Is there a doctor on the plane?

On my flight back home from Sweden last week came that dreaded call: Is there a doctor on board?

And of course, I had my medical degree; only I hadn’t practiced for almost twenty years.

But that might have been more than the other passengers, so when I started hearing shouts and commotion behind two closed curtains, I decided it was time to rise to the occasion.

As I made my way back, the shouts got stronger, but I couldn’t discern the language or what was said.

Quite a few necks were craning and the fact that terrorism is on everyone’s mind made the calm in the cabin remarkable.

When I pulled back the curtains to the galley, I saw a half-naked man on the floor. Next to him stood a Thai stewardess and a Muslim woman. The woman with a headscarf told me she was a doctor too, and that the man was a diabetic. The airplane first aid kit was already unfolded next to him.

They had just checked his blood sugar and it was rock bottom.

So now the question was if the man who was flailing his naked arms and speaking gibberish simply had overdosed his insulin; if he was drunk, or if there was something else wrong.

He received a glucose injection, and didn’t markedly improve and it was virtually impossible to communicate with him. In his hand luggage we found his medication for a thyroid disorder.

Half an hour passed, his breathing and pulse was fine, skin tone great, and finally the sugar injection seemed to work. He became coherent, and started behaving like a fully reasonable person - an amazing transformation.

It reminded me of my last chopper rescue, back in 1984, when I gave a glucose injection to an unconscious young man, hoping he simply had hypoglycemia. That didn't work and that man never woke up again.

I wish I could take credit for the recovery of the man on the plane, but it was all thanks to the Malaysian doctor in a headscarf.

As for me, I was just happy that the crew hadn’t panicked and tried to make an emergency landing on Greenland, or that I had been the only doctor on board.

Sometimes it can be pretty scary to hear that call – is there a doctor on board?

Comments

[Scott]

According to the Journal of the American Medical Association (JAMA), insulin is responsible for some 56,000 incidents annually requiring hospital E.R. treatment, a majority of those due to hypoglycemia. Patient education has failed to prevent these adverse effects, as the number continues to grow annually.

One might think that big pharma would be looking to eliminate these adverse events, but instead, we just heard about Pfizer blowing more than $2 billion to bury inhalable insulin, a market whose necessity the industry vastly overestimated. It wasn't simply the size of the "bong" as some critics claimed.

Note to big pharma: the world doesn't need inhalable insulin, they need insulin that cannot cause hypoglycemia. No one in big pharma is working on this, but startups in Massachusetts are using nanotechnology to deliver it. What's wrong with this picture?

[Alan Carter]

With over a million insulin dependent diabetics in America, 56000 incidents indicates safe (if not always tight) control in the overwhelming majority of cases. Also, ER staff often get to know their repeat offenders. It doesn't translate to 56000 individuals with serious management problems.

However, safe management does mean being conscious of blood sugar at all times. In the last year I've read too many horror stories of diabetics having their insulin and glucose confiscated, and their protests ignored, until they become hypo or even fall into coma in American airports and aircraft. This fellow may be another such case.

In my view, the "security" hysteria has allowed airport staff to develop an abusive attitude to their customers, which easily slides into reckless endangerment where medical conditions are involved.

I wouldn't set foot in a nightclub where the bouncers were known to behave like that, and an airport is no different. Any aircraft which might even be diverted to an American airport in case of emergency is out of bounds for me until the mood improves. I'm amazed that U.S. traveller figures are only 10% down.