If it were a numbers game, Vivan Pearlman would have scored big in Vegas.
But instead of cards and dice, the 12-year-old girl’s life hung in the balance, and her triumphant return to Enumclaw Middle School late last year could have easily resulted in tragedy instead, had anything gone even a little bit differently.
It was a morning like any other on Oct. 17, 2022 — but if you’re like the roughly one million people that suffer from hypertrophic cardiomyopathy, that doesn’t mean anything when your heart can suddenly stop.
For Vivan, it happened right before history class. One minute, she was conscious — the next, on the floor, falling off her chair and hitting her head on the way down.
Call it luck, good preparation, divine intervention, or what-have-you, but long-term substitute Beth Madill knew exactly what to do, thanks in part to her husband being an emergency medical technician. She was watching the history classroom during passing period (the teacher stepped out to use the restroom) when Vivan had her attack, and immediately began CPR.
This was her first time ever using CPR, though she’s taken and even taught several classes.
“I kind of went into autopilot, knowing that I am trained to do this,” Madill said. “I felt like time stood slow, and I was able to think and methodically go through everything. I did have a sense of calm, until much later. ”
The nurse arrived quickly with an AED to shock Vivan’s heart back into a normal rhythm.
According to Becca, Vivan’s mother, this is the only reason she survived that day.
“Seattle Children’s [Hospital] says that her school is a hero, and that they haven’t seen that response… this is not usually the outcome,” Becca said. “Usually, children don’t get shocked in time, or no one knows CPR, and they don’t survive. With cardiac arrest, the only survival is CPR and being shocked. You can’t do one or the other.”
Vivan was airlifted to the hospital, the helicopter landing at the school.
At the hospital, experts worked to get Vivan stable, keeping her unconscious. Now that she was there, her chances of surviving were greatly improving, but it was more than possible the attack caused severe brain damage, given the organ was without oxygen for nearly three minutes before her school staff got her heart pumping again.
“That was scary. Before they woke her up, they sat us down and they said, ‘first of all, she had about a 5% chance of surviving. We don’t know what’s going to happen now. We don’t know if she’s going to go into heart failure; we don’t know if she’s going to be put on a transplant list,” Becca said. “‘You need to be prepared that there could be some damage to the brain.’”
So her parents waited with bated breath as doctors began the process of waking Vivan up.
When she finally regained consciousness, “she thought she was still at school,” said her father, Josh. “She thought she was in the school nurse’s office.”
“She actually tried to sit up and told us to get out of the way, because she’s late to class,” Becca added. “That’s a survivor right there.”
Further tests showed Vivan suffered no brain damage from her ordeal — but that didn’t mean she was out of the woods yet; she still needed to have her pacemaker/defibrillator installed.
There was also another issue — Vivan doesn’t just suffer from hypertrophic cardiomyopathy, but also Wolff-Parkinson-White syndrome, which, in short, means her heart has an extra electrical pathway that can cause a rapid heartbeat.
Her aunt had the same defects when she underwent the same surgery when she was five years old. Unfortunately, her surgery was fatal, as doctors cut that extra wiring while trying to lessen the thickness of her heart.
“Luckily, Vivan’s surgeon recognized the danger in removing this wiring and did not remove it, preventing Vivan from the same tragedy,” Becca said.
She was in surgery for nine hours. It was on Oct. 19, her 12th birthday.
But there was one final test — doctors had to make sure the pacemaker/defibrillator worked correctly.
So, under the watchful eye of experts, they induced cardiac arrest and watched as the device shocked Vivan back into a regular rhythm.
“’Everything fell into place,’” Becca said doctors told her. “She just kept beating the odds.”
Vivan was able to return to school in December, though only for half days as she continued recovering.
LOBBYING FOR A NEW LAW
Vivan’s family knew all along she had these defects, because Becca and her family does, too.
But while Becca’s mother died of sudden cardiac arrest when Becca was a teenager, she never had an attack, and hoped Vivan would be just as lucky.
Still, she wasn’t leaving that up to chance.
“I kept writing in her care plan since kindergarten, every year, to watch for sudden cardiac arrest,” Becca said. “And every year, I felt almost paranoid and silly… I just kept writing it. I’m glad I did… I’m really glad the school heard me.”
Becca also recognized that the quick response of teachers and school staff meant that, even though Vivan was new at EMS (having just graduated from elementary school), that meant they were more than passingly familiar with those health records.
“These were new teachers,” she added. “I will never forget that school.”
But while school staff did their best to make sure Vivan survived, it was more than possible EMS wouldn’t have had an AED available, which would have likely been fatal for her.
According to District Director of Communications, ESD doesn’t have a policy requiring AEDs at its buildings.
That’s not uncommon — according to Avive, only 24 states have laws requiring school districts have AEDs available.
This is despite the fact that about 2,000 children and adults under 25 suffer from sudden cardiac arrest every year, according to Healthychildren.org, and that American Heart Association recommends all states pass AED requirement laws.
“This happens more than you think,” Becca said.
As such, Becca hopes that she can get in contact with county and state representatives and lobby for a similar requirement become law in King County or Washington.
“There’s been a lot of moms that have reached out to me who had the same exact thing happen with their kids, and the kids didn’t survive,” she continued. “And it was always the same story; either the school didn’t have an AED, the AED hadn’t been checked and wasn’t working, or somebody didn’t know CPR.”
Madill would also like to see all schools be required to have AEDs in the building, not just for students, but because so many community events are held inside these buildings.
She also went further, saying all teachers and school staff should be required to be CPR certified.