Paul Niles still had some time left on his vehicle lease—there was no urgency to trade his truck in just yet.
But a year-end deal lured the Wyoming, Michigan, resident to the dealership on Dec. 30 to look at a new Chevy Silverado. He ended up striking a deal.
Having signed the paperwork, Paul climbed into the driver’s seat to check out his new truck’s features.
At least, this is what people have told him.
Paul, 65, remembers little of that snowy Monday—because that’s the day his heart stopped beating.
It didn’t take long for the salesman in the passenger seat beside him to grasp the unfolding emergency.
Jumping from the vehicle, the salesman, Darrell Pike, dashed to the driver’s side and pulled Paul gently to the ground, yelling, “Man down!”
A handful of employees raced over to administer chest compressions while Pike ran to the showroom to grab the AED.
Berger Chevrolet proved to be an opportune place for Paul to have a cardiac arrest—the company keeps its staff trained in CPR and first aid.
What’s more, a trauma doctor from out of town happened to be in the dealership at the time, two hours later than planned.
Hearing the commotion, she ran out and took charge of the scene until EMS workers and firefighters arrived.
At first, Paul’s heart didn’t respond to the defibrillating shocks. The team had to administer chest compressions for a full 10 minutes before his heart responded and kicked in.
On the way to the emergency department at Spectrum Health Butterworth Hospital, things looked grim.
“When I got there, he just looked—he looked dead to me,” said Mary Ann Niles, Paul’s wife.
“We had no idea what had happened to him, whether it was a heart attack or a stroke. All we knew is he was on life support.”
The emergency department team called in doctors from the cardiothoracic critical care unit and the cardiology team to evaluate Paul.
Ryan Madder, MD, an interventional cardiologist, then took Paul to the cardiac catheterization lab in Spectrum Health Fred and Lena Meijer Heart Center to find the cause of his cardiac arrest and see what, if anything, could be done to save him.
A coronary angiogram showed the source of his trouble to be a severe blockage in the left main coronary artery—“the most critical place in all of the coronary tree to develop a problem,” Dr. Madder said.
The blockage had caused a heart attack, which then triggered the cardiac arrest.
To keep Paul stable for the time being, Dr. Madder inserted an intra-aortic balloon pump through a catheter in his groin and threaded it up to his aorta.
The pump “inflates and deflates with every heartbeat to help rest the heart and … augment blood flow down the coronary arteries,” Dr. Madder said.
Dr. Madder also inserted a Swan-Ganz catheter into Paul’s heart. This device would allow the ICU team to monitor the heart as Paul rested, awaiting potential surgery.
Going without a heartbeat for 10 minutes can spell disaster for a patient’s brain. Yet, CT scan results gave doctors hope that Paul’s neurologic function remained intact—enough so that they scheduled him for coronary artery bypass surgery in the morning.
Stronger evidence came as he lay in the ICU, his family by his side.
“I rubbed his head and I’m saying, ‘Paul, it’s OK, you’re at the hospital, you’re going to have surgery tomorrow. I’ll let you know what’s happening. Just relax,’” Mary Ann said.
“And he looks right at me. So I said, ‘Oh, he’s there, he’s there,’” she said. “He sat up and looked right at me with his big blue eyes. And then he went back to sleep.”
Heart bypass surgery
The next day, Justin Fanning, MD, a cardiothoracic surgeon, performed a quintuple bypass surgery, using sections of vein taken from Paul’s left leg to redirect the flow of blood around his obstructed coronary arteries.
“He was a young guy, so we were pretty aggressive and did several grafts,” Dr. Fanning said. “We were able to take the balloon pump out right after surgery.”
His heart responded perfectly.
Two days later, Paul woke on the seventh floor of the Fred and Lena Meijer Heart Center.
As he took in the details of what he’d survived, Paul came to see the story as miraculous.
“It was one miracle after another,” he said.
“For me to be where I was at—to be at Berger … where everybody knows CPR, and to have a trauma surgeon just happen to be in that building … and for her to take that machine and take charge”—that’s too many events lining up just right to call it a coincidence, he said.
Mary Ann shares this perspective.
“I can see God’s hand in absolutely everything,” she said.
“From start to finish—from Berger Chevrolet to the EMTs, the firefighters, to the emergency room, the surgeons—we have nothing but praises. To Jesus first, but then to the hospital and all the workers.”
Since coming home, Paul has made a strong recovery.
It’s true to form for a man nicknamed Hercules, known for his ability to carry 50-pound boxes around the warehouse he managed until his October 2019 retirement.
He acknowledges that coronary artery disease is an inherited problem, something he should have been on the alert for.
Now that he has a second chance, Paul is determined to make the most of it.
“When I came home, I was hurting—but spiritually I wasn’t, because my life was saved and I got to see my grandkids, I got to hold my wife,” he said.
“We went out for a walk yesterday. Things like that you don’t take for granted anymore.”
On a recent morning, he walked back into the car dealership to thank the people there who helped save his life.
“They didn’t give up. They could have given up,” he said. “They never stopped.”
Good CPR is key, his doctors agreed.
“The more people that know CPR in the community and recognize cardiac arrest and can act on it, I think the better for the community as a whole,” Dr. Madder said.
The fact that Paul survived an out-of-hospital arrest is a testament to this community, Dr Fanning said.
“It was an amazing save.”