Instant Replay

Before events get too far ahead and the details begin to blur, it is probably therapeutic for me personally to throw out an instant replay version of the scariest few days of my life...



Around 11:00 on Thursday, our 15th wedding anniversary, Kev and Joe went for a jog. They had been working out together (along with Louisa at times) so that both kids would be in minimal shape for upcoming summer sports camps. Several days each week they either played soccer at the park, shot some hoops, or jogged through the neighborhood. On Thursday, Joe and Kev decided to jog. They jogged down to the park to run some sets of stairs. Joe ran 5, Kev did 10 then Joe says that Dad needed some water and to walk rather than jog back to Englewood Ave (our home street). Once they got to Englewood, they jogged uphill about three blocks and then decided to finish with a hard sprint from our drive way to the top of the block where Alabama intersects with Englewood. Joe remembers racing past his dad and getting to the stop sign first. He turned around and saw Kev slowly jogging, then stumbling, then collapsing.

A car drove by and told Joe to go get his mom, that he was calling 911. Joe ran the 100 or so feet to our house to get me. Another man was walking his dog and also called 911. Another man, Eric, was driving down Club Blvd on his way to get some more supplies for a job he was working on in the neighborhood. He needed to get to Hillsborough Rd, but instead of going all the way to Hillandale and then over, something told him to turn onto Alabama and cut through our neighborhood instead of his usual route. He turned onto Alabama and saw Kevin collapsed at the end of the block. Eric had just finished his CPR training. He dashed from the truck and began chest compressions. Joe entered our house screaming for me to come quickly, that Daddy fell down in the street and wouldn't get up. I sprinted to the top of the block where I could see a crowd forming and Kev lying in the road. As I ran up, Eric told me he had just finished CPR class. That Kev needed air but that he didn't know him and so hadn't given him mouth to mouth just compressions (exactly the right thing to do in that situation). I, however, did know him and began to alternate Eric's compressions with mouth to mouth. The whole time wondering if this was really happening.

EMT arrived from both the local fire department and the hospital after about 4 minutes (which seemed like an eternity). They took over CPR. Let me tell you, enthusiastic compressions is a definite euphemism. They cut off his shirt, applied the defibrillator paddles and shocked him. Eric took off both his hat and shirt to try and pad Kev's head from whacking the ground so hard. They shocked him 2 or 3 times with no response. Every body's shoulders seemed to drop, as they began strapping him onto the stretcher. "Can't you shock him one more time? Don't give up, yet." I pleaded. "We can't shock him again, right now." He had flat-lined. "We've got to get him to the hospital." EMT loaded him into the ambulance, and told me to follow them to Duke. The defib guy looked up and said, "I think I've got something." Kev seemed to take a very abnormal looking shallow breath. Three hands immediately tried to find a pulse. Nothing. "We've got to go." And they loaded him in.

John, one of our neighbors helped me get the kids back to the house (Joe, Nate and Savannah watched nearly the whole thing. Louisa was at camp.) I grabbed my keys, called my Mom and yelled at her to get here as soon as possible, hugged a sobbing Joe and assured him this was in NO WAY his fault and dashed out the door. Joe began e-mailing our teammates in Uganda and South Sudan to ask them to pray, and told John that he should call Nanny Rachel to come help with the twins. John let our church know what was going on.

I drove, sobbing the 3 minutes to Duke University not knowing whether Kev would be declared DOA (Dead on Arrival). I prayed that frantic generic "Please Help" prayer. Once I got to the ER a nurse said she would check to see whether he was alive, while I called Allan, our pastor and left and unintelligible message on his phone. I called WHM and they immediately started praying. I called my brother and he assured me he was en route. The nurse came out and told me he was breathing but in very serious condition and that I needed to go to a smaller more private room for the doctors to talk with me. I knew what this meant. This was the bad news room. This was the room you go to and they tell you that your husband has died. A social worker came in to help me deal with the situation and I'm pretty sure I told her the only help I needed was for her to find out if my husband was alive or dead. She came back moments later to say he was alive, but a lot of people were working on him. I asked her to leave so that I could pray. A few minutes later, Allan (our pastor) arrived with the doctors. We sat together, while they told me that Kev had been shocked in the ambulance and had regained a pulse, he had been breathing some on his own but not enough when he arrived at the ER. He had been intubated, but had struggled during the process (my only sign of hope during the next 24 hours). He was now on a ventilator. They were running tests to determine what had happened and had started a cooling procedure to minimize significant brain damage. They told me that the early CPR, especially Eric's chest compressions, had likely saved his life. BUT, and for the next 24 hours I was to hear this BUT after nearly every statement, Kev's brain had been without normal oxygen for 8-15 minutes. The chance that his cognitive function would never return was likely, which meant that they would also need a copy of our living will, especially as it pertained to being in a vegetative state.

