Preston Settles turned to a Brooks School teammate during a basketball game last Saturday with an unusual complaint, especially for a 15-year-old boy whose athletic résumé contains entries for hockey, football, soccer, and lacrosse.
“My heart feels like it’s spasming,” Settles told his friend.
Moments later, the Newton teenager collapsed on the gymnasium floor as his parents rushed to his side, wondering if their son had fainted or was having some sort of seizure.
“After a period of time lapsed, it was clear that neither one of those were the case,” said the boy’s mother, Lisa M. Owens, who is a doctor. “He stopped breathing.”
Settles remains hospitalized at Tufts Medical Center, where his parents are keeping vigil, bewildered by what caused their son’s heart suddenly to stop, and grateful for a series of seemingly random events that have given their son a chance to survive.
“This is a happy, healthy, smart, active kid who plays every sport,’’ said his father, Darryl Settles, a community activist, restaurateur, and developer in Boston. “And for this to happen — you just would never, ever think it a possibility. As least that’s what we thought.”
Preston was rushed from the Brooks School in North Andover to Lawrence General Hospital, where doctors shocked his heart eight times but could not get it to start again on its own. Doctors, a psychiatrist, and a hospital chaplain told the anguished family there was no hope left, and it was time to stop.
“The emergency room physician came back and said, ‘You know, his heart has started back up, and we think we should MedFlight him into Boston,’ “ said Owens, who is a primary care physician affiliated with Brigham and Women’s Hospital.
Preston was flown to Tufts Medical Center, arriving as the ER shift change was underway, a routine that means both the morning and night shifts of doctors are in the hospital for an overlapping hour. Settles said his son was in such extreme need, both shifts stayed to help.
“They said on a scale of one to 10, he was less than a one,” his father said. “It was just a coincidence that he had 20 professionals working on him for five and a half hours. It just doesn’t happen.”
When he arrived at Tufts, the high school freshman had been on life-sustaining equipment for 70 minutes and was hypoxic, meaning his oxygen level was at life-threateningly low levels.
“That’s when I met Preston,” said Dr. Haval Chweich, a pulmonary and critical care physician in the cardiac care unit. “He was extremely sick, his heart was extremely weak, and he was on a lot of medications to keep his heart pumping. And also his oxygen saturation was extremely low. It was in the 20 percent range. Basically, we cannot sustain life at that level.”
Chweich said the teenager’s perilous health status — along with the fact that he was an otherwise healthy teenager — led the medical team to deploy a machine not usually used in emergency medicine to take over for Preston’s heart and lungs.
“It was really kind of an extraordinary matter where we said, ‘Let’s take him on and see what happens.’ There was significant concern that his body or his brain had been damaged,” Chweich said.
Known by the acronym ECMO — for extracorporeal membrane oxygenation — the machine was connected through an artery in his leg to oxygenate and circulate his blood. ECMO machines, often used during planned open-heart surgeries, are not available in all hospitals.
“It’s a very serious procedure. To be frank, in cases like this, when somebody had a cardiac arrest for such a long time, and they had such a low oxygen level, it’s unclear to us whether a patient would be viable if we put a patient on this machine,’’ Chweich said. “But we decided to just give Preston everything we can and see if he would improve.”
By Friday, nearly a full week since he went into cardiac arrest, he no longer needs the ECMO to be a stand-in for his heart but continues to get mechanical assistance for his lungs, the doctor said. He is also on dialysis, his family said.
“He has kind of surprised us in pleasant ways, in that his recovery has been better than what we expected,” Chweich said. “But he is still in very critical condition and he has a really long way to go. We are hoping for the best.”
John R. Packard, headmaster of the 360-student Brooks School, said Settles has had an “incredible impact” on classmates and faculty in the short period of time he has been at the school.
“He’s only been here with us a half a year as a ninth grader,” he said. “We’ve just been wanting to do everything we can to support his family, his parents, and his sister. He’s just fun, positive, happy, upbeat, and engaging.… We’re looking forward to continuing to have him here. That’s the mind-set.”
Settles’ parents are hopeful as well. They said in a telephone interview Friday that their son has faced a series of new medical hurdles that have led to additional surgeries and forced doctors to deepen his sedation, anticipating it will accelerate healing.
His parents note that on Sunday and Monday when a slew of friends from elementary and high school visited, Preston briefly opened his eyes, seemed to follow voices as a person walked through the room, and clearly reacted when a close friend visited him.
“We definitely want people to continue to pray, pray for him to push him forward,” his mother said. “He is still in a very tenuous state right now. The message is hope. Our message is hope.”