This Queen’s student froze to death on a Kingston pier. Here’s how he came back to life — (The Star)

SSRI Ed note: Student prescribed ADHD meds (stimulants) and Remeron by psychiatrist attempts suicide, is miraculously revived. Nobody suspects potential role of meds.

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The Star

By Mary OrmsbyFeature reporter

Sun., Feb. 19, 2017

Tayyab Jafar was found on a sub-zero morning with no vital signs and a core temperature 16 C below normal. It would be easy to call what happened next a miracle, but it’s not — though some on his medical team are stunned at the results.

KINGSTON, ONT.—Tayyab Jafar walks through a gruel of slush coating the wide pier behind a King St. public works building. He stops and points to the place he died.

“Right about here,” says the fourth-year Queen’s University student from Oakville.

The spot is at the pier’s edge. Near a warning in long faded letters stencilled across the ground: “No Diving.”

He is silent for a moment. Wintry drizzle falls. Lake Ontario’s steel-grey waters slap below. The sky’s wet gloom frames Jafar’s slender figure.

The 22-year-old, shrugging, hands in pockets, says: “That happened.”

But what happened was far from ordinary. Jafar’s story is one of resurrection; how tenacious medical teams brought a frozen man back to life.

A year ago, cloaked in the darkness of a frigid January morning, this is where Jafar chose to end his life. Two days before his 21st birthday, Jafar was found at early light — shoes off, coat over his face, an empty prescription sedative bottle nearby — without vital signs.

“Vital signs absent means dead,” says Julie Socha, one of four Frontenac County paramedics who rushed to the scene.

Engaging and intelligent, Jafar had been studying physics courses at Queen’s in hopes of getting into engineering. That plan began to unravel just weeks before he quietly left the off-campus house he rented with friends. He’d placed a goodbye note on his desk and, a stickler for details, banking instructions so his housemates wouldn’t miss a bill payment.

Then he walked 10 minutes to the pier.

On that sub-zero morning, Jafar lay in a snow bank. His body was starting to freeze. His core temperature would later be recorded at 20.8 C — about 16 degrees below normal. Hypothermia occurs when a person’s core temperature dips below 35 C, a condition often caused by exposure to cold weather or water immersion.

The death appeared to be an intentional overdose to the paramedics, who promptly initiated CPR. But how the young man died was a medical puzzle for Kingston General Hospital emergency teams to solve:

Did Jafar die from an overdose, then get cold? Or did the drugs only render him unconscious, then he died because he became so cold?

“There’s actually a difference,” says Kingston General cardiac surgeon Andrew Hamilton.

The faintest hope of resuscitation flickered only if Jafar had become profoundly hypothermic after his overdose attempt. The key was determining that sequence: a seemingly impossible task on a very cold body.

Of all the critical work done at Kingston General to return Jafar from the dead — an hour of CPR at 110 chest compressions a minute, streams of heated saline flooding his system, multiple doses of epinephrine, a transfusion of more than 100 units of blood products culled from 134 individual donors, machines to warm and oxygenate his cooled blood and a 200-joule jolt to his chest — it was a simple blood test that would give Jafar a chance at survival.

Even so, odds were bleak. At best.

Texting goodbye

Queen’s students Tayyab Jafar and Alex Reid last May. Reid is the one who found Jafar with no vital signs on a pier four months earlier.

Six Queen’s students, all friends, lived in the house on Nelson St., a short walk from campus.

Alex Reid woke up in his second-floor bedroom just before 7 a.m. on Jan. 15, 2016. It was a Friday. Almost the weekend.

The biology major reached for his cell phone. He saw texts and Facebook messages that filled him with dread.

Sorry I couldn’t be stronger.

Love you.

Good bye.

They were from his housemate, Tayyab Jafar.

Jafar had been suicidal before. Reid had talked him through moments of distress. Talked him off the top of campus buildings. Talked him into visiting Kingston General for mental health attention in second year.

Jafar had been seeing a university psychiatrist since first year, initially to regulate prescription medications for two disorders: OCD and ADHD, diagnosed during high school.  He says he also had “a few issues with depression.” In fall 2015, sleeplessness became new trouble when his usual nighttime medication, mirtazapine, was no longer effective.

