To save a life in Sisters

David Adler is still coming to terms with a journey right up to the threshold of death.

On February 12, while he was working out at Sisters Athletic Club, Adler, 65, collapsed in sudden cardiac arrest. Thanks to quick, concerted action by the people around him, Adler not only survived - despite the fact that he was not breathing and had no pulse when he hit the floor - he is expected to make a full recovery.

"It will take a long time before I fully process it," Adler said. "In truth, I can't stop thinking about how extraordinary it is that I am actually alive - and well."

It was a very, very close-run thing.

Adler's wife, Marcy, recalled that David had wanted to go down into the crawl space under the house for a second time to check a gas line that had been giving them trouble. She persuaded him not to do that, and he went to the club instead.

Clyde Dildine was at Sisters Athletic Club working out when Adler was there. He noticed that his friend was working hard, bench-pressing a pretty good stack of plates.

Recounting the event at Angeline's Bakery last week, Dildine said, "I just walked over to glance at the TV... I turned around and you were down. My first thought was epilepsy - an epileptic seizure."

Dildine and another SAC patron named Rob checked Adler for a pulse. Neither could find one.

"That's when I immediately started CPR," Dildine said.

It was that action that saved Adler's life.

Dildine had learned CPR as a commercial raft guide, along with wilderness first aid.

"I knew what to do - but I'd never done it before," he said. "I just went to work. It was instinctive. I knew that had to happen."

Citizen or bystander CPR does have to happen. Sisters Fire Paramedic Jeremy Ast, who responded to the call at SAC, told The Nugget that survivability in sudden cardiac arrest goes down 10 percent per minute that a patient goes unattended. That means that if it takes just five minutes for paramedics to respond to a call and get into action, a person's chance of survival diminish by half.

CPR keeps blood circulating through the lungs and brain and "keeps heart tissue viable," according to Paramedic David Keller, who also responded to the call. Without CPR, it is "less likely that defibrillation would work," Keller said.

"It saved his life, for sure."

Dildine kept up CPR while SAC staff contacted 911. Some of the paramedics responded from Sisters High School, where they were teaching students in the health program.

The minutes felt very, very long, as Clyde kept up the compressions, keying the rhythm to the Bee Gees' "Stayin' Alive." Knowing the man he was trying to save gave a special urgency to his efforts, as he kept talking to Adler, bidding him to come back.

Defibrillation from the SAC automatic external defibrillator did not bring back a pulse; the contact wasn't sufficient.

Emergency responders hit the scene and went to work, and Adler's wife, arrived shortly thereafter.

"The parking lot was just ablaze," she recalled, the memory making her flinch.

When she got upstairs to the weight room, "David was white," she said.

His heart had just started, jolted by the defibrillator Ast carries in his command vehicle.

That was a critical development, but things still did not look good. Marcy unclenched her husband's hand and peeled off his workout glove.

"His hand was white and cold," she said. "I was holding his hand and talking to him."

The Sisters Fire crew had mobilized air transport, but Ast made the call to transport via ground ambulance rather than driving to the airport and waiting for the chopper to come in.

"There's times when it's quicker just to go by ground," Ast said.

Though Adler was breathing and had a pulse again, he was far from safe. Even if he survived, it was far from certain that he would be "OK." Doctors were concerned about the possibility of brain injury. The medical team induced hypothermia for about 20 hours to preserve brain function.

"It was pretty tenuous," Marcy recalled. "At first it was pretty scary."

One of the first indications that David was "there" when he was brought out of sedation was that he recognized Marcy. When the doctors asked him who she was, he said. "My soulmate."

Within days, it became apparent that not only had Adler survived stepping right on the threshold of eternity - he had survived in healthy condition. His heart and his arteries appear undamaged, and his short-term memory, which was foggy, has come back - though he remembers nothing of the day or two leading up to the event and nothing of the event itself.

His prognosis is excellent. Right now, he's working on getting his energy back.

His good condition - almost certainly enhanced by his high level of physical fitness - leaves questions.

"They couldn't really tell what happened," Marcy said.

There had been no warning signs, and a recent physical had raised no red flags. In fact, David is noted for being exceptionally fit and training hard.

Adler feels like he's been given a second life.

"It is nothing short of miraculous that I am alive," he said. "Given the amount of time that passed, I believe Clyde and the EMTs brought me back from the very edge of life and death. The statistics for a successful recovery following out-of-hospital CPR (are) extremely low, and I can only attribute my survival to the extraordinary effort and fortitude of Clyde and the EMTs."

For his part, Dildine is gratified that David has done so well - but uncomfortable being given so much credit.

"While I appreciate and am truly humbled by all the accolades I have personally received for my role in David's survival, I feel I alone did not, and should not receive the credit for saving David's life," he told The Nugget. "All of us who were involved in those first frantic minutes are still second-guessing ourselves on what we did, or what we could have done better or differently. But it was a TEAM EFFORT from everyone involved.  Each of us working as hard as we knew how within the limits of our experience and training, hoping for a successful outcome.  There are no heroes in this story, only a bunch of wonderful people trying to save the life of another."