Author’s Note: I write this having suffered an anoxic brain injury. Cardiac arrest stopped my breathing for 11 minutes, and another four times on the way to the hospital. Years ago, this was called brain damage, but now the softer sounding phrase is brain injury.

The weather was unseasonably warm on January 11, 2018. My wife, Lisa, was taking down Christmas lights outside of the house. I was going for a quick run, just four miles. I would be flying to New York the next day to join my client for his most important trade event of the year.

I went for my run, and as had been happening recently, I kept having to stop to catch my breath. Any runners reading this knows how very frustrating that can be. Running wasn’t something I just started. Several years earlier I started walking, and then running short distances. When I ran a mile, I discovered I loved running.

That led me to run several 5Ks, 10Ks, two half-marathons and one full marathon. To be very clear, I was never fast, and my marathon time was terrible. As some say, I’m not fast, not last. Other runners remind me that regardless of the time, just completing a marathon means I can call myself a marathoner. The spring after my one and only marathon, I decided to start marathon training again to redeem myself. I had only been running short distances for a few months after the marathon to let my body recover. Most runs were four to five miles, and sometimes on a weekend I’d run seven or eight miles. Still, I’d need to walk for a minute off and on to catch my breath.

Most serious runners who are struggling evaluate everything they can to improve. That includes diet, sleep, running form, shoes, weather, and a long list of other things that might be the cause of poor runs. My primary doctor recently retired, and I found it surprisingly difficult to find another doctor who could see me in the next month. Any doctor who was accepting new patients had a wait list of six to nine months.

I went to an urgent care, and the doctor who owned it agreed to become my primary doctor. At the urgent care visit I requested an asthma inhaler. I had been diagnosed—or misdiagnosed—years earlier with exercised-induced asthma. My new doctor prescribed the inhaler but required me to come back in two weeks for further evaluation. The inhaler didn’t help at all. So I had an ECG, echocardiogram, and pulmonary function test. Everything appeared fine. I was told I had the lungs of a competitive swimmer. I shouldn’t be short of breath, but I was.

My doctor, still new to me, said he could not rule out my heart as the cause of my shortness of breath, so he ordered an exercise stress test. It was September 2017. I was somewhat surprised, since I was continuing to run, even though poorly. I didn’t realize someone with a serious heart condition would be able to run, but I’m not medically trained.

I received a letter from the facility that was to perform the stress test. It included information such as what to wear, what to expect, and the duration of the test. A few days prior to the stress test, I received a letter from my health insurance company, which stated, in part:

“Based on the review of the information provided to us, the service referenced above is not medically necessary.

Our physician consultant concluded the following: We cannot approve this request. Your doctor told us that you have trouble breathing. Your doctor ordered a special heart test. This test measures blood flow to the heart. This test should be used if your doctor is looking for a condition causing blood vessels in the heart to become narrowed or blocked and you are at moderate or high risk for heart disease. For this reason, this test is not medically necessary for you.”

It’s come to light in recent years the depth of corruption behind these denial form letters. Was my health insurance company putting profit over patients? Or was my new doctor, though highly respected, ordering a test unnecessarily? Back then, I didn’t know who to believe. I do now.

There is a detailed and complex process to get a denied test approved. Let me be clear. If my doctor, an MD, couldn’t convince a heath insurance company to pay for a test, it’s pointless to think I could call a customer service number and demand a test. On what grounds? That I want one? They already had orders from a medical doctor, so any action I’d take would be a waste of time.

I called my doctor’s office and asked them to send more information to the health insurance company. I made a series of calls and sent messages in the doctor’s patient portal. My doctor’s office responded and took action. It wouldn’t matter anyway. The health insurance company had closed this request.

My doctor tried another route and insisted I needed a stress test. He referred me to a well-respected local cardiologist. When that cardiologist’s office called me to schedule an appointment, they asked about my stress test results. I explained that I hadn’t had one yet. They shared that there was no point in meeting with the cardiologist without a stress test, otherwise, it’s a useless appointment—just a meet and greet. They told me to schedule an appointment once I had a stress test.

So, on January 11, 2018, I went for my run, frustrated that I kept having to walk to catch my breath. I’d learn after the fact that I was having a heart attack during that run. I had no chest pain, and no indication that I should be concerned. It was no different than the previous 100 runs. If you told me I was having a heart attack, I wouldn’t have believed it. I felt fine.

Once my run was over, I reached my street and started to walk home for my cool down. Running pumps a lot of blood up to your brain, and once I started walking, much less blood was making its way to my heart and brain. I felt very dizzy all of a sudden. I considered lying down on my neighbor’s grass, but was wet, and I didn’t want to get muddy. Besides, if you want to improve, you need to push yourself, right? If I did so, I would have died there.

When I walked in my back door, Lisa was in the kitchen. She asked about my run, and I was annoyed that it was bad. I told her I thought I had low blood sugar, and that I was going to make a smoothie before I took a shower.

I put quite a few ingredients in my smoothies. I don’t remember why but that day I decided to cut fresh fruit instead of using frozen fruit. I had no idea that in less than 10 minutes, I wouldn’t be breathing. Fresh fruit and so many other things would no longer matter.

My wife went to the basement, and I went upstairs to take a shower. By this point, the dizziness increased, and I cut my shower short—not something you want to do after a run. I had to hold on to the shower bar, then the vanity counter, just to make my way to the bedroom floor where I lay down. I called my wife and told her I thought I might need to go to the hospital. We had been married 29 years, and neither of us ever said that to the other. Plus, we just had a short conversation 10 minutes earlier, so it was understandably odd to her.

Lisa ran upstairs and asked if I wanted her to call an ambulance. I said no, but I had no strength to stand up either. Instead, I asked her to get me a pair of shorts. I was only wearing underwear. It’s ridiculous to think now that I was inches from death’s door, yet when she handed me a pair shorts, I said, “No, not those shorts.” In a minute, that wouldn’t matter. We talked for 10 more seconds, and I turned blue.

Of course, this next part was told to me. I wasn’t conscious for it.

My wife called 911. She was previously trained in CPR because she worked at a school. They tried to guide her in chest compressions. She did them, but was hysterical at the same time.

The 911 operator told my wife she needed to leave me to open our front door. She didn’t have a choice. She ran downstairs, opened it and turned on the front lights as instructed. A police officer arrived first. He gave me chest compressions with the goal of Return of Spontaneous Circulation (ROSC). That’s when a victim’s pulse returns and they are breathing on their own. I still wasn’t breathing.

When paramedics arrived, they used a LUCAS (Lund University Cardiopulmonary Assist System) device. It gives perfectly timed chest compressions to someone in cardiac arrest. Despite those efforts, still, no spontaneous breathing.

As a last ditch effort, paramedics used a small drill to inject a large dose of epinephrine below my knee cap. The outcome is either the restarting of the heart or death. After 11 minutes without oxygen, I’m glad to say it restarted my heart.

While enroute to the hospital in the ambulance, I stopped breathing four more times. Who knows for how long, but it’s safe to say, it’s not good for your brain.

As of this writing, only 9% of people survive Out of Hospital Cardiac Arrest, or OHCA. I was fortunate to survive, especially after so long with no oxygen.

I would soon find out that I was a living miracle, but that miracles can have aftermath.