“In my fugue state, I’d just stare,” recalls Jafar, who’d been working with his psychiatrist and was still attending classes. “I didn’t care. I’m not talking much. I’m reserved, socially excluded.”

Jafar’s housemates — young men busy with classes and assignments — didn’t realize how desperate their friend had become. Jafar says lack of sleep hurt his marks and, ultimately, his engineering aspirations. He’d been rejected from engineering as a freshman despite an 87-per-cent high school average and was hoping to reapply.

When Reid saw Jafar’s notes, sent about 3 a.m., he panicked.

“Right away, you could tell that somebody was saying goodbye.”

Reid checked Jafar’s bedroom. Empty. He ran down the stairs to look for Jafar’s jacket and shoes. Gone. He called Jafar’s phone; no answer. Reid ran to campus to search.

“I knew a few places to look,” the 21-year-old says.

Reid scanned the tops of school buildings. Then he checked the ground below. Nothing.

He called 911 to report that a missing friend was suicidal. The Kingston police began to hunt, too.

Reid considered one last place: the pier.

“I thought that if you were going to kill yourself in Kingston, that’s where you’d go. It’s a beautiful spot — a fantastic place to end it,” he says, laughing grimly.

Running across King St. to the back of the public works building and up a slight rise to the pier, Reid spotted a black bump. It was Jafar’s jacket. He saw an empty beer can. Close to the jacket was his friend. Lying face up in the snow.

It’s a beautiful spot — a fantastic place to end it –  Alex Reid, Friend of Tayyab Jafar on how he knew where to find Jafar after reading his suicide note.

“I was like, ‘S—, he’s dead.’ ” You could tell,” Reid says. He noted Jafar was “as cold as a rock” and had coughed up blood. The empty prescription bottle was nearby.

Reid called 911 again, then “I was sitting there, trying to wake Tayyab up.”

“Shaking him, giving him the sternum rub for a while to see if he was conscious, checking for breath, checking for a pulse. Couldn’t find anything,” he says.

Reid threw Jafar’s abandoned jacket over him. A frightened, futile effort to warm his friend.

The police arrived within a minute, paramedics seconds behind. It was close to 8 a.m. — about five hours after Jafar had sent Reid the goodbye texts.

On the pier

Jonathan Andreozzi and Julie Socha were two of four paramedics that began to treat Tayyab Jafar as he lay on the pier on the Kingston waterfront.  (Steve Russell)

In Tayyab Jafar’s body, capillaries had contracted long before Frontenac County paramedic Jonathan Andreozzi put his fingers on the young man’s carotid artery to check for a pulse.

Capillaries form a network of thin blood vessels between small arteries and veins. They allow delivery of oxygen, nutrients and heat to the tissues.

Jafar’s body was trying to retain heat at its core, one of its first protective acts while outside on a morning that, according to paramedics, dipped below -11 C.

“Constriction is at the capillary level,” says international cold-weather expert Gordon Giesbrecht, a thermophysiologist at the University of Manitoba who’s also known as “Professor Popsicle.”

Giesbrecht says once you get cold, “you mount thermoregulatory defences including vasoconstriction (which) decreases capillary blood flow to the skin to decrease heat loss.” Like turning off the valve to a hot-water radiator, the professor says.

Shivering — involving involuntary muscle contractions — is also part of the thermoregulatory process.

“Shivering is muscular energy and we all know that muscular energy produces heat,” Giesbrecht says.

Giesbrecht, who does not know Jafar and was not part of his care, says ingesting drugs and consuming alcohol can affect how a person experiences hypothermia.

Jafar recalls that besides downing a large dose of the powerful sedative chloral hydrate, he took at least “10 different” types of prescription pills that he washed down with three or four beers that morning.

“Those drugs sound like the kind of drugs that would have diminished his shivering capacity,” says Giesbrecht, who’s also director of the university’s Laboratory for Exercise and Environmental Medicine.

“If a friend of similar weight and clothing went out there and sat beside him, this guy (Jafar) would have cooled quicker because A, his shivering response would have been blunted by the drugs and B, he was lying down on the ground and C . . . he took some clothing off.”

Giesbrecht says there are two possibilities why someone in this situation might remove clothes: to hasten suicide, or from “paradoxical undressing.”

