Recently I spread a You-tube video to my research group because I found it a fascinating example of communicating research results. It was a simply animated very pedagogical piece on the epidemiology of emergencies that happen on airplanes and contained some advice for medical practitioners who are called upon for assistance.
The main message was that most emergencies are minor and can be treated on board and that the Good Samaritan law applies in terms of legal liability, i.e. someone who helps out in an emergency should not be liable unless gross negligence has occurred.
The piece begins by the words “You’re in that half-conscious state between wakefulness and sleep when a voice calls out on the PA system: ‘Is there a doctor on board?” I was not sure if I was dreaming of that clip or waking to an actual call.
But a call it was. A young man with ample nosebleed for more than 20 minutes sat pale on the toilet. The crew were alarmed because “there was blood everywhere”. Any medical student who has gone through their obstetric training without fainting away from the scene will have seen “blood everywhere”. So I could see right away that the blood loss per se was not of concern for the patient’s safety.
A nurse, who had also come to answer the call, started cleaning the patient up while I took the history. Another doctor popped in his head and asked the most relevant question: are you on any blood clotting inhibitors? With a “no” to that he was gone, nothing dramatic was going to happen.
The young man’s blood pressure was fine and he had no blood dripping in the back of his throat. For being a public health physician and not seeing all that many patients nowadays I remember most of my training very well and like treating patients. The dripping at the back was something the ENT surgeons had always warned us for.
He had no such thing, but he was still bleeding a bit in the front and the staff was getting nervous because of the time that had passed so I applied a makeshift tamponade. I had to change it once to remove the clotting and put in the second tamponade to stay for a couple of hours.
I was asked to write a full medical report and while the event was still ongoing I was also required to assess the patient and state if he was fit to fly. With eight hours to go of the flight the captain was relieved to know that the patient was stable for now. He had contacted the ground medical officer who advised nasal congestants which I gave when I removed the first tamponade.
The staff was very thankful as was the young man’s family. It hadn’t been anything major, but I did spend two hours on it in the middle of the night and signed off the patient for continued flight. Because of that signature I felt it was not just a short advice I had given, but we (the Airline and I) had entered some kind of a formal relationship.
Because the halving time of favours is very short I made my way to the service desk upon arrival and asked if they could make a note in the system that I would very much appreciate to be upgraded to business class on the long leg flight on my way back. No such thing was going to happen.
I like being the Good Samaritan; like most doctors, I actually enjoy helping people. But was it really an unreasonable request to ask to be upgraded if there was availability on the way back? The last time I helped out the airline made me pay for two kilos extra on my luggage on My return flight. Things like this make any Good Samaritan annoyed. Well, pissed, to be honest.
Will I get up next time they call? Sure, the Good Samaritan never learns. And being able to help out is not a bad reward after all.