STRAIGHT FROM THE HEART
Former Vancouver Sun columnist Jamie Lamb went into cardiac arrest on May 1, and then again and again, until dedicated medical staff, first at the ER in Delta, and then at Royal Columbian Hospital got his arrhythmia under control by installing a series of
I was washing the dog on Monday, May 1, when I suddenly felt lightheaded and vaguely nauseous, then began to sweat profusely. I sat down on the edge of the tub. I knew something was wrong, but being a guy — and therefore stupid — I sat for five minutes on the bathtub and waited for the feeling to go away. It didn’t.
So I stood up, told my wife my symptoms, and she said she was driving me to emergency at Delta Hospital.
I walked up to the ER registration desk, produced my beat-up 1976 Care Card, recited my symptoms and said, “Something’s wrong.” They took me into the treatment area, put me on a gurney, and a doctor told me I was having a cardiac “event” and that an ambulance had been summoned to take me to Royal Columbian Hospital. I was saying something to my wife when I lost consciousness.
When I came partially awake, I was mistily aware of many people doing things around me, calling out numbers, giving orders, and I seemed to be the focus of their attention. This was, I thought, like a scene out of Knowledge Network’s excellent Emergency Room: Life and Death at VGH. I was also aware that someone was sitting astride my stomach and pounding on my chest.
It was only then that the situation hit me. I’m on a gurney in the ER and they’re pounding on my heart. I’m in trouble.
Then, through the dimness, I heard one very distinct word. “Clear!”
There was an instant of white light and white heat, a thunderous crack — as if a fresh young lightning bolt had leapt into existence in my right ear and bolted through my brain to the left ear — and I felt myself convulsing like a bloated fish on a boat deck. I also heard myself shout, “Je-sus Ch-rist!”
What an odd thing to say, I thought. It’s something my father would have said. Then I realized: They just shocked my heart. I’m in big trouble.
Actually, this had been the third time they’d used a cardiac defibrillator on me, but I didn’t know that then.
All I knew was they’d stabilized me and were putting me on an ambulance gurney, strapping a Lucas machine to my chest — if my heart stopped again, the Lucas would pound my heart/ribs like a piledriver — and were trundling me out to an ambulance for a rush-hour run along the South Perimeter highway to New Westminster and the Royal Columbian Hospital’s cardiac catheter lab.
In the cath lab, they put me on a slab, administered sedation, ran a catheter from the groin up to the heart, and with an X-ray machine swivelling here and there above my chest, installed a stent in my heart. I was awake but it wasn’t painful, and afterward I was wheeled into a ward where I was able to talk to my wife, daughter, son and friends.
Next morning, having had no sleep, I told my daughter I wasn’t feeling well, the same symptoms as the day before. My daughter convinced a nurse I was in trouble and I was sent down to the holding area in the cath lab while my family waited outside. Just as I was being wheeled into the operating area, I said, “I think it’s happening aga …” and promptly went into cardiac arrest. With the exception of one moment — and this would be the single most frightening moment in my life — I was unaware of anything for the next 20 hours, unaware I was repeatedly arresting and prompting “code blue” alerts, unaware that multiple cardiac surgeons and nurses and technicians were inserting more stents and attempting to rein in and stabilize my heart’s wildly erratic electrical rhythms.
The “frightening moment” is indescribable, but I can outline its basic emotional and visual content. I heard medical voices in the dark and heard the word “intubate” and I know now this was when they were putting in a breathing tube and placing me on a ventilator. At the time it was happening, the sensation was as if I had been hung upside down in complete blackness, unable to draw a good breath, unable to talk or scream no matter how hard I tried. The frustration was overwhelming. In that complete blackness, shiny black tiles began to fall past me. Think of glossy domino tiles, but instead of white dots on the tiles these had glowing white words, phrases and sentences on them. They were all falling away from me in vertical columns. Dozens of columns. Hundreds of columns. All of the words burning in intense electrical whiteness against a liquid darkness, as vivid as any James Cameron hi-def, 3-D, hyper-real visual effect.
