This story made the social media recently:
Yes, I can well believe that many chiros are daft enough to interpret the incident in this way. Yet I think it’s a lovely story, not least because it reminds me of one of my own experiences:
I was on a plane to Toronto and had fallen asleep after a good meal and a few glasses of wine when a stewardess woke me saying: “We think you are a doctor!?”
“That’s right, I am a professor of alternative medicine”, I said trying to wake up.
“We have someone on board who seems to be dying. Would you come and have a look? We moved him into 1st class.”
Arrived in 1st class, she showed me the patient and a stethoscope. The patient was unconscious and slightly blue in the face. I opened his shirt and used the stethoscope only to find that this device is utterly useless on a plane; the sound of the engine by far overwhelms anything else. With my free hand, I tried to find a pulse – without success! Meanwhile, I had seen a fresh scar on the patient’s chest with something round implanted underneath. I concluded that the patient had recently had a pacemaker implant. Evidently, the electronic device had malfunctioned.
At this stage, two stewardesses were pressing me: “The captain needs to know now whether to prepare for an emergency stop in Newfoundland or to fly on. It is your decision.”
I had problems thinking clearly. What was best? The patient was clearly dying and there was nothing I could do about it. I replied by asking them to give me 5 minutes while I tried my best. But what could I do? I decided that I could do nothing but hold the patient’s hand and let him die in peace.
The Stewardesses watched me doing this and must have thought that I was trying some sort of energy healing, perhaps Reiki. This awkward situation continued for several minutes until – out of the blue – I felt a regular, strong pulse. Evidently, the pacemaker had started functioning again. It did not last long until the patient’s color turned pink and he began to talk. I instructed the pilot to continue our path to Toronto.
After I had remained with the patient for another 10 minutes or so, the Stewardesses came and announced: “We have moved your things into 1st class; like this, you can keep an eye on him.” The rest of the journey was uneventful – except the Stewardesses came repeatedly giving me bottles of champagne and fine wine to take with me into Toronto. And each time they politely asked whether my healing method would not also work for the various ailments they happened to suffer from – varicose veins, headache, PMS, fatigue …
So, here is my message to all the fellow energy healers out there:
We honor the creator’s design.
We know of the potential of the body is limitless.
Remember, you did not choose energy healing.
Energy healing chose you.
You were called for a time like this.
In case you are beginning to wonder whether I have gone round the bend, the answer is NO! I am not an energy healer. In fact, I am as much NOT an energy healer, as the chiropractor in the above story has NOT saved the life of his patient. Chiropractors and stewardesses, it seems to me, have one thing in common: they do not understand much about medicine.
On arrival in Toronto, the patient was met by a team of fully equipped medics. I explained what had happened and they took him off to the hospital. As far as I know, he made a full recovery after the faulty pacemaker had been replaced. After my return to the UK, British Airways sent me a huge hamper to thank me.
I do hope the chiropractor had consent before publishing this patient’s picture.
Sounds like the chiro had been on the wacy baccy, champers or was oxygen deprived himself.
He obviously has an altitude problem!
A lovely story, but I’m surprised it didnt convert you to recognising your powers
It did convert me!
… to the powers of amusing yet educational stories.
If you ever find yourself faced with somebody with a pacemaker who has apparently had a cardiac arrest, you should place a magnet over the pacemaker box. This will cause the pacemaker to default to a safe mode, where it paces steadily at 70 beats per minute regardless of whether there is already a heartbeat present that might normally inhibit it. This isn’t optimally efficient but at least it is safe.
Unfortunately most doctors aren’t aware of this, and although there are special magnets available for this purpose I have never seen one outside a cardiology department.
