Restoring Life

Doc Stewart

Arish Rountree passed away on April 4, 2013. Below is a story from 2005 of how Mr. Rountree received the opportunity to live his last eight years.

Restoring Life

By Michael Terrill

On April 9 th, 2005, Arish and Shirley Rountree were enjoying a leisurely afternoon with their granddaughter, Lamya, at their home in north Scottsdale, Ariz. “She’s my little shadow,” Arish says fondly. However, in mid-afternoon Arish began coughing severely: deep, persistent, and rasping. Concerned, Shirley said, “I think we ought to go to the emergency room.”

In fact, the Rountrees had been to various emergency rooms several times over the last few years, when Arish had experienced similar difficulty breathing. This time, however, Arish shrugged the suggestion off. “For what?” he replied, believing he could handle the situation himself. “I’ll be okay.” However, Arish’s cough was rapidly growing worse, and it left him gasping for air. “Papa, I don’t want you to die,” Lamya said.

“Papa is not going to die,” Arish reassured her, his statement punctuated by another fit of coughs.

Over the telephone, Arish and Shirley’s daughter L’Tanya, who suffers from asthma, was immediately concerned. “I don’t like the way you sound,” she said. “I’m coming over right now with a nebulizer.” However, the nebulizer treatment didn’t seem to be effective. “You have to go to the emergency room,” L’Tanya concluded. As Arish fought for breath, the family coaxed him into the car, with Shirley driving and L’Tanya and Lamya following in the car behind. However, as Arish and Shirley approached the freeway on-ramp, his body seized up. “I’m not going to make it,” Arish gasped to Shirley, and collapsed, his unconscious body falling on top of her. Shirley struggled to hold Arish’s body up with her right hand while she drove with her left. Panic-stricken, she accelerated to full speed, weaving through traffic and running red lights, going so fast that L’Tanya and Lamya were unable to keep up in the car behind. Finally, she pulled to a screeching stop in front of the emergency room at Mayo Clinic Hospital in Phoenix, leaped from the car, and ran inside, screaming, “We need a doctor now!”

Emergency room staff rushed out with a gurney to get Arish and bring him directly into the emergency room. “He was unresponsive and gray and looked terrible,” recalls Dr. Christopher Stewart, the critical care physician who headed Arish’s treatment. Arish had no pulse, no blood pressure, and wasn’t breathing. He was clinically dead.

Restoring Life

Arish did not have a do-not-resuscitate order, so ER staff immediately began administering chest compressions in an attempt to get his heart beating again. Because Arish was not breathing, he was immediately intubated on a respirator. “Just restoring the oxygen to his lungs was enough to get his heart beating again,” Dr. Stewart explains. However, “we didn’t yet know what the problem was, for example, whether Arish had suffered a stroke or a heart attack.” Dr. Joel Larson joined the team to supervise Arish’s treatment in the intensive care unit as Mayo staff performed a complete diagnostic workup. Meanwhile, Dr. Stewart spoke with Shirley, who revealed Arish’s history of breathing problems.

Arish has a disease called sarcoidosis, which causes inflammation of the body’s tissues, starting in the lungs and eventually spreading to other organs. While some patients with sarcoidosis may have only a vague feeling of illness or no symptoms at all, others may develop emphysema, with symptoms including shortness of breath and a cough that won’t go away. Many persons with sarcoidosis are unaware they have the disease until it is diagnosed through a chest X-ray, MRI, or CT scan. The inflammation caused by sarcoidosis and emphysema destroys the fragile walls of the air sacs within the lungs, overstretching them and causing them to lose their elasticity. Patients with this condition often endure bronchial spasms, which can cause a person to “stack breaths,” meaning the lungs fail to completely exhale one breath before inhaling another. When breaths stack in this way, more and more air remains trapped in the lungs, causing lung pressure to increase and forcing the patient to take smaller and smaller breaths. Eventually, pressure in the chest may build to the point where it compresses veins and restricts blood flow to the heart, causing circulatory arrest.

“In Arish’s case, his lungs were really the primary problem, and his heart was the secondary problem,” Dr. Larson explains. “The chest compressions helped force air out of his lungs, and allowed his circulation to return.” Doctors also prescribed medicine to help alleviate and prevent the bronchial spasms. However, Arish was still unconscious, and his treatment team was concerned that he might have suffered severe brain damage. “The uncertainty is always how long a person was without blood flow or oxygen to their brain,” says Dr. Larson. “If they’re down too long without blood flow, it’s like drowning.”

Arish recalls the long struggle to wake up. “I could hear everything that was going on,” he says. “But I was paralyzed—I couldn’t move. It wasn’t an out-of-body experience; rather, I was trapped in my own body.” Arish struggled to move an arm, a leg, or to call out, “I’m here!” But he could not. “My concern was actually for the staff,” he explains. “They were working so hard, and it was time to tell them they could relax. They had done their job.” Finally, Arish managed to slightly open one eye. “That’s when they knew I was alright.” Arish remained in the hospital under Dr. Larson’s care for five days, to make sure his breathing pattern, mental status and behavior were all normal. The treatment team also arranged for the Rountrees to receive counseling to help them cope with the psychological trauma of the event. “The family members are really the ones who went through all the trauma and stress that day,” Dr. Larson says.

“Two Birthdays”

Back at home, Arish and Shirley are preparing to celebrate their 50 th wedding anniversary. And they don’t take their time together for granted. “I love her so much,” Arish says. “And life itself. Getting up every morning and seeing the sun means so much to me.”

A week following his discharge, Arish endured another asthma attack, and promptly returned to Mayo Clinic Hospital for care. “You know,” said Dr. Stewart, “you really look much different alive than you did dead.” Arish gave him a handshake and then a hug. “Thank you for saving my life,” he said.

“I’ve been practicing emergency medicine for 16 years,” Dr. Stewart recalls, “and Arish is only the third person I’ve ever met alive after being clinically dead. It’s a neat thing to see such a good outcome from an event that’s potentially so devastating.”

Arish has a simpler way of putting it. “Through God’s will and the staff’s skill, I’m still here,” he says. “Now I celebrate two birthdays.” Arish Rountree suffered from breathing problems that caused a cardiopulmonary arrest and left him clinically dead. Quick action at Mayo Clinic hospital literally gave him a second chance at life. Read more…

“Through God’s will and the staff’s skill, I’m still here,” says Arish Rountree. “Now I celebrate two birthdays.”