At 68, my husband Ron was considered active and healthy by any standard. He played hockey twice per week. He lifted weights, chopped wood, worked his excavation business and had been a police officer for 45 years. The word “rest” was not in his vocabulary. He worked hard to build his business while also working full-time for the New York State Police. A veteran of law enforcement, he’d been a deputy for the Livingston County Sheriff’s Office prior to becoming a State Trooper. Then, soon after retiring from the State Police in 2010, he returned to the Sheriff’s Office as a deputy again simply because he missed the work. 

About a month prior to Ron’s event, we’d adopted a rescue dog, Tate, and the two of them cemented a quick bond by going for daily runs. Ron’s energy and drive were boundless. I was fourteen years his junior, but I often liked to kid that he was in better shape than most of the people I’d graduated high school with, including myself. Ron and I had been married for almost 30 years by this time, and I don’t think I’d ever seen him slow down once. As for myself, I’d spent 17 years as a nurse working in the neonatal intensive care unit before transitioning into a stay-at-home mom.

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November 11, 2022 began like most other days for our family. It happened to be Veteran’s Day, which meant that our daughter Carys had the day off from school. Because she was home, I decided to take a morning off from the gym and relax with a second cup of coffee before beginning what should have been a day of leisure. However, “leisurely” would be the last word anyone would use to describe the events of this day, the 56 days of my husband’s hospitalization that followed, and the year of rehabilitation afterwards. 

By 7:30 a.m., Ron had taken Tate for his first walk of the day, and they returned about a half hour later. We were chatting in the living room and making plans for Thanksgiving when we heard Ron gasp. Carys immediately cried out, “Oh my God mom, what’s wrong with dad?!” I looked over and saw Ron staring ahead expressionless. I approached him, turned his face toward me, and said, “Hey, what’s the matter?” But he gave no response. His arms suddenly stiffened, his hands began to twist at the wrist, and the cup of coffee he’d been holding spilled all over. I called 911, wondering if he’d suffered a stroke. As I spoke with the 911 operator, who was a co-worker of Ron’s at the Sheriff’s Department, we quickly realized that I needed to pull him out of his chair and onto the floor to begin CPR. He’d suffered a cardiac arrest. 

Carys pulled her father’s legs out from his chair while I held his head so that it would land gently on the floor. Once Ron’s whole body was on the floor I began to perform CPR, giving the phone to Carys to continue speaking with the 911 operator. Just five minutes after starting CPR I was joined by another of my husband’s wonderful co-workers, Becky Kane, who’d received the call from the 911 dispatcher. As the two of us continued CPR while waiting for EMS to arrive, Ron would occasionally seem to take a gasping breath but had no palpable pulse. Some minutes later, we were joined by a 3-person EMS team. One positioned himself near Ron’s head and delivered a total of 5 shocks. His heart had gone into ventricular fibrillation, a dangerous rhythm. As they worked, worried friends and family began to arrive at the house by the dozen, and soon there were more people than I could count. Despite the chaos that surrounded us, nothing distracted the team from their work. They worked together with a quiet, seamless flow, and after 31 minutes, they were able to regain a pulse. 

The Livingston County Sheriff, Thomas Dougherty, had also arrived at the house shortly after hearing of Ron’s cardiac arrest. Tommy was processing the enormity of what was happening to Ron in the moment along with all the family present, yet still had the kindness to think of me and offer a ride to the hospital. He stayed with me as I entered the Emergency Department at Strong Memorial Hospital and made every effort to facilitate my continued presence in the cubicle where Ron was now lying unconscious as staff buzzed around, initiating his plan of care. However, due to space constraints, I was soon forced to leave as there just wasn’t enough room for everyone involved. I’d have to wait outside and trust that Ron was in good hands. 

Upon his arrival to the Emergency Department he was placed on a ventilator, and his vital signs had stabilized. A CT scan of his head was completed, and thankfully there was no immediate evidence of any brain injury. He was eventually admitted to the ICU, where his body temperature was cooled to protect his brain—a process that required sedation and paralytics. We settled in, knowing there might be a long wait to see what Ron’s ultimate outcome would be. Unfortunately, my experience as a neonatal nurse didn’t offer much of a foundation of knowledge for what to expect for Ron’s hospital course, but the amazing ICU staff spent hours with me on our first day there explaining the science behind the cooling treatment and what to look for in the coming days that would indicate that Ron was making good progress. I was welcomed to listen in when the team rounded on him, and I received a visit from one of Ron’s doctors afterwards to ensure I understood everything that was discussed and how they were feeling about his prognosis. 

The team had performed an echocardiogram, or an ultrasound picture of the heart, and it showed that Ron had a significant cardiomyopathy—in other words, his heart was not pumping well. This cardiomyopathy likely led to his cardiac arrest, but it wasn’t clear what had caused it. Ron would need a cardiac MRI as well as an angiogram, but everyone’s first priority was to stabilize him and preserve his neurologic function. 

