Arisha Nawaz submitted 2020-10-31

The first time I saw someone perform a cardiopulmonary resuscitation was when I was 12 years old. I live in a third world country and this exhibition was an opportunity that didn’t get presented to many students. We were crowded in my middle school gymnasium in front of an instructor who performed it on a mannequin. The instructor was a twenty-something woman and the way she spoke conveyed to every person the importance of what we were learning in that room. When she called for a volunteer to repeat what she had taught, my arm went up without much thought. That ended up being the first time I performed CPR. My instructor told me it was a reasonable effort for my first time, and she taught me how to position my hands to facilitate the thrusts. But more than anything else, I still remember my first class because that day it struck me that my instructor had a superpower. She had the incredible skill to bring a person back to life. I decided that I had to master that skill myself.

Before getting accepted into medical school for my MBBS degree, I had already taken part in more training sessions like my first one. In the first year of my medical school, BLS was a part of our primary clinical skills, and we were once again taught to perform on mannequins. I had the steps memorized by now, but an incident at the end of my first year really put my abilities to the test. It was past midnight. I was studying with the light dimmed and my mom was sleeping peacefully beside me. I remember footsteps; I didn’t look up until I heard the big gasping breaths of my dad weakly trying to wake up mom. As mom got up, we were panicking and couldn’t understand what was going on. There were tears, rushed dialing of phone numbers. I was stunned when dad fell on the floor, still in mom’s arms. I pushed the shock away and ran to him, desperately trying to remember my training. Although I couldn’t think clearly, my hands went into autopilot and took over… One hand on top of the other, push, count, two breaths. Mom was sobbing and my arms were numb, but I kept on going. By the time the paramedics took him away, I was shaking, and my hands were clammy with sweat. The shock really swept over me now and didn’t leave until I got to see him talk and eat 2 days later in the stark bright ICU.

Now at the end of my third year in medical school, 2 years since that incident and amidst a pandemic, I always try to stay mentally prepared for any kind of emergency that may arise. I take myself back to that room that night, think about the situation I was in and visualize how to react to an emergency. In my medical rotations and electives, I volunteer to do tasks that put me amidst demanding situations. During our A&E ward, I helped the nurses perform ECG on emergency patients, some of whom were in critical condition. It allowed me to manage my fears and taught me to be quick, assertive, and confident in myself. I also try to educate my family members and friends regarding Basic Life Support procedures by relating my experience. They all have the mnemonic C A B (compression airway breathing) memorized!

Living with someone who is at high risk for emergencies, I must prepare physically. I do this by keeping an Ambu bag at the house and in the car. I always keep sublingual nitrates with me for dad’s heart condition. However, even before his illness was apparent, I had devoted myself to building my strength. I made sure my diet was consistent and healthy, knowing that I needed to be strong to perform CPR. I’ve always kept emergency numbers on speed dial because I know that when it’s about life or death, every second is essential.

I would advise everyone in healthcare professions or even considering one as a premed to take proper BLS training. Talking to colleagues and teachers who have experienced real-life emergency situations lets you know what to expect. Most training is given on mannequins, and often when it’s a real person, the experience is very different. Is it okay to push hard during compressions even when the patient looks frail? Are you going to hurt them by pushing hard? Do you keep going if there is no recoil of the chest? Or if you’ve been hard at work doing compressions and you’ve performed two cycles, but there is still no response, do you fight the mental fatigue or give up? It’s essential to ask your instructor questions and repeat the procedures until you are confident you understand them completely. Tell people about your training and experience. It can teach them a lot, and they can be there to help if a situation arises. If you have a certification, you can volunteer to train beginners to revamp your own skills. The more you repeat, the easier it will be to do it when it’s needed.

Most of all, be patient with yourself; you will forget steps, you might not remember them after your first few sessions, you might not feel strong enough or feel like you have the stamina to go on doing compressions for a long time. However, with practice, your body evolves and adapts to your needs, as does your mind. You should never hesitate to ask for help and always prioritize the end goal, which is to save a life. Practice. Evolve and involve.