Apparently, Not All Medical Emergencies are Medical Emergencies

For most of the time, aviation is predictable. Flights operate to schedules, crew operate to rosters, cargo is moved according to demand and room. Even the weather is largely predictable.

It’s the passengers you have to worry about….

In this article, John relates a story that has remained large in his memory for the last several years…

The role of Captain is one I took very seriously. I was conscience of the fact that not only did I have an enormous hunk of metal bits and pieces to safely manoeuvre from A to B; but that I also had a large contingent of passengers and crew behind me – relying on me and my tech crew to keep them safe.

This was not only to keep them safe from aviation induced harm but also to keep them safe from the terrors their own bodies could unleash on them (and others) at any given moment. Heart attacks, strokes, gastro bugs and all manner of nasties could suddenly change a cruisy flight into something resembling the best of anxiety inducing action movies.

As it is not often you find Flight Crew who are also trained Doctors, airlines rely on an international institution called Medlink, based in the USA, who have a number of doctors who can help with inflight medical emergencies by giving advice on possible diagnoses and treatments available on board.

In my career, I had experienced a few medical emergencies and no doubt most airline tech crew can also count up on their fingers, the number of times they’ve had to consider diverting to save someone’s life – or at least, make them someone else’s problem!

There is, however, one Medical Emergency that stands out in my memory and I’d like to share it with you.

We were relaxing part way through a routine flight to San Francisco on the B777. The flight deck duties were well managed and the co and I were chatting to each other and sipping on our coffees. We were interrupted by a call from the cabin. A medical event was unfolding. Our coffees were promptly stowed as we asked for more information.

The patient was female and a non English speaker. She was travelling with a group and she has abdominal pains that were getting progressively worse. She was terribly uncomfortable and quite distressed.

Our procedure was to contact Medlink and request help. We also had two doctors onboard who were in attendance and with guidance from Medlink, they opened the aircraft’s Physicians Kit (sort of a mini ambulance set up).

Pain relief was administered by injection, but it had almost no effect and the lady was deteriorating with the pain simply getting worse. She was on the floor writhing with abdominal spasms. Sweat beaded on her brow and she begged for help.

This was clearly quite a serious event and so we at the pointy end began to prepare for a possible diversion into Western Samoa, where the lady could get hospital treatment. Quite quickly, we were ready to divert. We waited for updates from the cabin to know our next move – to divert or to continue…

After a while, we were beginning to move away from being able to divert to Western Samoa so we called the cabin for further advice. After a while we were advised she had recovered sufficiently to carry onto San Fransisco. She had a flight attendant of her ethnicity sitting with her, reassuring her. In her own language.

We stood down from our war footing and resumed our flight in a non-eventful fashion.

With the flight complete - and yet another flight load of sleep deprived, knackered passengers filing off the plane plucking up the courage they needed to face US Customs and Immigration - my tech crew and I met up with the flight attendants to make our own way through the entry point into the States. As flight crew, our progress through this choke point was supposed to be streamlined but… yeah…

Anyway, as we waited in our own queue, curiosity got the better of me and I asked the Cabin Crew what had happened to the lady and how had she recovered?

With hand on heart, what I am about to say is the truth, the whole truth and nothing but the truth.

The lady’s pain had come on quite quickly as the aircraft had been in the climb and at first, she had managed to handle the pain privately, but as the flight wore on, her ability to cope with the pain was overwhelmed and she became agitated and very distressed as the pain only worsened.

It is most fortunate that a crew member spoke her own language. The Flight Attendant also held private suspicions of what was happening to the lady. When it was clear that medical help was not actually helping - with the attention only making things worse, the Flight Attendant stepped in and said she could help the lady.

With considerable doubt that a Flight Attendant could help where the best medical knowledge and drugs could not, the doctors nonetheless withdrew leaving the Flight Attendant alone with the patient. The Flight Attendant talked quietly to the patient, calming her down, and gently rubbed her back as she reassured the lady about what was happening. Eventually, the lady relaxed, and the pain was gone. The medical event was over.

So, what the heck had just happened? What was the miracle cure for an issue that almost diverted a full B777 into a remote island nation in the middle of the night????

The cure was a looong …. FART!

Yes, that’s right ladies and gentlemen. A full B777 almost diverted because of a held in fart. The lady was simply too polite to let one go as it wasn’t ladylike. And so her suffering began.

Moral of the story is:- the cabin of an aircraft is pressurised and results in a comfortable cabin altitude of 8000 feet to allow ease of breathing and… living (compared to cruising altitude of around 36,000 feet). Although creating a comfortable environment, it also causes air within us to swell making us feel bloated and causing us all (yes - ALL OF US) to pass wind during flight.

As far as I was concerned, the Flight Attendant was a hero! She saved the day and we got to San Fran on time rather than a likely 4 - 6 hour delay had we diverted.