Stayin’ Alive

Gary Pagtama and Emery Desilets have been friends for years, “gym buddies” who play basketball together multiple times per week.

But one December day in 2022, after the two had played basketball, Gary’s heart suddenly stopped.

Emery, who had gone to the gym’s weight room, saw people running from the basketball court and went to see what was happening. He found his friend seizing on the floor.

He immediately started doing cardiopulmonary resuscitation (CPR).

A 26-year veteran of the Houston Police Department and a member of the security detail for the last three Houston mayors, Emery was trained in how to do CPR but had never had to use it. “I remember thinking when I first got CPR training that I hoped I’d never have to,” he says, “but then Gary went down right in front of me.”

After less than 10 minutes, paramedics arrived and took over. Gary was rushed to a hospital where it was discovered that, even though he was physically fit and seemingly in perfect health, four of his arteries were blocked. He required open-heart surgery.

“Emery is why I’m alive,” Gary says simply.

 At the gym at the time, though a crowd of about 40 had gathered around Gary, Emery was the only one who performed CPR.

In 2020, Mark Nitcholas was similarly lucky to have had a person willing and able to do CPR nearby. Mark, a former marathon runner and father of three, had been out for his usual early-morning run when he collapsed. As was reported in The Buzz soon after [Heart Attack Foiled: When a heroic nurse drives by by Annie McQueen, Sept. 2021], Ashley Miller, a nurse practitioner, happened to be driving by and saw him lying in the street. She directed another bystander to call 911 and did CPR on Mark for six and a half minutes until the ambulance arrived.

Mark says it was never determined exactly what happened to the electrical impulses in his heart, but he was put into a coma and onto a ventilator and a heart pump for 10 days to allow his heart to recover and now has a defibrillator implanted in his chest. (A defibrillator is a device that shocks the heart when it’s beating abnormally to correct its rhythm.)

At the time of his incident, he says, the doctors were “not very positive about my chances” when they spoke to his wife.

“If it were not for Ashley, I wouldn’t be here,” Mark says.

STRANGERS TO FRIENDS Nurse Ashley Miller saved runner Mark Nitcholas’s life by performing CPR on him in the middle of the road. They have since become friends and recently went to dinner together. From left: Scott and Ashley Miller and Mark and Zamara Nitcholas.   

Cardiopulmonary resuscitation, or CPR, is a simple act that can save lives. Receiving “bystander CPR,” immediate CPR from whoever is around, “can potentially triple a person’s chances” when they are experiencing cardiac arrest, says Salil Bhandari, an emergency-medicine doctor and the director of medical education at the McGovern Medical School at UTHealth Houston. Cardiac arrest is when a person’s heart suddenly stops functioning; the person also becomes unconscious and is either not breathing or is breathing abnormally. It can be caused by heart disease, a heart attack, a heart defect the person never knew they had (as happened recently to Lebron James’s 18-year-old son Bronny, whose life was also saved by someone performing CPR) as well as from accidents like drowning or choking. 

Cardiac arrest is a leading cause of death, with more than 400,000 people dying of it each year in the U.S., according to the American Heart Association. According to Gail Gould, it’s been estimated that 100,000 to 200,000 of them could be saved if CPR is done immediately.

Contrary to popular belief, CPR does not restart the person’s heart. Basically, the person doing the chest compressions is acting as the victim’s heart, keeping the blood pumping to vital organs including the brain, until more medical care, such as a shock from an automated external defibrillator (AED), can be provided.

Also contrary to popular belief, CPR is simple to administer. While the general public was once taught to do both chest compressions and rescue breathing (mouth-to-mouth resuscitation), now the guidelines for “bystander CPR,” also called “hands-only CPR,” for adults, is just to do the chest compressions. 

“There are literally just two steps,” says Dr. Bhandari. “Call 911 and put your phone on speaker (or have someone else call) and start pushing on their chests at the rate of about 100 beats per minute.” Often, CPR trainers recommend thinking of the song Stayin’ Alive by the Bee Gees because the song’s tempo is just right for CPR chest compressions. (There are several CPR music playlists online, including from the American Heart Association. Other songs with the correct tempo include the also-fitting I Will Survive by Gloria Gaynor and the less-fitting Another One Bites The Dust by Queen.)

