Back in June, during one of those spells of hot sticky weather, I was just finishing a nice meal with coworkers in a restaurant when we were approached by an anxious waitress asking if we were doctors and could help. A few tables away, a middle-aged man was slumped, unconscious, covered in perspiration with occasional snoring respirations, but no pulse when I checked his neck. "Lie him on the floor and call 911," I commanded the stunned bystanders, and we soon had him flat on his back with his feet elevated.
As we did this, I heard his wife exclaim, "He was working all day in the hot sun!" Within moments, I could feel the pulse return to his neck, his eyes fluttered open, he took some deep breaths, and looked around with astonishment. "What happened? I feel fine. Let me up!" he said.
I kept him flat on his back as I asked a few questions, which gave further information as well as time to confirm that he was lucid, articulate, had a steady pulse, was breathing easily and had no noticeable neurologic loss to suggest a stroke. Yes, he was on a blood pressure pill and could name it. Yes, he had worked all day in the hot sun and not had much fluid to drink until he settled into the restaurant and attacked a generous martini.
At this point I let him sit up and start drinking ice water. By the time the ambulance crew had bustled him out the door on the way to the emergency room, he was well recovered and sadly contemplating the lovely dinner he was leaving behind. Fainting occurs wh.