I have twice been called upon to give emergency assistance to a collapsed passenger during a flight. The first time I was on my way home from Thailand, I was feeling very weak after a nasty bout of diarrhoea, I had had a couple of gin and tonics and some temazepam and I was in the toilet prior to settling down to sleep. My wife banged on the door to say that they were calling for a doctor. The purser showed me to a woman who was unconscious, very white and looked as though she had had a cardiac arrest. With my head reeling I asked if she could be laid flat so that I could have a look at her. At that point she turned pink again and started breathing. One of the groups travelling with her produced a huge bag containing her medication, which mostly seemed to be the sort of thing you might take for anxiety, some of it prescribed and some over-the-counter. The purser handed me a cheap stethoscope, and like you, I could hear nothing through it. It then turned out that she (the purser) was an ex-nurse from the same hospital where I was currently working, so she wanted to catch up on the latest gossip. The patient seemed to be doing a bit better, and somebody was able to translate (she was French) so I established that she had spent the whole day on the beach. Once her colour had returned she looked very sunburned, and I think the problem was a combination of dehydration due to flying and not drinking, together with shunting of blood to the skin, which together had dropped her blood pressure and caused her to faint. At this point the purser asked me if the pilot should divert the plane to Bombay or continue to London. I advised continuing. “Very wise, doctor,” she replied. “She’s only French. If she dies, she dies…”.
The second time I was returning home from Barbados, and the plane had stopped in Antigua to pick up some additional passengers. As we were descending to land at Schripol a young man started hving an epileptic fit. A Dutch doctor was also present but there wasn’t very much we could do except lay him flat in the aisle and ensure that he was breathing. We landed a few minutes later and the Dutch doctor handed over to paramedics who met us at the plane. I still wonder whether he could have swallowed condoms as a way of smuggling drugs, one of which had leaked. If so it was probably cocaine (heroin would have simply caused respiratory arrest) and he would have been very unlikely to survive.
I suppose in your situation I would have attempted cardiac massage, but without an intensive care unit to transfer him to it probably wouldn’t have been very helpful. Probably the most useful thing that a doctor could do here would be to recognise, as you did, that he was dying. For the same reason I have serious doubts about the utility of the publically available defibrillators which are becoming popular in villages in the UK (there is one located in a former telephone box about five minutes’ drive from where I live). Even in hospital, with a fully trained team on-hand and all the resources available only a small proportion of people are successfully resuscitated after a cardiac arrest.
In the classic textbook of intern medicine ( note the distinction from internal medicine) “House of God” by Samuel Shem, (the pen-name of the American psychiatrist Stephen Joseph Bergman) one of the more important lessons called “the Fat Man’s rules”, is the following (from memory). “When confronted with an (apparent?) cardiac arrest, the first thing you do is check your own pulse.” The wisdom in this rule is that 1. You need to calm down and this may take a while. 2. The patient may make a spontaneous recovery meanwhile.
I once watched a man collapse in a pulseless, noncresponsive state. As I was preparing to start CPR (trying to remember how to 🙂 ) I had the brilliant idea to try aa shock cardioconversion by delivering a smart whack to the anterior aspect of his chest. This is an old trick I heard of as a medical student. In this case the immediate result of this apparent mishandling of my patient was the return of breathing and subsequent consciousness. I will never know if it was the propagated pulse of energy reaching the heart that had this reviving effect, or the man would have spontaneously revived notwithstanding. But it seemed like a good idea at the time. This story has repeatedly irritated the teachers of my annual CPR recertifications as the described intervention has apparently been struck from the standard CPR procedure as unproven :).
During the clinical section of my MRCP exam I was shown into a cubicle expecting to see a patient and there was a Rescus-Annie training mannequin instead. I was told that the patient had just collapsed and asked to demonstrate what to do. I was so surprised that I went into cardiac arrest mode and continued on autopilot. I started with a precordial thump and then continued with cardiac massage etc. This was my third attempt at the MRCP, which has only about a 25% pass mark, and this time I did pass.
The “Precordial thump” as it is known is now (according to my wife) only used to treat witnessed ventricular tachycardia – so the patient is already wired to an ECG – and only within seconds of this happening. She’s seen it done a couple of times and it was, apparently, very cool.
