Last Tango of the Living

               Last Sunday I drove my mother and sister to Mesa Verde. On the final leg of our twenty-mile journey through the park we came across three mountain bikers in the middle of the road. Their arrangement immediately struck me as odd and I remarked that it looked like someone doing CPR, cardio-pulmonary-resuscitation.

               I hoped I was wrong but I was not:-(

               We pulled past them and parked the car. I got out and went over to the three people, who looked to be in their late sixties or early seventies: a woman standing, a man performing chest compressions on another man who lay sprawled on the ground.

                My thirty years of river running experience has led me to expect that more qualified people than me would be around to handle such a situation. It saddened me to find this was not the case here.

               The victim’s skin was tinged blue. I discovered later he had been unconscious for five to ten minutes before our arrival. Since someone was already compressing the chest it seemed logical to me that the best way I could help would be to deliver oxygen to the victim.  

               Shortly after the advent of AIDS, most of my CPR instructors advocated for the use of a plastic device as an interface between the rescuer’s mouth and the recipient’s mouth. I’ve always wondered what I would do in such a situation if I didn’t have such a device and yesterday I found out. Reluctantly, I tilted his head back, pinched his nose and extended his chin with my thumb. Placing my large mouth over his unshaven face I exhaled a huge breath into his body.

               This was disgusting!

               Once I started artificial respiration I lost focus of everything else. I remember hearing a woman crying in the background. The victim’s skin tone returned back to its normal color immediately upon receiving my breaths.

               That’s as far as we got towards resuscitation.

               It was difficult to exhale into the lifeless body in the position we found it and I began to consider what we could do better. I unstrapped his small backpack which was still beneath him and encouraged others to help straighten him out to maximize the effect of our efforts.

               While I was blowing air into the man’s lungs, an annoying woman started singing the song ‘Stayin’ Alive’ by the Bee Gees. This seemed out of place to me but no one ejected this crazy person from the premises and I was in no position to object to the distraction.

               “Uh, uh, uh, uh, stayin’ alive, stayin’ alive,” she tried to sing, her voice obviously strained, “uh, uh, uh, uh, stayin’ alive…”

               I couldn’t for the life of me figure out why she was singing. I later learned that the timing of this melody is also the same timing at which chest compressions should be delivered. Students getting their CPR certifications are taught this in class.

               I continued with the breaths hoping someone would relieve me. I heard sirens and then a woman offered to take my place delivering breaths. After a valiant effort she conceded that her mouth was not big enough to cover his. It seems my thirty year lucky streak of finding expert help in dire situations had completely run out this day and I was forced to continue providing breaths until emergency personnel arrived with a manually operated breathing apparatus.

               I wasn’t relieved of my duties, however, once the respiratory contraption was in place. A female park ranger delivered compressions while someone else delivered oxygen via a hand pump. When she got tired, she asked me to take over for her. It took me five seconds to get the hang of it but soon I was administering compressions just like a trained professional. We took turns pumping his heart until the paramedics arrived in a helicopter.

               Eventually another person arrived to administer chest compressions and my part in the CPR was done. I finally had a chance to speak to the woman who was singing. By this time she was wailing uncontrollably and I told her she was not making recovery any easier for the man on the ground. She immediately quieted down only to erupt again a few minutes later.

               When I rejoined my mother and sister watching from a distance of only a few yards away, I found out this woman was the victim’s wife of forty-nine years. They had married when he was twenty-one.

               Unfortunately all our efforts were not enough to revive the man who lay on the ground. He stayed dead in spite of more than two hours of sustained emergency life support assistance. Well-equipped, trained park personnel arrived on the scene within forty minutes. A helicopter and paramedics were there inside of an hour: a pretty good turnout for southwestern Colorado’s remote Four Corners Region.

               I have thought about this event a lot. I couldn't sleep very well until I answered two questions.

               Question#1: how will this affect me psychologically? Other than my repulsion at having to cover another man’s face with my mouth, I don’t have any feelings I could classify as negative. I’m certain he will show up in my dreams from time to time but that would be normal.

               The deceased’s body-shape was much like mine and that has had an impact. Even though he was seventy years old we both have the same size beer belly. It has been four days since the event and my diet has changed considerably. No more egg mcmuffins or sausage biscuits for breaksfast for me, from now on it’s cucumbers and tomatoes.

               I’d been having a difficult time getting back into an exercise routine but not anymore. I walked for an hour with my sister the next day and then swam ten laps at the Durango Recreation Center pool. I feel a heck of a lot ‘cleaner’ inside after four days of a diet consisting mostly of fruits and veggies.

               Question#2: was that a satisfactory end to that man’s life?

               His friend since they were both seventeen years old had been riding with him when the man collapsed.  After the helicopter left, we shuttled him back to his car and he identified the dead man by name. With a little research I discovered the man was a professor of biology. Considering what I had learned from his death, I’d have to say his final ‘lecture’ was invaluable to me and others as well.

               I have been training for an incident like this for most of my adult life. I always carry a well-stocked first aid kit but now I know I can improve it with a good respiratory shield. I’m fairly certain I could administer effective CPR, tandem or solo, now that I've had some hands-on experience. Hopefully there will never be a need for it but, if there is, this man’s death may lead to the successful resuscitation of someone else.  

               I now know that I can handle, emotionally and psychologically, a negative outcome in such an event. I'm sure that, if I do everything in my power to achieve a more positive ending, I won't suffer any recurring stress after the event. The distressed spouse added greatly to level of anxiety at the scene. That I was able to perform competently in spite of the hysteria gives me comfort when I think about future wilderness excursions and the possibility that a similar calamity may occur.  

               If I think of this man's death in tango terms, then I'd have to say it is like the end of a great tanda of tango dancing: if the participants break their embrace longing for more, this is the sign of a healthy engagement. His wife definitely indicated her desire for him to stay with a cry that rent the very fabric of the universe through which his life force must have escaped.

               I have to conclude that the answer to the second question is that he died well. I know I would be flattered to have a spouse miss me the way his wife obviously did. Any man would be proud to have a woman put on such a public display of anguish at the loss of her husband.

               That everybody did so much in his final hour to keep him here contributed a sense of closure to his departure, if not for him then certainly for his wife. 

               That we worked without expectation of compensation is probably the finest aspect of the event. I guess it was our way of saying that we truly did not want him to leave. In America, anyone with adequate health insurance is in danger of being kept alive until every last bit of revenue is drained from every available resource a person has which, to me, seems like an undignified death.

               When I consider all the other ways there are to leave this world I am reminded of an old Irish proverb that advocates for a person to ‘leave the pub a little bit thirsty, the table a little bit hungry and the bed a little bit tired’.

                The man that died that day left life with a little bit of it still in him. As in all of Life’s lessons there was a great deal to be learned in his passage to the Great Unknown. In the greatest of all tangos that we dance, the Tango of Living, these two participants parted ways hungering for more. Theirs was a dance well done.

              
 Note: For an in-depth look into the mind of the Kayak Hombre, read his book, available on Amazon: http://www.amazon.com/River-Tango-perri-iezzoni/dp/1453865527/ref=sr_1_1?s=books&ie=UTF8&qid=1369366756&sr=1-1&keywords=River+tango