Jun 21

Jun 21 Tennis With a Dead Man

Just as he was starting his serving motion, about to raise his racket over his head, Dan stumbled and fell, landing squarely on his back, his head connecting solidly with the clay court surface.

It was Father’s Day. We were in the final stages of pre-match warm-ups. Dan had just tossed the ball for his fourth practice serve. His racket never made contact as the ball suspended at the peak of its flight, then fell, untouched, to the court.

Dan was a smooth, coordinated tennis player, a typical member of our group of avid, male players in our 60’s and 70’s. We played up to five times a week, sometimes singles, sometimes doubles, but each time from 90 minutes to two hours, and because of this avidity (our spouses might more likely call it an addiction) we were all quite fit.

At the same time we were becoming more aware of our advancing age, and the possibility, albeit remote, of mortality, a minor detail that we had ignored or simply refused to consider. Our attitude was formed by the swagger and arrogance of youth, a youth that had lasted for us until only a few minutes ago.

“We’d often say, when I go, I want it to be on the tennis court. Chasing one deep into the backhand corner. Yup. That’s the way I wanna go.”

This was at once a hope and a way to strike back playfully at our growing awareness of an eventual demise. It was our way of whistling in the dark as we tiptoed by the graveyard. It implied good health right to the very end and allowed us to laugh at the inevitable—to laugh, that is, until we saw the inevitable happen.

Dan was tall, wiry, with almost no extra flesh on his athletic bones. He was a national age-group squash champ in the winter and an accomplished, dedicated tennis player in the summer. He was a joy to play with, completely trustworthy on line calls even in the most tense situations when eyesight and integrity can suddenly desert many players, and with a steady smile and reliable sense of fun and good humor.

He was part of our uber-competitive doubles group at our small club: five clay courts nestled behind a gingerbread barn of a clubhouse located almost across the street from Mt. Auburn Hospital.

Receiving Dan’s warm-up serves on the opposite side of the net, I was staring directly at him when he fell. I was confused. I couldn’t work out how this sure footed athlete could inexplicably lose his balance and fall backward with his hands frozen in their uplifted position, not even flailing to regain balance or reaching behind to break the fall.

The brain can conjure many presumptions in split seconds during occasions devoid of logic, and mine searched for an explanation. Dan’s sense of humor came to mind. This was a Dan joke. And what a good one. It looked just like an actual fall. He must have practiced it.

I expected to hear him call from the ground, “Help. I’ve fallen and I can’t get up.” But there was no sound. No parody. No movement.

I watched his partner look back over his left shoulder to discover Dan on the ground. He didn’t understand either. He smiled, dropped his racket and turned, hands on his hips to look down at Dan as if to say, “Ok, wise guy. Very funny.”

He reached down, took each of Dan’s hands and, using his own weight, began to lever him up. Dan’s shoulders lifted, but everything else—his chest, his stomach, the core of his body remained on the ground. Most disturbingly, his head refused to come along. It dangled backwards, and, in that moment, everything changed.

Only seconds had gone by since the fall. I watched it all from across the net as if the action was in slow motion.

Dan’s doubles partner Alex, eased Dan gently back to the court surface, dropped to his knees straddling Dan’s waist, placed both hands over his heart and started pumping while shouting to us. His voice ripped through the sounds of court-side banter and the pop of rackets connecting with balls like a klaxon call.

“Somebody call 911!”

We’d always joked that, if you’re going to have a heart attack, this tennis club is the place to do it. Years prior, I had taken an overhead smash at close range directly in my right eye. I had staggered, pyrotechnics bursting before my closed eyes, as parts of my glasses flew in multiple directions. I was helped off the court by the head of cardiology at the hospital across the street and treated in the clubhouse by the head of the emergency room at a major city hospital nearby. Both members of the club and regular players. It was not unusual that they were there that morning.

The doctor factor was in play for Dan, too. Alex, who was pumping his chest, was a doctor. Peter, a cardiac surgeon, who would take over the pumping when Alex tired, was playing on the adjacent court.

While running to the scene, Peter screamed at me and waved his hand toward the clubhouse. “Go get the AED!”

Alex shouted at everyone again to call 911 as he was not having much luck with his CPR efforts. But several players from other courts had already run for their cell phones and made the call. Dan was fulfilling our wish, leaving this world on the tennis court, dying with his Nikes on, departing the way we all said we wanted to. But in the moment, the reality was quite different than our facetious wish.

