Washington City Paper 2001

Unlike D.C. Fire Department rescuers, who took so long to respond to the 911 call, detectives from the Metropolitan Police Department responded with alacrity to Rusinek's troubles. At about 8 p.m. on July 15, 1999; barely 30 minutes after Rusinek had been pronounced dead by an emergency room doctor, a 3rd District detective phoned witness Philippe Chabot, who had given his name and number to a patrol officer on the scene. The detective asked Chabot if he would come down to the station, at 1624 V St. NW, to provide a statement. Sitting down at a police computer less than half an hour later, the 31-year-old agricultural economist typed out a 300-word statement, a copy of which he retained for his own records. He subsequently provided it to me.

In his statement, Chabot said that he was riding his bicycle north on 16th Street, on his way home from his job as a researcher at the International Food Policy Research Institute at 20th and K Streets NW, when, "out of my peripheral vision," he saw Rusinek topple forward onto the pavement. While serving in the Peace Corps in Sierra Leone, Chabot had seen his share of death after civil war broke out in the West African country in 1994 (he was evacuated, along with his fellow volunteers); he told police that on that hot July evening in D.C., he "became very alarmed" when the young woman's "head hit the ground and made a loud sound."

Thinking he might be able to help, Chabot "rode up to her [but] there was [already] another woman there with a cell phone who called 911." At that point, said Chabot, Rusinek "was lying on her stomach in a rather contorted position. Her eyes were slightly open, her mouth was open. She was breathing though it appeared to be labored and she was letting out these slight, labored moans." He added: "Throughout the time I was there she never spoke a word or seemed to become conscious in any way."

About five minutes after Rusinek collapsed, noted Chabot, "a passerby who happened to be an EMT arrived...and monitored the woman's pulse and breathing. After that the police arrived and the firemen and...after that an ambulance [that] was taking too long."

Although detectives never interviewed them, at least four other witnesses, including me, were disturbed enough by what they saw to take action. Nardin, who had summoned help for Rusinek, wrote a letter to Battalion Chief Stephen M. Reid, who at the time was the D.C. Fire Department's senior public information officer. She offered to "collaborate with any investigation of this terrible" incident, most notably "the long wait for a rescue team."

According to Nardin, neither Reid nor any other fire department official ever responded to her Sept. 8, 1999, letter.

InTowner reporter Greg DuRoss, who had come upon the scene as the paramedics were loading Rusinek into the ambulance, subsequently wrote two stories about the incident for the local monthly newspaper. In the August 1999 issue, he wrote, "Information obtained from multiple sources raises questions about the response time of the Emergency Medical Service (EMS) unit in this and other instances, especially during shift changes."

DuRoss' stories brought forth another witness, who later wrote a letter to the InTowner describing what she had seen. Neighborhood resident Hilary Gates said she, along with her partner, Henry Posner; the man with the white Van Dyke beard; had seen Rusinek collapse about 5:55 p.m. After waiting for several minutes, "keeping our ears peeled for sirens from the U Street [fire] station," Gates wrote, "Henry left the scene to go alert the firefighters, thinking that perhaps they had somehow not received the call.

"Needless to say," she continued, "this whole incident furthered my lack of confidence in the District of Columbia's [EMS] operations."

Perhaps most difficult of all for her and Posner, Gates wrote, "We were helpless bystanders...appalled at the abysmal response time of the U Street station." She told the newspaper, "Henry and I continue to discuss this incident, shocked at the death of a seemingly healthy young woman." She closes her letter: "I am not sure what would have happened had a crew arrived at the scene earlier."

Just over a week after burying their daughter, Dr. Henry Rusinek, an associate professor of radiology at New York University Medical School, and his wife, Roza Rusinek, who teaches mathematics at Queensborough Community College, came to Washington. They wanted to learn how; and, more important, why; their seemingly healthy youngest child had met an early death. Besides breaking their hearts, the whole thing didn't make sense to them. They had immigrated to the United States from Poland when their native country was still under Soviet rule. They relished their new life of freedom, while nestling into the reassuring familiarity of the thriving Polish Jewish community of Great Neck, Long Island. They doted on their American-born daughters, Vivian, born in 1973, and Julia, who came along five years later, on Feb. 17, 1978. They worked hard to provide every opportunity for their children, both of whom attended Yale. When she died, Julia was about to enter her senior year. Vivian had graduated in 1995 and gone on to medical school; today, she practices medicine in New York City.

