By Katie Ginn
More than two years after the worst night of her life, Elizabeth Ann Howell’s eyes glisten as her husband tells the story. He gives a thorough account, even of the parts when he was unconscious.
Tyler describes January 26, 2023, as a “routine” evening: “I ate dinner, watched some Netflix, went to sleep – (and) the next time I was conscious and aware of my surroundings, I was on a ventilator at University (of Mississippi) Medical Center.”
Elizabeth Ann, or “EA” as loved ones call her, had woken up around 3:30 a.m. – a miracle in itself, Tyler says, since she’s not a light sleeper. Their golden retriever, Annie, had been coughing the past few nights, so EA assumed the sound that woke her was the dog.
“But it was me,” Tyler says, “gasping for air.” When she shook him – once, then again more forcefully from his side of the bed – he was unresponsive.
EA ran to unlock the front door while dialing 911. By the time she got back to the bedroom, Tyler was no longer breathing. EA started chest compressions.
“What’s funny (is) she was staying on track (by) singing the song from the Bee Gees, ‘Stayin’ Alive,’ as everyone’s taught to sing,” says Tyler, an internal medicine physician at Baptist Hospital. “The 911 operator had to ask her, ‘Ma’am, please quit singing. I’ll help you count, but I need you to tell us your address.’”
A Flowood police officer arrived first and took over the chest compressions, which EA had been doing for nine minutes. EA called her mom.
“Then she called one of my good friends, Samer Mehio, who lives thankfully just five minutes away and happens to be a second-year cardiology fellow,” Tyler says.
First responders had to shock Tyler a couple of times to restart his heart before loading him onto the ambulance. They took him to Merit Health River Oaks, and then Samer facilitated a transfer to the cardiac ICU at UMMC.
“I was stabilized, and they were able to figure out that I had indeed had a cardiac arrest,” Tyler says.
If EA hadn’t been trained in CPR less than a year earlier, he might not have survived. “Less than 10 percent of people survive a cardiac arrest outside the hospital,” EA says. “However, if CPR is started immediately, it can double a person’s chances.”
‘God put us together’
Tyler’s heart attack happened in his and EA’s Flowood home. When EA purchased the lot, she was still Elizabeth Ann Miskelly, single, and in her fifth year of teaching. (She’d earned a business administration degree with the intent to work at the family business, Miskelly Furniture – eventually. Now, though, she thought she’d spend the rest of her career teaching.)
“As I kind of started doing (house) plans, I went to (Miskelly), but there were a couple things I wanted that weren’t on the floor at that time. So I said, ‘Can I go to market with y’all?’ (Then) it evolved into, if I’m looking for these things, I know there are people my age who are looking for it,” she says.
The rest is history. Readers will notice that Miskelly Furniture’s MCL ads are frequently centered on the Elizabeth Ann collection, curated by EA to add some contemporary flair to what she calls the “bread and butter” of the Miskelly showroom.
Meanwhile, before she’d built her house, EA met Tyler – for the second time. After a Mississippi State-LSU game in Starkville, the two were both standing awkwardly on the fringes of the same friend group when Tyler noticed her.
“I said, ‘Man, that girl’s really pretty. I need to get her number.’” So, after introducing himself and chatting for a bit, Tyler did just that.
“As soon as I punched in her number, it came up ‘Elizabeth Ann Miskelly’ – it was already in my phone. And she already had my number saved.” But neither of them could remember how they’d met.
“It wasn’t until (she) talked to her friends from college (that we figured it out). About six years earlier, we had both been at Orange Beach (and) were staying at the same condominiums (with) our friend groups and had actually met out by the pool.”
“They had a boat … so we got his number,” EA interjects with a laugh.
“When you think about how many people go down to the Gulf Coast … And then there were a lot of people at that Mississippi State-LSU game,” Tyler notes. “God put us together.”
When they started dating, Tyler was in his fourth year of med school at UMMC. When it came time for him to match with a residency program, he wanted to stay in the Southeast – but “I had interviewed in Tennessee and Alabama and a few other places,” he says.
