"Is there a doctor aboard?"
No physician wants to hear these words while flying, but this time I was already primed by the frantic sounds of a female passenger in distress. We were over the North Atlantic, and my husband and I were on our way back to North America after a European holiday. The cabin was darkened for the in-flight movies when pleas of "Wake up! Oh, help!" rang out.
I was out of my seat, fast. The flight attendant and I arrived together to see a frightened elderly woman clutching the hand of her husband, who wasn't responding to her. His head was back, mouth open. He may have been asleep, except that he couldn't be roused.
I did a quick examination: irregular but steady pulse, colour good, no evident pain, breathing regularly without effort. I sat on the arm of the seat across the aisle, still monitoring his pulse, and asked the woman about her husband. At 80 years old, he had a clean medical history and took no medications. The couple had travelled to Scotland to celebrate their 60th wedding anniversary, and they were on their way home. It had been a good holiday, she said, but tiring.
Suddenly her husband opened his eyes, looked at me, smiled and said, "Hello. What's happened?"
"Well, you lost consciousness for a few minutes," I said. "Your heartbeat isn't quite right, and that may have caused this."
Soon after, looking down on the expanse of snow over Greenland from the cockpit, I reported to the pilot that there was no other plausible explanation for the man's episode.
"We can put the plane down in 20 minutes in Gander," he told me, "or carry on for two hours and land in Toronto.
What do you want me to do, doc?" "Put it down," I said. It wasn't worth taking any chances, and the safest thing was to get him hospital care quickly.
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