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

When the sedatives take effect and Snitzer’s jaw relaxes, Goodman has the difficult task of fitting a Combitube down the esophagus and into Snitzer’s airway. Once the tubes are inserted, Goodman turns on the oxygen.

5:36 — 6 minutes left: With Snitzer now getting a rich supply of oxygen, Svoboda administers epinephrine followed by amiodarone, a drug that combats rapid, irregular heartbeat. She also gives him another jolt from the defibrillator.

5:37 — 5 minutes left: Snitzer’s heart jumps to rhythmic life. Then, like a car engine flooded with gas, it sputters, hesitates, and stops. Snitzer can’t be taken to Mayo until his heart is beating on its own — there isn’t enough room in the chopper to perform CPR. So the volunteers keep queuing up four at a time to wait their turn. One of them points to Snitzer’s gym attire and deadpans, “That’s what exercise will do to you.”

5:40 — 2 minutes left: Goodman — well aware of the 45-minute CPR limit — calls Mayo for help. An ER physician advises him to give the patient another dose of amiodarone, then shock him once more. If that doesn’t work, he tells Goodman, stop treatment.

5:42: The team gives Snitzer one more dose of amiodarone and another shock to the heart. Once more, he lies still, his heart unable to beat without help.

The score of volunteers say little. The younger volunteers, for whom all of this is still new, hang back, nervously shuffling around, massaging the cramps out of their hands — whatever they can do to keep themselves occupied. One man is visibly upset. A close relative has just died of a heart attack, and this is all too soon for him.

The 5:42 deadline has come and gone. Kneeling by Snitzer’s head, Goodman asks aloud, “Is anyone else uncomfortable walking away from this?” Everyone says yes. Goodman picks up the phone again. There is one last person to reach out to.

5:55 — 13 minutes over: Dr. Roger White, a cardiac arrest specialist at Mayo, is home entertaining a friend when his phone rings. “We can’t get this guy out of V-fib,” Goodman tells him. White listens as Goodman explains the case. He has seen hundreds of similar cases. Most ended badly — in death or in brain damage.

“It sounds like a clot in the LAD [left anterior descending artery],” he says. The clot has stopped blood from being expelled from the left ventricle and has sent the heart into fibrillation. Because of the sudden, massive heart attacks that ensue, LADs are known as widow makers. They’ve brought grief to the wives of novelist John Gregory Dunne and newsman Tim Russert.

An awful situation suddenly gets worse. Such a clot can be removed only in an operating room. But Snitzer can’t be transported until his heart is beating on its own. So they keep working on him.

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