The resurrection of Tayyab Jafar
This Queen’s student froze to death on a Kingston pier. Here’s how he came back to life.
KINGSTON, ONT.— Tayyab Jafar walks through a gruel of slush coating the wide pier behind a King St. public works building. He stops and points to the place he died.
“Right about here,” says the fourth-year Queen’s University student from Oakville.
The spot is at the pier’s edge. Near a warning in long faded letters stencilled across the ground: “No Diving.”
He is silent for a moment. Wintry drizzle falls. Lake Ontario’s steel-grey waters slap below. The sky’s wet gloom frames Jafar’s slender figure.
The 22-year-old, shrugging, hands in pockets, says: “That happened.”
But what happened was far from ordinary. Jafar’s story is one of resurrection; how tenacious medical teams brought a frozen man back to life.
A year ago, cloaked in the darkness of a frigid January morning, this is where Jafar chose to end his life. Two days before his 21st birthday, Jafar was found at early light — shoes off, coat over his face, an empty prescription sedative bottle nearby — without vital signs.
“Vital signs absent means dead,” says Julie Socha, one of four Frontenac County paramedics who rushed to the scene.
Engaging and intelligent, Jafar had been studying physics courses at Queen’s in hopes of getting into engineering. That plan began to unravel just weeks before he quietly left the off-campus house he rented with friends. He’d placed a goodbye note on his desk and, a stickler for details, banking instructions so his housemates wouldn’t miss a bill payment. Then he walked 10 minutes to the pier. On that sub-zero morning, Jafar lay in a snow bank. His body was starting to freeze. His core temperature would later be recorded at 20.8 C — about 16 degrees below normal. Hypothermia occurs when a person’s core temperature dips below 35 C, a condition often caused by exposure to cold weather or water immersion.
The death appeared to be an intentional overdose to the paramedics, who promptly initiated CPR.
“I was like, ‘S---, he’s dead.’ ” You could tell.” ROOMMATE ALEX REID WHO FOUND JAFAR’S BODY
But how the young man died was a medical puzzle for Kingston General Hospital emergency teams to solve:
Did Jafar die from an overdose, then get cold? Or did the drugs only render him unconscious, then he died because he became so cold?
“There’s actually a difference,” says Kingston General cardiac surgeon Andrew Hamilton.
The faintest hope of resuscitation flickered only if Jafar had become profoundly hypothermic after his overdose attempt. The key was determining that sequence: a seemingly impossible task on a very cold body.
Of all the critical work done at Kingston General to return Jafar from the dead — an hour of CPR at110 chest compressions a minute, streams of heated saline flooding his system, multiple doses of epinephrine, a transfusion of more than 100 units of blood products culled from 134 individual donors, machines to warm and oxygenate his cooled blood and a 200-joule jolt to his chest — it was a simple blood test that would give Jafar a chance at survival.
Even so, odds were bleak. At best. Texting goodbye Six Queen’s students, all friends, lived in the house on Nelson St., a short walk from campus.
Alex Reid woke up in his second-floor bedroom just before 7 a.m. on Jan. 15, 2016. It was a Friday. Almost the weekend.
The biology major reached for his cell phone. He saw texts and Facebook messages that filled him with dread. Sorry I couldn’t be stronger. Love you. Good bye. They were from his housemate, Tayyab Jafar. Jafar had been suicidal before. Reid had talked him through moments of distress. Talked him off the top of campus buildings. Talked him into visiting Kingston General for mental health attention in second year.
Jafar had been seeing a university psychiatrist since first year, initially to regulate prescription medications for two disorders: OCD and ADHD, diagnosed during high school. He says he also had “a few issues with depression.” In fall 2015, sleeplessness became new trouble when his usual nighttime medication, mirtazapine, was no longer effective.
“In my fugue state, I’d just stare,” recalls Jafar, who’d been working with his psychiatrist and was still attending classes. “I didn’t care. I’m not talking much. I’m reserved, socially excluded.”
Jafar’s housemates — young men busy with classes and assignments — didn’t realize how desperate their friend had become. Jafar says lack of sleep hurt his marks and, ultimately, his engineering aspirations. He’d been rejected from engineering as a freshman despite an 87-per-cent high school average and was hoping to reapply.
When Reid saw Jafar’s notes, sent about 3 a.m., he panicked.
“Right away, you could tell that somebody was saying goodbye.”
Reid checked Jafar’s bedroom. Empty. He ran down the stairs to look for Jafar’s jacket and shoes. Gone. He called Jafar’s phone; no answer. Reid ran to campus to search. “I knew a few places to look,” the 21-year-old says. Reid scanned the tops of school buildings. Then he checked the ground below. Nothing.