It was now just over a minute or two since he collapsed. My confusion cleared, replaced by a growing wave of nausea. I was relieved to have an assignment, it held my queasiness at bay. I sprinted for the clubhouse to retrieve the AED, a process that, in my near panic, seemed to take way too long. But before I could find it, I heard the surprisingly welcome sounds of sirens close by. I returned to the scene with the EMT’s right behind me.

They arrived miraculously under ten minutes after Dan’s collapse. Five poured onto the court with their array of equipment. One immediately replaced Peter as the chest pumper without losing a beat, while others unrolled and applied the defibrillator paddles - and soon an automatic chest pump - to Dan’s still lifeless body.

Other players gathered to watch from a safe distance. No one could avert their eyes, but no one wanted to be too close. There was some whispering, but we were all shocked into silence and just watched the drama unfold. With paddles and pump in place, the first shock brought a strange, guttural gasp as Dan’s body went straight and stiff, shaking and seemingly levitating before collapsing back to the ground. The EMT’s watched, hoped.

Nothing. Another shock. Another sharp, thunderous gasp from Dan as if there was something inside him desperate to get out. But nothing more. We avoided counting the number of shocks. Repeatedly, the professionals tried to bring him back to us without success.

It was agonizing to watch, and none of it seemed to make sense. Dan was such a lovable character and a true sportsman, a joy to play with. And so fit. Able to outlast any of us in an extended rally, the last one of us we would expect to see collapsed on the court.

“But at this moment he was so much more than that. He was a symbol. An icon. He was at once Dan and each of us at the same time. He had held up a giant mirror that vividly reflected our own impermanence. ”

After several minutes of trying, it appeared that the EMT’s had not been successful. They changed their strategy and working calmly, wordlessly but very quickly, four of them operating as one, lifted him onto the stretcher as though he was weightless. In seconds he was strapped in and wheeled off the courts bound for the hospital across and down the street.

We watched and feared the worst as Dan disappeared horizontally through the club’s front gate. The last thing we saw were the soles of his Nikes. The three of us who were Dan’s doubles cohorts were in shock. Without speaking, we gathered on a bench under the shade of a tree next to the court. All tennis at the club had stopped.

I ventured into the silence. “God, Alex. You were on him right away. Was there any response? Anything? I mean, shit! What’re we lookin’ at here?” I was afraid to utter the word.

Alex, the calm doctor, responded. “Yeah. At first I thought he was kidding. You know Dan. Then when I tried to pull him up, I knew it. His eyes were rolled back. Cardiac arrest. All that pumping. I got nothin’.”

Joe, our third member, asked, “Did the shocks work at all? Did they get any reaction?”

“Nope. Nothing.”

“So...” I wanted confirmation, “he essentially wasn’t breathing for that whole time?”

“Right,” Alex said, head shaking.

Not the word I was hoping for but the one I anticipated.

“Man. How many times have I said ‘when it’s my time to go, I want it to be on the tennis court.’ I’m not so sure about that any more. That was gruesome to watch.”

“Oh yeah. We’ve all said that,” Joe agreed, head nodding.

Alex said, “You know, we just don’t get to choose the time and place, but even if we could, it probably wouldn’t be pretty.”

Then we were quiet again. Movement gradually came back to the club. People edged back on their courts carefully, as if the courts themselves had become dangerous.

Slowly rising from our bench Joe said, “That’s it for me. I’m done with tennis for today.”

Alex and I stayed where we were. I felt too exhausted to move. We were silent for what felt like a long time. “Wonder what Dan would want us to do?” I asked.

“He’d say, ‘Sheeit. Don’t waste a perfectly good morning like this. Get your butts back on the court.’”

“Yeah,” I agreed. “That sounds like Dan, but I don’t know. I really feel spent.”

We thought about it for a few more minutes. “Man, I hate just sitting here thinking about him,” I said. “Let’s play. Maybe we’ll feel better. Maybe we can play him back to life.”

“I don’t know about that,” Alex said, “but almost anything will feel better than just sitting here re-playing that scene over and over. Shit.”

And with that, Alex and I made the worst possible decision. In our mutual states of sadness, we rose from our shaded bench, tried to shake off the shock, ambled slowly to either end of our court and resumed playing.

After a few minutes of warm-up hitting, we began to play again as we always do. The kindling of competition flames to life. Neither player gives in. All balls are chased down no matter where they’re hit. And it was working. The intensity of play distracted us from the trauma of the day and the uncertainty of whether our good friend was still with us.

