Professor Wilson takes us through the inception of the platform as a way to reduce deaths from cardiac arrest and it’s take-up by many across the UK and further afield. The platform has gained additional services and responsibilities and is being used to manage the NHS Coronavirus Volunteer responders programme.
In just a few years the GoodSAM team have built an enviable platform and reputation and Professor Wilson takes us through what it can do to help those in cardiac arrest and beyond.
In episode #49, Paul talks to son and lifesaver Mark Holt about his father’s cardiac arrest in a remote Lake District pub. Mark takes us through the event that occurred soon after his seemingly fit and healthy father had completed a run and a walk up the Old Man of Coniston.
Mark talks about his work as a carer and how the experience of doing CPR in a medical environment differs from doing it on a family member far away from a hospital. He talks about how it has affected him and his family, his dad’s recovery and how a previous stranger’s cardiac arrest effectively saved his dad’s life.
On Sunday 16th March 2008 my heart stopped, this isn’t a romantic story of where I fall in or fall out of love. On this day the hardest working muscle in my body suddenly stopped working, I suffered a cardiac arrest.
We all live life a little blindly, we learn from an early age about death, but for many years we’re shielded from it by our parents, then when we do understand it, we don’t talk about it. We accept that death will happen to ourselves one day, but that day won’t come for a long time so why pursue it?
Our first experience of death for some can be the death of a family pet, some parents may purposely buy a pet with a short life span, for example, a hamster, a rabbit. For the child to grow a bond with the animal for well known in a couple of years that pet will get sick and die, then you can introduce your child to life and death. You can explain that it happens to all beings, we all die and this pain and sense of loss your feeling will dissipate in time but your memories never die. (That too can be a lie!) We can’t control death, even when we put plans in places it sometimes can bite you in the ass before you can say boo to a goose or bury your cat at the Pet Sematary.
I had a different introduction to death, it was through the world of horror movies from the 80s, I watched my first horror film at the age of six, blame it on bad parenting if you must. I wouldn’t go to sleep, my parents tried with all their might, they weren’t going to win this fight, so my dad caved in. He sat me down and explained to me that all this is make-believe it is not real, with that said my dad popped the VHS tape of Friday 13th into the VCR and pushed play “Kill her mommy, kill her.”
Death is not make-belief, death is unforgiving, in the summer of 1992 my grandad passed away after losing his fight with cancer. I remember coming downstairs, my mum was on the phone sitting on the third step from the bottom, she broke down in tears with the handset resting between her head and shoulder, I don’t think she heard me coming down the stairs.
When she realised I was behind her, she wiped her eyes with the back of her sleeve and apologised. I never understand why adults have to apologise to a child for crying in front of them. She then went on to tell me that grandad had passed away, she explained to me that she didn’t know how she was going to tell dad. I didn’t know at the time that my father wasn’t good at handling grief, a couple of years before I was born one of my dad brothers committed suicide after being jilted, this sent my dad off the rails. She was worried that losing his father would bring on a repeat performance and this would be the final straw that broke the camel’s back.
Surprisingly my dad coped well with the news, he did break down a couple of times that I remember, mum also made sure that me and my brother were out playing when she broke the news to him. My dad coped because he had mentally preparing himself for this moment, when you find out someone got an illness you start preparing yourself, you get to say goodbye and bury the hatchet so to speak. With death there is the aftermath, the bringing people together, the fallouts that can follow and the grief, it is a process that we all have to navigate at some point in our lives.
So back to Sunday 16th March 2008, I entered the Hastings Half marathon, the year before I completed the London Marathon, and I vowed never to run again. A few months later an opportunity for the New York Marathon 2008 came through in an email from CF Trust (Cystic Fibrosis), then the itch to run returned before I knew it I had applied and secured my place for New York. I made an oath to myself to take training for the marathon seriously, so I rejoined the job shop running group that ran every Sunday and decided that Hastings Half Marathon would also be good preparation for the marathon. I nearly didn’t run Hastings, I had a cold the week before and I wasn’t feeling the run, but then my manager put me in to work on that Sunday. I had requested to have that day off for the half marathon, so I refused to work, my decision was made.
On that Sunday I caught a lift to Hastings with another runner I met through Brighton Jog Shop run group that was also running that day. I’d never been to Hastings before, it was a warm day, overhead gloomy clouds carrying a mist of fine rain the sky, the perfect weather for a run and not a pre-warning of what was to come!
