Saturday, March 28, 2009

Is there a doctor on the plane?

On the red eye home Thursday night, I was curled up against the airplane window, dreaming of the Kardashians again, when all of the sudden, the flight attendant made this announcement:

"If there are any doctors, RNs, EMTs, or paramedics on-board, can you please ring your call light?"

I groggily woke up, looked at the BF and thought to myself, do I REALLY want to claim my profession at 3 in the morning on a plane? Unfortunately (or maybe fortunately), my sense of duty won out and I sleepily reached for the call light. The little red light flashed and suddenly a flight attendant appeared at our side. She said that a girl had passed out in the back of the plane and asked if I'd go take a look at her.

I made my way out to the aisle, hair a mess, with bad breath, and without my shoes, and walked briskly towards the back of the plane. A young girl was sitting on the floor, surrounded by a couple of flight attendants and very concerned passengers. As I knelt down to talk to her, one of the flight attendants asked, "Are you a nurse?"

Ok, now, one of my pet peeves is when people ask me if I'm a nurse. This is not because I think it is a bad thing to be a nurse or because I don't think nurses do a very difficult and noble job. Actually, I could NEVER be a nurse and I have a ton of respect for most of them. What irritates me about that question is that the only reason people ask it is because I am female. If I were a man responding to the flight attendants call, I would NEVER have been asked if I were a nurse - it would have been automatically assumed I was a doctor. And, even worse was the fact that a FEMALE asked me that!!!! It makes my blood boil.

But, I digress. On with the story...

I grudgingly replied, "No, I'm a DOCTOR," in my firmest voice.

Apparently, the girl had been making her way back from the bathroom, became lightheaded, and blacked out. The flight attendants had provided her with oxygen and some ice to cool her down. By the time I got to her, she was awake and coherent.

Unfortunately, there's very little I can do without some equipment when it comes to syncope. Luckily, the flight attendants were able to provide me with the crappiest stethoscope and blood pressure cuff known to man (or woman). We were right over the wing of the plane - the loudest part - and I couldn't hear a thing. In fact, I was wondering if maybe she was dead. But, since she had a pulse and was talking to me, I figured that wasn't the case.

As I was assessing passenger #1, another passenger began to feel lighheaded and said, "everything is getting very dark!!!"

Now, I'm thinking, "Oh god, we're gonna have an epidemic right here on flight 734. YIKES!"

Because passenger #1 had actually passed out, I focused my attention and energy on her. I asked her more questions, in an attempt to get a history, and silently swore to myself that I didn't have better physical exam skills. Typically, syncopal patients get a head CT, EKG, telemetry monitoring, blood work, accuchecks etc and about 40% of the time we never find out why people are syncopal. But, without those things, it's difficult for me to rule out hypoglycemia, stroke, arrhythmia, et cetera. So, the best I could do was get a decent history, examine her minimally, and reassure her that she was likely just orthostatic (dehydrated) and maybe hypoglycemic.

In the meantime, passenger #2 puked her guts out in a puke bag and suddenly felt all better. AKA - she was freaking out secondary to passenger #1 fainting.

I stayed back there with the two of them until we could get passenger #1 back into a seat. After a couple glasses of water, some orange juice, and cool air, passenger #1 began to feel better and her color gradually returned back to normal. Once I felt assured that she was going to be ok, filled out some paperwork, and encouraged the flight attendants to be sure paramedics met the plane when we landed, I made my way back to my seat.

When we landed, the paramedics filed on to the plane and walked both girls off to the emergency room, where they undoubtedly spent four to five hours laying on an uncomfortable ER bed and likely being sent home without any new information or diagnoses.

Most of my drive home that morning, I wondered what I would have done if the situation had been more serious. What if it were a cardiac arrest or a stroke? What am I supposed to do on a plane, without diagnostic tools, drugs, and other therapies? Yikes. What I did decide is that I will respond again if the flight attendants ever ask, "Is there a doctor on the plane?"


  1. i think you'd respond the same way every time! what a great post. i read every word! thanks for stopping by. how'd you find me?

  2. WOW! I know those flight attendants and passengers were happy to have you answer the call. Good question you pose though...what would you do if it was a serious medical emergency? Scary thought when you are miles in the air.

  3. I think it just makes people feel better to know there is a doctor on board... & yeah, you can only do so much without the proper equipment, but at least you'd know what to do ... others would probably just freak out... Hence, passenger #2.... I'd be like her, I'll admit - I'd freak & pass out myself :-) Its why I'm in accounting! :-)

  4. Wow you really are a superhero, that's really the right thing to do, nobody should do otherwise really. Good call.

    ps. I'm so annoyed with the women stereotypes in any kinds too.

  5. You are my hero. Sort of like Batman- but female, and more awesome.

  6. Wow. I find it would be hard to work without equipment! Good job for working with what you had.

    When I went to London last year, our patient care manager (she's a nurse manager), told me to bring my stethescope on the plane. Just in case. She said she always does, and if security gives her grief, she shows them her nursing license. I don't think I want to be stopped by security thanks, but I think it would be beneficial to have the proper equipment when needed.

  7. Great story. I would be annoyed too by the attendant assuming you were a nurse. She should have known better!

  8. My colleagues and I have had this discussion. What do we do as a pathologist? We're not even ACLS trained and the clinical knowledge is rapidly disappearing. I guess if there was no one else, we'd be better than nothing. Luckily the only flight that ever happened to me on was when I was a pre-clinical med student and there were several doctors on it.


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