Today I Watched a Man Die – Chinese Medicine and Emergency Medicine

About two hours ago along one of the busiest streets in Portland, I held a man (feeling his pulses all the while) as he died from a heart attack. To be fair, I couldn’t stay until the bitter end and the man could have pulled through but I strongly, strongly doubt this.

I was taking the bus from my house to my connection at this busy intersection. When I reached my stop, I pulled the cord and both he and I waited until the bus came to a stop to rise. He was around 60, traveling alone. As he walked off the bus and down the sidewalk, I noticed that he was unsteady and his breathing was labored. I was walking quicker than he was and said, “Excuse me” as I passed him on the sidewalk.  It seems strange now to realize that those are likely the last words he ever heard.  Somehow I was interested in him, I thought about waiting in the intersection with him as he crossed as he seemed not to have the energy to make it all the way before the light changed. He barely made it across. I continued to my connection stop.

I placed my bag on the ground and started to look around. I suddenly had an urge to look behind me and there he was, flat on his back with his red and white striped umbrella and Oregon State Beavers’ cap lying unceremoniously in the street. I ran to him at the same time as another two men ran to him. He wasn’t breathing. I grabbed his arm to find a pulse and found something very slow and ponderous forcing itself against his vessel walls. This was almost immediately followed by an intense fluttering that grew dimmer and dimmer… Yin and Yang were separating. He began to turn blue, the man next to me started CPR as a recently arrived woman called 911.

We worked on him for about 7-8 minutes before the paramedics came. During that time he gurgled once or twice and thrust his tongue out as it turned purple. All I could think was, “That’s the color of his heart muscle right now and that is not good.” I felt him leave, but we kept working with him. He grew cold. The paramedics arrived and began their hard work – but got no response. I remained for a short time but knew there was nothing more for me to do, so I left a short time later when my bus arrived.

For the last two hours, I’ve been thinking hard about what I saw. I’ve also been thinking a lot about our medicine. I am never going to be a M.D. I do have CPR training and our program gives us a fair overview of Western medicine. When my fellow students and I discuss the limits of Chinese medicine we usually indicate our boundaries somewhere around the realm of acute heart attacks, intense bacterial and viral infections and, of course, major surgical conditions. I understand that it is best for me to refer patients in these conditions to Western doctors as this is their realm of expertise. I’m happy to do that. However, what about when I’m the only one around? I know our medicine is capable of helping people in dire situations and I am inexplicably drawn to the most severe illnesses and disorders.

We have acupuncture points that are meant to revive consciousness, we have herbs that in certain administrations are meant to reverse terminal conditions. But how far can we go?  What do you know about emergency medicine in Chinese medicine? Do you have any experiences with it? I’m going to start doing some investigation – but your thoughts would be most appreciated.

[This post has been updated during the 2020 site updates. My goal during post updates was to keep the character of the original post, but update for corrections and clarity, as well as to remove broken links.]

7 Comments Add yours

  1. Cm says:

    something i think about constantly

    like when western medicine, helps defect people/babies to survive and/ or reproduce. i type this as plainly as possible as it is of intense emotional issue to many.

    your heart attack case, was in the state of being because of long / chronic pathology state, if you revive him without knowing the particulars, you are then responsible for his well being, of which he may or may not appreciate, from the perspective of our training

    if you met earlier ( life is a lot of ifs ) you may have counseled as a friend/practitioner/whatever. and he may or may not have listened

    you can only do the best you can, under the conditions life has granted.and who is to say you wouldnt have brought him back to consiousness using, Kd1 say, what then, how many minutes before his obviously serious state continues its course.

    we are what we eat, is as true as we are who we become from the decision we make and the choices we delude ourselves into.

    you’ll help far more by being you, conscious and aware of where you are and what you can and cant do with what materials are present at the time.
    lead by example
    just being there for him was ultimately far more value spiritually for the man, than any re-start of a functionally decaded system.

    potential & capacity, both yours and his
    highly valuable, though sad experience

    wishing you a less trouble path in your travels

  2. Michael says:

    Wow dude…hope you’re helping yourself to a little Yunnan Bai Yao as that has to have been more than a little traumatic. I think about this one a lot too. I would really like better First Aid training than I currently have. A girl at my school was behind a nasty wreck where she likely saved the persons life by properly holding C-spine on them til the paramedics showed. This was due to her previous EMT training. I wouldn’t have had a clue on what to do and may have accidentally killed the person. I wouldn’t think too highly of a doctor who didn’t know what to do in an emergency, yanno? Then again, one of my teachers was at a wedding reception during the blistering Florida summer when a guy started feeling the effects of alcohol and sun and promptly started vomiting, on his way to some serious heatstroke. Teacher started slapping cubital/popliteal fossas to bring heat to the surface then drove his thumbnail into Ren Zhong till the guy stabilized. he was able to be taken home by his friends without the need for 911 assistance. That story always makes me feel better.

