Printed on August 27, 2007 National Geographic Channel

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A heart-stopping experience

September 2, 2008 11:22 AM

Kendra Gahagan

Coordinating Producer

When we first met George Justice, we knew that in a few hours, we’d be peering into his gaping chest and staring at his beating heart. We were so grateful that George had graciously agreed to let us film his open-heart surgery. This man wasn’t only gracious – he was accommodating, having moved his surgery up several days so that it worked with our filming schedule. Only in Los Angeles, we thought.

It’s all in a day’s work, apparently, when your job is saving lives and repairing broken hearts.

As we donned our scrubs and surgical masks at Saint John’s Health Center well before sunrise, our whole team knew that we were about to experience something few people ever get to see without years of medical school. We would be filming -- not through glass, but hovering right beside the patient’s chest -- a coronary artery bypass operation. The hospital was not only allowing us incredible access in the operating room to film this surgery, but we would be doing so at the invitation of one of only a handful of female cardiothoracic surgeons in the world, Dr. Kathy Magliato. We would watch Dr. Magliato and her partner, Dr. John Robertson, do something routine for them but extraordinary to us: stop and re-start a patient’s heart to repair his many blocked arteries and save him from what they said was an almost certain premature death.

Once George was wheeled into the OR, he was anaesthetized quickly -- but by the time he was on the operating table and prepped for surgery, it was hard to remember there was a person under there. Sterile towels covered his face and entire torso except for a large rectangle perfectly framing the incision area. Next, the doctors effortlessly cut the incision down the middle of George’s chest. The sound of the sternal saw cutting through the breastbone lasted only a few seconds but would make a great addition to any horror movie soundtrack. Once the chest was opened, the doctors inserted a heavy, metal device to keep the rib cage spread apart enough for them to do their delicate work.

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Close calls and brushes with death

By explorer

August 31, 2008 1:23 PM

Retiree Bill Bondar says he no longer fears death after being clinically dead for over three minutes from a cardiac arrest. He details his story below Imagine coming home from a band practice and then waking up in the hospital three days later with the doctors telling you that you died from cardiac arrest. Hard to believe, isn’t it? I still have doubts that I am not truly dead but living another life. Maybe life for us all is a train ride and when we die, we are switched to a different track to continue our journey where there is no end. God and religion seem to have no place here. When you get a taste of death, you feel that death is really so simple. You’re here one minute, and gone the next. No regrets, no worries, no missing your family or friends. You’re gone baby, clean and simple. Death is easy - staying alive is hard. Each day that I live now is to its fullest, and if I die again, well, I know now that there is nothing I can really do about it. The last time I was extremely lucky. I had help from the police, EMT’s (emergency medical technicians), doctors and my wife. I know that the odds are against me of ever having them lined up like that again, so why worry? Think about the future but live for today. I now play with a new band and am enjoying life and reflecting my experience to others who want to know the story. As the guys in the band regularly announce to the audience, “Bill was dying to play with us.” Michaela Roser was the victim of a serious car accident in her teens that left her in a coma for two weeks. During that time, she says she had vivid near death and out of body experiences. I grew up a happy and adventurous girl in an extremely small town with a full and exciting life ahead of me. With a world of opportunity to look forward to, there wasn’t much stopping me. That is, until July 4th, 1994, when my family and I were in a serious car accident. I ended up in a coma for fourteen days that nearly took my life. During that period, I was forced to work harder than ever to put myself back together. By the grace of God, I was shown what life and death are all about.

Continue reading Close calls and brushes with death.

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What point do we pass?

By explorer

August 30, 2008 1:23 PM

Lance B. Becker

There are few things that bring you to total alertness as much as when you’re working desperately to bring someone back to life after they’ve suffered a sudden cardiac arrest or major traumatic injury. It is not an easy task and the odds are not good, but it is precisely what we are trained to do during emergencies.

