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Chest pain, shortness of breath and lightheadedness. These are just a few of the most common warning signs of a heart attack. However, symptoms can vary based on age, gender and health history.
For instance, “silent” heart attacks (aka silent myocardial infarction), which represent 45% of heart attacks, do not often produce the most common heart attack symptoms. In fact, most patients ignore the symptoms because they’re noted as mild or brief. Patients often attribute the symptoms to other issues, such as fatigue related to lack of sleep or mild chest pain due to heartburn or indigestion.
For Bob Stanczyk, his warning sign was even smaller – and could have been missed entirely.
‘It just didn’t feel right’
On July 26, 2020, at about 1:45 p.m., the Newburg (Wisconsin) Fire Department was dispatched to a report of a vehicle on fire in a driveway. The fire was threatening to ignite the house, which was about 10 to 15 feet away from the vehicle.
When crews arrived on scene, the vehicle was fully involved. Moreover, the siding on the house was beginning to melt. Crews deployed two hoselines, and the fire was eventually brought under control.
While checking for hot spots, Stanczyk, a 49-year-old firefighter-EMT and 11-year department veteran, felt discomfort on the top of his left shoulder.
“It just didn’t feel right,” he said. “It was probably the size of a quarter where the area was. It almost felt like I had something stuck under my suspenders from my bunker gear.”
Stanczyk took off his jacket to check his shoulder for any debris that may have fallen during the fire attack, but there was nothing there. Minutes later, he decided to sit inside an engine, cooling off with the air conditioning while drinking some water. He initially attributed the unusual discomfort to a possible heat-related issue, as it was 96 degrees with a heat index of 107.
“I knew I was getting dehydrated. I thought it was heat-related,” Stanczyk recalled.
He still didn’t feel right.
“If it was a strain or a pulled muscle, it wouldn’t be just that one spot,” he said.
He decided to ask the EMTs on scene to look at his shoulder to see if they could find out what was going on – a decision that ultimately saved his life.
A colleague in distress
When EMTs Tony Scholten and Danny Powell walked up to the engine, Stanczyk alerted them to his left shoulder discomfort.
“We figured it was heat exhaustion,” said Scholten, a 28-year veteran firefighter-EMT with the department and 23-year veteran STAT nurse at the local hospital’s ER. “He seemed OK and he insisted on walking to the ambulance.”
Powell, who has been with the department for four years, also initially thought Stanczyk was overheated, noting how sweaty he was when they opened the engine door to assess him.
“I said, ‘Well, let’s just get you checked out,’” Powell recalled saying to Stanczyk. “And, he said, ‘Let me sit for a minute. Let me just sit and get cool.’ Then, I said, ‘You know, better than that, let’s go.’”
Stanczyk walked on his own to the ambulance, where Scholten and Powell decided to hook him up to a 12-lead, still thinking – at the time – he was most likely experiencing a symptom related to heat exhaustion.
“When he mentioned left shoulder discomfort, it kicked in the back of my mind, ‘Well, it could be cardiac-related,’” Scholten said. “I didn’t really think it was. He didn’t present any shortness of breath or chest pain.”
Scholten and Powell took Stanczyk’s 12-lead three times.
“When I read it the first time, I disregarded them. I didn’t believe them,” Scholten said. “Finally, after drying him off and using some alcohol, we did the strip and then looked at the 12-lead. I wasn’t believing what I was reading. I read the interpretation and I’m like, ‘Is it a heart attack?’ I just wasn’t believing it.”
Powell, who was also in disbelief, remembers Scholten telling him that Stanczyk was in trouble.
“I looked at the EKG strip and I saw an elevation in leads five and six and I’m like, ‘Oh my god, he’s having a heart attack,’” Scholten said.
Powell then yelled, ‘Well, let’s get going!’” to firefighter-EMT Jeff Walczyk, a 22-year veteran with the department, who drove the ambulance to the hospital.
