My tenth-grade biology teacher was a large, lumbering man who resembled a bear. He was seventy years old, married with no children, and obsessed with gardening. He did not tolerate misbehavior and spoke with a bellowing voice, a surviving relic from his background in theatre. In the high school lore, he was a legend: if you were accepted into the honors science track, people would shiver and whisper, Bill.
On our first day of our human anatomy unit, Bill rolled a plastic skeleton into the classroom. He proceeded to demonstrate—to a classroom full of tenth graders—ten different ways to end a human life.
The next day, Bill taught us how to save a human life.
The bell rang, and Bill stared at us for five seconds of agonizing silence. Then he exclaimed, “Heart attack!”
A poor choice of words; I thought he was actually having one. But thankfully, he was only teaching us how to assist someone suffering from a heart attack:
The most important step is: be sure the ailment is actually a heart attack, which means “any damage to the heart or heart tissue.” Unlike movies, which depict a dagger-like stabbing of the heart, most heart attacks feel like a strange, pulling sensation, like the cardiac muscle is being unraveled slowly, the contents of the heart being strung out for display. Or perhaps the victim feels a tight tension, like a tiler has just set a marble slab across your chest.
The most common heart attack is called coronary thrombosis, which means that an artery has been clogged. Arteries carry blood away from the heart, but if they become stopped up, the clots push blood back toward the heart, which causes strain on the heart tissue. Think of coronary thrombosis as a traffic jam on a steep hill: the cars come to a stop and begin rolling backward. The cars crash into each other and devastate the landscape. Part of the heart muscle has died.
Now imagine that Griselda, a girl in your class, has just had a heart attack. She is feeling a pulling sensation in her chest, like someone is trapped in her aorta, weeding through her cardiac muscle to find a way out of her chest. And you, being trained in basic heart attack response, jump into action.
The first thing you do is remain very calm. Stress is contagious. If you come across as anxious, then Griselda will assimilate that feeling, causing further damage to her heart. The goal in this step is to calm Griselda through your own demeanor.
The second thing you do is lay Griselda on the ground, so the blood in her body is flowing horizontally across the length of her body, relieving some stress off the heart. Pumping blood vertically (while standing) is more work for the heart than the back-and-forth flow of blood while you sleep; this is why your heart rate slows down when you are resting. Imagine a boy on a bicycle, pedaling his way up a hill—he will find a flat expanse easier to traverse than a hilly terrain.
The third thing you will do is cover Griselda’s body with a sweatshirt, a towel, a blanket, a cardigan—anything that can provide additional warmth to the body. This step draws from Kinetic Theory, which posits that all things—solids, liquids, and gases—are made up of particles that are constantly in motion. Heat speeds up the rate of vibration of these particles. Kinetic Theory explains why water, when heated, begins to boil. Similarly, heat causes blood to flow faster.
The fourth thing you must do is stay beside Griselda and keep her calm—hold her hand, speak in a soft, slow voice, or instruct her to close her eyes and assure her that help is on the way. Then you will call emergency services. EMTs will arrive shortly and relocate Griselda to a medical facility.
To recap:
Remain calm,
Have the patient lie down,
Keep the patient warm, and
Stay with the patient and call EMS.
Perhaps you are not directly saving a life in these steps. You are not, after all, administering blood thinners or clot dissolvers, and you should not attempt to perform surgical operations. But these four steps serve an important role: reducing the physical stress on Griselda’s heart, thereby reducing her mental and emotional stress.
There is great value in taking any steps when they may, indirectly, save a life.