Health Care Quarterly:

Meaning of ‘be here now’ becomes clear as real-world emergency happens

The older man’s face was blue. His body was still, and his head rested on his shoulder. He was seated in a miniature racing car used to drive around the track of the large indoor amusement center. But now all the cars were stopped, and people were milling about, not sure how to help.

I had been in the far corner of the amusement center with my husband, Dmitriy Kosyagin (also a doctor), my youngest and middle sons (10 and 14 years old), and my co-worker, Dr. Wong Khaw. Khaw is an emergency room hospitalist, my husband is an internal medicine physician and I work as chief of cardiology at Southwest Medical in Las Vegas.

I had met Wong just a few weeks earlier at a UnitedHealth Group Culture session. “Be Here Now” was the takeaway from that day. It was at that time that we discovered our 10-year-old sons were not only in the same local school but were friends. So, when I set up this party, I made sure to invite Wong and her family.

At this moment, we were in a private party room setting up birthday festivities. I could see there was a commotion, but it was far off and initially, we did not give it much concern. More commotion grew from the far corner. We glimpsed the person in the car, not clearly, but with a growing number of people around him, including amusement center employees, and what seemed to be his grandchildren — younger teenagers, now pacing around the car. One of them was sitting on the ground, his arms up in the air, as if frustrated or distraught. Khaw, my husband and I instinctively knew we might be able to assist and made our way to the commotion. The more we saw, the quicker we moved.

No Pulse and Unresponsive

Finally getting through the crowd, we saw the man and his color. He was unresponsive and did not seem to be breathing. His family members were crying. Death was potentially closing in and time was of the essence. Dmitriy and I both took his pulse. There wasn’t one.

“Is there a defibrillator?” Dmitriy asked. Employees looked at each other, somewhat stunned, and shook their heads.

Without speaking, we began to take action, lifting the gentleman from the car and laying him upon the floor. We began chest compressions. The manual compressions on the sternum moved oxygenated blood through his blood vessels. The goal was to keep a good blood flow — especially to the brain — for as long as it took until he could get more care from the paramedics, who had more tools. It did not look good. The three of us felt that, at best, the man would likely have major health issues if he managed to make it. But our job was to bring this guy back.

As minutes ticked by, his heart still did not beat on its own. Suddenly, the paramedics arrived. As they moved the man to the gurney, Wong took one last pulse check. She felt the faintest movement. The three of us then consoled those who were still there and were optimistic with the remaining crowd. Of course, we all hoped for the best. What we witnessed made us think that the outcome would not be good.

A Different Tone

Needless to say, our birthday party regrouped with a somber tone. I had some concern for my youngest son that his celebration of life now had, well, the shadow of death mixed in. Still, this was a learning opportunity for the family that could not be discounted. Life is precious and we should appreciate every moment.

On the way home, our 14-year-old middle son seemed very contemplative. Eventually, he quietly asked, “Mom … Dad ... is that what you guys do at work every day?”

Dmitriy and I exchanged a smile.

I’m pleased to report that I was contacted later about the man’s condition. He made a full recovery.

Looking Back

Needless to say, it’s easy to wonder how things might have turned out if we, as physicians, had not been there that day. My sincere hope is that my fellow health care professionals will do their part to ensure their office staff, patients and others they may encounter are aware of the importance of CPR and resources that are available to those who wish to learn.

For anyone else who may be reading this article, I sincerely hope you consider CPR training as well. Those who are responsible for children, the elderly or others not fully capable of caring for themselves should consider CPR training, as well as anyone in a position that requires them to be around the water, live electrical lines or other dangerous activities on a regular basis. Regardless, I encourage anyone with a family to learn CPR, because 85% of cardiac arrests occur at home. This could mean the difference between life and death for your child, parent or spouse or friend.


Dr. Svetlana Barbarash is the chief of cardiology at Southwest Medical Associates.