18 Years. It went by quick. I took another bite of my dessert and smiled at my beautiful wife. We were at our favorite steakhouse enjoying our dessert. Coconut fudge Sundays. The same ones we get every time we go there. Couple that with an espresso and it is the end to an amazing meal. So far the night had been perfect. Grandma was at home with our little ones and we had the night to ourselves. Great service, amazing food and celebrating our 18 year wedding anniversary with my lovely bride. We were lost in conversation talking about life, kids, professional path, etc.
"Help, she’s choking…"
The plea came barely audible over the sounds of the nightly dinner rush and the piano playing in the bar across the floor. The plea came from the table next to ours that was separated by a partial height partition. It wasn’t a frantic cry for help and it seemed almost unenthusiastic. Regardless, I was out of my seat around the corner and to the table in about 3 seconds. By the time I got there a man was struggling to pull an elderly women out of her bench seat and get her over a chair. He was struggling to lift her weight. I grabbed her and threw her over the chair, hoping to get a better angle on her and use it to support her. Once over the back of the chair I pushed her into it hard, which caused her to expel a bunch of liquid and some food. There was no struggle. No flailing of arms. No distress. She was unconscious. I would later find that this is odd as the request for help had only come seconds earlier.
Lifting her up I proceeded to administer the Heimlich maneuver. By this time the restaurant staff was gathering around. The woman was limp in my arms and even as I thrust my hands in and up into her abdomen she remained un-responsive. No more food came out. I then laid her out on the floor.
The lighting had been turned down for the ambiance of the evening so visibility was poor. I always carry a light with me so reaching into my pocket I grabbed my Elzetta Alpha and activated it. 415 lumens hit her and I saw her face clearly for the first time. She was quite old. Her eyes were open and her mouth agape. As I am examining her I asked if anyone had called 911. Many had and the staff informed me the first responders were on their way. As I looked into her mouth I could see a lot of food still in there. I began to sweep the food out. I had asked what she had eaten. "Lobster." someone said.
I hate lobster. They are just big ass sea bugs that have a rubber texture. Perfect thing to block an airway. As I swept her airway I asked a bystander to give upwards thrusts just below her rib cage, in hopes of forcing some sort of expletory reaction. This caused her to expel some air. Well that seemed to be a good sign. If air can get out it should be able to get in. I rolled her into a recovery position and reassessed. I put my head down to her face. I couldn’t feel any breath on my cheek. I took her pulse. I couldn’t find one. Not good. I rolled her back over and I gave her two rescue breaths to test for chest rise and fall. "Did any air go in?" I asked my assistant. "No." Shit. I had no success in opening up her airway. She wasn’t breathing. Neither I, nor my assistant, (who turned out to be a member of her dinner party), had any luck clearing her airway.
ABCs… Airway, Breathing and Circulation. The first two were a no-go so I began chest compressions. I needed to get her oxygen rich blood circulating. During this entire process I was talking to her. Telling her to hang on. To spit it out. That she could do it. I have no idea how long I gave her compressions. I just kept rhythm with the Bee Gees. "Stayin’ Alive, Stayin alive…" Good song, but no response. Maybe we could still get whatever was blocking her air way out. I was willing to try anything at this point. Pausing compressions I picked her back up and threw her back over the chair. Just as a last dich effort in hopes that gravity would be on our side. Nothing.
As I was bringing her back down to the ground to begin compressions again the first Emergency Medical Technician (EMT) showed up. "I got her." He said. We laid her down as more first responders came in. Me and a firefighter moved the tables out of the way so the team could get around her. They requested the lights be turned up. The restaurant staff complied however restaurant lighting is usually on a timer to allow the light levels to rise and fall gradually, so the change in illumination is not perceptible to the guests. This was the case and the light levels would take a long time to come back up. I still had my Elzetta so I stood over the group of guys working on her and lit up the area. More guys showed up. Paramedics, fire, EMT. One of the guys asked for my light which I gladly turned over. Time for me to move out of the way. Once out of the way I watched with great admiration as 10 men worked on this woman. These guys were pros and I am happy to know many first responders and call them my friends. You guys and gals have my utmost respect.
The restaurant staff was around me as well and we looked on. Their reaction was that of shock. Some of them were crying. I began to pray for her by name. My wife, had long ago climbed over the partition to be with the woman’s husband who was just as old and frail as his wife who lay on the floor. There were two other men in their party who were their care takers. My wife was with them trying to comfort the elderly man who was silent, unaware or unable to process what was going on. He just kept saying, "Oh, Dear, oh Dear…" I couldn’t imagine the feeling of helplessness he must have had. I could tell that my wife and one of the care takers was praying for the man and his wife. This made me smile and I was so proud of my compassionate bride. I turned my attention back to the grim scene and the important task at hand.
The first responders had been taking 2 minute shifts of compressions and were administrating oxygen. They reached in with clamps and removed more green spinach and a huge piece of lobster. Fucking lobster. I don’t know why people like that stuff. They had her on drips. They defibbed her numerous times. I had a view of their screen. No response from her. No pulse. Time was slipping away. I had worked on her for about 10 minutes and the first responders had been at it for at least 20 maybe 30. Hard to tell as the concept of time seems to distort in situations like that.
