Scuba accident survivor: I'm here because "hero" husband did not stop CPR
Bill Greenberg was not going to stop CPR.
Forty minutes after his wife Hilary had been found at the bottom of the sea with her scuba breathing regulator removed during a family trip to Costa Rica, a physician who specializes in cosmetic medicine continued to perform cardiopulmonary resuscitation on his unresponsive wife.
"I sort of went into rescue mode," Bill told CBSNews.com in his Scarsdale, N.Y., home. "If I had freaked out, who knows what the outcome would have been?"
And nearly one year after the ill-fated trip with her husband and their three boys, Hilary is on a mission to tell whoever she meets to learn CPR -- because it could help save a life, just like her husband had saved hers.
"I feel like I'm a miracle because my hero is sitting next to me," said Hilary, 49, who like her husband was a physician, trained in internal medicine, before she started working in mortality assessment for life insurance.
When the Greenbergs went on vacation, a dive was often on the agenda. Bill, 51, had been diving since he was about 15 years old, and estimates he's been on over 100 dives. After marrying Hilary, the two went diving on their honeymoon and his wife also got hooked after immersing herself among the colorful fish, coral and breathtaking views of wildlife like eels and sharks.
Bill and Hilary Greenberg pose with their three boys during a family trip to Costa Rica on April 7, 2012. In the background are the Catalina Islands, below which Bill and Hilary would dive.
/ Personal PhotoThe two kept up their hobby as they started a family, and as their three boys got older, they also wanted to join in the fun. When their youngest turned 11 and was old enough to get his junior scuba certification, the Greenbergs and their two other sons, ages 13 and 15, took off for Costa Rica for family vacation on April 6, 2012.
Bill had dove in Costa Rica several times and had a good friend living in the area who would join the group, so the family figured the picturesque Catalina Islands off Guanacaste Province provided the perfect setting for the boys' first chance to dive in open water.
On Saturday morning, the family boarded a boat together with other divers where they soon split into groups with the kids taking off for training with one instructor and Bill, Hilary and the more advanced divers in a second group with a divemaster.
Their first dive that morning went off without a hitch outside of a few small currents. Afterwards, the divers met up back on the boat to unwind before the next dive that afternoon. For the next dive, the adults would go deeper, 35-feet below the water's surface.
"We were probably the most advanced divers in the group so it was going to be an easy dive," said Bill.
By the time the couple would leave the water, their lives would be forever changed.
The second dive
The divemaster had told the group he expected currents deep underwater, and warned them to go with the current if they got caught up in one. The group of six divers, including a divemaster, got in a single-file line where they moved along the rock formations beneath the islands: Bill was fifth in the group, Hilary sixth.
One of the last things Hilary remembers is giving Bill the OK sign following their descent. Bill explains that soon after, the divemaster warned that a strong underwater wave, or "surge" was coming. Hilary described it as feeling like terrible shoving.
"In my mind I'm thinking 'oh my God what is this?' recalled Hilary. "And that's the last thing I remember."
Bill said the force was so strong that the group couldn't fight it, and could only move along with the underwater wave as it took them about 40 feet forward. When he turned around, Bill discovered not everyone in the group had been carried with the surge.
"I look behind me and I don't see Hilary," he said. "She's not there where she's supposed to be."
Bill then signaled the divemaster, who went back about 30 feet toward the start of the surge while the remaining group clung to the rock formation flanked by a coral reef, as the continuing surge swayed them back and forth. Bill anxiously watched four minutes tick off his dive watch, worrying whether it was time to get back to the surface where groups typically gather after an aborted dive. None of the other divers had seen Hilary pass them, and the divemaster soon came back and told them to move forward another 20 feet, past the rock formation. All of a sudden out of the corner of his eye, Bill spotted his wife sitting on the bottom of the sea floor with her regulator out of her mouth. She had cuts on her arms and legs; the surge may have thrown her into the coral, knocking out the apparatus.
"I'm freaking out, I mean, I couldn't believe this, she looked...I just couldn't believe it," Bill recounted. He feared his wife had drowned.
Springing into action, Bill began to lift his wife toward the surface with help from the divemaster. Hilary was not breathing and CPR was almost impossible on the surface of the water, so Bill tried to get air to Hilary while the divemaster yelled for the boat -- which now rested more than 400 feet away. He estimates more than seven minutes had passed from the group losing Hilary to the time she got to the surface of the water. Another three minutes passed as the boat made its way to the troubled divers. Once they got her on the dive boat, Bill confirmed his fears: Hilary was not breathing and didn't have a pulse.
"All I can think of is, 'we've just got to do CPR'," said Bill.
He started compressions and breathing using a now-outdated method of repeating 15 compressions followed by two breaths. The American Heart Association currently recommends a fast compression-only approach, suggesting rescuers pump to the tune of the Bee Gees' 1970s disco hit "Stayin' Alive." Others soon helped with compressions as Bill continued to get air into Hilary's lungs, but the physician worried as no water would come out of her mouth when he turned his wife to her side. Her pulse and breathing had yet to return.
"I just keep thinking I've got to bring her back. She's my buddy, got to bring her back," he recounted. "I'm not going to let her die."
