Emergencies happen anywhere, anytime, and sometimes, medical professionals find themselves in situations where they are the only ones who can help. Is There a Doctor in the House? is a Medscape Medical News series telling these stories.
It was my first night off after 12 days. It was a Friday night, and I went to a bar in Naples to get a beer with some friends. As it turned out, it wasn't a night off after all.
As soon as we got inside, we heard over the speaker that they needed medical personnel and to please go to the left side of the bar. I thought it would be syncope or something like that.
I went over there and saw a woman holding up a man. He was basically leaning all over her. The light was low, and the music was pounding. I started to assess him and tried to get him to answer me. No response. I checked for pulses — nothing.
Now, I'm in a bar, right? It's a cardiac arrest. The first thing you think is overdose or alcohol. I asked the woman if the man was doing any drugs. She said she didn't know. Turns out they were both employees. He was a bouncer and a DJ.
The woman helped me lower him to the floor. I checked again for a pulse. Still nothing. I said, "Call 911," and started compressions.
The difficult part was the place was completely dark. I knew where his body was on the floor. I could see his chest. But I couldn't see his face at all.
It was also extremely loud with the music thumping. After a while, they finally shut it off.
Pretty soon, the security personnel from the bar brought me an automated external defibrillator, and it showed the man was having V-fib arrest. I shocked him. Still no pulse. I continued with cardiopulmonary resuscitation (CPR).
I hadn't noticed, but lots of people were crowding around us. Somebody came up and said, "He's my friend. He has a 9-year-old daughter. He can't die. Let me help with the compressions." I was like, "Go for it."
The guy started kind of pushing on the man's abdomen. He had no idea how to do compressions. I said, "Okay, let me take over again."
Out of the crowd, nobody else volunteered to help. No one asked me, "Hey, what can I do?" Meanwhile, I found out later that someone was filming the whole thing on their phone.
But what the guy said about the man's young daughter stayed in my brain. I thought, we need to keep going.
I did more compressions and shocked him again. Still no pulse. At that point, the police and emergency medical services showed up. They checked, nothing had changed, so they got him into the ambulance.
I asked one of the paramedics, "Where are you taking him? I can call ahead."
But he said, "That's HIPAA. We can't tell you." They also wouldn't let me go with him in the ambulance.
"I have an active Florida license, and I work in the ICU [intensive care unit]," I said.
"No, we need to follow our protocol," he replied.
I understood that, but I just wanted to help.
It was around 10:30 PM by then, and I was drenched in sweat. I had to go home. The first thing I did after taking a shower was open the computer and check my system. I needed to find out what happened to the guy.
I was looking for admissions, and I didn't see him. I called the main hospital downtown and the one in North Naples. I couldn't find him anywhere. I stayed up until almost 1:00 AM checking for his name. At that point I thought, okay, maybe he died.
The next night, Saturday, I was home and got a call from one of my colleagues. "Hey, were you in a bar yesterday? Did you do CPR on somebody?"
"How did you know?" I said.
He said the paramedics had described me — "a tall doctor with glasses who was a nice guy." It was funny that he knew that was me.
He told me, "The guy's alive. He's sick and needs to be put on dialysis, but he's alive."
Apparently, the guy had gone to the emergency department at North Naples, and the doctors in the emergency room (ER) worked on him for over an hour. They did continuous CPR and shocked him for close to 40 minutes. They finally got his pulse back, and after that, he was transferred to the main hospital ICU. They didn't admit him at the ER, which was why I couldn't find his name.
On Sunday, I was checking my patients' charts for the ICU that coming week. And there he was. I saw his name and the documentation by the ED that CPR was provided by a critical care doctor in the field. He was still alive. That gave me so much joy.
So, the man I had helped became my patient. When I saw him on Monday, he was intubated and needed dialysis. I finally saw his face and thought, Oh, so that's what you look like. I hadn't realized he was only 39 years old.
When he was awake, I explained to him I was the doctor that provided CPR at the bar. He was very grateful, but of course, he didn't remember anything.
Eventually, I met his daughter, and she just said, "Thank you for allowing me to have my dad."
The funny part is that he broke his leg. Well, that's not funny, but no one had any idea how it happened. That was his only complaint. He was asking me, "Doctor, how did you break my leg?"
"Hey, I have no idea how you broke your leg," I replied. "I was trying to save your life."
He was in the hospital for almost a month but made a full recovery. The amazing part: After all the evaluations, he has no neurological deficits. He's back to a normal life now.
They never found a cause for the cardiac arrest. I mean, he had an ejection fraction of 10%. All my money was on something drug related, but that wasn't the case. They'd done a cardiac cut, and there was no obstruction. They couldn't find a reason.
We've become friends. He still works as a DJ at the bar. He changed his name to "DJ the Survivor" or something like that.
Sometimes, he'll text me: "Doctor, what are you doing? You want to come down to the bar?"
I'm like, "No. I don't."
It's been more than a year, but I remember every detail. When you go into medicine, you dream that one day you'll be able to say, "I saved somebody."
He texted me a year later and told me he's celebrating two birthdays now. He said, "I'm turning 1 year old today!"
I think about the value of life. How we can take it for granted. We think, I'm young, nothing is going to happen to me. But this guy was 39. He went to work and died that night.
I was able to help bring him back. That makes me thankful for every day.
Jose Valle Giler, MD, is a pulmonary, critical care, and sleep medicine physician at NCH Healthcare System in Naples, Florida.
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