"[Roza Rusinek] could hardly hold her head up," recalls a manager at Results, the U Street gym where Julia had worked out immediately before she collapsed, of the late-July day in 1999 when Roza and Henry Rusinek had stopped by the gym. "They were both just devastated."

The Rusineks also paid visits to the 3rd District police station house and to Engine Company 9. Neither organization provided much information; or consolation. In a personal letter to DuRoss, who had contacted him following his daughter's death, Henry Rusinek quoted from what he described merely as "a very sketchy report" he had received from the police: "Entered gym at 5:30 p.m.," the report said, and "at 5:54 observed walking (running?) southbound in the 1900 block of 16th St, observed falling face down to the ground. 6:03 call to 911, 6:05 police/fire truck arrives, ambulance arrives a few minutes later, pronounced dead at Howard Hospital."

In the same letter, Henry Rusinek described his and his wife's equally frustrating visit to Engine Company 9, on July 27, 1999: "We went to the Fire Dept. and spoke with the officer who attended to Julia [Desautels]....He said that Julia was unconscious but breathing and with heartbeat at the time he arrived. He did not want to tell us when the ambulance arrived."

Rather than filling them in on the details of their daughter's final minutes, wrote Henry Rusinek, Desautels advised the grieving couple instead to "get the report from Chief Reid." Rusinek added: "We have called Mr. Reid's office...but he did not return my call." The veteran medical researcher and radiology professor also noted, "We are still awaiting the report from the DC medical examiner."

Rusinek closed his letter to the InTowner reporter by sharing his sense of futility: "Roza and I have decided that pursuing this matter by asking for official reports will lead us nowhere."

The same day he met with the Rusineks, Desautels filed an official memo with then–D.C. Fire/EMS Chief Donald Edwards, citing Duarte and Palacios for their roles in the failed rescue attempt of Julia Rusinek. He recommended that they both be charged, under regulations codified in the District personnel manual, with "negligence in performing official duties, including failure to follow verbal or written instructions" by not responding "in a timely manner on a run as per F.D. orders" and by then responding "to an incorrect location."

Desautels also wrote in the document that Duarte, who had just come on duty for his shift as an Ambulance 1 crew member, was "standing in front of the firehouse" at 6:02 p.m. on July 15 when "several citizens arrived at Engine 9's quarters reporting a woman down on the street and unconscious, possibly not breathing, at 16th and Caroline Streets." Desautels wrote that the civilians' arrival had immediately followed a vocal dispatch made over the engine company's radio speaker system instructing Engine Company 4 (1.1 miles away, at 2531 Sherman Ave. NW) to respond to the above-mentioned address. He said that he then instructed Duarte "to respond immediately [to 16th and Caroline Streets] and to contact [Fire Department] Communications by radio so as not to delay this response." At this point, wrote Desautels, "Communications immediately dispatched [Truck 9] over the Vocal to the [same] address." Thus, Duarte by then had had three different opportunities to learn where the emergency was. He got a fourth chance when the hook-and-ladder truck, carrying Desautels and three other firefighters, "responded immediately and went on the scene" less than 200 yards from where Duarte was standing.

At 6:05 p.m., Desautels noted in the memo, the ladder truck commander "looked towards the firehouse but still no A-1." After another two minutes had passed, during which time he asked Communications to dispatch a second ambulance to the scene, Desautels finally "saw A-1 respond east on U St. and then north on 16th St. instead of south to our location." He noted that "several citizens who had gathered around the scene [had] witnessed A-1 responding in the wrong direction as well and began yelling at me. They were demanding to know where the ambulance was going."