More time passed as the dive boat awaited a rescue vessel from almost 500 feet away. Hilary's pupils were fixed and dilated. She was blue, Bill recounted. Others on the boat began to urge him to stop because the CPR wasn't working, but he wouldn't have it. Thoughts raced through his head that if she did recover, she might be a vegetable, but Bill refused to give up, clinging to the hope that Hilary was just healthy moments ago before the dive, so he might be able to bring her back. More than 20 minutes into the ordeal, Bill and Hilary's kids got back to the boat where they saw their father frantically performing CPR on their mom.
Thirty minutes since Hilary had first vanished, the small rescue boat full of emergency technicians finally reached the divers. The rescuers had no equipment other than an oxygen tank and mask, according to Bill, who, fraught with exhaustion, turned his wife over to them. As they began to perform compressions, however, Bill says he soon noticed the mask was leaking air and oxygen was going into Hilary's stomach instead of her lungs. With a language barrier, Bill felt he had no choice but to push the technicians out of the way, where he started doing mouth to mouth again.
"I didn't want to fool around with this mask," he said.
He'd continue another 10 minutes as the boat made its way back to shore where it would be met by EMS workers who had more advanced equipment, like a defibrillator. More than 40 minutes had passed since Bill last saw Hilary conscious, and during most of that time he had performed CPR. Bill himself remembers during his medical training that he had never performed CPR for more than 20 minutes, but his resolve was unshakeable.
Once on shore, emergency crews hooked up the defibrillator and found a very weak heartbeat. While she still wasn't breathing on her own, that was the first positive sign for Bill -- that his wife's heart had hopefully started beating at some point while he was performing CPR, but it may have been too faint for him to notice. Bill joined Hilary for a 45-minute ambulance ride to a small hospital that had equipment required to conduct tests and to keep Hilary stable. Still soaking in his wetsuit, Bill diverted his efforts to calling the Divers Alert Network to arrange for his wife's evacuation and treatment back in the United States. Their children would arrive about an hour later.
Hilary's lab tests showed she was stable, but she was in a coma and completely unresponsive. A Learjet organized by the network transported the whole family to Delray Medical Center in Delray, Fla., where they arrived by 2 a.m. ET. Neurologists at the hospital ran tests but said it was too early to tell the extent of her damage. Bill told their worried children the family has to be lucky, but in the back of his mind he knew of the possible outcomes his wife faced.
"She was alive, her heart was beating, but we just didn't know anything as far as her brain function, what was going to happen," he said. "What was going through my head was, 'Did I do the right thing?'"
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FS
He had first tried HBOT which did not help. But perhaps it would have helped except for the fact the fellow weighed upwards of 475 to 550 pounds, he was into CHF and his lungs filling with fluid........
FS
On October first, 2010 my (then) 57 year old Father had an "electrical issue" with his heart, while on the roof of the giant building, where he worked at the time, resulting in an anoxic brain injury. The one person he was with, called 9-1-1 from his cell phone, followed the dispatchers CPR directions and made sure to tell the dispatcher they were on the roof of a giant building (an old GM plant in Lansing). When firetrucks arrived, they had no way to find where they were on the roof, so the person doing the CPR had to stop administering CPR, run to the side of the building (a five minute run), flag the paramedics over, run back (another five min. run), and continue CPR until they could get the ladders up to the roof. My Dad didn't have a heart beat for over 43 minutes. He arrived at Sparrow Hospital in Lansing almost 50 minutes after the 9-1-1 call and the ER team started him on hypothermia treatment immediately.
It has been over two years now. My family and I have watched him go through the very stages of "coming back online" as in this story, almost exactly. He went through multiple kinds of therapy sessions for over a year and a half as well. The day he came home from the hospital, two days before Christmas Eve, is Father died. Having no short term memory, it was extremely difficult to watch him re-live that moment for the first two or three months he was home. There have been many set-backs, but just as many forward moments. We are still seeing slow, small improvements, even two years later.
My family and I believe there were many factors as to why he's still with us today, besides the fact that it's a miracle! Two weeks before his "event", the same paramedics and firemen had drills on that building, even going on the roof. The man he was with wasn't afraid to do CPR and the hospital he was taken to had the equipment for the hypothermia treatment. My Mother of course, is another factor, for her love, patience and persistence.
This article helps give other families with similar situations hope, when in the beginning, it can seem absolutely hopeless. I would love to see more articles covering similar stories, but digging deeper into just how hard the patient has to work to get better, how hard it is on families, loved ones and caretakers or how the road to recovery isn't a straight line, it's a bumpy line that moves backwards (a lot) sometimes, but still propels you forward.
And an especially HUGE thank you Bill and Hilary Greenberg for sharing their miracle story!
By most accounts, husband Bill did all the right things with a cool head amidst some frightening ethical dilemmas-- even had Hilary survived, she might have been severely disabled, unable even to care for herself, and perhaps in a permanent coma. This happy outcome from a "hopeless" situation reminds us correct action often carries the day, even when onlookers are pessimistic and unsupportive.
That's also when sustained action takes courage. Part of what drove Bill to continue was he faced the awful prospect of letting his wife slip away from him by surrendering to the undertow of despair-- not to mention comments of onlookers that Hilary was dead, and Bill was foolish for continuing to try to revive her.
Hilary's recovery is one of thousands of similar cases, many from the battlefield and other sources of traumatic brain injury. Today's medicine is what might be called the golden era of neurotherapeutics, bringing more people who might have been left permanently disabled back to full and/or functional recovery.
Many thanks for the well-focused reportorial depth of Jaslow's article, including links to Medscape and recent article from The Lancet. This is the kind of medical journalism that draws readers hungry for real news to CBS.