Reid recalls Jafar was not wearing his jacket or shoes. The paramedics did not recall if his shoes were on.

“It’s not uncommon that people, when they get close enough to being cold enough to become unconscious, their body plays some tricks on them,” Giesbrecht says.

“They think they might have a feeling of warmth and in a deluded mindset, they think, ‘Oh, I have to take some clothes off,’ and that can range anywhere from just loosening clothing to being completely naked.”

As Jafar’s core temperature plunged, his body was still trying to protect its internal organs and the brain by slowing metabolic activity.

“Cooling protects everything,” Giesbrecht says. “As you cool any tissue, its metabolic requirements decrease so a given amount of oxygen will last longer, and that effect is greater in the brain.”

The heart will stop when it cools and that can occur any time the core temperature drops below 28 C, says Giesbrecht, who has jumped into icy Canadian lakes — sometimes with skis — and rivers to conduct extreme-weather research and promote survival education.

“You can still have a beating heart as low as 20 (C). It’s possible.”

Giesbrecht theorizes that with Jafar’s core close to 21 C, his heart may have arrested around 25 C. Without a pumping heart, there was a finite amount of oxygen in his system. The brain, though extremely sensitive to no or low oxygen, was cooled enough to need less oxygen — but not forever.

“The brain can go longer without oxygen than if (his heart had stopped) at regular body temperature,” Giesbrecht says.

A key unknown in Jafar’s case: how long had his heart been still? There’s no way to know. It could have been seconds. Or hours.

Jafar’s sister, Rida, a University of Guelph student, calls her big brother’s resuscitation and recovery “a miracle.”

Giesbrecht sees it differently.

“It’s not miraculous. I’m a Christian and I believe in miracles,” he says.

“Everything that happened can be explained physiologically.”

Normally, “the colder you get, the longer (your heart is stopped), the more difficult it is to get a full recovery — or to survive at all,” he continues. But Giesbrecht does allow for a bit of luck.

“This guy, once he collapsed, he collapsed in a very good place and he was lucky he had a very good friend,” he says, referring to Reid’s frantic search.

“And when he got to the ER, he had a medical team that didn’t just pronounce him dead.”

Kingston General Hospital

Nurse Jane Lewis chronicled everything going on in the emergency room when Jafar came in, to chart treatments.“I’ve never seen anybody that cold.”   (Steve Russell)

Just before 8 a.m. on that Friday, two paramedic teams had finished separate calls that brought them to Kingston General’s emergency department when their dispatcher called.

Jonathan Andreozzi and partner Andrew Liersch bolted in their ambulance, racing to the pier in just over a minute. Julie Socha and her partner, Lise-Anne Lepage-McBain, followed. The police were already there, speaking to Alex Reid.

Andreozzi found Jafar had no carotid pulse. No breathing. He and Liersch began a rapid assessment, scanning for obvious signs of death: rigor mortis, stiffness in the muscles, lividity in tissue. None were apparent.

“How long was he down without a pulse?” says Andreozzi. “For all we know, it could have been hours.”

As they quickly began CPR and moved Jafar to a stretcher, the paramedics all had the same thought: a hypothermic patient isn’t dead until the patient is warm and dead.

Liersch and Lepage-McBain shared CPR duty. Andreozzi and Socha pulled the stretcher across heavy, crunchy snow and loaded Jafar into the lead ambulance. Socha started a saline solution intravenous in Jafar’s arm. Andreozzi suctioned vomit from Jafar’s mouth and cleared his airway. A heart monitor was attached: no heartbeat.

Lepage-McBain took over CPR while Liersch drove the ambulance the 900 metres to Kingston General’s emergency department.

The hospital doors whooshed open. Staff was ready. Liersch had radioed: 21-year-old male, VSA.

Jafar was whisked into the resuscitation room. Andreozzi gave a verbal report while the emergency team began its work.

Chest compressions continued as Jafar was wheeled in. His wet clothes, a thin T-shirt and pants, were cut off. He was intubated for assisted breathing. A heart monitor replaced the paramedics’ gear. Epinephrine shots were prepared. Two more IV lines were inserted. Saline solutions were being heated to 43 C — fluid to warm body cavities. A rectal thermometer read: 20.8 C.

