Regional Industry & News

By all accounts, it’s a miracle to even speak to Joe Meligan, a veteran paramedic working in the area for some 30 years, and a greater miracle still that he is as he ever has been – lucid, energetic and passionate about his work.

Meligan suffered a heart attack on July 27, while responding to an incident of a vehicle driving into the reservoir. Part of a joint response by a number of agencies, including Pierre Rescue, Game, Fish and Parks, Meligan was going about his duties in the same way he has for decades.

“Then we get to the back of the ambulance, and I get literally to the back leg bumper. Between the back bumper and that door, as you make that turn, I had no chest pain, no shortness of breath. I felt fine that morning. You know, I had no issues. I don’t have previous cardiac history. I don’t have any previous medical problems. Nothing,” Meligan recalled. “So, I make the turn from the back bumper to reach up to open the door to get the monitor out, and I get this sudden onset of shortness of breath, where I can’t catch my breath. I remember reaching up and touching the door handle, and as soon as I touched the door handle, that’s the last thing I remember.”

Meligan was surrounded by medical professionals and first responders. They noticed him quickly, responded quickly. The entire incident was caught on body cam, and Meligan describes the surreal experience of reviewing the footage of his own near-death.

“I’m trying to put, like, my head behind—or my hand behind my arm. You see this all on body cam,” Meligan said. “You can see me suffering in my eyes … as I’m kind of gasping for air. I have no memory of this. You know, because I watched the body cam a handful of times, they do everything correct. He just starts screaming, ‘Medic down! Medic down!’”

Meligan had suffered a block of a critical artery in his heart, nicknamed “the Widowmaker” for the sheer lethality of blockages there. Saving somebody suffering this sort of cardiac arrest has an incredibly low likeliehood of success. Even in the company of men and women trained to save him, Meligan’s odds were low.

“ I’m in the middle of dying. You know, I mean, you can just see that,” he said. “Then I start having agonal respirations. Agonal respirations are just kind of the brain’s last attempt at trying to breathe, because my heart had went into a rhythm called ventricular fibrillation. So, I didn’t have a pulse, and then I stopped breathing. They noted that I had stopped breathing. They checked for a pulse. They couldn’t feel a pulse.”

The Cost of Vigilance

Meligan didn’t have any prior history of heart issues, a generally clean bill of health, no warning signs that this was coming. Yet in a way, it isn’t surprising that it did – not to him and not to anyone who serves the long hours, the constant watch, of law enforcement, firefighting, emergency medical response.

“My adrenaline was going,” Meligan said. “That’s one thing that is very hard on first responders’ bodies. That’s why, if you look at firefighters, the number one cause of what kills firemen is cardiac problems. That includes career firefighters, line-of-duty deaths. It’s all these career guys. You know, they sit at the station, they lift, they eat right. But they’re now starting to come out with studies of first responders. The things that we love—as soon as the tones go off, what do we do? We get the adrenaline rush.”

An adrenaline rush sees both a huge spike in adrenaline and in cortisol, the stress hormone. Meligan says first responders love that feeling, live for it. Yet it is hard on the body. It’s killing them – causing wear and tear that often results in cardiac arrest.

This is the working theory for why Meligan fell that day. He went into cardiac arrest and, in his own words, he died. Resucitation attempts kicked in. They tried CPR, to no avail. Then, an Automated External Defibrillator (AED) was deployed.

And Meligan woke up.

“My memory clicks in. I remember hearing sounds. I remember hearing Matt Hardwick, Bob (Hardwick), who was right next to me,” Meligan said. “Then I could hear some of the other rescuers: ‘Just lay there. You coded. We had to shock you.’ I’m perplexed because I’m just kind of coming around. I felt extremely air-hungry. I mean, just super air-hungry. Just imagine the hungriest you’ve ever been and multiply that by, like, 10. If there was an oxygen molecule in front of me, I’d be eating it. That’s how air-hungry my brain was. Along with that, I had horrible chest pain.”

It wasn’t simply the pain of having had chest compressions done, Meligan described the pain as far more intense.

“You ever ordered anything on a pallet, and they use those little bands to wrap the pallet—or whatever your thing is that you want onto it—to secure it? Those little bands, and they’re really, really tight? That’s what my heart felt like. It just felt like my heart was banded and squeezing with a lot of pressure,”

Meligan was given IVs, sent to the hospital. It would be while in the ER that Rick Cronin of the Fort Pierre Volunteer Fire Department would come to visit Meligan, an event Cronin himself recalled in a column he penned on Facebook that was run in the South Dakota Firefighters Association Newsletter. As Meligan recalls the scene:

“I have cords and wires and tubes and just—you know, they had me stripped down in the bay, and I have wires and tubes and everything going every direction. They had medication hanging, and all these medications behind me were starting to form, and they’re adding more,” Meligan said. “I tell Rick, ‘See? These do save lives. Now we need to get more out there.’”

Cronin echoed this scene in his own post, and he notes the irony that he and Meligan had been making a concerted push to purchase and distribute AEDs out into the broader community, to see them in local businesses. During a cardiac event, seconds matter. Life or death, brain damage – the outcome of heart attacks is rarely good, and if Meligan had not been where he was, with who he was, and in the presence of exactly the life-saving equipment that was needed to save him, this story would be very different.

Yet he was. The application of an AED saved his life, directly and irrefutably. Having already had a successful fundraiser over the Fourth of July, the FPVFD will be continuing these efforts to get more of these into the hands of the community.

And they won’t be alone.

The Aftermath

Matt Hardwick, Operation Supervisor for AMR in Pierre, spoke to the concerted effort local first responders, including AMR at a corporate level, and area medical facilities are making to turn this near-tragedy into a successful campaign for better community health and accessibility to life-saving tools.

“Joe was already working on the AED drive with Fort Pierre Fire about getting more AEDs in the community. Since then there’s been an even larger response since the medical event. We’ve had businesses donate AEDs themselves, we’ve had some businesses donate money for AED purchases,” Hardwick told the Capital Journal. “We’ve also had businesses reaching out wanting AEDs or organizations looking at wanting AEDs if some are available. We’d like to continue that.”

The pragmatic value of more AEDs in circulation is to address scenarios like Meligan’s, and commonplace across America. Heart attacks can come suddenly, and rarely is a hospital conveniently in reach. The prospects for surviving those sudden cardiac arrests are low.

“Out-of-hospital cardiac arrest, currently nine out of ten don’t survive. Every minute they’re in cardiac arrest outside of the hospital decreases their chances significantly,” Hardwick explained. “Most differences are made in that first five minutes of cardiac arrest. So we really rely on bystanders, members of the public and family to start CPR and then also make sure that AEDs are available.”

Local hospitals are looking to help. Avera, Hardwick said, is going to expand their Planet Heart