You Only Live Twice

On a cold Minnesota morning, Howard Snitzer collapsed on a sidewalk. Ninety-six minutes later, he still didn't have a heartbeat. Here's how he survived.

By Gary Sledge from Reader's Digest | November 2011

5:03 — 39 minutes left: Two 911 calls are relayed to flight operations at the Mayo Clinic in Rochester: man fallen, cardiac arrest, CPR in progress. The weather has been bad all day and the helicopter grounded. But conditions have improved enough for a crew to chance it.

5:06 — 36 minutes left: Dave Schaller, a Zumbrota medic, is working on Snitzer. “Doing CPR is a very personal, intimate thing,” Schaller explains. “You are right there over a victim, your hands over his heart, your face over his. It’s not easy. Old people are soft. Children are fragile. Sometimes you break ribs in the process. I’ve seen medics cry while working.”

Snitzer’s is an unusual case. “He was a big guy, big chest,” Schaller recalls. “I felt resistance, like pushing on bagpipes or a cushion. But as much as we worked, his heart didn’t come back into rhythm.”

5:20 — 22 minutes left: In Rochester, flight nurse Mary Svoboda climbs into the helicopter Mayo One and takes a seat behind paramedic Bruce Goodman. The flight to Goodhue is 30 miles — 14 minutes — away. Once airborne, the two review the case, concluding that they “will probably not have to transport.” That is, they will not have a living patient to take back.

5:23 — 19 minutes left: Paramedic Tony Korder, from Red Wing, is starving. It is getting late, and he hasn’t eaten in a while. But he puts thoughts of dinner aside and keeps performing CPR until he tires. “Switch me!” he shouts. Another volunteer moves in. “I got it,” he says as he seamlessly replaces Korder. Another man gets ready to spell him. “I’m next,” he says quietly. Without being told, three more line up behind him. Dave Schaller calls up an app on his iPhone that runs a metronome. He sets it for 100 beats per minute to keep the CPR up to speed.

5:28 — 14 minutes left: Twenty minutes earlier, Gary Albers, a Zumbrota EMT and county maintenance worker, was home preparing dinner for his two kids and quizzing them on their day. “‘What did you learn?’ I asked them. ‘Nuthin,’ they said.” Now he is waiting his turn to give Howard Snitzer CPR. In his experience, no one has ever survived in this condition. But that doesn’t stop him from giving Snitzer CPR a total of five times. Whatever the outcome, when he gets home, he won’t tell his family about this case. He and the others consider it a violation of the patient’s privacy.

5:32 — 10 minutes left: The grocery store is crowded with EMTs and paramedics as well as curious employees. Since the crew from Mayo will arrive soon, Snitzer is placed on a gurney and wheeled to the more spacious firehouse.

5:34 — 8 minutes left: The chopper touches down in the firehouse parking lot, and the Mayo team takes charge. The first responders have done all the right things: They started CPR only minutes after Snitzer collapsed. They shocked him four times. They used an Ambu bag to provide oxygen — Al Lodermeier is still at it. And the patient is expelling CO2, which means the CPR is working and oxygen is circulating. All good. But they couldn’t insert an air tube into Snitzer’s throat, because his teeth were clenched tight. Svoboda needs to get his jaw loose so Goodman can insert the device. Goodman instructs Schaller to use an electric drill with a needle at its tip to penetrate Snitzer’s shinbone. An IV line is then inserted into the vein-rich tibia to provide a direct route for sedatives and other medications. Some in the room gather around, watching intently and quietly, careful not to interfere.

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