***

Shortly after Ron’s transfer to the ICU, Strong Memorial Hospital’s Chief of Surgery, Dr. Mark Gestring, introduced himself and explained that he had a close working relationship with the New York State Police. He let me know that he’d be checking in on Ron as frequently as possible and asked that I let him know if we needed anything at all. True to his word, he  checked in almost daily for the next 55 days, and to this day remains a source of support and friendship that we appreciate beyond words. Meanwhile, flocks of supportive family and friends came from near and far to support Ron throughout his hospitalization. They visited every day, making every attempt to wake him once he was weaned off the paralytics and sedatives, and were a mighty source of support for me too. My sisters-in-law Irene and Paula made sure Carys was taken care of at home while I spent each day at Ron’s bedside. Law enforcement officers, both in uniform and out of uniform, came to the hospital by the dozens to offer their support, and my own former hospital co-workers checked in regularly too. If the support, love, and prayers of friends and family were all that were needed to ensure a quick recovery, we had the bases more than covered. 

Unfortunately, Ron’s recovery was not progressing as we had hoped. He still hadn’t woken up by the fourth or fifth day of his hospitalization, even though his body had been rewarmed after completing the cooling period. He was having jerky movements (known as myoclonus) throughout his body, which typically is not a good sign. His EEG was described as “angry” with a lot of abnormal electrical activity in his brain, and he was started on two anti-seizure medications. When he did finally show signs of awakening, he initially wouldn’t respond to any stimuli. I often sat at his bedside and held his hand, asking him to squeeze my hand even a little if he could, telling him about each day’s events and that we loved him so much. He remained intubated and still required too much support from the ventilator for it to be weaned. Then another blow came when the results of his brain MRI were disclosed, as there were signs of damage from lack of oxygen in multiple areas of his brain. 

As some of this information accumulated and his exam did not improve, the ICU staff decided it was time to gently broach a terrifying subject with me. I was encouraged to begin having conversations with family to determine whether it would be best to continue to go all-out with Ron’s plan of care, or opt for “Comfort Care,” withdrawing support and allowing him to pass comfortably. The Palliative Neurology team was introduced to me, and a member of Strong Memorial Hospital’s Child Life department was brought in as a support for Carys. Dr. Daryl McHugh, the neurologist on service who had been following Ron, informed me that Ron’s prognosis was grim, as his tests indicated that he’d be likely to require nursing home care if he were to survive. I was encouraged to make a decision at the two-week mark. If we opted for all-out care and Ron still hadn’t shown more signs of awakening by that time, he would need a tracheostomy and feeding tube placed, then likely transition to a skilled nursing facility. If we opted for Comfort Care, he’d be made as comfortable as possible until he passed, and the breathing tube would be removed. We decided to have a family meeting involving ICU staff, Neurology, and Palliative Care that would take place on the afternoon of Ron’s seventh day of hospitalization. 

On an early morning the week after Ron’s cardiac arrest, his niece Shelley arrived at the hospital, and we held each other’s hands as we walked the corridors together. Shelley shared that she believed in miracles, and she was sure that her Uncle Ronnie was going to fully recover. I told her that was also what I hoped for, but his tests showed that there was a strong chance of his being destined to live in a nursing home, confined to a bed, unable to breathe, walk, or eat on his own. In the year or so leading up to Ron’s cardiac arrest, he’d worked many shifts as a deputy at our county nursing home, and we’d had countless conversations about his time there that began with my expressing pity for many of the residents and ended with him saying: “Let’s just enjoy the time we have right now. This is the best time of our lives.” 

While I knew he would be horrified at the prospect of being bedridden in a skilled nursing facility, I also didn’t know whether I’d be emotionally able to initiate withdrawal of support if it were deemed necessary. My greatest fear was that I’d either doom him to a life of dependency on a ventilator and with a feeding tube, unable to walk or talk, and that he’d eventually die of pneumonia, or else I’d “pull the plug” and never know if he might have achieved the miraculous recovery that Shelley was so confident in. Either way, I was sure he’d hate me from the afterlife. 

That afternoon, our family assembled in a small room outside the ICU and listened as Dr. Roberts, the new neurologist on call, reviewed Ron’s test results with us. In her words, while his neuro tests and exams were not encouraging, she couldn’t say for certain what his outcome would be. “We just don’t know,” she said. It was likely that he’d experience some deficit, but we’d have to determine what would be a meaningful existence for him going forward. I decided that as long as we didn’t know, we’d continue to throw everything we had at him medically and hope for the best.

After the meeting ended, I wandered down to the cafeteria to look for dinner and think. As I perused the salad bar, sandwich bar, and dinner specials in a fog, hoping I’d done right by Ron, I thought I heard the opening chords of one of our favorite Cars songs, and almost laughed out loud. I looked up toward the ceiling to listen clearly, and sure enough, the hospital cafeteria was playing “Just What I Needed” by the Cars. As I listened to the obscure tune that Ron and I had probably played a hundred times for each other, my heart lifted, and I wondered if it was possible that Shelley was 100% right after all. Thankfully, mercifully, and miraculously, Ron woke up later that same evening.