13 ms·

The Fight

734 points by relation 14y ago

phren0logy 14y ago
It's only trite because it needs to be repeated so often.
- vitalique 14y ago
  Yes and no. This is a very personal, very delicate subject, almost impossible to be expressed in or understood from a single random post at a random blog. Sadly, constant repetition of this particular appeal usually leads to cheap, bleak, even personally and socially irresponsible substitutions like YOLO movement that have very little in common with the level of awareness and appreciation of being alive that OP has acquired (and lost, and acquired again).
  - unimpressive 14y ago
    >even personally and socially irresponsible substitutions like YOLO movement that have very little in common with the level of awareness and appreciation of being alive that OP has acquired (and lost, and acquired again). I'm pretty sure YOLO is a joke. At least I've never heard anyone say it without at least a hint of facetiousness in their voice.
huhtenberg 14y ago
It's all good, but if you haven't had a close relative or a close friend die or come close to it, then no amount of preaching - Live now! Fight the momentum! Live it to the fullest! - is going to do any good. You have to experience it, unfortunately there's no other way. My dad died suddenly two years ago. Just like that - here he is, poof, here he is not. I tried to capture the feelings in a written form and then have people relate. It does not work. It is a sort of experience that no one will re-live willingly. It's just too damn dark.
- kghose 14y ago
  This is very true. In a way, now I think that protecting children from the fact of (natural) death is counter-productive. I think that when a relative dies it is important to make children part of the grieving process and to show how important family and friends are, how important it is to show support for the bereaved, and how important it is to live life knowing that it does not last for ever and that it is important to see the 'big picture'. I would like to add, condolences for your loss. I lost my parents recently too and it has slowed me down and made me appreciate my family and my life more, and made me less spoilt.
- rickdale 14y ago
  Going on 10 years, similar experience. People don't understand how much suddenness of the death affects you. What I have come to realize is that there is no right way to deal with people dealing with death. And that everyone will deal with death differently. I remember at my dad's funeral stuff the number one line I heard from people was, "if you ever need anything..." I didn't know what that meant then, or now. But its a good line. As a side note, I was in AP comp sci at the time with only 4 other students. Our teacher was an ex marine computer programming since the punch card days and really strict and emotionless. My indian friend that was in the class with me said that it was so sad and quiet in class the next day that they could hear the teachers heartbeat. I'll never forget that line.
  - groby_b 14y ago
    That line means "if you need somebody, I'm here". It's there to let you know that while you have to go through this by yourself, you are not alone. But yes, words are insufficient. Even if the other person speaking them has gone through the same pain.
- wpietri 14y ago
  I agree that words cannot convey the experience of loss. But I don't think that means that you can't do some good with it. The trick for me has been to try to exemplify and communicate the lessons I've learned, not the process by which I learned them. Being more joyful in the moment. Being more compassionate in the face of suffering. Facing death and loss squarely when it does come up. Declining to participate in the American game of pretending that death does not exist. Also, I think you can sometimes talk effectively about the direct experience of loss. For example, I got a lot of positive feedback on this, despite the darkness of the topic: http://www.quora.com/Death-and-Dying-1/What-does-it-feels-like-when-doctor-says-youll-just-live-X-days-months http://www.quora.com/Death-and-Dying-1/What-does-it-feels-li...
pdx 14y ago
For those of you who haven't had a CPR refresher in a few years, they now heavily promote the use of AED's [Automated external defibrillator]. The prognosis for recovery after CPR alone is in the single digits and moves well, well into the double digits if supplemented with an AED. Gyms, schools, and works areas should all have a $1000.00 AED onsite. I was surprised that he had to wait for the ambulance to arrive before being defibrillated, since he was in a gym.
- grannyg00se 14y ago
  What are the legalities involved here? If you attempt to help are you opening yourself up to potential blame and legal action? What about DNR wishes the person may or may not have, or religious beliefs?
  - pdx 14y ago
    Nobody wants to live in a world where people find a dying person laying on the floor and let him die because they're afraid of legal issues. The law protects you from such nonsense. Even if it didn't, in my opinion, no person worth a damn would allow that consideration to color their response.
    - Jare 14y ago
      A few months ago there was an incident in China where a young girl was run over by a truck while crossing a street. Nobody stepped in to help, precisely because they were afraid of the legal consequences. The entire thing was recorded on video, and it got a lot of exposure. It was horrific, the kind of thing one wishes you had never seen or heard about. On the other hand, and thankfully this was a much minor event, my wife once got a traffic ticket for moving her car a few meters past a red light in order to make room for an ambulance. Something like that is enough to make you think twice.
      - pdx 14y ago
        I just watched it, after googling for it. As a dad, I'm sick and want to go home and hug my kids. I can't understand how these people lost their humanity, but I've certainly lost mine towards them.
siscia 14y ago
It was an amazing article, really, it get a tear out of me. Thank you for sharing so much.
ahoyhere 14y ago
This is the most sincere and human thing you've ever written, Dustin. Bravo.
tomhoward 14y ago
It's a great post, but to me there's another message that Dustin - understandably - hasn't focused on: "perfect health" is often (usually?) an illusion. Given what I've learned about health in recent years, I can't accept that this guy really was in perfect health; if he was, he wouldn't have suffered a major cardiac arrest while simply jogging on a treadmill. I think it's mostly a failure of modern medicine and modern attitudes towards health that most of us walk around feeling and looking like we're in "perfect" health, only to find all too late that a severe condition was lurking undetected. The answers may lie in fields like Quantified Self [1], or PG's suggestion of Ongoing diagnosis [2]. But whatever the case, we're only just starting to scratch the surface of an area that I think this post demonstrates is hugely important. [1] http://quantifiedself.com/ http://quantifiedself.com/ [2] http://paulgraham.com/ambitious.html http://paulgraham.com/ambitious.html
