On a warm summer evening in July 2021, Doug Schwartz, a healthy 50-year-old former college soccer player who lives in Edwards, was having dinner in a corner booth at Etown, a popular restaurant he owns in the Riverwalk plaza. Many of Schwartz’s longtime friends were scattered around the room, as is often the case on Friday nights.
Around 6 o’clock, he turned to his girlfriend, oncology nurse Shelly Belknap, and his friend Eric Ross. “I feel lightheaded,” Schwartz said. Then he slumped to the floor.
Ross dragged him from under the table by his belt buckle. Belknap immediately started CPR. She and a food runner named Stephen McGaffick, who works in the winter as a ski patroller at Beaver Creek, took turns performing chest compressions while a customer ran to grab an automated external defibrillator 100 yards away. Starting Hearts, a local nonprofit founded by a sudden cardiac arrest survivor named Lynn Blake, had placed the AED on a centrally located lamppost three years earlier, but it had never been used.
As Belknap and McGaffick continued CPR, an Etown employee pulled aside Schwartz’s 15-year-old son, who was working as a busser that night. “Your dad’s getting help, but you don’t need to see it.”
Belknap and McGaffick applied the AED, which delivered two shocks to Schwartz’s heart. Then an Eagle County paramedic arrived and shocked him again. Soon after, Schwartz came to. The crowd erupted in applause. He was later transported by helicopter to Denver.
This story first appeared in The Outsider, the premium outdoor newsletter by Jason Blevins.
In it, he covers the industry from the inside out, plus the fun side of being outdoors in our beautiful state.
In many ways Schwartz’s survival marked the culmination of one woman’s extraordinary quest to keep strangers alive. Schwartz met Blake, who lives in Eagle-Vail just up U.S. 6 from him, for coffee five months after his cardiac arrest. Emotion overcame both of them — Schwartz for his gratitude, Blake for the full-circle moment that Schwartz’s survival represented. They learned that their kids attend the same school. Schwartz even invited Blake to his “first second-birthday party,” thrown by Belknap.
“If you’re going to have a cardiac arrest anywhere in the country,” Schwartz said last month, fighting back tears on Etown’s patio, “because of what Lynn did your odds are better here.”
Colorado is better prepared than other states
Not just in Eagle County, but in Colorado. A year after Schwartz’s survival, on a sunny June day in Steamboat Springs, Blake stood behind Gov. Jared Polis as her 7-year-old son, Thomas, clung to her leg. Polis was there to sign a bill that Blake had pitched, drafted and spent much of her adult life working on — one that established America’s first state office to combat cardiac arrest.
Polis made it clear in a letter to lawmakers that he was not in favor of creating a new office, which he said could “silo our approach to public health and health care.” But he conceded that the work required by House Bill 1251 “will help to prevent sudden cardiac arrest deaths,” so he supported it.
The bill provided the most comprehensive legislation in the country to address one of society’s most ruthless and unpredictable killers. Sudden cardiac arrest occurs when the heart abruptly stops beating, more often than not without prior symptoms (which can include chest pain, dizziness or shortness of breath).
A still heart no longer pumps blood, which starves the body and its organs of oxygen, quickly leading to death. Sudden cardiac arrest causes an estimated 325,000 deaths annually in the U.S. and is most common among people in their 30s and 40s. Only around 1 in 10 who suffer an arrest survive to hospital discharge. The reason they survive is because they received immediate lifesaving measures from a bystander or first responder, including CPR and, sometimes, a shock from an AED.
More than 3,700 people in Colorado suffered an out-of-hospital cardiac arrest last year. The new Office of Cardiac Arrest Management is charged with creating a public outreach campaign, centralizing a list of CPR trainings (CPR can keep oxygen in the brain until an electric shock from a defibrillator restores the heart’s normal rhythm), tracking arrests by county and maintaining a statewide AED registry to improve the odds that bystanders will use one.
Though it sounds like common sense, none of this has been done elsewhere in remotely the same scale.
Lynn Blake’s life was saved, but for what reason, she wondered
The catalyst was Blake’s sudden cardiac arrest on Valentine’s Day 2007. Fresh off her honeymoon, Blake, a fit, healthy, 27-year-old Vail resident, was starting a new job at the Vail Valley Partnership when she collapsed. Sue Froeschle, a coworker whom Blake had never met, immediately started chest compressions. First responders from the Vail Fire Department and the Eagle County Paramedic Services arrived within minutes. A paramedic shocked Blake’s heart with a defibrillator before she was transferred by ambulance to a hospital.
Though immensely grateful for her survival, Blake struggled to move forward.
“I was grappling with, what am I supposed to do with this? If my life was saved for a reason, what is that reason?” she recalls.
She started researching cardiac arrest and noticed a dearth of information. No hard statistics existed, only estimates. The CDC and National Institutes of Health websites lumped the condition into broad sections on cardiovascular disease. Sudden cardiac arrest, which accounts for 13% to 15% of all deaths in the U.S., appeared to be a blank spot on the medical map.
“I just thought, why are so many people dying of this, and nobody’s talking about it?” Blake says.
What’s more, when she searched for CPR trainings, nothing existed that was quick and inexpensive — a typical class took all day and cost more than the masses could be expected to spend.
“That’s when I realized, OK, I need to do something,” she says.
Blake founded a local nonprofit called Starting Hearts in 2010. But the lack of data hindered her efforts to fund it.
“When I’d apply for grants, people would say, ‘Well, where are your numbers?’ And I wouldn’t have any to show them, and nobody could tell me,” she says, describing a scarcity of AEDs in public buildings. “If they did have one, it was behind a locked door or some even said, ‘Not for public use.’”
