When Cardiac Arrest Becomes Personal: An ICU Physician’s Perspective

By Rajesh Harrykissoon, MD

Published 2026-10-16 by Navigate After Loss

Hemanth could strike up a conversation with anyone, anywhere, at any time. Before long, he could make you feel as though you had known each other forever.

He was my sister Samantha’s husband, and one of the kindest, most considerate people I have known. Before I tell you about seeing him in an intensive care unit, I want you to know that about him.

I am a critical care physician. I have cared for people after cardiac arrest and sat with families facing devastating news. But when Samantha called to tell me that Hemanth had suffered a sudden cardiac event, I was not simply a physician receiving a clinical update.

I was her brother. And the person at the center of the emergency was someone I loved.

The journey I cannot remember

My wife, Paula, and I were on vacation, tubing the Guadalupe River in the Texas Hill Country. When the call came, I needed to get to Atlanta.

Paula drove me to the airport in San Antonio while I booked a flight on my phone. She dropped me off and began the journey home.

What followed still feels dreamlike. I do not remember the flight, landing, or either airport. I do not remember how I got from Atlanta’s airport to the hospital.

I remember seeing Hemanth in the ICU. I arrived roughly six to eight hours after the cardiac arrest; by then, the acute resuscitation efforts had ended, and he was being maintained on life support.

I tried to look with my professional eyes. I took in the vital signs, the ventilator, and the medications running through his IV lines, trying to assemble what I saw into an assessment.

My physician’s mind had questions. What had caused the arrest? How quickly had someone responded? When had CPR begun? When had circulation returned? Had his condition stabilized, or had there been further instability?

Those were questions, not answers I can now reconstruct. My memory of that day has gaps, and I do not want to fill them with certainty I do not have.

I knew that look

It was evening when we waited for the doctor to speak with us. Samantha, Hemanth’s parents, other family members, and I were there. The wait felt long.

When the doctor arrived, he looked tired. His body seemed to fold into the chair.

I remember thinking, “I know this look.” To me, he looked like someone who had worked hard to save a life and now faced the anguish of speaking with the family. I recognized that moment because I had been the doctor delivering difficult news many times myself.

I do not remember the details of the conversation. I remember my sense of how grave the situation was.

That was my experience of the room, not a medical test. A doctor’s expression cannot establish a prognosis, and I cannot reconstruct Hemanth’s clinical assessment from body language or from these fragments of memory.

Our family ultimately reached the decision to allow a natural death. As I understand it, Hemanth had previously expressed to Samantha that he would not want heroic life-support efforts after a devastating health event, and she understood that continuing those efforts was not what he would have wanted.

What television can leave out

In my work, I have perceived a gap between what families expect after cardiac arrest and the outcomes they may have to confront. I worry that the recoveries depicted on television can make resuscitation seem more predictable, and its aftermath less complicated, than it is.

There is research behind that concern: a 2021 study of 123 episodes of three American medical dramas found that favorable resuscitation outcomes were overrepresented compared with the real-world data the researchers used, although it did not establish that those portrayals caused particular viewers’ beliefs or decisions (study in Cureus).

The distinction I want families to understand is not “television gives hope, medicine takes it away.” It is that hope needs an honest explanation of what is known, what is uncertain, and what the next stage of care may involve.

Cardiac arrest means the heart has stopped pumping effectively; it is not the same as a heart attack, although a heart attack can lead to an arrest (American Heart Association). Restoring circulation is an important step, but subsequent care may still require support for breathing and blood pressure, investigation of the cause, temperature control, and assessment of brain and other organ function (AHA post–cardiac arrest guidance).

That is why “They got a pulse back” and “They are going to recover” are not interchangeable statements. Families deserve help understanding the space between them.

What the numbers tell us, and what they do not

The CARES registry’s 2025 report offers one useful perspective: among its recorded non-traumatic, out-of-hospital cardiac arrests in adults older than 18, 10.5% survived to hospital discharge, and 8.2% of the full adult cohort survived to discharge with a Cerebral Performance Category score of 1 or 2 (CARES 2025 national survival report, adult table).