“The lowest temperature I’d ever seen was 28 C,” says nurse Jane Lewis, an emergency department veteran who was “scribe” that day — the chronicler of all the “organized chaos” in the room to chart patient treatments.

“I’ve never seen anybody that cold.”

Jafar was also “asystole.”

“That’s what people call a flat line,” says Dr. Joey Newbigging, one of the emergency department physicians working that day.

“There was no blip-blip-blip on the screen. It was just a straight line.”

Calm but aggressive teamwork continued to, essentially, manually warm the man found on the pier.

The heated saline flowed into veins in Jafar’s arms. It was also cycled into his bladder through a catheter; add, drain, repeat.

Newbigging cut into Jafar’s chest, just under his right armpit. The incision was to insert a tube “through which we could flow warm fluid into his chest (to) bathe the right lung and right side of his heart, which would warm his blood,” the physician says.

Tayyab Jafar shows the marks on his body where tubes were inserted to help warm up his body. His core temperature entering the hospital was 20.8 C.  (Steve Russell)

There were as many as 15 on the team to help Jafar; doctors, nurses, respiratory therapists, support staff, aides running bags of saline into the room.

“Everyone was pretty invested in this case because it was a young person,” Newbigging says.

The emergency department staff also knew the patient had likely tried to end his life.

The team pushed to buy Jafar time should he be deemed a candidate for the next stage of resuscitative measures. Chest compressions, a physically exhausting manoeuvre performed for at least an hour, were as vital as any other act that day to force oxygen-carrying blood to the brain.

“With the CPR, it’s trying to make the blood vessels squeeze to get more blood to his brain because that’s really what we’re trying to preserve and rescue,” Newbigging says.

Soon, a critical question arose: was Jafar suitable for a procedure called extracorporeal rewarming, which could quickly raise his core temperature closer to 37 C? Using the cardiopulmonary bypass system, the procedure takes circulation outside the body so blood can be warmed and oxygenated then returned.

One way to determine Jafar’s suitability was through a blood sample drawn for a serum potassium test.

Upon death, human cells break open and spill their potassium stores into the bloodstream. Those salty spills can be measured. High readings from a serum potassium test would suggest Jafar was too far gone — dead too long — to be saved. He needed a result of less than 10 milliequivalents per litre to be considered for the next round of last-ditch resuscitation efforts on the cardiopulmonary bypass machine.

Jafar’s test result was 7.

“That, basically, is the green light,” recalls Newbigging at seeing the lab result.

The quick decision in the ER: “Let’s try.”

Dr. Joey Newbigging of Kingston General’s emergency department said “everybody was pretty invested in this case because it was a young person.” Staff also knew the patient had likely tried to take his own life.   (Steve Russell)

Still, other things needed to line up. A bypass machine and a cardiac surgeon had to be available, along with support teams and technicians.

Surgeon Andrew Hamilton was free. He said he’d try, too.

At about 8:48 a.m., Jafar was wheeled from emergency — with a nurse on the stretcher, straddling his stomach, still performing about 110 chest compressions a minute — and rushed into the operating room. Newbigging accompanied Jafar.

Jafar’s last core temperature in the emergency department was recorded by Lewis at 22.8 C; a two-degree increase in about 45 minutes, largely from heated saline irrigations and the warming blanket. Extracorporeal rewarming could raise his core temperature by nine degrees in an hour and during that time, perhaps his heart could be restarted. Perhaps.

Another question lingered: would he want to be revived?

The student had attempted to end his life. Now an all-out resuscitation effort was underway. This was not lost on the emergency department team — and that this patient “was a young kid who was obviously unhappy,” Newbigging says.

“If we get them back, are we helping them?” the physician says of patients who arrive with no vital signs. “Because we may not be bringing them back to the state of health that they were in when they first got sick. A lot of people ended up being quite disabled and never get back to independent living.”

Nurse Lewis was blunt.

“Did we do him a favour?”

Cardiac bypass

Fortunately, cardiac surgeon Dr. Andrew Hamilton was available to work on Jafar after he was brought into Kingston General Hospital. Jafar turned out to be a good candidate for extracorporeal rewarming.

In the earliest days of heart surgery half a century ago, controlled clinical cooling of the body aided intracardiac surgery. Surgeons had a little extra time to work on an inert heart when circulation was temporarily halted.

