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With Americans ill and injured every minute of every day, it's no surprise then that many nurses find themselves running a trauma code while they are on vacation, shopping for groceries, on their way home or even at church.

In early November, Margery Affleck-Gadd, RN, had a weekend straight out of the television show "ER." It started when the 56-year-old legal nurse consultant was on her way back to her hotel after finishing the Nov. 3 New York City Marathon. Another subway passenger-a middle-aged woman who also had run in the race-fainted on the train. Affleck-Gadd's 21 years as a trauma nurse immediately kicked in; she helped the woman lower her head and sip some leftover Gatorade from the race. The woman was on her feet in time for her stop. Little did Affleck-Gadd know that her role as subway rescue nurse was just a warm-up for a much bigger drama to come.

The next day, Affleck-Gadd was on the runway in St. Louis, a stopover on an American Airlines flight home to Tulsa, Okla.

"I was in seat 17B," Affleck-Gadd said. "Someone several rows up yelled, 'This man is in trouble.' I jumped out of my seat and ran to him, and found a priest having what looked like a seizure, but with no pulse."

Affleck-Gadd directed several passengers to pick up the priest and lay him down in the aisle-"a very narrow aisle, and he was a big man," she said. Affleck-Gadd squeezed in, ripped off the man's shirt and clerical collar, and started CPR.

"It all happened very quickly. I knew I had only about three minutes until he was brain-dead," said Affleck-Gadd, her voice as no-nonsense and precise as her memory of the event. She asked the flight attendants if they had a defibrillator on board. To her surprise, they did and wheeled out a sparkling new crash cart. What they didn't have was the training to use the equipment.

"I slapped the pads on him and went with 360 joules at the first jolt. I didn't mess around. I could see he was in V-Fib, the death rhythm," said Affleck-Gadd, who is certified in advanced cardiac life support. "We defibrillated him only once, and he returned to V-Tach. Then he opened his eyes and tried to talk and we were finally able to understand him, and why he was going to Tulsa."

The priest, a hospital chaplain from California, had already undergone open-heart surgery twice, and was scheduled to receive an implanted pacemaker/defibrillator device in Oklahoma.

"I started an IV on him, and the paramedics came in and carried him out of the plane awake and alive, with much cheering from all the passengers," Affleck-Gadd said.

According to the cardiologist in St. Louis who performed emergency surgery on the priest, he would have died had he not been defibrillated, said Affleck-Gadd, who received an instant upgrade to first class for the rest of her flight, as well as a chunk of frequent-flier miles as a thank-you for her help.

The priest and his rescuer have talked several times on the phone since that day. "She saved my life," said the 68-year-old man, who requested anonymity. "I'm so grateful."

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