The death of Bill Eden: A Southlake couple's quiet evening takes a bewildering turn

By Tim Madigan

tmadigan@star-telegram.com

First of three parts

SOUTHLAKE -- On a Tuesday night last April, Bill and Cathy Eden watched the latest episode of Dancing With the Stars, with Tobie, the family beagle, stretched out with them on the living-room furniture. Cathy rolled her eyes when her husband of nearly 30 years professed an attraction to one of the male dancers. Bill was a great husband and father. Family photographs taken in the mountains or on a beach captured a radiant family of four, Bill and Cathy and two lovely daughters, and now that the girls were grown, their parents happily shared an empty nest.

But there was that sometimes raunchy sense of humor.

"You're going to go to hell," Cathy said that night.

She had spent her day managing a Southlake boutique and was tired -- her feet were aching. Bill, a self-employed entrepreneur, had played golf with two friends.

"Let's trade places," she said. "I need to lie down."

Bill hugged his wife when he got up from the sofa and told Cathy he loved her, which was unusual for him on a typical night at home. He went to the kitchen for an apple, hoping to appease heartburn from a big bowl of leftover queso that Cathy had snatched away from him earlier. He finished the apple and returned to the living room, taking a seat in a chair next to his reclining wife.

Then he died.

The noise he made was something between a snore and a cough. He can't be asleep already, Cathy thought. The moment she looked at him, she knew he was gone. Eyes rolled back into his head. Hands curling grotesquely at his sides. Motionless chest. Cathy rushed to her husband, a strapping former college football player, slapped him across the face once, twice, three times without any reaction.

"Bill, wake up! Breathe!" Cathy screamed. "Daddy, wake up!"

Her old lifeguard instincts kicked in. She blew into Bill's mouth and slapped him again. He's dead, Cathy thought. I will be without a husband and our two girls without their father. I need to call 911, but the telephone is in the kitchen and I can't leave him. No. I have to call 911.

"911. Where is your emergency?" A woman's voice.

"402 Southridge Lakes Parkway," Cathy screamed.

"What's going on, ma'am?"

"I don't know ... I can't ... I think he's having ... I don't know. Come quick."

"OK. Do you need paramedics?"

"Yes. Ambulance."

"OK. Let me get help on the way. Don't hang up the phone, ma'am. OK? Don't hang up the phone. I'm getting help on the way now."

"Breathe. Breathe, Daddy," Cathy screamed.

She slapped him again and blew into his mouth.

"Do you know how old he is?" the 911 operator asked.

"Fifty-seven."

"Does he have any heart problems?"

"Yes."

"Is he breathing?"

"No."

"He's not breathing?"

"No."

Cathy slapped Bill again.

"Dad!"

"OK. Can you get him on his back?"

"Bill, get on the ground. Bill help me! Help me! I can't get him on the floor. He's 6-4.... Hurry. Come on, Bill.... Hurry.... Breathe, Bill, breathe."

"You should be able to hear the sirens soon. Can you go to the door and see if they're there?"

"I can't leave him."

"Go unlock the front door. The paramedics are pulling up."

Tobie barked as the ambulance arrived.

Calling for help

It had been a slow shift in the affluent suburb of northern Tarrant County, just a routine call or two, until the alarm sounded just before 9:30 p.m. on April 12. The intercom at Southlake's Fire Station No. 2 issued a series of deafening beeps, followed by a loud human voice above static.

"Medic 402. Engine 402." Ambulance and fire engine.

Southlake Fire Lt. Ron Testerman and his crew, watching television in recliners, jumped up and hurried toward their vehicles before they knew the nature of the call. Had a fire alarm been tripped by accident? Someone overreacting to a proverbial stubbed toe? Or would it be something more urgent, which was often betrayed by tension in the dispatcher's voice? They listened for certain words that caused even a veteran firefighter's adrenalin to spike. "Structure fire," for example. Or "child."

That night they heard three more: "CPR in progress."

A 57-year-old man had apparently suffered cardiac arrest at home. No call was more urgent than that. The survival rate of people whose heart stops away from a hospital was only 5 percent. Every second that the organ did not pump blood, every second that the brain was deprived of oxygen brought a person closer to death. Testerman, the most veteran of his crew, had handled scores of such cases over three decades on the job and remembered only three or four patients who had eventually walked out of the hospital.