Duke had in place a new, cutting edge cooling protocol to increase Kev's chance of recovery. Since he had been without a pulse and normal oxygen flow to his brain the chance that he would be in a vegetative state was high. As they ran more tests they did find that he had a mild to moderate aortic valve issue. They ruled out both heart attack and stroke. Within 2 hours he was up in the Cardiac Intensive Care Unit in critical condition, on life support and was being cooled to 33 degrees Celsius (91 degrees Fahrenheit). They would keep him at that temperature and in that condition (completely paralyzed to prevent shivering and under heavy sedation) for the next 18 hours. They would warm him back up slowly over 6-12 hours and then it would be another 24-72 hours before the drugs wore off and we could see if he would wake up. So, on Thursday night the best timeline they could give me was perhaps he might wake up by Saturday evening BUT the likelihood that he would remain in a vegetative state was significant. Nobody could predict how his brain would handle the lack of oxygen.


Most of that time is a blur, but what was significant to me was the way everyone seemed to wrap their arms around us. Multiple, multiple folks connected with Duke and us through either Science and Math or Blacknall quietly stood beside us. Nurses, doctors, so many people associated with Duke in one way or another made sure we were taken care of. Katie, our Sunday School Leader was by my side interpreting and explaining. Amy arrived shortly after Allan and stayed with me throughout those first two days. Mom made lightening fast time from Charlotte. Arriving to be my main emotional support. Doc was steadfastly calm and influential. Newland providing much needed hand holding. Cherie began coordinating meals. Beth made sure Joe and Louisa were okay for days. My sister and her husband Kevin took care of the twins and then took all four children back to her home in Belmont so that I could be with Kev around the clock. To my amazement Chris, the director of the Cardiac ICU was a friend we had just eaten dinner with at another friends 50th birthday party. My dad flew in from Nevada and some of Kev's sisters arrived in person as others kept up over the phone. We were surrounded by people who both knew us and cared deeply for us. Calls began to come in from Bundibugyo and Sudan. Christ School was in the middle of a school strike when they got the news of Kev's cardiac arrest. They stopped striking and began praying for their former headmaster. In Durham and all over the world (London, Spain, Tonga, South Sudan, Uganda...) people were praying for Kevin.

As I cried out to God, pleading with him to explain how this could possibly be him "being gentle with us" (my constant prayer this year as we sought his will for us and for our future) I began to understand more fully the dreadfulness of our situation. I know completely that God can be trusted, that He loves us deeply and yet that did not guarantee a positive result for Kev. Kev could die, would likely never wake up again, and I would be left alone with four small children and without my best friend. This was God being gentle? I ached and my heart was sore. I could only take a deep breath, trust, and continue on at the hospital. Watching Kev's chest rise and fall on the vent. Watching the nurses turn his body every 45 minutes. Listening to the doctors explain yet again the difference between normal cognitive function and wishful thinking. Knowing everyone was hopeful and yet seeing the doubt in my eyes reflecting in theirs.

As I continued to play out the events in my head I knew that God had given us no "if onlys". If only he hadn't been alone, or if only someone had given him early CPR... Kev was getting top notch medical care. He collapsed minutes away from one of the best hospitals in the nation. One of the few equipped with this new cooling procedure. Eric got to him almost immediately and had just finished his CPR training. Kev was running close to the house with Joe instead of in the woods somewhere alone (as was his more common practice). We weren't in BGO. We weren't out west hiking in the mountains or down in a canyon. We weren't even at my mother's house (45 minutes away from a top hospital). Kev's collapse happened within a very narrow window of near perfect timing to insure his best chance of survival. Would it be enough?

