A mother’s message: When athletes collapse, think heart first

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AT LEAST ONCE a month, Jewel Upshaw gets a notification on her phone and braces herself. She’s part of several online groups that share news about sudden cardiac arrest, and when someone tags her, she knows it has happened again.

Then she looks to see if the person lived or, like her son, Zeke, died.

The alert she received on Feb. 11 involved a professional hockey player, Jay Bouwmeester of the St. Louis Blues, who collapsed on the bench during a game. He was revived. When Jewel went to read about it, the article had a video, but she couldn’t watch. “That’s too hard to do,” she said.

The scene of a seemingly healthy athlete collapsing, the medical staff rushing to his side, teammates and opponents worried and dumbstruck, was just too much like what she saw when Zeke Upshaw fell to the court while playing for the Grand Rapids Drive of the NBA’s G-League two years ago this week.

In the case of Bouwmeester, 36, EMTs saw he was in cardiac arrest and immediately began CPR. Another mother was spared Jewel’s loss.

“It just takes me back,” Jewel said. “It’s bittersweet. I’m so happy they recognized it and saved him. [But] my heart immediately goes to sadness because it wasn’t that case with Zeke.”

Upshaw dropped to the floor with less than a minute to go in the Drive’s game against Long Island. It would be seven minutes before paramedics conducted CPR while en route to a hospital. ESPN

ON MARCH 24, 2018, the Grand Rapids Drive played the Long Island Nets in the last regular-season game, and there was a playoff berth on the line. Zeke, a shooting guard from Chicago, had played at Illinois State University and then as a graduate transfer at Hofstra. His 3-point shooting entering the season finale was 40.9%, enough to make him a credible contender for the NBA’s summer league, where every team would be able to see him.

Even if he couldn’t get the call to the league, he might have received a chance to play at a higher level in Europe.

He had a solid game that night, scoring 11 points in 29 minutes. With less than a minute left, the Drive led 100-97. Long Island inbounded the ball with 47 seconds to go. Along the baseline, away from the ball, Upshaw dropped to the floor, face down, palms up.

No player on the court seemed to notice immediately. Then one opposing player reacted. Then another. Then the referee blew his whistle. About six seconds after Upshaw collapsed, a team doctor and trainers sprinted to the corner of the court where he was lying.

In video of the incident from two angles, we see what happens next: The Drive’s assistant team physician and trainers from both teams say something to Upshaw while huddled over him. They ask for someone to get a towel to place under his head. But no one can be seen checking Zeke’s pulse. No one turns him over. No one can be seen checking to see if he’s breathing.

Two minutes after the collapse, two EMTs, seemingly unhurried, walk their stretcher onto the court. Seven minutes after the collapse, the paramedics begin CPR in an ambulance, according to their report, but Zeke’s heart did not start again until he was at the hospital, about 40 minutes later.

About 1,600 miles away in Henderson, Nevada, Jewel had been watching the game on a Facebook stream. So was Zeke’s girlfriend, Julia Turner, whom everyone referred to as his fiancée because he was going to propose after the season. Jewel saw Zeke was down. Then Julia called her, screaming. They saw the messages scroll by on Facebook: Prayers for Zeke. Say a prayer for Zeke. Jewel was straining to see her son. All she could tell was he wasn’t moving.

Jewel and Julia got the first flight they could from the Las Vegas airport, a Delta flight that left at 12:30 a.m., connecting through Minneapolis. Six hours of holding each other and crying with little information. At the hospital after a sleepless night, Jewel saw Zeke and realized the situation was as bad as she feared.

You almost couldn’t see his face, there were so many tubes connected to him. His brain was swollen, she was told. Jewel convinced herself that if they wrapped his head it would somehow help the swelling. Mercifully, uselessly, someone wrapped Zeke’s head in gauze so Jewel would have something to hope for.

The head of cardiology came to speak to Jewel, a conversation she remembers only in pieces. But she remembers what the doctor said: “There’s no coming back from this.”

A day later, March 26, Jewel made the decision to disconnect her only child from the machines. The 26-year-old who thought he might have a shot at an NBA roster, who was planning to get married, was gone.

The funeral was on the South Side of Chicago, where Zeke grew up. He was a success story, raised by a single mother, the neighborhood kid who got into a top academic high school and earned a college basketball scholarship. There must have been a thousand people there. An alderman spoke. Arne Duncan, the U.S. Secretary of Education under President Barack Obama, was there, because he knew Zeke as a fellow alum of the University of Chicago Laboratory Schools.