They then made the determination that it was time to transport her. They got her onto a board and strapped a Lucas CPR device to her chest. This is a device that automatically continues to give compressions without the aid of human assistance. Once on the gurney they covered her with a sheet to give her a little dignity and wheeled her out. The firefighter who borrowed my light gave it back and thanked me saying, "Thanks man, It was a life saver." Ironic. Actually it wasn’t. He knew it and I knew it. She was gone.
I looked right. It was almost surreal that only 10 feet away there were people still eating their dinners and engaging in conversation. I looked to my left towards the bar. People were laughing and having a good time. They were completely unaware that a woman had just died only mere feet from where they were. Really? Unbelievable. Looking down at where she had been laying it was a massive mess of medical supply wrappers. Amazing how much effort and equipment went into that effort. I went to go wash up. I was covered in her food. I wiped my mouth. I could still taste her food and still feel her cold lips on mine. I could smell her saliva on my facial hair. I could still see her eyes.
I returned to my wife who was still with the husband and care taker. I talked briefly with the care taker. I had no idea what to say to her husband. "I’m sorry, Sir." Came out of my mouth. What else do I say? He just witnessed his wife die on his 87th birthday. Yeah, let that one sink in. They were there celebrating his birthday. We said our goodbyes, had some words with the staff and made our way to the lobby. The hostesses were still a bit shaken up and one of them told the manager the woman’s wheel chair was still in the coat check. The manager got it out and looked at it, unsure of what to do. Ironic. She was rolled in to the restaurant in that chair… and was rolled out on a stretcher.
As we walked to the door my wife stopped me and pulled my head down and kissed it. Life is short. We are not guaranteed the next minute let alone the next 50 years. We walked out to the sight of ambulances and flashing lights. Valet had brought the husband’s car around and his care taker was helping him over to it. We made eye contact, we waved and said we were so sorry. It was kind of an awkward moment. That was it. He is 87, she was 86. They had probably been married well over half a century. He would go to bed without his wife and wake up the next morning hoping it was all a dream, but reality would soon sink in. She was gone.
As we drove home we talked about what had happened. I had been in a handful of medical emergencies in my life, most of which were during my military service 20 years prior. I had received excellent medical training during that time and put it to use on more than one occasion. I was very aware that my performance tonight was a bit rusty. Probably shouldn’t have given her rescue breaths without some sort of barrier. I didn’t have any gloves. My compressions started out somewhat sloppy which I quickly corrected. I should have made note of the time, I should have… I should have… I should have… Could I have done more? What could I have done better? I was also reminded that ten of the city’s finest couldn’t bring her back with exponentially more experience and training than me. I guess it was just her time.
As we talked about it we began to discuss how unresponsive she was from the second I got there. No panic. No flaying of arms. No look of distress. We talked about how only a week earlier our 1 year old began to choke at the dinner table. She was freaked out, very distressed and very obvious she was choking. She was easy. Flip her upside down, do a few back blows and out it came. The woman tonight showed no signs of that. Now we will probably never know her actual cause of death but it is most likely she had some sort of cardiac event while she was eating. I would assume it caused a startle response in her and she inhaled what was in her mouth which would explain the very large piece of lobster the paramedics removed. It would also explain why she had zero response only mere seconds after the distress call. I have no definitive proof, but I believe she was dead the moment I got to her.
As we continued to talk out our After Action Report (AAR) we found it ironic that I was the only cat in the place with a flashlight and that included the first responders. Maybe they had them but didn’t use them as mine was readily available. Who knows? Regardless, I recommend you carry one. You never know when it could come in handy. We also noted the number of people willing to help was few. Don’t get me wrong, a few patrons and a lot of staff were there doing what they could, but the majority of the restaurant was either unaware, unwilling or incapable of responding. Don’t be unaware. This means don’t get drunk off your ass when you go out to eat. If you do, you will be unable to respond to anything and may end up being a liability yourself. Don’t be unwilling to help. Get the training you need. Not saying you need to be an 18 Delta (I’m not), but at least have an idea of what to do. Get CPR and basic first aid certified. I need to get re-certified now that I think about it. Act. Even if you don’t know what to do you can call for help and assist a responder. If you are an able-body person, you are capable of helping.
Moments like that make you take stock of your life. What’s important. What isn’t. I am a Christian and as a man of faith it makes you examine how you are living your life. To what purpose do you exist? What legacy will you leave? What impact will you make? How will you be remembered? Will people think back and say, "Man, she took the best selfies on Instagram." Or "He was the most tacti-coolest dude online."? None of that is worth anything. There is usually very little dignity in death. Our time on earth is short. Make the most of it. Love those around you. Be known for your good character and how you treat people. Take care of yourself. Spiritually and physically. Lastly, be prepared. There is an old saying I learned in the military that most have probably heard before.
"You don’t chose the time. The time choses you."
When that time comes, will you meet it head on or not?
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