- ryanwaggoner 14y ago
  I can't accept that this guy really was in perfect health; if he was, he wouldn't have suffered a major cardiac arrest while simply jogging on a treadmill. That may or may not be the case. I suspect that the vast majority of cases of sudden cardiac arrest are attributable to risk factors, but probably not all. Our bodies are pretty incredible, but not perfect. Sometimes they just malfunction.
  - tomhoward 14y ago
    I think we largely agree - differing only on the interpretation of the word "perfect". In my interpretation, perfect health means this type of malfunction doesn't happen. But these days, such perfection is very rare, though it's possible with sufficient knowledge and access to diagnostics.
    - skrebbel 14y ago
      By that definition, perfect health doesn't exist.
      - 14y ago
jgrahamc 14y ago
Some time ago I came across an elderly man in some difficulty lying in the street in London. While waiting for an ambulance he 'died' (no heart beat, no respiration, no signs of life at all, blue lips and gums) and I immediately did CPR on him until the ambulance arrived. Months later I learnt that he survived. Any brush with death makes you seriously think about your own mortality. I know that watching this stranger's eyes go dead was quite life changing for me.
- dmix 14y ago
  May I ask how you found out he survived?
  - jgrahamc 14y ago
    Well, he clearly lives near me because I saw him the other day. Looked a bit frail.
    - andrewflnr 14y ago
      Actually it wasn't clear at all that you saw him near your house.
      - nikatwork 14y ago
        Reread the sentence with a different emphasis and a British accent - the meaning was probably "he must live nearby".
      - damncabbage 14y ago
        I don't believe that wasn't a shot at dmix so much as a "Well, I didn't know this previously, but evidently he lives near me because I saw him the other day".
- JshWright 14y ago
  This is a field where a surprising amount of progress is being made. People still tend to assume that CPR is mostly a token effort so bystanders feel like they're doing something. In reality, high quality CPR + rapid access to an AED can give just about any heart a fighting chance at beating again (assuming the underlying problem is transient or easily treatable... if your LAD cardiac artery is 100% occluded and half your heart has died, there's no coming back from that...). Techniques like 'hands only CPR' are dramatically increasing the willingness of bystanders to get involved and do something productive. The area where really exciting progress is being made is in improving the rates of survival to discharge from the hospital. Techniques like the therapeutic hypothermia mentioned in the article are rapidly gaining acceptance. ACLS (Advanced Cardiac Life Support, the standard of care for acute cardiac emergencies, including cardiac arrest) now suggests that providers should 'consider' therapeutic hypothermia whenever a return of spontaneous circulation (ROSC) is achieved (I know 'should consider' doesn't sound all that exciting, but the American Heart Association is an (understandably) conservative organization, and doesn't make broad based recommendations without a fair amount of data to base them on). I could ramble on about this for a long time, there's a lot of exciting research being done (continuous compressions, continuous EtCO2 monitoring for evaluating compression efficacy and alerting when ROSC has occurred, even really controversial stuff like withholding Epinephrine (a large scale study from Japan has shown that while Epi increases the odds of achieving ROSC, it may _decrease_ the odds of survival to discharge)). This is a topic near and dear to my heart. I volunteer with my local ambulance service, and I'm very close to my New York State Paramedic certification (just need to take the exam). Calls like the ones described in the comments here are exactly why I love doing this... The overlap between my work in EMS and my day job (development) is bigger than you might think... Debugging is debugging... the stakes are just a lot higher.
shocks 14y ago
A very close friend was in a car accident that put him in a category 3 (GCS) coma for two weeks. Worst two weeks of my life... Until my girlfriend was electrocuted and hospitalised for two weeks barely able to move her body. Worst two weeks of my life... Until I lost a close friend overnight. Bam. Gone. Forever. Life is meant to be lived. Unfortunately, that is a lesson you can only learn by yourself.
- JshWright 14y ago
  Despite the name, comas aren't generally categorized by GCS. If they were, most of us would be walking around in a "Category 15" coma all day...
marshallp 14y ago
He's given the typical FOOLISH response people give after brushes with the death plague - live life to the fullest. How about instead thinking of ways to fix the problem. That can also be considered - living life to fullest - and also fixing the problem. In his case, he could have considered how can cardiac arrest be better dealt with. Have drones nearby that automatically go towards the patient and revive them. What's involved in that, collecting the data, manufacturing drones etc. etc. The entire world is focused with having the latest shiny bullshit from the mall/walmart. Go there and see the masses of consumerist idiots picking up plastic crap and clothes like monkeys. How about they instead spend that time crafting a pitch for a new invention that solves a death-related problem on kickstarter. There are 7 billion people, probably only a few thousand of them are working towards actually worthwhile things. Living life to the full doesn't have to mean buying or building crap to fulfill child-like urges to see shiny things, it can instead be using the "god given" brain to tackle the most important challenges, of which survival is number 1. Animals probably look at humans and think what retards, they themselves spend all their time trying to survive.
galapago 14y ago
The romans used to say.. "memento mori".
philwelch 14y ago
Memento mori.
adrianwaj 14y ago
"Running at the gym" ..so many people do it, but wouldn't the energy be put to better use building something? Running barefoot outside would be my choice.. getting grounded and Vitamin D. Gym running is a weird sensation, and unnatural: it's more a striding exercise. Gyms can also be very dirty. But good that he recovered, he should try and work out the how and why so it doesn't happen again.
dmor 14y ago
It's not trite. Especially when things aren't working, and it would be so safe and warm and simply to stop wanting to do extraordinary things and sink back into momentum, inertia, the rhythm of everything that has ever been or will be. Not that I wish any of you to have a huge loss, or near loss, but once you do it is galvanizing - if you let it reach you at the core. As others on this thread have said, memento mori.
alexkus 14y ago
