From flatline to full life

Photographer Laurence Salzmann was saved by Becker’s cooling technique after his cardiacarrest in 2009. This photo is from his 1974 series, entitled “La Baie / Bath Scenes.”

Dr. Lance Becker is an international leader in bringing the dead back to life. 

Becker, chair of emergency medicine at Northwell Health, has devoted much of his career to advancing the science of resuscitation. 

Becker was one of the first doctors to pioneer the use of automatic external defibrillators (AED) in emergency medicine and saw the need for this kind of life-saving technology in public spaces. An automatic external defibrillator  is a device that uses electrodes to generate an echocardiogram, a visual representation of a person’s heartbeat, which it then interprets in order to deliver an electric shock that can ultimately save a life. 

Today, millions of AEDs can be found in a variety of public settings such as airports and schools. The effects of the use of this technology can be seen in emergency rooms all across the country and in the homes of the patients and families they’ve helped to save.

“I remember when we put the automatic external defibrillators into the airports of Chicago. I got a note, written in crayon by a 4-year-old that said, ‘My grandpa is alive because you put a box in the airport, and I wanted to thank you.’ Becker recalled the note fondly, “…for a very long time I kept that note. That was one of my early attempts to change the way we did things.”

Inspired by the innovation already around him, Becker began re-examining and redefining the limits of medical technology. “I’ve been doing this for many years and so I saw the remarkable, life-saving change that automatic external defibrillators brought to people,” Becker said.

Becker set out to improve resuscitation in other ways. Until the last decade, a person who suffered cardiac arrest could only be revived after five or 10 minutes of no blood flow. But all too frequently, the patient was considered brain-dead and beyond saving. Becker and his colleagues are developing a new technique that promises to extend that window of time of 20 to 30 minutes. The new therapy is personalized and can be molded to fit the needs of different patients. It involves using a number of interventions at once, including cooling techniques, drug cocktails and extracorporeal membrane oxygenation machines, which stand in for the functions of both the lungs and heart, all combined to restore life. 

Becker’s methods are focused on two goals, which include protecting the brain and restoring the heart. “As part of the therapy, we lower the temperature of the blood to around 33 degrees (91.4 F) from around 37 degrees (98.6 F),” said Becker. “People have found that is very, very protective for the brain and we use that as part of this therapy.” 

“Cooling,” as Becker calls it, in combination with a drug cocktail, is used to preserve the brain as life begins to dwindle. Preservation of both the brain and heart are essential to not only restoring life but reducing the impact that medical trauma can impose on the quality of life.

While all this is happening, the extracorporeal membrane oxygenation machine acts as an artificial heart and pair of lungs. The same kind of machine is used every day for cardiothoracic surgery all over the world.

About ten years ago Becker’s technology helped to save the life of Laurence Salzmann, a photographer and  filmmaker who has walked very closely at death’s door. Salzmann, who suffered a cardiac arrest, was placed under an induced coma and cooled, or as he described, “put on ice.”

“Any event where you have a major health crisis makes you extremely aware of just how fragile and how momentary our lives are,” Salzmann said. With the help of  Becker’s cooling methods Salzmann beat the odds and went from his flatline back to his full life.

Becker’s drug cocktail is still in its preliminary stages, but he and a team of Northwell Health doctors and scientists are working to perfect it.

In the meantime Becker’s cooling technique is being implemented in hospitals all over the world helping to save lives that he will never personally touch. But receiving credit doesn’t matter much to Becker. He is driven by a  genuine passion to save lives.

“Truthfully, the cases that keep me up at night are the ones that don’t have a happy ending,” said Becker, “and I think about those a lot.”