Yes, Lenny and Julian. I like to think I saved the blokes life. Being a surgeon one thinks mechanically rather than molecularly (is that a word? 🙂 ) and a good thump propagated to a heart that just started fibrillating should have at least a small chance of resetting the rythm (defibrillation). It takes only half a second and can’t hurt. When a minute or two of ventricular fibrillation have passsed the heart muscle is already being starved of oxygen and the fibrillation needs much more energy to reset. My simple surgical train of thought tells me that in the abscence of a defibrillator it might be worthwhile to try the thump again after a period of chest compressions in the hope that the compressions have managed to push some oxygenated blood into the coronaries? In an airliner situation I think I would definitely use the oxygen flask they have on board to increase the chance of oxygenating the heart muscle and try the thump.
Does anyone know if they have defibrillators on board nowadays?
I just remembered am going on a five hour flight tomorrow so I hope this discussion will not “jinx” my trip 😀
For awareness. The process of applying a magnet should absolutely not be used to treat someone who appears in cardiac arrest.
Whilst in some patients the application of a magnet will indeed set the pacemaker to its safe mode, in other patients use of a magnet on a cardioverting defibrillating pacemaker will turn their defibrillator off when the pacemaker unit is delivering inappropriate shocks. so unless you have other equipment available you just 100% killed your patient. https://aci.health.nsw.gov.au/__data/assets/pdf_file/0008/179990/ACI-Deactivate-ICDs.pdf
You are quite right that a magnet will turn an implantable cardioverter-defibrillator (ICD) on or off. I last dealt with these in the late 1980’s where the battery was so large that they had to be implanted in the abdomen, not the chest wall, so there wasn’t much chance of confusing one with an ordinary pacemaker. Battery technology has moved on a lot since then so I expect they are much smaller now and probably implanted at the same site as a standard pacemaker box.
So if you know for certain that the person who has collapsed has a pacemaker and not a defibrillator then a magnet will put the pacemaker into VVI mode where it is pacing continuously, but if they have a defibrillator it may prevent it from delivering a life-saving shock. On the other hand they may have collapsed because the defibrillator was already turned off; without an ECG it is impossible to know. CPR can be safely started either way, and if an implanted defibrillator does deliver a shock it will be localised to the heart and too weak on the surface of the body to be dangerous to anybody else.
Oh wow, interesting stories from doctors here. I have a friend with pacemaker, have so many questions now. If one has a pacemaker, can you provide CPR, chest pumps or will it harm him? I am a layperson but have CPR training, actually performed CPR on a person with blue lips, he came back but eventually died on life support days later. He had a very bad brain hemorrhage according to doctors.
I will have to research this now, my friend told me he needed pacemaker for low blood pressure, I think he said that. Being his best friend and hanging out a lot, will need more research. Will carry a magnet for sure.
CPR from bystanders should always be attempted (unless the patient protests 🙂 and the general rule is to continue until medical aid arrives. A pacemaker is not a contraindication.
Jokingly, the only contraindication to CPR attempt is rigor mortis.
You did right, absolutely!
I’m sorry to hear that he didn’t make it, but at least you gave him a chance.
Really the only people who are likely to recover with CPR are the ones who were fit to begin with and have a single reversible problem causing a cardiac arrest (usually a coronary thrombosis). Most of what you hear about “do not resuscitate” orders is nonsense, as anybody who is seriously ill can’t be resuscitated no matter what you do – they will simply die. Asking them (or their family) what their decision might be is effectively offering them something that is not in your gift. My criterion for whether or not any of my patients should be for resuscitation was very simple – was there a reasonable chance that it could be effective.
There is no reason why you shouldn’t start CPR on somebody with a pacemaker. I’m not sure what sort of magnet you need to get. I expect the official ones used in cardiology departments are very expensive. You want one that is going to be powerful enough. I am guessing that the magnet from a loudspeaker might work (and is the right shape) but you should look up what is required before you decide what to carry.
