Caveat. While not specifically about Scuba, this is a true experience I had to deal with today and it applies to your diving. Also, even though I go by 'NetDoc', I am not a medical doctor. I fix sick Networks, not people.
It's a gorgeous day here in the Keys. It's mid eighties, the sky is blue, I've been working on my van, sussing out a brake light issue and needed to get some exercise. I hadn't been to Pigeon Key and done the walk on the old seven mile bridge in like forever, so I decide to take the now fixed truck on an hour's drive to just south of Marathon. It's the middle of the afternoon, and did I mention that the Keys are gorgeous this time of year? Considering traffic on this weekday, I'm not the only one who feels that way. Oh, it's not too bad and since I'm already in paradise, there's really no rush.
I found a parking spot, almost the last one, and got my tunes going and hat on. There's a bit of a breeze that will keep me from sweating too badly, but I'm ready for the challenge. It's only 2.2 miles from Marathon to Pigeon Key, and with walking around the Key a bit, I might get five miles in. Perfect. I have been here before, but always with others. Sometimes that keeps you from noticing the details. I was surprised that the hand rails are reclaimed train tracks. Man, that's a lot of steel! 'Maryland 1911' is cast into the tracks which fits with the time Flagler was building his railroad. How cool is that to see steel that's over a hundred years old?!? Yeah, there's some rust, but it looks great. There's a few people out on the bridge and a few boats fishing under us. The current is swift and the water has a lot of sediment in the outgoing tide. A nice German couple is trying to take a selfie and I offer to take a picture for them. Eight pelicans fly by in formation and the gentleman tries to get that on his GoPro. What could possibly go wrong today?
Then it happens. I'm just about half way, and I run into a couple that's obviously in distress. He's speaking a language I've never heard or it's gibberish. It's pretty slurred and I can't make out a single word. I know a little of a lot of languages but this is really weird. The lady is frantic trying to talk to him and her English is perfect. He's sitting awkwardly on the pavement and the railing is supporting him. I approach and ask the lady if something is the matter and she tells me that her husband collapsed, tried to get up and now she can't understand anything he's saying. I ask for his native language and she tells me it's 'American'. They're down visiting from Kentucky.
That's when I realize that this poor guy is suffering some sort of stroke: a brain attack! Part of his brain has just shut down. I tell her to call 911 and what followed wasn't pretty. It's obvious she has no clue where she is and is totally confused by the situation. I gently take the phone from her and talk to the operator. I tell her where we are at, give her the symptoms and that I think it's a stroke. She seemed to know where I was (GPS???), asks me to stay with them and tells me that help is on the way. I give her my phone number just in case this one craps out. Fred (the husband) is trying desperately to get up at this point. I think he has been all along, and that's what he was probably trying to tell us. I crouch down, put my arm under him and pull him up. I doubt if he weighs more than 160. He's reasonably fit and looks to be about 40. He points with his right hand to the end of the bridge and tries to walk. Whoa, he's got no coordination or balance. I'm not sure this is the thing to do, so I humor him and help him to walk. We stagger from time to time, his wife is now crying about his condition, but I'm not going to let him fall. In the next ten to fifteen minutes, we make 50 feet or so. I am drenched in sweat and am glad to see the paramedics. They're off with Fred and Mary and I try to keep pace. We can't. We're too exhausted to even try. The ambulance is gone by the time we make the parking lot and she has calmed down quite a bit. She elects to drive to the Hospital against my judgement. I followed her to be sure she didn't get lost and went with her inside.
That was about four hours ago and my heart is still racing. Whoa! However, there are a number of things that really struck me about the incident.
I've taught a number of First Aid, CPR and even Emergency Wilderness First Aid classes. I've assisted in an accident or two here and there, but I think this was really the very first medical emergency where I was the First Responder. I know I didn't do everything right, but this was anything but a text book emergency. I was way over my head, but I think I'll give myself a passing grade if only because I took the initiative and never lost sight of that. I have no idea what will become of Fred and Mary. I do know that their Keys vacation went to hell in a handbasket and I feel badly for them. I have two friends, Brad Nolan and John Lewis who have suffered strokes and while I felt badly for them, I don't think I understood what happened to them. OK, I still don't have a clue about what they are going through, but I certainly gained a new perspective on it.
So, back to my original question: How prepared are you for a medical emergency? Do you have the training? The mentality? The focus? I'm sure there will be a lot of second guessing what I did and should have done. Some will see me as incompetent while others may see me as a hero. It doesn't matter. What does matter is how prepared you're going to be when something like this happens to you.
It's a gorgeous day here in the Keys. It's mid eighties, the sky is blue, I've been working on my van, sussing out a brake light issue and needed to get some exercise. I hadn't been to Pigeon Key and done the walk on the old seven mile bridge in like forever, so I decide to take the now fixed truck on an hour's drive to just south of Marathon. It's the middle of the afternoon, and did I mention that the Keys are gorgeous this time of year? Considering traffic on this weekday, I'm not the only one who feels that way. Oh, it's not too bad and since I'm already in paradise, there's really no rush.
