More Than A Medical Record: The Hearts Between The Lines

On June 6, 2011 Grace Firestone went tubing on the Brandywine River, trained at her local gym, and later went into sudden cardiac arrest on her mother’s bedroom floor. She was 18 years old. The momentary event altered the course of her life thereafter. Here, the second-year Sidney Kimmel Medical College at Thomas Jefferson University medical student tells her story of adversity, hardship and recovery—and how it will forever change how she views a patient.

Grace is a second-year Sidney Kimmel Medical College at Thomas Jefferson University medical student.

It has been almost seven years since I spoke at my high school graduation in Delaware on June 4, 2011. I was 18 years old and in good health with hopes of playing collegiate soccer in the fall. Two days later, I went tubing on the Brandywine River and trained at the local YMCA in the afternoon. Around 11:30pm that night, I collapsed on my mom’s bedroom floor in sudden cardiac arrest. The events following would include immediate CPR by my older brother, multiple shocks with an AED (automated external defibrillator), intraosseous infusion, therapeutic hypothermia and a medically induced coma.

My mom and brother’s lives were also forever changed that night. My mom hearing, “No pulse. Confirmed. No pulse,” from the paramedics. My brother Grant running down the stairs never expecting to see his little sister on the floor unconscious, then trailing behind the ambulance in his car, watching the lights go off inside and not knowing what that meant. The image of my eyes open and fixed, skin cold and grey in therapeutic hypothermia. An ER resident walking into the annex to give them a plastic bag of my belongings, again unsure of the implications.

Flashes of these stories have transformed into memories for me. I have heard them told with such emotion and repetition that it has become difficult to distinguish what I have heard from that which I actually experienced. Hospital-stay diary entries by my dear friend Maddy are below:

June 7:“At 4 am this morning, you woke up and moved your limbs a little which was really good news, so great job kiddo. We have to wear these masks, and we have to wash our hands if we want to touch you… Coach Mike was told by the nurse to talk to you, so he leaned in and said, ‘Grace, it’s me, Coach Mike,’ and you turned and opened your eyes. You followed his voice and looked at him! It was amazing. I’m so proud of you.

Grace with nurse who cared for her following her sudden cardiac arrest.

June 9: Today at 8am you shook your head ‘no’ when asked if you were in pain, and at 10am you came off the ventilator and off the drugs. You whispered your name to the nurse when you were asked to!

June 11: You ate solid food today, Grace! At one point after dinner, when you knew only Amanda (friend) was paying attention, you whispered, ‘let’s get out of here.’”

When I walked, however slowly, out of the hospital ten days later, I found myself fitted with an ICD (implantable cardioverter defibrillator) in my left chest. I was soon to discover that my future would be shaped by the split second that had nearly ended it. June and July consisted of remedial cognitive and physical rehabilitation, such as basic arithmetic and 25 minutes of monitored walking on the treadmill. Through those summer months, I struggled with short-term memory loss and retention. After an encouraging neuropsychology exam in late July 2011, however, I decided to start college that August as a biology major. With my doctor’s “preference” that I limited myself to light exercise, I also started playing for the university women’s club soccer team at center midfield. Through December of 2012 and January 2013, I volunteered at a remarkable Kenyan orphanage called Flying Kites and climbed Mt. Kilimanjaro (19,341 feet) in Tanzania as a fundraiser with a group of volunteers. That trip and the children I met forever heightened my appreciation for the intangibles in life.

I often look up at the Jefferson plaques and instinctively shake my head—half in disbelief, the other in gratitude. It is difficult to fathom just how many people played an instrumental role in getting me to this point. To have the privilege to study medicine, and to be able to thank the people who saved my life in this way—there are no words. As a student and hopeful future clinician, I know that every patient has a story much deeper than we will ever know—that he or she will likely leave the hospital with a scar that extends beyond the immediate nature of his or her illness. That patient is a person, with unique hopes and dreams and loved ones in their lives. Patients are more than their medical records, and my experience has taught me that these are the details inscribed carefully and complexly between the lines. It is with them that our care endures in perpetuity.

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