He called 911 to report that a missing friend was suicidal. The Kingston police began to hunt, too. Reid considered one last place: the pier. “I thought that if you were going to kill yourself in Kingston, that’s where you’d go. It’s a beautiful spot — a fantastic place to end it,” he says, laughing grimly.
Running across King St. to the back of the public works building and up a slight rise to the pier, Reid spotted a black bump. It was Jafar’s jacket. He saw an empty beer can. Close to the jacket was his friend. Lying face up in the snow.
“I was like, ‘S---, he’s dead.’ ” You could tell,” Reid says. He noted Jafar was “as cold as a rock” and had coughed up blood. The empty prescription bottle was nearby.
Reid called 911 again, then “I was sitting there, trying to wake Tayyab up.”
“Shaking him, giving him the sternum rub for a while to see if he was conscious, checking for breath, checking for a pulse. Couldn’t find anything,” he says.
Reid threw Jafar’s abandoned jacket over him. A fright- ened, futile effort to warm his friend.
The police arrived within a minute, paramedics seconds behind. It was close to 8 a.m. — about five hours after Jafar had sent Reid the goodbye texts.
“You can still have a beating heart as low as 20 (C). It’s possible.” GORDON GIESBRECHT A THERMOPHYSIOLOGIST AT THE UNIVERSITY OF MANITOBA
On the pier In Tayyab Jafar’s body, capillaries had contracted long before Frontenac County paramedic Jonathan Andreozzi put his fingers on the young man’s carotid artery to check for a pulse.
Capillaries form a network of thin blood vessels between small arteries and veins. They allow delivery of oxygen, nutrients and heat to the tissues.
Jafar’s body was trying to retain heat at its core, one of its first protective acts while outside on a morning that, according to paramedics, dipped below -11 C.
“Constriction is at the capillary level,” says international cold-weather expert Gordon Giesbrecht, a thermophysiologist at the University of Manitoba who’s also known as “Professor Popsicle.”
Giesbrecht says once you get cold, “you mount thermoregulatory defences including vasoconstriction (which) decreases capillary blood flow to the skin to decrease heat loss.” Like turning off the valve to a hot-water radiator, the professor says.
Shivering — involving involuntary muscle contractions — is also part of the thermoregulatory process.
“Shivering is muscular energy and we all know that muscular energy produces heat,” Giesbrecht says.
Giesbrecht, who does not know Jafar and was not part of his care, says ingesting drugs and consuming alcohol can affect how a person experiences hypothermia.
Jafar recalls that besides downing a large dose of the powerful sedative chloral hydrate, he took at least “10 different” types of prescription pills that he washed down with three or four beers.
“Those drugs sound like the kind of drugs that would have diminished his shivering capacity,” says Giesbrecht, who’s also director of the university’s Laboratory for Exercise and Environmental Medicine.
“If a friend of similar weight and clothing went out there and sat beside him, this guy (Jafar) would have cooled quicker because A, his shivering response would have been blunted by the drugs and B, he was lying down on the ground and C . . . he took some clothing off.”
Giesbrecht says there are two possibilities why someone in this situation might remove clothes: to hasten suicide, or from “paradoxical undressing.”
Reid recalls Jafar was not wearing his jacket or shoes. The paramedics did not recall if his shoes were on.
“It’s not uncommon that people, when they get close enough to being cold enough to become unconscious, their body plays some tricks on them,” Giesbrecht says.
“They think they might have a feeling of warmth and in a deluded mindset, they think, ‘Oh, I have to take some clothes off,’ and that can range anywhere from just loosening clothing to being completely naked.”
As Jafar’s core temperature plunged, his body was still trying to protect its internal organs and the brain by slowing metabolic activity.
“Cooling protects everything,” Giesbrecht says. “As you cool any tissue, its metabolic requirements decrease so a given amount of oxygen will last longer, and that effect is greater in the brain.”
The heart will stop when it cools and that can occur any time the core temperature drops below 28 C, says Giesbrecht, who has jumped into icy Canadian lakes — sometimes with skis — and rivers to conduct extreme-weather research and promote survival education.
“You can still have a beating heart as low as 20 (C). It’s possible.”
Giesbrecht theorizes that with Jafar’s core close to 21 C, his heart may have arrested around 25 C. Without a pumping heart, there was a finite amount of oxygen in his system. The brain, though extremely sensitive to no or low oxygen, was cooled enough to need less oxygen — but not forever.
“The brain can go longer without oxygen than if (his heart had stopped) at regular body temperature,” Giesbrecht says.
Akey unknown in Jafar’s case: how long had his heart been still? There’s no way to know. It could have been seconds. Or hours.
Jafar’s sister, Rida, a University of Guelph student, calls her big brother’s resuscitation and recovery “a miracle.” Giesbrecht sees it differently. “It’s not miraculous. I’m a Christian and I believe in miracles,” he says.
“Everything that happened can be explained physiologically.”