These were my words, my phrases, my sentences, and I knew I’d never get to say or write them if I didn’t fight for them. There were things I had to say to my wife and daughter and son, and to my friends. Before he died, my father said a few words to me that meant the world to me, and I’d be damned if I was going to nonchalantly die of some heart ailment without telling my family and friends a few important words that meant something to me and, hopefully, to them.
I woke up in the ICU, was transferred to a room with pressure cuff and external pacemaker and enough leads and IVs to ensure I couldn’t sleep a moment.
But here’s what I knew. I knew I was one of the luckiest people in the country. Each time my heart stopped, I was in a place where they could do something about it — the small Delta Hospital ER geared to stabilize you and get you to where you need to be for specialized work, and Royal Columbian’s cardiac catheter lab, one of the places to be if your heart is failing you.
One week after my heart first stopped, they wheeled me down to the operating theatre — the last operation of the day in a busy OR — to install a pacemaker. Sedated but wide awake, I was aware they were carving out a little pouch in my upper chest to implant a watchsized device and its attendant leads into the heart when the monitors started making funny noises and a voice said, “No, no, no, no …” and I felt myself arresting again. The surgical team scrambled to attach defibrillator pads, the anesthesiologist quickly upped the sedation — including a hit of nitrous oxide — and they zapped me.
“Sorry about that, Mr. Lamb,” somebody said.
“Hey, I’ve been shocked by tougher guys than you over at Delta Hospital,” I replied. Not a perfect line, but not bad under the circumstances. I told the night nurse about it, and she laughed.
Next morning, the day I was due to be discharged, a different cardiac doctor was on the morning rounds and mentioned he’d heard I’d made a joke about my heart failing during the pacemaker procedure. I told him about it, he made a call to the surgeon who’d installed the pacemaker, then returned saying he couldn’t in good conscience discharge me yet. He wanted to get me into the hospital’s cardiac electrophysiology lab before shipping me home.
Two days later, I was on the table in the cardiac electrophysiology lab, surrounded by a young and confident team who were going to “tickle” my heart to find the electrical problem that was causing me to arrest every time I found myself on a gurney or operating table. Took them eight minutes to find it, and I was in and out of cardiac arrest in a defibrillator’s heartbeat.
Two days after that I was wheeled back into the OR where they removed the pacemaker and installed a larger device — about the size of a deck of cards that’s been cut in half — that combines cardiac resynchronization with an internal defibrillator.
There was an instant of white light and white heat, a thunderous crack — as if a fresh young lightning bolt had leapt into existence in my right ear and bolted through my brain to the left ear — and I felt myself convulsing like a bloated fish on a boat deck.
I was discharged the next day. So what have I learned that I can pass on to you?
Couple of things.
Our health authorities tend to take a bad rap, particularly Fraser Health with its burgeoning population that forever drives a need for more facilities and more staff.
It’ll never be perfect or even sufficient to what we demand, but I’m here to say the system works.
You probably know someone who works in some capacity in some hospital but you don’t really know what they do there.
That’s because you have to be in some degree of medical distress to find out what they actually do.
I spent 13 days on N2, a cardiac floor at Royal Columbian, and I can say with confidence that the health system has changed radically in my lifetime and pretty much all of it for the better.
Everyone works in teams now, across age and race and old medical silos, and it’s a vast improvement over 20 or 30 years ago.
Doctors, nurses, techs, food and janitorial staff, without exception, they were friendly, efficient, and all-around great. (And while I didn’t get anybody’s name in the Delta ER, I’m compelled to say that RCH nurses Angela and Jennifer and Hyone and Tara and Lucas and Jas and Gavin and Edna and Serena, and doctors Leung and LeMaitre and Amin and Chan and Epstein and Latham and Karim and a bushel of others worked patiently to ensure I remained on the top side of my beloved B.C. soil.) Our health system — in this province, in this country — is terrific.
Also, all the trauma brought my family closer together.
I wouldn’t wish any of it on you or yours — way too emotional, way too frightening — but there’s part of me that thinks it’s one of the best things to ever happen to me.
Finally, and most important, never wait to tell the people you love — family, friends, neighbours — how much they mean to you.
Don’t sleepwalk out of your life without discovering and acknowledging those who make it worth living.
Live long and prosper.