Location: Lakeside, California
Date: September 5, 1991
On September 5, 1991, thirty-five-year-old John Endicott and his wife, Lynn, both of Lakeside, California, had a near-fatal encounter with electricity, but in their case, it came from the sky.
They, who had rarely been able to get away together during their 7 years of marriage, had just returned from their first vacation in 3 years--an experience that they both believed had restored the intimacy of their relationship. "We had just come back from a camping trip," Lynn said. "Until that time, we really hadn't had a vacation or any time off together for a long time. It just put our relationship right back where it was when we first met. It was a very wonderful feeling for the two of us."
Lynn was preparing their first dinner at home after coming back when John, hearing their dogs bark, decided to take them for a walk. "Hurry up," Lynn told him. "Dinner's ready." "I'll just be a second, honey," John called out as he headed for the door. About 15 seconds later, Lynn heard a deafening crash of thunder, which was accompanied by a brilliant flash of lightning.
"I was absolutely terrified," Lynn said. "I knew that lightning was close, and that he was out there." Lynn raced out into the pouring rain, and found her husband lying face down in the wet driveway, apparently struck by the lightning. "Johnny! Johnny! Are you all right?" she called, but there was no response. "There was absolutely nothing," she said, "nothing, nothing."
She ran back to the house and dialed 911. "Fire and medical emergency," said Heartland Community Facility Authority dispatcher Scott Cullen, who took the call. He took Lynn's address and immediately dispatched Lakeside Fire Department medics to the scene. Then he proceeded to get more information from Lynn about her husband's condition.
"He's just lying in our front yard," she said. "Okay, is he conscious?" "No, he's not." "Or breathing?" "No. Please, what do I do now?" Lynn asked desperately. "Okay, they're on their way. They'll be right there, okay?" Cullen said. "You've got to help me. What can I do?" Lynn pleaded. "I knew right away from the emotional level that it was something pretty serious," Cullen said. "Can you bring the phone out where he is?" he asked Lynn. "Yes," she said, although the phone extension nearest to where John was lying was in the garage, a good distance from where his body lay sprawled. "You've got to help me," she repeated.
"I started to hesitate about giving CPR instructions, because, technically, I hadn't been told to do this," said Cullen, who had fortuitously completed an emergency medical dispatch course just 2 hours before the call came in. Legally, he couldn't yet give medical instructions, and the conflicted dispatcher tried once more to reassure Lynn. "The medics are on their way now," he told her. "They'll be there in a short period of time. Is he breathing?" he asked Lynn again. "No." "Is there any way you can get him to near where the phone is?" "Can I drag him?" "Can you drag him close enough? They're already on their way. I'm just staying on the phone with you."
"I knew that we had to get him near the phone," Cullen later said, "and it was totally up to her to do it." "I grabbed him to try and drag him to the garage, but he was too heavy," Lynn said. "My first thought was that I'd have to spend the rest of my life alone without him, and I couldn't do that. I don't know how, but I just got the strength somewhere down inside of me, got ahold of him, and dragged him however many feet it was to the garage." When she had gotten her husband's 180 pound body to the edge of the garage, she returned to the phone. "You've got to help me," she said again to Cullen.
"Okay, is he by where you're at?" Cullen asked. "Yes." "Okay, I want you to shake his shoulders and yell at him--make sure he's unconscious. Do it now," he told her. "The initial objective before you give anybody CPR is to make sure they are not conscious, that they do not have a pulse, and that they are not breathing," he later explained, "because you can hurt someone if they don't need CPR."
"Did he respond at all?" he asked Lynn. "No." "Is he breathing?" "No." "Are you sure?" "Positive," she said. "The engine is going to be there any minute," Cullen said, still hoping that he would not have to give her the instructions he was legally bound to withhold. "No," Lynn said emphatically, "I can't see them coming over the hill. They're not here. Help me now!" "If you lose your job for doing the right thing, then you lose your job," Cullen later said of his decision. "There's a moral imperative here. If I don't tell her what to do, he's going to die. No question about it."
Now Cullen told Lynn, "I want you to go kneel on the side of your husband next to his head. I want you to place the palm of your hand that's closest to his feet under his neck and use your other hand to push his head back and tilt his head back. Do it now." Cullen was giving her the instructions for opening John's airway and checking for breathing, the first step before starting CPR.
"As soon as I was on my way back to John, I knew what the answer was already," Lynn said. "That there was nothing there." "He's still not breathing?" Cullen asked her when she returned to the phone. "No," she said desperately. "Now calm down, we're going to get through this," Cullen told her, and proceeded to instruct her in giving John two rescue breaths that begin the CPR cycle of pulmonary and cardiac assistance. "Blow into his mouth and see if the chest rises." "It rises. It's making a gurgling noise," Lynn said. Cullen then instructed her how to feel for John's pulse on the side of his neck. "There's no pulse," Lynn reported.
"The medics are going to be there," he said, trying to encourage to her, and proceeded to instruct her in giving John chest compressions. "I was very nervous," Cullen said, "because he was basically clinically dead." After the 15 compressions, Cullen told her to go back to the rescue breathing. "He's just blurting it out," Lynn said, discouraged. "Is he breathing?" "No." "Okay, I want you to keep doing that--the breathing and then the compressions--until the paramedics get there," Cullen told her.
