Dec 12, 2009
2B or Not 2B: Flying in the Age of Innocence
Missouri Medicine Editorial #12
John C. Hagan III, MD
“Is there is a doctor on the plane? Please come to the First Class cabin”
I’m an Ophthalmologist, in a plane 30,000 feet over the Atlantic Ocean, returning from a much needed winter vacation. It’s 1995, the world and air travel were different then.
We’re halfway between Puerto Rico and our Miami destination. There are more than 200 people aboard this Boeing 747. I’m rapidly calculating the odds that there’s an Emergency Medicine specialist or Internist on board.
The announcement is repeated, a little more urgent, the voice noticeably more desperate.
“We need a doctor in first class. Pause. The female announcer draws a deep breath. Any kind of doctor will do.”
Heads are turning expectantly back in cattle-class where my wife and I are traveling. As yet, no Good Samaritan has stepped forward from the hoi polloi. The woman on my left murmurs, “I’m a registered beautician. I worked one summer as a lifeguard. Maybe I should see if I can help.”
It occurs to me that if someone is drowning in a martini or having a bad hair day, she would be just the ticket.
“John, you have to go. There’s no other doctor on the plane,” my wife opines. I have reluctantly arrived at the same conclusion.
Marshalling my best bravado and sang froid, I head for the First Class cabin. Rapid pulse, perspiration, dilated pupils-I exhibit all the symptoms of a full-blown “fright on flight” reaction. Bladder and bowel control suddenly become an issue.
More eyes than I examine in a week follow me down the aisle. Bits of conversation catch my ear.
“Why did he wait so long to stand up?”
“Maybe he’s hard of hearing.”
“Maybe he’s a pathologist.”
After what seems like a mile and a half, I reach the front of the plane.
There I meet the flight attendant with the edgy voice.
“I just can’t understand it. We always have a doctor in First Class. We never have to go back there in an emergency”.
This elitist flight attendant whom I dub ‘Queen B’ has spent too much time in first class. The caviar fumes have damaged her brain.
Why are there no physicians traveling First Class? She understands nothing about doctors’ favorite oxymoron-Medicare reimbursement.
“You’re a doctor?”, Queen B asks suspiciously.
“Yes, I’m an Ophthalmologist.”
“Well you’ll have to do. The man in 2B is having chest pain.”
I was really hoping for a corneal abrasion or a hard to remove contact lens.
I try to recall all the specifics of cardio-vascular resuscitation. Just as I’m ready to order boiling water and clean sheets, I remember that’s only for obstetrical emergencies in cowboy movies.
2B is a man in his 70’s. Like his attending physician, he is gray and sweaty.
2B’s wife, 1B, says her husband has angina. They ran through the San Juan airport to catch the flight.
It’s been a long time since I managed a chest pain patient. Do I apply leeches or ‘bleed him’? Just kidding- hasn’t been that long.
“Where are his medications? ”, I ask.
“Up there,” says 1B, pointing to the overhead storage, “in our carry-on luggage.”
I stand up to open the overhead bin.
“Careful” Queen B says sharply, “shift happens!”
Chastised, I carefully retrieve 2B’s medications.
After some oxygen and nitroglycerine, 2B is pink and his chest pain has abated. He expresses an interest in lunch. I realize I’m the only passenger that’s still gray and sweaty.
I’m about to ask 2B to share the oxygen when Queen B says the Captain wants to see me. I’m escorted to the cockpit door, which opens after a series of knocks and a code word.
Queen B introduces me to the Captain. “This is the doctor, (pause) but he’s an eye doctor (zing)”
I step inside the cockpit. “Wow” I gush, “what a great view you guys have up here.”
“That’s why we drive it from up here, doc.”
I realize I have just blurted out a candidate for the Inane Comment Hall of Fame.
The captain wants to know the details. I tell him things are going well, 2B has probably only had an angina attack and he seems to be back to normal.
He thanks me. Queen B asks me to return to my seat and reminds me to fasten my seat belt.
As I retreat through First Class I notice how much more appetizing the food looks. Back in coach, cold ‘mystery chicken’ awaits me.
I find 2B off oxygen and enthusiastically discussing wine selection with 1B.
“Thanks for the help, doc. My wife could never have got those medications out of our carry-on without you. Are you really an eye doctor?”
“Yes, I’m an Ophthalmologist”
“Do you have one of those little tiny screwdrivers that tighten glasses frames? Mine are kind of loose.”
“No,” I say, “I’m on vacation and traveling light.”