Public awareness was woeful — at one of Blake’s first appointments with her general practitioner, he referred to her cardiac arrest as a heart attack. (A heart attack often occurs due to a clogged artery, or, in layman’s terms, a plumbing problem, while cardiac arrest refers to an electrical issue in the heart.)
Eventually Blake developed a 45-minute CPR course that she could offer for free and trademarked the phrase “Call, Push, Shock,” the three things one must do after a cardiac arrest, a la “Stop, Drop, Roll” in fire training. Instead of teaching eight people at a time, like in traditional CPR courses, she trained entire school assemblies or business staffs — sometimes more than a thousand people a week.
She took out a credit card to pay for a CPR mannequin and defibrillator and set up a tent wherever event organizers would have her — at the GoPro Games in Vail or World Cup ski races in Beaver Creek, for instance.
“I was just trying to cover my expenses,” Blake says.
She also got Eagle County — and, later, the state — to begin participating in the nationwide Cardiac Arrest Registry to Enhance Survival, or CARES, a voluntary reporting program that collects incidence data and is overseen by the CDC and Emory University.
“It still baffles me that contributing cardiac arrest data is a volunteer thing,” Blake says.
“Shocking” lack of action to save lives
In 2018, state Sen. Dylan Roberts, then a newly elected state House representative, took a meeting with Blake. He says their conversation demonstrated “the lack of action being done on a governmental level — and even a societal level. It was shocking.”
Together they passed a bill to mandate businesses’ acceptance of an AED if a third party, like Starting Hearts, was willing to pay for it. Before then, businesses had worried about liability if someone misused the device on their premises. This is one reason why you’re more likely to see AEDs at stores like King Soopers or Walmart.
Over time, Starting Hearts, with financial support from Vail Health, placed more than 200 defibrillators around Eagle County, everywhere from chairlifts to police cars to schools to shopping centers. (AEDs, which cost about $1,200 each and were not publicly available until the 1980s, are used in less than 3% of cardiac arrests, yet victims who suffer an arrest near an AED are twice as likely to survive.)
“Our robust defibrillator network is why we have some of the highest survival rates in the state,” says Will Dunn, the chief clinical officer for Eagle County Paramedic Services, who has lectured on cardiac arrest survival at national conferences.
House Bill 1251 isn’t perfect, Blake says. What started as a $2 million appropriation got whittled down to $200,000 by the time the bill passed — barely enough to support one full-time employee in addition to programming and administrative costs. “It’s a drop in the bucket,” she says, “but it’s something.”
Still, Roberts calls it one of his favorite bills of the more than 100 he has sponsored, because “it wasn’t driven by industry; we didn’t have lobbyists helping with this.”
There are signs that the cardiac arrest movement is cresting far beyond Eagle County or even Colorado.
When NFL player Damar Hamlin collapsed on live television in January, people accurately called the condition cardiac arrest and saw what it looks like — the terror — when a healthy person’s heart stops. (LeBron James’ 18-year-old son Bronny’s sudden cardiac arrest, and survival, during basketball practice at the University of Southern California on July 24 drew further attention.)
The new state office is still ramping up, but those at the Colorado Department of Public Health and Environment, which oversees the office, view their mandates as “a really unique opportunity,” says Amber Viitanen, the state’s emergency medical and trauma services section manager. “We typically focus on what happens to the patient after they’ve received care — is the care adequate? But now we get to start talking about preventing some of those situations and improving outcomes before EMS providers get there.”
Gaps remain: Colorado’s statistics are still drawn from just 79% of its population, because not every jurisdiction reports cardiac arrests (in fact, only five states in America report arrests across 100% of their populations). “It has to be addressed at the national level,” Blake says. “We can’t just keep tackling it from the bottom as a grassroots thing.”
According to CARES statistics, people are significantly more likely to experience a cardiac arrest in a public setting in Colorado than in other states, which can mean more opportunity for a bystander to intervene. Colorado’s survival rate is slightly higher than the national average — 11.6% to hospital discharge, versus 9.3% nationally. However, the Netherlands, a world leader in addressing cardiac arrest, has a 23% survival rate, which shows the potential.
Blake is devoting more time to her family now, hoping that the state office carries out her vision. But somehow her course never strays far from the event that shaped it. Last February, while skiing with her son and father-in-law at Vail, she stopped for lunch at Two Elk Restaurant, which sits at 11,200 feet. As they hiked up to the entrance, Blake said, “Whew, that’ll get your heart going.”
Then she glanced at a group ahead of them, just in time to see a man collapse.
Instinctively, she shouted, “Start CPR! Go get the defibrillator!” She rushed to his side, found him unresponsive, and yelled again, knowing an AED was posted next to the bathrooms, “Get the defibrillator!” A woman ran inside. Blake, her heart racing, popped her skis off, dropped to her knees, and prepared to start CPR when suddenly the man’s body convulsed. A few seconds later, he sat up, oblivious to what had happened.
“Are you OK?” Blake asked.
“Yeah,” he said, explaining that doctors had placed an implantable cardioverter-defibrillator, or ICD, in his chest a few weeks earlier — the same device that Blake and Schwartz now have. It’s essentially a pacemaker that shocks the heart if an abnormal heart rhythm is detected.
“Well, that just saved your life,” Blake told him.
Later, in an interview, she said, “I was so thankful I didn’t have to perform CPR. But I was so happy that I knew what to do.”
The man’s loved ones were, too.