Firefighter Bryan Thomas jumped behind the wheel of the ambulance, Frank Molinets into the passenger seat next to him. On this call, Molinets was designated as the lead medic, a rotating responsibility in the crew to oversee the attempts to rescue and revive. Testerman, Chris Lillie and Joe Crowder climbed onto the fire engine to chase the ambulance east a few miles on Southlake Boulevard.

Department policy dictated that emergency vehicles travel at no more than 10 miles per hour over the posted speed limit, but traffic was light, and with cases of cardiac arrest, minutes made the difference between life and death, between full recovery and irreversible brain damage. With lights flashing and siren blaring, Thomas pushed the ambulance to about 60 mph on the suburban thoroughfare. Next to him, Molinets ran through a mental checklist: equipment they would need; treatment protocols for cardiac arrest they had studied and practiced dozens of times.

That training was for cases like this, calls that firefighters live for -- the chance, however remote, to bring someone back from the dead.

Fight for a chance

They pulled up in front of the spacious home in five minutes. Thomas and Molinets jumped from the cab and grabbed from the back of the ambulance a portable heart monitor/defibrillator; an artificial breathing apparatus; and kits of drugs. A weeping woman stood outside in the dark, speaking frantically to someone on the telephone.

"My husband's in there," she said, pointing into the house. "He's in the back."

They hurried through the front door to the back of the house, where a burly, athletic-looking man in gym shorts and a T-shirt was slumped in a chair in the living room. His face was ashen. He had no pulse or respiration. Thomas, a large man himself, grabbed the victim behind the shoulders and lowered him onto the floor so they could begin chest compressions against a hard surface.

The three other firefighters from Station 2 rushed in and joined the lifesaving choreography. Molinets cut off the man's shirt. Lillie began chest compressions. Testerman quickly took his place so Lillie could start an IV. Thomas checked to make sure nothing blocked the victim's airway, applied a mask to his face, and began squeezing a balloonlike bag, pushing oxygen into the lungs. Seconds had passed since they entered the home.

Molinets placed electrodes on the victim's chest, and shallow squiggles appeared on the monitor, which was the first good news. The monitor showed that his heart was in a rhythm called ventricular fibrillation, v-fib for short. In v-fib, the heart still generates electricity, which is what powers a normally beating heart, but the cardiac rhythm is chaotic, causing the organ to quiver but not to beat.

Unlike other rhythms like asystole (flat-line,) v-fib is "shockable," which means a jolt of electricity can jump-start the heart back into a normal rhythm.

"We've got a good chance with this guy," Molinets told the others. "He's still in v-fib. Let's work."

At Molinets' command, Testerman paused and removed his hands from the victim's chest. Molinets applied the first jolt from the defibrillator. The victim's torso twitched, and his heart bounced into a normal rhythm, but for only a beat, before falling back into v-fib. The team pushed the first dose of epinephrine, a form of adrenalin, into the IV. The drug enhances blood flow in the heart and brain and can help the heart begin beating again on its own.

Testerman resumed chest compressions. Thomas worked the breathing bag. After two minutes, Molinets delivered another shock at nearly twice the voltage. The heart would still not budge from v-fib. The paramedics pushed more drugs. The victim's frantic wife waited outside with a police officer. Molinets delivered a third shock to the moribund heart. A fourth. A fifth.

The firefighters cursed to themselves each time the heart slipped back into v-fib. The man hadn't flat-lined, but with every ineffectual jolt of electricity, chances of a happy outcome dwindled. After about 30 minutes, the decision was made to load the man onto a backboard, then onto a gurney. The crew wheeled the man out his front door and past his wife, while Testerman continued heart massage and Thomas worked the breathing bag.

As bystanders gathered in the night, one said it looked as if the man were dead. Technically, that was correct. On the six-minute trip to Baylor Regional Medical Center at Grapevine, paramedics delivered two more jolts, the last as they opened the ambulance doors just outside the emergency room, but the results were the same.

