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Archive for the ‘Sudden Cardiac Arrest (SCA)’ Category

I remember the weeks following my cardiac arrest where my experience of life was really quite different. I was much more present for each moment of each experience that I had. While my mind was much less cluttered with the thoughts that typically tumbled one after another like an endless line of circus clowns, I was much clearer about life.

It’s not that I knew what life was all about, as far as having it in a nice neat little pigeonhole; it was just that I wasn’t making up all of the extra crap that I had been used to making up about it. I was so much more sensitive to each individual experience, each individual person, and awe-inspired by each of them! It was really the simple things in life that were most amazing (love, connection, presence) and the absurdities that typically characterize human relationships were simply unintelligible gibberish that was easy for me to simply ignore. The precipice of death has this uniquely clarifying quality that is rather compelling. I have found myself drawn towards this space, wanting to return ever since. Secretly, I can even be defiant at times, taunting death in my own mind, pushing limits, rather unconcerned about my mortality and the temporary nature of this life (not that I put myself at mortal risk, really).

but, what a peculiar a thing to say!? To want to return to this edge between life and death!? What is this paradoxical attraction? No, I’m not afraid of death and no, I don’t want to leave this planet either. And yet I also long for this freedom from the absurdity that characterizes most human interactions! How is it, that we human beings have turned this precious and amazing existence into a funhouse hall of mirrors? Hiding from each other, posturing, and getting our highest priorities completely wrong!? How is it that I find myself entranced by this, yet again, after such a profound clarity? Swept up by utterly inconsequential interactions!?

A friend, a fellow SCA survivor, recently said, “I want to die again. Just so I can remember how unimportant all of these trivial day-to-day emotions/feelings/experiences really are. I mean, I don’t really want to die, but…” As someone who has been to this edge, I completely understand this compelling attraction, but unless one has stepped onto the precipice of death, it is difficult if not impossible to understand. Some of us (SCA survivors) remember having what could be called Near-Death Experiences. Others, like myself, don’t remember having such experiences. However, I have a sneaky suspicion that I nevertheless had such an experience, but simply don’t consciously remember it! Otherwise, why would I feel this way?

How do you explain to somebody, who has not been to this edge, the compelling nature of it? It would seem crazy to them, but to us it was so much more sane than the insanity of what everyone else seems to call “normal life.” To just about every SCA survivor that I have met, “normal” life is absurd and incomprehensible and even though most of us eventually, reluctantly, become re-entranced by its illusions and absurdities, we also remember the clarity of being beyond the fray. We long for that clarity again and worst of all, find ourselves perpetually in a neither-land, stuck between the two. We no longer live in the land of clarity of presence and yet we can no longer completely buy into being “normal.”  We are left with having a foot in each world and yet at are at home in neither. It’s a purgatory, of sorts, that we now live in. I don’t see how those who have never died could possibly understand the depth and breadth of this paradox that we live each day.

I have a special affinity for Daniel Ladinsky’s translations of Hafiz because of his ability to speak certain truths that resonate with me.

For your consideration:

“Listen: this world is the lunatic’s sphere,
Don’t always agree it’s real,

Even with my feet upon it
And the postman knowing my door

My address is somewhere else.”

~ Hafiz

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At one point, shortly after my sudden cardiac arrest (SCA), I very carefully reviewed the string of memories from just before my SCA until I woke up in the hospital. In doing this, I was very careful to not add anything to the string of memories or to subtract anything. Specifically, I did not add interpretation or elaboration.

I remember starting my run. I had just started the running app on my phone (Endomondo) and the song on my randomized playlist was Satori Waterfalls, by Ohmna. I particularly love listening to Trance music while running. Then, I have a memory of running down Grand Avenue towards Lake Merritt, but honestly it seems to blend in with the numerous other times that I’ve run down Grand Avenue so I’m not particularly confident in its veracity. The next thing I remember is this subtle reddish brown color and then, eventually, a recognition of other people nearby whom I couldn’t quite make out, but they felt very familiar and comforting to me. Later, I would recognize them as family members (mom, stepfather, sister) and the room was a hospital room and that I was lying in a hospital bed. I would have further memories of increasing mental acuity as the drugs that were used to put me into a coma so that I could undergo the hypothermia protocol wore off. My head was well clear of the drugs by the time I undertook this very specific and precise review of my memories.

