REKINDLING A PHYSICIAN’S SOUL | Zoran Naumovski

Monday, Memorial Day, 2022. Indian Shores Beach, Florida

We piled into my 21-year-old Ford Diesel Excursion, the family truckster, our tow vehicle, threw our duffle bags and suitcases in the back, fought valiantly with each other for access to the lone charging port, and then sauntered along the highway. It was the lap of luxury (leather seats, now cracked; CD player with not one but six-disc capability; power windows and door locks; and even 4WD shift on the fly drivetrain) … in 2001. Now, in 2022, that Limited version of my Excursion, with its rust holes on the undercarriage and rear passenger door frame, did not exude luxury, status or notoriety. But we all fit comfortably in our seats, possessed ample elbow and leg room and could easily fall asleep (except me). Barely 30 minutes elapsed before my boys were fast asleep. I tried to engage my wife in much needed conversation over the thundering roar of my diesel exhaust, but when she failed to respond, I looked over to my right and saw that she, too, was fast asleep. It was just me and the open road…to entertain, to quell and to sooth my mind and aching soul.

The pandemic was nearing its end. Many of us on the frontline were now left with fleeting thoughts, pondering, wondering … “now what?” I was in dire need of a little R&R. For over two years, I struggled to curtail my emotions and personal turmoil as I cared for, witnessed the deaths of, and signed countless death certificates of my friends, neighbors and community members of my southern Ohio community in the northern foothills of Appalachia. With that mindset, I set off for a 10-day vacation to the beach with my wife and children.

We arrived on Memorial Day Weekend, after driving over 1100 miles and 18 hours in our vehicle, and hit the beach. I was looking forward to some peace and solitude with my wife, my children and a book I planned to read. But first, we had to endure the actual Memorial Day madness before we—before I—could officially unwind and relax.

Memorial Day arrived, and we ventured to the beach early that morning to secure our spot, set up our shade tent, our beach chairs and mark our territory. If we waited past breakfast, our sandy sanctuary would be overtaken. Later after lunch, we returned to our shelter with our 16-year-old son, the others choosing to stay behind at the hotel, and to my pleasant surprise, the beach crowd had already thinned. Book in hand, I adjusted my beach chair, buried my feet in the sand just above the ankles, tilted my ballcap forward to block the sun’s rays from piercing through the gap between my sunglasses and my forehead, fastened my Bose headphones over my hat, turned on some music to offset the commotion nearby, and opened my book, page 1.  Bliss!

Before finishing the first paragraph, I was startled by my son. He pointed toward the water to the pandemonium brewing before us, and frantic pleas for help.

“Everybody out of the water! Somebody call 911. Help! Help! Help!” shrill voices bellowed from the shoreline, only yards before us and our little oasis.

“Dad, Dad…I think someone sees a shark!” my son exclaimed.

I reached for my cellphone, dialed 911 and was immediately placed on hold. As I stood there studying the unfolding scene, I witnessed crowds of parents, children, grandparents rushing out of the water, to ‘safety,’ clutching their loved ones and each other. Then, as the crowd retreated to their beach chairs and blankets, I witnessed two big burly men, muscular, save for their protuberant abdomens, dragging a lifeless body to the shore. It was then that the beach crowd unloaded a cacophony of fear, worry and primal cries – such cries only heard when a mother loses her premature infant son after countless hours of labor, when a grandmother buries her doped-out teenage granddaughter, when a father retrieves the human remains of his son who served in the U.S. Army and was callously murdered in a war overseas many, especially he, did not support.

“Dad! Dad! I think you need to go help!” my son exclaimed anxiously.

I handed my phone to my wife, asked her to talk to the 911 dispatcher whenever they responded, and to protect and watch over our son. I ran to the huddled crowd, to the brawny men, to the lifeless, apneic, ghost-white body of a man at the shoreline.

“Give him mouth to mouth! Raise his legs! Pound on his chest!” the huddled crowd screamed.

“Excuse me, I’m a doctor,” I murmured.

“Somebody…DO SOMETHING ALREADY!!!” several onlookers roared.

