When a student suffered sudden cardiac arrest, a small-town high school refused to let her die.
On May 11, 2005, an alarm clock that had been ticking silently for five years went off at a high school in Rhinebeck, N.Y. It was 1:30 in the afternoon and warm, and 15-year-old Kaitlin Forbes was playing co-ed softball. Over the past eight months, her sophomore P.E. class—the “randomest” mix in the beginning, Kaitlin says—had become “so close it was, like, ridiculous.” They had nicknames for each other, and despite her delicate face and long, sweetly girlish hair, Kaitlin had been dubbed Carl. She’d been doodling on her hand in art class a few minutes before, and there she’d written the lyrics of a song that would mislead the paramedics who would shortly be called: I need the high to get me through the ever after.
Kaitlin gripped the bat and stepped up to the plate. She had a lingering cough and dizziness from a spring cold, but she’d come to school an hour early that morning, as usual, to practice batting with a friend on this same field. An avid athlete, she played varsity softball, volleyball and basketball, and she went to UConn basketball camp every summer.
Kaitlin nailed the ball, as usual, and it flew past the shortstop to the bright-green leafy ever after.
She ran, but she felt so odd. “I don’t feel good,” she told Dylan Alben as she rounded first. Then everyone saw her fall.
“I was a jokester in that class,” Kaitlin says. “They thought I was joking until I turned blue.”
Kaitlin had lost consciousness because her heart had stopped beating. It was quivering erratically, a useless trembling called ventricular fibrillation. Roughly 95 percent of all sudden cardiac arrest victims in America—including those who, like Kaitlin, are young and healthy—are not revived quickly enough, and they die.
But Kaitlin’s gym teacher, Ron Keefe, saw almost immediately that she wasn’t joking, nor had she simply fainted. He did the first four things that saved Kaitlin’s life: He told her classmate Thomas McCormack to bring the AED, an automated external defibrillator that was stored like a fire extinguisher in a glass case by the gym door. He told another student, Matt DeIulio, to have the school secretary call 9-1-1. He sent Dylan Alben to get Bonnie Murphy, the school nurse. Then he started doing CPR on Kaitlin.
Football coach and P.E. teacher Mike Piccione was not usually on the field at that hour. “Normally I let the kids set up,” he says, but on that particular day he’d decided to set up the cones himself. The first sign of trouble was Thomas McCormack sprinting toward the gym with a scared look on his face.
“I saw Ron Keefe behind him, looking like he’s doing CPR on a kid, and I was like, holy Jesus.”
Piccione ran past Thomas McCormack. When he reached Kaitlin, she was purple, and she had no pulse. The breaths she took were far apart and strange, the telltale gasps of something called agonal breathing. Then Kaitlin stopped breathing altogether.
A Parent’s Worst Fear
Rhinebeck is a town of just 690 families. Kaitlin’s father, Darren Forbes, a state trooper, was in the office at the New York State Police barracks when he heard about a 9-1-1 call involving cardiac arrest on the high school field. He headed immediately to the school to offer help.
Kaitlin’s mother, Linda Cotter-Forbes, also worked for the State Police as an investigator. That morning, she’d set her cell phone to vibrate because calls were interfering with her work. Then she put the phone in the pocket of her jacket.
“I had driven home to check something—a computer that wasn’t working,” Linda says. Her house is so close to the high school that she can see the baseball field from the tree fort in their backyard.
“I saw my mom and my little ones, and then I stopped at the deli to pick up an iced green tea,” she recalls. “I grabbed two bottles—one for Kaitlin to give her later—and then I headed back to my office.”
It was such a beautiful day that Linda took her jacket off and set it on the seat of her car. The jacket still held her cell phone, and the ringer was still off. “So it wasn’t until I got back to my office and was approaching the door that I saw everyone looked quite upset,” she says.
“Everything’s going to be OK,” her colleagues told her, “but they’re doing CPR on your daughter.”
Linda didn’t even know which daughter they meant—she has three—but she got back into her car. Someone from the station jumped in beside her, and she headed for the road that led both home and to the hospital.
School nurse Bonnie Murphy was not in her office when Kaitlin collapsed. “She had an eighth-period gym class,” Murphy says, “and that’s when I eat my lunch.” Dylan Alben told the greeter, who sits in the school lobby and helps visitors sign in, that a nurse was needed outside. The greeter called the secretary upstairs, and then the secretary called the faculty room where Murphy was. They still had no idea that a student was in cardiac arrest.
