From Provider to Patient: A Flight Paramedic's Story of Aortic Dissection
By Jason Bazelow
“He’s dissecting” are the words Amy will never forget. She dropped what was in her hands and ran off her unit. I sat quietly in the background. My nurse barely reacted to the phone being slammed down; she was too busy to care. In the background people buzzed about in a hurry. I sat quietly, trying to remain calm, hoping she would make it across the campus in time.
In December 2023, a routine echocardiogram revealed that I had an ascending aorta that measured 5.2cm—well past the normal width of 3cm to 4cm. This finding led to an immediate referral to cardiothoracic surgery, where a computed tomography angiography (CT-A) scan of my aorta was ordered to confirm the presence of an aneurysm.

Ascending aortic aneurysms (ATAA) are a life-threatening weakening of the aorta under pressure, which can lead to blood leaking between the layers, peeling them apart and causing pain, further weakening, and increased mortality. While many aneurysms stay stable, others deteriorate immediately. Left untreated, the aorta, which has a large intrinsic volume and pressure, can rupture, leading to immediate death. As a critical care flight paramedic, I have transported countless aortic aneurysm patients. Many of them have been stable enough to enjoy their first flight, while others have deteriorated long before we landed.
The surgeon reassured me that their transverse plane measurements indicated a width of 4.4cm, not 5.2cm as previously thought. According to ACC/AHA guidelines, elective surgery is typically recommended only when the aneurysm reaches 5.5cm due to the elevated risk of mortality.
Confident that this would not be an issue, when I experienced acute chest pain three weeks later, I did not consider my aneurysm. I assumed it was my normal reflux, hitting me stronger than usual. In the moments that followed, I did what anyone who works in medicine would do. I took my normal GI cocktail and waited to see if it got better, and it did.
That night, I felt colder than I ever had in my entire life, my chronic back pain unrelenting. Amy laughed at how many blankets I had piled on top of me and joked, “You’ll be fine.” Knowing she had to work in the neonatal ICU in a few hours, I moved to the couch so she could sleep. In the morning, I followed her to the hospital on my own. The ED staff quickly assessed me; vital signs,12-lead ECG, and 325mg of aspirin, all routine. Everything choreographed, so nothing was missing.
After returning from an emergent CT-A, my nurse wanted a second intravenous (IV) line. She moved more quickly than before, dodging my questions. Over In the NICU Amy answered her phone, confused. Initially hesitating, the nurse finally told her, “He’s dissecting.” Amy yelled to her coworkers and ran off the unit. The realization of my own pigheadedness the night before hit me hard. I was suffering from a type A dissection, which occurs near where the aorta leaves the heart; type B dissections involve a tear in the aorta after the arch. Both may extend into the arch or abdomen. Overall, the more of the aorta involved, the higher the mortality. Mine began below the sinotubular junction, extending through the arch and the right brachiocephalic artery.

Amy appeared a few minutes later. I tried to hide my trepidation as she stepped through the doorway, her eyes brimming with turmoil, skin as pale as my own. My nurse worked feverishly, shaving me from neck to ankle while others titrated doses and compared notes.
“When I said I wanted to try new things, this isn’t exactly what I had in mind,” joked Amy. My children rushed through the doors a short while later, beating the cardiothoracic team who were on call. It was hard to know where to step over, under or around. My youngest wrapped herself around me—“I’m so sorry.” My oldest said, “I love you daddy.” My son hardly said anything, everyone’s eyes pink from crying.
We hugged, held hands and joked at my expense as the shaving continued. Would this be our last time together? Would I be able to walk my daughters down the aisle or see my son live out his soccer dreams? Tears were occasionally filled with laughter. For a moment it felt like this would be a little more than an unscheduled inconvenience. Amy’s kids waited at home and were on the edge of their seat a few miles away.
At 12:56, almost 18 hours after the initial insult, my predicament evolved again. A wave of heat swept over me, followed by intense sweating and nausea. The little bit of color I was desperately holding onto washed away. My pain, controlled until then, became unrelenting. I knew what was happening but bit my tongue; a sense of doom permeated my senses. “I think we need to get moving,” I said as calmly as I could. My son stared at Amy, expecting her to be able to do something. His voice painfully cracked like a whip through the air, “What are you doing? Do something!”
I was hypotensive and bradycardic. The Esmolol and Cardene were halted. My cardiothoracic surgeon called the OR before heading out ahead of us. He stopped: “The next time you see him, he will be sleeping with a tube in every orifice of his body. Do you have any questions?”
Amidst the flurry of activity, I hugged my kids one last time and said goodbye. Suddenly, the bed railings were slammed and locked in place. I looked back to see the tears flowing from their eyes as we rounded the corner.