At 6:08 p.m., wrote Desautels, he heard the crew of Ambulance 1 on the radio "asking for an address check stating they are at 16th and Kalorama Sts. and don't see T-9." At this point, Desautels asked the dispatcher to contact Duarte and Palacios and instruct them to turn around. According to Desautels, Ambulance 1 finally "marked on the scene" at 6:11 p.m. (For the record, a transcript of the 911 tape obtained from the fire department appears to corroborate Desautels' timetable. But Duarte, Palacios, and a fire department incident report all stated that Ambulance 1 actually arrived seven minutes later, at 6:18 p.m. The fire department declined to make any of the rescuers available to clarify the discrepancy.)

In a written response to Desautels, Duarte criticized Truck 9 crew member Cooper for not immediately shocking the patient with the automated external defibrillator he had taken from the truck. Desautels had defended Cooper in his memo, explaining that the firefighter/EMT had not taken this action because Rusinek "was still breathing until A-1 had marked on the scene." Desautels himself had noted that the unconscious woman also had a pulse. According to a leading D.C. emergency physician, Cooper was probably following the correct medical protocol when he did not immediately shock the patient. "You do not defibrillate somebody who's got a pulse," said the doctor, who had reviewed a detailed account of the incident before being interviewed.

For her part, Palacios; who, like Duarte, had just reported for duty when the call about Rusinek came in; provided an elaborate explanation for why she was late in joining her partner for the run. At 6:05 p.m., three minutes after Desautels and others at the firehouse had heard Engine 4 being dispatched to 16th and Caroline Streets over the firehouse speaker system, Ambulance 1 crew member Palacios; who had somehow missed the announcement; "went to the watch desk and saw that the printer was not working and started fixing it," according to a report she submitted to Desautels the day after the incident. As she puttered with the malfunctioning printer, Palacios wrote, she became aware of "a commotion going on outside" the room. Palacios wrote that she did not know what it was about. Palacios wrote that she saw Duarte get in the ambulance but thought he was merely moving it out of Truck 9's way. In fact, Duarte was preparing to go on the run, as ordered by Desautels. Rather than join Duarte, however, Palacios "went to the back [of the firehouse]" to retrieve her personal belongings, whereupon "one of the day crew people told me we had a run."

Palacios now indisputably knew what was happening. But, instead of reporting immediately to Ambulance 1, she decided to double-check its destination on the watch desk computer. "I did not see anything," she recalled in her account. Finally, Palacios, who already had delayed the run for several minutes, "went to the ambulance and found out that we had a call." According to Palacios, it was Duarte who told her that Desautels had dispatched the pair to "16th and Kalorama Road, N.W." She blamed the episode on "miscommunications on directions." She took no responsibility for the fact that she had missed the call not only on the station's speaker system but on the computer system as well, where, Desautels stated, Truck 9's location would have been shown. Nor did Palacios attempt to explain why she didn't leap quickly into action when told she had been put on an emergency run.

Desautels, however, stated in his memo to Edwards that both Palacios and Duarte had had "several opportunities to learn the correct address." The Engine Company 9 truck commander concluded that if the EMTs had responded immediately as ordered, "they would see which way T-9 went." He noted that the rear of the mammoth ladder truck "wasn't 100 [feet] from the intersection of 16th and U Sts."; when the duo drove through the intersection on their way to the wrong address.

D.C. Fire Department officials have declined repeated requests for interviews with Duarte, Palacios, Desautels, or any other official who could talk about the Rusinek rescue. Nor would officials say whether they had taken any action in response to Desautels' memo critical of Duarte and Palacios.

Just two weeks later, another patient died after riding in Ambulance 1 to Howard University Hospital. Duarte also ran that call and, once again, his actions were officially questioned. On Aug. 1, 1999, a 40-year-old homeless man reportedly suffered a seizure at the intersection of New Jersey Avenue and O Street NW. According to newspaper and television reports at the time, Duarte and a fellow EMT; neither of whom was named in any of the stories; had loaded the heavyset patient into the back of their ambulance, then allegedly failed to treat him on the way to the hospital, where the man was pronounced dead. A report published in the Washington Times on Aug. 19, 1999, said that an emergency room doctor at Howard, who had tried unsuccessfully to revive the victim, subsequently had "complained [to fire department officials that] the rescue workers should have given the patient cardiopulmonary resuscitation on the way to the hospital."

