When every second counts

This article is adapted from the fifth edition of the Foundation’s magazine.

There are certain moments that serve as reminders of how unpredictable life can be. In these jarring instances, the ability to work as a team and operate with synchronized precision makes all the difference.

Julie is a mother of three children, aged 12, 15, and 16. On July 22, 2024, she left her home in Saint-Constant, on her way to Montreal. "I remember leaving my house very early, around 6 a.m. But after that, nothing. I have no memories of that morning or what made me head to the Institute. Was I in pain? Was I not feeling well? All I know is that I got to the ER without calling my children or even understanding why I was there. It’s as if my body was on autopilot. I think that day, the stars were aligned for me," she said.

Dr. Carmen Baltazar is an ER physician at the MHI. She remembers seeing Julie. "She took a seat in the waiting area after handing me her hospital card and telling me she didn’t feel well. Then, she collapsed. The team reacted immediately. There was no time to waste. We had to get her to the resuscitation room to start CPR. Needless to say, events like that don’t happen every day," said Dr. Baltazar.

Meanwhile, the team in the emergency department tried unsuccessfully to get in touch with someone at Julie’s home. They finally reached her exspouse, and he was able to be there for their kids. They didn’t go see her at the Institute right away, given all the unknowns and how frightening the situation was. But they were there two days later when Julie regained consciousness. "When I finally woke up, I immediately recognized my daughter through the mask I was wearing. She was very emotional. She kept telling me not to move, that she had met with the doctors and that everything was going to be all right. Then Dr. Bellemarre, the intensive care physician on call, asked me if I recognized him. I said no. He told me he had been part of the team that first saw me and that I’d suffered a cardiac arrest."

When Julie showed up at the MHI, the medical teams on the day shift had just come in to take over from the night shift, but rounds hadn’t yet begun. That meant there were a lot of staff members on site. Dr. Pierre-Emmanuel Noly is a heart surgeon who was there that day. He explains what happened next. "The emergency physicians immediately sprang into action. We have an entire protocol in place for when a cardiac arrest occurs in the emergency room. She was lucky to be in the right place at the right time. It all happened in a highly specialized healthcare centre, surrounded by people who reacted immediately—they had the right training, the right skillsets, the right tools. Because many different specialists were available, in the span of a few minutes she was being cared for by orderlies, perfusionists, surgeons, anesthesiologists and lots of other specialists," said Dr. Noly.

The team quickly decided to put Julie on ventilatory support. "When someone is having a cardiac arrest, there is a very small window of time to act," said Dr. Noly. "Every minute counts. But interventions in this kind of situation present extremely complex technical challenges. For instance, connecting the patient to an extracorporeal blood pump to temporarily replace their heart and lung function requires specialists from different disciplines to work seamlessly together. Effective communication, especially between anesthesiologists and surgeons, can sometimes make all the difference." In that critical moment, it all came together. The healthcare teams administered CPR, were able to quickly and effectively relay information, and carried out a transesophageal echocardiography to get images of her heart in real time. In other words, they saved Julie’s life.

An event like the one experienced by Julie—and the teams who treated her—is rare. "It really got to us. There was something incredibly satisfying for every professional who helped her that day. It really is a testament to the power of solid teamwork, where everyone comes together like a well-oiled machine. There wasn’t just one single thing that saved her life. It was a combination of everything that took place and the continuity in the care she received— from the moment she experienced a cardiac arrest to her discharge from the hospital. At the MHI, we work very hard to mobilize several key actors at the same time and make the right decisions because we know it’s vital that we do so. We know time is of the essence," added Dr. Noly.

When it comes to cardiovascular medicine, interdisciplinarity is crucial. Implementing this approach in an efficient way is a complex endeavour that constantly requires meticulousness, attention, and dedication. It is a fine balancing act that all the teams at the MHI are already good at and are committed to improving on an ongoing basis.

After a three-week stay at the MHI, Julie was able to go back home. We asked her if anything had changed in her life since that fateful day in July 2024. Her answer is an emotional one. "It’s clear to me that I really have to enjoy life. I’ve gotten a second chance. I used to put things off all the time and postpone my plans. For instance, I promised my youngest that we’d go to New York when she turned 12, but we didn’t end up going. Once I’m completely recovered, we will make that happen, so we can create new memories together," she said, confident in the knowledge that the universe was indeed looking out for her that day.

If Julie’s heart could speak, here’s what it would say:

"It would say how each one of its beats is a gift. I now embrace every moment with my kids and loved ones, knowing that we can’t take anything for granted. I’m here today because a whole team refused to give up. To everyone who took care of me, who put their knowledge and their whole heart into every action you took: thank you! Thank you for believing in me. Thank you for giving me a second chance at life."