"The Afterlife of Debra Miller"

Debra Miller, a 36-year-old San Francisco business and estate attorney, was headed out of a downtown St. Helena hotel, milk and granola carefully balanced in her hands, to meet her new husband for the first day of their first real getaway trip after their marriage. They were looking forward to a glorious April Saturday of Valley touring when the totally unexpected happened. Debra, who had only three weeks before run the Paris Marathon, collapsed with a pulmonary embolism.

"I'd seen people who looked like she looked," said her husband, Mike Dobler, "and they were all dead." As the former ski patroller looked at his wife's dilated pupils, he knew he didn't have time to wait for an ambulance. If she was going to survive, he had only minutes to get her to a hospital with a crack team that would make no mistakes. He called 911 and got directions to St. Helena Hospital.

Emergency physician John Boright, MD, and cardiology specialist James Lies, MD, were there. Lies pronounced the diagnosis: Coach Class Syndrome (forming of blood clots following a long period of not sufficiently moving one's legs). Debra, who had virtually no vital signs and had to be sustained by CPR, had a 20% chance of surviving the surgery that would have to be performed immediately-and a 2% chance of emerging without significant brain damage.

"Three things told me she was going to die," said Mike recalling his reaction to the grim prognosis, "Dr. Lies, Dr. Jones [who performed the surgery] and my own experience." From the parking lot where he paced, Mike called Debra's sister, Elizabeth Miller, a cardiothoracic surgery resident in South Carolina. Elizabeth asked her co-worker to pack a bag for her, and include a black suit because she was almost certain she'd be flying to a funeral. ER nurse Melissa Davis, recognizing the important difference emotional and mental support from Mike could make, led the stunned young businessman by the hand into the ER, urging him to coach his wife to hang on. Soon St. Helena's surgical team got to work. Debra underwent immediate surgery, and the miracle happened. She not only survived, but she lived with no after-effects of the pulmonary embolism.

On August 23, 2001, Debra Miller returned to SHH to meet the caregivers who brought her back from almost certain death. She never knew who had given her the precise care during those critical hours. Now as she met for the first time the nurses who had performed CPR for nearly an hour-it was clear that this was an important moment for Debra.

Over a celebratory lunch Debra and the ER staff and doctors who saved her life swapped stories about their experience of that memorable day. A mere four months after her surgery, Debra was back practicing law, as sharp and vivacious as before. A small cheer went up when she reported that, just three months after surgery, she was running again for short periods, building up her runner's aerobic capacity.

Besides bringing closure to an amazing chapter in her life, Debra had another purpose for returning to SHH. Back at home recovering, e-mails from workaholic friends flooded in and Debra began to realize how one person's health touches many others. "A lot of my friends have revised their priorities," says Debra. "When I got home, I got all these e-mails saying, 'How could this happen to you? You're the most fit person we know!'" But one e-mail- from a relative-chilled her. Debra's cousin had died of a misdiagnosed pulmonary embolism. Twice her cousin had been to the emergency room in her Ohio hometown, and twice been sent home without treatment.

"I want to turn this experience around, into something that will have a lasting effect," explains Debra. "I know I can't fix everything. But if I can provide something that will benefit people even beyond St. Helena-like my cousin-and combine that with recognition for St. Helena Hospital's excellence, that's what I want to do."