I saw a man dying, right in front of me. And there was nothing I could do about it.
I was just getting into the evening paper on a Friday night subway ride home when I became aware of a gurgling noise behind me. It seemed to get louder, and the thought flashed through my mind that some lout was slurping a milkshake to annoy everyone.
I turned around to see what was going on.
He was 60-ish and big, wearing a coat and tie and carrying a briefcase, and the gurgling was coming from him. His mouth was open, his tongue was out, and he was sliding from his seat to the floor. The train had just stopped, and people were frozen there, looking at him. A couple of women got up from the seats nearby and hurriedly walked away. No one was helping him. No one knew what to do.
A couple of us ran over to help him sit up, but he wasn't conscious and his body sagged back toward the floor, I ran for the door to tell the motorman or an attendant, but then I was afraid the train would pull out of the station. I remembered the intercom at the end of each car.
"Tell him the car location," someone shouted, and I pushed the button.
"There's someone sick in one of our cars," I said. In the excitement and confusion I forgot we were in the last car.
"We've got someone on the way," the motorman answered.
Everyone was standing. The man was stretched out on the floor. He seemed to be exhaling at times. "He's breathing," said the young man who had positioned himself near the sick man's head.
Another man, who had seen cardio-pulmonary resuscitation CPR) on TV, as I had started to sort of slap this big man on the chest. But you could tell he wasn't doing it right. None of us was trained. When do you know if it's right to do CPR? I thought. Shouldn't someone check his tongue, help him breathe?
Someone suggested that we all sit down and give the man plenty of air. Meanwhile, nothing substantial was being done to help the man who was surely dying.
He'd no doubt been on his way home at the end of another work week. One minute he was fine, the next he was dying before our terrified eyes.
The motorman's voice came over the loudspeaker:
If there's a doctor on the train or someone who knows emergency first aid, please go to the platform at the rear of the train."
Soon a young woman came rushing through the car. "I know CPR, she said. The man who had been slapping at the victim's chest stepped aside, and she took over. She gave instructions to a man nearby to begin mouth-to-mouth breathing. Alternating with his breaths, she rhythmically pushed the heel of her hand against the sick man's breastbone while she counted out loud: "One, two, three, four, five, six, seven."
Had they begun in time? Doesn't it take just four minutes of oxygen starvation for our brains to begin dying? How long had it been?
By now two more who knew CPR were nearby. One big man offered to help her. She said maybe he could deliver more punch to the victim's chest and turned it over to him. He tore off his coat and soon was shouting "One, two, three, four, five . . ." in a southern accent while he pushed hard on the victim's chest. Then he stopped to look for a pulse.
A bystander urged them to keep up the breathing and pumping, but the big man replied, "If he's got a pulse we could be doing more harm than good." Alternately, you'd hear someone say he felt a weak pulse, that the man was breathing or that he wasn't. The woman, who had taken charge so well before, looked frustrated and anxious. The whole thing seemed to be failing.
Finally, some Metro police, who we assumed were trained to handle this kind of thing, appeared and ordered everyone off the train. But they didn't being CPR right away either.
Precious minutes were ticking away. The man was ashen and unresponsive. Those who had helped try to keep him alive stayed near the train to see what would be done. When our replacement train came and we were boarding, I saw a stretcher. Had the interim help been enough, or had we found trained people too late?
Moving on the Blue Line again, I found the evening paper didn't matter much now. I started thinking about the faces of concern on the train -- the faces of people watching as a life ebbed away, people with the frustrating knowledge that they couldn't do a thing about it and the thought that the victim could be one of them, one day.
We've all seen the public service ads for CPR training. We've all been encouraged to take it at one time or another, and most of us -- myself included -- have said we don't have the time. Besides, there's always medical help close at hand.
But is there? Here we were in a major U.S. city. How long had it taken -- 20 minutes? a half hour? -- for professional help to arrive?
And yet an oxygen-starved brain can only survive for a few minutes.
I work on the Hill, just a few minutes walk from the Capitol physician's office. What if someone on our staff were to keel over? Or at home, or at the store, or in the car -- how long would it take an ambulance to get there?
I know now that CPR has something to offer. That young woman on the subway knew what to do at once. She acted with authority and made the rest of us feel that the man's life was in capable hands.
But, usually, there's no one there but us when fate strikes.