Stephen Kouba, M.D., swore it was a dream when he woke up in an ambulance and learned that he was headed to the Christiana Care Center for Heart & Vascular Health.
The last thing he remembered was sprinting toward the finish line of the half marathon portion of the 10th Annual Delaware Marathon Running Festival, held Mother’s Day, May 12, in Wilmington.
“When I crossed, I felt kind of funny,” said Dr. Kouba, an orthopaedic surgeon from Fayetteville, N.C. “I stopped, and the next thing I knew I went down. And that was the beginning of my journey.”
It was almost the end of his life, said Linda Laskowski-Jones, MS, RN, ACNS-BC, CEN, vice president of emergency services for Christiana Care, who was leading the medical team at the race that day.
“He was gone,” Jones said. “His heart had stopped.”
Fortunately for Dr. Kouba, his episode began in quite possibly the only place it could have ended well. Waiting at the finish line medical tent were 20 members of Jones’ staff and the equipment — most notably an automated external defibrillator (AED) — needed to save his life.
“There was no delay,” Jones said. “Once they determined that he had stopped breathing and his heart had stopped they immediately initiated CPR.”
One of the first members of the ED staff to reach Dr. Kouba that day was Kellie Glenn, who was volunteering at her first marathon. When she reached him, he collapsed in her arms, and what followed, she said, was a flurry of teamwork that saved his life.
“It looks like this really chaotic moment,” Glenn said. “Being a part of that team, I know it’s actually organized chaos. It’s seamless.”
Dr. Kouba’s wife, Marsha, was running the full marathon that day, and she is no stranger to tragedy at a marathon — she was at the 2013 Boston Marathon when the second bomb went off.
But this was different. Dr. Kouba said Marsha, a nurse, broke down when ED staff reached her on her cell phone during the race and told her what had happened.
Part of what caused Dr. Kouba to go into cardiac arrest was exercise-associated collapse, Jones said. It typically occurs at the finish line and is caused by a redistribution of blood when a runner stops abruptly. Walking a little after crossing the finish line can help prevent this from happening.
Dr. Kouba had other heart issues, including an atrial flutter that was discovered in North Carolina. After the incident at the Delaware race, he was fitted with a pacemaker.
As a token of appreciation for saving his life, Dr. Kouba and his family purchased a second AED for the Emergency Department at Christiana Care. At the May 12 marathon, the staff only had one AED on hand, and once it left in the ambulance there was no spare.
“Hopefully, the AED I purchased helps someone else,” Dr. Kouba said.
Jones is certain that it will.
“He’s paying it forward by giving us equipment to save lives in the future,” Jones said.