"One, two, three, four, five, six, seven--God--eight, nine..." Lynn panted, counting the compressions. "You're doing fine," Cullen encouraged her. "The more I did the compressions the more frustrated I got," Lynn said. "There was no response from John at all-nothing." "One, two, three, help me, five--help me--seven..." Lynn went on. "Keep going, you're doing fine." "...eight, nine--don't die! don't die--eleven, twelve--I love him--fourteen." "Okay, just stay calm. Just keep doing what you're doing. You're helping him," Cullen said.
"With a full arrest, you start CPR and you don't stop until somebody comes in and takes over," he explained later. "You have to make them understand that they are helping by doing what they're doing." "Tell them to come quicker!" Lynn yelled, finishing another compression count. "They're on their way," Cullen said again. "They're here," she said excitedly, almost as soon the words were out of his mouth.
It was 12 minutes since Cullen first picked up the phone to take Lynn's call, and paramedics from the Lakeside Fire Department were on the scene, including Scott Culkin, who was on his first call as a paramedic. "My initial concern was that lightning was still striking in the area," he said. "My first was to get the patient quickly loaded into the ambulance. The patient was in a rhythm called asystole, which is also known as a flat line on the monitor. The patient was clinically dead."
"I asked them at the time, 'Were you able to start his heart on its own?' and they said, 'No,' " Lynn said. "It didn't look very good, but somehow I just couldn't give up. He wouldn't give up on me, and neither would I. Ever." "We gave the patient several rounds of medication, and we got no response," said Culkin. "At that point, we felt that the patient probably would not survive. He remained on a flat line with no pulses and never was breathing on his own."
Thirty minutes after John's heart had stopped beating and two before the ambulance arrived at the emergency department at Valley Medical Center, the paramedics received an order by radio phone from their base hospital physiciam to give John sodium bicarbonate, which was a deviation from their standard protocol for cardiac arrest. "Apparently, the base hospital physician knew what lightning did to the heart," Culkin said, "but I don't think that any of us felt that he would survive this, although he did have a pulse when we delivered him."
John was taken to the University of California San Diego Medical Center and put under the care of Dr. David Hoyt. "John was in a deep coma," Hoyt said. "His CT scan suggested that his injury was due to the fact that he had had a cardiac arrest. His EEG also suggested that he was not likely to make any useful recovery."
"A doctor finally came out after they had worked on him for over an hour," Lynn said. "The first thing he did was give me my husband's wedding ring, and then he started to tell me that things were not very good." "We tried everything," the doctor told her. "Somehow I felt that he was talking to someone else, but he was looking at me in my eyes, saying, 'Your husband's going to die.' "
In spite of the grim prognosis, Lynn wouldn't despair, and visited John for hours every day, even though he was comatose. "I would go in and talk to him or hold his hand. I always touched him, talked to him, and told him what was going on; that I missed him and loved him. I used to sing to him, 'Johnny Angel, Johnny Angel.' But I never gave up hope." "We try hard to balance what we call hope with the concern that we don't want to prolong unnecessary suffering," said Hoyt. "What we did with his wife is talk to her, to allow her to participate in the decision as to whether we should continue support or consider backing off."
"They were talking about if he lived, he had a 1% chance of becoming a functioning human being," Lynn said. "That's like somebody who can get out of bed, and that's about it. Has so thought process at all." But after 2 weeks, amazingly, Lynn did see a change in her husband's condition. "I just walked right over to him leaned right down to him, and gave him a kiss right on the lips, and he kissed me back. So I did it a second time, just to be sure that I wasn't imagining things. And he kissed me back, a second time. That's when I knew that there was someone in there and he knew who I was."
Five weeks after being struck by lightning, John was released from the hospital, but it took 20 months of speech, physical, and occupational therapy before he could return to work. "I'm happy to be alive. I want to thank everyone who saved my life," John said. "Without their help, I wouldn't be here today. I hope that someday I can repay them."
"He's got short-term memory problems right now and sometimes has reactions that are a little slower than they used to be," said Lynn, "but physically there are no scars or any other problems. He's just quite as strong as he used to be, but in time that will come back. It truly is a miracle that he is alive." "The most amazing thing to me about John's recovery is that fact that we were wrong," said Hoyt. "We had lost hope, but his wife did not. She saw us through that extra week and that made the difference. I think there's no question that had she lost hope at that point, there might have been a different outcome."
"It's wonderful to have him back," Lynn said. "We'd like to go on someday and maybe even have a family. And we're just so glad to be back together. Scott Cullen, the emergency operator, didn't just do what he had to do. He made a judgement on his own to give me that CPR information, and my husband is alive because he made that decision. I could never tell him thank you enough."
"I've been a dispatcher for 9 years," Cullen later testified in 1993, "and this last year is the first year that they've let us give these prearrival instructions. A lot of people are under the impression that when they call 911, the people on the other end are going to be able to tell them exactly what to do--CPR mouth-to-mouth, whatever. But the sad fact is that most fire departments do not allow dispatchers to tell them what to do. There's nothing more helpless than a dispatcher when somebody calls up and says, 'What do I do? What do I do?' and you have to sit there and say, 'Well, I can't tell you what to do' because the agency you work for is worried about getting sued by somebody. It's a call that I'll forget. It was my first CPR, and John survived. And I really thank the Lord that he's around."