If your friend has low blood pressure treated by a pacemaker then it is likely that his heart was beating too slowly, probably due to an electrical conduction problem. If he collapses, the first thing would be to lay him flat (which would improve venous return and might be enough to bring up the blood pressure), then try the magnet if you have it to hand, but if he is still unconscious you need to dial 999 (or 911 in the US) and start CPR without much delay. With CPR, if you can do it effectively, it is possible to keep somebody alive until the professionals arrive to take over. I have twice managed to establish an effective enough circulation purely with cardiac massage so that the patient regained consciousness, though sadly in neither case could we restart the heart and they both died.
Do not attempt cardiopulmonary resuscitation (DNACPR) decisions, NHS England:
The important thing here is that although people can opt-out of being resuscitated in advance, they have no legal right to demand CPR if their doctor has decided against it. One thing to come out of this policy is that it is now more common for doctors to initiate a conversation about death with patients who are terminally ill, which is often very helpful for all concerned. But to even consider the question of CPR in somebody who is terminally ill is seriously daft.
I have no idea why you are trying to explain it (incorrectly) to me. I happen to understand this topic; clearly, you do not. I provided a reference because, as usual, you ignored the red banner:
Please remember: if you make a claim in a comment, support it with evidence.
You wrote “But to even consider the question of CPR in somebody who is terminally ill is seriously daft.”
That speaks volumes about you. Your comment has reminded me of doctors who have taken that stance just a little further into the realm of ‘playing God’.
Some terminal illnesses last two or more years. Technically speaking, being born is being given a 100% guaranteed terminal illness. I shan’t ask you where you draw the line between, being eligible for CPR, and it being “seriously daft”, because, fortunately, you no longer have the authority to complete and/or sign DNACPR forms.
I would not regard somebody who has a reasonable chance of surviving two or more years as terminally ill, whether they had an incurable cancer, serious heart disease or whatever else. However, when the end stage of an illness has been reached, the body systems are starting to fail and death within weeks or a couple of months is inevitable, then CPR has no chance of being successful and is completely inappropriate.
Somebody still having active treatment and judged likely to survive an admission to ITU, should of course be resuscitated if they collapse.
As I stated before, my criterion for a “do not resuscitate” decision was whether or not resuscitation had a chance of being successful.
We had this conversation a few months back with my mom’s oncologist. She elected to cease infusions (for myelodysplasia) and said she did not want to be resuscitated. Although the oncologist couldn’t give us a life expectancy due to some of her biomarkers he said 6 months was probably her max. The oncologist said it was her option and respected her decision.
I am sorry to hear about your mother, though it is clearly a good thing that she was able to have this conversation with her oncologist and was able to make her own decision without pressure from anybody else.
Any estimate of life expectancy is only an average of course, and it is misleading to apply it too rigorously in an individual case. I hope she proves to be one of the 50% who do better than predicted.
You don’t seem to grasp the salient points of having a do not attempt cardiopulmonary resuscitation (DNACPR) order in place.
The default position is to provide CPR (and other emergency procedures) to everyone who needs it, as if they had previously provided informed consent. Because an incapacitated person is probably not in a fit state to give informed consent at the time it is required. This is ‘opt-in by default’.
A DNACPR order is an ‘op-out, default override, order’. The first thing everyone must do before attempting CPR is to check that the patient is not carrying or wearing a DNACPR order. Obviously, the patient’s special notes must be consulted if they are reasonably accessible at the time of the emergency.
Of course the default position is to provide CPR and any other necessary treatment to somebody who is acutely unwell. The point of DNAR notices is so that if they are actually dying they are allowed to do so with dignity.
The question of consent is that same as that which arises whenever somebody is in need of acute medical attention but is incapacitated. If they are a minor then their parent or guardian can give consent for them, but in the UK nobody (other than the Court of Protection) can give consent on behalf of an adult unless there is a Power of Attorney in place. In practice the physician in charge of the situation will provide treatment in the knowledge that this is criminal assault, although it is very unlikely that anybody would press charges.