A stubborn heart

In the Emergency Department at Baylor, Dr. Alwin Arendse went through his own mental checklist as the Southlake ambulance barreled in his direction.

"Let's get respiratory down here," he told his staff. "Let's run this code."

Like the firefighters, he had chosen emergency medicine largely for cases like this, an opportunity to have maximum impact on a person's life. But as he waited in the hospital, it was hard not to consider the slim odds of whomever the paramedics were bringing in. It was hard not to think about the message he might have to deliver to the patient's family.

"To me, the medicine is easy," Arendse would say later. "It's going and looking at the faces of the children and the wife, having to say your husband died, your father died. That's hard."

But the physician felt a surge of hope when he saw the man being brought in. He was relatively young. He had suffered his arrest in the presence of his wife, who had immediately called 911. Without treatment, irreversible brain damage typically sets in between four and six minutes, but paramedics had arrived in five. And the man's heart stubbornly remained in v-fib.

"This gentleman is 57 years old," Arendse told his staff as they headed for a trauma room. "His downtime is short. This is a salvageable person if we do everything right."

Arendse checked the pulse and the breathing tube. Nurses pushed more drugs. Arendse shocked the heart again, the eighth jolt in all. Still nothing.

But on the ninth ...

The heart bounced out of v-fib and held. As Arendse and his team studied the monitors, the organ settled into a near-normal rhythm. A pulse returned. Blood pressure rose. After so much time, so many jolts of electricity, that almost never happened. He's back, Arendse thought.

"This gentleman is going to be a candidate for the hypothermia protocol," the doctor said.

In the past decade, medical studies had shown that reducing a cardiac arrest victim's body temperature slowed the metabolism and helped prevent brain damage from oxygen deprivation. Nurses immediately began to apply ice packs to the patient's head and torso. The unconscious man was hurried to the elevator for a ride to the third-floor intensive-care unit.

"In this case and many other cases, where someone is on the brink, they are going to die and they give you a glimmer of hope, basically you give yourself a little high-five, pump your fist a little bit," Arendse said later. "Then you move on to your next patient. That takes all of five seconds. But you do kind of say: 'Wow. That's why I do this kind of thing.'"

Outside the hospital, the five Southlake paramedics cleaned up the ambulance, preparing it for the next call, and quietly celebrated. The victim's heart had gone for more than 30 minutes without beating on its own, but they had kept blood and oxygen flowing to his brain. In most calls like this one, their only satisfaction was knowing that they had done all they could. But this guy's heart was beating again. Perhaps not for long. But it was beating.

Good news and bad

Cathy Eden would vaguely remember the ride to the hospital in a police patrol car. Her youngest daughter, Megan, who lived in Dallas, was not answering her cellphone, and Cathy pushed away the notion that something had happened to her, too. Cathy's own parents arrived from their home in Keller. Her legs trembled as she sat in the Baylor waiting room. Her father sat on one side during the desperate vigil, her mother the other.

A doctor approached.

"The good news is that your husband is not dead," he said. "The bad news is that he's very critical."

Nearly four decades before, Bill had stopped her on the campus of the University of Texas at Arlington. He was a UTA football star about to go to training camp with the New York Giants.

"You dating anybody?" he asked.

She was.

"Why don't you get rid of him and come hang out with me?" he asked.

That was typical Bill. And Cathy did just that, eventually. She was in the stands at the Houston Astrodome a few months later when Bill dropped a pass in a Giants exhibition game that got him cut from the team. He came back to UTA and was elected student-body president while he finished his degree. He ran unsuccessfully for the state Legislature while they were dating, then entered the business world. They were married in 1981, and had two daughters, Ashley, who was now 27, and Megan, who was three years younger. Both were thriving. Both adored their parents.

And this is the way it would end.

Cathy called Megan's number again. Still no answer. A family friend finally drove to Dallas and woke up the daughter at her apartment. Megan had forgotten her cellphone at work.

Back at Baylor, another doctor approached in the ICU waiting room.

"I have a daughter in Washington, D.C. Should I call her?" Cathy asked.

"Call her," the doctor said. "Call everyone you know."

Tim Madigan, 817-390-7544

Looking for comments?