Friday, July 31, 2015

Is there a medical doctor on the plane?

“Is there a medical doctor on the plane?
I’m unlucky this way.  I’ve responded to a medical emergency in flight several times now in the past 2 years.  It is Air Canada this time.  The plane has taxied to the take off position on the run way.  I hope another doctor is on board. There isn’t anyone else joining the stewardess leaning over the man in the section ahead of me.
I walk up the aisle, identify myself.  The man is in the window seat.  He appears obtunded.  The two passengers beside him move out to let me slip in.  He is breathing slowly.  I place my fingers on his pulse talking directly to him. He’s moving very slowly, pupils midway.  He smells of alcohol.  Maybe something else.
I proceed to ask the emergency questions, talking to him, reality testing, conclude he’s disoriented, slurring words, fluctuating consciousness, disoriented.
The stewardess leans over and asks if we should take him back to the terminal.  “Yes, “ I answer that will be best.  He’s irritated and admitted he’s been drinking rum and tea before the flight. He’s a very poor historian given mental state.  It’s all I can do to engage his floating attention.  I don’t know if he’s just taken alcohol and whether the blood level is rising or falling.  It’s best that we return.
The airport’s emergency services come aboard when the pilot gets the plane back to the terminal .  I briefly tell the fellow the salient features and my diagnosis Delirium secondary alcohol and possibly drugs.  He engages the man, professionally and efficiently. It’s apparent this airport team is particularly time aware.  The man staggers and stumbles sailor walking the length of the stationary plane.
The stewardesses thank me.  I find a card, write down my college #, put my diagnosis on the back.  The stewardess are all young and beautiful. Throughout the flight they each stop to thank me.  I am rather happy to have beautiful young women smiling at me.  Bit of a novel experience at my age.
I love the irony or synchronicity.  Being a physician/psychiatrist/ and addictionist I couldn’t be better suited to this particular emergency.
The last emergency I helped with on Air Canada was coming back from Hong Kong.  Pseudo seizures secondary to  metabolic acidosis after panic attacks.  When I was a family physician I’d have been hard pressed to handle either of these cases.  Both were custom made for me today.
Back when I was a gp I was faced with a delivery on a train. Despite delivering a hundred babies in my day I was incredibly relieved   when an obstetrician came forward and  took over.  Personally I'd given a Doctor of Divinity a similar sense of relief when I came forward.  He'd been good enough to heed the call.  
I'll never get cocky though. Handling an angry psychotic  man on one flight had taxed all my skills despite my psychiatric expertise.
 This time I was lucky.  God was kind.
It was good to be of service too.
I rather liked all those  smiling grateful young stewardesses though.  Made me feel like Brad Pitt must feel always.  Not bad. Not bad for an old guy.

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