External Cardiac Compression: Beating a Dead Horse

Abstract

As we saw in chapter 3, many of the folk therapies employed in the resuscitation of the drowning victim involved the use of considerable physical force in an attempt to rid the lungs of water and excite the fading life-force back into action. Victims were hung by the heals and beaten with sticks, rolled back and forth over a barrel, jogged up and down on the back of a horse, and so on. ‘Successive concussions … incite the hidden springs of life into action’ (A. Fothergill, 1795, p. 143). One of the primary goals of the Humane Society was to mitigate the more violent of these ‘pernicious’ practices: ‘It is natural to imagine that these [medical] Gentlemen … will be more cautious not to employ these pernicious and justly-exploded methods’ (Humane, 1777, p. 100). The Society justified its prohibition on beating victims on two grounds: one empirical, the other theoretical.

The Royal Humane Society would be rooted out like a horde of assassins …

(G. K. Chesterton, Heretics, 1919, p. 1)

The patient was an elderly Hasid. When he collapsed at home his son started chest compressions, gave his father mouth-to-mouth, did what he had been taught in the ‘Heartsaver’ classes he had attended at the community centre. The paramedics arrived. Took over chest compressions. Intubated. Attached the old man to a cardiac monitor. Defibrillated — normal sinus rhythm. Started an IV. Gave drugs. Loaded him in the ambulance and sped to the ER. The electrocardiogram in the emergency room showed an inferior MI. The standard coronary protocol was commenced. The old man was agitated and trying to pull out his ET tube and IV. We sedated him with morphine. Put him on a ventilator. Put in a central line, arterial line, urinary catheter, and nasogastric tube. Transferred him to ICU. He was coded three more times in the ICU and survived. The son sat in the ICU waiting room and wept. Tears of shame for the sin he had committed. It was Shabbath.