I returned a ball in the worst place, short, at mid-court on Alex’s forehand side. Alex possesses a blistering forehand, and I gave him the opportunity to use it and angle me far off the court to my forehand side, if I had the temerity to give chase.

Not conceding—and misjudging both my physical and mental state—I pushed off hard and sprinted to my right in pursuit. Now well beyond the line, entering the adjacent court at top speed, my right ankle caught my left foot. As I planted my right foot to slide on the clay and stretch for the ball, my body’s momentum forced my ankle to roll as I tumbled onto the clay.

I screamed out. The pain in my ankle engulfed me, and I started sinking under its dark weight. My ears rang as blood drained from my head. My head spun. Vision narrowed. I was about to pass out.

Alex, an unexpectedly busy doctor that morning, sprinted towards me. While I rolled on my back, ankle suspended in excruciating pain, he bent over me and staring in my eyes I heard him say, “Oh, Jesus, no. Not another one.”

I was able to get a few words out as the pain gradually receded. “It’s only my ankle, not my heart.” Other players had run towards me and now there was a circle of them around me. Embarrassment pushed through my pain. How could I be making such a scene after the seriousness of what had happened just minutes before?

Alex helped me roll into a sitting position and instructed me to put my head as low as I could between my legs. The ringing stopped. My head stopped spinning. With his help I took off my right shoe and sock. My ankle started to swell. After sitting for a time I was able to limp off the court with Alex assisting.

“God,” he said. “What a terrible decision we just made!”

“Yeah. That was nuts,” I agreed.

“Ok. Now what you’ve got to do...do you think you can drive?”

I tested my ankle carefully. I could move my foot up and down without pain, but not side to side. “Yes, I can drive.”

“Ok, I’ll get you to your car. Then I’ll get all your gear, put it in your car, and you’ve gotta get yourself to the emergency room, ok?”

My ankle was puffing up like a blowfish.

“You’ve gotta find out if its broken or just a sprain, but I don’t think you’re gonna be back out here any time soon.”

As I drove to my own hospital several miles away, all I could think about was Dan. My ankle, throbbing, ballooning, changing colors as it was, was nothing.

I was alive.

Three hours had passed since I had limped to my car, endured the usual emergency room wait and had my ankle x-rayed and diagnosed as a bad sprain. I approached my front door, crutches rubbing painfully under my armpits, ankle suspended in space and shrouded in ace bandage. I was an alarming sight for my wife. She saw me through the kitchen window and ran to meet me at the door.

“Oh my God. What happened?”

“Sprained my ankle,” I answered in massive understatement. I needed to talk, but was not sure I could.

With her help I struggled in the door, set the awkward crutches against the wall and collapsed in the chair next to the door. I was exhausted, not physically though. We’d only played about 15 minutes of tennis that morning. My own accident had served merely to delay my confronting the cold reality of what had happened.

As I sunk into the cushions, I exhaled deeply and, finally, the words came pouring out. “Dana,” I said. “My ankle, believe it or not, is nothing.” And I told her the story of that morning’s trauma on the tennis court.

“We left the club not knowing his status,” I avoided the four- letter word. I felt somehow that if I used it, it would be true.

Dana was on her knees in front of me, her eyes locked on mine, listening not just to hear, but to understand. When I finished, she proceeded—carefully. “So,” she said. “You um. Actually—you don’t know if he, ahh, survived?” She avoided the word, too, and I knew what she was doing.

“No. I don’t, and, honestly, I think the chances are slim. Very slim.”

Then she ventured, “You could call the hospital.”

“Oh, no. No. I don’t think I’m ready to do that. I’m not sure I want to know. Not yet.”

“Alright. Let’s get you settled. You probably need to get that up in the air. And some ice, right?”

My wife got me situated, allowing me time to consider making the call. It didn’t take long. I had to know. I wasn’t certain what hospital he’d been taken to, but assumed Mt. Auburn, just a few hundred yards from the tennis club.

“Mt Auburn Hospital, this is Shirley. How can I help you?”

“Shirley, I’d like to speak with a patient who recently checked in.” Using her name seemed to give me some false courage, and I liked the sound of “checked in.” It was normal. Like I was calling the local Hyatt. And it all helped me delay the inevitable.

“His name is Hogan. Dan Hogan.”

There was a pause. Was it too long? What would I do if she said “there is no patient here by that name. “

I had trouble breathing.

“Room 427. I’ll connect you.”

Her unexpected words sliced through my courage.