“Most of the time, we have a sprained ankle,” Murphy says, so she got the wheelchair. “I asked Dylan, ‘What’s the problem?’ and he said, ‘It’s Kaitlin Forbes.’
“She had always been very special to me,” Murphy adds. Every morning, when she ate a bowl of oatmeal in her office, Kaitlin and a group of her friends would stop by during their free period to tease Mrs. Murphy about her “porridge” and then, sometimes, stay and eat a little porridge themselves. “They’d re-apply their makeup and talk about where they’d bought their latest cool pair of shoes,” Murphy says.
When she reached the edge of the field, Murphy saw that Kaitlin’s condition was far more serious than a sprained ankle, so she began to run. “The closer I got,” she says, “the more I saw how purple she was.”
The field seemed incredibly far from the school that day, Murphy recalls. She reached Kaitlin perhaps three minutes after her collapse, and from then on was aware only of her face and that terrible color. She put her stethoscope on Kaitlin. No heartbeat. She breathed twice into Kaitlin, and then Mike Piccione, six-feet-four and 260 pounds, pressed down repeatedly on her chest. They did at least one full round of CPR, Murphy estimates, and then the AED arrived.
Once the AED appeared at his knee, Piccione says, “We did the steps we were trained to do—we put it on her, it shocked her, and it brought her back to life. Here’s a person who was purple, and showed no signs of life, and now she was back.”
The paramedics arrived, and so did Darren Forbes. He offered his assistance, and the emergency workers looked at him and realized who he was. They moved to the side slightly, and Darren recognized his own daughter.
At the hospital, doctors determined that Kaitlin’s sudden cardiac arrest had been caused not by drugs (as the lyrics on her hand had inadvertently suggested) but by acute myocarditis, an inflammation of the heart triggered by the walking pneumonia no one knew she had. Her heart never re-established its own rhythm, and after four days on an external pacemaker, doctors attached an internal pacemaker to her heart.
That Kaitlin not only survived but reached the hospital in relatively good shape—“I almost never get kids in such good condition,” her cardiologist told the Rhinebeck staff members who visited Kaitlin the next day—was due to excellent preparation and foresight: The school had not one, but three, AEDs and had conducted drills in responding to sudden cardiac arrest.
But preparation, unfortunately, can usually be traced to someone else’s heartbreak.
Five years before Kaitlin’s collapse, on March 25, 2000, a 14- year-old boy named Louis Acompora began playing his first high school lacrosse game in Northport, N.Y., a town on the north shore of Long Island three hours from Rhinebeck.
“He was the goalie, so I always worried,” Louis’ mother, Karen Acompora, says. “I’d ask him, ‘Why do you want to be the goalie?’ and he would get mad at me. ‘Don’t you think I’m good enough?’ he’d ask. I did—I just worried about him getting hurt.”
It was surprisingly warm for March, a bright 65 degrees. Louis’ older sister, Alyssa, was playing lacrosse, too, but just a scrimmage game. Normally Karen and her husband, John, split up on such occasions so that each of their children would have a cheering section, but this was Louis’ first high school game, so they sat in the stands together. Karen still felt a little divided.
Sticks twisted and clacked in the sunshine. A ball flew toward the Northport goal and Louis, who was wearing a chest protector, blocked it with his chest. Then he went down.
“We thought he had the wind knocked out of him,” Karen says. Seconds passed, and he didn’t stand up.
“You should go down on the field,” Karen told her husband.
“He’s in high school now,” John said. “The parents can’t be running out on the field.”
But Louis still didn’t stand up. The coaches remained huddled around him, so Karen and John stood up and walked out to Louis.
“When we got to him,” Karen says, “we realized it was serious. Though it still was not registering how serious.”
The trainer, panicking, said Louis had no pulse.
“He has to have a pulse,” John said.
Karen had never heard of sudden cardiac arrest or an automated external defibrillator. No one realized that Louis had suffered sudden cardiac arrest caused by ventricular fibrillation—the same chaotic, fatal quivering of the heart that would fell Kaitlin five years later. The lacrosse ball had struck Louis’ chest—padded with an approved chest protector—at precisely the wrong moment in the heart’s electrical cycle, triggering a life-threatening phenomenon called commotio cordis.
