To The Guy On His Phone Next To Me In Last Night's Infant CPR Class.
I took an infant and child CPR class last night at Wesley Medical Center. I’m glad I went; I learned things I didn’t know. What they can’t teach, however, is how to react the moment you realize an unresponsive person needs help. I’ve been through this, and it’s not easy to write about. I’ll share what I can, and I’ll add some takeaways from last night’s class, too.
Most of you know my mom died a few years ago. We were really close—I got my literariness (if you can call it that) from her. After about a decade, her breast cancer returned. She had a wonderful oncologist—someone I and we have known most of our lives, a physician whose earned national recognition for his work fighting cancer. He was and is a gift to the community—his personality is light! (And I can think of few things I enjoy seeing as much as this physician celebrating at weddings. If you’ve seen it, you know what I’m talking about. He has a wonderful family [children who are doctors and bankers and nonprofiteers] and a wife whose thoughtfulness has reached countless lives.) Even though my mom had a double mastectomy when we first discovered the cancer, some of those cancerous cells metastasized into her lungs, where they lay dormant for years. When the cells began to grow, the working theory was that she had anywhere from two to 10 years remaining. The whole thing was treatable. This is my understanding of the diagnosis and medicine. Doctors who read this may know or understand more about this process, and I’m happy to update this post accordingly.
My mom died on a Saturday, a few months after the initial diagnosis and a few days after she’d had a tube inserted to drain fluid buildup. I’d gone over to my parents’ house to take my dad out for dinner—he’d been working hard physically and emotionally to take care of my mom, and I thought he could use a night out. We were in the kitchen, which, in today’s modern home layouts, doubles as a hearth room, when I heard my mom say, quietly, that she was about to pass out. It’s one of those things you hear and don’t hear at the same time—you know something is happening, but from the time you hear it to the time you process it, whatever is happening happens. You’ve now found yourself in an emergency.
This is where it’s important to note, embarrassingly, that I’ve had no formal CPR training. Perhaps we studied it in Cub Scouts (of which my mom was a Den Mother), but other than seeing episodes of E.R. or Grey’s Anatomy, I had no idea how to resuscitate a human.
My mom fell back on the couch. We’d been talking about how we could never figure out how to set the timers on the dual ovens in their kitchen. Yes, that was the discussion: dual oven timer settings. When I reached her, she was on the couch in a seated position with her head tilted back, wheezing. Not knowing what to do, my first thought was that I needed to establish a way to communicate so she could tell me what was wrong. I climbed on top of her, placed my hands at the sides of her head—thumbs adjacent the sockets of her eyes—and asked if she could hear me. It seems silly now, but I said, “If you can understand me, blink twice.” No blinking occurred.
I didn’t know then but know now she was beyond help the moment she passed out.
I shouted to my dad to call 911. Let me reiterate that this happened in between 30 seconds and one minute. Take a moment, now, to set your iPhone timer for one minute. Pause and begin the countdown. Wait. Imagine all of everything I’ve just told you happening within that timeframe. First responders are heroes—they move inside flicker streams when lives are at stake.
There are details that I’m not going to share here. It’s not that they’re private; I’m not ready to write about them. It’s been 935 days since my mom died, and I’ve thought about this sequence of events at least once on each of those 935 days. Throughout last night’s CPR class, I relived this sequence in an especially awful and difficult way.
But I’ve learned to accept that this memory will go with me, and I’ve done so in large part to some really special people, one of whom I will name directly: John Kilroy. John’s mom had passed a few years prior, and he took it upon himself to talk me through the first year after my mom died. He called. He texted. When in town, he met for breakfast. At each stage of my grief, he told me how he felt and what he did when he was at that same stage. It’s one of the greatest things a human being has done for me. No one asked John to do it; he did it because he cared. If you’re reading this, Kilroy, I apologize for sharing your name directly—but it’s author’s prerogative, and I’ve decided anyone who reads this should know what you and your big and thoughtful heart did (I’ll change it if you ask me to though, but I’ll give you an utterly ridiculous name). I only hope I can do the same for someone else what John did for me. (See endnote.)
We moved my mom from the couch so she lay on a hard, flat surface. At this point, we had already called 911, whose operator instructed us to place them on speaker while they walked us through CPR’s compression beats. My dad and I followed directions and went to work. I was grateful when paramedics arrived. They left in a flash and took my dad with them, although they wouldn’t let him ride in the back, which gave me worry.
Before leaving for the hospital, I stayed behind to clean up all the plastic bagging and tubing pieces left behind by the fast-moving paramedics. Things get ripped open during traumas. What happens to those little plastic pieces littered over the ground? My thinking was this: If my mom died, I didn’t want my dad to come home to a hearth whose furniture had been upended and a floor scattered with leftover medical equipment. I righted the furniture and bagged the plastic bits. Who thinks like that?
I called my sister to tell her what had and was happening. I even told her, “Listen, I think it’s bad; but I don’t think she’s going to die.” I didn’t want to interrupt her dinner plans. Can you believe that?