“No. Wait!” I needed more time to consider this— and connect me to what? I stalled.

“Ahh. What room was that again?”

“Room 427. I’ll connect you now?”

I waited before I answered. “OK. Thank you.”

A woman’s voice answered. “Hi,” I managed. “This is Jim Baldwin.” I felt a need to explain myself and the potential interruption this call could be to a family struggling with a tragedy. “I was playing tennis with Dan this morning...”

She cut me off. “Oh sure.” She almost chirped. “Would you like to talk to him?”

Really? Talk to him? “Well, if he can talk.” Only a few hours ago he was— “Sure. I’d really like to talk with him.”

I heard her say, “Jim Baldwin for you.”

There was some muffled shuffling, and then, “Hey Jim! How ya doin.’” There was no mistaking Dan’s voice, and he sounded not only alive but buoyant.

“Unbelievable,” I said. “This is just unbelievable. How am I doing? How are YOU doing?’”

“I feel great. No worse for wear.”

“Well,” I said “this is pretty fucking amazing. Honestly, I had no idea if you were dead or alive. But I have to say, man, I don’t think I’ve ever been happier to hear someone’s voice than yours right now.” I was so relieved. My fatigue lifted like a fog vanishing in the morning sun.

“Yeah, I guess I gave everyone a scare.”

“A scare? Are you kidding me? The whole place was in a state of shock. We were panicked. Nobody knew what to do, or what to think. Honestly, man, it did not look good when you left. Can you tell me what happened?”

“I don’t know, really. I have no memory of anything. The EMT’s told me that they finally got my heart started in the ambulance on the fourth or fifth shock. Then they gave me Fentanyl in the ER, which, they tell me, didn’t go down too well. Guess I’m allergic to it. But I gradually got my voice and senses back and now everything seems fine. Really. Except for tubes stuck in me everywhere, I think I’m fine.”

“Well you sure didn’t look fine, when you left the club. I think we’re all really lucky that Alex and Peter were on you so fast. Did you hear what they did?”

“Yeah. The EMT’s told me all about it,” Dan said. “I owe those guys. Big time.” Then he became downright chatty, filling in some of the empty spaces. While the EMT’s shocked his heart into starting, he still didn’t breathe for a few more minutes, no oxygen nourishing his brain. He arrived at the hospital in his tennis clothes, of course, without any identification. Having no idea who he was, they assigned him the code name “Missouri.” He was still unconscious as he had been for 15-17 minutes and counting.

Then he said, “ They told me I’m one of the lucky ones. It wasn’t a heart attack. It was sudden cardiac arrest. I guess very few people survive what happened to me.”

“Honestly, we thought you were dead.”

“Technically, I guess I was, for about 10 or 15 minutes.”

After hearing this I swallowed, took a long, slow breath. Dan was quiet, too. “So, Dan. I’ve gotta ask you: did you have one of those experiences with lights and stuff?”

“No man. Sorry. None of that. No lights. No angels coming to greet me. No dramatic return. I remember absolutely nothing. I don’t even remember being at the club. Everything is just a blank.”

“Well, I guess in the hereafter they know what kind of jerk you are,” I joked. “So you went coach, not first class.”

“Yeah. And there was no movie in coach.”

There it was. Proof that he was back.

We stayed in touch over the next few weeks, but Dan disappeared with his family to recover, and I lost track of him as the summer wore on.

Then, in late August I entered the club’s men’s over 65 tournament and was surprised to see his name not only in the draw, but the top seed. “Wow,” I wondered. “Complete recovery in a very short time?” I concluded that his ranking was based on his reputation and certainly not on his current physical condition.

Successfully dragging my still reluctant ankle around the court, I managed to survive into the semi-finals and a meeting with, of course, Dan.

On the day of our match I walked through the club gate, the one Dan had passed through horizontally three months before, with my large tennis bag on my shoulders like a backpack. I saw Dan standing on the deck looking at me. Neither of us thought about it. It happened automatically. I let my bag straps slide down my arms. We moved towards each other, arms extended, and embraced, a long, close, warm hug.

“I’m just so unbelievably glad to see you, and to see that you’re ready to play,” I said.

“I can’t tell you how glad I am to be here,” he said as we separated.

