Diana Nickel with her husband, Paul, and granddaughter Quinn. (Photo courtesy of Diana Nickel)
On a November evening, Diana and Paul Nickel played a spelling game and shared an ice cream birthday cake with their 6-year-old granddaughter, Molly. The couple was staying with Molly and her 8-year-old sister, Kate, while the girls' parents were out of town.
Around 7:30 p.m., the girls began getting ready for bed. Paul was looking for a book to read to them when he heard a crash from the kitchen. He ran to find his wife of 44 years collapsed on the floor.
Diana was lying on her back with her open eyes staring blankly into space. She wasn't breathing.
Paul had taken a CPR course 40 years earlier and started chest compressions.
After a minute, he paused to call 911, then followed the emergency dispatcher's request to count out loud for her.
"You need to pick up your pace," she said. "Here, do it with me."
Paul followed her direction, moving quicker through the compressions.
Meanwhile, Dr. Ryan Jacobsen, the medical director for the Johnson County (Kansas) EMS system, was settling in at home after work. Typically, he turns off his beeper when he's home. This time he didn't. He glanced at the emergency call alert and saw the street – only a couple blocks from his house. He headed out to help.
Paul had been performing CPR for seven minutes when the doctor took over.
"Diana, fight!" Paul pleaded. "Stay with us!"
Other than making gurgling sounds, Diana remained unresponsive.
A minute later, more than a dozen responders arrived, including firefighters, police officers and EMTs.
They placed her on a gurney and used an automated CPR system to try restarting her heart. Paul was startled by the machine's forcefulness, compressing his wife's chest.
A defibrillator was used to deliver a dose of electric shock to Diana's heart. The shock can potentially stop an irregular heartbeat (arrhythmia) and allow a normal rhythm to resume following cardiac arrest. In this instance, it didn't work. So they tried again. They tried a total of seven times with no visible results.
After 40 minutes, Jacobsen determined it was time for the "Hail Mary" attempt, one last try at resuscitation. Since nothing else was working, he tried the unusual maneuver of putting paddles on her chest and back, what's known as a double sequential defibrillation. Th