Today, extracorporeal rewarming equipment (commonly called cardiopulmonary bypass machines) is so “biocompatible” with living tissue that cardiac surgeon Andrew Hamilton says the hard part “is making the decision to do it. That’s No. 1.”

Extracorporeal rewarming is the only way to effectively rewarm a patient whose circulation has arrested, Hamilton says. That is done by circulating the blood outside the body where it is warmed, oxygenated then returned.

Potential candidates can be rejected if deemed they are beyond saving. Jafar’s low serum potassium count got him on the bypass machine — even though he was still flatlined.

“It doesn’t matter if the heart’s not beating at this point,” Hamilton says.

The surgeon explains that for Jafar’s extracorporeal rewarming, one tube about the size of a thumb was fed up from the groin vein into the venous confluence of the heart, allowing removal of the blood from the body to the machine. Another slightly smaller tube was inserted into a groin artery and was used to return the warmed oxygenated blood back to the body.

A perfusionist attended the machine constantly.

Hamilton recalls when Jafar’s core temperature reached about 28 C, he applied external contact pads to the chest and delivered an electric shock of 200 joules. That was likely before 10 a.m.

“He was easy to get started,” the surgeon says, noting the patient had age on his side. “Nice young heart like that? Poof!”

Finally, heartbeats. Strong ones.

But serious complications flared when the time came to remove Jafar from the extracorporeal rewarming circuit. The combination of the hypothermia and duration of cardiopulmonary bypass had rendered his blood incapable of clotting, explained Hamilton. “In addition, this combination of factors caused his blood’s protective mechanisms to become abnormally activated, leading to, among other things, edema (swelling) of his lungs,” the surgeon says.

Hamilton says extracorporeal circulation can be used for days if needed, “but it’s a very toxic event to have your blood running through an external machine.”

“The longer you’re on the extracorporeal circuit, the more likely that you’re going to accumulate this toxic damage,” he says.

Jafar developed a condition called coagulopathy; his blood could not clot despite an alchemy of medications and adjustments to remedy the issue. Hamilton recalls there was bleeding into Jafar’s chest. Intensive-care-unit nurses Jennifer Bird and Vanessa Holmes recall blood was gushing out of the chest tube incision, too.

Jafar now required massive transfusions.

Over his first 48 hours in hospital, Jafar received: 50 units of red blood cells; 32 units of frozen plasma (the liquid portion of whole blood that needs to be frozen in storage, then thawed for use); 20 units of cryoprecipitate — a concentrated component of plasma that contains high levels of clotting proteins — and eight units of platelets.

Dr. David Good is Kingston General’s hematopathology service chief. He wasn’t directly involved in Jafar’s case but reviewed records of the blood components used in his care.

“The most common blood component is the actual pack of red blood cells (and) over two days, he received 50 units,” says Good. A red blood cell unit is about 400 millilitres per bag.

“A normal person’s blood volume is about 10 units,” Good continues. “He basically had his blood replaced about five times over the two days.”

Jafar’s blood group is AB positive — rare in Canada and found in about 3 per cent of the population, says Good. People with AB blood are considered universal recipients for red blood cells and platelets (meaning they can get these components from donors of any blood type) but require frozen plasma from an AB donor. Good says the hospital had enough frozen AB plasma on site. (It was quickly restocked through daily Canadian Blood Services shipments from Ottawa after Jafar depleted hospital reserves.)

Canadian Blood Services spins whole blood from individual donors into four basic components, which are then stored. In Jafar’s case, Good calculated the number of individual donations required to supply all the stored components needed for his transfusions. His estimate: 134 people had rolled up their sleeves.

“To look at it another way, it took 134 people to save this man’s life,” Good says.

Saving his lungs, though, required mechanical intervention.

Jafar’s lungs were hit hard with inflammatory edema: fluid build-up. In this situation, which Hamilton calls common in rewarming efforts, it’s difficult for oxygen to reach the bloodstream from the lungs.

It took 134 people to save this man’s life

Dr. David Good

Hematopathology service chief at Kingston General.

