Thursday, January 21

Cardiac arrest showed me what it feels like to die. How should I live in Life 2.0? | Health


meIt was exactly like a scene from Casualty. An ambulance, the siren sounds, the lights flash, pulls up in the emergency bay of a hospital. Paramedics quickly open the doors and pull out a middle-aged man with an ashen face and barely conscious. Doctors and nurses change it: “By elevator. Ready, sign, get up! “- on a bed, then immediately connect the patient to a medical support: cannulas in the veins, oxygen tubes in the nostrils, and ECG patches on the torso, arms and legs.

The monitors show a pulse of 250 beats per minute and a blood pressure of 40 over 20, a near-terminal case of ventricular tachycardia. The upper and lower chambers of your heart are out of control, increasing your pulse and lowering your blood pressure.

Doctors agree. There is no time to wait. They stick electrodes to their chest, press the defibrillator paddles on top, and order everyone “Clear!” before pressing the button. A 200 joule charge passes through the body in one thousandth of a second. Then, much to the amazement of the doctors, the patient sits up and yells, “That was the most painful thing I’ve ever felt in my life,” before collapsing unconscious and without a pulse. That patient was me.

I had realized that I was dying half an hour before. My heart had gone wild during a kick on Tooting Common, south London. Suddenly I felt tired and asked to go to the goal to rest. Then I broke down. I remember feeling confused to find myself lying on the grass and too weak to move. I could feel my body shutting down like someone was walking down the hallways and flipping the switches – first the right foot, then the left, then the lower right leg, then the lower left, then the thighs. Everything was getting cold, like one of those mortally wounded characters in an old war movie.

“I’m dying,” I thought. “That’s what dying is like.” I was curious, a sense of wonder. To my surprise, the realization was nothing scary. It was almost smooth. That may have been because I didn’t have the energy to panic or maybe my brain instinctively knew that the best thing to do was stay calm. I thought very deliberately about my family and friends and how lucky I was to have so much love in my life. “I want you to tell my girlfriend, my daughters, my sister and my mother that I love them and I am not afraid,” I insisted to a colleague, while they tried to maintain my attention until the ambulance arrived. I silently gave thanks for a wonderful life and smiled at the evening clouds and the leaves of the tree above me. I hadn’t had a drop of morphine yet, but Tooting Common seemed incredibly beautiful to me. He wasn’t eager to die, but he was ready. “Worse ways to do it than to play soccer,” I thought.

My cardiologist later told me that she had been “almost dead” for several minutes. It took two more electric shocks and Qualified and rigorous CPR to bring me back to life. I don’t recall any of that, no pain, no fuss, and certainly no sight of white tunnels or looking down from the ceiling. There was not even darkness or time. There was nothing. And then… then there was something when I regained consciousness, hospital lights, concerned faces staring at me and voices, asking, “How do you feel? What her name? What is your birth date? What happened to you? Do you know how lucky you are to be alive?

I did not do it. Not completely. Not then. I was too tired and my body too full of morphine. My feelings were a mixture of gratitude towards the doctors, concern that my family would be upset, a little fear in case there was more pain and fascination for what had happened.

That night I was surrounded by ping machines in the heart failure ward, feeling a bit groggy but in awe of being alive. The only visible evidence that I had nearly dropped dead was a couple of purple bruises left, I suppose, from the defibrillator, and a large number of tubes and wires on my body. The nurse warned me that I might have suffered some brain damage, so I tested my mental acuity by counting up in prime numbers and seeing how many times I could double the number two before the digits got too long to deal with. I reviewed old memories. Everything seemed fine. This may sound strange. But I felt privileged to have made a journey from which few can return. The journalist in me was intrigued and felt a responsibility to report (which I finally feel ready to do now).

In five days, I returned home, having rested, tested, filled with beta-blockers, and had an ICD implanted, a nifty device that monitors my restless heart and calms the discord between the upper and lower chambers. It can also shock me if I need another. The quality of care was excellent and even more notable for having been provided in the midst of a pandemic. I was even able to request the music that the surgeons played on the speakers in the operating room as they opened me under local anesthesia to insert the ICD. David Bowie is even better on morphine.

Jonathan Watts recovering from his cardiac arrest.
Jonathan Watts recovering from his cardiac arrest. Photography: PR

Later I did some research. The doctor was right: I am very lucky. According to the British Heart Foundation, only one in 10 people in the UK they survive cardiac arrest outside of a hospital. All over the world the odds are closer to one in 100. My cardiologist told me that I would definitely be dead without the defibrillator. Even with him, things can be touched and gone. Unlike television dramas, the chances of preventing death from shock are considerably less than 50:50. Even if cardiac arrest occurs in a hospital, studies suggest there is only a 15% chance of getting out alive.

If the medical staff hadn’t physically pumped my heart, I could now be suffering from neurological problems caused by interrupted blood flow to the brain (a common problem in survivors). In other countries, it could also have ruined me financially. In the United States, treatment for cardiac arrest and ICD surgery can cost more than $ 170,000, and could have billed me the full amount if emergency services had taken me to a hospital outside my insurance network. As it is, according to the NHS, I only had to pay my usual monthly contribution to national insurance.

So my survival is not just luck. It is thanks to a society that still believes in social medicine and invests in coverage for all. Unlike private insurance policies, I don’t have to worry about my contributions going up in the future to cover the outpatient checks and subsidized medications that I will need for the rest of my life. Doctors tell me the prognosis is good, so I hope it will be at some point.

Five months after cardiac arrest, I am very much recovered, walking five miles a day, but still not quite up to speed. I’ll probably never be at the level I was. My heart muscle is strong, but its electrical system is down. Until the cardiologists have identified the cause of the misfire, I will have to exercise at a lower intensity and reduce daily stress. You may need more surgery. I also need to rethink who I am and how I live. The ICD below my collarbone means that I am now part man, part computer, one step closer to singularity. And I take beta blockers every day, which sometimes makes my thinking slow. I appreciate biotechnology and pharmacology more, and I envy those who don’t need to depend on either of them.

It has also given me a good excuse to think about the important things. Where is the boundary between life and death? Did I cross briefly? How do I get the most out of Life 2.0? How do I pay society? I have spent a lot of time reflecting on these questions and reviewing my past. At first this was a mental exercise, then a way to pass the time. In the hospital ward, we were not allowed visits due to Covid restrictions, so on each of the five days, I revisited a different decade of my past, and delved into the close relationships, the wonderful trips and the happy moments. Five months later, I still have great pleasure doing this.

I am also trying to live more in the present. It’s a cliché, but for weeks after discharge I marveled at the simplest things: rain, sparrows, insects, cups, beans, books, talks with family and friends. I vowed that I would never again waste precious time on things I did not fully appreciate.

Those vows are already fading. I’m starting to take old pleasures for granted again and fall into old routines, reviewing Donald Trump’s tweets first thing in the morning, emphasizing little things like how many articles I’ve written and what people think, and important things like the climatic collapse and collapse of nature. The whole world feels stressed, out of place, and needs a hit to re-establish a healthy rhythm.

I certainly don’t want to go back to the way things were before. I want to make the most of this reboot. I haven’t fully figured out how to do it yet, although a perfect start was getting married last month (and refuting my wife’s suspicion that my heart was rebelling against our wedding plans. She’s still a bit upset with me for saying I was ready to go. To die). I guess I’ll be working on the question of how to live a good life until I actually do.

• Jonathan Watts is the Global Environment Editor for The Guardian.

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