I remember having to pee on the beach as the portable toilets queue was long and I didn’t want to miss the start. At the starting block, I chatted with fellow runners, then I started to construct a message that I would send to a group of friends. I won’t lie, I’m an attention seeker, I wanted people to know that I was running and when I finished the half marathon I wanted to see who responded. The message was the following…
“Hey Everyone I’m running Hastings half marathon today. It starts at 10.30 and I’m feeling nervous. Not good, something not right so wish me luck”
One hour and forty-nine minutes later I collapsed at the finish line.
I don’t remember running that day.
I don’t remember the crowds.
I don’t remember the St John Ambulance doing compressions on my chest, being taken away from the crowds to a tent to be given defibrillation treatment.
I don’t remember the blue and twos of the ambulance driving me away to my isolation.
I don’t remember yanking out the endotracheal tube.
Through all this mentally I was asleep, and then I was put to sleep.
Whilst I was fighting for my life in an ambulance, wheels were set in motions, my emergency contact on the back of my race number was contacted. My sister Debbie was my emergency contact because she is level headed and would know what to do, thankfully on that Sunday, she was visiting my parents. They were in the pub when she got the call, the police informed my sister what happened to me and gave the stark warning by the time that they would get there I could be gone. I am unable to fathom how my sister drove the 1hr 33 minutes to Conquest Hospital with my family in the back of the car, discussions of my funeral were made on that journey, followed by stony silence.
As I write this I get cold at this notion, that those discussions were made, for a moment I was considered already dead.
The police would make their rounds, first visiting my home, my housemates were informed and the police searched my room. They searched my room because they hoped to find a reason to why a 26-year-old had a cardiac arrest if there was a reason to be found.
With no reason found, they escorted my housemates to the hospital blues and twos all the way to Hastings from Brighton. Officers visited my place of work to inform my manager what had happened to me; my manager joked to me at a later date that he thought I’d been arrested when they first approached him.
As I laid in ICU (intensive care unit) for a couple of days, my family would surround my bed, willing me to pull through. Questions were asked, family history discussed, no answers could be given, plenty sleepless nights for all concerned. Warnings were made that I could suffer some form of brain damage, my brain was starved of oxygen for over 7 minutes. If it were not for the fast thinking actions of St John Ambulance delivering vital defibrillation treatment I’d not here.
On Tuesday 18th March specialist decided it was time to bring me out of my medically induced coma and put me on the cardiac ward, my home for the next couple of weeks. Tuesday was a dreamy haze for me as I faded in and out of consciousness. I remember seeing my parents sitting at my bedside, I was wearing a hospital gown that barely covered my modesty. In this druggy haze, I remember this bothering me more than anything, I remember pulling down on my hospital gown several times, I didn’t want people to see my junk especially my parents. That evening sleep was restless, I remember I kept thinking I was in one of those horror movies that I love to watch, a nurse from New Nightmare, surely “One, Two, Freddy coming for you!”
Wednesday 19th March fully awake from my induced coma, welcomed into my New Nightmare with Sweep (cuddly toy) beside me. Having Sweep reassured me that I was alive, Sweep a childhood toy that I have cuddled every night throughout my life and my sister had her senses to get him for when I woke. I was fully aware that I was in a hospital, I had all these wires attached to me, beeping monitors, nasal cannula, catheters in my arm and an intravenous drip to treat ailment (chest infection) brought on by the cardiac arrest.
When I switched on my mobile messages wouldn’t stop coming through, finally getting that attention that I craved before starting the half marathon. Once awake my parents went home, knowing that their baby boy alive to live to tell his tale; I wouldn’t see them again throughout my hospital stay. My sister would visit when she could, though living in Kent and, life goes on even if you nearly lose your brother.
One of the first things I remember doing is calling my place of work to make sure that my manager had sent payroll; payroll was one of my responsibilities. He reassured me that he had sent payroll, that I had nothing to worry about, the company agreed to pay me throughout my recovery. With a million and one worries swimming through my head at least he put one of my worries at ease, still, I didn’t know if I could work again and how far that kindness stretched.
