The Collinwood Observer

Cardiac Arrest after Curtain Call

UH rheumatologist saved by physicians in cast, audience at community play performance

The curtain had just closed on the community theater’s opening night performance of Macbeth when Elisabeth Roter collapsed. But the 57-year old University Hospitals’ physician and thespian who survived a cardiac arrest that night will always remember her good fortune to be in a theater – surrounded by bystanders who knew CPR – when her heart stopped.

And the “curse” of Macbeth means something entirely different to this mother of three who has performed on stage since she was a young girl.

In theater circles, the famous Shakespeare play is marred by a curse that even uttering the name “Macbeth” in a theater outside of an actual performance conjures bad luck. Legend has it that the actor playing Lady Macbeth died on the opening night of the Bard’s play in London in 1606.

To Elisabeth, who does not believe the superstition, the play could not be luckier.

“It certainly was good luck for me that this happened in the theater,” said the actress and singer, who began performing on stage at the age of 9 and acted in community theater until medical school.
Her son, Samuel, with whom she has performed in a few plays, was in the audience that night to see his mother in the role of First Witch.

A fellow cast member saw the Beachwood woman stumble and caught her, breaking her fall as she lost consciousness. They quickly called for back-up from medical professionals in the audience.

Michael Saridakis, DO, a UH family medicine physician who practices in Broadview Heights and Parma, was watching the play with his sister-in-law, an Akron-based emergency medicine physician. Her husband was in the play and summoned her backstage. Dr. Saridakis quickly joined her to see how he could assist also.

“I saw her on the ground, and they were attending to her,” he said. “While we were assessing her, she stopped breathing and we started CPR and called for the AED.”

While Dr. Saridakis checked Elisabeth’s pulse, another doctor performed chest compressions while a third physician began mouth-to-mouth resuscitation. When Elisabeth stopped breathing, he took over chest compressions while his sister-in-law, the emergency medicine physician, set up the automated external defibrillator (AED), which Ohio schools are required to have on site. The defibrillator jolted her heart back into a normal rhythm and she opened her eyes.

Bystanders performing CPR before emergency personnel arrive can double or triple a person’s chances of survival. Each year, more than 350,000 cardiac arrests occur outside a hospital setting where trained caregivers know exactly what to do. In fact, cardiac arrest claims more lives each year than colorectal cancer, breast cancer, prostate cancer, influenza, pneumonia, automobile accidents, HIV, firearms and house fires combined, according to the American Heart Association.

This is the fourth time that Dr. Saridakis has been involved in saving a life with CPR in a public setting. The other incidents occurred in his church, a restaurant and on a residential street.

“Oftentimes it happens with loved ones, and family members are right there,” Dr. Saridakis says of the 70 percent of cardiac arrests that occur at home. “We hear so many stories from patients, so we strongly encourage people to learn CPR. You actually can save a life.”

An ambulance took Elisabeth from the theater at Andrews Osborne Academy in Willoughby to UH Lake West Medical Center, the hospital where this physician maintains privileges. A cardiac catheterization was performed and a small defibrillator was implanted in her chest. She was discharged a few days later.

As a member of the Chagrin Valley Little Theater’s production and technical board, Elisabeth can personally attest to the importance of schools and theaters having AEDs. She urges people to know the location of the nearest AED at the places they frequent, and to learn CPR.

“You never know when you will need it,” says Dr. Roter, who has been a rheumatologist at UH for 22 years and sees patients in Mentor and Richmond Hts. “The faster you start CPR, the better off the person is, because you want to keep blood flow circulating so they will survive and not suffer brain damage. Even doing proper CPR without rescue breathing can be helpful. It’s enough to save people.”

About 90 percent of people who suffer a cardiac arrest outside a hospital do not survive. She is fortunate to be among the lucky 10 percent.

“Most people who have a cardiac arrest outside the hospital setting do not survive, because it’s not witnessed, or people don’t get there quickly enough, or they don’t know what to do,” Elisabeth says. “By knowing CPR, there’s a greater chance that lives can be saved.”

She’s also grateful she had an opportunity to fulfill a lifelong dream of performing in a Shakespeare play, one which had an unexpected but fateful ending for her.

“Doing Macbeth was a dream come true,” she says. “I always wanted the opportunity to do Shakespeare. And for this to happen right after the curtain call – the timing was perfect. At least it didn’t happen while I was driving or when I was at home asleep.”

The UH EMS Training & Disaster Preparedness Institute offers American Heart Association CPR and AED training classes. For an upcoming class near you, click here.