“Is There A Doctor On The Plane?”

I was all set to write a wrap-up of my month abroad before starting on another away rotation. I had a wonderful time, learned an incredible amount of information that I could never have obtained in the States, and got to spend a month exploring a wholly different culture. It was great. I was jazzed to write about it.

And then I flew home.

I am fairly convinced that in a previous life, I either murdered one of the Wright Brothers or sabotaged the Hindenburg, because the travel gods absolutely hate me. I was delayed, in total, longer than my actual eight-hour total in-flight time.

But delays weren’t the whole story. I was flying back from the South American country of Guyana to Miami, which runs four hours and change. When we took off three hours late, it became apparent that not only was the air conditioning on the plane dysfunctional – it was 85 degrees the entire way – but that the infant sitting across the aisle from me was intent on screaming colicky murder the entire time. One hour in, the mom got sick of the grating noise and pulled out her iPad, playing the Surinamese version of The Kangaroo Song from Big Daddy, over and over again at maximum volume.

I would have preferred the screaming. Of course, the screaming continued anyway despite the best efforts of the knockoff Teletubby-creatures on the screen, jingling away like a kind of demented horror movie.

I put on a pair of headphones, turned my white noise app to maximum volume, and tried to hold still to minimize sweating.

Almost four miserable hours later we were finally, mercifully descending into Miami. Although the fasten seatbelt sign was on, most of the plane’s occupants paid it no mind, milling in the aisles and helpfully ramming me with their butts as they squeezed by.

A commotion kicked up: someone had apparently fallen in the aisle. I looked up to see a teenaged girl slump to the ground, then look up a bit woozily. She seemed okay until the horde of ladies she was traveling with went absolutely and completely nuclear. They hoisted her up by the armpits and dragged her back to her chair, fanning her with the in-flight magazines like she was on fire. Three of them started gesticulating to the front of the plane for help like the girl had just had a cardiac arrest.

One lady, attempting to Do Good, dumped a cup of ice water on the girl’s head. It was legitimately like a TV show. Women were waving their hands in the air, their arms jiggling like they were celebrating the resurrection at a megachurch revival.

It was immediate escalation to DEFCON 1 on the plane. Total pandemonium.

“Don’t call for a doctor. I’m not a doctor. I don’t have to go anyway, right?” I kept telling myself.

The overhead intercom dinged. “We are requesting a doctor if there is one on the plane, or a nurse would be okay also. Please come to the front of the plane.”

No one moved. Well, no one except the orbiting horde of wailing/fanning ladies, who continued to make dramatic hand gestures like a traffic cop on bath salts.

Ugh. Fine. I got up, grabbed my bag, and went to the girl’s aisle.

Or rather, I tried to. I had to forcibly move a large woman in a floral print dress out of the way as she was intent on soothing the patient, primarily by squeezing her face.

A helpful man in the seat behind the patient tapped me and said, “Her airway is patent. She is breathing.” (I could see that.) “Her pulse is approximately one hundred and ten.”

“Great,” I answered. “Did you see what happened?”

“ATLS,” he responded. ATLS is a certification in training for taking care of patients who have suffered trauma. That explained his report of the patient’s airway and breathing stuff.  I thought he had misheard my questions so I repeated it.

“ATLS,” he replied again. I couldn’t understand. Why was he insistent on telling me his certification?

I turned to the patient and announced myself as a medical student here to help. The first thing we’ve been taught to do in this situation is to control the scene – i.e. get everyone out of your way.

I tried to control the scene. “Okay, I need some space,” I declared. “Unless you are her mother I want you back in your seat.”

The lady wearing bright green reached her arms around my head to mop some of the ice water off the patient’s face. My call went unheeded.

Eventually I established a semblance of order and tried to talk to the patient, although all the ladies were simultaneously bombing her with questions and helpful statements such as “THROW UP. THROW UP GIRL.” Not surprisingly, the girl started hyperventilating and began having a full-blown panic attack.

I, too, would have a panic attack if a bunch of people started wailing and freaking out around me on a hot airplane right after I had a vasovagal episode.

I did manage to get her pulse and a good-looking oxygen saturation, thanks to the pulse oximeter I had brought to Guyana stashed in my carry-on. Her lungs sounded clear. She was intermittently answering questions, breathing really fast, and sweaty. Then again, someone had dumped water on her head earlier.

She also said she really needed to pee, although we were about 10 minutes from landing so that was a no-go.

The flight attendant arrived with a bottle of oxygen and a mask. One thing I learned on my month abroad is that everyone gets oxygen, regardless of whether they need it or not. Even if the patient is having a claustrophobia + overheated + fear of flying + hysteria-induced Perfect Storm Mega-Panic Attack, someone insists on throwing a mask on the patient.

I wasn’t happy about this but I didn’t really mind – it’s just oxygen – but then one of the Helpful Ladies decided that she needed to physically seal the mask onto the girl’s face. With her hand.

Almost losing it, I pried the woman’s hand off the poor girl’s face, looked her in the eye with my best Mean Face, and said,

“Sit. Down.”

She sat.

Finally.

The patient was relaxing a little bit – still hyperventilating, but responding to my cues to slow her breathing down and not panic herself into a hypocarbic respiratory arrest. I took off the oxygen mask she didn’t need. Taking advantage of the pause in the crazy, I asked the flight attendant to bring the med kit to make sure she wasn’t hypoglycemic and to make sure her blood pressure was okay.

All was going well until the plane bounced briefly and she got agitated again. This would have been fine except that it drew the Helpful Ladies out of their Helpful Seats (despite the fact that we were about a thousand feet off the ground and about to land) to Helpfully Massage The Face of the patient, which of course sent her into another hyperventilatory paroxysm of unvarnished panic.

The med kit arrived. When I took my emergency medicine course, we had a class on airborne emergencies. We were instructed that the kit should have at least a few basic items, like a sphygmomanometer (a blood pressure cuff) and IV supplies. You know, the absolute bottom line.

I opened the kit to find:

  • About 19 bandages
  • An inflatable plastic splint
  • A bottle of Imodium
  • One single dose of oral tetracycline – what?! – with someone’s name on it
  • One tube of ketoconazole, which is basically fungus cream.

That was basically it. I am not exaggerating. Notably, the kit contained no tools for taking vital signs, no glucometer, and no intravenous access supplies whatsoever. It was thoroughly and totally useless – unless you had a jock itch emergency at 35,000 feet.

I was so done. There was nothing I could do except tolerate the incessant hysteria and intervention of the Helpful Ladies until the plane landed. Then I went back to my seat and waited to disembark with the rest of the cattle.

When I finally got off the plane 25 minutes later – mostly due to the man who spent ten minutes attempting to de-wedge the largest carryon bag I have ever seen from the overhead compartment – I saw the girl sitting off to the side with the Helpful Eight clustered around her. Walking by, I waved. She smiled and waved back, looking all the world like a normal teenager again.

The airport medic stood on the periphery of the Ladies, hopelessly trying to wedge himself between the herd of ladies – still fanning the poor girl with their in-flight magazines.

I would have grinned, but I was still too angry.

My flight from Miami to home got delayed 3 hours because the gate agents miscounted during the boarding process, at which point I very nearly had a psychotic break and lost touch with reality.

I’m renting an RV for residency interviews. I’m never flying again.

 

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5 thoughts on ““Is There A Doctor On The Plane?”

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