The first few days were a haze of information, it would be explained to me that I had suffered a cardiac arrest and at some point that I would have an operation to have an ICD ((Implantable Cardioverter Defibrillator) implanted in my chest. Before that procedure, they would like to do some investigations on me to understand what happened. They wouldn’t be able to start any investigations until I recovered from my chest infection, so for the time being Hastings would be my home. They handed me pamphlets to read to help me understand what happened, one was happily titled “When a young person dies suddenly”, but I hadn’t died.
People had commented on how I took everything in my stride, how I accepted it, honestly not sure I had, a part of me went into autopilot, happy to be alive, slowly crumbling inside.
Throughout all this time my mind would run through a million and one concerns, would I be able to run again?
Will I be able to work?
What does mean to me going forward?
Will anybody love someone that could suddenly drop dead?
I would question what if in my life, what if I didn’t run the Hastings?
Could I have collapsed on a run on my own?
Why did this happen on that Sunday?
How did my body know to get to the finish line where people were there to save me?
It makes you question everything about life and death.
Questions that nobody can give the answer and sometimes it’s easier not to explore ‘cause otherwise you’d go crazy.
I’d easily get upset, being attached to all these monitors, my independence stripped relying on the nurse’s call button if I required anything. I’d get upset if I needed the toilet and the commode was rolled over to me, especially because nurse Ratchet was happy to unplug me from all these monitors and let me use the toilet on the ward, so why couldn’t nurse Wilkes? Why do I need to leave my bed? She not keeping me here against my will with a sledgehammer to the ankles.
Needing a pee, a pulp disposable urine bottle was brought over, curtains drawn. Sometimes they would wait for you to finish your business, other times they would leave you and not return which felt like an entirety with your business stewing in your private enclosure.
Privacy a luxury, being on a ward curtain closed meant a few things, toilet, sponge bath, or the nurse doing their rounds. Forget self relieving, my little friend popped up a couple of times, yet there was nowhere for him to go, even with the curtains closed, the sounds of the ward are a boner killer.
The nurses would do their rounds every 4 hours like clockwork to take your vitals blood pressure, ECG(electrocardiogram), and sometimes they would take your blood for good measure. On one of these occasions when putting in a new catheter a nurse severed a nerve in my hand, which resulted in pins and needles in the palm of the right hand to this day! Taking vitals were like a ritual for some nurses, some would wake you up in the night to take your vitals, others would let this sleeping beauty sleep.
Being in Hastings I was too far for many people to visit.
Yes, I had other bedfellows, being in a cardiac ward these people were all from a different generation. 12 years on these bedfellows have all surely now moved on! I remember one of my bedfellows passed away next to me one night, I asked the nurse the following day what happened, she said he was moved to another ward, the noises from behind the curtain told me a different story. I befriended a couple of people on the ward, I remember going over to lady that had a room just off the ward, we would play cards and drink tea, these were the things that broke up the days for me.
I became a minor celebrity on the ward, the BBC South East News came to interview me from the bed. That evening the nurses on the ward rolled the TV down to the ward so we all could watch the news. I remember the next day a kid came to visit his grandad on the ward and was pointing at me because he’d seen me on the TV. I also made the front cover of the Hastings Observer with my finishing brass medal looking gravely ill; I keep a copy of this edition in my memory box at home.
Back then wi-fi in hospitals wasn’t a thing, Debbie purchased me a dongle so I could go online. I had a bucket load of DVDs including my favoured Friday 13th collection brought to me from home that I watched on my laptop, “Kill her mommy, kill her”.
Lights out on the ward at 10 pm so having to be considerate of others, yes I would plug in my headphone, still fully aware of where I am at. During this time I had to keep myself busy, I posted blogs online telling people what had happened to me. A mother contacted me after reading one of my blogs, she told me about the charity C-R-Y (Cardiac Risk in the Young). Here I am 26 in hospital after having a cardiac arrest and nobody was telling me about the support out there.
I called people, I made an effort to talk to people, I reached out, wanting to be heard.
You learn very quickly during this time the people that matter, or at least you thought that mattered.
I hated missing out on things, I had tickets to the X-Factor tour that I had to give away to my brother, I missed out on watching Wrestlemania with my friend Nick, Easter holidays, life outside this building.