He quickly filled me in on some details. I knew that he’d been transferred from Mt. Auburn Hospital to Mass General, but I’d lost track of him soon after that. The genius doctors at Mass General inserted a special combination pacemaker/defibrillator in his chest, so the electrical malfunction that triggered the arrhythmia that suddenly stopped his heart couldn’t happen again. Four weeks later he was playing tennis without fear—little to no chance of dying with his Nikes on. Ironically, his recovery from near death happened far faster than mine from a mere ankle sprain.

I joked that now I had to face a literal robot in the semi-finals, which hardly seemed fair. He laughed and flashed me that disarming smile.

Even though my ankle was still a hindrance, I thought maybe I should go easy on Dan, the idea of losing to a man who was virtually dead three months prior not entering my mind as remotely possible. The reality was far different than my naive expectations. With his new bionic equipment, Dan was better than ever, skipping around the court like a retriever puppy, tirelessly— even enthusiastically—reaching balls hit to the most remote sections of the court.

He took me apart. One particular point says it all. I had forced him back to his base line, had him on his heels. I charged to the net in a totally offensive position and volleyed the next ball deep into his backhand corner. He took off at full gallop, stretched, then launched a lob over my head. I was shocked that he had even caught up to the ball. All I could do was turn and watch it land well inside the baseline behind me. He had stolen the point, one of many, that should have been mine.

I turned back and glared at him. Then a shout escaped from me, out before I could reach and grab the words back. “Goddammit Dan. Turn off that fuckin’ pacemaker.”

He said nothing and just beamed that smile back at me. As I trudged back to my baseline, exhausted, I thought how amazing it was that this man had literally come back from the dead, not just to play well, but to beat me soundly. In the spirit of true sportsmanship I could say that if there were ever a loss I felt good about it was this one. But sportsmanship be damned.

I was very glad he was alive, but I still hated losing to him.

EPILOGUE: TWO YEARS LATER

Dan and I met for lunch to review my memoir of that fateful day and compare my remembrances to his. Soon after we started, tears came to his eyes. “Sorry,” he murmured, not that there was any need to apologize. “Whenever I talk about that day, I get teary. Every time. I guess it’s because I was so close to not being here...”

His memory of the event had come back a bit. He remembered seeing the tennis ball in flight just as he was preparing to strike it. “I will forever remember seeing that ball about four inches from my racket,” he recalled, “then realizing I’m dizzy, then starting to fall backwards, then thinking, ‘I’m gonna faint.’ Then that’s all I remember. Everything went black.”

Some time after he was admitted, a member of the tennis club had walked his cell phone to the hospital. Shortly thereafter, his daughter, trying to find him on Father’s Day called his cell, and a nurse answered in his room to solve the puzzle of who Missouri was. Meanwhile, if I had called before that time of discovery I might have received the response I was so afraid of hearing. “No, we have no patient here named Dan Hogan.”

During his hospitalization, he learned a lot about sudden cardiac arrest and shared some statistics with me that confirmed just how fortunate he was to be alive. According to Dan, less than six percent of SCA victims who are stricken outside a hospital survive. Of those, between only two and seven percent survive without significant brain damage. So, after the math he concludes that his chances of being where he is, in his healthy state were at best 1 in 420; at worst 1 in 1200. The conclusion? Alex and Peter, the doctor tennis players who kept oxygen flowing to his brain for the first ten minutes, were essential to saving his life and his brain function.

The afternoon of his collapse, the EMT’s who had helped rescue him came to visit in the hospital. There were tears on both sides and both amazement and joy from the EMT’s, who don’t usually win in situations like Dan’s. “It was spectacular to be able to thank the guys who helped save my life,” Dan said.

Given the unlikelihood of surviving his experience, he became a celebrity during his stay at MGH. There were many visitors. “I think I became part of the grand rounds for residents,” he said. “And in this room, we have the guy who survived OHSCA.” (Outside Hospital Sudden Cardiac Arrest.)

Finally, we reminisced about our semi-final tournament match. His memory of it was quite different, and, admittedly, more accurate than mine.

He said that he definitely did not, as I have stated, “take me apart.”

“It was a three set, two and half hour marathon,” he said. (In my defense, I think I have successfully forgotten most of the match.) He even remembered the set scores. “One of the reasons I remember it is because I knew it would be a tough match, and I wanted to see how well I could tolerate that kind of physical intensity. I was happy to win, for sure, but I was really pleased that my body could take it.”

It was a final irony. With his new equipment installed, he had much more stamina than I did. While he could still run, the first two exhausting sets had emptied my tank. The score of the tiebreaking third set? 6-0.

I’m still not happy about it.

Dan went on to win the tournament.