Duarte and his male co-worker; who reportedly said that the man they had picked up "appeared to be breathing normally during the ambulance ride"; were briefly suspended from ambulance runs, with pay, until they could receive "remedial training," according to the Times  report. After this training, the exact nature of which the department declined to specify, and after passing a written exam, both men were reinstated to full work status, and they continue to work as EMTs today.

Nearly six weeks after Rusinek's sudden, unexplained death, the D.C. medical examiner's office finally released its autopsy report to her parents, who had requested it days after the incident. The report said a postmortem examination of the body revealed that Julia Rusinek had succumbed to a previously undetected congenital heart condition known as arrhythmogenic right ventricular dysplasia, or ARVD. In lay terms, this condition occurs when normal heart tissue in the right ventricle, or lower right pumping chamber of the heart, is gradually replaced by a buildup of fatty tissue, which interferes with the ventricle's ability to function. Relatively rare, ARVD can be either hereditary or "sporadic" (random). It most frequently manifests itself in young athletes such as Rusinek, who suffer sudden cardiac arrest while vigorously exercising or soon thereafter. Often, they experience no symptoms until the onset of the crisis; but when it occurs, if normal heart rhythm is not restored in very short order, they are very likely to either die or, if belatedly revived, suffer permanent brain damage because of prolonged oxygen deprivation.

There are cases on record of people surviving a sudden cardiac arrest brought on by ARVD. One such case; that of a 25-year-old former U.S. Olympic swimmer who collapsed during a training run in Boston; underlines the importance of providing rapid, high-level medical treatment to the victim immediately after such a collapse. Lisa Buese suddenly felt dizzy and short of breath, with a rapidly increasing heartbeat while on a training run near the Charles River. These are classic symptoms of cardiac arrhythmia, or irregular heartbeat, leading to a sudden cardiac arrest. They are the same symptoms Rusinek is believed by doctors to have experienced before she collapsed. Buese, however, was more fortunate; she was able to hail a passing taxicab, in which she then immediately slumped over, unconscious, in the back seat. The driver rushed her to the nearest hospital, where physicians using a defibrillator successfully revived her in the emergency room. After surviving a second cardiac arrest shortly after her first, Buese had a miniature defibrillator surgically implanted in her abdomen. Today, at age 36, she successfully competes in both marathons and triathlons.

According to the American Heart Association, only about one in 20 people who suffer cardiac arrest outside of a hospital today in the United States survives. However, says the association, the survival rate jumps dramatically when early CPR and rapid defibrillation are combined with advanced emergency care.

Rusinek's life ended, ironically, at the precise moment she seemed finally to have chosen a career path; no mean feat for any young adult; and was in the midst of perhaps her greatest adventure. Other than going away to Yale, in New Haven, Conn., coming to Washington in June 1999 to work as an intern for the Children's Law Center marked the first time she had been on her own in a strange city. From all indications, she was relishing her newfound independence. She had sublet an apartment on 16th Street and joined the athletic club around the corner. When she wasn't at work or at the gym, she spent time with friends from New Haven or Great Neck who also happened to be summering in the District. So, it seemed, she had the best of all possible worlds; combining the comfortable and familiar with the new and unexplored.

For the six weeks she interned at the Children's Law Center, recalls its former executive director, James Marsh, Rusinek "was just a pleasure to be around. She was attractive and very personable and not a high-maintenance person." On the other hand, says Marsh, Rusinek also was "very self-contained. She didn't share a lot about herself. But I knew she was having some financial issues, in terms of whether she should get a part-time job, make a little bit of extra money to make the summer more pleasant for her."

As an unpaid intern at the center; which provides free legal services to low- and middle-income "at-risk children" and their families; Rusinek handled multiple tasks, including helping the center's legal team in court. "We had a 14-day trial that just finished on the day that she died," said Marsh, "and she had been going to that every day, and that had interested her quite a bit. And she had told her family that she felt that she had finally found something that she wanted to do. She was seriously going to consider pursuing a law-school career to do child-advocacy work."

