A week before Halloween 2021 and five days before her 68th birthday, Sarah Katzenmaier slipped into a royal blue bridesmaid dress and carefully applied her zombie makeup.
Then she made her way to Main Street in Lexington, Kentucky, like she had for the past 12 years to perform in the annual "Thriller" event.
Sarah was waiting in her assigned location with hundreds of zombies and spectators as the show began. Someone dressed as Michael Jackson, and someone else playing Ola Ray, Jackson's girlfriend in the iconic 1980s music video, danced in the street.
Shortly after starting her part as an "extra" in the parade, Sarah collapsed.
She wasn't breathing and didn't have a pulse. A woman started CPR as the zombie hoard started to move. Someone else called 911.
All around them, the zombie mob continued performing multiple renditions of the dance, creeping down Main Street. Finally, when the crowd started to thin, spectator Charlotte Callan noticed a commotion in the street. It looked like a medical emergency.
A pharmacy technician by day, Callan was completing her pre-med requirements by night. She wanted to become a doctor.
Callan had recently completed a CPR course as part of required training to administer COVID-19 vaccinations at the hospital where she works. Callan also learned the importance of CPR from her mother, who is a registered nurse.
The woman performing CPR on Sarah wasn't doing it consistently. Callan tapped her on the shoulder and stepped in. Sarah still had no pulse. She wasn't breathing.
For 10 minutes, Callan performed chest compressions as an ambulance navigated through the crowd. Finally, EMTs arrived.
They loaded Sarah onto the ambulance and continued CPR. When she arrived in the emergency room, she had a pulse.
Meanwhile, the event had ended. Sarah's husband, Barry, was waiting at their designated meeting point. When she didn't show up, he called their son, Kagen. He used an app to track his mother's phone. It showed she was at the hospital.
"They didn't know who she was," Kagen said. "She was a Jane Doe. She didn't have her wallet with her."
At the hospital, Sarah's blood pressure and oxygen were dangerously low. She was unconscious in the ICU for seven days. On Oct. 29, her birthday, nurses sang to her, even though she wasn't awake to hear the song.
Doctors determined Sarah's cardiac arrest was likely caused by an abnormal heart rhythm and blood clot in her upper heart. They speculated it could have been caused by a virus. Doctors implanted a device that includes a pacemaker and defibrillator to monitor her heartbeat and correct any irregular rhythms.
She spent the next few months doing physical therapy alongside Kagen, who had graduated from college in 2018 as a kinesiology major.
Callan, for her part, kept thinking about Sarah. She wondered what happened and was surprised more people in the crowd didn't know how to respond.
"If my parents or other loved ones had an emergency in public, I'd want someone in the public to know what to do for them," Callan said.
She contacted a local news station with the hope of spreading the word about how citizens can prepare themselves to respond during emergencies.
She ended up on the 5 p.m. news. Sarah's nurses saw Callan on TV and told Sarah's family. The family reached out to thank her.
Weeks later, Sarah and Callan spoke. Sarah told Callan she nominated her for the Spirit of Lexington Award. The two met when Lexington Mayor Linda Gorton gave Callan the award and named Feb. 17, 2022, "Charlotte Callan Day."
"When I first saw Charlotte, it was very special," Sarah said. "I'm alive today because of Charlotte and CPR lifesaving techniques. CPR saves lives. Period."
For Callan, the experience reaffirmed that she wanted to become a doctor. Now 30, she'll take the MCAT this spring, then apply to medical schools.
"I'm going to put my hat in the running for a DO or MD program because now I know I have the grit to do it," she said.
Sarah has made it her mission to encourage more people to get CPR training. Her extended family members took a CPR class offered by her physical therapist's office, and she's reached out to the local school board to help ensure all students complete the training voted into law years ago before they can graduate.
She's retired now and spends her days helping Kagen with the nano brewery he bought. She makes dog biscuits out of spent grain and gives proceeds to a local animal charity and is involved with the American Heart Association.
This past fall, Sarah was determined to dance in the "Thriller" event again. She wanted Callan by her side. Event organizers named them parade grand marshals. They sat in a sports car and led the parade. Then, Sarah got out to dance.
EMTs had ripped her blue dress, so she donned a new costume: blue leggings and a Kentucky Wildcats jersey.
"It felt cathartic," she said, "to get past that moment from last year."
American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email [email protected].
By Deborah Lynn Blumberg, American Heart Association News