At first, Walczyk said they were going to go to the nearest hospital. However, after reading the monitor, they made the decision to go to another hospital with a cardiac catheterization lab.
‘It was just like somebody unplugged him’
In the back of the ambulance, Powell was trying to keep Stanczyk calm.
“I was asking him his name and his phone number,” Powell said. “I was trying not to get into the heart attack thing with him, because I didn’t want to cause him further stress or anxiety.”
The crew put a nasal cannula in Stanczyk, and two minutes later, he said, “Hey, I’m kind of lightheaded.”
Stanczyk’s eyes, Powell remembers, stayed open as he began to lay back.
“It was just like somebody unplugged him,” he said. “Tony laid him down and I ran up front and yelled to Jeff, ‘CPR in progress,’ and I grabbed the radio to call an intercept, but nobody answered. Tony said, ‘We’re just going to go.’”
Walczyk said his foot hit the gas pedal harder when Powell yelled out about CPR in progress.
“That’s something you don’t do every day, with one of your team members in the back,” he said.
Meanwhile, Scholten, who’s now seeing on the monitors that Stanczyk is in v-fib, is frantically grabbing pads, but ended up flinging the first set of pads.
“The first set of pads I grabbed was pediatric, and I’m like, ‘Oh god,’ and I tossed them and got the adult pads out,” he said. “I finally got the package open and I couldn’t find the end of the cord and Danny had to redirect me and calm me down a little bit.”
They shocked Stanczyk one time, but he was still in refractory v-fib.
“I jumped on his chest and started CPR,” Scholten said. “I said to myself, ‘I’ve got to put this in manual mode and shock him again.’ I’m shocking him a second time and he’s still in refractory v-fib. I broke protocol and put old-school STAT shocks on him to get him out of the fibrillation. I knew the longer that he was in that, all the tissues were going to start to not become recoverable. I was scared.”
While this was happening, Scholten said he couldn’t stop thinking about Stanczyk’s wife and two children.
On the third shock, Stanczyk regained consciousness and started yelling at Powell.
Powell recalls: “He looked over at me and said, ‘What the hell is going on?’ I said, ‘You just coded in the ambulance.’ And he said, ‘No, I didn’t.’ Tony yells back, ‘I shocked you three times!’ I was emotional. I had a lump in my throat and thought, ‘What the hell just happened?’”
Stanczyk has no recollection of being unconscious for over four minutes.
“The last thing I remember is saying that I was dizzy and then I remember slouching to my side,” Stanczyk said. “When I regained consciousness, I thought I was only out for two or three seconds. I started talking with Danny and Tony in the back and tried sitting up.”
Once at the hospital, Scholten, Powell and Walczyk waited for Stanczyk’s wife to arrive and stayed until he was taken to the cath lab.
“We weren’t going to leave the hospital until we knew he was stabilized, which took quite a bit to stabilize him,” Scholten said. “They put him on four different drips to stabilize him in the emergency room.”
‘I know how lucky I am’
Stanczyk spent four days in the hospital and had two stents placed.
And, as Stanczyk laid in the hospital, he tried to remember if there were any other symptoms he may have missed at the time.
“I thought about that long and hard, because Tony, Danny and myself are all CPR instructors,” he said. “You tell people what symptoms you should be looking for, but I didn’t have any other symptoms. I even asked my wife and kids, ‘Did I ever complain about anything being sore or hurting my chest or numbness or tingling?’ They all said no. It still baffles me.”
Currently, Stanczyk, who has been in occupational therapy, is finishing cardiac rehab and hopes to return to work soon.
“I’m feeling really good now,” he said. “I know how lucky I am. As soon as I feel that I’m strong enough, I’m ready. I’m not going to jump the gun and come back until I truly believe that I would be ready to do it.”
Stanczyk has made lifestyle changes, like tightening up his diet. “I’m more mindful of what I’m doing,” he said.
‘It’s going to change our practice’
The call has also had life-changing effects on Scholten, Powell and Walczyk.