Nurses took us to a private family waiting room in the ER. Now I knew things were bad. And this woman kept dropping by—she said she was the hospital’s chaplain—to see how we were doing. Again, not a good sign. Her name was *******, which I found beyond ironic. One of the great maneuvers I’ve seen in life was when my brother-in-law said, in the nicest possible terms, that we, as a family, didn’t need ****** to visit us any more.
When the doctor told us my mom died, it happened like it does on TV. Again, there are private details here I’m not going to share. I sat with her for a while afterward—I had things to say. And we refused to leave the hospital until the funeral home team came for her. That took over an hour. I took charge of my dad’s phone, and when it rang, I answered. The person on the other end said they were with “the eye bank”. Now, I come from a family of bankers, so when they said “eye bank” I thought for some insane reason they meant “iBank” which, at the time, baffled me. Why was someone calling about a banking problem on Saturday night. And who or what is “iBank” anyway? I saw the word “iBank” in my head, like iPhone or iPad. I later realized they were part of an organ donation team. I’m an avid believer in organ donation. But at the time, I had no idea idea what was going on—it simply didn’t register.
I really didn’t mean to go so deeply into this very personal experience today. For some reason I feel like I need to apologize for that, and I can’t explain why. What I meant to share was that emergencies are emergencies because they’re emergencies. They happen fast. They didn’t cover that during last night’s CPR class, although harried acting by video actors suggested as much. There’s nothing I can think of to say about how to prepare for an emergency other than to say I think you should trust your instincts. We have them for a reason, and they’re usually right.
I did learn some interesting things in class. Here are some takeaways:
(1) The basics: 30 compressions followed by two breaths. Push hard and fast. When you breath, watch the unresponsive person’s chest to see if it inflates.
(2) If you’re performing CPR on an infant, when you administer breaths, use your mouth to cover the infant’s mouth and nose. You won’t be able to pinch the nose closed and create the proper seal over the infant’s mouth to push air into the lungs.
(3) If you’re in a group, shout (yell) for a help. And make direct eye contact with someone. Tell that person specifically what you need them to do. (Call 911, help with compressions, find an AED.) By being direct, you avoid confusion about who should do what.
(4) If you’re alone and your phone is in another room, begin and conduct five (5) rounds of compression sets and breaths before you go for your phone to call for help. When, after the five sets, you make your move for the phone, take the infant with you.
(5) Before you breath into the infant’s mouth, tilt its head back by placing your fingers under the chin and your hand and palm on its forehead.
(6) Use as your compression mechanism, for infants, two fingers; and for children, use the base of your palm. Depress approximately one-third of the unresponsive patient’s body cavity. (This is about two inches.)
(7) Don’t worry about cracking the sternum or ribs. Better to break the cartilage or bone but save the patient.
(8) If someone brings an AED, or Automated External Defibrillator, as soon as you open it, it will tell you what to do. (Or it will have a clear button that activates the machine.)
And to you, Mr. “I needed to check my text messages during infant CPR class”, also known as the fellow I sat next to in class, I hope you already know how to administer CPR and other life-saving techniques. And I hope you don’t regret reading that way too important text while missing out on some of the most important information you’ll ever learn.
Emergencies happen fast. Several of Joseph Conrad’s novels take events that occur in seconds or minutes and slow them down so he can capture all of the different elements which occur within these explosions of action. He’s a master at it. And I think his use of this technique mimics reality. For while I say these moments of emergency happen quickly, when you’re in them, time slows down. I’m glad, though, that I have some training ready to apply if necessary in those slow moments of fast emergency.
Endnote amplification: John was a savior. And there were many others. Friends of mine came from all across the country. Many surprised me. Within thirty minutes of my mother’s passing, I called a close friend and mentor, Paul, who was so honest when he said he’d never been through what I’d just gone through, but he was available to listen. There was the time Paul and Mark just sat with me while I cried. My best friends from high school (Logan, Nick, and Matt) came over to my dad’s house on Sunday (the day after) and we all hung out together to try to cheer my dad up. My friends from college teamed up with my friends from high school and threw a gathering after the funeral to help us cope. My now-wife was only a distant acquaintance from yoga at the time, and she heard me talking about it and came up and sat down next to me and asked if I was okay. People are amazing. And your friends—your really close ones—they don’t say, “Let me know if there’s anything I can do to help,” they just help. They don’t ask; they do. My sister’s friends bought a collection of clothing for her, snuck into her house and lined them up in her closet. This gave her a choice from a collection of clothing about what to wear for the funeral—it was one less decision she had to make. I could go on and on. I could write about how just the day before (Friday) I’d taken my suits to Satish for altering, and whenever I’m at the tailor’s, I never ask for things back immediately because it’s rarely a big deal. But when I went back on Monday, I asked Satish if I could have the pinstripe by Thursday; he said he’d have it for me by the end of the day. And I could go on and on and on and on. I’ll stop now. But these people and so many more did so many little things in this small window (and, I might add, my grandmother had died 60 days prior—I was incredibly close with both my mom and grandmother; this was one of the most difficult times of my so-far life) that while I remember the hard stuff I wrote about above, I inevitably remember the kindness and love shown by friends who carried me when I couldn’t walk. And that leaves me warm, which is a fine way to end this post.