Those in the UK (or soccer fans in general) will be more aware of this due to incidents involving Marc-Vivien Foé who collapsed and died during a game, and more recently Fabrice Muamba who survived a cardiac arrest (his heart had stopped for over an hour but was receiving CPR[1] during this time). http://en.wikipedia.org/wiki/Marc-Vivien_Fo%C3%A9 http://en.wikipedia.org/wiki/Marc-Vivien_Fo%C3%A9 http://en.wikipedia.org/wiki/Fabrice_Muamba http://en.wikipedia.org/wiki/Fabrice_Muamba After the Foé incident there was a lot of promotion of the Cardiac Risk in the Young charity in the UK http://www.c-r-y.org.uk/ http://www.c-r-y.org.uk/ who do ECG and Echocardiogram screening for those between 14 and 35 for a donation to the charity. I got myself tested a couple of years in a row (until I turned 36!) as I was doing a lot of long distance (>200 miles a day for multiple days) cycling and my HRM showed me that I've got an atypical heart (resting heart rate down to ~40bpm at my fittest but I could regularly see >200bpm on my HRM whilst playing 5-a-side and I could average ~185bpm for an hour without feeling uncomfortable at all). A chat with the cardiologist after the scan(s) put any fears at bay, whilst mildly unusual there's nothing fundamentally wrong with my heart, if anything it's just a little smaller than average (hence the high HRmax). Thoroughly recommended and you won't be wasting their time as you'll be helping support the charity by donating. 1. From, among other medical staff, a consultant cardiologist who just happened to be at the game, the same cardiologist later treated him throughout his stay at hospital.
bpatrianakos 14y ago
Just over a year ago my favorite uncle died suddenly in a freak car accident. Besides his immediate family, my mother and I were the very first ones to make it to the hospital where he was DOA. They took us in to see him one last time before he was sent to the morgue or wherever they take the bodies of those who die in the hospital. Everyone says great things about people who are recently deceased but I must stress that he was an extraordinary man. Really. And I thought that long before he died. Seeing his lifeless body there was shocking. What got to me the most was seeing the lifeless expression on his face. He was a man who was always smiling and more full of life than anyone I've met. The contrast between the live man I knew and the heap of dead flesh I saw will stay with me forever. From that day on I have thought about death at least once a day since and always remind myself that every fear I have and every psychological block that keeps me from being who I want to be and doing what makes me happy is an illusion. It's not real and it can't hurt me. But it also reminds me that my hopes and dreams are meaningless too. But if I'm going to be alive I might as well live happy regardless, right? Unfortunately, the problem is that knowing this has not changed my behavior. There's this weird mental barrier between knowing you have a short life and need to really live it and actually doing it. And so despite knowing this truth and coming to realize it in such a traumatic way, I still don't live it nearly as often as I should. I suspect many people are like that. I don't know why that is but I hope someday we can figure out how to go from knowing how we need to live to really doing it in a real way.
nate 14y ago
An interesting bit about Steve Jobs (from the biography) was that he had a foreboding feeling that he'd die early. That also seemed to encourage him to work against the status quo before it was too late.
warrentr 14y ago
Im curious to know the suspected cause. Since he was young, it seems like it was http://en.wikipedia.org/wiki/Hypertrophic_cardiomyopathy http://en.wikipedia.org/wiki/Hypertrophic_cardiomyopathy
- JshWright 14y ago
  There are plenty of other cardiac abnormalities that can cause sudden cardiac death. Wolff-Parkinson-White (and other conduction pathway disorders), prolonged Q-T syndrome, etc...
rdl 14y ago
All reasonably-sized gyms should have Automatic External Defibrillators (AEDs). CPR on its own is not incredibly useful on its own (although it does buy you time for paramedics to arrive). They're only about $1k, which is about 25% of one of the treadmills. I'm surprised it's not mandated by law.
peterhajas 14y ago
You know what's really classy? A giant kudos button at the bottom of this page. Awful.
notlisted 14y ago
Heart attacks in young people (under 35) are rarely related to smoking or high cholesterol (unless accompanied by morbid obesitas) and more often undiagnosed heart or congenital issues (hypertrophic cardiomyopathy, et al.), related to drug abuse (cocaine, weight loss drugs) and/or eating disorders (bulimia). Memento mori, carpe diem, but know that your chances of being struck with heart attacks at a young age are very slim. If it runs in your family, get a screening, but other than that, don't worry too much.
barbs 14y ago
I know the person he's talking about in this article, he's an old friend of mine from primary school, he's only a little bit younger than me. It was a shock to everyone. He was incredibly fit, in the prime of his life and everything. I'm on the other side of the world from him now, but it was still a bit of a wake-up call. Inspired me to go travelling, something I'd been putting off for ages.
bashzor 14y ago
I can not +1 this enough
swilson7 14y ago
In my final year of university, I worked on a project to build a device that induces therapeutic hypothermia. Following graduation, 3 friends and I decided that there was enough need for this device to pursue the venture full time. We won a few business plan competitions, received funding through a small incubator, and set out to improve the outcomes of cardiac arrest patients. Two months in to full time work, the four of us were walking back to the office from from lunch when one of my colleagues collapsed of a sudden cardiac arrest. Similar to Dustin's friend, mine was immediately treated with bystander CPR and first responders were on the scene within 5 minutes. Unfortunately however, my friend was not as lucky as Dustin's. He is no longer with us today and it's devastating to think that his life was taken at the age of 24 by a cardiac arrest. As someone who has been extremely close to this topic for the past year, I can't stress enough the importance of basic understanding. People who seem to be "very healthy" can still be impacted by cardiac arrest. A sudden cardiac arrest is not the same as a heart attack. Bystander CPR and the use of automatic external defibrillators can have a significant impact. "SCA kills more Americans than lung cancer, breast cancer and HIV/AIDS combined." [1] So please spend some time understanding the risk factors that contribute to cardiac arrest, take a CPR course, and educate those around you. I really believe that a single individual can have a significant impact in a situation such as this. [1]http://wwwp.medtronic.com/Newsroom/LinkedItemDetails.do?itemId=1347640295807&itemType=fact_sheet&lang=en_US http://wwwp.medtronic.com/Newsroom/LinkedItemDetails.do?item...
dakrisht 14y ago
