Rosalind Kaplan

Dancing with Death

My dress is bright red. It is Lycra, shiny, its bodice clinging close to my upper body. The skirt, though not tight, is too short for my comfort and ends in a handkerchief hemline. When I twirl it flares out dramatically. Underneath the skirt I wear black fishnet pantyhose. My shoes are gold, with a stiletto heel and an ankle strap; the sole is soft leather, specially constructed for the smooth wood floor.

If I’d known this would be the costume for the Latin number Larry and I would be performing at the Showcase for the School of Ballroom and Latin Dance, perhaps I would have advocated for a foxtrot or a West Coast swing instead. It was the idea of our instructors, Scott and Christina, to perform a paso doble, a Latin salsa-type dance. Scott acted as choreographer and Christina came up with the costumes. Of course, Larry’s outfit is much more subdued—black pants and vest with a white shirt. Christina wanted the red Lycra and the fishnets, and I didn’t want to hurt her feelings by rejecting her design.

Lest anyone believe that Larry and I are proficient dancers on this night, let me dispel that notion right away. We’d been taking dance lessons for only a couple years, and our skills are quite mediocre. We get the steps right, usually. I’m graceful enough, after years of ballet lessons as a child and teen, but don’t have the confidence to throw in dramatic hand or head motions, so my style is lacking. For Larry’s part, he never quite got the hang of “Latin hips,” so he’s a little stiff on the dance floor. Together we get most of the steps, but our teamwork needs ongoing attention.

* * *

No matter our level, all the students are encouraged to perform once a year, and the School of Ballroom and Latin Dance rents out the largest ballroom at the Union League Club of Philadelphia, a venerable institution founded as a patriotic society in 1862. Larry and I call it the “Bastion of Old White Men” as the hallways are lined with portraits of its original white male members; women and people of color were not allowed in the Union League until the late twentieth century. Nevertheless, the ballroom is grand, and the dance floor is massive. Families and friends of those of us performing buy tickets and come to eat dinner, watch the show, and dance during “open dance” numbers between performances.

Larry and I are third on the schedule. We watch the first couple glide by in formal wear, engaged in a foxtrot, before we are entertained by a rousing jitterbug from a woman in a flapper dress and a man in high-rise, cuffed trousers. When our number is announced, we arrange ourselves in the center of the dance floor with our right hips jutted out and our left knees flexed a bit. The music starts and our body memory kicks in. We flub a double turn but manage to get back on the right foot and proceed. Our enthusiastic audience (with rather low standards, apparently) claps wildly as Larry dips me at the end, my leg high in the air showing plenty of fishnet-covered thigh.

Later we will watch the video and laugh at our mistakes and our sometimes awkward movements. No harm; the Showcase is always good fun. But for now we scamper back to our seats to catch our breath. The host announces an “open dance” Viennese waltz, and a stately older couple, perhaps late seventies, tall and lean and white-haired, begins to dance. I notice how beautifully the woman holds her head, the straight line of her back, and how firmly her partner (I assume her husband) guides her. He is a strong lead, something Larry is working on but has not yet mastered. They move together as one and it appears effortless. I muse at the grace and lightness of their steps. And then, suddenly, the man drops to the ground. It happens so quickly and so silently that I almost wonder if I’ve imagined it. But no, he is lying on the dance floor catty-corner to our table, and there is now a flurry of activity around him as his partner stands stock-still, the serene tilt of her head now gone, her hands covering her mouth and her eyes wide.

Larry, who is busy chatting with the man to his right, hasn’t noticed this spectacle. Without thinking or saying a word, I leap up from the table and run across the floor. Another guest is leaning over the fallen gentleman, who is unconscious.

“He’s breathing!” I hear her say hopefully. But I look down and his face is pallid, grayish, and he makes a tiny gasping noise that I recognize as agonal breathing, a reflex indicating that the brain is not getting oxygen, a sign that he is near death, most likely from cardiac arrest or massive stroke. I kneel beside him, yelling, “Someone call 911!” as I check his pulse. Absent. I tilt his head back to give a rescue breath and look around to see if someone else appears capable of performing CPR.

A crowd has now gathered, and every mouth around me is agape, but Larry has seen the commotion and is on his way across the floor. I give the breath and then straddle the man to begin chest compressions. Larry moves in wordlessly and we embark on two-rescuer CPR. Larry fortunately has the presence of mind to turn to a man next to him and bark, “Go to security and ask if they have a defibrillator.” Meanwhile someone announces that they’ve alerted 911, and the EMTs are on their way.

* * *

I can’t accurately say how long all this takes. Time is suspended. After four or five cycles of compressions, my arms ache, and Larry and I switch places. Then an automatic external defibrillator appears, and Larry rips the man’s already-ruined dress shirt off and attaches the pads to his chest. We both move away enough that we are no longer touching him, and I watch the defibrillator box register a wavy line. “VFib,” the machine announces. “Proceed to shock.”

