Lance Becker: Back From the Dead
The doctors who think it’s risky aren’t wrong — cooling a patient too much or for too long might actually cause cardiac arrest. When Mike Rossman was flown from Pueblo to San Francisco for open-heart surgery to unblock his arteries, the cardiac surgeon was incensed when he found out Rossman had been cooled.
“They could have killed him,” the surgeon said.
“No,” Rossman’s wife answered. “He was already dead.”
Becker knows that advances in medicine tend to stumble forward, which is clearly not his speed. But 50 years ago, cancer was just cancer, and everyone who got it died from it. Becker points to just 10 years ago, when premature babies who were born weighing less than two pounds frequently died. Now, they don’t.
In the midst of change, though, chance is all there is. “Right now, it’s pretty much all luck,” Becker says. “If you end up in the wrong hospital, you might not make it.”
LANCE BECKER’S NEW favorite thing is a “slurry.” It’s the technical name for a crazy solution, a saline-and-ice-water slushy that can be pumped directly into a patient’s IV. It cools the body to 91 degrees several hours faster than it can be done now.
He points to a boxy metal contraption in the center’s lab. One of the engineers built the slurry-making machine — part mini fridge, part margarita mixer — which, as is, is way too big. But they’ll keep tweaking and tinkering until it’s small enough to fit in an ambulance. Because that’s the point.
The earlier the cooling starts, the better. Seventy-five percent of cardiac arrests happen outside of a hospital. But only 100 of the 24,000 emergency medical companies in the country now have the means to cool a patient in an ambulance; none of them are in Philly. If having a slurry machine on the bus doesn’t freak out EMTs enough, using it means completely changing how they do their jobs. Doctors think it might be even better to start cooling before the EMT restarts the heart. Before the defibrillator. Before the epinephrine.
“We have to revise what we think we know,” Becker says. And perhaps Becker needs to follow his own advice.
One Saturday morning last summer, a neighbor knocked on the door of Becker’s house in Powelton Village. “Did you hear about Lawrence?” the neighbor asked, referring to a man who lived down the street. “They’re saying you saved him.”
“I don’t know what you’re talking about,” Becker replied. “I haven’t even seen him.”
“They’re saying that they used your technique on him.”
The day before, Lawrence suffered cardiac arrest in his office in West Philly. The paramedics took him to Presbyterian. When they brought him into the ER, he was in terrible shape. The docs couldn’t keep his blood pressure up. He arrested again. And again. The staff thought he would die right there.
But just the month before, the ER at Presby had adopted Becker’s cooling protocol. They had the suit. They had the saline. They were ready. Lawrence was the second patient they had ever cooled. For the cardiologist on duty, Lawrence was the first. And Lawrence recovered. Slowly. Steadily. But he recovered.
Lawrence wasn’t brought to Becker’s hospital. He didn’t have Becker’s cell-phone number. He didn’t even need it. Becker says, right now, it’s only luck. But Lawrence wasn’t one of the lucky ones. He just got the standard treatment — a second chance.