Have you read Part I yet? If not, click here for Part I.
020b - Cambodia - Siem Reap Part II
Tragedy in Cambodia
Hannah and I were hiking back down the mountain after having visited Kbal Spean, one of the lesser known temple sites northeast of Angkor, when something completely unexpected occurred.
The trip to Kbal Spean was rough. The site is located about 50 km from central Siem Reap on dirt laden roads filled with rocks and potholes. Not so bad for a 4x4 pickup, but pretty miserable when you're on the back of a motorbike tuk-tuk with questionable shocks and breathing red dust for an hour and a half. Once at the site, a 1.5 km hike up the mountain gets you to the temple carvings. The hike itself is medium difficulty, but still pretty taxing since it's filled with uneven terrain and overgrown jungle.
Hannah and I reached the top and took our time looking at the carvings before we decided to head back down. It was around 11 AM. About 500 meters from the bottom we came across a couple hiking to the top. As we neared, the male, John Morningstar (aka
Star), fell over suddenly onto the side of the trail. We got nearer and asked if he was okay. He stood up, shook the dirt off his shirt, and proclaimed he was okay - he had a fainting spell. We looked at him and his wife, Leslie, and suggested he take a breather and drink some water. We waited a couple of minutes and he seemed to be doing fine. So we said goodbye and started down the hill towards the bottom; probably just some low blood sugar or something.
We walked about 10 meters when all of a sudden Star collapsed again. We turned to see and Leslie yelled for help. Hannah and I ran towards them and immediately knew something was wrong. Star was struggling for air and appeared to be having a seizure. Hannah immediately took over. She laid him down and started talking to him asking if he could breathe on his own. He coughed a bit and struggled with each breath he was taking. All of a sudden his lips started to turn blue and she saw his eyes dilate - this became a true emergency. Hannah started giving orders and we moved him
John Morningstar on a better day
Photo courtesy of Leslie Morningstar
to flat ground and elevated his feet to get more blood flowing to his brain. Then he stopped breathing. Shit.
Hannah started giving slow steady rescue breaths (mouth to mouth resuscitation). They seemed to help and we could tell that his heart was still beating because he was twitching. But the beating was irregular so we were concerned. The twitching stopped; his heart stopped beating. Star lay motionless on the ground. Double shit.
I started giving him chest compressions (as part of CPR) in an effort to revive him. Thirty compressions per set at a rate of 100 compressions per min. In between sets Hannah would give two rescue breaths. How did we know this? If you recall, we both just finished our Emergency First Response training as part of our Rescue Diver course so it was all fresh in our heads. Thank God for that course!!! We did everything by the book, just like we learned.
We yelled at one of the local guides to run down the hill and call an ambulance. Keep in mind, we're in Cambodia, at a site at least 50 km to the nearest hospital by horrible dirt roads, and we're 500 meters up uneven terrain on a jungle mountain. Did I mention we were in Cambodia?!?! CPR on it's own has a minimal chance of resuscitating someone in cardiac arrest - a defibrillator, typically an AED (Automated External Defibrillator), is required to shock a heart back into rhythm. CPR can, however, keep oxygen rich blood flowing to the brain and vital organs to reduce the risk of damage until the difibrillation starts. Getting an ambulance was our only hope, but we had to keep oxygen in his system and keep his blood flowing in the meantime. I started my stopwatch to keep a track of time.
After a few minutes of CPR and rescue breaths (I thought it was about 10 minutes but Hannah remembers it being closer to 3 minutes) Star started breathing again. I heard a heartbeat and saw a significant improvement in the color of his face. Blood was actually starting to flow on its own! We stopped the CPR and laid him on his side in the recovery position. He was breathing but it was shallow and weak. His heart was beating but it was irregular and also very weak. He took a few breaths, sputtered, twitched a bit, and went motionless again. He was back into full cardiac arrest. No breathing and no heartbeat. We immediately started the rescue breaths and compressions again.
During this time a crowd of people had gathered. I yelled at another group of locals to call an ambulance as soon as possible. I also told them that we would need to transport Star (who weighed over 200 lbs) to the bottom of the hill and that we needed some sort of stretcher and lots of help.
A makeshift stretcher arrived. Literally, this was a tree branch with a hammock attached to it. But it worked. Elapsed time, 20 minutes since we first started the CPR. We rolled him on to the hammock and started the hike down the hill with about 6 people carrying the tree branch stretcher. It was ridiculously difficult negotiating the uneven terrain. On the way, we laid him down at two separate locations and gave 3 cycles of CPR and rescue breaths; same as before, Hannah giving the breaths while I administered the compressions. We were trying to keep some oxygen in him and keep the blood circulating as best we could.
After numerous slips and near catastrophes we made it to the bottom. Elapsed time, 45 minutes. We carried him to a covering and continued with the CPR. A larger crowd gathered. Locals started pinching him (hard!) and putting menthol around his nose in an effort to wake him up. Hannah and I ignored them and carried on. A foreigner came up (we later found out he was an Australian volunteer working on the grounds) and said he had called the international hospital and they were on their way... but they were 45 - 50 minutes away. We carried on. Hannah felt faint after a bit so we swapped: I gave the rescue breaths and she gave compressions.
At some point while under the covering we both realized it was futile. There was a huge gathering around us and Leslie was still holding on to hope and talking to Star, asking him, begging him, demanding that he wake up. I thought about what I would do if this was someone close to me. Would I give up? Would I stop? Would I say it was too late? No way in hell, not while I had a single iota of energy left in me would I stop. So we carried on, sweating profusely in the 90 degree heat, until the ambulance came.
The medics finally arrived. Elapsed time, 85 minutes. No AED.
John Morningstar passed away that day. I'm not sure of the exact time but it was while we were administering the CPR. He was 56 years old and left behind his wife Leslie, and their two children (who were back home in Virginia City, Montana).
Afterwards, Hannah and I reflected on the experience. Given the circumstances, we did everything in our ability to try and save Star. It felt good to use the training we had just learned. It felt good to reach out and help a fellow human being. It felt good to try to the best of our ability. But in the end, his time had come; the story had already been written and there was nothing we could do about that. The story continues in Part III, Recovery: Compassion, Corruption, and Closure. Click here.
Tot: 0.131s; Tpl: 0.017s; cc: 5; qc: 49; dbt: 0.0124s; 1; m:saturn w:www (10.17.0.9); sld: 1;
; mem: 1.4mb