Fantastic. Great start to the week. Everyone go out there and fucking kill it this week.
noonespecial 14y ago
My grandfather is 96, he's been on dialysis for nearly 2 years now. He has zero kidney function and a tumor that has literally taken the place of one of the kidneys. His mind is sharp and he's totally lucid. He won't let us sell his cars. He believes that he's going to get better. He talks about it all the time. "As soon as I get better, we'll..." It doesn't matter if one lives 20 years or until the heat death of the universe, everyone has the same experience. Death is unexpected and unwelcome. And completely inevitable.
- delinquentme 14y ago
  > Death is unexpected and unwelcome. And completely inevitable. DO SOMETHING ABOUT IT.
  - noonespecial 14y ago
    As for death at 20, I'm with you, but as for the latter example, I'm open to suggestions on ways to prevent the heat death of the universe. I'm not entirely sure there's anything I can do about that.
ForrestN 14y ago
This, as any would be, is certainly a valid way to respond to a brush with death. But implying that this is somehow a lesson to be learned by everyone, suggesting that others should live their life this way, seems misguided to me in context. Contemplating your mortality shouldn't necessarily convince you to double down on your current priorities (especially if those priorities are centered around banal platitudes like "doing something remarkable with your life," which are probably masks to keep you from thinking about what really motivates you.) It should cause you to reevaluate them. The fact that you will die, the fact that everyone you know will die, and the fact that eventually the universe might become a field of equidistant neutrinos means that it really, really doesn't matter what you accomplish. All roads, if you stay on them long enough, lead to the same place. There will be no progress. There will be no one remarking. I would say that the lesson to be learned from thinking about death is just that there's no reason to adhere to anyone else's values, or to feel pressure to do anything in particular. You should do what you want, what makes you happy, even if it's humble. Existential steps backward can be a tool to remove yourself from things that aren't really helpful, like for example a hyper-competitive capitalist rat-race justified by language like "fight the status quo" or "great visions of the future" that, instead of contributing to humanity, is mostly really about love, insecurity, and fear of death (like so many human pursuits). "Fighting" here, the battle between the heroic pursuit of accomplishment on the one hand and the "insidious machine called quo" on the other, is just the author reporting his own conflicts about what he wants to do. Part of him wants to expend massive amounts of energy attempting to out-compete the people he sees as his peers. But another part of him doesn't want to do that, which is why he loses motivation and doesn't always end up behaving the way a hero-CEO might. There is not some kind of evil, inherent inertia at work that all people must fight against. Instead, there is only ambivalence and subconscious motives. In my opinion, if you really internalize death and it's implications, the notion that you can justify prescribing ways of thinking or behaving just starts to look absurd.
- jordo37 14y ago
  Not sure how much I buy this. I had a similar situation to the OP in high school - a friend and mentor passed away and in the wake of his life I felt the need to Find My Purpose and conquer the world. While I realize with almost a decade under my belt that ForrestN has point - any individual mark tends to blur and disappear, I would still argue that during the days where I am fighting for something, those are the days where I feel good and alive. The days where I let ambivalence win are a waste. I will say, the biggest difference in how I view the mark I want to make is that my scope has widened. Creating a product that changes the world, spending time with family, helping pass laws that make life Better according to my admittedly limited worldview all work.
aswath87 14y ago
Inspired by Steve Jobs' quote mentioned in the article, I built this thing that reminds us about how much time we really have: www.lifing.it
simplegeek 14y ago
Why do people get heart attacks in such a young age? Is it life style, something in genes or etc? Are there things one can do to reduce risks?
charlieflowers 14y ago
"I had once again become a cog in the insidious machine called quo." That is a masterful turn of a phrase!
troubme 14y ago
If only such a comment were made in, say Dr.Phil, the same HN community would have scoffed at it. Somehow when a fellow techie expresses it, it is sagely wisdom. Oh, bow to thee, emotions have surfaced here. These are not the same ones that they world feels, these are special. These are HN folks'.
anigbrowl 14y ago
Fighting is a waste of energy. Find your flow and go with it.
johnconroy 14y ago
The real takeaway from this excellent essay is that change requires a fight. Wonderfully expressed dcurtis, and absolutely true.
greghinch 14y ago
And depending on which country he lived in, this whole episode either cost nothing or has saddled him with crushing debt for the rest of his life
edanm 14y ago
This really reminds me of Paul Graham's post from a while ago, talking about things people in the future will think are weird about our time. One of the things that struck a chord with me from pg's post: In the future, people will get regular health checkups to prevent problems before they happen. I don't know about this particular case, but it makes a lot of sense to me that many people who seem to be in perfect health, might not be. Today, the extent of checking up on yourself is mostly taking a blood sample, talking to a doctor, etc. And it's not done that often, either. In pg's future world, people would check themselves out several times a year (maybe more), with machines that catch many of the most basic problems. In fact, I'd wager that one of the most promising avenues for advancing humanity is to develop better, more affordable tests to check for common problems that we can cure with some foresight.
melc 14y ago
I agree, i believe we should not forget death to help us fight the ordinary vain reality. Thanks for sharing this.
sown 14y ago
I never really understood what those words meant, "Live life fullest, live like its your last day, etc" Can anyone tell me what that really means?
FireBeyond 14y ago
As a tangential aside, reading the opening paragraph of this article reminded me - in the US, if you have cardiac arrest, you want to have it either the counties surrounding The Mayo Clinic in Minnesota or Puget Sound: While cities like Detroit, Chicago and New York have less than 10%, down to 2% survival for /witnessed/, VF/VT (ventricular fibrillation / tachycardia, the rhythms an AED can shock) arrest (i.e. the "best" cardiac event to have), Rochester Minnesota, and the three counties of King, Pierce and Thurston (Seattle, Tacoma and Olympia) have above 40 to nearly 50% survival. Learn CPR. -- a paramedic