Oddly enough, if I don’t add anything to this stream of memories, I didn’t die, I didn’t have a cardiac arrest, and I wasn’t rescued by Good Samaritans to beat the astronomical odds against my survival. If there were no memories, these things really happen? According to my memories, I simply started my run and woke up in the hospital with nothing special in between. I didn’t feel any sense of space or time that occurred between my memory of running down Grand Avenue and that brownish reddish color. None whatsoever! So, from a purely experiential perspective (direct unembellished memories of experiences), how can I say that any of it happened?

And yet, my rescuers (Andy, Mario, Jon, Alis, etc.) my doctors and my family all have very clear memories and they have told me everything they remember. I even have a picture of myself that my sister snuck when I was still in the hypothermia protocol. To them, I died, was resuscitated, taken to the hospital, phone calls to next of kin were made, and the start of almost $200,000 in hospital bills were acquired (luckily I had insurance). To them I absolutely did die! So, which is it?

Now, that I volunteer as a caregiver in hospice and have outlived the first patient that I have worked with, I too can attest to the fact that she is no longer with us. But, did she experience death? Does she experience death or nonexistence? Or is it only the survivors that experience it? Is death just a concept, a mental construct, a label for the phenomena that someone that we know and love is no longer with us? Just a label for this seemingly disturbing phenomenon? I suspect that this idea does not apply to those who are no longer with us, but only to the survivors. It’s so very easy to make something up. One thing that I know, is that if I had never woken up from my cardiac arrest, I would not have ever known. It would not have been a problem.

What I am not doing here, in writing this, is providing any number of concepts or ideas or beliefs to fill in the gap of unknowing about this most mysterious of phenomena. Some believe in heaven and hell. Some believe in perpetual reincarnation. Some believe in oblivion. They one of them or all of them may be true and maybe not. We seem to want a definitive answer!

(And an especially loving note for many of my dear SCA friends who have had Near-Death Experiences of various forms (light at the end of the tunnel, etc.), I say TRUST YOUR DIRECT UNADULTERATED EXPERIENCE! It’s unassailable! But don’t think too much about it; it’s enough to just trust the fearlessness that arises from your direct experience! Besides, it’s the stories that we make up about it and the need to defend them that can cause the fear.)

These concepts, ideas, or beliefs about our temporary presence here and what happens when we are no longer here are infinite, but I have personally never found any of them to be verifiable in any directly observable sort of way. Besides, I am no longer interested in making something up to soothe some sense of anxiety about death. I lost that anxiety when I died, even though I wasn’t given any beliefs to hold onto. 🙂

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I wrote this three months after my cardiac arrest.

On March 1, 2011, at the age of 42, I was about 20 min. into a routine two-hour run around Lake Merritt in Oakland when I collapsed from Sudden Cardiac Arrest (V-Fib). To my fortune, there was a runner, Andy Hill,  who happen to be close enough to help break my fall and provide immediate aid.  Additionally, three other bystanders rendered CPR and contacted 911. While under the care the paramedics, they continued CPR and used a defibrillator 2x before getting some semblance of a life-sustaining rythm from my heart. They took me to the hospital where I was put into a drug-induced coma and put in a therapeutic hypothermia for 24 hours in order to protect my brain as my heart stabilized.   I spent three days in the intensive care unit and a total of 10 days in the hospital.  All I remember of this event is beginning my run that day and then waking up in the hospital, days later.

