A week before Christmas, I got a message from my dad on WhatsApp (it took a pandemic, but he has finally got his head around using it) which started, as many of his messages do, with a ramble about the post not arriving and the garden fence falling down.
And then, at the end, he dropped in: ‘Also, I’ve had to be admitted to hospital following a totally unexpected collapse/fit in the early hours of today.
‘Scans not very comforting. Will update as and when I can.’
Mail on Sunday Health Editor Barney Calman, pictured, said he received a WhatsApp message from his father to tell him he had collapsed and was in hospital
He finished by asking me to forward this bombshell to my elder brother, as he couldn’t work out how to.
Am I the only person who has a dad who’d do something like this?
Massively worried, I called him immediately. It turned out he’d come to that morning to find himself on the floor of his bedroom, undressed, and surrounded by paramedics telling him he’d had a seizure and needed to go with them to hospital.
‘I just thought, what a strange dream I’m having,’ he joked.
But there was worse to come. Scans had revealed a tumour on the side of his brain, which is what caused the fit.
Obviously not great news – at 75, he’s the right age for horrible things such as gliomas, the kind of aggressive cancer that killed Labour MP Tessa Jowell.
But to cut a long story short, after a few tense days, it turned out to be a meningioma, the vast majority of which are entirely benign. The kind of brain tumour you want, if you had to pick one. It had probably been there for years, causing no trouble – until it did.
My dad, Chris, a retired GP, will need an operation to remove it soon. It’s no walk in the park, but the chances are that will be the end of it. He’s fine now, obviously not delighted at the situation, and on medication to stop another fit. But he’s also back to normal, making dad jokes and talking about the post and fences.
There is something, however, that’s continued to trouble me – more so, the more I think about it.
On the morning it happened, Dad’s partner, Angela, had woken up to find him ‘making weird gurgling noises’. She shook him, but he didn’t respond and then began to convulse. She called 999, and was put through to the ambulance service. This is where things started to go awry
On the morning it happened, Dad’s partner, Angela, had woken up to find him ‘making weird gurgling noises’. She shook him, but he didn’t respond and then began to convulse. She called 999, and was put through to the ambulance service. This is where things started to go awry.
As Angela explained to me: ‘I told the call operator that he’d been making strange gurgling noises and shaking, but at some point she must have asked me if he had any health problems, and I think I must have said he’d had a heart problem.’
My dad had a stent put in about three years ago, having suffered from a bit of angina. And he’s been well since. Angela continued: ‘That’s when the operator starting telling me I had to get him on the floor, flat on his back, and begin CPR. By this time, your dad had stopped shaking and was just unconscious. She said I should drag the sheets, to pull him off the bed and get him on the floor. I said I was scared he’d hit his head, but she said, “Don’t worry about that, you’ve got to get him on his back and start doing chest compressions.” ’
Angela did what she’d been instructed to do, until the paramedics arrived – by which time Dad was regaining consciousness. So, here’s why I’m bothered.
Cardiopulmonary resuscitation, or CPR, can be lifesaving, if given within minutes of a person’s heart stopping – a cardiac arrest. The first-aid technique involves firmly pressing down in the centre of an unconscious person’s chest, in a regular rhythm.
This keeps blood circulating, so the brain isn’t starved of oxygen, keeping that person alive until the emergency medical services arrive.
Emergency call handlers will advise a caller to start CPR if they discover a person who is unconscious, unresponsive and not breathing normally (not necessarily not breathing at all, as people in cardiac arrest may make gasping noises). But my dad was breathing. And Angela, as far as she can recall, was never asked whether he was or wasn’t.
If someone is having a seizure, good first-aid practice is to try to make sure they don’t bang their head – possibly using a makeshift pillow to prevent this – and, when they’ve stopping shaking, to put them in the recovery position to make sure they can breathe OK. Not to put them flat on their back, and certainly not to administer CPR.
Angela has the same niggling concern that I do.
