He had seen me reading my Step 2 Secrets book prior to takeoff, and so of course had asked me all about medical school, how many months it would be until I would officially get my M.D., and then proceeded to describe his chronic constipation to me in excruciating detail. I finally lied and told him that I had a terrible hangover when really, all I was was tired, just so that he would stop telling me his vomit-inducing stories. And now he was nudging me. Poking me. Loudly ahem-ing at me.
There was a bustle of commotion at the front of the aircraft. And then came the announcement overhead that I was dreading. "If there is a medical doctor on board, please identify yourself and come to the front, thank you."
I stayed in my seat. I wasn't a doctor - I was just a medical student. And god knows what was going on. What if I couldn't do anything? Or worse yet, what if I did something wrong?? I could barely remember my BLS training. Was it 30 compressions and 2 breaths, or was it just continuous compressions now? I wasn't equipped to help out. Or at least, that's the excuse I told myself.
My neighbor stared at me, judgement written across his face. "I'm not a doctor yet!" I protested meekly. "I'll go if there's no real doctor on the plane," I promised. But as the seconds ticked by, it became evident very quickly that there was no real doctor on the plane. My neighbor just continued to look at me every now and then, and although he didn't say anything, I could hear him going tsk tsk in his head. The flight attendants were now fumbling with large headsets, trying to connect to a medical center on the ground. And then, overhead again, another request, "If there are any medical personnel on board, we'd appreciate your help at this time."
I swear my neighbor's head snapped so quickly to look at me again, he must have pulled a muscle. I unbuckled my seat belt and made my way to the front of the aircraft.
There, a woman was protesting that she didn't need anything, that she felt fine, that she didn't need the oxygen mask that an older woman was trying to slap on her face. Another woman was trying to take her blood pressure, but the cuff was inside out. And in the seat next to the patient were stethoscopes, reflex hammers, pen lights, tongue depressors, IV tubing, glucometers, bandaids, and everything else you could possibly imagine. It was as though a doctor's office had regurgitated its entire contents onto the unwanted middle seat. And now this older woman was trying to place AED pads on the patient.
And then, somehow, someway, my training kicked in, and I thanked my physical exam instructors for forcing us to go through the SEGUEway at every patient encounter. I stepped in, quickly got a history from her, as I took over blood pressure duties from the overwhelmed retired nurse who had come forward. She had gone out drinking the night before, had way too many drinks, had thrown up way too many times, and was late for the flight, so she hadn't had anything to eat or drink all morning. No past medical history except for anxiety. And maybe some possible claustrophobia. And so when the plane took off, she got a little anxious, then realized she forgot her Xanax in her carry-on that was now out of reach, and then started freaking out more. And that's when she started hyperventilating, and then passed out for maybe a couple of seconds.
I immediately took off the oxygen mask, and waved off the woman who still wanted to shock the patient, for some reason. "She needs fluids," the retired nurse kept interjecting, her own anxiety projecting onto all the flight attendants. "Let's put an IV in her!!" The flight attendants all nodded, and handed me a 500cc bag of normal saline, along with the IV kit.
I haven't put in an IV since Intro to Clinical Clerkships, which was less than a year and a half ago, but might as well have been a lifetime ago. And although I might try to forget it, I remember that I pretty badly bruised up my IV partner. And I was still trying to figure out the history and the best next course of action. I looked at the patient, worried that she could see the fear in my eyes. "Are you nauseous, or do you think you could drink something?" She nodded at me. And with that nod, the nurse started yelling out commands, "Let's get her some water!" "Actually," I interjected, "Let's get her some orange juice."
She was fine. More mortified than anything. Her blood pressure was low (90/60), she was breathing a little fast, and she was a little tachycardic - although I couldn't be positive that I wasn't just feeling my own pulse. The color was coming back into her face, and like she said, she felt fine.
The head flight attendant looked at me. "Do we need to make an emergency landing?"
"No no," I replied, hoping with all my might that I was making the right call, and that the woman wouldn't pass out again. "She's just a little tachy, but I think --"
"SHE'S TACHY!!!" one of the flight attendant freaked out, before the other flight attendant quickly reassured her, "That just means her heart rate's a little fast." "Oh," said the first flight attendant, now considerably calmer, "I thought that meant she was having a heart attack or something like that."
Things now under control, I went back to my seat, telling them to come get me if anything else happened. Nothing else did, thank the lord. And once we landed, she was whisked away in an ambulance. I grabbed my carry-on, and as I de-planed, one of the flight attendants pressed a few coupons into my hands - and now I can pay for a round of alcoholic beverages for everyone on my next flight!