Hamilton and his colleagues ultimately were able to calm the distressed lungs and restore clotting ability on a system called ECMO — Extracorporeal Membrane Oxygenation. ECMO temporarily replaced the function of Jafar’s swollen lungs. Not all Canadian hospitals have ECMO capabilities.

ECMO capabilities.

“Every now and then we have somebody whose lungs don’t work for whatever reason and you go through all the various things you can try,” Hamilton says.

“When you get to the bottom of your drop-down menu, it’s ECMO.”

After at least a day on this system, the Queen’s student stabilized.

“Over time, his body cleared the toxic effects of the hypothermia and the cardiopulmonary bypass,” Hamilton says. When that was achieved, ECMO was discontinued.

Jafar’s fragile lungs were functioning. His clotting ability returned. His heart was beating. Kidneys and liver were up and running, too.

“Once you have all that stuff working well enough that he can take care of his own environment, then you start to figure out: is his brain working?” Hamilton says.

“Until then, you don’t know.”

The surgeon had to explain the situation to Jafar’s “poor, shattered parents” after hours in the operating room trying to save their son.

“ (I said) ‘OK, we have a circulation established, we don’t know if the lungs can recover to the point where they can continue and we have zero idea of how his mental state will be,’ ” he says.

“ ‘We may have just saved him into a chronic vegetative state and you’re going to have a really awful decision to make.’ ”

Hamilton pauses and shakes his head.

“You can imagine.”

Intensive care unit


The thumping sound filled the ICU. It came from a high-frequency oscillation ventilator that was pulsing oxygen into Jafar’s lungs.

He’d undergone a tracheotomy; a tube snugly in his throat would allow the flow from the oscillator. He was off cardiopulmonary bypass and ECMO.


Dr. Daniel Howes was not Jafar’s assigned ICU physician but he helped with care. Howes says Jafar could not use a standard ventilator because his highly inflamed lungs were at risk.

“A normal breathing machine pushes air in,” Howes says.

“When (lungs) get inflamed, they get sort of waterlogged. They’re like sponges — but instead of (being) like nice dry sponges, which is the way they’re supposed to be, they get soaking wet and very stiff,” the doctor continues.

“So if we try to blow air into them the same way we breathe, they end up being injured.”

Howe says the oscillator is “notable because of its thumping and it looks like a big bass speaker,” adding: “It, essentially, vibrates oxygen in and carbon dioxide out of the breathing tube.”

The swelling wasn’t only in Jafar’s lungs. His head and face bloated. Body, limbs, hands and fingers had ballooned.

Howes says sometimes critically ill patients will experience swelling.

“It has to do with inflammation in the body. It makes the blood vessels very leaky; fluid leaks out and gets into the tissues and they get very puffy.”

Jafar’s once-slender, 140-pound frame was almost unrecognizable to his mother, Lubna Jafar, and father, Jafar Hussain, at his bedside in the ICU. After racing from their Oakville home to Kingston by car on Jan. 15, they would rarely leave their eldest son’s side. Alex Reid, who found his friend on the pier, was often there, too.

Jafar’s parents had originally been informed by Oakville police — relaying the news — that their son was found without vital signs. That was around 9:30 a.m. About an hour later, when the parents were readying to drive to Kingston, the police had an update: Jafar had a pulse.

When the worst had passed, it was Sunday. Jafar’s 21st birthday. By then, more family had arrived. Cautious optimism emerged.

“I think my brother, deep down inside, had some will (to survive) when he was coming back to life, to continue improving,” says Rida, 20, also noting the skill of doctors who “did an amazing job” rescuing her brother.

During his three weeks at Kingston General, Jafar remained under heavy sedation but recalls fleeting moments of consciousness. Of his parents’ presence. Of mouthing words like “water” to his ICU nurse, Holmes, who’d learned to read his lips. Of his father and Reid sharing a joke when they thought he was asleep.

On Feb. 5, Jafar was stable enough to be transferred by ambulance to the ICU of Oakville Trafalgar Memorial Hospital. He remained intubated but was switched to a standard ventilator. Howes recalls the move was primarily to be closer to his family during his rehabilitation phase.

In Oakville, a recovery of another sort would be needed.

Jafar was not at peace with being revived from the dead.

The earliest days at Oakville Trafalgar were Jafar’s darkest after resuscitation.