The Fight

734 points by relation 14y ago

phren0logy 14y ago

It's only trite because it needs to be repeated so often.

vitalique 14y ago
Yes and no. This is a very personal, very delicate subject, almost impossible to be expressed in or understood from a single random post at a random blog. Sadly, constant repetition of this particular appeal usually leads to cheap, bleak, even personally and socially irresponsible substitutions like YOLO movement that have very little in common with the level of awareness and appreciation of being alive that OP has acquired (and lost, and acquired again).
- unimpressive 14y ago
  >even personally and socially irresponsible substitutions like YOLO movement that have very little in common with the level of awareness and appreciation of being alive that OP has acquired (and lost, and acquired again). I'm pretty sure YOLO is a joke. At least I've never heard anyone say it without at least a hint of facetiousness in their voice.

huhtenberg 14y ago

It's all good, but if you haven't had a close relative or a close friend die or come close to it, then no amount of preaching - Live now! Fight the momentum! Live it to the fullest! - is going to do any good. You have to experience it, unfortunately there's no other way. My dad died suddenly two years ago. Just like that - here he is, poof, here he is not. I tried to capture the feelings in a written form and then have people relate. It does not work. It is a sort of experience that no one will re-live willingly. It's just too damn dark.

kghose 14y ago
This is very true. In a way, now I think that protecting children from the fact of (natural) death is counter-productive. I think that when a relative dies it is important to make children part of the grieving process and to show how important family and friends are, how important it is to show support for the bereaved, and how important it is to live life knowing that it does not last for ever and that it is important to see the 'big picture'. I would like to add, condolences for your loss. I lost my parents recently too and it has slowed me down and made me appreciate my family and my life more, and made me less spoilt.
rickdale 14y ago
Going on 10 years, similar experience. People don't understand how much suddenness of the death affects you. What I have come to realize is that there is no right way to deal with people dealing with death. And that everyone will deal with death differently. I remember at my dad's funeral stuff the number one line I heard from people was, "if you ever need anything..." I didn't know what that meant then, or now. But its a good line. As a side note, I was in AP comp sci at the time with only 4 other students. Our teacher was an ex marine computer programming since the punch card days and really strict and emotionless. My indian friend that was in the class with me said that it was so sad and quiet in class the next day that they could hear the teachers heartbeat. I'll never forget that line.
- groby_b 14y ago
  That line means "if you need somebody, I'm here". It's there to let you know that while you have to go through this by yourself, you are not alone. But yes, words are insufficient. Even if the other person speaking them has gone through the same pain.
wpietri 14y ago
I agree that words cannot convey the experience of loss. But I don't think that means that you can't do some good with it. The trick for me has been to try to exemplify and communicate the lessons I've learned, not the process by which I learned them. Being more joyful in the moment. Being more compassionate in the face of suffering. Facing death and loss squarely when it does come up. Declining to participate in the American game of pretending that death does not exist. Also, I think you can sometimes talk effectively about the direct experience of loss. For example, I got a lot of positive feedback on this, despite the darkness of the topic: http://www.quora.com/Death-and-Dying-1/What-does-it-feels-like-when-doctor-says-youll-just-live-X-days-months http://www.quora.com/Death-and-Dying-1/What-does-it-feels-li...

pdx 14y ago

For those of you who haven't had a CPR refresher in a few years, they now heavily promote the use of AED's [Automated external defibrillator]. The prognosis for recovery after CPR alone is in the single digits and moves well, well into the double digits if supplemented with an AED. Gyms, schools, and works areas should all have a $1000.00 AED onsite. I was surprised that he had to wait for the ambulance to arrive before being defibrillated, since he was in a gym.

grannyg00se 14y ago
What are the legalities involved here? If you attempt to help are you opening yourself up to potential blame and legal action? What about DNR wishes the person may or may not have, or religious beliefs?
- pdx 14y ago
  Nobody wants to live in a world where people find a dying person laying on the floor and let him die because they're afraid of legal issues. The law protects you from such nonsense. Even if it didn't, in my opinion, no person worth a damn would allow that consideration to color their response.
  - Jare 14y ago
    A few months ago there was an incident in China where a young girl was run over by a truck while crossing a street. Nobody stepped in to help, precisely because they were afraid of the legal consequences. The entire thing was recorded on video, and it got a lot of exposure. It was horrific, the kind of thing one wishes you had never seen or heard about. On the other hand, and thankfully this was a much minor event, my wife once got a traffic ticket for moving her car a few meters past a red light in order to make room for an ambulance. Something like that is enough to make you think twice.
    - pdx 14y ago
      I just watched it, after googling for it. As a dad, I'm sick and want to go home and hug my kids. I can't understand how these people lost their humanity, but I've certainly lost mine towards them.

siscia 14y ago

It was an amazing article, really, it get a tear out of me. Thank you for sharing so much.

ahoyhere 14y ago

This is the most sincere and human thing you've ever written, Dustin. Bravo.

tomhoward 14y ago

It's a great post, but to me there's another message that Dustin - understandably - hasn't focused on: "perfect health" is often (usually?) an illusion. Given what I've learned about health in recent years, I can't accept that this guy really was in perfect health; if he was, he wouldn't have suffered a major cardiac arrest while simply jogging on a treadmill. I think it's mostly a failure of modern medicine and modern attitudes towards health that most of us walk around feeling and looking like we're in "perfect" health, only to find all too late that a severe condition was lurking undetected. The answers may lie in fields like Quantified Self [1], or PG's suggestion of Ongoing diagnosis [2]. But whatever the case, we're only just starting to scratch the surface of an area that I think this post demonstrates is hugely important. [1] http://quantifiedself.com/ http://quantifiedself.com/ [2] http://paulgraham.com/ambitious.html http://paulgraham.com/ambitious.html