Those are different outcomes, not competing estimates. CPC 1 or 2 is commonly described as a favorable neurological outcome, but it includes people with moderate disability who can manage daily activities independently; it does not necessarily mean an unchanged life or no need for support (CPC explanation).

Context changes the picture considerably: in the same adult CARES report, survival to hospital discharge was 33.1% in the subgroup whose arrests were witnessed by a bystander and whose initial rhythm was shockable (CARES 2025 national survival report). A shockable rhythm is one that can be treated with a defibrillator’s electrical shock (AHA explanation).

These are registry averages, not a bedside forecast. The overall group includes people who never reached the hospital alive, so its survival percentage should not be applied directly to someone who has already survived the initial arrest and reached the ICU (CARES admission and discharge outcomes).

Nor do these figures mean that CPR is futile: calling 911, beginning CPR, and using an available automated external defibrillator can save a life (American Heart Association). The point of sharing the numbers is to encourage an informed conversation, not to replace one.

Survival is also not the end of recovery: some survivors need rehabilitation or support for physical, cognitive, and emotional difficulties, and AHA guidance recommends assessment and planning for those needs before discharge (AHA survivorship guidance).

Not every answer is available immediately

There is an important boundary between my family’s story and general medical guidance. The fact that I arrived six to eight hours after Hemanth’s arrest does not establish when a reliable neurological prognosis could have been made, and I do not remember enough of the medical discussion to describe its basis.

For adults who remain comatose after cardiac arrest, AHA guidance recommends appropriately timed assessment using multiple sources of evidence, with attention to confounding factors such as sedating medications and temperature management; a single early finding is not enough (AHA neuroprognostication guidance).

Questions about neurological recovery are also distinct from decisions involving other life-threatening illness or a patient’s previously expressed wishes, which the guidelines recognize may affect the course and timing of care (AHA post–cardiac arrest guidance).

You can ask the treating team to make those distinctions explicit. “What do you know now, what remains uncertain, and what might become clearer with more time?” is a reasonable place to begin.

You do not have to become the expert in the room

I knew the vocabulary, the equipment, and the questions. Yet whole stretches of my own journey are missing from my memory.

I share that because I do not want another family to feel ashamed of being shocked or confused. You are allowed to need an explanation again. You are allowed to ask someone you trust to sit beside you. You can rely on professional guidance without surrendering your right to ask questions.

Consider bringing these questions into the conversation:

• What happened? What is known about the cause, and what is still being investigated?
• What is supporting them now? What are the ventilator, medications, or other treatments doing?
• What might recovery mean? What are the best-case, worst-case, and most likely possibilities, and how confident is the team?
• What needs deciding now? Which decisions are urgent, and which can wait for more information?
• How do their wishes guide us? Given what we know about the person’s values, what does the team recommend, and why?
• How will we stay informed? Who is our main contact, and when should we expect the next update?

If it is helpful, ask a trusted person to write down the answers or repeat back what they understood. You can ask for plain language, a family meeting, or support from a social worker, chaplain, or palliative care team where available.

Practical help matters, too. In my family’s story, Paula drove while I booked the flight. The support someone needs may be that concrete: a ride, a meal, a phone call, or another person keeping track of the next step.

Remember the person beyond the ICU

The person in the bed is not simply a diagnosis or a survival percentage. For us, that person was Hemanth, someone who could make a stranger feel like an old friend.

I want families to have an honest understanding of cardiac arrest without feeling that they must suddenly become clinicians. Ask for the expertise around you. Bring in people you trust. Tell the team who your loved one is and what matters to them.

You do not have to understand everything at once. And you should not have to carry every part of the experience alone.

October 16 is World Restart a Heart Day, a reminder of the importance of bystander CPR and being ready to act in a cardiac emergency (American Heart Association). For me, that awareness also means remembering the families beside the hospital bed, who need clear explanations, honest guidance, and support whatever the outcome.

This article shares a personal recollection and general information, not an assessment of another person’s prognosis. If someone collapses, is unresponsive, and is not breathing normally, call 911, follow the dispatcher’s instructions, begin CPR, and use an available AED according to its prompts (American Heart Association).