CPR in hospital, with experienced clinicians and all the necessary resources to hand is still usually unsuccessful, except in cases where the patient was previously reasonably fit and well and has suffered acute and reversible failure of a single body system, such as a cardiac arrhythmia following a myocardial infarction, circulatory collapse after major haemorrhage, respiratory depression from drugs or carbon dioxide retention etc. If the medical history is unknown then resuscitation should be attempted, but if somebody is expected to die soon a DNAR notice can spare everybody, particularly the patient’s family, the distressing experience of a failed resuscitation.
In the community the situation is a little different, as CPR is most likely to be attempted where somebody who is apparently reasonably well suddenly collapses. If the people attempting resuscitation know what they are doing and an ambulance can get there in time there is a chance of survival. I know this from personal experience: When I was a junior doctor I was once nearly knocked off my bicycle by somebody driving their car through a red light. I turned round to shout at the driver and saw that he was unconscious and blue and somebody was trying to get him out of the car. I managed to improvise a resucitation team from passsers-by and showed them what to do (I had to do mouth-to-mouth myself as that is much harder than cardiac massage – happily he didn’t vomit, which is quite common in this situation). An ambulance was summoned and took him to the hospital were I was working. A few days later he was well enough to thank me when I went to see him on the ward, and shortly after that he went home.
I have also been the subject of a crash call myself, when my airway obstructed as a result of acute epiglottitis and I lost consciousness. Luckily I had already taken myself to Accident and Emergency, and I ended up spending a week in ITU afterwards. I caught epiglottitis as I was immunosuppressed as a result of an incurable bone marrow malignancy. That was in February 2017. I have been having regular treatment since then but I am still here.
I am curious to know whether your understanding comes from practical experience of dealing with medical emergencies and dying patients or from familiarity with legislation and policy-making.
You stated “Most of what you hear about ‘do not resuscitate’ orders is nonsense…”
I simply replied with a link to the topic on NHS England because, as usual, you don’t bother to heed the red banner.
You went off on a rant, and it seems that you’re unable to stop. Your replies have confirmed your statement.
Julian, thanks. She was dx about 7 years ago and from what I understand she has already beat the odds. As a family we discussed with her her wishes. Although there is mild dementia we were confident that she could make her own decisions. Her oncologist has been awesome and very upfront with her about her options re treatments and side effects.
Today I am taking them out to celebrate their 65th wedding anniversary and it will most likely be their last one.
Anyway, based on your own history I thought I would share the story.
Also, blamed myself for months for guy dying after performing CPR on him. Finally, a professional told me chances of someone surviving cardiac arrest outside hospital environment, utilizing CPR is very slim but still should be performed, their best chances.
Fwiw. It appears the chiropractor in the above story belongs to the group called MaxLiving (Maximized Living). They use to call themselves Body by God. They are considered by some as the most extreme “philosophical” group within chiropractic (we have other words for them which I will refrain from stating in a public forum). I have seen their contracts and scripts. I have talked to former members aka patients and chiropractors who belonged to their group but got out (not easy to do). They have a lot of money and if you call them out they are known to take you to court without hesitation.
From what I have read they recently signed a contract with Walmart to start putting chiropractic clinics in Walmart stores. IMO….That may end up being one of the worst things for chiropractic (or best, if one wishes to see chiropractic profession shrivel up and die). Glad I’m only a few years away from retirement.
if you think that this group is bad, please tell me what you or the chiro profession is doing against them.
I’ve said all I am willing to say on this matter in a public forum.
If you want to dig into them and pass along findings, feel free.
how courageous of you, particularly considering that you are anonymous here.
Anonymous to you but not to everyone who follows this blog.
Edzard, I know these people. I have engaged some of them in the past. I know what they have done and are willing to do. I know what chiropractic colleges, professional and private organizations, state boards and individuals have done and are doing to address this issue. Is not a matter of lacking courage, it’s called being smart. I’m out.
I could say the same about various groups of SCAM practitioners and enthusiasts and even have had death threats for not meekly shutting up about the danger they pose. And I can tell you this: IT IS A MATTER OF COURAGE!