Amy, still in her hospital scrubs, camouflaged herself amongst the ED staff, her hand indistinguishable from mine. We traversed the halls, the wheels of the IV pole screaming to keep up, any bump or change in inertia causing our hands to clench tighter. One bump hit so hard; everyone’s eye turned upon mine as I clenched my chest. We all expected that one to be the last. Once off the elevator it was now time for us to say goodbye. We held on tightly for as long as possible. I could still feel the weight of her body on mine as they pulled the stretcher away. Seconds later she was standing by herself in disbelief. She did not know it, but members of my flight team were on their way; they refused to let her go through this alone.
Inside the OR, strangers bustled about. I was naked, cold, in excruciating pain, and I knew this was it. The range of emotions I was cycling through touched everyone, their surgical masks unable to hide their concern. Too unstable to make comfortable, they had no choice but to get to work. I felt the Foley go in, a femoral line, the first of two radial arterial lines. Tears flowed as my world turned dark. There was no counting backwards from ten—the lights just went off. In the waiting room, Amy received updates from the OR, breaking any levity her and my coworkers created.
I arrived in the CVICU at 22:45—nine hours after I crashed through the operating room doors, an hour and fifteen minutes before my 47th birthday. I had been in arrest for 34 minutes, on bypass for over six hours, and I had received every blood product imaginable. My chest was zip tied and glued back together after a median sternotomy. All my ribs were broken in the back and front, enabling me to be opened as wide as possible. Underneath they found a contained rupture that came within 2 mm of the orifice of the left main coronary artery, which extended into my neck and right arm. Tied to my bed, I could feel Amy's hand in mine and every inch of the ET tube as sedation waned. Tubes, drains and lines ran out of my neck, chest, and groin. Hanging from the IV pole was every drug imaginable. I opened my eyes and there she was.
I made it.
We learned later from the surgeon that one in three patients don’t survive this event—50% of those who do suffer a stroke, spinal cord injury, or some other decrease in their quality of life. One ICU nurse told me that in all her years, I was only the fourth patient she had seen who came out without complication. Over the next few days, someone in surgical scrubs would occasionally appear at my door, make eye contact, nod, and walk away. Everyone in health care needs closure when it pertains to certain patients; I appealed to theirs.
This event lives in my mind every day, at every moment. At the same time, my memories of this experience are blurred, coming in flashes of clarity punctuated with intense moments of pain. The dissection, the intubation tube, all the lines and tubes sewn into me, the emotional weight of saying goodbye, and the rehab that followed. Until this, the worst pain I'd ever experienced was from kidney stones.
The career I strived for as a flight paramedic is over. My mind, body, and soul can’t handle it. My hope is to evolve, using this experience as a compass to help those around me grow.
This March, with any luck, I will celebrate both my first and 48th birthdays with the ones I love.
Jason Bazelow is a board-certified flight paramedic with more than 30 years of experience in prehospital care, critical care, and EMS education. He previously flew with AirLink/VitaLink out of Wilmington, North Carolina. He served on the Board of Directors for The International College of Advanced Practice Paramedics (ICAPP). He has presented at multiple conferences at the state and national level and contributed to the second edition of The Critical Care Transport Core Curriculum. Bazelow resides in Greenville, North Carolina, and is employed by Lenoir Community College.