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"Let Me Tell You About The Day I Died."
Virginia survived cardiac arrest while driving.
"My heart stopped beating while I was talking to a friend. She heard me very calmly say 'Oh no, oh no.' She thought I'd spilled coffee."
Actually, Virginia Wallace can't tell you much about the day she died -- she doesn't remember it. "What I do know," she says, "is that I had many angels watching over me." Driving to work on the New Jersey Interstate early one morning in May 2010, the 48-year-old insurance manager went into cardiac arrest. "Her heart stopped beating completely and she collapsed at the wheel," says Benjamin Abella, MD, assistant professor of emergency medicine at the Hospital of the University of Pennsylvania.
"I had on an earpiece and was talking to a friend," Wallace says. "She heard me very calmly say, 'Oh no, oh no.' She thought I'd spilled my coffee." The first miracle is that she didn't die in a car crash, says Dr. Abella. Instead, her car plowed into a protective guardrail that brought the vehicle to a stop without causing Wallace further injury.
The second miracle was that two people -- one an EMS worker and one a CPR instructor -- saw the crash and immediately stopped to help. (The next thing Wallace's friend on the phone heard was these men's voices.) Dr. Abella estimates that Wallace, with no heartbeat or pulse, was medically dead for about 10 minutes as CPR failed to revive her. But the third person to arrive was a state trooper whose patrol car happened to be equipped with a defibrillator, which he used to shock Wallace's heart back into action. "Her chance of surviving at that point was about 2 percent," Dr. Abella says.
Wallace had a pulse when she arrived at a nearby hospital, but even revived cardiac arrest victims face a serious threat of brain damage. In another twist of fate, an ER nurse, a doctor, and a critical care nurse had all recently been to a workshop on a new technique that reduces this risk by cooling the body as soon as possible to reach the goal temperature within six hours of cardiac arrest. Only 33 percent of hospitals in the United States offer it -- and this wasn't one of them. But a pen the nurse held in her hand was imprinted with the number of the Hospital of the University of Pennsylvania, which does offer the procedure. She dialed, and Wallace was flown there by helicopter. Upon arrival she was comatose and her involuntary posture -- arms extended with wrists flexed -- indicated significant brain injury. Doctors lowered her body temperature from 98.6 to 91 degrees, which reduced her brain's need for oxygen and curbed the release of toxins that can kill brain cells.
Wallace remained in a state of hypothermia for 24 hours while doctors anxiously watched her vitals. Then they gradually warmed her up and weaned her off the medications. "There's no specific way to know who will wake up from therapeutic hypothermia and who won't," Dr. Abella says. Three days passed with no response as Wallace's husband, Andy, and two boys, ages 16 and 9, kept a somber vigil. Then suddenly she opened her eyes and saw her family and members of the medical team crowding the room. "I rushed to meet her and welcomed her back into the land of the living," Dr. Abella says. Wallace was stunned and amazed. "I thought, 'Why am I here in the hospital?' People kept saying they were glad I was back and I just looked at them and wondered what they were talking about."
Wallace showed rapid improvement and went home in a week. After six months of cognitive therapy she went back to work. She now has a small defibrillator implanted in her chest to give her heart a jump start if it ever fails again. Though dogged by minor memory loss for a couple of weeks after the procedure, as well as some occasional fatigue, she has had no further problems. "To look at me, it's like nothing ever happened," Wallace says. "It's very overwhelming to think about at times, but I've always had incredibly strong faith and I know it just wasn't my time."
"They Said I'd Likely Be Gone in 15 Months."
Mary survived an aggressive brain tumor.
"My doctor's side of the conversation got quiet, and then he left the room. When he came back he had tears in his eyes."
For two weeks in the fall of 2006, Mary Wong Lee of San Dimas, California, had been plagued by on-and-off headaches, but when words began escaping her the 55-year-old office manager got worried. "I'd be writing letters or reports and know I wanted to say 'appreciate' or 'opportunity,' but couldn't think how to spell them," she says. She told her longtime general practitioner, who sent her for an MRI. About a week later Lee stopped by his office to say she'd gotten the test. "Let me call and see if they have the results yet," he said. "His side of the conversation got quiet and then he left the room," Lee says. "When he came back he had tears in his eyes."
Lee had glioblastoma multiforme, one of the most aggressively malignant types of brain cancer. "It's a formidable enemy," says Keith L. Black, MD, director of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles, where Lee was referred. "Most of the time we lose the battle." Even with standard treatment she'd likely be dead in 15 months. Dr. Black immediately scheduled surgery to take out a golf-ball-size tumor in Lee's brain, keeping her conscious and asking her questions during parts of the procedure to avoid cutting areas that controlled her speech.
