Mass transit commuters have the routine down. They know exactly when to leave the office, which subway car lets them off at the best exit and where they prefer to sit on the train.
But Michael Kiernan’s commute on a Friday evening in October 2009 turned out to be anything but normal.
Michael, then 50, left his office at the Bronx County Courthouse, where he worked as a computer network administrator, to make his way home to Long Beach, New York. He got off the B train at 145th Street and raced up the stairs to catch the A train to Penn Station, where he planned to board a train on the Long Island Railroad.
“My heart was pumping, but I got on the subway and I felt fine,” he recalls. He remembers the next two stops. And then, he says, “this is where the story ends for me.”
He remembers waking up feeling like someone was suffocating him. A firefighter was holding an oxygen mask to his face.
Moments after the doors closed at 125th Street, Michael went into sudden cardiac arrest and fell to the floor of the subway car. Foaming at the mouth, with his eyes rolling back into his head, Michael started to turn blue. Dr. Sonia Tolani, then a cardiology fellow and currently attending cardiologist at NewYork-Presbyterian/Columbia University Medical Center, normally wasn’t on the train at that time but by chance she had left work 30 minutes earlier than usual. Dr. Tolani leapt into action and shouted for help from anyone else who knew CPR. Luck struck again. Riding across from her was Anthony Medaglia Sr., then labor relations manager at NewYork-Presbyterian/Columbia University Medical Center and now director of security at NewYork-Presbyterian. He’d learned CPR during his career as a police officer. They pulled Michael into the center aisle and alternated delivering CPR for 27 minutes.
When the subway pulled into 59th Street station in Manhattan, transit police were waiting on the platform. Dr. Tolani asked for a defibrillator and, once again, luck was on Michael’s side. At the time, only five subway stations in Manhattan were equipped with them. After two shocks, Michael’s pulse returned, and a firefighter lowered an oxygen mask to his face. He was then taken 2 miles to NewYork-Presbyterian/Weill Cornell Medical Center.
During the ambulance ride, Michael came around enough to ask the EMTs to call his girlfriend, Nancy, who was waiting for him at the Long Beach train station. Later, Michael recalled Dr. Tolani saying, “I’ve never seen anyone go from dead to telling people to call their girlfriend’s cellphone.”
Michael stayed for a week in the cardiac intensive care unit, where a mini defibrillator was implanted in his chest. It works as a pacemaker, explains Michael, and helps to regulate his heartbeat. It can shock him out of an abnormal heart rhythm that could lead to another cardiac arrest.
His operation was followed by 12 weeks of outpatient cardiac rehabilitation at a NewYork-Presbyterian-affiliated facility. Michael would arrive at 7 a.m. three days a week, squeezing in his appointments before going to work two hours later. During each session, he was hooked up to EKG equipment to monitor his heart’s electrical activity while he walked on a treadmill for 20 minutes. As the weeks went by, his therapists increased the speed and length of time on the treadmill. He also progressed from using 5-pound weights to 15-pound weights to improve his strength and performed rounds of pushups. “The goal was to get my body to improve how it uses oxygen,” he explains.
Michael met with a NewYork-Presbyterian nutritionist, who advised him on dietary and lifestyle changes he should make. The suggestions included eating more vegetables, cutting down on carbohydrates, sugar and alcohol, and doing regular exercise, such as brisk walking, to keep his heart healthy.
Michael had been diagnosed with heart issues back in 2006. Michael’s primary care physician on Long Island had noticed he had a heart murmur and referred him to a cardiologist, who performed a nuclear stress test, which evaluates blood flow to the heart. They discovered one artery was calcified and fully blocked. That meant a stent was not an option. Instead, Michael was put on two kinds of heart medication — one to dilate his blood vessels and the other to regulate his heartbeat — and told to avoid strenuous exercise. He thought he was in the clear.
But the day of the accident, Michael’s sprint to the subway and his stressful commute aggravated his heart condition.
He still commutes to the Bronx, but in the seven years since his collapse, Michael, now 57, has gained a fresh perspective on life.
He renovated his garage into a man cave, connecting water and electricity so he can brew beer occasionally. One corner is devoted to woodworking equipment, which he plans to use to make items like cutting boards and jewelry boxes. On warm days, he and Nancy pull out their double kayak and head to the water or sometimes cruise in a 13-foot, 1969 Boston Whaler that Michael restored and Nancy jokingly refers to as a “surfboard with a motor.”