ryanwaggoner 14y ago
I can't accept that this guy really was in perfect health; if he was, he wouldn't have suffered a major cardiac arrest while simply jogging on a treadmill. That may or may not be the case. I suspect that the vast majority of cases of sudden cardiac arrest are attributable to risk factors, but probably not all. Our bodies are pretty incredible, but not perfect. Sometimes they just malfunction.
- tomhoward 14y ago
  I think we largely agree - differing only on the interpretation of the word "perfect". In my interpretation, perfect health means this type of malfunction doesn't happen. But these days, such perfection is very rare, though it's possible with sufficient knowledge and access to diagnostics.
  - skrebbel 14y ago
    By that definition, perfect health doesn't exist.
    - 14y ago

jgrahamc 14y ago

Some time ago I came across an elderly man in some difficulty lying in the street in London. While waiting for an ambulance he 'died' (no heart beat, no respiration, no signs of life at all, blue lips and gums) and I immediately did CPR on him until the ambulance arrived. Months later I learnt that he survived. Any brush with death makes you seriously think about your own mortality. I know that watching this stranger's eyes go dead was quite life changing for me.

dmix 14y ago
May I ask how you found out he survived?
- jgrahamc 14y ago
  Well, he clearly lives near me because I saw him the other day. Looked a bit frail.
  - andrewflnr 14y ago
    Actually it wasn't clear at all that you saw him near your house.
    - nikatwork 14y ago
      Reread the sentence with a different emphasis and a British accent - the meaning was probably "he must live nearby".
    - damncabbage 14y ago
      I don't believe that wasn't a shot at dmix so much as a "Well, I didn't know this previously, but evidently he lives near me because I saw him the other day".
JshWright 14y ago
This is a field where a surprising amount of progress is being made. People still tend to assume that CPR is mostly a token effort so bystanders feel like they're doing something. In reality, high quality CPR + rapid access to an AED can give just about any heart a fighting chance at beating again (assuming the underlying problem is transient or easily treatable... if your LAD cardiac artery is 100% occluded and half your heart has died, there's no coming back from that...). Techniques like 'hands only CPR' are dramatically increasing the willingness of bystanders to get involved and do something productive. The area where really exciting progress is being made is in improving the rates of survival to discharge from the hospital. Techniques like the therapeutic hypothermia mentioned in the article are rapidly gaining acceptance. ACLS (Advanced Cardiac Life Support, the standard of care for acute cardiac emergencies, including cardiac arrest) now suggests that providers should 'consider' therapeutic hypothermia whenever a return of spontaneous circulation (ROSC) is achieved (I know 'should consider' doesn't sound all that exciting, but the American Heart Association is an (understandably) conservative organization, and doesn't make broad based recommendations without a fair amount of data to base them on). I could ramble on about this for a long time, there's a lot of exciting research being done (continuous compressions, continuous EtCO2 monitoring for evaluating compression efficacy and alerting when ROSC has occurred, even really controversial stuff like withholding Epinephrine (a large scale study from Japan has shown that while Epi increases the odds of achieving ROSC, it may _decrease_ the odds of survival to discharge)). This is a topic near and dear to my heart. I volunteer with my local ambulance service, and I'm very close to my New York State Paramedic certification (just need to take the exam). Calls like the ones described in the comments here are exactly why I love doing this... The overlap between my work in EMS and my day job (development) is bigger than you might think... Debugging is debugging... the stakes are just a lot higher.

shocks 14y ago

A very close friend was in a car accident that put him in a category 3 (GCS) coma for two weeks. Worst two weeks of my life... Until my girlfriend was electrocuted and hospitalised for two weeks barely able to move her body. Worst two weeks of my life... Until I lost a close friend overnight. Bam. Gone. Forever. Life is meant to be lived. Unfortunately, that is a lesson you can only learn by yourself.

JshWright 14y ago
Despite the name, comas aren't generally categorized by GCS. If they were, most of us would be walking around in a "Category 15" coma all day...

marshallp 14y ago

He's given the typical FOOLISH response people give after brushes with the death plague - live life to the fullest. How about instead thinking of ways to fix the problem. That can also be considered - living life to fullest - and also fixing the problem. In his case, he could have considered how can cardiac arrest be better dealt with. Have drones nearby that automatically go towards the patient and revive them. What's involved in that, collecting the data, manufacturing drones etc. etc. The entire world is focused with having the latest shiny bullshit from the mall/walmart. Go there and see the masses of consumerist idiots picking up plastic crap and clothes like monkeys. How about they instead spend that time crafting a pitch for a new invention that solves a death-related problem on kickstarter. There are 7 billion people, probably only a few thousand of them are working towards actually worthwhile things. Living life to the full doesn't have to mean buying or building crap to fulfill child-like urges to see shiny things, it can instead be using the "god given" brain to tackle the most important challenges, of which survival is number 1. Animals probably look at humans and think what retards, they themselves spend all their time trying to survive.

galapago 14y ago

The romans used to say.. "memento mori".

philwelch 14y ago

Memento mori.

adrianwaj 14y ago

"Running at the gym" ..so many people do it, but wouldn't the energy be put to better use building something? Running barefoot outside would be my choice.. getting grounded and Vitamin D. Gym running is a weird sensation, and unnatural: it's more a striding exercise. Gyms can also be very dirty. But good that he recovered, he should try and work out the how and why so it doesn't happen again.

dmor 14y ago

It's not trite. Especially when things aren't working, and it would be so safe and warm and simply to stop wanting to do extraordinary things and sink back into momentum, inertia, the rhythm of everything that has ever been or will be. Not that I wish any of you to have a huge loss, or near loss, but once you do it is galvanizing - if you let it reach you at the core. As others on this thread have said, memento mori.