Thankfully, EA told him that if he matched out of state, she was willing to either build her house and sell it, or keep the lot and put her plans on hold. She would move to be in the same city as Tyler.
Praying for the impossible
The Howell family after Tyler’s cardiac scare in January 2023.
EA and Tyler wasted no time: They got married in December 2018, during Tyler’s first year of residency at UMMC. They had their daughter, Everly, on August 25, 2021.
In 2022, “since we had a daughter,” EA says, she decided to participate in CPR training at Miskelly Furniture. CPR Stars, run by Seth and Karie Loman, conducted the training. They made it so much fun, EA came home and showed Tyler what she’d learned.
Less than a year later, when Tyler’s heart stopped, “everything they had taught me the year before just kicked into gear,” she says. “That’s just the Lord.”
In the wee hours of that morning, when she and her family were waiting for Tyler’s ambulance to arrive at UMMC, “(My brother) said, ‘EA, I feel like the Lord has given me the word “whole.” And I just think we need to pray that word over Tyler.’ So we did. Because really, what else is there to do?”
EA initially assumed Tyler had had a seizure because he was young and in good health. When she learned he’d had a heart attack, “I couldn’t understand,” she says.
“When I saw him for the first time at the UMMC ER, he looked a lot different than the guy I had gone to bed with the night before,” she says.
“And then you see your friends who had done residency with him – and (gruesome medical) things just don’t really faze them – so to see them really rocked and upset by that, I think is when I was like, this is really bad.”
She was told she wouldn’t know anything for 48 hours – and that when Tyler woke up, “he may be really different.” But everybody kept praying.
“When we got moved to the ICU, it was just me and him. And obviously, he’s not responding, he’s on a ventilator, he’s sedated – (but I’m) just feeling this peace (that passes understanding) – really, really praying and believing that the Lord was really going to do the impossible.”
Tyler says the data indicated that “none of my tissues or organs got adequate blood flow (during my cardiac arrest). If I saw this in another patient, and I knew that they had had no heartbeat for about 15 minutes and CPR had been done … it would be very reasonable to talk to the family about the anoxic brain damage that was probable.”
As it turned out, he woke up about 15 hours after the heart attack and was coherent – just confused and scared to realize he was on a vent. Soon he gestured for something to write with.
“The first thing I started writing out was SBT, which stands for spontaneous breathing trial,” he says. “But because I was on some medicine that impaired my ability to form memories, I wrote it out every five minutes – just begging to be taken off the ventilator.”
He didn’t have to wait long. That evening, EA went home, since the ICU doesn’t allow overnight visitors. The next morning, she was pouring a cup of coffee when she received a FaceTime call from one Tyler Howell.
“I was shocked!” she recalls. “I answered and he said, ‘What’s up?’ and I’m like, ‘What’s up with YOU?’ I knew there was a chance of him being extubated (that) day but had no idea I would hear his voice that quickly. I threw on clothes and drove straight to the hospital.” When she arrived, he was sitting up and eating Chick-fil-A.
Miraculously, Tyler’s brain was not affected by the lack of blood flow during his cardiac arrest. The biggest physical memento, two years later? An implantable defibrillator installed under his skin on the outside of his chest.
“Because I have had one cardiac arrest, I’m at increased risk of having another. And to make sure I don’t go nearly as long without a heartbeat … if my heart decides to go into V-fib, which is the name of the arrhythmia that happened, then I will get the shock (from the defibrillator) to take me out of it.”
“He hates it, and I love it,” EA says.
“It’s never gone off, praise the Lord,” Tyler adds. His own patients have said it feels like being struck by lightning or kicked in the chest by a mule!
Gratitude, chaos, and the grace of God
When EA talks about Tyler’s heart attack – or even thinks about it sometimes – “I think Satan likes to use it as a way to bring up a little anxiety,” she says.
Instead of dwelling in that anxiety, what she tries to do is be thankful. “Tyler and Ev will be back in her playroom, and she will just be cackling laughing, and (I’ll) pause and (say), ‘Lord, just thank You.’”
Tyler has experienced a similar perspective shift. “There hasn’t been a day that I have not held my little girl, held EA, and just (been grateful) – only the Lord knows how long our time is.”