“OUT OF MY WAY PLEASE! I’M A DOCTOR!” I then forced my way, both verbally and physically.

As I kneeled down to the lifeless man before me, I acknowledged a confident, aggressive, tanned and sweaty young lady in a barely-there bikini assessing his airway. She looked at me… “I’m an ER nurse!” she said. I smiled at her. “I’m a doctor…let’s go,” I replied.

Seeing the man was not breathing, she sealed her lips around his and delivered two rescue breaths (mouth-to-mouth) while pinching his nose. I kneeled by his side, palpating his wrist, assessing for a pulse, and monitoring for chest rise while she delivered those breaths.

 “Don’t just sit there! Do something! Give chest compressions! Raise his legs! What the hell kind of doctor are you?!” a crowd member roared.

That ER nurse, bewildered, stared at me, waiting for a response. I noted a faint and thready palpable pulse in his right wrist. “He has a pulse! Let’s turn him on his side…he’s gonna vomit and aspirate,” I told my new-found friend, my comrade.

“He’s gonna die! Do something you idiot doctor!” that same voice roared, stoking the fire, my fire.

“BACK OFF! WE GOT THIS! ME AND HER! NOW GIVE US SOME SPACE AND GO FIND EMS!” I retaliated, fueled by two years of pandemic rage.

Seconds later, his radial pulse, no longer bradycardic, intensified, almost normal now. He had yet to breathe spontaneously, so my nurse friend prepared to deliver two more rescue breaths. Suddenly, my intuition confirmed, he gasps, he chokes, and then he vomits gallons of ocean water from his stomach, lungs and upper airway. Fortunately, we earlier positioned him on his side, and we did not perform chest compressions or raise his legs…as the crowd suggested.

My nurse friend and I sat by his side monitoring him closely, waiting for any sign of neurologic recovery. He continued to gasp, choke and cough, but he remained unconscious. His pulse was racing now, bounding, throbbing. His ghost white complexion transitioned to a purplish hue and then slowly to a subtle pink tone. As we monitored him, his adult son and his two young grandsons huddled by my side, crying, begging him to wake up, begging me for assurances that “he’ll be OK.” He suddenly opens his eyes, coughs some more, startled, and starts to respond to our inquiries.

“Where am I? What’s going on?!” he utters forcefully through coughing fits and gasps for air.

“What’s your name?” I ask.

“Tim,” he replies.

“Tim…you nearly died. You drowned in the ocean. Those two big guys over there pulled you out of the water. This nurse here gave you mouth-to-mouth resuscitation. These folks saved your life. EMS is on their way. You need to get to the hospital, to the ER, to be assessed, to be admitted, likely to the ICU, because you could develop acute lung injury, pneumonia and may even need life support.” I explained as his son and grandsons sat next to me, crying.

“I…I…I’m fine. I’m not going anywhere. I’m going home,” he proclaimed between coughing and choking fits.

“Where are you? Can you tell me?” I asked.

He looked around, studying the crowd, the ocean, his son, his grandkids, and replied, “I don’t know.”

“What day is it? What holiday is today?” I asked.

“I don’t know. Why are you asking me this?! Who the heck are you?!” he inquired angrily.

“I’m a doctor from Ohio. I’m monitoring you until EMS arrives,” I responded as EMS showed up.

“I don’t need a doctor. I’m fine. I don’t need EMS. Leave me alone!”

“Hook him up to a monitor, get an EKG, and check his blood glucose,” I commanded the EMS officer.

“Who are you and why should I listen to you?” EMS boldly retaliated.

“I’m a freekin’ doctor from Ohio, on vacation, trying to revive my dead soul from COVID, and now I’m dealing with you and this non-compliant patient who just died only minutes ago, who may still die because he’s too proud and you’re too stubborn to heed my advice!” I retaliated.

I caught myself in the heat of the moment, yelling, scolding and directing my ire at this EMS medic, the very one trying to help me, trying to help this drowning victim. I surveyed the remaining crowd, those who stood by—aghast at my demeanor, my vitriol, my rage. I paused, cleared my throat, glanced at my EMS comrade, and offered a heartfelt apology.