If death is a process occurring over time, we have the opportunity to modify and alter the process and thereby the outcome.

As a medical student 30 years ago, I was usually the person who performed chest compressions on the dying person. Failure meant death. That bothers me just as much today as it did then. When our therapies are unsuccessful, we pronounce the patient dead. The first time I was involved with this I said, “Is that really it? What point did we pass that told us the patient was dead? Do we just stop?” What happened at 8:42 that was not true at 8:40, or that might not have been true at 8:45? After a lot of these experiences, it occurred to me that the time of death is an unsettlingly flexible time and that one physician might, for example, call the moment of death at 8:42 and another one will do it at 8:45. Still another would do it at 8:47, and somebody else would continue the same resuscitation efforts until 9:00, and there didn’t seem to be any particular rhyme or reason to what happened when. It was my first insight into the mysteries of death and the possibilities for restoring life. We began to theorize that death does not occur in a single moment -- rather death is a process that occurs over time.

If this is true – and increasingly, our research at Penn shows that it is -- it would imply that we have vast opportunities to save lives lost using our current therapies. If death is a process occurring over time, we have the opportunity to modify and alter the process and thereby the outcome. Scientists and doctors are standing on the brink of a new understanding of death – and as a result of understanding death, a better understanding of life. It will mean new definitions for when a patient is declared dead, when their organs may be used for transplant into a sick patient waiting for their own second chance at life, and it will force us to confront some ethical dilemmas on how to use limited high technology resources. But this new understanding will allow us to save the lives of people who will otherwise die – and so we are going for it. Dr. Lance Becker practices Emergency Medicine and is Director of the Center for Resuscitation Science at the University of Pennsylvania School of Medicine

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But what is death? Is it a process? Is it a moment?

By explorer

August 29, 2008 1:14 PM

Kathy E. Magliato

MD, MBA, FACS

This morning my two-year-old son asked me, “Mommy, what does the heart say?” “Lub-Dub,” I replied with a nurturing smile. “Lub-Dub.” The heart makes two sounds in sequence with each beat. And your heart, a very persistent organ indeed, beats 80 times each minute, 100,000 times each day and 42 million times in an average lifetime.

Until it stops.

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Until you die.

But what is death? Is it a process? Is it a moment? Does death occur when the heart ceases to beat? As a heart surgeon, it is my honor and privilege to make the heart stop beating each day in order to repair it and yet, this is not death. The definition of death has evolved over time. A person can be clinically brain dead and have no viable brain function but still have a beating heart. So when is the moment of death and what is is the process? Having been at the bedside of many patients that cross the threshold between life and death, I can tell you that there is a distinct change that occurs in a person when both their brain function and heart function cease. While the death of a loved one is truly a tragic event, the actual process can be quite beautiful. There is a stillness that washes over the dying body and culminates in a peacefulness that is far more serene than is seen in a sleeping state. This is followed by a distinct moment when death overtakes a person - their features seem to change and become less lifelike. It is as if their essence, or that which made them who they were in life, leaves their body. The shell of who they once were is left behind for those to mourn. It is not a frightening process. It is simply a part of life, for without life there can be no death and without death there can be no life. They coexist in a meaningful and necessary relationship that constitutes the journey we all must take. And sometimes, people teeter on the edge between the two. I have borne witness to patients who have survived a near-death experience. They all have one thing in common: they have experienced something extraordinary. They have stood on that line between life and death, hesitated for a moment, and simply took a step back. And they are forever changed. So when your heart no longer says “Lub-Dub” and your brain no longer functions, please understand that you are in the moment of a process on a journey that is as much a part of your life as life itself. Dr. Kathy Magliato is one of the few female cardiothoracic surgeons in the world. She is the director of Women’s Cardiac Services at Saint John’s Health Center in Santa Monica, California.

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Recently in Medical Category

A heart-stopping experience

Close calls and brushes with death

What point do we pass?

But what is death? Is it a process? Is it a moment?

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