Zeke’s coffin was placed in a crypt at the legendary Oak Woods Cemetery on the South Side. You can see Jesse Owens’ grave from the building where Zeke rests. Jewel is proud of that.

After the funeral, after she flew home to Nevada, Jewel forced herself to watch the video of what happened, from the time Zeke collapsed until the EMTs arrived and the cameras panned away.

The video pulled something out of her grief and confusion that was more direct. As she watched the apparently confused reaction of those around her motionless son, she felt rage.

“I’m screaming at the [screen], ‘Somebody, anybody, go to his aid!’ They were around him, but it’s like they were trying to figure out what’s going on. No one’s touching him. No one’s pumping his heart. Mouth to mouth. Do something.”

Jewel Upshaw speaks at a news conference two months after her son died. She has since settled a lawsuit with the NBA for an undisclosed amount and is in the process of suing others over her son’s death. AP Photo/Seth Wenig

ESPN SPENT MONTHS going through Zeke Upshaw’s medical records. The picture that emerged was muddled. More than a dozen experts in cardiology and emergency medicine couldn’t agree on what led to his heart attack or even what underlying genetic heart disease afflicted him.

In its report, the Kent County Medical Examiner’s office in Grand Rapids identified a disease called arrhythmogenic right ventricular cardiomyopathy (ARVC). But several other top cardiologists said they were convinced Upshaw had a similar disease, hypertrophic cardiomyopathy (HCM). There was no evidence of drug use or any other mitigating factor.

Between November 2016 and March 2018, Upshaw went through three different heart screenings. Two were routine tests required by the NBA and one followed a fainting episode in 2017 — nine months before he died. An unexplained fainting episode, experts say, can be a harbinger of a larger cardiac problem.

Upshaw’s episode happened while he was working out at a Las Vegas gym the morning of June 21. By 6 a.m. that day, the temperature outside was already 106.

Karlton Grant, who runs the gym, said Upshaw was doing a drill with several other players: drive the ball toward Grant, make a move, then get past him. As Upshaw passed, Grant turned to look at the next player.

“We heard this noise. He just hit the floor super hard, like he knocked himself out, that’s how hard it was,” Grant said.

Grant turned to see Zeke unconscious, foaming at the mouth, convulsing. He estimated that Upshaw was unconscious for 10 to 15 seconds. As they talked about calling 911, Upshaw came to.

“He didn’t say anything. He was just more like in shock mode, like, ‘did I really black out?'” Grant said. “We were thinking it was because it was hot. … I wouldn’t think it was something to do with the heart.”

They gave him a sports drink and a granola bar, and Zeke called his girlfriend. “He said, ‘Baby, I fainted like 30 minutes ago. I’m fine. I just want to get checked out. So, please take me to the hospital.'” Julia Turner said. “I was like, ‘What happened?’ He said, ‘I think I was dehydrated.’ He looked fine. He was normal, like nothing happened.”

Upshaw stayed in the hospital overnight for observation. The hospital report has several references to possible dehydration, but a blood test showed something else: elevated troponin, a protein released into the bloodstream when the heart is damaged.

The next morning Zeke was discharged. Among the instructions on his discharge papers: “You may resume your normal activities when you are feeling back to normal.”

On June 23, Upshaw had an echocardiogram. The report identified his heart as having “left ventricular cardiomyopathy,” a thickening of the heart wall.

But even in hindsight, the indications were unclear. Some thickness in the left ventricle is not uncommon in athletes. The more you use the muscle, the thicker it can get, which can lead to a benign condition known as “athlete’s heart.”

Martin Maron, a cardiologist and the director of the Hypertrophic Cardiomyopathy Center at Tufts University Medical Center in Boston, reviewed all of Upshaw’s medical reports, including his three echocardiograms, at ESPN’s request. He also asked one of his partners to review them. Both agreed there was nothing in any of those screenings to indicate heart disease.

“It wasn’t even a close call,” Maron said.

According to hospital records, as well as Jewel Upshaw, Julia Turner and a hospital employee, Upshaw was told he could return to activity when he felt ready. Jewel Upshaw and Turner said they don’t believe Zeke knew he had a heart condition.

