My father ran a medium-sized insurance company in Kansas City in my youth and, when we were driving around town, he would point out accidents waiting to happen—say, leaving one’s bicycle sprawled across a path for someone to trip over in the dark. A more subtle form of foresight is playing the percentages—and some improving percentages lead to my suggestion, "Don’t Sleep Alone!"
Young adults mostly die, or become permanently disabled, from accidents. Later in life, heart attacks, cancer, and stroke become more common than accidents. Cancers are insidious but the three others strike without warning. They often require fast treatment to prevent permanent disability or death. How fast is fast?
The chances of survival, for an out-of-hospital cardiac arrest, are no better than 5 percent. Yet greater than 90 percent survive if a defibrillator resets the normal heart beat within a minute. For each minute that defibrillation is delayed, 10 percent fewer survive. By ten minutes, survival is dismal. Seattle now saves 45 percent of cardiac arrest victims, and Boston saves 40 percent. Los Angeles, however, is down at the national average—a mere 6 percent.
Things are improving as automated external defibrillators are housed in hallway cabinets with a red broken-heart sign. You grab it and run. Once AEDs were installed at O’Hare airport in Chicago, the survival rate jumped to 64 percent. The $1,000 AED analyzes the heart rhythm and automatically decides if and when to shock. They are very user friendly. In a study of mock cardiac arrest, it took untrained sixth-grade students a mere 90 seconds to do the right thing, only 23 seconds longer than trained personnel.
For strokes that plug an artery, there is now a clot-busting drug, tPA, but it must be given cautiously and in the first three hours after symptoms appear. That’s why you should call 911 for any sudden occurrence of neurological symptoms, such as disorientation or a weakened arm. Don’t just have someone drive you to the nearest hospital. Hospitals lacking a stroke center often take too long to get their act together. Properly trained medics will know which hospital to take you to—-it may be across town.
But if you are wondering how your local medic services and hospitals rate when compared to best-practices standards, you can’t find it on the web. It still takes an enterprising reporter to pry loose the numbers from those hospital administrators who would prefer not to discuss the subject.
Even those unafraid of death ("Just like falling asleep") are reasonably concerned with the other common consequence of too-little-too-late: permanent brain damage. There is a similar concern with the process of dying—say, lying around helpless for many hours hoping to be rescued. Senior living arrange-ments often feature an optional "door check" system but it is about like waiting for the maid to discover you in a hotel room when a heart attack, broken hip, or stroke has prevented you from reaching a phone. A cell phone helps but if you are unconscious, or leave it in your purse, or collapse while taking a shower, you may be stuck for a long time. For a friend of mine, it was 36 hours.
Fortunately, there is an excellent, low-tech solution: a companion who can notice problems and summon help. Just as you can avoid the hazards of hiking alone, you can avoid living alone and traveling alone. Since the long nighttime hours are more than a third of the total, the best single thing you can do to improve your chances is to share a bedroom with—-literally—-a roommate.
"Don’t Shower Alone!" was the bumper sticker of the 1970s California water shortage. The logical bumper sticker to promote playing the improved percentages is, of course, "Don’t Sleep Alone!"
DRAFT for an Op-Ed