Now that I know what I’m without
You can’t just leave me
Breathe into me and make me real
Bring me to life
— Amy Lee
Before we lose a life in the hospital, clinicians must fight.
Suppose an expectant lady presents to the maternity ward with weak fetal heartbeats. We begin something known as intra-uterine fluid resuscitation, where the mother is given IV fluids, with the hope that it gets to the foetus.
Let’s say you have bled significantly regardless of the source of the injury. We replace the blood by giving blood or fluids that would remain in the vessels rather than freely distribute to other tissues. This process is known as resuscitation.
The most violent one is when your heart rate stops, which calls for cardiopulmonary resuscitation (CPR). It begins with the first ‘S’ — someone “shouts” for help. The second ‘S’ is safety. You must glove up and ensure you have a mask and, if possible, a sterile gown. Roles are quickly assigned. The most recent sequence of events preceding the cardiac event is quickly relayed, and interventions begin.
There will be someone to get blood samples for a quick analysis (blood gas analysis), another compressing the chest in an effort to massage the heart from outside and spring it back into action while another continues to give air to the lungs, either through a tube or a bag and mask or a combination of both. In case we get a rhythm but the atypical kind, we may need to shock the patient.
“CLEAR!”
The siren is sounded. The pads are positioned. The shock is delivered. The body jumps. Adrenaline is given. Repeat. After several cycles, the body can be yanked back to the world of the living. That is usually not the case. Others will have already crossed past the valve of no return.
The message from all these levels of resuscitation is — humans fight before they accept death. It is a tradition that surpasses what we observe inside hospitals, long before the development of CPR protocols. It started inside communities.
To better appreciate this tradition, we need to go back in time when we used to live in villages, before the reinforcement of concrete and steel to make solid homes.
Double crowds
(Wake me up) Wake me up inside
(I can’t wake up) Wake me up inside
(Save me) Call my name and save me from the dark
(Wake me up) Bid my blood to run
(I can’t wake up) Before I come undone
(Save me) Save me from the nothing I’ve become— Amy Lee & Paul McCoy
There were many wars before the two major ones in the early 20th century. Raids continue to date. In Kenya, it’s among the pastoralist communities. In the Nordic lands, it was between Viking clans. Wars are a staple of humanity. It continues to date, albeit in subtle ways, on our online platforms.
Wars pick strength from numbers. These numbers have characteristics consistent with a crowd as defined by Elias Canetti. The first quality is growth.
Before Alexander the Great launched a fatal blow to the Persian Empire, he travelled South, to Egypt. He converted the lands to follow Macedonian ways, recruited their army, then marched to Asia on a revenge mission. The Macedonian army grew.
The second is equality. Everyone on the battlefield feels a sense of equality as they fight for a common cause. The desired outcome is victory. Whether on top of an elephant, a horse, or a chariot, wars took the kings from their lofty palaces to the ground where they were united with the soldiers. On the battlefield, you either survived or were killed. That, too, was an equalizing factor.
The third is density. True crowds increase density. Armies organized as foot soldiers represented the very meaning of density. In troops, the infantry would occupy the unwanted gaps inside it. The density reinforces the sense of equality.
The final is a goal. Before that goal is attained, crowds will fight to keep themselves intact however they can. In an army, it is victory by completely demolishing the members of the other side. These are features of a single crowd. But Canetti introduces an interesting type — double crowds.
For double crowds to form, there must be minimal difference between the two sides. A classic example is between men and women.
One crowd fosters strength in the other. In Madagascar, Mirary was the dance women performed during war to inject strength in the men, regardless of the distance. Firmly believing the women were dancing, the men could be united knowing they had security because of their women’s efforts. Together, the density in the women cemented the density and the goal among the men.
For the Kafirs of the Hindu-Kush, the women performed their dance when the men were out on a raid. The Jivaros in South America would gather every night to dance as long as their men were out on a raid. The strength in numbers on one side created the needed support on the other.
In modern times, we see it in sports. Cheerleaders are usually female. They tend to support the males who are fighting on the field for victory. The more energetic the cheers, the more empowered the team will be.
Also, growth does not have to happen physically. It can be mimicked by the raising of voices and the stamping of feet. It’s one of the hypotheses around dancing, which involves the movement of feet, showing that the numbers are more than they actually are. These acts are a subtle form of resuscitation.
