Life after death
Joey Hirl had no warning he was going to die that night.
“I had felt good all day,” said Hirl, who suffered a massive heart attack and died on July 2, 2014. “I had no idea.”
But there he was. Joey Hirl, 48 at the time, died on the table at Spectrum Health Big Rapids Hospital.
Lucky for him, a persistent emergency room doctor, Harold Moores, MD, refused to give up on him. Dr. Moores directed a dedicated team of medical professionals as they performed CPR for 57 minutes that night.
Typically, death is pronounced after about 10 minutes of attempted resuscitation.
But in this case, Joey’s will to live pushed back through death’s door.
‘My husband is dying’
“That night I was lying down, getting sweaty,” Joey recalled. “I had a couple of chest pains, but nothing to indicate I was going to die that night.”
The sensations grew. Joey attempted to drive himself to the hospital with his wife, Carole, as a passenger. They switched drivers partway there.
Irony and fate twist and turn. As the Hirls sped toward the Big Rapids Hospital, Dr. Moores, working in the emergency room that night, stepped outside to make a call on his cell phone.
“I’ve probably only done that four or five times in the almost 20 years I’ve worked here,” Dr. Moores said.
As Dr. Moores talked on the phone to a friend in California whose father was dying, Carole squealed up to the emergency entrance.
“She was screaming, ‘You have to help me, my husband is dying,’” Dr. Moores recalled. The doctor saw Joey’s limp body, slumped in the van’s seat, his face a sickening shade of blue.
Dr. Moores grabbed a gurney and summoned emergency room staff.
Joey’s breathing and pulse weakened as Dr. Moores moved him to the gurney.
Just as they entered the ER, Joey crashed. No pulse. No breath. No response. Nothing but the eerie silence of a void where life once was, a transition to a tomorrow that will never come.
Dr. Moores couldn’t let it end that way. He rushed Joey’s lifeless body into the major cardiac trauma room. And there, after 57 minutes of CPR, medicine and electrical shocks to the heart, his patient’s heartbeat returned.
‘He kept trying to live’
Life illuminated once again.
And in a world where medicine is more prevalent than miracles, Dr. Moores is convinced one truly did occur for Joey, who had suffered a heart attack in the left anterior descending artery, commonly known as the “widow-maker.”
“He technically was dead,” Dr. Moores said. “Here we are 13 minutes into it. The standard for CPR is you go 10 minutes, then you’re done. We kept trying because he kept trying. He would get a sustained rhythm with a pulse, then we would lose it. He kept trying to live.”
Each time he was about to call it, Joey’s heart fluttered. Dr. Moores said he’s never known a patient to survive after working on him or her for so long.
“When I tell this story to other medical professionals, they don’t believe it,” Dr. Moores said. “It’s like what Yogi Berra says. It’s not over ’til it’s over. Just when I was ready to quit, his heart kept coming back. Thank God for deciding it wasn’t his time to go.”
He puts the odds that night of Joey making it at 8 percent, 12 percent tops.
“I’ve coded people 40 or 50 minutes, but they never wake up,” he said. “I’ve never had a 57-minute code that survived. Neurologically, he’s normal. With a lot of outcomes, they’re vegetables and they never return to normal life.”
Big Rapids ER staff took turns doing compressions.
“It’s very time-sensitive,” Dr. Moores said. “The CPR never stopped. It’s important that you do everything by the book.”
Joey calls Dr. Moores and the staff “rock stars.” Joey’s become a bit of a rock star himself, and a real-life poster child. His face adorns Spectrum Health Big Rapids Hospital posters that tout the facility’s rehabilitation resources, where he spent several weeks regaining strength after his ordeal.
“This team down here is like second to nobody,” Joey said with a warm Boston brogue. “The doc doesn’t take enough credit, but he teaches these guys. All these kids idolize rappers. They should be spending time in the emergency rooms and spending time with these teams.”
Dr. Moores and Joey reunited recently in the Big Rapids Emergency Department lobby. They held each other in a brief bear hug, neither one believing what the other had accomplished in their respective lives.