‘I’ve done first-aid courses,’ she said. ‘I’ve sat with people who’ve had fits. I was doing the right thing – I had him in the recovery position. But at the time, I was in such a state of terror. Nothing like that had ever happened to your dad before, and I didn’t know what was wrong. Without feeling certain, I just did what I was told.’
Why does this matter? Well, CPR is not without risks. Serious bruising, rib fractures, and fractures of the sternum, the bone in the centre of the chest that the ribs are attached to, are incredibly common. These are excruciating, and disabling, while healing. Worse still, there’s often severe trauma to internal organs – bruised, punctured, collapsed lungs, or bleeding inside the lungs. More rarely, the liver and even the heart can rupture.
If someone’s in cardiac arrest, and it’s their only chance, the benefits of CPR far outweigh any of these risks. But such injuries can, in themselves, be fatal. In my dad’s case, CPR was simply the wrong thing to do.
I don’t for a second hold Angela responsible. My dad doesn’t either. I doubt many in her situation, with an emphatic emergency call operator on the line giving orders, would have had the confidence to do differently. And, to be honest, the fact this happened disturbed but didn’t surprise me.
In 2017, this newspaper revealed that emergency call handlers were ordering callers to attempt to resuscitate the bodies of loved ones who were obviously beyond help.
Of course, they’re just following the protocol. But horrifically, readers told us that it meant they’d been commanded to perform futile chest compressions on corpses already blackened with decomposition, stiff with rigor mortis or badly damaged.
In many cases, family members had helped nurse a loved one through terminal illness, to find them finally at peace – but were then instructed to try to ‘give them a chance’ and somehow bring them back to life, even though they had been dead for hours.
One woman, who was compelled to carry out CPR on her dead husband for 15 minutes, said having had to do so was worse than him actually dying. Others were told they would ‘get into trouble’ if they did not comply with instructions, and they spoke of how they were made to feel guilty for not doing enough if they objected to carrying out CPR attempts. Someone was made to attempt resuscitation on their husband, who’d be found very much dead having taken his own life.
After we published our investigation, we received dozens more harrowing accounts like these. The worst was from a young woman whose elderly, frail father had woken up to find his wife had passed away. He mistakenly called 999 – if you discover someone who is truly dead, Citizens Advice say you should call their GP, or failing that 111.
The emergency call handler began instructing him to perform CPR. Weak and in ill health himself, he couldn’t manage to get her on to the floor, but gave chest compressions on the bed, which must have been particularly difficult and undignified. The paramedics eventually arrived, and told him to stop. She’d been dead a while. There was nothing he could have done. But he couldn’t forgive himself, said the reader, not having been able to ‘save’ her, as the call handler had told him to. A week later, he took his own life.
I know there are those who say, well, if it saves some lives, it’s probably a good thing that emergency call handlers are somewhat over-zealous. I disagreed with this wholeheartedly before, but now even more so.
In the case of my dad, the call handler’s instructions, while no doubt intended to save his life, could have killed him.
After we published our last investigation, MPs called for a review into 999 call operator protocol. As far as I can discover, this didn’t happen.
When we put all this to NHS chiefs, they responded: ‘In almost all cases, advice to start bystander basic life support/CPR is appropriate and may give a person who appears to be lifeless a chance of survival, until an ambulance arrives.’
But I think something needs to change, particularly if their call handlers are mistaking a seizure for a cardiac arrest.
There’s been much focus recently on inappropriate use of DNACPR, in which blanket ‘Do not resuscitate’ orders were put on older people in care homes without their knowledge last year. This is abhorrent.
But it’s also important to acknowledge how aggressive CPR can be, and how unlikely it is that someone frail, elderly and unwell with Covid would ever recover from such a situation, even if they did survive.
In such cases, many doctors have passionately argued that not giving CPR is the kinder choice.
Meanwhile, it seems ordinary members of the public are being forced to give chest compressions practically against their will. And few in the medical profession seem to want to discuss it.
I’d like to think what happened to my dad and his partner was a one-off, but somehow I doubt it.
Please do write to me and let me know what you think, or if anything like this has happened to you.