He was weaned off heavy sedation and quickly became aware of his situation — though he had, and still has, no memory of attempting to end his life.

(As part of telling his story, Jafar agreed to sign consent forms giving his permission for Kingston General Hospital and Frontenac Paramedic Services staff to discuss his personal health-care details with the Star. He also sat in on some of the interviews, learning more about the resuscitation.)

Jafar couldn’t speak because he was intubated. There was extensive nerve damage across his shoulders, down his arms and into his hands and fingers. He was told he might never use his hands again. Pain was constant. He’d lost almost half his body weight; down to about 80 pounds.

He cried. From frustration. From fear.

“Am I dying? Just let me die. What are you guys trying to do?” Jafar recalls thinking as he lay immobile in the Oakville facility, unable to communicate with doctors and nurses directly.

“I was in a lot of pain. I couldn’t talk to them either. They’re doing things (to care for him) and I’m trying to talk, but I can’t say anything.”

Jafar had “terrible” headaches. He’d hold his sister Rida’s hand for comfort, squeezing it with his weakened grip when pain crested.

“It was physical and psychological pain,” says Jafar. “I don’t know how I endured that.”

Eventually, the tracheotomy tube was removed and with help at first, he could eat and drink normally. Jafar began occupational and physical therapy. A social worker met him. His mood lightened as he healed.

He was assessed for brain damage — Jafar says he quickly “aced” cognitive assignments. Clusters of nerve cells were repairing but for a time, some body parts, like his hands, still felt like they were burning from a phantom cold. His lungs continue to recover.

Jafar learned to walk again, doing laps around ICU with a rolling aid.

On March 29, 10 weeks after he wasfound on the pier, Jafar strolled out of the hospital with his parents to continue his remarkable recovery as an outpatient; he hadn’t even lost a toe to frostbite.

Jafar returned to Queen’s last fall. That was always his plan once he recovered. To be back in the house on Nelson St., supported by housemates and a small group of friends who knew the truth about his life and death and resurrection. The only visible clue that he’d been ailing were white splints on his hands (while muscle tissue rebuilds).

When Jafar heard a rumour that he’d had a stroke, he wrote a Facebook post last year stating, incorrectly, that he froze in a snow bank after falling and sustaining a concussion. He says he used that explanation to address his long absence from Queen’s and spare his parents and housemates (who knew the truth and were offered counselling by a Queen’s chaplain) further emotional toll.

Jafar agreed to disclose the full truth after consulting his housemates and his psychiatrist, whom he visits monthly. Jafar, who stays in regular contact with his parents through Skype, says he feels strong enough now to confront what really happened on the pier.

“He’s definitely in a much better spot at this point,” says housemate Nick Musicco, 22, a public health major from Connecticut. “There was a point when we didn’t know if he was going to make it, so I just prayed a lot. I’m happy he’s pulled through.”

The Kingston General staff who treated Jafar lost track of him after his transfer to Oakville. Many learned of their patient’s full recovery in December when a student publication repeated the Facebook information.

“I thought . . . probably he would have a lot of disabilities and I didn’t even know if he would survive,” Newbigging says.

Andrew Hamilton, the cardiac surgeon, says he’s treated hypothermic patients before but Jafar was unique.

“I’ve been doing this 25 years and he’s the first survivor that I had,” says Hamilton, smiling.

Jafar survived his own death. Is he happy with a second chance at life?

“That is kind of an interesting question,” he says.

“Obviously I survived but still, I’m happy because I want to do many things (regaining use of his hands was key to that contentment) . . . but I’m pretty much happy at this point.”

He seems upbeat. He’s sleeping well, using a trio of prescription drugs at night that balance well with the OCD and ADHD medications he takes each morning. The Nelson St. housemates have a Florida trip planned for late February. (Alex Reid will miss it. The B.C. native has taken a year off of school to work in Calgary.)

Jafar, studying general mathematics, is already planning to return to Queen’s this fall. He enjoys life in Kingston, the campus, the challenging classwork, the camaraderie.

He’ll even take jaunts back to the pier. Jafar was there during frosh week last summer, a hot day with students jumping in the lake for a refreshing dip.

The pier does not haunt him.

“It’s just a place to me,” Jafar says. “For me, I don’t have any real connection to it.”