How a Heart Attack, a Bright Light and CVI Doctors Changed One Man's Life
By Margaret Pantridge
Beth Israel Deaconess Medical Center staff
Almost losing your life can change your life in miraculous and unanticipated ways. Just ask Tam Van Tran.
For Mr. Tran, a hard-driving and successful 57-year-old Vietnamese émigré, the transformative moment came at 1 a.m. the morning of Friday, February 8, 2008.
Two hours earlier, he had suffered a massive heart attack at his Andover home. Now he lay on his back at the CardioVascular Institute (CVI) at Beth Israel Deaconess Medical Center. Medical personnel swarmed around his gurney, urgently preparing to take images of his barely beating heart. He was startled when a cardiology fellow, looming over him, cut his shirt away with a scalpel.
"I remember seeing the doctor cut that shirt, and thinking -- that's all right, you can't take it with you!" he recalls. With this crystallizing thought, he lost consciousness for five days. When he finally awoke in the CVI's Morse Cardiac Intensive Care Unit, he experienced a feeling of peace he had never known before, a peace that continues to this day.
"I woke up and thought, there are a million guardian angels protecting me," recalls Mr. Tran, an engineer who converted from Buddhism to Catholicism but does not consider himself a religious person. "I don't argue any more. I believe in some superpower somewhere, but I don't know who." Of his near-death experience, he says, "It made me happier."
Dr. Eli V. Gelfand, the CVI cardiologist Mr. Tran credits with saving his life, he says, "God used Dr. Gelfand's hands and his knowledge to save me."
Mr. Tran's story began in a Mekong Delta village in Vietnam. His father, a journalist, was killed by the Communists. When Mr. Tran was six, his widowed mother told him he would have to fend for himself because she could not feed him as well as his siblings. The boy lived from hand to mouth, working odd jobs for neighbors. He learned to read and write by standing outside the local school and listening at the window. He practiced writing in the sand.
At age 11, he was taken in by an aunt who sent him to public school. He sold bananas, cigarettes and matches at the bus station, studying only at school but rising to the top of his class. Despite the war that exploded around him, he finished high school and won a place in medical school in Saigon. Convinced the city would soon fall, however, he took an exam and won permission to study chemical engineering in the United States, leaving Vietnam in 1971.
Mr. Tran earned degrees in chemical engineering and nuclear engineering and went on to attain a master's in chemical engineering from Northeastern University.
Mr. Tran married another Vietnamese émigré, with whom he had two daughters who have graduated from college. He worked for many years as an engineer specializing in membrane technology for Ionics, a developer of water treatment systems, traveling widely and securing three patents. In 1999, he left engineering and bought a RE/MAX real estate franchise in Quincy with the intention of eventually opening a bank to serve the Vietnamese community. He was also active in the Vietnamese cultural events and earned two black belts in karate.
Mr. Tran had achieved the American dream. This country, to him, is "heaven on earth." But his success came with a cost - stress and tension. His heart attack struck without warning. He exercised regularly, was slim, had low blood pressure and didn't drink or smoke.
On the night of the heart attack, Mr. Tran had just arrived home late from work when he suddenly experienced shortness of breath, sweating and crushing chest pain. His wife called an ambulance and after a stop at the local hospital, was rushed to the CardioVascular Institute at Beth Israel Deaconess Medical Center in Boston.
"Mr. Tran had an acute myocardial infarction - a heart attack - when a cholesterol plaque ruptured in a major coronary artery that night," says Dr. Gelfand. "A clot formed in his coronary artery and for about two hours, a full half of Mr. Tran's heart muscle was starved of blood. When he arrived at the hospital, he was in shock."
In the CVI cardiac catheterization lab, one of Dr. Gelfand's colleagues,
Dr. David Leeman, successfully placed a stent in the artery to hold it open, but, Dr. Gelfand says, "Mr. Tran was not really breathing on his own and his heart was so weak, that we had to help it with a balloon pump - a sophisticated assist device placed in the aorta to help the heart pump blood forward and nourish itself with oxygen-rich blood."
Because the heart attack was so massive, Mr. Tran stopped breathing and was placed on a respirator. "At this point, we put him in a medically-induced coma to rest his body and give him his best shot at recovery," says Dr. Gelfand.
The next four days proved pivotal. Mr. Tran experienced kidney failure and life-threatening stomach bleeding. His heart stopped beating twice and had to be electrically shocked back to life. Dr. Gelfand remembers a crucial night, when the medical team worried that Mr. Tran was bleeding internally.
"He was, frankly, too unstable as it was, and our doctors and nurses were with him continuously through the night, never leaving his bedside. So when at 1 am we decided that an urgent CAT scan was needed, we had to improvise. We assembled an equivalent of a mobile intensive care unit to take with us a few floors down to the radiology suite. We took with us all the supplies, medications and resuscitation equipment we could possibly need on the road, and like an ancient caravan with the unconscious Mr. Tran at its heart, five or six of the CVI personnel slowly made their way four floors down. Through this team effort, we made it back safely after the CAT scan was done. It was this spirit of 'anything, anytime, in the name of the patient' that made Mr. Tran's eventual recovery possible."
Communication between the medical team and Mr. Tran's wife and daughters was extremely important. Dr. Gelfand's team provided updates several times a day and encouraged them to spend more time at home resting and taking care of themselves as well as the patient.
In the end, after 10 days in the hospital, Mr. Tran's condition turned around so decisively that he went home without even a need for a rehabilitation facility stay. In the end, his heart recovered with only minor residual damage and he is doing well under Dr. Gelfand's continuing care in the outpatient clinic.
"I view this as a triumph of teamwork, science and technology, but ultimately of Mr. Tran's own sense that he was not ready to depart this world," says Dr. Gelfand.
To Mr. Tran, it was a miracle. When he awoke from his coma, he remembered seeing the bright light that is often reported by people who have had near-death experiences. The light suggested the presence of an angel, perhaps the embodiment of the prayers his wife had solicited from the family's large circle of friends in the Vietnamese-American community. However, unlike many near-death patients, he did not see his life passing before him, and that gave him pause.
"Remember, I'm an engineer. I don't believe in all that nonsense," he says. "I saw the light, but not my life. That means time and space is not the limit. My logic confirmed that there is a soul. It changed me completely."
With his new sense of the meaning of life, Mr. Tran has made many life changes, taking time to smell the roses. He now plays guitar at church every Sunday and presents monthly talks about "Understanding God through Science." He is thinking about writing a book, "Five Days with My guardian Angel."
At his daughter's wedding in June, he gave a speech. "I said I was dead but now, today, I am standing in front of all my friends and family. What else can there be? I'm the happiest man in the world."
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted December 2009