All these happen inside a common tribe. Outside it, another double crowd can form from two opposing sides. Consider a battle. One side may have men and women of equal number as the other side. Little difference. The presence of one strengthens the other, as nobody wants to betray their loyalty at this crucial moment. Thus, one crowd increases the equality, density, and goal of the other. United, both sides will fight to the bitter end, until one side registers victory. It could be several battles or a single one. But before either side admits defeat, they will put up a fight synonymous with the fight of the clinical team before losing a patient. This was how tribes resuscitated themselves.
However, there is another crowd. Humans are the only species that, to our knowledge, largely because of our sophisticated means of communication, believe in life after death. The dead are another crowd. And they have all four features of crowds.
They continue to increase in numbers, so they grow. First feature, check. It is always assumed that the space they occupy is central. They are never usually scattered. Thus, density is ever increasing. Second quality, check. Equality features in several ways. Christians await the final judgement. All are equal before God. Vikings await Valhalla, where they fight, die, resurrect, and celebrate every day. For the ones who die in jihads, a land with food and women awaits them. Equality, check. The goal is now united with the need to increase in number. And with every death in the life of the living, their numbers increase.
But the living will not give up easily.
Traditionally, there will be all forms of potions, medical herbs, songs, chants, incantations, and at the final stretch, wails, the pulling of hair, songs of sorrow, shedding of tears, and a final wish to the gods or God to spare one of them. This is the fight. The resuscitations that don’t end as well as we may have wished.
Unlike the two crowds between men and women, where there is minimal difference, the land of the dead continues to grow in numbers. The living will inevitably lose. But because they unite as a crowd, they will fight however they can. Today, we have achieved much success to the point of increasing the longevity of humans from the 20s to nearly four times this, so much that in most countries, humans are no longer called biological beings. We have been baptized a new name — social beings. Social is at the core of what it means to be a crowd.
Death can be so bitter as to plot revenge. When one of your sons or daughters (as Vikings had women fighting side by side) dies in battle, it is not uncommon to plan for a revenge mission.
When I was growing up (I still am), Friday nights were known for a popular themed movie airing on Citizen TV — Action Night. That is, Chinese or Japanese films heavily packed with fighting, hence the name. Most movies would either begin or end with a common theme. The son shows up before the main antagonist, with the usual schema:
1. A salutation
2. Ask if the antagonist knows who they are
3. Mention that the antagonist murdered their father or mother
4. The antagonist should be prepared to die
Death continues to foster unity in the crowd of the living in more ways than the mere plotting of revenge. Another way is through naming rites. I was given the name of my grandfather, Peter. The Agikuyu have a skip-generation pattern of the naming of children. My cousin, Maria, was named after my grandmother.
We also find qualities that have been passed down from one generation to the next. I, for one, like to think I inherited the vampire-like canine from my grandmother. Parents also see the faces of those who have gone in their grandchildren. These features are taken as a means to resuscitate the tribe, to keep the faith that they have not completely lost against the dead.
It is essential that the dying know that they were fought for. Families will bring healers famed for their abilities. The financially able will admit their patients to the best hospitals. And some will even consider alternative medicine if there’s a slight chance it will work. As Evanescence sings:
Don’t let me die here, there must be something more
Bring me to life
At work, we notice this practice every time. A daughter or sister will come with oil they believe possesses healing qualities. A priest will be called. Or a pastor. Basically a religious leader. Prayers will abound. And words of reassurance will be whispered, even if they may not be heard by the dying.
Meanwhile, the ICU team continues to fight from the clinical front. Inotropic infusions, ventilatory support, dialysis, corrections of acidotic blood pictures. Humans put up a fight as they used to back then before the health space advanced. In short…
What I’m trying to say is…
Resuscitation is a fancy word often thought to occur inside hospitals. This is far from the truth.
In the spirit of tradition, uttering the name of the dead is a means of keeping people alive. They say you die twice — once when in the grave, and the other time when people forget your name. Small wonder some tribes rename their children after the dead.
As long as we continue being a social species, resuscitation will never cease. If it does, it would be admitting self-defeat. Living organisms don’t admit defeat easily.
Resuscitation is the last resort of the living. As long as there is life, resuscitation, in whatever form, is here to stay.
This song inspired some of the lines used in this article. Source — YouTube