While in the hospital, they ran numerous tests including: a cardiac MRI, and did an EPS (Electro-Physiological Study).  Unfortunately, the doctors were never able to determine the reason for the deadly arrhythmia that I had and, in the end, they implanted an Implantable Cardioverter Defibrillator (ICD) in my chest  just in case my heart ever goes into a similarly deadly arrhythmia. I hear that it’s not particularly comfortable to be shocked, but I haven’t had that experience yet. I have since learned that I now belong to a rather exclusive club of survivors given that only about 8% of people survive sudden cardiac arrest.  I consider myself profoundly lucky to have had good Samaritans that quickly stepped up to care for me when I could not care for myself by providing CPR, impressively high quality medical care, as well as having previously invested in my own physical health.

Currently, I am back to running under some limitations set by my cardiologist and have largely resumed normal life except for the fact that I’m not allowed to drive for six months following my loss of consciousness.  As I write this, it is almost 3 months to the day since my sudden cardiac arrest. I still can’t wrap my head around what happened to me and may never be able to, but I am grateful beyond words to everyone that has shepherded me through this experience and feel strongly that we (as a society) should do more to save each other. It’s been quite a surreal and mind blowing existential experience.

I continue to maintain contact with the bystanders and the paramedics that saved my life. This is both good and sometimes challenging as there is a part of me, somewhere deep in my subconscious, that actually remembers the trauma of what happened to me on that day. I know this because of the subtle anxiety/dread that I feel in their presence sometimes our when thinking about spending time with them. Sometimes it can feel a little like opening a Pandora’s box.  Some the feelings are rather uncomfortable. Also, as I have reintegrated myself back into normal life, I have had a few examples of pretty classic post-traumatic stress responses to things such as hearing sirens or like on the day that I went on my first run around the Lake where I had my cardiac arrest. While, I’ve been surprised by the subtle triggers that can bring a very visceral sense of dread or impending doom, I’m also determined to recognize any discomfort for what it is and have not let it dictate the terms of my life!

Additionally, there is a way that this experience helps me understand why many survivors do not seek out or maintain contact with their rescuers.  Contact with one’s rescuers can also trigger a post-traumatic stress response.  What an unfortunate irony! There will probably always be a part of us that remembers exactly what happened, whether were conscious of the experience or not that we were headed, very quickly, towards our own death before we were so miraculously rescued by such earthly Angels!

Life is indeed precious and fragile. May we step up to the plate MORE for each other!

May success stories like mine become more common!

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While I don’t remember what happened during my cardiac arrest (if I had an NDE like many of my SCA friends), I have had a variety of non-ordinary experiences in my lifetime prior to my sudden cardiac arrest.  This is a list of my non-ordinary or “spiritual” experiences that I have had in my life before my cardiac arrest. Each of these events have been profound openings and are precious to me.  They are gems that are close to my heart and I have never publically disclosed them. They have each required translation into verbal language as they didn’t occur originally in that modality. This could give you a little bit of a better picture of where I’m coming from and why I am the way I am.

Title: May the Force Be with You

Category: Void Experience

Age: 16 or 17

One night, when I was a teenager, after a long day of work I came back home.  I lie on my bed and closed my eyes to rest for just a moment.  Suddenly, I found myself walking slowly down this hallway which seemed to be made of a polished black steel.  The walls of the hallway, however, appeared to have depth.  It was as if I could see into a vast darkness.  While I couldn’t quite see anything in particular this vast darkness did not seem empty.  As I continued to walk down the hallway, it branched into two directions at right angles in a “T” shape.  Right in front of me were a set of double doors with simple gold handles.  Curious, I grabbed the handles and opened the double doors.  Inside was a massive vertical cylindrical cavern that seemed to have no bottom to it.  As I stood in front of the double doors looking into this cavern, I could see many thousands or hundreds of thousands of white dots in row after row for as far as the eye could see both up and down.  Although it was too small to actually see, I could tell that each white dot was actually a large window and on the other side of the window were people staring longingly into this cavern.  It was as if out of a Star Wars scene.  All these people were looking into the cavern window after window grow after row from countless windows.  Inside this cavern I could feel, I knew, was infinite wisdom, infinite knowledge.  I wanted to enter this cavern as well because I wanted to have this infinite wisdom/knowledge.  I knew, however that if I did step into this cavern that it would be the end of my life as I knew it.  Forever!  I would lose much, but that wasn’t important.  I wanted, with all my heart, to step into the cavern and to find, to have, that infinite knowledge/wisdom.  Unlike the rest of the people looking out of their windows, I had access to this beauty and wonder.  All I had to do was step in!  So, as I went to step in, I was suddenly back in my room lying on my bed only to be denied what I long for so greatly.  I was annoyed for days after this experience.