Just an anonymous nymshifting posturing sock puppet that sometimes attempts to impersonate a chiropractor. Gives the impression of being functionally illiterate and functionally innumerate, almost as if the puppet master is trying to discredit chiropractors.
“Is not a matter of lacking courage, it’s called being smart. I’m out.”
I’m reminded of Lyndsey finally realizing that Alan was a spineless chiropractor, Two and a Half Men.
I speak about SCAM in public, “it’s called being smart”. Smart enough to tell people how SCAM actually works, ESPECIALLY when some arrogant quack doesn’t like it. Professor Ernst set a wonderful example, which in my own way, I try my best to follow.
IT IS A MATTER OF COURAGE!
So revealing various ongoing strategies against a radical opponent in a public forum is considered courage. I call it stupidity. But maybe some don’t understand the difference.
I tweaked my back about 2 days ago and wonder if you could send some of your clearly very powerful healing through the vibrational ether. I’ll give it 2 weeks, some gentle exercise, mild pain relief and not get to stressed out about it and let you know if you have helped. I sense the cult of edzard coming on??
I can do it – BUT IT WILL COST YOU!
[sorry, I was trying to behave like a SCAM practitioner]
Intuitively you were holding the patient’s hand in maybe his last moment..
The warmth (energy) of your hand was perhaps the spark of life-energy, which restarted the circulation.
It cannot be proved but also cannot be excluded, that perhaps your help was essential in this calamity.
It also cannot be excluded that the Spaghetti Monster was involved.
Seek out your local Reiki practitioner (grade II)!
It’s apparently rare for someone to spontaneously recover from cardiac arrest.
But when it happens,
So if the person’s lungs were hyperinflated and they deflate after people have given up on resuscitating them, it can start their heart beating again.
But sudden jerks such as a chiropractor would administer are not described as a possible cause of “Lazarus phenomenon” 🙂
So the chiropractor is taking credit for something that was caused by mainstream medicine. But in reality, they just had the good luck not to be the first one to work on the patient.
Hopefully chiropractors won’t try to be the first one, based on this story.
There are several clear tell-tale signs that the patient in this photo is NOT unconscious at the time it is taken, which he most definitely would be if he was in respiratory and cardiac arrest like the chiropractor suggests. His knees are flexed and upright, his hands resting on his chest as most people place them voluntarily when laying down and feeling unwell and the visible eye is wide open and directed forward,which is unusual in an unconscious patient. The hands invariably fall down from this position upon loss of consciousness. I have in my life seen thousands, maybe tens of thousands of unconscious persons, whether anesthetised or dying in respiratory arrest or from other causes. I can with confidence claim that this man is not in respiratory or circulatory arrest and probably not fully unconscious either at the time the photograph is taken. It is very possible he was having what is called a heart attack, but he is not in cardiac arrest and circulatory failure. Also, if a horde of MD’s, EMT’S and whatnot are on the scene, they would be all over him still doing CPR in such a situation, probably with his torso bared – or have declared him unmistakeably dead otherwise.
Either the chiropractor is repeating his theatrical performance after the return of consciousness he describes happened following his ministrations, he is lying about the situation or he is simply grossly ignorant and incompetent in basic physiology and the clinical evaluation of a compromised patient.
I wonder what percentage of chiropractors globally would actually respond when a stewardess asks if there is a “Doctor” on board?
true! the patient does not look as though he is unconcious.
So like a lot of things on social media, it’s at least partly faked. And fake extraordinary stories on social media are a lot more common than the “Lazarus phenomenon”.
Would they get into legal trouble if they did, and prevented someone who was more capable from caring for the patient? Chiropractors do primary care in a lot of places.
There is a video of this performance out there.
I recall we had this ‘chiropractor on a plane’ discussion a few years back. I think the conclusion was: chiropractors shut up, sit down and if the patient dies, they die.
Remember, folks, flying first class saves lives!
Interestingly the Instagram account seems to have been deleted!