Saturday, July 27, 2013
PORTLAND — Prem Raghu’s lucky numbers might as well be his flight and seat: American Airlines’ No. 1006; seat 24D.
That’s where the 67-year-old retired custodian was about 2 p.m. April 3, when he suffered cardiac arrest at 29,000 feet.
Ominous as that sounds, it was the right place at the right time, given that he was surrounded, far and away, by the right company.
Prem was in the middle seat. His wife, Manjula, was next to the window. As they headed toward Dallas to visit their daughter, the Southeast Portland couple chatted and joked.
Prem fell silent.
When Manjula glanced his way, she noticed his eyes closed. His pallor looked gray. He sat too still.
She tapped him on the cheek saying, “Wake up!”
He didn’t respond.
She doesn’t recall what she said next, but Manjula’s distress got the attention of those around her.
Dr. Joaquin Cigarroa, seated on the aisle one row behind Prem, handed his laptop to Judi Workman, his co-worker across the aisle. He stepped forward, turned to Prem and checked for a pulse but couldn’t find one.
He called to flight attendants to get an automated external defibrillator, then tried to drag Prem out of his seat onto the floor.
The armrest, stuck in the down position, was in the way.
Flight attendants and passengers converged to help but in the cramped space, they couldn’t budge Prem.
A woman sitting by the window, behind Prem’s wife, sprang to her feet. “I’m a nurse from OHSU,” she said. “I can help.”
Candace Funicello bolted past her mother, seated in the middle, and helped Cigarroa lift Prem across the armrest and onto the aisle floor.
Panic-stricken, Manjula watched as Cigarroa opened Prem’s shirt and started hands-only cardiopulmonary resuscitation.
Other than the sound of the doctor at work, she says, all she heard was the nurse’s mother, Betty Osmondson, saying, “Don’t worry, honey, I’m praying.”
Within a minute flight attendants arrived with a defibrillator, which, when powered on, delivers electricity to stop arrhythmia, allowing the heart to re-establish an effective rhythm.
Cigarroa, clinical chief of the Knight Cardiovascular Institute at Oregon Health & Science University, placed the defibrillator pads on Prem’s chest. Just before electrifying the device, the doctor noticed Prem move.
Workman, director of OHSU cardiovascular services — the woman holding Cigarroa’s laptop — heard Prem moan. She saw his eyes flutter open.
Cigarroa felt for a pulse.
There it was.
Manjula heard two words: “He’s back.”
Cigarroa advised flight attendants to disarm the defibrillator.
Over the next 10 minutes, Prem fully regained consciousness.
Cigarroa told the attendants the plane should land as soon as possible. Prem needed a hospital.
The aircraft was near Salt Lake City and on the public address system, the pilot advised passengers they’d make an unexpected landing there for a medical emergency. They shouldn’t be on the ground long, but if they had connecting flights in Dallas, they might miss them.
Workman, who held Prem’s hand and comforted him through the landing, didn’t hear anyone grouse.
Cigarroa turned to Manjula and inquired about Prem’s cardiac history.
Thirteen years ago, she told the doctor, Prem had a heart transplant at, of all places, OHSU.
Workman remembers thinking, “How can this be?”
“We were meant,” she says, “to be together that day.”
The plane made a quick, steep descent. When it rolled to a stop at Salt Lake City International Airport, the pilot got on the PA again. He explained what Cigarroa and Funicello had done for Prem.
Passengers burst into applause.
When medics boarded and took Prem away in a wheelchair, they applauded again.
“The spirit on that plane was so high,” Workman says. “A life had been saved.”
In Dallas, Funicello and her mother continued on their way, heading for a cruise through the Panama Canal. Workman and Cigarroa, in Texas for a meeting of cardiology leaders, went about their business.
Back in Portland, Workman nominated Cigarroa and Funicello for a Golden Rose Award, given monthly at OHSU for exceptional patient care or outstanding service.
None of them knew Prem’s name, so without telling the doctor or nurse, Workman sleuthed around OHSU’s transplant program, inquiring which patient, likely a gentleman in his 50s then and of South Asian descent, had a heart transplant 13 years ago.
She dialed his phone number.
“Oh my goodness,” she remembers him saying, “I’ve been looking for you.”
He’d not known who saved his life. He wanted to thank them.
Workman asked if he’d like to surprise Cigarroa and Funicello and thank them in person at Wednesday’s Golden Rose Award ceremony at OHSU.
Shortly after noon, Workman stood at a microphone before a crowd of co-workers and told them the story. Applause, of course, ensued.
As it quieted, a man and his wife, hidden away in a side room, slipped through the door and made their way to the front.
Recovered from a recent operation to install a pacemaker, Prem looked the picture of health. Manjula beamed.
Workman turned to Cigarroa and Funicello. She had someone she wanted them to meet.