurses, PCAs, respiratory techs, PT) have to be trained in basic and advanced cardiac life support (BLS and ACLS). We're required to recertify every few years to stay up to date. One of the spokesperson for this program at my hospital is a consultant of mine in endo, Dr. A.L.
Why would an endocrinologist be a spokesperson for ACLS, you ask?
Here's his story, told to me recently.

He was a youngish Scotsman, perhaps in his mid-30's then. Lean, active, keen on research. One of those M.D/Ph.D types. Had just attended our division's annual BBQ/picnic on a Saturday, where he stuffed himself silly like most of us do. Which soon followed with dyspepsia.
Despite it being a weekend, he had experiments going on in the lab. Probably tissue cultures or something similar, I imagine. And so he decided to drive back to work. Now, here, the employee carpark is at one corner of the medical center, connected by a network of long, lonely tunnels. His lab, on the 5th floor of the hospital, far away from the patient-care areas, and certainly vacated on weekends, except for the cages and cages of mice.
And so he parks his car on that late afternoon, and starts walking to the lab. Huffing and puffing from the now-worsening dyspepsia/heartburn. And it so happens that the emergency department was just midway between the carpark and the lab. In the tunnel, not too far from the ED, he falls to the ground. Unconscious. In cardiac arrest, from an acute myocardial infarction ('heart attack'). And it was serendipitious, that at that very moment, an off-duty ED nurse walking out sees him on the ground, and promptly begins CPR and activates the code team.
The code team arrives and immediately begins 'coding' him. However, despite the CPR, medications and shocks, he remained pulseless. And 20 minutes into the code, they are ready to cease efforts and to 'call' the code (ie terminate resuscitation). Not knowing who this young man was. And at that time, someone moves him, and out of his jacket falls his employee nametag.
Dr. A.L.
Seeing it was one of them, the code team hesitates, and resumes resuscitation. Not wanting to give up yet despite knowing it was likely going to be fruitless. And after what seemed an eternity, his pulse returns. And against all odds, he suffered no hypoxic brain injury.
He take his endocrinology board exams a few months later, passing with flying colours and proceeds to become one of the foremost world experts in thyroid cancer.

A series of events led to that fateful outcome. Had he passed out 3 mins earlier (in the carpark) or later (in the lab) , or had the nurse not seen him in the lonely tunnel, he would have been dead.
Sheer dumb luck? Fate? Do you believe?
And are you ACLS-certified?