Title: Shattered

Category: Void/Unitive Experience

Age: 24

I had been experiencing an extremely unsatisfying and frustrating day.  In the afternoon, at one point, I had decided that the only thing there was left to do was to meditate, that there simply wasn’t anything else to be done of any value.  So, I sat on my meditation cushion facing the wall in the style of Zen meditation practice that I was going at the time.  The meditation was uneventful other than the fact that I was unusually disinterested in any of the sensations, thoughts or desires that typically occupy my consciousness.  At one point, late into the 30 minute meditation, I simply found myself in this vast dark expanse.  I was this hollow, smoky-dark, glass figurine sitting in a meditation position amidst this vast expanse.  In the distance, there were some subtle swatches of color and before me was a light source that looked like the sun or some star that glowed yellow.  After some time of this, an object that looked like a shooting star rapidly moved towards me, from behind, hitting me between the shoulders right where I was feeling a twinge of pain That I had been experiencing.  It shattered me, The glass figurine, into a million iridescent pieces of glass shards!  Suddenly, there is no difference; no separation between me and the rest of this vast expanse.  I was everything!  I felt a sigh of relief.  It’s all perfectly okay.  There’s nothing to protect.  Tears came to my eyes as a result of the depth of relief and intimacy that I felt; the joy that I felt.  Then, something seemed to open up and I felt a coursing of light, of energy moving up through me.  As if I were sitting on a volcano and it erupted through me!  The sensation was so intense that I was immediately jolted out of the experience that I was having and I was in this body, back sitting on the meditation cushion in front of the wall.  My eyes were wet with tears.

Title: The Place Where Joy and Sorrow are one

Category: Soul Retrieval

Age: 23

It was an ordinary Saturday evening in September of 1992 in Goleta, CA.  I had participated in the Sage Experience nine months before.  I was antsy because I did not have plans for the evening and I didn’t want to be at home by myself on a Saturday night.  Inspired by what I had been learning from The Sage Experience and the community that had grown around it, I decided that I would choose to stay home and experience what I felt completely.  I had been recently drawing pictures using my left hand.  These pictures represented drawings done by Stephen, the name that I gave my inner five-year-old because it was my name when I was adopted at five.  Of the many drawings that represented the many different feelings and experiences that I/Stephen had, one picture was a particularly angry and violent one.  As I lay on my bed, candles lit in my room, soft music playing and a pleasant smelling stick of incense burning; I looked at that picture and found myself feeling sorry for pain that I had felt and how I hated that part of me.  I knew he only needed love, somebody to care about him and somebody to value him enough to keep him.  I let myself feel compassion for him, for his pain, for my pain.  I allowed myself to fall into this pain with a heart full of love and compassion.  After a while, it was as if I was falling down this cavern with no bottom to it, no grasping, no second-guessing, no controlling.  Just loving.  Then, I seemed to fall into this space where joy and sorrow were incomplete without each other, where they were complementary to each other, where they completed each other, where they were one.  A more sweet sorrow, I have never felt before!  Neither then or after.  I slowly drifted off to sleep amidst this bliss.  When I awoke the next morning, there was definitely something missing!  There was actually a lot missing, but I couldn’t figure it out immediately!  It was my mind!  It was empty of all the thoughts and longings that had been there for so long as to not even recognize their presence.  Instead of all these thoughts and longings racing through my mind at light speed, I found that my senses were heightened.  Everything was very vivid and alive to me!  I felt so calm and my body my mind empty of thoughts and I felt joy, joy, joy.  This was the start of a profound month, where I felt more present, where I felt complete, where my heart overflowed with love and compassion and it was all I could do but to share it with everybody that I ran across.  In my conversations with people I did not feel the need to use unnecessary words and I often said very little.  When I did speak I used essential words and use them as seeds that would grow over time and allow this person to know that no matter what they too were perfect and beautiful and there is absolutely nothing wrong with them even though they were completely convinced to the contrary.  I was overflowing with unconditional love!  During this time I felt as if I could hear the heartbeat of life itself, of the universe itself.  I seemed to have the ability to manifest what I wanted with virtually no effort.  And I had so much more love than I could hope to contain and so gave away as much as I could.