“It makes you step back and think,” Walczyk said. “I’m probably the oldest guy at the first department, so it’s like, ‘OK, here we go, folks. If a younger guy can go down, anybody can go down.’”
Powell said it made him reflect on himself and his own lifestyle choices: “I don’t eat the healthiest; we eat fast food all the time. I have three children and you get home sometimes from work and you eat whatever they’re eating. But, what about when you get that 2 a.m. fire call? You get up, run out and your heart is beating 100 mph and you’re next. You’ve got to be careful.”
As for how the three plan to teach future CPR classes, they all agree on one thing: You can’t take any symptom lightly.
“Bob’s shoulder hurt; it was very atypical,” Scholten said. “It wasn’t anything that you would think that he was having a widow-maker heart attack. It’s going to change our practice.”
Stanczyk agreed, noting the importance of seeking help if anything doesn’t feel normal or right.
“Each person knows their body better than anybody else,” he said. “If something is different and just doesn’t feel right to you, get it checked out.”
If you don’t feel well, don’t make it your farewell
Pointing out that something isn’t right – and having someone ignore it – is a common denominator among many firefighters who have died from cardiac events, explains Champaign (Illinois) Fire Chief Gary Ludwig, the most recent past-president of the IAFC, and FireRescue1 board member and columnist.
In early 2020, the IAFC launched the “If You Don’t Feel Well, Don’t Make It Your Farewell” campaign, which aims to curb fatal firefighter cardiac arrest incidents. The initiative was launched with a video that illustrates how ignoring symptoms and signals our bodies send during cardiac incidents too often leads to death.
“At some point, they say, ‘I don’t feel right. I don’t feel well. Something’s wrong.’ And we always tell them to go there in the back and lay down in the bunk hall or go home,” Ludwig said. “If a citizen were to walk into your fire station, you wouldn’t tell them to go home and lay down. So, why do we tell our firefighters to do that?”
Denial, Ludwig said, is the main culprit behind this fatal mistake.
“We’re these superheroes,” he explained. “We’re these firefighters that are pretty much resilient. This doesn’t happen to us. This happens to all these other people that we get dispatched for on calls. But firefighters are people, too. We’ve got to lose this tough guy image and realize that we’re just as susceptible of having this happen to us as anyone else that we go out on the call for.”
Ludwig’s educational campaign, he said, is aimed at changing this culture – this paradigm of telling firefighters to go in the back and lay down in the bunk hall.
Newburg Fire Department Chief Mark Chesak said he reminds his firefighters all the time that they’re not superheroes – now, more than ever, since Stanczyk’s close call.
“We need to realize our limitations and if we’re feeling tired or you just think something isn’t right, get someone to look at you, get that ambulance and get checked out,” said Chesak, a nearly 40-year fire service veteran.
Chesak added that Stanczyk’s story could have ended much differently: “It was a good thing it happened at the car fire. I truly believe that if he had gone home, I don’t think he would be with us today. By the time we would have gotten the call, and if he wasn’t with somebody, I don’t think he would have made it.”
Powell credited the entire team and their training for helping save Stanczyk’s life: “If it wasn’t for the team that we have here and the training that we have, this could have been possibly a little bit different. We don’t treat anybody differently in the call. If this had been somebody off the street, it probably wouldn’t have shook us up as much, even though we work just as hard. It’s just the fact that it’s somebody who we know and we work with.”
The call, Powell said, still shakes him up talking about it today. “It’s like, ‘Holy smokes. I’m just glad that we were all together that day.’”
Chesak continues to stress the importance of checking to make sure someone is OK if they’re not feeling well: “Get checked out. Don’t write it off. I don’t care if you think it’s heat exhaustion or you think it’s a little hot and you’re just out of breath. Get checked out and make sure it’s nothing. They’re warning signs for a reason. We can’t just push them off.”
After all, there is nothing worse than having to ask yourself, “What if we had just listened?”
