It was December 2022 and I was headed back to Boston for work after a tiring several days of a family vacation in Cancun. I had spent the morning at the airport lounge after endless eating and was mentally preparing to return to the real world. After boarding the plane, I slumped down into my seat, put my headphones on and closed my eyes.
“Is there a doctor on the plane?“
In a fog, the words of the flight attendant slipped through a pause in my music and I shot up to push the call light. I exited to the aisle, grabbed my stethoscope not knowing what was going on, and ran to the front of the cabin. Another passenger had volunteered to assist just before me but due to not having any proof of medical license, was legally prohibited from opening the medical kit. As I am constantly traveling from one job to the next, I flashed my badge and she ushered me to the supplies. My heart was racing, I still had no idea what the call was for. I broke the seal on the kit, opened it and walked towards the other doctor. As I approached, I flipped through the supplies… epinephrine… adenosine… IV fluids… We had the tools to run a full cardiopulmonary resuscitation on that airplane. I walked up to the other doctor standing in the aisle with the kit opened and then turned to look at the passenger, shocked to what I saw…
***
According to the New England Journal of Medicine, an in-flight emergency happens on roughly 1 out of 604 flights. The question of interventions on airplanes by medical providers has become wrought with legal discussion over the years. The concept of a Good Samaritan is challenging in a contemporary environment of worsening litigiousness. A fear of lawsuits has overpowered a need to do good and to help others, and understandably, when it comes to situations as such, not everyone may jump to push the call light. But while the overall answer is that there is some protection in genuine well intention, this post isn’t for that purpose.
After the ordeal, the flight attendant came to my seat to document what had happened and told me that over the years she has noticed that when these events happen, although less commonly than in the past, she has noticed two kinds of people that I describe as such: Those that jump to push the call button, and those that turn up the volume on their headphones and sink further into their seats. Not everyone wants to get involved, and who could blame them.
I realized that in life, and obviously in medicine, there are those that will volunteer when the call is raised and those that will wait out the call unless there is nowhere left to hide. I have for many parts of my life, actually been the latter. As time has progressed and as my experience has changed I have become more apt to jumping for the call button. The sense of urgency and the confidence I have needed to foster, has overtime changed the way I interact with these situations. But it has led me to contemplate often how we handle difficult or scary situations in our lives. My instinct has matured over the years to push me into the action and by working in locum tenens, I realized that I have grown so much in this regard. From my very first time leading a neonatal resuscitation to my help with a spinal tap in the emergency room, I am slowly becoming more aggressive and eager to help when it is needed, offering my hand up first as the volunteer. Many things may hold us back when the pressure mounts, and it will inevitably be stressful; but, it is how we react and what we do next that will echo in eternity. I have never been one to completely sit in the shadows, but now I do all I can to come out of them.
So when the time comes and you are needed, which one will you be? Will you push the call button? Or put your headphones back on?
***
The 2 year old sitting in that seat staring up at us was quiet, smiling, and curious that night. He had fallen and bitten his lip to create a small cut on his chin. We shuffled through a second medical kit, put a bandaid on his chin, told him to go to the ER for stitches when we landed, and sat back down. But at least we answered the call.
The Nomadic Pediatrician 