Title: Zen and the Art of Washing Dishes

Category: ?

Age: 23

I was washing dishes while living in Goleta, CA.  I made a special effort to simply wash the dishes with all of my attention that day.  Towards the end of washing the dishes, one of my roommates came into the kitchen.  As I listened to her talk it was as if I could see the layer of self-misunderstanding that she was speaking from.  And it was as if I can see all the layers of the mistaken beliefs of her imperfection has she spoke.  Yet, it was her perfection that I can see shine through most clearly.  I recognized that even though she had many misunderstandings about herself and others that she was in fact perfect and there was nothing wrong with her at all.  I further recognized that even though she didn’t know this, that the truth of her and everybody’s perfection is the only, and inevitable, conclusion that one can come to despite however many years of misunderstandings one may have.  You can run, but you can’t hide, forever!

Title: The Return

Category: ?

Age: 42

I woke up in the hospital. My mom, sister, stepfather, and biological mother were in the room. Initially, everything was still pretty fuzzy and I would realize that it was because of the drugs used to put me into a drug-induced coma for the hypothermia treatment that I had received after my cardiac arrest. Over the days, my awareness sharpened, but it would be some time (weeks) before I would become re-entranced by the stories that I tell myself about life. Often, thought required an effort that I simply wasn’t interested in and the stories that I could tell about life seemed arbitrary and an important relative to perceiving what was right there. So, why bother? It thoughts and feelings would occur. They seemed to be like an isolated billowy cloud in an otherwise completely clear blue sky. I would watch them with a measure of curiosity, even recognizing them as somewhat odd. I realized at this time that hope was also suffering, attachment to life or preferring life over death was suffering, that death was not a problem, and if I had not returned, I would have never be the wiser for it. I was very aware of what people did not or could not say. If someone came in with openness, compassion, presence, I could feel it and it was more important than anything they said. If, however, someone came in who was unkind, annoyed by me, incongruent, or simply didn’t care, I could feel that to and that was louder than any of the words they said. I have always been this way to degree, but during this time my perception of the nonverbal was profoundly heightened. Slowly, I have become re-entranced by the stories that I make up about life with one important difference. They seem that much more absurd to me now and while they play themselves out, it’s hard to believe in them anymore.

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As a cardiac arrest survivor, I found Dr. George Lundberg’s advocation of nonintervention in out-of-hospital sudden cardiac arrest truly deplorable. As a former longtime editor of JAMA, I would have hoped that he would’ve exercise a little more discernment. Please take the time to read the comment section has a number of cardiac arrest survivors and other medical professionals have posted comments against and in agreement with his position. Below is the text of the statement that he made and my rebuttal.

————-

Why Do CPR?
By MedPage Today Staff
Published: June 06, 2012

http://www.medpagetoday.com/Columns/At-Large/33114

Transcript:

Hello and Welcome. I’m Dr. George Lundberg and this is At Large at MedPage Today.

I don’t know how many of you readers are old enough to remember the frequent use of open chest cardiac massage, first successfully performed in 1901. It began as a way to resuscitate suddenly dead people, assuming that their hearts had arrested or fibrillated.