If serving children in need was Rusinek's vocation, running was her passion. During her four years at Great Neck North High School, the 5-foot-8, 125-pound athlete set six indoor and five outdoor school records in girls' track. She was a three-time divisional champion in the 4 x 400-meter relay and was named most valuable player of the girls' track team an unprecedented five times. As a senior, she was named Great Neck North's female Scholar/Athlete of the Year. She went to the Nassau County championships twice, placing third in the pentathlon in her junior year. In that demanding event, she competed in the 100-meter low hurdles, 800-meter race, shot put, long jump, and high jump. According to Rusinek's former track coach, Chris Omeltchenko, Rusinek also, at various times, competed in the triple jump and ran the 400-meter dash for Great Neck North. "She was the most versatile athlete I ever coached [in 14 years at the school, coaching runners of both sexes]," says Omeltchenko, who currently teaches physical education at New York's Aviation High School and coaches the track team at Queensborough Community College. He adds, "She was the star of the team, but she was also one of the most dedicated members of the team"; running on weekends, for instance, without ever being asked to do so, to make sure she stayed in top form.

In Rusinek's senior year, Omeltchenko recalls, the team's star runner effectively guaranteed her early acceptance at Yale; and a future spot on that university's women's track team; by her outstanding performance in the 4 x 400-meter relay in the high school division of the annual Yale Invitational track meet in New Haven. "I was talking to the [Yale women's track] coach while Julia was on the starting line," he recalls. "And I remember pointing her out to the coach, saying, 'That's Julia. She wants to run for you next year.' And then the gun goes off and she hands off the baton in first place, just blowin' everybody away on the first leg." He adds, "You couldn't have scripted that any better."

In the slightly more than two decades that Rusinek lived, she left many others in awe; although, say those who knew her best, never purposely. And after her death, she left a legacy: a charity race and a children's fund established in her name by family members and friends. The first annual Julia Rusinek Memorial Road Race was staged in New Haven on April 9, 2000, just nine months after the honoree died. Despite unseasonably cold weather and a light snowfall, 242 people competed in the 5K run, including Rusinek's parents and her older sister. In a fitting tribute to their lost daughter, sister, and friend, the memorial racers raised $6,000 for low-income children in New Haven. Plans are under way to hold a second memorial race this spring.

Almost one year to the day after Rusinek died, D.C. Mayor Anthony A. Williams hired a new fire/EMS chief from Augusta, Ga. Ronnie Few, a 29-year veteran firefighter named Fire Chief of the Year in 1998 by the International Association of Firefighters, became the third man to steer the department in seven months. One of the new chief's long-range goals, says Senior Public Information Officer Denise Reed, is to "cross-train" all D.C. firefighters as paramedics, so they eventually can provide skilled medical care quickly in response to every 911 call. In the short term, says Reed, Few wants to reduce the average time required for getting advanced life support to the scene of a medical emergency to eight minutes or less. Succeeding will necessitate shaving more than two minutes off the District's current average response time of 10 minutes, seven seconds. If the department reaches this goal, it will be a significant improvement, but it will still leave the District nearly three minutes behind the national average response time of five minutes, 24 seconds for advanced life support. And it will only slightly improve the chances for survival of people, like Rusinek, who fall victim to cardiac arrest in the District.

Meanwhile, the fire department also has accountability problems to address. Officials decline to say whether anyone from Medic 24's ambulance crew was ever disciplined for taking 22 minutes to respond to the July 15, 1999, urgent dispatch call to an unconscious woman, possibly not breathing, at 16th and Caroline Streets NW. Nor will the department reveal whether the unnamed emergency dispatcher who initially assigned a fire truck from a more distant firehouse to the call was ever questioned about his or her role in the deadly drama. Indeed, it appears that, other than the official slap on the wrist administered to Duarte and Palacios, nobody was ever held accountable for  Rusinek's delayed rescue.