On Friday, they began bringing his body temp back up to normal. By 9:30pm the nurses turned off the paralytic drip and restrained his hands (so that if he did wake up he wouldn't yank out the vent tube). We settled in for a long wait. We were told Saturday evening would be the earliest he could begin to wake up, that Monday even Tuesday might be likely. He was very heavily sedated. I needed to "re-orient" him by talking to him loudly and clearly and consistently until he woke up. Telling him it was okay to enter into the pain and confusion that waking up would surely bring. Telling him it was safe to come back. Was Kevin even still in there? As the drugs started to wear off, I plugged in his I-Pod and played some classical music, then some of his favorite songs from our time in Uganda. As he began to involuntarily twitch, I continued to talk non-stop in his ear. "Don't you dare leave me. I love you. I can't do this by myself. We have four kids. I know it hurts but open your eyes and come back to me." And he opened his eyes. We gasped. No one said he could wake up so soon. We were only 30 minutes into the expected 24 hour talking marathon. "Can you squeeze your left hand?" A weak squeeze. More and more of the ICU staff gathered around as we cheered and talked to him. Withing 15 minutes he was breathing on his own. Katie asked him, "Do you want that tube out of your mouth?" He raised his eyebrows in the Ugandan non-verbal affirmation signal. After the tube was out, he asked "Why am I here? What happened to me?" He was clearly confused, but his cognitive recovery was assured.

The next few days were a blur for both of us. He suffered from significant short term memory issues for the first 24 or so hours as the sedatives cleared his system. We lovingly refer to that time as his "Dori-Day" (from Finding Nemo). During that time we also learned that his aortic valve was severe rather than mild/moderate. The choice was simple. He had to have open heart surgery to replace his faulty valve with a new mechanical one or die. I like to say that on the Thursday of his collapse it felt like someone shoved us off a steep cliff unexpectedly into deep water. We weren't sure we could even swim. On Tuesday, we stood at the edge of the same cliff. Held hands, told each other "I love you," and jumped into the water. Of course, with life boats waiting at the bottom. Still very scary. But with the strong sense that God was watching, as an active participant and that we were surrounded by people who knew what they were doing professionally, medically. We were within a community of loved ones supported by their prayers and emotional support, rather than alone.

Kev came through the surgery like a champ. He has a new carbon valve that should dramatically improve his heart's ability to pump the needed blood throughout his body. His life long heart murmur now replaced by a mechanical clicking sound. Days later he received an internal cardiac defibrillator (ICD). While his doctors are 99% sure that his valve was the real issue and cause for the cardiac arrest, the ICD is his insurance policy. If his heart ever begins to enter a life threatening rhythm again, this device will try to pace him out of it while it charges up. If the pacing function doesn't work it will then deliver up to 6 shocks... although 1 should do it... to shock his heart back to a normal rhythm. Just like the paddles used by EMT except that these "paddles" are transmitted through a wire straight into his heart muscle. Totally fascinating and reassuring.

How do we explain that Kev will walk out of the hospital only weeks after he coded on the street? Even with all of the favorable conditions surrounding his collapse the odds still were not in his favor. Both doctors, extremely experienced, have told us that they have never heard of someone surviving what happened to Kevin. The best theoretical odds with the new cooling protocol gave him only a 30%-40% chance. (Fortunately this is information no one shared with me last week.) Everyone wants to shake his hand. To meet the man who survived.

We can only hold forth that God was good and gentle with us. Not that this recovery was "payback" for years of service in Uganda, nor that it points to some special future work that would have gone unfulfilled with Kev's death. There are certainly many people out there for whom death was the outcome, whose worthy, amazing lives were cut off too short. Why did Kev survive?? Surely that is a question we won't have answered this side of eternity. Yet while we have no answers, no cliche pat response, we do feel that Kev's recovery is a sign. A big neon, beautiful glaring sign of God's power and faithfulness. A sign that points to a time when God's Kingdom comes to earth in full power. When death is no more. When evil is overcome. When horrible sickness and loss are abolished and God's glory abounds. When crying turns to laughter, and sorrow to joy. When our loved ones open their eyes and come home. Obviously that world isn't here yet. Problems abound and suffering is persistently tenacious. But there are signs, miracles if you will, that point to another reality, to a future hope of something far different. Kev's recovery from death stands as one of those pointers.

Kev should have died on our anniversary, yet he lives today. We're continuing to plan for our upcoming move to Exeter, rather than for a heart-wrenching funeral. We give thanks to God. We thank Him for the skilled hands who took care of us here at Duke and for the many, many people who lifted us up in prayer and surrounded us with love.