The surgeon would open the chest between ribs 5 and 6 and rhythmically squeeze the heart to move the blood and re-establish life. Sometimes it worked; usually it did not.

Then, in a JAMA Landmark article in 1960, Kouwenhoven, Jude, and Knickerbocker at Hopkins described closed chest cardiac massage and everything changed. Suddenly, patients who were observed dying could be brought back to life without an open thoracotomy.

Great, or so it seemed.

Big organizations taught the procedure; new categories of emergency medical workers were created; ordinary people were educated to save lives dramatically; medical associations sponsored research and published papers, even entire theme issues in JAMA every several years.

A mass of television shows taught the public that codes were called and enacted with teams of beautiful male and female doctors breathing and beating the dead back to life. It became such a pervasive cultural phenomenon that any person who did NOT wish this effort to bring them back to life after they died the first time would have to file a predeath Do Not Resuscitate order and hope that it would be followed.

After the performance science was solid and positively enacted to create a culture of resuscitation, then came the hard data.

Judged on favorable outcomes (meaning a well functioning body and brain at 30 days) after the drama ended and the TV cameras went elsewhere, the whole schmear was found to hardly ever work to the patient’s or the family’s advantage.

But the culture was already ingrained.

Now we see a huge Japanese study of more than 400,000 people who experienced out-of-hospital cardiac arrest, published in the JAMA on March 21, 2012. Approximately 18% of those who were administered CPR and epinephrine did achieve spontaneous circulation but fewer than 5% survived 1 month and fewer than 2% survived 1 month with good or moderate cerebral performance.

So, if an average adult keels over in the street, is found unresponsive and pulseless by a bystander, and is administered CPR while a 911 call is made, the odds that such a person will emerge from the eventualities of the resuscitation effort healthy and with a normally functioning brain are about 2%.

The other outcomes are death — soon, or within 30 days — after lots of cost and much suffering for many, or being discharged from a hospital, alive but mentally impaired, presumably lifelong.

So, I don’t know about you, but if I drop dead on the street, observed or unobserved, I suppose the observer will feel obligated to call 911, but PLEASE do not administer closed chest cardiac massage to me.

I don’t want my rib caged collapsed and I don’t want to live with iatrogenic squash rot, only to have to die all over again sometime later.

That’s my opinion. I’m Dr. George Lundberg, At Large for MedPage Today.

——————-

This was my response to his article:

“To the world you may be one person,
But to one person you may be the world!”

On 3/1/11, I personally had a cardiac arrest (V-fib). The ONLY reason I am still here and able to practice my craft (psychotherapy) is because complete strangers gave me immediate bystander CPR and I received defibrillation within about 5 minutes resulting in a viable heartbeat. From there, I received quality medical care. The end result: 100% recovery. I do not have any discernible anoxic brain injury.

Would you have just stood by and watch me die? All the while thinking, “Oh, statistically the chances aren’t good.” How would that have impacted my friends and family? How would that have impacted the children and families that I work with? How about the people that I hadn’t impacted yet, but will, because I’m still alive? And last, but certainly not least, how would that have impacted you, personally, to watch me die and not at least try? Would you sleep well at night or have nightmares? As for me, I’m at peace with my own mortality now and yet I recognize life, existence, has so very precious!

Now, of course most people that have cardiac arrest aren’t as fortunate as I have been (this is true), but doesn’t everybody deserve the best chance at life? How about using proven ways to improve the abysmal survival statistics instead of giving up altogether? As a hospice volunteer, I recognize that a DNR can be a very important, appropriate, and respectable choice for the right people and not just for hospice patients, but a wholesale advocacy of nonintervention seems truly myopic and an unnecessary tragedy.

Now, I am part of a very small community of survivors of cardiac arrest. We look after each other across great distances. Some survivors certainly do struggle with some degree of anoxic brain injury, but we all value the additional life that has been afforded to us through the generosity of others. So, when you look at those statistics, try to improve them! Don’t abandon the lives behind them.

“To save one life is as if to save the world.” The Talmud.

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