UNC doctor, now patient, grateful for second chance at life
No expression of gratitude will be too elaborate for Dr. Bruce Cairns when he sits down to a turkey dinner with his family Thursday.
Every day is Thanksgiving Day now.
For the past 68 days, Cairns has been giving thanks for something he equates to winning the lottery – the chance to see his children grow up.
Sept. 18 started like any other for Cairns, chairman of the faculty at UNC-Chapel Hill, where he is also a surgeon, medical professor and director of the North Carolina Jaycee Burn Center. At the beginning of a nonstop day in his nonstop schedule, Cairns arrived early for his morning workout at the UNC Wellness Center in Chapel Hill.
After swimming laps, Cairns, 52, stepped on the treadmill for a cool down, a gentle jog, as the TV screens played the morning shows. The timer on the machine counted down the seconds – 20, 19, 18, 17, 16, 15.
He was about to push the stop button when he felt lightheaded. He grabbed for the rails.
“Then the next thing I know I’m ... laying on the ground, looking up and I’m listening to people talking about coding,” Cairns said in a recent interview at the center where he collapsed. “I’m thinking I’m watching a TV show, and I’m wondering why I’m doing that when I need to be at work.”
Cairns had suffered sudden cardiac arrest. His heart stopped.
Here’s where the lottery part comes in. In the next room, just behind a purple curtain, was UNC’s cardiac rehab staff – nurses, trainers and a cardiologist who run a program to help people recover from heart attacks and surgery.
Though Cairns had a family history of heart disease, he was not a patient there and, as far as he knew, had no heart problem. He just exercised regularly at the Wellness Center. The treadmill where he jogged was less than 10 feet away from an automated external debrillator, or AED, a lunchbox-sized device that, within seconds, can monitor heart rhythm and deliver a jolt to restore a heartbeat.
Several staffers responded that day when an emergency call went out.
Pam Broscious, a nurse in the cardiac program, sprinted to Cairns. He was face down, gasping and turning blue. At first, people hesitated to turn Cairns over, fearing a spine injury from his fall.
Broscious turned him and started chest compressions. The AED was yanked from the wall, its pads attached to Cairns’ chest.
One shock, and the doctor was back.
The whole event lasted a minute, maybe 90 seconds. The quick response time meant Cairns defied very long odds.
In the United States each year, 600,000 people a year suffer cardiac arrest, defined as the cessation of the heart’s electrical activity. It comes without warning, and the survival rate is less than 6 percent for people who are stricken outside a hospital, according to the Institute of Medicine.
Cairns didn’t immediately understand what had happened to him.
“I just thought I had fainted,” he said, “and I was embarrassed.”
He wanted to sit up. He asked the staff to call his wife. He said he needed to get to a meeting. He even asked someone to take his picture, because he wanted to document his experience as a patient.
Cairns was rushed to the emergency room, and then the cardiac catheterization lab, where doctors determined that a ruptured plaque in an artery had caused a blood clot, which in turn, caused the cardiac arrest.
The problem, in the left anterior descending artery, has a nickname: the widowmaker.
The clot was removed, and two stents were placed in his heart to keep the artery open.
My life has changed forever. I have four children. It’s an adjustment. It’s been an adjustment for all of us.
Dr. Bruce Cairns, who survived sudden cardiac arrest
Despite an almost miraculous rescue, Cairns’ heart was initially in bad shape, pumping at about half the normal volume, said Dr. Paula Miller, the UNC cardiologist at the Wellness Center that day, who now treats Cairns.
He spent six days in the hospital before going home. There, he said, he began to process what had happened. As a doctor, intellectually he understood everything; psychologically, it was overwhelming.
He slept for days on end. “I fell into sort of a black hole for about two weeks,” he said. “My life has changed forever. I have four children. It’s an adjustment. It’s been an adjustment for all of us.”
His wife, Ellen, is a recovery room nurse at UNC. She helped to calm him during panic attacks but nudged him to get better, too. “I was saying, ‘We’re going to move this along.’”
So did Miller, who sent him back to the Wellness Center about a week later. He needed to get out, she said, and witness the recovery of other people who had suffered a similar catastrophic event.
“You can ‘what if’ yourself to death,” Miller said.
So he began working out a little, even though the leg injury from the treadmill fall forced him to use a walker.
“We named it Lucille, don’t you remember?” joked Broscious, the nurse who performed CPR on him and who now oversees his exercise in cardiac rehab.
“They gradually allow me to increase my heart rate,” Cairns said.
Cairns may soon start swimming again. He has gradually resumed limited duties as head of UNC’s Faculty Council. He has not returned to treating patients, but he has a new understanding of their needs.
“You realize,” he said, “nothing is a small thing. When you’re a patient, yes, the medical decisions matter, but how people treat you on every level matters.”
A few weeks ago, Cairns spoke to a reunion of burn victims treated at the center he leads. He told them that he was a survivor now, too.
He’s on eight medications, and he’s modified his diet. His prognosis is good, if he continues to follow doctors’ orders.
Cairns said his future schedule will have more balance. Other people can do his job if need be, but he’s concentrating on being a husband to Ellen and father to his two daughters and two sons. “At this point, I’m just grateful to be there for them.”
Cairns’ story could help spread a message about the importance of CPR and automated defibrillators, which are common in public places such as malls and airplanes, Miller said. The machines are easy to operate and designed for anyone to use.
“We’re getting better at resuscitating people, but we still have a long way to go,” Miller said. “If he had been running on the road, or if he’d been running on his treadmill at home, chances are he wouldn’t be here with us.”
Cairns knows this, which is why he is constantly showing his gratitude to the people who saved him that September day.
“They’ll always say, ‘You don’t have to thank me,’ ” Cairns said. “I go, you know, I’ve said that before, but I’m telling you right now, I absolutely have to thank you.”
Heart attack vs. cardiac arrest
A heart attack can lead to cardiac arrest, but they are not the same. Here are some of the distinctions:
▪ Caused by blockage or narrowing of coronary artery; lack of oxygen damages tissue.
▪ Symptoms include chest or upper body pain, unusual fatigue, weakness, nausea and shortness of breath.
▪ Patient is breathing.
▪ Heartbeat may be irregular.
▪ Risk factors include coronary artery disease and congenital abnormalities.
▪ Treatment can include medication, surgery and angioplasty with stents.
▪ Caused by stoppage of mechanical activity of the heart, a malfunction of the heart’s electrical system.
▪ Symptoms can include palpitations, dizziness, chest pain or shortness of breath before loss of consciousness.
▪ Patient is not breathing but may be gasping.
▪ Complete lack of heart rhythm.
▪ Cardiac risk factors include coronary artery disease, cardiomyopathy, heart attack, valvular heart disease, congenital heart disease and genetic syndromes.
▪ Treatment includes CPR, defibrillation, advanced cardiac life support and post-arrest care.
Source: Institute of Medicine, 2015