When paramedic Ryan Jones lowers the defibrillator paddles to Adam Quilty's chest for the third time, the 17-year-old Charlotte Vance High lacrosse player has been without a pulse for 19 minutes.

There's a doctor on the scene -- Chuck Frederick. By chance, he had been refereeing this lacrosse game in Greensboro when Adam collapsed and his heart stopped.

Frederick, an anesthesiologist, caught up to Adam seven seconds after the fall. Soon afterward, the doctor and a certified athletic trainer at the game had begun cardiopulmonary resuscitation, trying to save Adam's life.

The CPR has helped. Adam isn't dead. But Dr. Frederick thinks to himself that even if Adam doesn't die, serious brain damage is likely.

"Clear!" Jones says.

Adam's father, Ken Quilty, lets go of his son's hand.

Adam's body jerks.

This time, Adam's heart jumps back into rhythm.

But no one gathered around Adam on the football field at Southeast Guilford High applauds.

Adam still looks bad. He is face-up, his eyes closed. Unconscious. His No. 19 jersey and his lacrosse pads have been sliced into pieces. His lips are a chalky blue. On his left hand are the words "I (heart) Ashley" -- a reminder of a happy moment earlier in the day.

A second truck has pulled onto the field, this one from a nearby fire station. More help. More equipment. More medicine for the IV Frederick has started.

The Guilford County ambulance is the third and final rescue vehicle to arrive, at 9:46 p.m., 15 minutes after the first call to 911. The ambulance rumbles onto the football field and stops a few feet from Adam. The medics are unloading equipment about the same time Adam regains a pulse after the third shock from the defibrillator.

The sight of the ambulance invigorates players on both teams, huddled together on the sideline.

"Quil-ty! Quil-ty!" they start chanting. They start clapping rhythmically, faster and faster, as the medical technicians load Adam onto a stretcher. Ken climbs in with him. Then the players loudly recite "The Lord's Prayer" together.

At 9:56 p.m., the ambulance doors close -- 26 minutes after the teenager collapsed. As the ambulance makes a sweeping turn on the 50-yard line, one player shouts: "1-2-3!"

In unison, the players scream once more:

"Quilty!"

Quality of life

Adam doesn't hear the chants. His heartbeat is relatively stable, but he is unconscious. He breathes with the aid of a ventilator, but he hasn't moved since his fall.Five minutes into the ambulance ride, Ken Quilty sees the big toe on Adam's right foot move. It is miraculous proof to the father that his son is alive.

The ambulance pulls into Moses Cone Memorial Hospital in Greensboro at 10:11 on that night -- March 31, 2000.

Adam's father is with him. His mother, Dena Shenk, is coming from Raleigh, 80 miles away, to Greensboro. She's so upset that a friend is driving.

Adam's mother hardly ever misses a game, but was away at an academic conference. She did not see Adam's brief run at glory or the mysterious fall that followed in the crucial 17-second sequence that was documented on a friend's videotape.

Dr. Frederick heads toward the hospital. Mark White, the trainer from Southeast Guilford High who along with Frederick administered CPR, goes home. White calls his best friend and tells him he won't believe what just happened.

At the hospital, with Adam unconscious, there is no way to make an assessment on what, if any, brain damage he has suffered. But his heart seems to have established a good rhythm.

He will live.

The quality of his life is the question.

Within two hours, doctors in Greensboro recommend that Dr. Richard Smith, a pediatric cardiologist in Charlotte, take over Adam's care. Smith works at Charlotte's Sanger Clinic and is well-known in his field. Adam is also from Charlotte. On a grim night, the fact that he can go home to be treated is a welcome coincidence.

Adam can even go to Charlotte right now if he is taken by ambulance, doctors say. Do his mother and father want that?

Yes, of course, they say. Wherever he has the best chance to live. Just help him.

Dena Shenk, Adam's mother, has barely gotten to the hospital before it's time for another frantic ride. She gets in the front of the ambulance.

She looks back through the window and shudders as she realizes medics have taped Adam's eyelids shut. The medics want to keep Adam's eyes closed and moist, but it looks ominous to Dena.

Dena hears the siren scream for 90 miles from Greensboro to Charlotte's Carolinas Medical Center.

She will never hear a siren again without cringing.

Adam's father will travel to Charlotte with the Vance High lacrosse coach, Chris Dryden. Ken insists on driving, over Dryden's protests. Ken tailgates the ambulance on the freeway before Dryden convinces him to slow down.

The other Vance players all rode to the game with their parents since lacrosse is a club sport and doesn't qualify for an activity bus. They go back home, too, and disperse silently once they get back to school close to midnight.

Several think Adam probably will die. A few believe he already has died and they just haven't been told.

Why did this happen?

Dr. Smith is almost certain Adam won't die when he first sees him on April 1, 2000, about 10 hours after Adam's fall. But does his new patient have brain damage? Most people would under these circumstances.

And what would cause a seemingly healthy 17-year-old to go into cardiac arrest on a lacrosse field, anyway?

Over the next couple of days, Smith looks into the family's medical history. Not much there. He does one test after another. What he finally comes up with is a "probably." He never will get to "for sure."

Smith believes Adam probably has a viral infection in his heart called myocarditis.

Myocarditis, conceivably, can go away. But if it isn't really myocarditis, what then? Another cardiac arrest would likely be fatal.

The best way to prevent such an occurrence is to place a sort of pacemaker called an internal cardiac defibrillator into Adam. The ICD could automatically convert Adam's heart to a normal rhythm within seconds of detecting an abnormality.

The downside: Once you put in an ICD, you hardly ever take one out.

And you have to get the device checked every six months and get cut open every few years to get the battery replaced.

And the patient has to be careful. Forever. Contact sports like football or lacrosse are usually prohibited for patients with ICDs.

Decisions to come

Adam is heavily sedated for most of the next couple of days and attached to numerous tubes. Once, about 28 hours after the accident, his mother is alone in the room holding his hand. She remembers saying to him, "Adam, you're doing great. Just keep fighting. I love you so much."Adam doesn't open his eyes. But he squeezes her hand.

Adam flickers in and out of consciousness several times once he is taken off the ventilator.

Finally, he begins to speak, a few words at a time. He usually asks the same questions each time, in a croaky voice, but can't remember the answers a few hours later.

His would-be girlfriend, Ashley Lusk, comes to visit.

"I still have you on my hand," Adam says, suddenly brightening. He shows her the "I (heart) Ashley" phrase she wrote on his left hand hours before the accident.

Adam doesn't remember some things, including anything about his collapse or the next 24 hours.

But he doesn't slur his words much. That's a plus. Dr. Smith starts to feel hopeful that Adam has not suffered any significant brain damage.

Adam's 13-year-old sister, Shayna, is in the room two days after the fall along with some other family members when Adam asks his usual questions.

What happened? Why am I in the hospital?

Shayna explains.

Adam asks another question.

Will I ever play lacrosse again?

No, Adam's mom tells him gently.

Adam starts crying. Shayna does, too.

But Dr. Smith isn't sure of anything yet. He wants to see how the next week goes before making any big decisions about the rest of Adam's life.

Editor's Note

The story of Adam Quilty's near-death experience is being told in three parts, ending Tuesday. In Part 1, Adam Quilty was playing for Charlotte's Vance High when he mysteriously crumpled to the ground in a 17-second span. Adam's heart stopped. Rescue efforts began.

This series is based on extensive one-on-one interviews with all the key characters -- including Quilty, now 20 years old. The details come from the recollections of those involved, two videos of Quilty's collapse and its aftermath, and medical records. The Shenk Quilty family provided full access and cooperation. Scott Fowler

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