“You’re a first for me,” Dr. Moores told the now-50-year-old Massachusetts native who moved to Michigan 17 years ago after meeting his wife here.
Joey bantered back.
“I had the easy part,” he said. “Dying is easy. Coming back is the job. For these guys to bring a person back to life, that’s magical.”
Dr. Moores walked Joey to the trauma room where staff worked on his heart, then shared how they cooled Joey’s body to 33 degrees that night to increase chances of a positive outcome.
After the long odds of bringing Joey back to life, the odds of a positive outcome took another dramatic turn when Dr. Moores tried to arrange emergency transport for Joey to the Fred and Lena Meijer Heart Center in Grand Rapids.
A turbulent storm forced the helicopter en route from Kalamazoo to turn back.
“They got halfway here and aborted because of the storm,” Dr. Moores recalled. “Minutes count. He needed a stent put in; that’s what needed to be done. It was killing us to think we could run out of time.”
As thunder rolled, so did the tears of Joey’s family as Dr. Moores painfully revealed slim survival odds.
Staff arranged ground transport, knowing it might be Joey’s last trip alive.
But Joey’s will to live, and his unwillingness to say goodbye, triumphed again. Joey made it to Grand Rapids, where West Michigan Heart cardiologists put in four stents and performed an ablation.
“I was pretty much on life support for 15 days,” Joey said. “Every time they pulled me off it, I would crash.”
‘Joey, it’s not your time’
Joey said he saw his mother during that time. His mom had died two years prior.
“I don’t know if it was the Fentanyl (pain medication) or what, but I saw my mom and she told me, ‘Joey, it’s not your time, you have to go back.’ That was the first thing I told my wife. That I saw my mom and I needed to turn back and come back. It was very vivid for me. I don’t know, but I know there’s something great that awaits us.”
Joey experienced that greatness here on Earth, in Big Rapids and in Grand Rapids.
Spectrum Health Medical Group cardiologist Nagib Chalfoun, MD, said Joey’s heart was functioning at only 25 percent when he arrived at the Meijer Heart Center.
“Throughout the next several days he started having an irregular heartbeat from the top part of his heart called atrial fibrillation and eventually atrial flutter,” Dr. Chalfoun said. “He was shocked again for this irregular heartbeat.”
But the bad beats persisted, and his heart raced at 140 beats per minute despite medications aimed to put on the brakes.
“Because we were trying to maximize his heart recovery, it was important to control his rhythms,” Dr. Chalfoun said. “I proceeded with an ablation procedure to burn the atrial flutter.”
That procedure has a 95 percent long-term success rate, and Joey is among the positive statistics.
“By the time he left the hospital, his heart function was up to 60 percent, which is normal,” Dr. Chalfoun said. “He has an excellent prognosis and should be considered cured with this ablation. He can live a healthy long life if he continues to control his other risk factors.”
Those risk factors, for Joey, for you and for me, include avoiding smoking and keeping blood pressure and cholesterol down and our weight under control.
‘Graced with God’
Joey said the experience changed him. He no longer takes health, his family, or moments for granted. He eats healthier, exercises more and encourages other people to get tested for heart disease.
He spends more time talking to strangers, until they aren’t anymore.
“I used to go shopping at Meijer’s, get my stuff and go home. Now, I take time. I know the kid at the fish department that no one talks to. I talk to him. Life is busy, but what am I in such a rush for? Now, I sit and talk to people. They know about my life. I know about their life.”
When he hears an emergency vehicle, he gets out of the way immediately because he knows better than anyone—every second counts.
“When I see (a medical helicopter) fly over my house it takes my breath away because I know there’s somebody going on that journey that I went on and they’re fighting for their life right now. I’ll look up and I’ll have a tear in my eye because I know there’s a family facing what my family faced.”
And he says a prayer, that the family, and the patient, will be graced with God, and the right people in the right place at the right time.
“God truly puts the right people in your path,” Joey said. “How do you bring a guy back from the dead? How do you thank somebody for giving you a second chance in life? It’s magical what they did. It’s just a totally amazing story.”