Holistic Family Medicine • Primary Care • Eugene/Springfield

Flight 666 was jam-packed, and I had a nice aisle seat in the back of the plane near the potty. With the pristine green and high-fiber cuisine I eat, you never know when you have got to go. Then the call came blaring over the speakers from the flight attendant. I had put on my Boise noise-canceling headphones and was just laughing out loud at Steve Carell’s antics in The 40-year-old Virgin. I was laughing and relaxing on vacation and barely heard the flight attendant say, 

“Medical personnel to the front!” 

Through the corner of my eye, I saw a young man of 30-something jump up and rush to the front. I thought to myself, perhaps he is an ER doctor or an ICU nurse, so we are in expert hands. Then I thought, what if he is a radiologist or a dermatologist? We are all doomed. I don't have imposter syndrome, but it is always best to have only one captain of the ship. I'm on vacation and medical personnel have already rushed to the scene, I thought to myself. This inner dialogue took a fraction of a second. Then, as if it were a message from the universe, the IT geek next to me gently elbowed me and says, 

“Are you a doctor?”

I removed my headphones, and he confirmed what I suspected was happening. A medical emergency in the plane's front.

I have seen countless medical emergencies in my career, and I can tell from a mile away what this was… Even an intern soon learns that a genuine emergency is an arterial bleeder, a surgical abdomen, or a patient found down and unresponsive, etc. What most laypeople categorize as a Medical emergency is just a drama of mild name the non-life threatening condition of your choice. As I walk up to this so-called emergency, I see the “medical personnel” and a flight attendant. They were fumbling and stumbling, trying to put an oxygen mask on this poor patient. Right before my eyes, the patient began to decompensate and hyperventilate because it was not an oxygen issue. I asked the gentleman who rushed to the scene what he did, and he says,

“I’m an assistant at a nursing home.” 

Most laypeople are not up to date on the latest medical literature and still use the ABCs, so they check the airway first. Give oxygen and check breathing. The new guidelines are CAB. We check circulation first. 

The patient was a frail-appearing elderly gentleman 79 years old. He had fallen to the ground after going to the restroom, so a medical emergency was called. There was moaning, so I immediately knew his airway and breathing were fine. He slumped over in the chair and started hyperventilating, and I realized he was essentially being suffocated by a contraption of a plastic oxygen bag that was erroneously put on his face. This was not an oxygen problem, I thought to myself. Once I smelled his breath, it was pathognomonic. I checked his pulse and blood pressure and did a one-lead EKG with my Apple Watch. I immediately made the diagnosis. It was a circulation and volume issue. He had orthostatic hypotension and got a little vasovagal and suffered from pre-syncope from one too many IPAs. Even a third-year medical student could make this diagnosis with eyes closed. A radiologist, that’s a different story. After a very brief interview to ensure he was not having a stroke or a heart attack; I realized he would not die. Especially when he told me he was going to Orlando to visit his mother and father, who were both 99. He was a GOMER, as described in the cult classic House of God. And those in the medical field know, GOMERS don’t die, they go to the ground.

The flight attendants handed me the wired headphones with a mic to communicate with medical personnel on the ground in Atlanta airport, who we're expecting a potential emergency landing. I explained in medical jargon that the patient was stable after pushing fluids and he perked right up. It averted an emergency landing. I was going to Disney on vacation to celebrate the fact that I would be retiring from clinical medicine, but this emergency made me change my mind. 

As I’m walking back to my seat at the back of the plane, you would think I got a standing ovation and roars of admiration from all the passengers. But no, you can hear a pin drop. Most passengers remained engrossed in their gadgets or were sleeping as if nothing had transpired. From a few mindful folks, I received a soft thank you doctor, or a distant nod of the head in approval. It was just business as usual.

When I sat back in my seat, I had a strange idea as I dozed off. The flight attendant comes up to me and taps me on the shoulder and says,

“Doctor, the captain would like to have a word with you now.”

I enter the cockpit, and the plane is flying on autopilot. The captain thanks me profusely for saving a potential emergency landing. He pours us both a potent drink and says, cheers Doctor! He says doctors are overworked and underpaid just like pilots. We commiserate about sleep deprivation and the hazards of our respective occupations. I remind him that mine is a calling. Then he does the unthinkable and truly catches me off guard. He hands me the microphone: 

“Say whatever you want from the heart doctor”

Taken aback, I swallowed hard and noticed my throat was parched. The captain had a large cup of soda with ice and I asked him for a small sip and he obliged. With one small sip from the captain's cup, I felt a burn of a blow torch down my throat and esophagus. I guess the captain started drinking early.

I grabbed the microphone and say a few words to the passengers: 

“Ladies and gentlemen, this is your doctor speaking. I have good news and bad news. The good news is that we will land safely in Orlando after stabilizing a medical emergency. The bad news is the Captain is drunk and will be blackout momentarily. Not to worry, I will stabilize the Captain and disengage the auto-pilot. Not only am I a doctor, but a retired Navy pilot. I have my instrument-rated pilot license and will safely land us at Orlando International Airport, even though there is a thunderstorm with poor visibility.

But just for a moment, think about your life if we make an emergency landing in Atlanta tonight. Think about the cost, the delays, and the headaches. Some of you would have missed a wedding, a special family gathering, an anniversary, a birthday, or a closing on your dream house. 

My only gentle request is the next time you visit a charlatan quack for some snake oil remedy for a minor ailment, please ask your doctor what he or she thinks about the potion before you swallow it. Also, the next time you immediately challenge your doctor about a diagnosis that you googled moments before entering the examination room, consider first asking your doctor for his or her professional opinion.

Also, consider thanking a medical provider next time you see them for their selfless service and for being on call 24/7. Most professionals, such as lawyers, chefs, electricians, plumbers, CEOs, accountants, influencers, life coaches, and interior designers, get to relax while traveling on vacation. A doctor or nurse has a duty to be on call 24/7 in case of a medical emergency.”

Then, I awaken from my red-eye slumber and touch down on the sacred ground just in time. In a euphoric state, I'm back in the Sunshine state. With the power of the pen, I don't pretend to waiver and savior the moment and sign the papers. And just like that, one spouse, two houses, and I embark on the journey to join the senior PGA tour.

Disclaimer: The medical stories shared by the author are based on real patient encounters. All patient identifiers and medical facts have been removed and altered to such a degree that you are reading a work of fiction. Therefore the stories shared are merely to entertain you. However, for the astute reader you may find powerful and profound lessons for living. These messages of universal truth should not be construed as medical advice, but feel free to use them as free Cuban soul spice to live your truth.