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chicago Tom M. and his wife, Janet, walked into the gallery housing Grant Wood’s famous painting American Gothic at the Art Institute of Chicago. The gallery was crowded, as usual. Tom and Janet had to work their way over to the painting, and they were gazing at it with admiration when a wave of nausea broke over Tom. Sweating profusely, he looked for a place to sit down, but the few seats in the gallery were already taken. He turned to Janet and motioned toward the gallery’s exit. Janet felt a surge of panic—she had never seen her husband so pale, not to mention dripping in perspiration this way. They walked together toward the door at the other side of the room, but even before they reached the next gallery, Tom slumped onto her shoulder . She could feel that he was still partially supporting his own weight, but a few seconds later that was no longer true. He went completely limp, and before she could call out to the guard at the door, Tom crumpled slowly to the floor as Janet tried to control his fall. The guard saw what was happening, but he didn’t know exactly what he was dealing with. Was this a simple faint? No—the man on the floor was lying too still. Could this be a cardiac arrest, then? No, the guard decided—it must be a seizure. Well, he told himself , at least I won’t have to do CPR. That was a relief, since there was blood on the man’s face—probably from hitting the floor a little too hard. All these thoughts passed rapidly through the guard’s mind as he relayed what he had seen over his radio, first asking for 911 to be called, then saying it wasn’t necessary, then reversing himself and asking again for EMS personnel. While Tom was still lying on the floor, the guard’s request for EMS was being routed 77 five Who Will Live and Who Will Die? from the museum’s switchboard to the police department’s alarm center to the fire department ’s alarm center and then to the fire station. And while Janet and the guard were waiting for the firefighter EMTs to arrive, Tom received no CPR. The time between his collapse and the EMTs’ arrival and application of the automated external defibrillator was fourteen minutes. It took another six minutes for the fire department’s paramedics to arrive and take over the resuscitation. (Even though twenty minutes had now gone by, the actual response time of the fire department was listed on the run report as only six minutes.) Tom received one shock from the AED, but subsequent analyses indicated that no further shocks were necessary. After a total of fifteen minutes at the scene, Tom was lifted onto a stretcher and rushed to Northwestern Memorial Hospital. Physicians in the emergency room determined that Tom was in asystole, and they declared him dead without continuing the resuscitation. SAN DIEGO Usually Lorraine J. loved shopping at Macy’s. She especially liked the bonus Tuesdays, when she could use her Macy’s credit card and receive a 10 percent discount on top of the Macy’s Days 20 percent discount. And there was the 5 percent senior discount, too, not to mention the automatic discount on all the clothing hanging on the clearance rack. It was almost like they were giving stuff away, she liked to say. But on this Tuesday Lorraine was not feeling well, nor had she felt like herself for the past few days. She had noticed increasing fatigue and shortness of breath even when she walked only a short distance. Not being an alarmist, and especially because her doctor had made no adjustments to her medications, Lorraine concluded that what she was feeling must be early symptoms of the flu. Now, already at Macy’s, Lorraine regretted her decision to go shopping. But she wasn’t yet ready to contemplate taking the bus back to her apartment at University House, so she asked the sales clerk if there was a seat nearby—her fatigue was overwhelming. Lorraine sat down on an upholstered chair, sighed deeply, and stopped breathing. The clerk didn’t hear a thud. It was more of a faint whisper as Lorraine slid off the silk upholstery and onto the carpeting. Two security personnel arrived within three minutes of Lorraine’s collapse. One was carrying an automated...

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