The day he turned 29 this past February, things were going along just as Nate VanderVeen had planned.
He found himself in Detroit for a wedding. It was a fun day, a reprieve from the rigors of his classes at WMed, and that evening he was among about 60 guests who gathered at a small Italian restaurant to celebrate with the newlyweds.
And then, suddenly, VanderVeen heard someone in the restaurant call for a doctor.
"I heard, "òIs there a doctor? Is there a doctor? We need a doctor,"ù VanderVeen, a third-year student at the medical school, recalled recently. "My ears perked up. My partner looked at me and says, "òNate, go. Just go.'"ù
VanderVeen said he got up from his seat ready to help but hoping there might be an actual doctor in the room, someone he could provide assistance to and help remedy whatever emergency had prompted the request for a physician.
VanderVeen realized quickly, though, that he would have to take the lead.
He spotted a man just across the restaurant from him in a booth who was in distress. The man's face was blue, he was giving the universal sign that he was choking. The scene in the room quickly went from one of celebration to one of panic and chaos.
And, in the midst of it all, VanderVeen said his training, everything he learned during the Medical First Responder course for first-year students at WMed, turned on like a switch.
"I guess people were getting a little frantic, but for me there was this moment of clarity where I knew what I needed to do,"ù VanderVeen said. "Nothing else really existed around me. I was entirely focused on what I had to do to help this man."ù
VanderVeen said the man, who was 82 years old, was surrounded by people in the booth where he was sitting. He shuttled the people out of the way to try the Heimlich maneuver. The man immediately lost consciousness, prompting VanderVeen and others to move the table out of the way so the man could be placed on the ground and VanderVeen could begin CPR.
VanderVeen went right to his MFR training, checking the man's airway, his breathing and his circulation.
"There was nothing,"ù VanderVeen said. "No pulse, no breathing. We had to start CPR."ù
He began chest compressions and was eventually joined by a doctor "ì a dermatologist "ì who was at the wedding and began rotating with VanderVeen to help with chest compressions. They checked for an AED but there wasn't one. They made sure someone had called 911 but paramedics were hindered in getting to the restaurant because of a bad snowstorm in Detroit.
VanderVeen said he and the physician performed chest compressions for about 20 minutes before paramedics arrived. They informed the paramedics of what had happened as they connected an AED and found no shockable rhythm.
VanderVeen said the paramedics started an IV and used long, curved forceps to remove a large piece of meat from the man's airway. They intubated him and CPR continued for another 20 to 25 minutes. Then, about 45 minutes after VanderVeen had begun CPR, he said the paramedics finally got a spontaneous rhythm.
"It was such an unfortunate memory for this couple to have on their wedding day,"ù VanderVeen said. "But the mood changed completely when they got a rhythm back. People were hopeful and relieved that the man was alive after so much drama."ù
The paramedics took the man to a local hospital in Detroit and it was later determined that after he began choking on the large piece of meat he had suffered a heart attack. VanderVeen said he worried about the man's condition and whether he would pull through.
As VanderVeen dealt with his own emotions, the doctor who helped VanderVeen told him his actions and quick thinking saved this man's life. He told VanderVeen that although he had been a physician for the last 30 years he would not have known what to do.
In the days after the incident, VanderVeen said he continually got updates on the man's condition.
"I wanted to know how he was doing because, in a way, it felt like he was my first patient,"ù he said. "I was the first point of care and I felt really invested in how he was doing."ù
VanderVeen said the man remained in the hospital for about three weeks after the incident. Then, he said, the news came that the man had passed away.
"That was hard,"ù VanderVeen said of the news of the man's death. "I felt like I had done everything I could and you always hope things turn out great so for that not to happen was tough."ù
Despite all of that, VanderVeen said he takes solace in the fact that the MFR training he received during his first year at WMed allowed him to be in a position where he was able to help the man that night and be part of the effort to save his life.
In the aftermath of it all, VanderVeen said he received notes and text messages from different guests at the wedding expressing gratitude for what he had done.
Shortly after the incident, VanderVeen said he reached out to Dr. Bill Fales, associate professor of Emergency Medicine and division director of EMS and Disaster Medicine at WMed, who heads up the MFR course for first-year students. The two met for a debriefing at the medical school and VanderVeen said the session was beneficial and, in a way, cathartic.
"Dr. Fales is amazing,"ù VanderVeen said. "He put his elbows on the table and said, "òTell me everything.' For someone who's seen it all and who's been doing what he's been doing for his entire career, he still understands the weight for someone going through that situation for the first time.
"The debrief was helpful and kind of validating in a way "¶ It made me so proud to be from WMed, to have the kind of training we've had."ù
VanderVeen said that prior to the experience in February, he had wondered "ì and questioned "ì how he might react in an emergency, whether he would be able to help.
Now, he said, he knows.
"Once you start this path to become a doctor and something happens, you might not have your white coat on but you'll always have a special responsibility to help,"ù VanderVeen said. "It was empowering to be in a situation where something bad was going on and I had something to offer and I was so thankful that I had my training and the muscle memory just kicked in. I didn't second guess myself.
"To the M2s and our future M1s, just embrace the process,"ù VanderVeen added. "The hours are long, the exercises are taxing emotionally and physically but embrace that, embrace the struggle and go through every step and try to take something away from the training and what we're learning because when you really need it, you don't want to have to think about it."ù