Near-tragedy sparks bystander research into families of trauma

It is a day that Dr. Megan Shore and her family will never forget. On June 9, 2018, her husband, Dr. Scott Kline (St. Jerome’s University), suffered a heart attack that led to cardiac arrest after a 50km bike ride. His heart stopped beating for 20 minutes. During that time, one of their neighbours, Dr. Anisa Mnyusiwalla, a physician, arrived and performed CPR until EMS arrived. When they arrived at the hospital, Kline’s heart began beating on its own, but that was just the beginning of this long journey.

The second leading cause of death in Canada is cardiovascular disease, which describes a range of conditions that affect the heart. One such condition is sudden cardiac arrest (SCA), which is an electrical malfunction that stops the heart from beating, essentially shutting down the heart. A person who experiences a SCA will collapse and be unresponsive, and within five minutes brain damage and death will follow if circulation is not restored. In Canada, an estimated 40,000 SCAs occur outside of a hospital setting each year, and the chances of survival of an out-of-hospital cardiac arrest (OHCA) is only ten percent.

The journey for Dr. Shore’s family included Kline’s recovery, surgery and rehabilitation program. Dr. Shore realized how lucky her family was. Only six percent of people survive out-of-hospital cardiac arrest (OHCA) without physical or neurological impairment.

At the same time, she realized that her husband was not the only one to have experienced trauma that day. “Scott danced with mortality in front of me and our two young boys,” Dr. Shore recalls. “My boys saw their dad dead on the floor and then rushed off to a hospital in an ambulance. You can’t un-see that.”

“I knew I was beyond fortunate. I knew I needed to use the experience to help others navigate this traumatic experience and help build up community support for families who go through this,” says Dr.  Shore. As an Associate Professor in the Social Justice and Peace Students program at King’s, she decided to use the experience to help others who must navigate the traumatic experience and build support for families and the “bystander.”  A bystander is a person who is present and intervene in an event like a cardiac arrest, but they are not a first responder.

Dr. Shore explains that without bystander intervention, an out-of-hospital cardiac arrest is always lethal. However, there is no support after the cardiac arrest experience for the bystander. The experience of intervening is extremely traumatic, and a high percentage of bystanders experience some form of post-traumatic stress. “If the narrative of the experience of the bystander is traumatic and negative, then we have the bystander effect, where no one will want to step in to help,” she says. Dr. Shore recognized that there need to be more support for bystanders after the event.

Her previous research had focused on how communities and faith-based organizations work together to respond to issues of justice and peace. Now, Dr. Shore says she realizes that her research and experience in getting communities to come together to work on crucial issues will help her in her work to address the role of bystanders.

In October 2019, Dr. Shore was asked to speak at the “State of the Future of Resuscitation Conference” in Paris, France. Her presentation, entitled “Don’t Forget The Bystander” chronicled Kline’s OCHA, his recovery and the journey she and her family continue to be on. As a result, she has now embarked on two research projects related to cardiac arrests.

The first project is with Dr. Kate Dainty, Research Chair in Patient-Centred Outcomes at North York General Hospital, and an Assistant Professor in the Institute of Health Policy, Management and Evaluation at the University of Toronto. Dr. Dainty pioneered the work on bystanders as the forgotten patients of cardiac arrests.  Dr. Dainty says bystanders “may struggle to deal with the fear, anxiety and guilty associated with the (cardiac) arrest, CPR provision, and subsequent care upon discharge of their loved ones from the hospital. This often makes the caregiver ‘a forgotten patient.’ In partnership with The Heart and Stroke Foundation of Canada, Dr. Shore and Dr. Dainty are examining ways for the resuscitation science community to take up the experience of the bystander in the training of resuscitation protocols and guidelines in a systems approach to OHCA.

The second project, is a book called “When the Heart Stops.”  This will be based on her experience of her husband’s cardiac arrest. It will incorporate the voices of the other bystanders and their perceptions of what happened when they experienced a person’s heart stop. “My intention is to contribute to a nonmedical, lay understanding of cardiac arrests, specifically focusing on the perceptions of what happens when the heart stops from the people who witnessed it,” she says. By demystifying the experience, the hope is that more bystanders will intervene in post-cardiac arrests.

On June 7, 2020, Dr. Shore and her family participated in the annual “Ride for Heart,” which each year raises over $3 million in funds for the Heart and Stroke Foundation of Canada. This year, because of COVID-19, a virtual Ride and Walk was held with physical distancing in place. Dr. Shore along with her brother-in-law, Doug Roth, CEO of Heart and Stroke Canada, organized an event in Stratford with a team of approximately 20 people, ranging in age from six– to - eighty years old. Prior to the virtual Walk and Ride in Stratford, a CPR refresher was held, with hands-on training with a CPR mannequin.  practice or try CPR. The team called Moving for More Memories, raised $22,000 for this one-day event.

For more information on the event, please visit: https://www.stratfordbeaconherald.com/news/local-news/heart-and-stroke-event-raises-20k-offers-life-saving-lessons