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A Piece of My Mind
September 27, 2000

Twenty Lessons From the Heart of Medicine

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Editor.

JAMA. 2000;284(12):1486-1487. doi:10.1001/jama.284.12.1486

I am a medical geneticist. Both of my grandfathers died in their early 50s of apparent myocardial infarctions. Numerous other relatives have had heart disease. On September 20, 1999, I stopped worrying about my family history and started living it.

Although in the previous two days I had run 30 miles training for a marathon, I felt so good that I ran eight more before going to bed. An hour later my sitting up and coughing awakened my wife, Brigid. I mumbled, even more incoherently than usual, and collapsed back to horizontal. Then I was silent. Profoundly silent. Like any spouse, Brigid was initially angry for being awakened. But the silence concerned her. To deal with both her anger and her concern, she yanked the bedclothes off me. When that failed to elicit my normal squawking, she switched on the light and observed that I was motionless, breathless, and pulseless, with eyes open and fixed. Brigid, an experienced volunteer EMT, having determined unresponsiveness, cool-headedly proceeded to the next CPR step, activating the emergency response system. She called 911, while attempting to rouse me with a mixture of reprimands ("Where do you think you're going?!"), invocations of saints, and physical assault. She was about to throw me to the floor to administer chest compressions when, after being out 90 seconds, I came around. Lesson 1: Never sleep with anyone who doesn't know CPR.

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