After surgery, Lee's headaches disappeared and her speech improved. She waited three months to recuperate before starting chemo and radiation treatments. But her prognosis was still grim. Glioblastoma tumors usually return with a vengeance only months later. "It's like an infection that you only treat partially with weak antibiotics," Dr. Black says. "It comes back even worse." Lee was holding up well, though, so Dr. Black proposed an experimental vaccine he was testing. "There were no promises, but what did I have to lose?" Lee says. Tailor-made to individual patients and their cancers, the treatment removed specialized white cells from Lee's blood and exposed them in the lab to cells from her tumor. Like sentries that have been given an exact picture of an enemy infiltrator, the white blood cells were then put back into her body, where it was hoped they'd recognize the cancer and mobilize the immune system's army to kill it.
That was more than four years ago. Without that treatment Lee's odds of surviving this long would normally have narrowed to 3 percent. "We have to be realistic," Dr. Black says. "We don't believe we've cured her. But we've had patients go seven, eight, nine years with this vaccine. And our hope is to give her the next-generation vaccine we're working on now." Lee is making the most of the time she has. Her main joys are spending time with her family and friends -- cooking or golfing with her husband, Edward, and two grown sons, knitting, playing bridge -- and working on the board of National Urban Fellows, a nonprofit that develops leadership among women and minorities. "Whether I live four years or 15, I have no control," Lee says. "I'm just happy I woke up this morning. My attitude has always been to enjoy each day."
"I Was Literally Torn Apart."
Rhonda survived an aortic dissection.
"I was very scared. I wanted to stop but there was almost no one else on the road. I told myself I had to do this on my own if I was going to see my family again."
Rhonda Mullen, 38, decided to go to her doctor for a physical after a young woman she knew died suddenly. "They checked my heart and I got all the right tests. Everything was perfectly fine," says Mullen, the mother of two young children, Liam and Rori. That makes what happened three weeks later even more shocking.
On a Saturday morning in February 2010, while talking with a customer at the suburban Chicago bank where she works, Mullen was hit between the shoulder blades with searing pain so intense she could barely catch her breath. Was it a pinched nerve? Heart attack? Stroke? Nothing made sense, but something was very wrong. She got in her car and headed to the nearest hospital, the one where her babies had been born. She felt tingling sensations and numbness in her legs as she drove. "I was very scared," she says. "I wanted to stop but there was almost no one else on the road so I thought no one could save me. I refocused and told myself I had to do this on my own if I was going to see my family again." By the time she reached the ER she was barely able to work the pedals of the car. Excruciating pain shot through her back, and the tingling seemed to be going everywhere. "It was like everything was shutting off," she says. She actually parked the car and tried to walk before someone spotted her and ran to get help to wheel her into the ER.
A CT scan revealed that Mullen had a tear in her aorta, the major artery feeding blood from the heart through the torso to the rest of the body. Aortic dissection, as the condition is known, happens suddenly, so it could not have been detected during her earlier checkup. (It's what killed the actor John Ritter in 2003.) But doctors couldn't explain why a tear would occur in a young woman with no known risk factors. Mullen's only hope was emergency surgery at the nearest hospital that could handle the procedure, Loyola University Medical Center. Her condition was so precarious that the medical team worried that jostling during the 30-minute ambulance ride to Loyola could make the tear worse. "It could be fatal if we hit a bad pothole," Mullen says.
Mullen's loss of feeling in her legs was a bad sign to Ross Milner, MD, chief of Loyola's division of vascular surgery. The tear was huge. "It ran about two feet from her upper chest all the way down to the arteries of both legs," he says. "Muscles and nerves in the right leg had no blood at all and the leg was rigid." If Mullen was lucky enough to live, she could lose both limbs at the hip. "I was just trying to get the pain in my back to stop," Mullen says. "I tuned in when I heard the doctors talk about whether I'd survive."
When Mullen's husband, Glenn, joined her at the hospital, Dr. Milner struggled to tell him he might lose his wife that night. "We're about the same age and have kids," the doctor says. "We were both fighting back tears." Glenn and Rhonda had known each other half their lives and been married for 10 years. "He looked devastated," she says. "I told him I'd see him when this was all over. Then we kissed and they started the anesthesia."
During the risky four-hour operation, Dr. Milner bypassed the torn aorta with a quarter-inch-wide Gore-Tex tube between two and three feet long, which would then permanently deliver blood to Mullen's lower body. Incisions in her legs relieved severe swelling as blood flow was restored. A day after surgery Mullen opened her eyes in intensive care to see Glenn enter the room. "He had a wonderful grin on his face, kissed my forehead and held my hand," she says. Not only had she survived, but she could move her thighs, bend her legs, and wiggle her toes. "The doctors and nurses were really excited," she says.
A long rehab road still lay ahead. First came tough therapy to master basics like lifting her legs and standing without assistance. "Just sitting in a chair was exhausting," she says. But she quickly moved from a walker to crutches -- and soon was even walking up the stairs.
"She's a very strong-willed person and that makes a huge difference," Dr. Milner says. "I've never seen anyone recover from a blood-supply loss that severe." Today Mullen walks with only slightly limited motion in her right ankle and toes and is back to working part time. "I can do everything I want to do," she says. "Live in the now" has become her family motto.