April 21, 2010

• “Is there a doctor on this flight?”, or, How I began my vacation

  So how did my vacation begin. 4 hours into an 11 hour flight…

  “Attention all passengers, if there is a doctor on board please identify yourself”

  Dr J’s thoughts: “shit shit shit shit shit”

  I’ll admit, I seriously considered not saying anything, leaning back in my chair and trying to sleep. Call it a lack of compassion, call it a fear of litigation, but there was a strong urge to just let the announcement pass. After All, I’m on vacation…and not only that but I’m just a first year resident, what do I know?

  And the answer is, probably more than the average person on the plane, meaning my stupid conscience wouldnt let me ignore it. So off I went to answer the medical emergency hoping to god it wasnt something serious.

  A 34 year old man with no past medical history had been complaining of palpitations and chest pain to the stewardesses intermittently, initially refusing further aid then becoming worried and agreeing to have a doctor paged. Which is where I come in, to find this man sitting on the floor clutching at his chest, damn near giving me a heart attack. The first and most important thing was to triage him…he was young to be having a heart attack but without any lab equipment, diagnostics, or even a stethoscope (at least initially) all i had to go on was my history and physical diagnosis

  After taking his pulse and checking his blood pressure, and learning that he had been seen three days earlier with a diagnosed panic attack and subsequently cleared to fly, I felt reasonably safe in diagnosing him with another panic attack and informing the captain that there was no need to land the flight in siberia to get him further medical attention. My reasons for this were as follows

  A 34 year old with no family history, no obesity, and no risk factors other than smoking with a previously worked up similar complaints 3 days before. Oh yeah and one other doctor was also on the plane, but as soon as he got there and saw me talking to the guy he basically asked what year I was, and after hearing I was a first year internal medicine resident, he was like, okay all yours and disappeared into safety from liability land up in first class.

  So I basically just sat and talked with the guy through his panic attack, gave him some oxygen, and retook his pulse. All without the aid of modern medical technology, and essentially doing nothing, he got better and was able to retake his seat and I mine. And for this doing nothing, AA gave me 25000 miles and a free bottle of red wine from first class. So this time, no harm, no foul. It was both a heady and terrifying feeling.

  And that’s how I started my spring break. Let’s hope the remainder of my trip is somewhat more uneventful

  Dr J

  • 10:17 am
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