“Clear,” I yell and push the red button. The unconscious man jolts. Larry checks for a pulse while I watch the monitor. “No pulse. Resume CPR.” I give a breath and he compresses. We move back again. “VFib,” the machine announces again. “Proceed to shock.” I silently wish for a hospital crash cart, for epinephrine and atropine and an IV to improve the chance of survival, but all we have is the AED. “Clear,” I yell and push the red button again. Another jolt and still no pulse. We repeat our ministrations.

It’s the fourth shock, or maybe the fifth, that finally works. There’s a spike on the monitor afterward, indicating a heartbeat. Then another, and another.

“We’ve got a rhythm,” I exclaim.

Larry cranes his neck to see the monitor. “Looks like a normal rhythm!” he says excitedly.

I feel the carotid artery for a pulse, and there it is, weak but present, and I can see the chest rise as he takes a shallow breath.

How long has it been? A minute? An hour? No, something in between, maybe fifteen minutes or twenty? Were our compressions enough to perfuse his brain? And where in hell is the ambulance? Where are the EMTs??

* * *

As though by divination, two EMTs arrive just at that moment, pushing a stretcher, crash box in hand. Larry begins to speak, explaining what transpired, how many cycles of CPR, how many shocks, while one of the EMTs checks vital signs and starts an IV line. I stand up from my kneeling position on the floor and register the group standing around us, some of whom, now that the extreme situation is over, are drifting back to their tables. The man’s dance partner still stands, silently watching, seemingly frozen in place.  

“Oh, my God, are you his…”

“His wife,” she says. I see her lip tremble and put out my arms in time for her to collapse into them.

“It’s okay, they’re stabilizing him,” I tell her. I know it isn’t really okay. The likelihood of someone surviving an out-of-hospital cardiac arrest is less than 10 percent, even with bystander intervention. Still it is as “okay” as it possibly can be, given the circumstances.

I turn to the EMT who is writing down what Larry tells him. “Where will you be taking him?”

“Closest ER is Graduate Hospital,” he replies.

“And his wife, will you take her as well?”

“No, we can’t—we’ll need space for all the equipment and both of us to work on him. We have a driver out there in the ambulance. She’ll have to come separately.”

“Are you here with anyone else?” I ask her.

“No,” she tells me, beginning to cry.

“Okay, we’re going to take you there.” I know Larry will agree so I don’t hesitate. “You need a coat. It’s very cold out. I’m going to get mine and meet you right by that door.” I point to the main entrance to the ballroom.

She nods silently as she watches the EMTs transfer her husband, still unconscious, now hooked up to IV fluids and a heart monitor, oxygen tubing in his nose, to the stretcher. They start moving the stretcher toward the door. She inhales sharply and turns to get her coat.

Larry goes to get our car from the parking garage, and I lead the woman, who is now teary and limp, down the steps and out to the street. Graduate Hospital, which will close as a full-service hospital just a year later in 2007, is only six blocks away, but the traffic makes the trip slow and plodding.

The time allows us to introduce ourselves; she is Mrs. P. We tell her we are physicians and try to calm and reassure her. She thanks us repeatedly and we demur.

“It’s just what we automatically do,” we say.

In fact, it was completely automatic. We’d been so thoroughly trained to recognize emergencies, to step in and take charge, to follow the protocols, that we couldn’t imagine doing otherwise. It was as though the flow chart for emergency procedure appeared in front of our eyes, and we carried out the steps without thinking.

There’d been other times I’d needed to perform CPR outside the hospital. There was the woman who collapsed right in front of me in the Philadelphia airport. I was holding my year-old son and had to hand him over to an airline agent while I tried to resuscitate her. Two years later, 8½ months pregnant with my daughter, I entered a friend’s apartment building to find a woman screaming for help in the lobby. Her husband had been pulseless on the floor for more than five minutes; she didn’t know how to do CPR. I’m pretty certain he was beyond help by the time I started resuscitation. As far as the woman in the airport, I never found out what happened, but my best guess is she didn’t make it.

* * *

Arriving at the ER, we park in the emergency lot and usher Mrs. P through the ER door. It is bracingly cold outside; I haven’t taken the time to close my coat, but I clutch the front panels together to stay warm. I hadn’t been in Graduate’s ER for over twenty years at that point, but as a medical student I’d done part of my general surgery rotation at Graduate, and I feel a spark of recognition even all these years later. I take Mrs. P’s arm and lead her to the reception desk.

“This is Mrs. P—her husband was brought in by ambulance probably just a few minutes ago,” I tell the nurse.

“Oh, yes, just a moment. I’m going to go get the doctor for you,” she replies.  

We sit on beige vinyl chairs in the stark and empty ER waiting room. She holds herself stiffly, her face now stoic. I wonder fleetingly how it would feel to be waiting to hear if my husband, the man who, not an hour earlier, was my dance partner, gliding me across a shiny wood floor in a ballroom, is alive. Then I shake off the thought.

“Mrs. P?” A male voice reaches us, followed by the man it belongs to, a stocky man with tired eyes and graying temples, in green surgical scrubs and a white coat. “I’m Dr. Smith. Your husband is stable. It looks like he’s had a heart attack, and the cardiologist is in with him right now. They want to take him to the cath lab. You know, he was really lucky. Most people who have a cardiac arrest like that don’t even make it to the hospital alive.”