alexkus 14y ago

Those in the UK (or soccer fans in general) will be more aware of this due to incidents involving Marc-Vivien Foé who collapsed and died during a game, and more recently Fabrice Muamba who survived a cardiac arrest (his heart had stopped for over an hour but was receiving CPR[1] during this time). http://en.wikipedia.org/wiki/Marc-Vivien_Fo%C3%A9 http://en.wikipedia.org/wiki/Marc-Vivien_Fo%C3%A9 http://en.wikipedia.org/wiki/Fabrice_Muamba http://en.wikipedia.org/wiki/Fabrice_Muamba After the Foé incident there was a lot of promotion of the Cardiac Risk in the Young charity in the UK http://www.c-r-y.org.uk/ http://www.c-r-y.org.uk/ who do ECG and Echocardiogram screening for those between 14 and 35 for a donation to the charity. I got myself tested a couple of years in a row (until I turned 36!) as I was doing a lot of long distance (>200 miles a day for multiple days) cycling and my HRM showed me that I've got an atypical heart (resting heart rate down to ~40bpm at my fittest but I could regularly see >200bpm on my HRM whilst playing 5-a-side and I could average ~185bpm for an hour without feeling uncomfortable at all). A chat with the cardiologist after the scan(s) put any fears at bay, whilst mildly unusual there's nothing fundamentally wrong with my heart, if anything it's just a little smaller than average (hence the high HRmax). Thoroughly recommended and you won't be wasting their time as you'll be helping support the charity by donating. 1. From, among other medical staff, a consultant cardiologist who just happened to be at the game, the same cardiologist later treated him throughout his stay at hospital.

bpatrianakos 14y ago

Just over a year ago my favorite uncle died suddenly in a freak car accident. Besides his immediate family, my mother and I were the very first ones to make it to the hospital where he was DOA. They took us in to see him one last time before he was sent to the morgue or wherever they take the bodies of those who die in the hospital. Everyone says great things about people who are recently deceased but I must stress that he was an extraordinary man. Really. And I thought that long before he died. Seeing his lifeless body there was shocking. What got to me the most was seeing the lifeless expression on his face. He was a man who was always smiling and more full of life than anyone I've met. The contrast between the live man I knew and the heap of dead flesh I saw will stay with me forever. From that day on I have thought about death at least once a day since and always remind myself that every fear I have and every psychological block that keeps me from being who I want to be and doing what makes me happy is an illusion. It's not real and it can't hurt me. But it also reminds me that my hopes and dreams are meaningless too. But if I'm going to be alive I might as well live happy regardless, right? Unfortunately, the problem is that knowing this has not changed my behavior. There's this weird mental barrier between knowing you have a short life and need to really live it and actually doing it. And so despite knowing this truth and coming to realize it in such a traumatic way, I still don't live it nearly as often as I should. I suspect many people are like that. I don't know why that is but I hope someday we can figure out how to go from knowing how we need to live to really doing it in a real way.

nate 14y ago

An interesting bit about Steve Jobs (from the biography) was that he had a foreboding feeling that he'd die early. That also seemed to encourage him to work against the status quo before it was too late.

warrentr 14y ago

Im curious to know the suspected cause. Since he was young, it seems like it was http://en.wikipedia.org/wiki/Hypertrophic_cardiomyopathy http://en.wikipedia.org/wiki/Hypertrophic_cardiomyopathy

JshWright 14y ago
There are plenty of other cardiac abnormalities that can cause sudden cardiac death. Wolff-Parkinson-White (and other conduction pathway disorders), prolonged Q-T syndrome, etc...

rdl 14y ago

All reasonably-sized gyms should have Automatic External Defibrillators (AEDs). CPR on its own is not incredibly useful on its own (although it does buy you time for paramedics to arrive). They're only about $1k, which is about 25% of one of the treadmills. I'm surprised it's not mandated by law.

peterhajas 14y ago

You know what's really classy? A giant kudos button at the bottom of this page. Awful.

notlisted 14y ago

Heart attacks in young people (under 35) are rarely related to smoking or high cholesterol (unless accompanied by morbid obesitas) and more often undiagnosed heart or congenital issues (hypertrophic cardiomyopathy, et al.), related to drug abuse (cocaine, weight loss drugs) and/or eating disorders (bulimia). Memento mori, carpe diem, but know that your chances of being struck with heart attacks at a young age are very slim. If it runs in your family, get a screening, but other than that, don't worry too much.

barbs 14y ago

I know the person he's talking about in this article, he's an old friend of mine from primary school, he's only a little bit younger than me. It was a shock to everyone. He was incredibly fit, in the prime of his life and everything. I'm on the other side of the world from him now, but it was still a bit of a wake-up call. Inspired me to go travelling, something I'd been putting off for ages.

bashzor 14y ago

I can not +1 this enough

swilson7 14y ago

In my final year of university, I worked on a project to build a device that induces therapeutic hypothermia. Following graduation, 3 friends and I decided that there was enough need for this device to pursue the venture full time. We won a few business plan competitions, received funding through a small incubator, and set out to improve the outcomes of cardiac arrest patients. Two months in to full time work, the four of us were walking back to the office from from lunch when one of my colleagues collapsed of a sudden cardiac arrest. Similar to Dustin's friend, mine was immediately treated with bystander CPR and first responders were on the scene within 5 minutes. Unfortunately however, my friend was not as lucky as Dustin's. He is no longer with us today and it's devastating to think that his life was taken at the age of 24 by a cardiac arrest. As someone who has been extremely close to this topic for the past year, I can't stress enough the importance of basic understanding. People who seem to be "very healthy" can still be impacted by cardiac arrest. A sudden cardiac arrest is not the same as a heart attack. Bystander CPR and the use of automatic external defibrillators can have a significant impact. "SCA kills more Americans than lung cancer, breast cancer and HIV/AIDS combined." [1] So please spend some time understanding the risk factors that contribute to cardiac arrest, take a CPR course, and educate those around you. I really believe that a single individual can have a significant impact in a situation such as this. [1]http://wwwp.medtronic.com/Newsroom/LinkedItemDetails.do?itemId=1347640295807&itemType=fact_sheet&lang=en_US http://wwwp.medtronic.com/Newsroom/LinkedItemDetails.do?item...

