Wednesday, September 3, 2014
'Is there a doctor on board this flight?'
I was recently on a commercial airline flight when I noticed a bit of a commotion across the aisle. Two flight attendants were responding to the situation, which was triggered when 1 of the passengers in that trio of seats reached over and started eating the food of her fellow traveler. They quickly moved “the victim” out of the way, and were struggling to manage “the perpetrator.” I overheard them agree that they were concerned about the medical condition of the passenger, and moments later, one of the flight attendants used the public address system to ask if there was a doctor on board.
I had noticed the passenger in question when we had boarded the aircraft earlier that evening. She was hard to miss: a woman in her 20s, strikingly tall, quite attractive (even with the collagen-fortified lips), wearing a long, clingy cotton dress with a plunging neckline and no back and, as the flight attendant later stated emphatically, no underwear. Oh, did I mention she also had a lap dog in a small carry-on?
When the call came, I was really in no mood to respond. I was tired and just wanted to get to where I was going, but when I heard the announcement, I tapped the flight attendant who was still in the aisle next to my seat, and identified myself as a physician. She told me what was going on and asked if I could evaluate the unruly passenger. I moved across the aisle into the seat vacated by the woman who had her snack box violated and tried to engage the young woman who was now slumped back in her seat next to the window, clutching her dog.
Let’s just say I did not get very far. The cabin was dark, so I could not see if her eyes were bloodshot or the state of her pupils, but her speech was slurred, her head was lolling around and she seemed only vaguely aware (though rather indignant just the same) of all of the attention being paid. I asked her a few questions, feeling about as competent as the average first-year medical student. “Are you OK?” That just got a face that said, “Are you OK?” “Do you speak English?” “Of course!” “Any medical problems?” Confused stare. Any medical problems? See question 1. You get the idea.
Sometime during my encounter with her, it occurred to me that she had used the lavatory while our departure was delayed, and that she had seemed perfectly “normal” when she had boarded and on her way to and from the restroom. She now seemed to be completely intoxicated, but not acutely ill. I left it to the flight attendants to help her settle down, and she soon fell asleep, tossing and turning in a variety of provocative poses that included at least one “Sharon Stone moment.“
In the end, I counted myself lucky. In-flight medical emergencies are not rare, and can have serious consequences. The American College of Emergency Physicians has published recommendations for how physicians should respond to calls for help while flying, and it is worth reviewing them before you board your next flight.
What is your experience with in-flight emergencies?
Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital. He then held a number of senior positions at Mount Sinai Medical Center prior to joining North Shore-LIJ. He is married with two daughters and enjoys cars, reading biographies and histories, and following his favorite baseball team, the New York Yankees, when not practicing medicine. This post originally appeared at his blog, Ausculation.
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