“Well, these are the people who saved his life,” she tells him, gesturing to me and Larry. I feel myself flush. I’m not yet sure that he was saved. He could die in the cath lab, or maybe he is already brain-damaged…

“Why don’t you go join your husband,” Dr. Smith says. “I’ll get some information from these folks.”

“Yes, please,” she answers. She thanks us again.

Before she walks through the door to the clinical area, Larry slips her his card. “Let us know if there’s anything we can do for you.” And then she is gone.

Larry and I stand facing Dr. Smith.

“So what exactly were you all doing when Mr. P collapsed?” Dr. Smith asks. I notice he is directing his question to Larry. He makes no eye contact with me and seems to be subtly smirking.

“Dancing,” says Larry.

“Dancing,” repeats Dr. Smith skeptically. “And how is it that you people know how to do CPR?” Now he looks at me. In fact, he looks me up and down. I glance down at my feet and see the gold stiletto heels and it hits me.

I am standing in an ER waiting room, my coat hanging open, in a red Lycra minidress and fishnet stockings. I’d performed CPR in a red Lycra minidress and fishnet stockings. At a ballroom dance showcase, nobody would think twice about my attire, but in the ER it’s…‌well…incongruous. I was so intent on handling Mr. P’s emergency that I didn’t think for a second about what I was wearing or how we (well, mostly I) must look standing there.

“Well, actually,” I blurt, “we’re doctors. I know we look kind of strange, but we were in the middle of a dance performance, and the whole thing happened right after we finished our salsa dance, and…” My voice trails off.

I imagine he thinks we are either crazy or we are lying. But really, who cares? Truth really is stranger than fiction, I think to myself. Dr. Smith works in an ER. He should know that by now. What difference does it make, anyway? What if he thinks I’m a hooker? What if he thinks I was “entertaining” Mr. P. when he had his cardiac arrest? What difference does any of it make?

“Okay, if there’s nothing else you need to know, we’re going to go,” Larry says, and we head for the door.

We return to the dance showcase. We’ve left our street clothes there at the Union League Club. Besides, there are two more hours of performances scheduled, and we think we want to watch. But when we get back there, I can’t keep my mind off Mr. P. What is going to happen to him? Is Mrs. P okay there by herself, waiting for her husband to come out of the cath lab?

Strangely, when we enter the ballroom, a few people greet us, but nobody comments on Mr. P’s collapse or asks about the resuscitation. Everyone is busy eating and drinking, talking about the dancers, watching the performances. They’ve all moved on already but I haven’t. I look at Larry and we lock eyes.

“I don’t want to stay,” I tell him quietly.

“Neither do I,” he says. “I can’t get back into it. Let’s go home.”

We don’t talk about it anymore. There isn’t anything to say; we both just need to process the events of the night. Like so many times our pagers went off during family dinners or in the middle of sleep, we were pulled abruptly out of the non-medical part of our lives and into someone else’s drama, into their intimacies, their complications, their tragedies and traumas, their near-misses. And once you are pulled in, it isn’t always easy to walk back out. Your mind lingers in the whys and the what-ifs, the realization that, someday, this could be your own tragedy or trauma or, if you’re lucky, your own near-miss. It was not my life that was altered that evening. Our lives remain, on the outside, unchanged, but everything looks a little different on the inside.

We get a call from Mrs. P a few days later. Mr. P, she tells us, has survived not only the catheterization but also a subsequent triple bypass surgery. He’s still recovering in the hospital, but she expects the doctors to discharge him the next day or two. His brain, she says, seems unharmed. It’s almost miraculous. Completely against the odds.

A few months will go by, and Larry and I will stop going to the School of Ballroom and Latin Dance, our lessons becoming a casualty of our too-busy lives and the priorities we set. We will have learned enough to dance at bar mitzvahs and weddings, to pull off a rhumba or a double-step, though the choreography and rhythm never became true second nature, at least not the way performing CPR did.

After the Showcase, whenever Larry and I dance, I will think of Mr. and Mrs. P. I’ll envision their graceful teamwork. I’ll relive the split second in which Mr. P stopped being Mrs. P’s dance partner, the moments in which he almost died, and I’ll wonder if they ever had the chance to waltz again.

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Rosalind Kaplan has been published in several literary and medical journals, including Amarillo Bay, Annals of Internal Medicine, Another Chicago Magazine, Brandeis Magazine, Eastern Iowa Review, HerSTRY, Minerva Rising, Open Arts Forum, Prompted, a Philadelphia Stories Anthology, The Pulse Magazine, The Smart Set, Stonecoast Review, and Sweet Tree. She is a physician and also teaches narrative medicine and medical memoir writing at Thomas Jefferson University/Sidney Kimmel Medical College. Dr. Kaplan is a 2020 graduate of Lesley University’s MFA in creative nonfiction, and she has attended a number of writing workshops. She lives with her husband and two rescue dogs, and has two grown children.