dakrisht 14y ago

Fantastic. Great start to the week. Everyone go out there and fucking kill it this week.

noonespecial 14y ago

My grandfather is 96, he's been on dialysis for nearly 2 years now. He has zero kidney function and a tumor that has literally taken the place of one of the kidneys. His mind is sharp and he's totally lucid. He won't let us sell his cars. He believes that he's going to get better. He talks about it all the time. "As soon as I get better, we'll..." It doesn't matter if one lives 20 years or until the heat death of the universe, everyone has the same experience. Death is unexpected and unwelcome. And completely inevitable.

delinquentme 14y ago
> Death is unexpected and unwelcome. And completely inevitable. DO SOMETHING ABOUT IT.
- noonespecial 14y ago
  As for death at 20, I'm with you, but as for the latter example, I'm open to suggestions on ways to prevent the heat death of the universe. I'm not entirely sure there's anything I can do about that.

ForrestN 14y ago

This, as any would be, is certainly a valid way to respond to a brush with death. But implying that this is somehow a lesson to be learned by everyone, suggesting that others should live their life this way, seems misguided to me in context. Contemplating your mortality shouldn't necessarily convince you to double down on your current priorities (especially if those priorities are centered around banal platitudes like "doing something remarkable with your life," which are probably masks to keep you from thinking about what really motivates you.) It should cause you to reevaluate them. The fact that you will die, the fact that everyone you know will die, and the fact that eventually the universe might become a field of equidistant neutrinos means that it really, really doesn't matter what you accomplish. All roads, if you stay on them long enough, lead to the same place. There will be no progress. There will be no one remarking. I would say that the lesson to be learned from thinking about death is just that there's no reason to adhere to anyone else's values, or to feel pressure to do anything in particular. You should do what you want, what makes you happy, even if it's humble. Existential steps backward can be a tool to remove yourself from things that aren't really helpful, like for example a hyper-competitive capitalist rat-race justified by language like "fight the status quo" or "great visions of the future" that, instead of contributing to humanity, is mostly really about love, insecurity, and fear of death (like so many human pursuits). "Fighting" here, the battle between the heroic pursuit of accomplishment on the one hand and the "insidious machine called quo" on the other, is just the author reporting his own conflicts about what he wants to do. Part of him wants to expend massive amounts of energy attempting to out-compete the people he sees as his peers. But another part of him doesn't want to do that, which is why he loses motivation and doesn't always end up behaving the way a hero-CEO might. There is not some kind of evil, inherent inertia at work that all people must fight against. Instead, there is only ambivalence and subconscious motives. In my opinion, if you really internalize death and it's implications, the notion that you can justify prescribing ways of thinking or behaving just starts to look absurd.

jordo37 14y ago
Not sure how much I buy this. I had a similar situation to the OP in high school - a friend and mentor passed away and in the wake of his life I felt the need to Find My Purpose and conquer the world. While I realize with almost a decade under my belt that ForrestN has point - any individual mark tends to blur and disappear, I would still argue that during the days where I am fighting for something, those are the days where I feel good and alive. The days where I let ambivalence win are a waste. I will say, the biggest difference in how I view the mark I want to make is that my scope has widened. Creating a product that changes the world, spending time with family, helping pass laws that make life Better according to my admittedly limited worldview all work.

aswath87 14y ago

Inspired by Steve Jobs' quote mentioned in the article, I built this thing that reminds us about how much time we really have: www.lifing.it

simplegeek 14y ago

Why do people get heart attacks in such a young age? Is it life style, something in genes or etc? Are there things one can do to reduce risks?

charlieflowers 14y ago

"I had once again become a cog in the insidious machine called quo." That is a masterful turn of a phrase!

troubme 14y ago

If only such a comment were made in, say Dr.Phil, the same HN community would have scoffed at it. Somehow when a fellow techie expresses it, it is sagely wisdom. Oh, bow to thee, emotions have surfaced here. These are not the same ones that they world feels, these are special. These are HN folks'.

anigbrowl 14y ago

Fighting is a waste of energy. Find your flow and go with it.

johnconroy 14y ago

The real takeaway from this excellent essay is that change requires a fight. Wonderfully expressed dcurtis, and absolutely true.

greghinch 14y ago

And depending on which country he lived in, this whole episode either cost nothing or has saddled him with crushing debt for the rest of his life

edanm 14y ago

This really reminds me of Paul Graham's post from a while ago, talking about things people in the future will think are weird about our time. One of the things that struck a chord with me from pg's post: In the future, people will get regular health checkups to prevent problems before they happen. I don't know about this particular case, but it makes a lot of sense to me that many people who seem to be in perfect health, might not be. Today, the extent of checking up on yourself is mostly taking a blood sample, talking to a doctor, etc. And it's not done that often, either. In pg's future world, people would check themselves out several times a year (maybe more), with machines that catch many of the most basic problems. In fact, I'd wager that one of the most promising avenues for advancing humanity is to develop better, more affordable tests to check for common problems that we can cure with some foresight.

melc 14y ago

I agree, i believe we should not forget death to help us fight the ordinary vain reality. Thanks for sharing this.

sown 14y ago

I never really understood what those words meant, "Live life fullest, live like its your last day, etc" Can anyone tell me what that really means?

FireBeyond 14y ago

As a tangential aside, reading the opening paragraph of this article reminded me - in the US, if you have cardiac arrest, you want to have it either the counties surrounding The Mayo Clinic in Minnesota or Puget Sound: While cities like Detroit, Chicago and New York have less than 10%, down to 2% survival for /witnessed/, VF/VT (ventricular fibrillation / tachycardia, the rhythms an AED can shock) arrest (i.e. the "best" cardiac event to have), Rochester Minnesota, and the three counties of King, Pierce and Thurston (Seattle, Tacoma and Olympia) have above 40 to nearly 50% survival. Learn CPR. -- a paramedic