Monthly Archives: November 2022

Pike Place Market

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I sat and ate a biscuit with a high cheese-to-dough ratio and a heavy pad of butter soaking into flaky perfection. It was my first true meal of the day. I was hungry and still having trouble believing I was on the US West Coast, having started my day on the US East Coast. The time change was confusing – the journey across the country was space and time travel. This biscuit shop was on the ocean edge of Pike Place Market in Seattle. Before arriving, I hadn’t known biscuits were popular in Seattle, but I was glad to find several biscuit shops as I wandered about the city.

The last time I’d been to Pike Place Market was in high school on a family trip. But, as all the places of family lore are, the market was familiar because my mother had told me about it many times. My parents met in Seattle. I’d lived there for several years before our family moved East, back to the coast of my grandparents. Pike Place Market is a place of fish stands and cute cafes. It’s full of people.

As I experienced the market for the first time on my own and as an adult, I was most struck by the maze that was the market and the perfect, stunning flower bouquets wrapped in parchment paper. I also liked the mosaic mural of North American birds. The mosaic bird mural reminded me of the bird murals in Harlem (where my sister lives). Per my sister, the bird murals in Harlem depict all the birds that will go extinct sometime sooner than I’d like. I wondered about the mosaic mural birds, would a day come when those birds (too) would only be found in murals?

I liked that Pike Place Market unfolded as a maze. It reminded me of Mercado Cuatro in Asunción, Paraguay. The markets share a maze layout, haphazard vendor stands, a huge range of goods, and people-filled walkways. Pike Place Market lacked the feral kittens that Mercado Cuatro had, but it had its own large bronze pigs with bronze pig hoofprints throughout the market. I followed the hoofprints for a bit. I decided the pigs were a good addition to the market.

I would later learn that the Starbucks in Pike Place Market was so busy because it was the founding Starbucks and people visited it for that reason. I was familiar with Starbucks because I’d worked there when I lived in Washington, DC. The Starbucks in Pike Place Market was much fancier than the one where I’d worked. However, I wasn’t inspired to stop at the first, ever, Starbucks. There were too many other places to choose from for me to pick a place I already knew.  I found a tea shop that sold crumpets (which I didn’t know existed outside of fairytales) and got an earl gray tea.

I was mildly disconcerted by the neon lights in Pike Place Market; they seemed a little aggressive for an enclosed space with so little wiggle room. I did like the nooks with tables and chairs and the scattered sculptures I stumbled upon when I rounded sharp hallway corners. I followed the hallways, stairwells, and odd steps until I thought I’d explored the whole market. I found the public bathrooms on both sides of the street. They were not striking, except that their stall doors were very short. A tall person could easily see over them.

I spent time looking out over the construction next to the market at the ocean. It was drizzling and cold, so I was glad I had worn my puffy coat. The waterfront was in flux. I’d later learn from a family friend that there used to be a highway between the market and the ocean. But, for many years now, they’d been slowly working toward reclaiming the waterfront. It’s funny how we call progress building roads and buildings, only to realize years later that beautiful park spaces are more important. I was glad that someday I’d be able to walk from the market to the ocean, but not today. This visit, there was no direct way because of the construction.

Once I felt that I had a good mental map of the market and had seen enough, I turned back to the city to explore its streets. Seattle was a home to me, but not a familiar one. It was a home of my distant past and the setting of early family stories. I wouldn’t have time to return to the market in the morning to watch them throw fish during this Seattle visit, but I knew I’d be back again. And I was grateful to have my own memory of the market. Lore-made memory to re-lived experience.

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Sometimes People Step Up to Be Heroes

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The patient sat with a blanket over their head. They were a little goofy and fairly expressed their distaste of their bed and various lines (IVs, urinary catheter, etc.). I didn’t blame them for not liking the hospital; nobody wants to get sick. The patient answered many questions correctly – they knew their name and their spouse’s name – but they couldn’t tell me where they were, why they were there, or what month it was. Yet, to see them sitting there alert and able to talk with me was a miracle that I was humbled to see.

The patient’s spouse and child had saved them. The patient had a cardiac arrest (their heart stopped) after going to bed one night. Their spouse noticed, pulled them to the floor, and started chest compressions. Sometime in that whirlwind, 9-1-1 was called and their teenaged child helped the spouse do compressions. The spouse and child did compressions for 45 minutes, just the two of them, until an ambulance showed up. Once the ambulance crew arrived, the patient received a couple of shocks and then, the patient’s pulse returned.

When I started as an EMT, my first medical experience, my crew chief told me cardiac arrest is death. All we can do is try to give the person’s whose heart stopped a chance at a cat life by doing CPR to pump blood while the heart isn’t pumping, delivering shocks (if indicated) to jumpstart the heart, and giving medications that sometimes help the heart restart. 

It’s important to realize that getting a pulse back isn’t the end of cardiac arrest. After getting a pulse back the main question is whether the heart stopped so long that the brain was irreversibly damaged by lack of blood flow. The likelihood of brain damage from lack of blood increases the longer the patient remains without a pulse. 45 minutes of CPR, especially CPR by non-medical people who don’t have access to a device that can deliver a shock, is a REALLY long time.

Most people won’t wake up after 45 minutes of CPR. But this patient did. They woke up and their brain was well enough to talk and move their body. It was too early to know if they’d fully recover to the mental state they’d had before their heart stopped. However, what was obvious when they woke up was that they were mostly there. Their brain had survived 45 minutes without a pumping heart thanks to their spouse and child.

When we successfully get a pulse back after CPR and the patient doesn’t immediately wake up, usually they are sedated and put on a ventilator (breathing machine) for 72 hours. This gives their brain time to rest after not receiving good blood flow. Usually after those 72 hours of rest, we decrease their sedation (medications used to put people to sleep while on a ventilator) and see how their brain is working. This patient underwent this process of sedation and then wakening after 72 hours.

It’s impossible to know exactly what the patient’s spouse and child felt as they waited those 72 hours to see if their loved one would wake up. What I can say from seeing them sitting at the patient’s bedside and sleeping in the hospital waiting room, is that the experience changed them. Once the patient woke up, the stress floating away from their family members was almost tangible. The spouse and child had saved the patient’s life; they had stepped up when the powers that be asked them to step up. They had given the patient a second chance at life. They were, by all definitions I know, heroes.