The trainer and Louis’ coach began CPR, but it took nearly 15 minutes for paramedics to reach the lacrosse field. Neither CPR nor defibrillation was started soon enough to save him. On a bright and sunny day in his freshman year, Louis Acompora died.
It’s the sort of loss, irreversible and agonizing, that can send grieving parents to an attorney’s office. But money wouldn’t bring Louis back, Karen says. “It wasn’t worth our energy to sue the school district for something I honestly felt they didn’t know.” AEDs were relatively new devices at the time, and few people had ever heard of commotio cordis.
The Acomporas started a foundation in Louis’ name, and in June of 2000, they held their first conference about the importance of AEDs at schools. The New York State Education Department agreed to investigate the need for placing AEDs in schools, and in October of 2001, the Acomporas’ home county of Suffolk passed a bill mandating AEDs in county buildings, parks and police cars. Encouraged by this success, the Acomporas produced a video and a written protocol for installing and using AEDs in schools. Their garage filled up with boxes, and they mailed kits at their own expense to school administrators. They went on Oprah, and they traveled across the state.
In May of 2002, New York passed Louis’s Law, which requires every public school in the state to install and maintain AEDs and to train personnel in their use. As a direct result of that law, 40 lives, including Kaitlin’s, have been saved in the state. Karen continues to work out of her home in what she calls Louis’ office, mailing out kits in the hope that schools and legislators in other states will listen.
“We felt that Louis gave us a job to do,” Karen says, “and we had no choice but to pursue it that way. Honestly, as weird as it sounds, we feel kind of blessed that he did give us a job. He gave us something positive to focus on.”
As John Acompora puts it, “our goal is, he’s not going to be forgotten. Possibly, he was put on this earth for a purpose, and if the purpose of Louis’ being was to save lives, then we’re going to do everything we can to help that purpose.”
Rhinebeck had passed a giant safety test. They were prepared, grateful, and—presumably— safe. Then, on July 27, 2006, just 14 months after Kaitlin’s cardiac arrest, Kaitlin’s best friend and softball teammate, Maggie O’Malley, became nauseated on a train ride back from New York City, where she’d gone with her boyfriend, Scott, to celebrate her half-birthday. Maggie suffered sudden cardiac arrest at 1 a.m. on July 28, just as Scott was seeing her home.
The signs were confusing. “I never suspected heart issues,” Maggie’s mother, Pat O’Malley, says. “She never had heart issues—it never even crossed my mind. I kept trying to say, ‘What’s the matter?’”
The 9-1-1 dispatcher told Pat and Scott to start CPR, but by the time they laid Maggie on the floor and began giving breaths, paramedics had arrived. Maggie died a few hours later, at the age of 17 and a half.
The cause was once again myocarditis, but chronic instead of acute, meaning that while Kaitlin was still outwardly suffering from what she thought was a cold, Maggie’s heart had been damaged by a past illness. Maggie’s death still reverberates through the community of Rhinebeck, and it makes those who knew her even more determined to remember and prepare.
“I have a tattoo on my back for Maggie,” Kaitlin says. “It’s on my left shoulder blade, on the same side as my pacemaker.”
Maggie’s mother responded as Karen Acompora did, with a vow to save other people’s children if she could. With Kaitlin and Linda Cotter-Forbes, Pat O’Malley formed the Heart Safe Club of Rhinebeck. She became a CPR and AED instructor. When Maggie’s friends teach CPR or play in the Maggie O’Malley memorial softball tournament, they wear t-shirts reading Heroes aren’t born. They’re trained.
“I think everyone should know CPR,” Kaitlin says. “You might think you’ll never have to know how to use it, but things happen every day that you don’t expect.”
Mike Piccione, who still teaches at Rhinebeck High School, acknowledges the expense of installing and maintaining AEDs and drilling students and staff in sudden cardiac arrest preparedness.
“But here’s the point,” he says. “This stuff saves lives. How can you save a life? This is it. Right here.”
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Laura McNeal is the author, with her husband, Tom, of four young adult books published by Knopf (http://www.mcnealbooks.com).
Photos by William Moree (http:www.williammoree.com).
This story may not be republished without express written permission of the Sudden Cardiac Arrest Foundation, the author, and the photographer.
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