'The Unthinkable'

Dateline: Sun 06 Jul 2008

Time magazine writer Amanda Ripley, who covers homeland security, has written a book with a message all should take to heart. "The Unthinkable: Who Survives When Disaster Strikes -- and Why" is a hard, cold and realistic look at the human response in the threat of a terrorist hit, an airplane crash, a fire or almost any other imaginable trauma.

Her point? Flight or fight is, in the majority of cases, a total myth. Most people, caught in the eye of the hurricane, simply freeze, or act as if everything is normal. Hence passengers on planes filling with smoke are observed gathering luggage, and some workers in the Twin Towers on 9/11 stayed put at their desks, waiting too long for instructions from some higher authority.

This is a timely message in light of two deaths: on July 3, 2006, well-respected photographer Mpozi Tolbert died at the age of 34 after collapsing in the Indianapolis Star newsroom with cardiac arrest. Last month, veteran NBC newsman Tim Russert died, also in his workplace and also from cardiac arrest.

Tolbert was young and seemingly healthy, but in fact an autopsy showed he suffered from arrhythmogenic right ventricular dysplasia, a congenital condition that, had he survived his cardiac arrest, could have been treated with either drugs and/or surgery. Russert, 58, had been under the care of a physician for heart disease and was taking medication for high blood pressure and cholesterol. And, he was overweight.

An article in the NYT on June 19 raised the question, "Could a Defilbrillator Have Saved Tim Russert?"

My question was even more basic: was an automated external defibrillator, or an A.E.D., even available in the NBC HQ in Washington, D.C.?

The answer, according to the Times, is yes. Among others, the paper interviewed Russert's physician, Dr. Michael Newman. Here's a portion of the article, from June 19:

"NBC had a portable defibrillator on site; however, it's not clear how soon after the collapse it was retrieved. Just as paramedics were arriving, NBC employers were preparing to use it, Dr. (Michael) Newman said. Instead, the E.M.S. workers took over, defibrillating Mr. Russert three times before his arrival at Sibley Memorial Hospital.

"In an interview, Dr. Newman said he did not know the exact amount of time between Mr. Russert's collapse and the first effort at defibrillation; however, he said it was 'significant, more than you would want.'"

In the case of Tolbert, no A.E.D.s were in the newsroom, altho Gannett HQ in Reston, Va., had them. I am told they were installed at the Star after Tolbert died. Also, Tolbert was given CPR by two newsroom copy editors. I am also told, in the aftermath of Tolbert's death, that the Star offered CPR training to employees.

This is no doubt an unpleasant subject for some readers. Nobody wants to play the blame game. But that is not the point.

We all need to think about the unthinkable. We all need to be prepared.

The Times piece points out the availability of A.E.D.s now in many airports, golf courses and other public/private venues. It also gives stats on the effects of A.E.D.s in reducing death:

"Survival rates for out-of-hospital cardiac arrest are only 1 percent to 5 percent and usually are predicted by how quickly emergency workers arrive at the scene. But in studies in which defibrillation was applied almost immediately, survival rates have reached as high as 80 percent. With each minute of delay in defibrillation, survival chances drop by about 10 percent. In June 1999, A.E.D.'s were installed throughout Chicago's O'Hare and Midway Airports so that response time would be about one minute at any location. In the first 10 months, 14 cardiac arrests occurred, and 9 of the 14 victims, or 64 percent, survived."

If we dare to think "The Unthinkable," which of course we must, we will all demand that A.E.D.s be in every workplace and that workers are trained -- and ready -- to use them. More power to that.

(And for those who want to criticize me for once again bringing up the sorrow of Mpozi's death, my father died in the newsroom of cardiac arrest in 1949. A.E.D.'s did not exist then. They do now, and they should be utilized).

Here is the NYT link, with thanks to intrepid friend Harriet Rosen for sending it my way:

http://well.blogs.nytimes.com/2008/06/19/could-a-defibrillator-have-saved-tim-russert/

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