Benefield: Cyclist’s friends knew CPR: ‘That’s the only reason I’m here’

John Mills had not ridden his bike since crashing two weeks prior.

His ribs were sore so he’d laid off for a bit.

But on Jan. 20, Mills, who is vice president of the Santa Rosa Cycling Club, decided to join a so-called “Friendly Friday” ride starting at Howarth Park.

He and his wife, Patty Graham, opted for the slower paced group, just to be cautious.

Graham rode directly behind her husband, to better keep “an eye on him,” she said.

They were barely underway, perhaps two miles in, when the group turned up Newanga Avenue and headed into Spring Lake Regional Park. Just past the entry kiosk, Mills, 69, went down.

“He just melts to the side,” Graham remembered. “Down.”

Guy Miller, a former lifeguard and swim coach who has performed CPR, by his estimate, eight times in his 68 years, said it was clear Mills was in distress, but he wasn’t immediately sure what kind.

“He was actually sitting up when I saw him,” Miller said. “But he was not responsive. Not responsive at all.”

Graham called for friend, fellow rider and vascular surgeon Loie Sauer.

“I turned and looked down the hill. I saw the faster group was coming up the hill and I knew Loie was with them. I said, ‘I need Loie here,” Graham said. “She appeared like an angel.”

Sauer, too, was not immediately sure what kind of distress her friend was in.

“I thought it was simply a bike crash. That is where my brain was,” Sauer said.

Then she saw Mills.

“He looked awful, he looked gray. He looked dead and I’ve seen dead,” she said. “He was making a terminal gasping noise.”

Mills, who had suffered a heart attack 12 years ago and undergone triple bypass surgery a year after that, was not having another heart attack. He had gone into cardiac arrest.

A heart attack occurs when not enough blood flows to the heart muscle, Sauer said. Cardiac arrest is a so-called electrical issue — when the wiring that tells the heart to beat gets screwed up.

“Cardiac arrest on the street almost always leads to bad outcomes because they don’t get help fast enough,” she said.

Mills was in dire straits but he was also surrounded by people trained to know what to do.

“His eyes were fluttering and he was panicking to get air,” Graham said. “I knew this was not good.”

Jan Smith Billing, another cyclist on the ride and good friend of Mills’, has decades of experience in coaching and high school athletics and as such, has had countless rounds of training in CPR.

But she’s never had to use it.

Smith Billing felt for a pulse. Mills had none.

“I said, ‘He needs CPR,’” she said.

Sauer began chest compressions.

Another rider ran to Sauer’s bike to get a CPR/mouth-to-mouth face shield she always carries. She began breathing into Mills’ mouth. Smith Billing took over chest compressions.

A doctor with decades of experience, many of them in trauma situations, Sauer had never done CPR outside a medical setting.

"I’m a seasoned healthcare professional and I felt that brain freeze and stress of a real life situation. I had to ignore my brain chatter,“ she said.

Other riders, there were probably 20 plus now, helped organize the scene.

Two riders had immediately called 911.

People moved bikes out of the road. Someone else directed traffic. Another ran to the park kiosk looking for an automated external defibrillator — AED — device.

Another still, went to comfort Graham.

David Levinger, the rider who had run to Sauer’s bike to get the face shield, found Patty and took her hand.

Graham, meantime, could not look at the unfolding situation.

“At this point in time, I’m not paying attention,” she said. “Every once in awhile I open an eye and know they are still doing CPR.”

Smith Billing, who had been doing chest compressions, turned to Miller for backup.

Miller, a former lifeguard who has done CPR on pool decks, gymnasiums and road sides, took over.

“I said, ‘Hey, I’ve done this before, I can take over,’” he said.

An ambulance arrived within 10 minutes.

Medics used an AED to try to shock Mills’ heart back into beating.

Nothing.

Then they put in an intravenous line, Sauer said. They “pushed” epinephrine, a powerful drug Sauer said was meant to get Mills’ heart going.

They shocked him again.

“I could hear all of this,” Graham said. “It was another AED then ‘OK I have a pulse, OK he’s breathing.’ And a shout went up from the crowd. It was like watching a movie, like I’ve seen this before, but usually it’s an actor, not my husband.”

Mills, for his part, remembers nothing of the day or his friends’ heroics.

When he toppled from this bike that morning, his head struck the pavement hard enough to destroy his trusty Bell helmet and also hard enough to give him a concussion and a brain bleed.

“Probably my biggest take-away is CPR works,” he said.

But it’s a skill that has to be not only learned but maintained, said Jenny Arrieta, regional communications manager for the American Red Cross.

Dramatic incidents like the one that befell Buffalo Bills safety Damar Hamlin who went into cardiac arrest and collapsed on live television in January, and that February is American Heart Month, has put increased emphasis on learning CPR and feeling comfortable with the use of an AED device, experts said.

Medical personnel administered CPR and restarted Hamlin's heart before taking him off the field in an ambulance.

“Even though it’s not hard, it’s a good thing to practice,” Arrieta said. “You want to refresh your knowledge and go through the physical motions.”

Mills has years of experience taking and refreshing his CPR training, including classes sponsored by the Santa Rosa Cycling Club.

“In my mind, we are taught and taught but we never really see it (in use). I have never even come close to using it,” he said. “I have had to deal with broken bones but never the Heimlich maneuver, or CPR stuff. Always in the back of my mind was ‘Am I doing this all for nothing?’”

“I know for sure now that it really works.”

Today Mills has a defibrillator implanted in his chest as well as a pacemaker.

And Mills has nothing but praise for his friends and fellow riders, as well as the Santa Rosa Cycling Club, for promoting safety and skills like scene management if a rider goes down.

“Enough people knew exactly what to do and how to do it,” he said. “I just can’t believe my friends were able to successfully do that and that we have created this little army of people who knew what to do.”

Sauer, for one, wants to make this episode a lesson for others.

For others to take and feel comfortable with CPR, to take a class on how to administer an AED, and for more public spaces to have AEDs readily available.

“I would love to be on a campaign with businesses and schools and churches to get AEDs. That is what really saved his life. CPR bought him time,” she said.

Mills, who spent two decades on the Sonoma County Parks & Recreation Advisory Commission, said he wasn’t “hit with a lightning bolt” to make his life’s mission to have everyone learn CPR and to have AED devices installed at park kiosks.

Then again, it’s probably not a bad idea.

All regional park ranger trucks have AEDs and all rangers are certified EMTs which includes CPR/AED training, according to a regional parks spokesperson.

The kiosk at the Newanga entrance was unstaffed on the morning that Mills went down.

Graham, who worked in the medical field, said she’s gone through countless CPR training courses, but seeing her husband lying lifeless in the road was too much that day.

“It’s possible that because it was my husband I was too stressed out to remember,” she said. “I tell you, the people that were there, it kicked in and they remembered, and they did what they needed to do. You gotta try.”

That muscle memory, that willingness to step in, that bravery in the face of a frightening situation is crucial to saving a life.

Mills is living proof that having that knowledge is lifesaving.

"Can a real life story actually encourage people to go learn CPR?“ he said. ”That’s the only reason I’m here.“

You can reach Staff Columnist Kerry Benefield at 707-526-8671 or kerry.benefield@pressdemocrat.com. On Twitter @benefield.