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cardiac arrest redmond, washington Peter A. had been doing fine, considering. He and his wife, Joanna, had been enjoying his retirement from Boeing, and they found the suburban community of Redmond, Washington —close to Seattle and its urban attractions, but with the advantage of quiet streets and large lots—perfect for them. Their yard was big enough for Joanna to pursue her hobby of butterfly- and bird-attractive gardening. For Peter, on this afternoon, lifting heavy bags of steer manure for Joanna’s garden had directly triggered another episode of the vague, intermittent ache that he had been experiencing in his upper left arm, mostly when he climbed stairs. This episode, though, was more severe than previous ones, and Peter felt somewhat nauseated. He also felt the ache radiating into the left side of his jaw. But it was his overwhelming sense of fatigue that prompted him to go back inside and lie down on the couch in the living room. One month before, Peter’s doctor had told him that his cholesterol had crept up to the “needing treatment” point, and that his blood glucose now placed him in the prediabetic range. But more disturbing had been his doctor’s concern that the ache in Peter’s left arm might be related to his heart. Peter’s cardiogram had been normal, a result in which he had taken some solace, so he had continued to put off the treadmill test recommended by his doctor. He wanted to believe that the statin medication he had started taking to lower his cholesterol must be working—it certainly cost enough! And though he hadn’t 1 one How We Die Suddenly lost any weight, as his doctor had also recommended, it seemed to him that the ache in his arm had become less frequent. Joanna, from her vantage in the den, saw Peter enter the house, and she knew from his slow gait and the way he half-collapsed into the couch that something was wrong. She rushed to his side and tried to control her panic as she noted his limp body, the pasty coloring on his face, and the bluish cast of his lips. “Peter!” she shouted, shaking him by the shoulders. He didn’t respond. With great presence of mind, Joanna brought the portable phone to Peter’s side as she called 911. “911 operator,” came the voice on the other side of the line. “What are you reporting?” “My husband has collapsed. He’s not moving.” The emergency dispatcher quickly asked Joanna where she was calling from. Thanks to his training, he knew right away that he should send a full medic response, which he accomplished by typing the directions to Peter’s house into his computer console and pressing several buttons on a “tone out” dispatching machine. As he did all this, the dispatcher continued to ask questions. “Is he conscious?” “No,” Joanna replied. “Is he breathing normally?” Joanna looked at her husband. Peter was taking breaths that were more like slow grunts—definitely not normal. She told the dispatcher what she was seeing and hearing. From Joanna’s description, the dispatcher knew that she was reporting agonal respirations —the kind of breathing associated with cardiac arrest, a sign of the brain’s last-gasp effort to send breathing signals to the lungs. He also knew that there was little air moving in or out. “Do you know CPR?” he asked Joanna. “Cardiopulmonary resuscitation?” Joanna did not. “OK,” the dispatcher said. “I’m going to give you some instructions. First, pull on his feet, and drag him onto the floor. Now lift his chin, so his head tilts back. Pinch his nose shut, seal your lips over his, and blow two deep breaths into his lungs, just like you’re blowing up a balloon. Watch his chest rise. Now move your hands to the center of his chest, one hand on top of the other, right between the nipples, and press down firmly, fifteen times. I’ll count for you.1 That’s it. Keep doing it, now. Two more breaths.” In the background, over the phone, the dispatcher heard the Redmond Fire Department ’s sirens, and he told Joanna to open her front door. She did, and she saw the fire department’s emergency medical personnel already running up the driveway, carrying heavy suitcases. It had seemed like an eternity to Joanna, but the two emergency medical technicians, or EMTs, had arrived within...

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