“I…I…I’m sorry. I didn’t mean to fly off the handle on you like that. I…”

“It’s OK doc. No need to apologize. I got this now.”

He then heeded my advice and recommendations.

“Tim…I’m gonna go sit with my wife and son over there now. I’m turning your care over to EMS now. You need to go to the ER,” I explained as I shamefully excused myself.

“I’m not going Doc! I refuse!”

“Doc?” EMS chimed in. “We can’t take him to the ER. He has a right to refuse. Patient rights…you know.”

“I don’t know about your laws in Florida. I don’t have a medical license here, only in Ohio. But if we were in Ohio, I would declare him medically and mentally incompetent at this time and send him to the ER against his will. He is not thinking, processing or comprehending things properly. He was submerged underwater, unconscious, for several minutes. He is not competent in my opinion,” I hesitantly responded.

“Doc. We can’t. He has a right to refuse. What do we do?” now seeking further guidance.

I turned toward Tim, garnered his attention, and then asked him a few more questions.

“Tim…where are you from?”

“Knoxville, Tennessee…God’s Country,” he responded proudly, albeit through more coughing fits.

“OK…it’s pretty there, but I can argue about that being God’s Country. Tell me, are these young boys and this man related to you?”

“Yes.”

“What are their names?”

“Umm…umm…I don’t know. I can’t remember. That’s my son, but I can’t remember his name right now,” he answered as his son and grandsons looked on anxiously.

“Sir, you need to go to the ER…”

“Damn it! I’m not going!” he ardently refused.

“OK…have it your way. You have rights. You’re an adult. I’m done arguing with you. But, before I leave and watch you die here, please do me a favor. Sit up please. Let me help you.”

He sits up, assisted by the nurse, me and several EMS workers and then inquires, “Now what?”

“Look at your son, look at your two grandsons, look them in their eyes, and tell them you love them; how much you care for them. But tell them Goodbye, because there’s a good chance, you’re gonna die. You were submerged underwater. You were dead. You were lifeless for several minutes. Those two guys, this young lady—they just saved your life. And now, you’re throwing it all away.” I counseled him angrily while trying, unsuccessfully, to contain my two years’ worth of pent-up anger, heartache and survivor’s remorse.

He gazed at his son, his grandsons, all three now sobbing, wailing, grieving. He studied them, coughing intermittently. He then turned to me, to EMS, to my nurse comrade, to the two big muscular guys who dragged him out from the depths of the ocean and then paused momentarily.

“OK. OK…I’ll go. I’ll go to the ER.” He responded in a defeated tone.

“Good choice,” I replied.

I stood up, wished him and his family well, then started to walk toward my wife, my son, my book.

“Hey Doc!” an EMS officer approached me.

“Yes?” I responded, still embarrassed by my demeanor.

“Dude! Damn! You’re hardcore! I’ve never seen any doctor talk to a patient like that. I’m proud of you! Usually, we just have to walk away…knowing their decisions can and often will lead to their demise. How do you do that? How do you convince a patient to follow your advice?”

I chuckled, then paused. “Whatever it takes.” I replied, “to save someone’s life. Guilt is an amazing tool I keep holstered by my side.”

I hesitated, then continued… “I’m still surviving COVID. So please excuse me. He’s your problem now.”

I walked away, returned to my wife, kissed her and then hugged my son, who was struggling with witnessing a near death experience. He hugged me in return, clutching hard, afraid to let go.

I later ventured toward my newfound friends, that ER nurse from Tampa General Hospital and those two burly guys, whose names I never inquired. Momentarily speechless, we studied each other. Each of us, in some fashion or other, was still reeling from the trauma we just witnessed. And some of us were still coping and dealing with two years of pent-up devastation. We were afraid to say anything, until that nurse broke the ice. Before long, we were talking, listening and even breaking a smile. Several minutes passed as we recreated the events that unfolded before us only minutes prior. We stood in that circle, congratulating each other, offering high-fives, words of encouragement and support, exchanging big bro hugs and well wishes and acknowledging we likely would never see each other again. But we realized that on this Memorial Day 2022, we did something—we made a difference. Four strangers came together to save someone’s life…and to rekindle our own souls.