Trial by fire

DSCN4615Hey all.

Apologies, I’ve had a lot of other Life Things going on at the moment – graduating in 2 days, moving in 6, trying to get all my residency stuff in order, editing the 1100+ pictures I brought back with me from Europe…

The silver lining: I found two bottles of wine sitting in my cupboard, woop woop!

But yes.

Back to the blogging.

The blog’s been blowing up today, for reasons I can’t explain, so I’m just gonna run with it.  Got a story to tell you.  About the slightly insane trip to Europe.

So my brother and I recently returned from a 2+ week trip to Italy, the Czech Republic, and England (see above).  I was pretty excited to go – after the huge slog of the MCCQ, I was stoked to leave my responsibilities and studying behind.  (Well, at least until my Advanced Trauma Life Support (ATLS) course this past weekend.)

I don’t want to give any identifying information, so we’ll just say that this was a flight where we were properly exhausted even upon boarding.  They fed us(!) early so we were nice and drowsy within the first hour of flying.  I was on the inside, my bro on the aisle, so I’m pretty sure I passed out on his shoulder.  And everything was fine.

Until it wasn’t fine.  In a dead sleep, the first thing I registered was movement in the seats in front of me.  Then a woman started shouting for help.

My worst nightmare was coming true.  Medical emergency on an airplane and mere weeks out of medical school.

Digression:  when I’ve been on call before, getting paged while sleeping isn’t pleasant, but you have a few seconds to pick up the phone and dial the number on the little green screen.  You have a minute or two to absorb what the person on the other end is telling you.  You then have a few more minutes of hurriedly putting your shoes on, grabbing your coat, and walking briskly to wherever you need to be.  All the while, you’re further absorbing the info you’ve been given while simultaneously prepping for what you might need to do.

I didn’t have that on the plane.  There was a maximum of ten seconds between the moment I heard shouting and by the time I was in the aisle, crouching over my patient.  I wasn’t on my game.  I was flustered and sleepy and scared and there was a person on their back in this cramped little aisle.

Thank God, another health professional jumped up to have my back during the assessment.  By then I had started to put pieces together.  Unresponsive.  Good pulse.  Breathing normal and symmetrical.  (At this point, I would’ve given anything to get hold of a blood pressure cuff and my stethoscope.)  My partner echoed my findings.

As the patient started to come around, a flight attendant tapped me on the shoulder and asked whether I was a doctor.  Thrown off my groove a bit, I might have been a little short with my “yes.”  I turned back to my patient, who was gesturing that they didn’t speak any English.  Awesome.  The attendant tapped me again.  “I’m sorry, but do you have any… identification to… show?”  I let my little flare of rage ebb before saying that no, I didn’t have my magic doctor card in my back pocket.  (Maybe with nicer words.)  It irked me that if I had been 30 years older and a man, they never would have asked.

To make an (hour-long) story short, the patient was fine.  Nothing a little water couldn’t fix.

But I didn’t sleep the rest of the flight.

It probably seems like I’m making a big deal out of nothing – after all, the patient was totally fine – but in that moment, I was absolutely petrified, adrenaline pumping, trying to figure out what was going on without all the tools I’ve been taking for granted.  A heart monitor.  A pulse oximeter.  IVs.  Without them, my diagnostic skills are limited; could it have been a heart attack?  Or hypoglycemia?  Or did he just get up too fast?  I had no way of knowing.  And I don’t like not knowing.  Not one bit.

And when I think back on it, that’s the thing that bothers me the most.  It wasn’t that the attendant doubted my credentials (though why anyone would pretend to be a doctor when something bad happens is beyond me), or that I was called to assess other people later in the flight (who were beyond fine), or that I never got a good history… what kept me up that night was the fact that once this patient got off the plane, I still wouldn’t have a diagnosis and, more importantly, I wouldn’t have any follow-up.

It cemented my resolve to become a good family doc.  (Or a great one.)  One that can not only handle those little emergencies competently and calmly, but also see to the patient’s needs afterwards.  There is no good family medicine without regular follow-up.  And now I definitely see why.

 – Atalanta

P.S. – (Congrats to all the grads across the country – we did it!!)

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2 Comments

Filed under Medicine, Travel

2 responses to “Trial by fire

  1. It’s good to get the mid-air emergency experience out of the way so early in your career!

    I’ve been following your blog with interest. Doesn’t med school go quickly?

    Best of luck with your residency! I’m sure you’ll be fine.

    • I might disagree with you on that one – even ATLS under my belt would’ve been helpful!
      And yes, hard to believe I’m convocating tomorrow. It strikes me (often) that I’m not qualified enough to do this!
      But thanks for reading, hopefully lots more adventures to come in the next two years!

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