She Was “Dead” for 45 Minutes
They literally ran her back to the operating room.
Forty-year-old Ruby Graupera-Cassimiro had just had a completely normal C-section, giving birth to a beautiful baby girl on September 23 last year. But when her medical team moved her to the recovery room, she fell unconscious. Suddenly, Ruby – now a mother of two – was in full cardiac arrest.
Dr Jordan Knurr, her anaesthesiologist at Boca Raton Regional Hospital in Florida, US, immediately intubated Ruby so a machine could breathe for her. He called a code, and about a dozen other doctors and nurses crowded into the room, frantically giving advanced cardiac life support. “For more than two hours, she was having life-threatening heartbeats,” Dr Knurr says. Most scary was when Ruby had a pulseless rhythm – her heart was beating but not pumping any blood throughout her body – and doctors delivered constant CPR compressions for 45 minutes straight to try to get her heart working normally again.
After about two hours, her doctors knew there was no hope. They brought her extended family into the room to say goodbye. After Ruby’s family returned to the waiting room, where they, along with a few nurses, frantically prayed on their knees for a different outcome, the doctors stopped pumping her chest. They were ready to call her time of death.
“I was seconds away from turning off the ventilation machine when one of the nurses shouted, ‘Stop!’” Dr Knurr says. “Without any medicine or CPR, Ruby’s heart began to beat on its own for the first time in two hours. It is just indescribable.”
It turned out that some amniotic fluid had leaked into the uterus and travelled through Ruby’s bloodstream and to her heart. Called an amniotic fluid embolism, it causes an air block in the heart and prevents blood from flowing. “These embolisms are rare, and we don’t know a lot about them,” Dr Knurr says. “Usually the patient passes away or has significant brain damage.” (Her doctors don’t know what happened to the amniotic debris; they assume it dissolved on its own.)
Not only did Ruby live, but “she is in perfect health. It’s almost as if this never happened,” says Dr Knurr. “It’s a miracle. I’m not a highly religious person, but you just don’t see this happen.” The next morning, Ruby’s breathing tube was removed. Four days later, she walked out of the hospital with her newborn daughter, Taily – without even a broken rib from all the chest compressions.
“Someone else was running the show that day; there’s no doubt in my mind,” Ruby says today. “I don’t know why God chose me, but I know he gave me this life again for a reason.”
The Heart That Healed Itself
He had been throwing up for four days. But clearly, this was not a mere stomach bug.
On August 17, 2012, 23-year-old Michael Crowe “froze up” – eyes open and staring into space – on the couch. He quickly snapped to, but when it happened again a few minutes later, his mother rushed him to the local emergency room.
There they learned that Michael was in real trouble. His heart was pumping out blood at just 25%, an alarmingly low rate. By the time he was transferred to Nebraska Medical Center in Omaha an hour later, it was down to 10%. A virus was causing acute myocarditis, inflammation of the heart muscle. If it got worse, he would need a heart transplant. With Michael’s family surrounding his bed, the doctors asked him to sign papers – while he still could – for that transplant. “They said I had only a 30 per cent chance that my heart would recover,” Michael says. “I remember thinking, I can take those odds. I haven’t won the lottery yet, I’m Irish, I’m due for some luck. I was strangely calm.”
His doctors, however, were not. “His heart failure was so bad,” says his cardiologist, Dr Eugenia Raichlin. “The rate of mortality is huge.” They immediately hooked him up to an ECMO, an external heart and lung machine, to pump his blood while his heart couldn’t. But it was a short-term fix, and Michael’s health continued to decline. Spiking fevers led to convulsions; ice cooled him but dropped his oxygen levels. “It was a balancing game just to keep me stable,” Michael says.
He desperately needed a heart transplant.
For 17 days they waited, while Michael’s condition continued to worsen. His heart stopped twice – once for an entire day (being hooked up to the ECMO machine prevented him from dying). Doctors had to fend off blood clots and excess bleeding.
At 6.30am on September 3, his doctors got the phone call everyone had been waiting for: a heart would be available that night. But a few hours later, they made a devastating discovery. Michael had developed a blood infection; a transplant would be too dangerous.
As Michael’s family despaired, Dr Raichlin noticed something unusual: His blood pressure, which should have remained constant because of the heart-lung machine, was actually rising. She ordered a test, which revealed that the left side of his heart was working at near-normal capacity. Unbelieving, she ordered another. Again, the same astounding results.
After four days hooked up to a different machine that assisted only the right side of his heart, Michael no longer needed a transplant. His heart had completely, miraculously healed itself, his body eradicating the virus on its own. “He overcame everything,” Dr Raichlin says. “He was very debilitated, but he rebuilt himself.”
Many patients with Michael’s condition die, or get a heart transplant, or survive but have permanent heart tissue damage. But today, as Michael works through his third year of pharmacy school, his heart is in perfect shape. “I’m so grateful that I got a second chance at life,” he says.