What Happens When You Are Dying

The script begins with a dramatic scene where Jake, a young Amazon warehouse worker, collapses after expressing frustration about a recent union vote and the television show they are watching. Despite being fit and healthy, he suffers a sudden cardiac arrest. His girlfriend, Becky, who is familiar with CPR from TV shows and karaoke nights, immediately starts performing chest compressions to the beat of a song, while also providing rescue breaths, which helps to circulate blood and oxygen to Jake's brain. Meanwhile, a neighbor calls for emergency services, but the survival rate for out-of-hospital cardiac arrests is grim, with less than 10% of victims surviving in the US, and only 6% surviving when it occurs at home.

Upon the arrival of the ambulance, the paramedics provide crucial information about Jake's condition to the hospital staff, who are prepared with a 'crash cart' of medical supplies. The hospital team, consisting of various specialists, works tirelessly to revive Jake, including administering adrenaline every few minutes to try to restore his heart rhythm. Despite their efforts, after 20 minutes without success, they are faced with the difficult decision of whether to continue resuscitation efforts. The lead doctor eventually makes the call to terminate resuscitation efforts after consulting with the team, as Jake's condition has reached a point where survival is no longer possible due to extensive brain and tissue damage.

Following Jake's death, the hospital staff begins the process of informing his family, who are waiting in a special room near the trauma center. The doctor responsible for delivering the tragic news removes his scrubs and uses Jake's name to deliver the message clearly and directly. He explains that all possible efforts were made to save Jake's life. The family, although shocked and grieving, does not blame anyone for the sudden and unexpected loss. The doctor also informs them that Jake did not experience pain during his death and that the cause of the cardiac arrest remains unknown, classifying it as sudden unexplained death (SUD).

Jake's parents, seeking answers, give permission for an autopsy to be conducted. The medical examiner investigates Jake's death, considering various potential causes such as heart disease, clotting disorders, viral infections, arrhythmia syndromes, or even poisoning due to Jake's girlfriend's past threats. The autopsy includes a thorough examination of Jake's organs, genetic testing, and toxicology reports to identify any substances in his blood. The medical examiner also considers lifestyle factors such as Jake's occasional cocaine use, which could contribute to cardiovascular toxicity.

Jake's body is prepared for the funeral, which includes embalming and other cosmetic procedures to ensure he appears at peace. The funeral director takes care to make Jake look natural, even using skin-colored wax to cover any marks from the autopsy. The final diagnosis from the pathologist is arrhythmogenic right ventricular cardiomyopathy (ARVC), a rare genetic condition where the heart muscle is replaced by fatty or fibrous tissue, leading to a potentially fatal heart rhythm disturbance. This diagnosis is controversial due to the lack of definitive autopsy criteria for ARVC and its rarity, but it is suggested that Jake's combination of hard work, stress, and substance use may have contributed to the tragic outcome.