In January, Justin Tsui became the fourth Columbia student to reverse an opioid overdose.

Walking along Essex Street in the Lower East Side, Tsui saw a middle-aged man passed out on the sidewalk. A bystander had called 911 but 10 minutes already had elapsed.

Tsui, a first-year student in Columbia’s psychiatric mental health nurse practitioner program, knew from his training what do. He tried to wake the man by calling to him and tapping his shoulders. He unzipped the man’s jacket and rubbed his sternum with his knuckles. When there was no reaction, Tsui checked to make sure his airway was not obstructed. Next, he used the light from his iPhone to examine his pupils and found they were pinpoint, a sign of opioid use. His pulse was slow and fingernails bluish, indicating low oxygen levels in the blood.

Knowing it was likely an overdose, Tsui grabbed the Narcan kit from his backpack and administered a single dose of nasal spray. No response. He administered a second dose, and the man came to, drowsy and confused.

When the police arrived, he told them he was a nurse and offered to help. “They said that while they appreciated what I'd done, it wasn’t my responsibility, and that I should leave. I was in shock for the next 24 hours and walked around in a kind of daze,” he said. “I mean, this person could have died if I hadn’t been walking down that exact street at that exact moment.”

Tsui said the ending felt abrupt, like leaving a room halfway through a story. “There’s a part of me that wants to know how he got there and what will happen next," he said, "and another part that feels that it’s none of my business.”

McNeil said that for many who go through this experience, the aftermath can be the hardest part. An opioid reversal requires no follow up or documentation. “Once the save is made, the saver’s job is really done,” McNeil said.

Rau had a similar reaction to Tsui's as she continued on her way to the train that day for apple picking.

“Sitting in my seat I tried to process what had happened,” she said. “I still think about the man. I hope he didn’t suffer and that he's all right."

And although saving a life was amazing, she doesn’t believe she did anything heroic. “I’m just someone who was ready and in the right place,” Rau said. “We all need to support each other and do what we can.”

Interested in getting involved? Columbia's Opioid Overdose Prevention Program offers training to members of the community. For inquiries about Morningside campus classes, fill out this form. For Washington Heights, contact Kellie Bryant at 212-305-2982 or kdb2146@cumc.columbia.edu.