It is still advised to do rescue breathing when doing CPR on children, in a pattern of 30 compressions, then two rescue breaths, because when children go into cardiac arrest, it is most often because of some problem with their lungs and their breathing. The same is true of unconscious drowning victims of any age.

Taking a CPR class is best because you learn all the details of doing CPR, such as exactly where to put your hands. “If it feels soft and squishy under your hands, you’re in the wrong place; your hands should be on the sternum, which will feel hard and bony,” says Gail Gould, Houston’s CPR and Safety Lady, a professional CPR and first-aid instructor with 35 years of experience. You will also learn how to perform rescue breaths if necessary, and how to perform CPR on babies. (You only use two fingers on their chest and you cover both their nose and mouth with your mouth when doing rescue breaths.) When you go to a class, you also get to practice on a specialized mannequin. And you learn and get to practice other skills, such as how to use an AED, which are available in many public places, such as government buildings, malls, and airports, to actually restart the person’s heartbeat and how to do the Heimlich maneuver (abdominal thrusts) when someone is choking. And you will learn interesting tips such as, don’t just call out, “Someone, call 911” to bystanders, but point to a specific person and say, “You, call 911,” to make sure it gets done. Completing a class will make you feel more confident in your abilities if you do ever need to use them.

But even if you haven’t been to a CPR class and you come upon someone in cardiac arrest, do it anyway. As Dr. Ben Bobrow, also of UTHealth Houston, says in a three-minute video called “How to do CPR during COVID-19,” “The only way you can mess this up is by not trying.”

For example, according to news reports, a 21-year-old man was able to save an unconscious woman’s life in Tucson, Ariz., though he had never been trained. He remembered, however, seeing CPR performed on an episode of the sitcom, The Office.

And AEDs, those portable defibrillators in public spaces? They are actually designed so that an untrained person can use them. The machine provides step-by-step instructions, usually spoken, and the device itself determines whether the victim’s heart can and should be shocked.

A common fear is you may hurt the person by doing CPR. When you do the chest compressions, you do them “really, really, really hard,” says Gail Gould. And it is not uncommon to break the person’s ribs. But broken ribs are a relatively minor injury that heals; an oxygen-starved brain does not. And people who try in good faith to help someone, including by performing CPR, are protected from liability by Good Samaritan laws in every state.

Gail Gould notes that parents of babies treated in the NICU (the neonatal intensive care unit of a hospital) learn infant CPR before discharge. “I think all new parents should be taught it,” she says. Mark Nitcholas thinks that everyone should be required to learn it when they get their driver’s licenses. And Dr. Bhandari says, “I still don’t understand why the training isn’t mandatory in all schools. It really, truly should be.” Dr. Bhandhari has special reason to think so. During his high-school graduation, his grandfather collapsed with cardiac arrest and was saved by bystanders who performed CPR.

Both Gary Pagtama and Mark Nitcholas are now certified and ready to do CPR should someone else need it. “You do not want to be twiddling your thumbs not knowing what to do if this happens to someone close to you,” says Mark. Dr. Bhandari points out that approximately 70 percent of OHCAs (out-of-hospital cardiac arrest) happen at home. “If you ever do need to do CPR on someone, the highest chance is that it will be on one of your family members,” he says. A 2022 article in Circulation, a peer-reviewed journal published by the American Heart Association, published an astonishing fact: Over 75 percent of the people who did perform bystander CPR did it on someone they had known for more than 45 years.

Gary has also trained in CPR and first aid and has volunteered to be a “floor warden,” one of the people in his workplace who are ready to respond to an emergency.

“I am a survivor,” he says, “and I want to give back.”

CPR Resources

Both the American Heart Association and the Red Cross maintain online directories that can be used to find CPR courses near you.

Gail Gould, known as The CPR and Safety Lady, teaches a number of classes covering CPR, the use of AEDs and first aid, to a range of groups and individuals, including an infant and child babysitting course. 

Many companies offer CPR and other first-aid training to their employees, as do many schools and colleges. Search local colleges and hospitals to check for CPR classes open to the community.  

Organizations, including fire departments and The Junior League of Houston, offer classes to the public. Some charge a small fee; others are free.

The cost in time is also minimal. A class “takes a couple of hours on a Saturday,” says Mark Nitcholas.