“If he knew he had a problem he wouldn’t have played. He would have told me,” Jewel said. “They said he was cleared to play in a couple of days. He told me everything. Julia, too.”

ESPN spoke to all but two of Zeke’s Drive teammates. All said he never mentioned the fainting episode or expressed concerns about his health.

“No one ever heard about it,” said teammate and close friend Kenneth “Speedy” Smith. “I’m sure no one knew anything of it.”

MARON ALSO REVIEWED two videos of Upshaw from the night of his collapse, one from the game broadcast and one shot by a fan. He was among 15 of 17 medical experts ESPN interviewed who said they could find no reasonable explanation why team medical personnel and the EMTs at no point in the video can be seen checking Zeke’s pulse. No one appears to check if he is breathing. No one turns him over. No one uses a defibrillator that can be seen on the stretcher.

“The first thing you have to be thinking in this situation is, could this person be in a cardiac-arrest situation? And the way you would know that is you would take a pulse,” Maron said.

Watching the way Upshaw suddenly went to his knees and then facedown on the court, Maron said it’s unlikely Upshaw felt anything. He lost consciousness immediately. Some people who go into sudden cardiac arrest and are revived don’t have any memory of it.

According to interviews with ESPN and in the medical examiner’s report, players said the medical staff told them they asked Zeke if he had hit his head — his lip was bleeding — and that he replied, “Yes.” If the medical staff thought they were dealing with a head injury, that could explain why no one checked for life signs.

Maron, again reflecting the majority of the experts ESPN interviewed, said he can’t say for sure whether Upshaw could have responded to questions the way the medical staff described.

“It’s difficult for me to imagine that he is having a conversation. I certainly don’t see evidence of that on the video, though it’s hard to say for sure,” he said. “Knowing the nature of the cardiac arrest that he’s experiencing and the fact that he’s so motionless here that makes it really to me seem unlikely.”

It’s possible, he said, that Upshaw was making noises that the staff mistook as responses. People in cardiac arrest often emit a gurgling sound as the lungs struggle for a while to get air. It’s known as “agonal breathing.”

One of the first responders was a veteran 55-year-old paramedic who was honored by the American Heart Association in 2015 for helping to save a heart attack victim. The other was 22. Based on the ambulance report and the autopsy, they had been told they were dealing with a concussed player.

Maron said it was difficult to explain why no one checked Upshaw’s pulse or why CPR was not started for seven minutes, according to the paramedics’ report.

“Obviously, I can’t speak for the first responders that were there,” Maron said. “They may have had a different assessment of things when they arrived on the scene. Based on the video that I saw, to me, it’s hard to understand how CPR wouldn’t have been started earlier.”

The senior paramedic did not return messages seeking comment. The younger one, reached by phone, declined. A spokesman for their employer, Life EMS, also declined comment.

There is no guarantee a defibrillator would have saved Zeke Upshaw. Maron said some patients with heart disease can be difficult to revive because the abnormal thickness of the muscle deflects the charge from the defibrillator. But, he says, it would have improved his chances.

In quiet moments, Jewel Upshaw finds herself overwhelmed. “I’m trying to stay on course,” she says. “Anytime I can talk about this silent killer, I do. I don’t always cry. I do try to educate.” ESPN

JEWEL UPSHAW’S LAWSUIT against the NBA was settled last July for an undisclosed amount. She’s still in the process of suing the companies that own the Drive and their arena, and Life EMS, the company that provided the ambulance and the paramedics. Those parties have declined to comment.

Jewel and and Julia Turner remain close and live not far from each other outside of Las Vegas. Jewel created the Zeke Upshaw Foundation to educate schools and athletic organizations about sudden cardiac arrest. She is focused on spreading the message that if someone collapses, assume it’s a heart issue. Try CPR. If there is an automatic external defibrillator, use it. It won’t hurt someone who has a normal heartbeat.

But in quiet moments, she quickly finds herself overwhelmed.

“I’m trying to stay on course. Anytime I can talk about Zeke, I do,” she said. “Anytime I can talk about this silent killer, I do. I don’t always cry. I do try to educate.”

And her phone keeps buzzing with notifications, sometimes once a week, about someone like Bouwmeester.

“More recently I got something about a couple of high school students,” she said. “It’s at least once a month. And those are just the ones I hear about.”

ESPN’s William Weinbaum and Mike Farrell contributed to this report.

Source: espn.com

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