I found a parking spot, almost the last one, and got my tunes going and hat on. There's a bit of a breeze that will keep me from sweating too badly, but I'm ready for the challenge. It's only 2.2 miles from Marathon to Pigeon Key, and with walking around the Key a bit, I might get five miles in. Perfect. I have been here before, but always with others. Sometimes that keeps you from noticing the details. I was surprised that the hand rails are reclaimed train tracks. Man, that's a lot of steel! 'Maryland 1911' is cast into the tracks which fits with the time Flagler was building his railroad. How cool is that to see steel that's over a hundred years old?!? Yeah, there's some rust, but it looks great. There's a few people out on the bridge and a few boats fishing under us. The current is swift and the water has a lot of sediment in the outgoing tide. A nice German couple is trying to take a selfie and I offer to take a picture for them. Eight pelicans fly by in formation and the gentleman tries to get that on his GoPro. What could possibly go wrong today?
Then it happens. I'm just about half way, and I run into a couple that's obviously in distress. He's speaking a language I've never heard or it's gibberish. It's pretty slurred and I can't make out a single word. I know a little of a lot of languages but this is really weird. The lady is frantic trying to talk to him and her English is perfect. He's sitting awkwardly on the pavement and the railing is supporting him. I approach and ask the lady if something is the matter and she tells me that her husband collapsed, tried to get up and now she can't understand anything he's saying. I ask for his native language and she tells me it's 'American'. They're down visiting from Kentucky.
That's when I realize that this poor guy is suffering some sort of stroke: a brain attack! Part of his brain has just shut down. I tell her to call 911 and what followed wasn't pretty. It's obvious she has no clue where she is and is totally confused by the situation. I gently take the phone from her and talk to the operator. I tell her where we are at, give her the symptoms and that I think it's a stroke. She seemed to know where I was (GPS???), asks me to stay with them and tells me that help is on the way. I give her my phone number just in case this one craps out. Fred (the husband) is trying desperately to get up at this point. I think he has been all along, and that's what he was probably trying to tell us. I crouch down, put my arm under him and pull him up. I doubt if he weighs more than 160. He's reasonably fit and looks to be about 40. He points with his right hand to the end of the bridge and tries to walk. Whoa, he's got no coordination or balance. I'm not sure this is the thing to do, so I humor him and help him to walk. We stagger from time to time, his wife is now crying about his condition, but I'm not going to let him fall. In the next ten to fifteen minutes, we make 50 feet or so. I am drenched in sweat and am glad to see the paramedics. They're off with Fred and Mary and I try to keep pace. We can't. We're too exhausted to even try. The ambulance is gone by the time we make the parking lot and she has calmed down quite a bit. She elects to drive to the Hospital against my judgement. I followed her to be sure she didn't get lost and went with her inside.
That was about four hours ago and my heart is still racing. Whoa! However, there are a number of things that really struck me about the incident.
- I shouldn't have helped the guy walk. The paramedic was a bit distressed about that. I'm not sure why that is, but I'm going to try to find out.
- I was the only one who tried to help. Wow. People passed us both ways and gave us a wide, wide berth. I don't think it's that they didn't care, but they had absolutely no clue that we needed help or how to give it. There were a lot of scared looking people on that bridge and I heard someone say 'I thought there was something wrong' when the medics showed up.
- While I think this was a stroke, it didn't have the textbook symptoms. Yeah, the speech was a bit slurred, but it was more like a charismatic speaking in tongues. The face didn't look paralyzed on one side either. Still, I could tell this was something neurological and that he needed help.
- The wife never thought to initiate EMS. When she did call she had no idea where she was or how to give symptoms. She was truly 'useless' and I think that's a function of shock and not intelligence. I found out later she's a science teacher at a middle school. It's not so much that she panicked but that she went catatonic: dear in the headlights.
- The wife needed almost as much monitoring as the husband. I probably should have recruited someone from the people on the bridge to help me, but I was immersed in looking out for him and her.
- When the caca hits the fan it can be devastatingly quick with no warnings. If this guy had been on scuba at thirty feet he would be dead now.
- Nobody thinks about the rescuer. I had gotten EMS on the way, stayed with the couple, tried to help him walk, followed her to the hospital and into the emergency room. When they took her back, I gave her my card, said goodbye and left. I called Elena on the walk back and about ten minutes later I felt I was going to hurl. My body shook, I had to turn off the AC, and then had to turn it on high. Whatever adrenaline I had been running on ran out on me. I felt kind of fragile as I drove back home for at least twenty minutes or so.
I've taught a number of First Aid, CPR and even Emergency Wilderness First Aid classes. I've assisted in an accident or two here and there, but I think this was really the very first medical emergency where I was the First Responder. I know I didn't do everything right, but this was anything but a text book emergency. I was way over my head, but I think I'll give myself a passing grade if only because I took the initiative and never lost sight of that. I have no idea what will become of Fred and Mary. I do know that their Keys vacation went to hell in a handbasket and I feel badly for them. I have two friends, Brad Nolan and John Lewis who have suffered strokes and while I felt badly for them, I don't think I understood what happened to them. OK, I still don't have a clue about what they are going through, but I certainly gained a new perspective on it.
So, back to my original question: How prepared are you for a medical emergency? Do you have the training? The mentality? The focus? I'm sure there will be a lot of second guessing what I did and should have done. Some will see me as incompetent while others may see me as a hero. It doesn't matter. What does matter is how prepared you're going to be when something like this happens to you.
