A miracle in the intensive care unit

Originally published on KevinMD

She fit into the palm of his hand. That long nine months. Waiting desperately for that baby they thought they could never have.

Jeff, football player from his high school days, met the love of his life, Bridget, at the school party. She was smart and beautiful; Jeff was big and burley, but as kind and gentle as a kitten. They hung out through their college days.. And finally said their “I do’s.”

Within a few years, they tried and tried to have a baby. Year after year, MD after MD. And finally, Bridget was pregnant.

Her water ruptured, a little too early, and Jeff drove her frantically to the hospital. Two months too early, little Samatha was born. Fragile and delicate, 3.5 pounds. And they had to rush her to the neonatal ICU. Jeff stared at this small creature they had made together.

As he held her in his hand, her tiny fingers grasped his finger. And they were smitten with each other. This little girl would be his baby princess. He would do anything forever to make this baby Sam happy. She was so tiny, everything was delayed, her speech, her fine motor skills, her walking. But with great love and diligence, Jeff and Bridget finally got to see baby Sam lift herself off the floor and started slowly hobbling over to her mom and dad. Those first steps were a triumph. Baby steps. They were so grateful for those baby steps.

Jeff was a hard worker and a good provider for his family. Almost to perfection. After he received his law degree, he went to work and rarely knew what a weekend was. But they always had a family vacation, and he taught his little princess how to canoe, ride a bike, climb a mountain, go camping, toast marshmallows on an open fire, shoot a basketball and attend those very special father-daughter dances at the elementary school.

Sam was so proud of her dad; she wanted to be just like him. And so off to college she went, to obtain that law degree, just like Dad.

Bridget noticed that her husband would get short of breath after a brisk walk through the neighborhood, sometimes his rosy cheeks turned gray, sometimes he would sweat profusely without any exertion. Jeff would never complain. And he never knew when to quit: He always had an excuse, “I pulled a muscle,” “It’s indigestion, it’s really hot outside.” Jaw pain was maybe the hard candy he had eaten.

So on a hot sunny day, Jeff was cutting the grass, the neighbors saw Jeff fall to the ground as the lawn mower ran down the yard by itself.

A neighbor ran over and looked at Jeff.

He was lifeless, lips were blue, cyanotic, he was barely breathing, slow gasping breaths, his radial pulse was thready. And the neighbor reached out of his pocket, and called 911 on his cell phone. Jeff stopped breathing; his heart stopped. His neighbor started CPR immediately, fast and hard compressions on Jeff’s chest. Hoping that this was just a temporary nightmare.

But Jeff never came to.. And he was rushed by the ambulance to the closest emergency department.

CPR still in progress, a code blue was called overhead.

CPR, shocking with the defibrillator, nurses pushing drugs into his veins to start his heart up again, the MD and respiratory therapists putting a tube down his throat into his lungs for airway, that life-saving endotracheal tube. It was a good team of ER doctors and nurses. They worked well together, especially in a crisis. And after that golden hour in the ER, CPR, shocking, epinephrine, shocking, intubation, vasopressors for the low blood pressure. They finally had Jeff with a cardiac rhythm and a blood pressure, but he never woke up.

The MD stated they would do a “code cool” on this patient. Jeff had had significant heart damage, a major heart attack, and the medical group would perform a procedure whereby this ER and this ICU team would induce hypothermia on Jeff.

Code cool is a treatment that puts the body into a hypothermic state, with pads that cool down the body to 32 to 34 degrees Celsius.

Since Jeff didn’t regain consciousness after his cardiac arrest, there was concern that Jeff had anoxic injury to his brain, easily caused during a cardiac arrest. Jeff, if he survived this, could end up in a vegetative state.
Bridget and Sam, shuffled in the waiting room, came to visit Jeff in the ICU during visiting hours. As they walked through that ICU, they saw patient after patient, lifeless, on ventilators, hooked up, IVs, millions of IV drips, chest tubes, nasal NG tubes, wrist restraints, nurses running in and out of rooms. Never a dull moment in this ICU, the word “quiet” was taboo, because quiet meant that the ICU at any given time, could erupt into pure chaos. Those lifeless bodies could drop their blood pressure down to nothing, or their EKG could go into a chaotic rhythm, or that patient coming out of his opioid overdose, could erupt into violence. Code blue, code gray (violence/attack), code stroke: We had them all.

He lay there lifeless. He didn’t move, didn’t open his eyes. Day after day, the ICU nurses and MDs proficiently kept this hypothermic machine going, preserving the heart, the brain, the kidneys, the liver, the lungs.
After a week of cooling Jeff, then rewarming and then a final 72 hours of being normothermic, the sedation and paralytic drugs were slowly being weaned. Jeff didn’t move for several days. The ICU doctors and nurses worried that there had been significant brain damage. An EEG showed some slowing of his brain waves. Bridget and her daughter almost abandoned all hope.

Sam proudly walked across that stage, law degree in her hand. Her mom smiling ear to ear. Their wonderful daughter, following her dad’s footsteps. Bittersweet, knowing that her dad was dying in an ICU.

Finally, Jeff improved, minute after minute, day after day. One sunny day, he was extubated, breathing on his own. He looked around wondering where he was, this strange place, these people coming in and out of his room. His wife and his little princess held his hand. And they told him how his heart stopped beating, how he stopped breathing, how he turned blue, how they almost had to pick out his coffin.

Sam told her dad, that she met her true love, and she was engaged. The wedding could wait until her daddy got better. Jeff was sent to rehab, and every day, he got better and stronger and more confident to where he finally graduated to his home. His own stomping grounds.

Sam was beautifully dressed in her white gown, a laced veil that covered her face. She could barely see as her eyes were filled with tears. She wrapped her arm around his arm. Her dad. Her hero. And together, Jeff proudly walked his baby princess daughter, down the aisle. One step at a time. Baby steps. They were so grateful for those baby steps.

With the persistence and expertise of the doctors and nurses and respiratory therapists, Jeff beat the odds.


Sometimes they really do happen.

This story is dedicated to the emergency departments, intensive care unit, and coronary care units who give their time and endless expertise in assisting critically ill patients who face high mortality outcomes.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s