It would be two weeks before respite would come, finally recovered from my chest infection, and the Easter holidays had come and gone, investigations would begin. To get to the bottom of why I had a cardiac arrest, a day trip to the Royal Brompton Hospital in London via a private ambulance was arranged. On the motorway, nurse Ratchet promised that we would stop by a hot dog stand, so I could have a hotdog.
After a couple of weeks of hospital food, that greasy hotdog smothered in ketchup, mustard and onions was like an orgasm in my mouth, small blessings.
At the Royal Brompton the only test that I remember having was an MRI (magnetic resonance image) scan, laying on the bed slowly entering this tube, being told to breathe, hold my breath, as they took scans of my heart. It is very surreal, feels like something out of a scientific film; the technician informed me that I’d fallen asleep.
The next day when back in Hastings I was informed I had a condition called Brugada Syndrome; in the next couple of days, I would finally be transferred to Royal Sussex County hospital to the ICD implanted.
Brugada Syndrome at the time and still is a relatively new disease, founded in 1992 by Spanish cardiologist Pedro Brugada and Josep Brugada who reported it as a distinct clinical syndrome. The genetic basis of Brugada Syndrome was established by Ramon Brugada in 1998. My cardiologist explained that they are still learning about this condition and that they will be learning from people like me. The normal heart has four chambers. The two upper chambers are known as the atria and the two lower chambers are known as the ventricles. Electrical impulses cause the heart to beat. In individuals with Brugada syndrome, the electrical impulses between the ventricles become uncoordinated (ventricular fibrillation) resulting in decreased blood flow. Decreased blood flow to the brain and heart may result in fainting or sudden death.
Brugada syndrome occurs worldwide but is seen more frequently in individuals of Southeast Asia and Japan. Families would usually find out about Brugada after a sudden death in the family, Brugada usually presents itself whilst at rest/ sleeping. I was an interesting case because I hadn’t a cardiac arrest whilst sleeping/ at rest and I wasn’t Asian, for many years I would question my diagnosis.
Sunday 6th April I left Hastings at 8 am for Brighton via another private ambulance. To be back in Brighton was a relief. There was no time to rest whilst in Brighton, my procedure was booked for the following morning. A doctor named Paddy came around, he checked my breathing, and talked me through the procedure, trying to put me at ease. Then he brandished these consent forms for this procedure I had to sign, one bullet point mentioned death. Death wasn’t likely but it was there to sign, like a bullet to the heart. I would have a couple of visitors throughout the day, they all became a distance blur has death loomed over me. I came this far, yet the fear of death and not waking up from this procedure was eating me up like cancer from the inside. I called my parents that evening, I’d hope they would put me at ease, my dad cries and the tumour feeds itself.
Surprisingly that evening I was able to sleep, waking up at 5.30 am so I could have some breakfast, it would be the only food allowed before the operation. Once digested I put my head back down, I didn’t want to be awake, that would leave me more time to stew. At 8 am I would finally rise from my slumber, throughout the morning nurses and doctors came in and check on me, getting me ready for my procedure. I would shower, dried myself off and then I showered again, I felt uncomfortable in my own skin. I tried to call my parents, no answer, maybe that was a good thing, but it wasn’t I was going out of my mind waiting for my time to come.
The porter arrived to take me down to the operating theatre, this was it and I wasn’t ready, I don’t want to die and I didn’t get to say goodbye to my parents. Once in the operating theatre, I had to get onto the operating table, the room was clean and clinical.
A solitary tear rolled down my cheek, fear escaping my tear duct, a nurse tried to reassure me that it was going to be alright. My memories of this procedure are vague, slightly aware because I was only given a local anesthetic combined with sedation. I remember seeing a monitor and on that monitor, I could see a beating heart, my heart. Seeing these two wires approaching, then entering the chambers of the heart on the screen.
Then I find myself awake in my room, it is 4 pm and I wasn’t dead, and maybe for the first time in three weeks, I believed that I will be alright.
My room was full of people, I planned for many to visit because after all these weeks I was starved for company and maybe subconsciously after my operation, I didn’t want to be left alone with my thoughts.
Maybe having so many people visit I overwhelmed myself, after having an X-ray to check the placing of my new gadget, I would throw up my guts in front of a couple of my guests.
That evening I was left with thoughts, it had been over three weeks since my heart stopped; the very next morning I was released from the hospital to start my new chapter!