  3. Eric says:

    I thank you both for your comments. Cm – I have been thinking about issues like this all day… where did this man’s pathology come from, was he ready to go? what part did he play in the creation of this situation? does that matter? if so – how? regardless – i am happy that I was there, able to be with him in those final moments. it was truly valuable and i only wish there was some way i could thank him.

    Michael – that story does make me feel better. 🙂 But, I do agree with your overall tenor – we should know more about emergency medicine, we should know enough to take care of basic situations although of course we shouldn’t hold ourselves responsible if something goes awry and we are unable to help. This situation has simply served to make me fight my school mandated CPR course a little less and look into Chinese medicine emergency medicine a little more.

    Thanks again to both of you and those of you who have replied to me in person about this situation.


  4. Abdallah says:

    Eric, I really feel for you, and I am impressed by your willingness to take on a personal search immediately on the heels of such a difficult situation. But, alas, that is a test of one’s mettle, and there is no question about your integrity, your passion or your immense aptitude.
    I believe that Seattle Institute of Oriental Medicine has offered some courses in emergency medicine recently.

  5. Bonnie says:

    Wow. I don’t intend to minimize that there is a necessity to understand emergency medicine. I think there are things that we don’t really learn in our schools about urgent care type things. I also think that often we in our rush to learn Chinese Medicine, we miss out on the important of what we can do from a western standpoint.

    However, I also think that our patients get what they need, not necessarily what we would like them to have. Obviously at this point, you weren’t able to save this man’s life–maybe he didn’t need to live. Maybe he needed someone there to witness his passing with compassion–someone to understand and witness when he was gone (which often EMT’s and people who are busy doing emergency medicine may often overlook in their business to be saving lives).

    The Oriental side of emergency medicine has often been taught at a sort of you happen to be there anecdotal level. I would love to see someone come out with a CEU course of some sort… think of it–there are huge world emergencies out there. Wouldn’t it be great to add our skills to those of other doctors? Wouldn’t it be great to do more than treat the first responders for stress and to see what sorts of things maybe our level of emergency medicine could do. When you think about it, Chinese medicine would have a lot to offer. Of the emergency treatments I’ve heard of, most use only one or two points and are more typically pressure add to these points rather than needling. If that could by a few moments until an emergency worker with more cumbersome equipment could get there, that could save more lives–who knows?

  6. Katrina says:

    Wow, Eric what a moving story. Like Cm, emergency care is something I think about a lot (as of the past few weeks). In Ontario, CM has just been regulated by the province. The college hasn’t been set up yet but legislation has passed.

    The President of my school was telling us a story during our orientation. She was on a plane when a gentleman collapsed and stopped breathing. They called for a doctor three times before she responded. She needled a point just under his nose and the colour began coming back to his face. She was saying that healers/health practitioners, we have an obligation to to assist those in need but at the same time, because CM isn’t fully regulated in Ontario, we need to be careful about providing emergency care. This is why she waited before offering assistance.

    It’s still early in my education and obviously I have a lot to learn, but the thought of providing CM emergency medicine makes me a bit uneasy. I think it’s because there’s so much I still don’t know combined with the fact that before the orientation and this article I hadn’t really thought too much about emergencies, if at all. I’m very interested in learning more.

  7. Killer says:

    I am a first aider for St. John Ambulance. Don’t know whether you ever heard of that? Yeah. We all use western ways to help the patients. And we are not allowed to give any medicine to the patients until they reach hospital. Emergency medicine in Chinese medicine? In my impression towards chinese medicine, they are usually slow and take a long time to recover from sickness. But I guess that there must be some emergency medicine in chinese medicine too. Maybe we just don’t really clear about that as now most of us use western medicines. 🙂

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