Recovery from Simultaneous Stroke and Cardiac Arrest

A health reporter’s non-scientific abstract on what really happened to her boyfriend during the scariest year of her life

Background:
Fifty-nine-year-old Caucasian male collapses without warning on July 26, 2011 at approximately 7 p.m. Central Time. Incident takes place on public street while patient is walking son’s dog, Joanie (as in Joan of Arc). Canine appears to be part Besenji. Unlike pure-bred animals of this species, canine can bark, as evidenced by repeated, vigorous, reciprocal communication with squirrels in subject’s back yard. Later recollections reveal that canine raced to neighbor’s house and vocalized. Neighbor raced to patient, called 911 then administered cardiopulmonary resuscitation (CPR).

Methods:
1. Paramedics and ambulance arrive within minutes. Exact timing unknown, though city government reports that 95.8% of all Priority 1-5 calls are reported on time, exceeding the performance target of 90%. Paramedics exit vehicle, attach defibrillator leads to patient’s now exposed chest, shout “Clear!” to warn any assembled crowd, then administer not one, not two, but three electric shocks before the portable EKG machine spurts out life signs in the form of spike on otherwise flat paper landscape. Patient, still unconscious, is raced by ambulance to nearest hospital.

2. Cardiologist on call places two stents in patient’s “widow maker” artery, then strides to family waiting room, angles himself into too-small plastic chair, places elbows on knees and looks directly into eyes of patient’s three adults children. All eyes are blue, like patient’s. “I’ve done what I can,” he says. “Let’s hope for the best.” Cardiologist wears blue suede shoes, having been at band practice when the call came. The band is called “Natural Causes.”

3. Message on whiteboard in patient’s room changes from “Grady, wake up!” To “Grady, move right side!” Neurologist compares CT scan of patient’s brain taken upon hospital admittance to CT scan take hours ago on lightbox in patient’s ICU room. Neurologist, who wears elongated shoes with square toes and appears to also sport copious amounts of hair gel, traces a small shadow in the earlier CT scan, then the same shadow but bigger, in the second. “He has a brain bleed,” he tells assembled children and girlfriend, who has flown in from New Mexico. “We didn’t notice it when he first came in but now it’s larger. He’s been on blood thinners.” Neurologist states that only 30% of patients with this type of injury are “living independently” three months out. Girlfriend hears whoosh of the respirator. Girlfriend exits room, descends stairs and sobs on bench outside revolving front door of hospital.

4. Cardiologist and neurologist tussle about advisability of administering blood thinners in patient with brain bleed. Cardiologist wins. No heart, no brain, even damaged brain. Cardiologist uses Bronze Age tools to assess patient’s reflexes: a hammer to the knee, light shined into patient’s eyes. Patient responds.

Results:
Patient is stepped down to medium care. Speech is fluent but garbled, indicative of aphasia secondary to hemorrhagic stroke. One word stands out. “Typically,” interrupting otherwise senseless babble. On Day 10 of hospital stay, patient moves right arm. “Did you see that?!” girlfriend and younger daughter cry in unison. On day of discharge to rehab facility, pulmonologist enters to confirm patient’s pneumonia has resolved. He turns to girlfriend, “With this type of injury, the only recovery you will see is what takes place in the first three months.” Girlfriend looks at patient and wonders why pulmonologist is telling her this. Neurologist is nowhere to be seen. Patient is transferred to rehab, having added new words to his vocabulary: “you know,” “anyway,” and “lunch.”

Conclusions:
“Schenectady,” says patient one year after initial medical event. Girlfriend-now-fiancee informs boyfriend-now-fiance that he can no longer claim to have had a stroke or aphasia after correctly pronouncing this multi-syllabic, tongue-twisting place name. Regardless, homeschooling continues. “Let’s play a game,” girlfriend-now-fiancee says one day when car is stopped at red light. “Let’s make words out of license-plate letters! Rabid White Jalopy,” she shouts. Boyfriend-now-fiancee counters, “Ride With Joy,” then shifts right leg from brake to accelerator to move forward with changing light.