Also, “I don’t feel like I’ve ever shied away from my faith, but I have become far more bold in sharing, especially in my work, just because I now actually can relate pretty well to a lot of the patients I see,” he says.
“He wasn’t the best patient, as it turns out. So now when people are (at the hospital), he’s like, listen, I get it,” EA adds, laughing.
Tyler’s cardiac scare even influences how the Howells think about what really matters in their daily routine:
“(His heart attack) puts perspective on, it’s really not that big of a deal if (Everly) doesn’t make it to K3 till 9:30 (in the morning),” EA says. “Even stuff at work, just trying not to let the little things bug you as much – not to say they don’t ever, but … things can just change in an instant. So trying to keep the main thing the main thing.”
Plus, even in a home designed by EA, no day is perfect.
“If you have a house that has a toddler and it’s not chaotic, please call us, ‘cause we would love to know what that’s like,” she says with a laugh. “Mornings are – creative, would be a nice way of saying it.”
If mornings are spastic, evenings are when the Howells spend quality time together, EA says. Everly is an only child, and the Howells’ schedules are fairly forgiving, so they’re able to enjoy more togetherness than perhaps the generation before them. And they live on their furniture – not just curate and display it.
“I have a 3-year-old and a 5-year-old golden retriever. So having furniture that will survive those things (is important), whether that’s marker on the sofa, or maybe Annie’s got muddy paws and hopped up on the chair,” EA says.
Still, the Howell home has a certain … feminine vibe.
“Thankfully, (Tyler) lets me do my thing,” EA says. “I feel like there’s more pink in this house than I feel like most guys care to have in their homes. … Sometimes he comes home and there’s just new stuff.”
Meanwhile, Tyler killed a turkey the morning of this interview. “We’ll find a special, special place for the turkey – probably not prominent, but special,” EA jokes. It might go into the bonus room/guest room, located over the garage, where Tyler has a desk and some workout equipment. “We keep that door closed,” EA says with a laugh.
A different animal-centric outdoor pastime provides an outlet for EA: equestrian training with Coolio, her Czech warm-blood horse, boarded at Southern Traditions Farm in Canton. She and Coolio compete in local hunter-jumper events.
“Tyler knew that I rode (horses) growing up, (and) when he did wake up and was talking (after his cardiac arrest), he was like, ‘Man, this is going to cost me a horse, isn’t it?’ Coolio is an extended member of the family.”
Whether enjoying their hobbies, their jobs, their daughter, or each other, the Howells know the only reason Tyler is still here is by “the grace of God,” he says.
“The fact that I woke up cognitively intact – as far as I can tell (laughs) … it would be statistically ignorant to attribute it to anything other than God. There are so many things that had to happen in the exact right order, at the exact right time. (It was) nothing but just the Lord working through the people I love most to keep me here.”
EA’s design tips and faves
- Invest in making your home a place of rest: “It’s easy to spend on clothes and things like that, but you don’t wear those items every day. You will look at your living room and bedroom furniture every morning (and evening). I think that if you invest where you spend so much time, it will pay off and help bring some joy to you when you walk in the door after a long day!”
- Her favorite place to relax at home: “It would be a tie between my swivel glider in my living room – I still beg my 3-year-old to let me rock her sometimes, and I love to have my morning coffee there too – and my bedroom. I look forward to getting in bed at night and watching Netflix with Tyler – plus I sleep really well thanks to my mattress from Miskelly’s!”
- Favorite item in her house: “Everly moved to a big-girl bed, and it actually was my grandmother’s bed. So we did sand it and paint it, so it’s a little more updated, but I think that’s probably the most special thing to me.”
How to get certified in CPR
CPR certifications typically last only two years, “because the guidelines change,” EA says. If you need a refresher, “The American Heart Association here has connections around the Jackson area of people they can recommend to do training. I love Seth and Karie (at CPR Stars).
“I was a little apprehensive, (because) oh my goodness, I have to get up here in front of everybody and do this thing that I don’t know how to do, (but) it was fun.”
Contact the American Heart Association at 601-321-1200. Find out more about CPR Stars in their ad in MCL.