Is There A Doctor On Board? Yes, But We Might Not Be The Right Doctor.

My husband and I travel internationally at least three times a year to give courses with live surgical demonstrations of colorectal conditions in children.

During the past 13 years making those trips, we had our share of hearing the famous announcement in the plane: “Is there a doctor on board?”

Those have happened in many different scenarios including having been on call the night before and therefore being on an almost semi-coma sleeping stage, in the middle of having dinner, during the best scenes of a great movie, with our kids traveling with us, with our boss traveling with us, and, sadly, on my way to my dad’s funeral.

Each event was a completely different experience.

Some were very mild and easy situations, others very scary ones, like when we were returning from Peru, and the woman sitting across the aisle from us, who we initially and erroneously thought was drunk, because she did not look normal, suddenly stopped breathing. Thanks to a jaw-thrust maneuver and some oxygen, she came back. After I went back to my seat, still feeling agitated and worried, my husband kindly told me: “You know that if she dies, you may lose your license,” needless to say, that I couldn’t sleep or rest anymore during that long trip. I kept checking on her every second.

After each event, ideas on how to improve the system come to my mind, but I was never able to move them forward. I am a pediatric colorectal surgeon, not an emergency doctor, and because of that, I have slowly let those ideas fade away until I am inside an airplane, and I hear again: “Is there a doctor on board?”

In my mind, a very easy improvement would be having passenger’s diagnoses and medications on file, on a confidential basis, the same way we have contact information, especially if you are traveling alone. That way, when the flight attendant calls for a doctor, he/she would be able to give us some valuable information. For example, if the patient is diabetic or hypertensive. The next would be to improve emergency kits in the airplane, if you have seen one, you know they are extremely limited. Now that we live in times of evidence-based medicine and protocols, data should guide us on common airplane emergencies, and it would be easy to create general protocols to guide doctors.

Two of my great friends, one a lawyer and entrepreneur, the other a pediatric radiologist, were near the pool where their kids were playing. After some unintentional kicks, screams were heard, and one of the kids had a bleeding nose. The lawyer quickly went to lead the rescue effort, got some water to wash the face of the child, and to try to understand where the bleeding was coming from. After a few seconds, she looked back and said to my doctor friend: wait, you are the doctor, come here. My other friend quickly answered: nope, I am a pediatric radiologist, and without a radiograph, I could not tell if the nose is broken or not.

After laughing about this story, I realized that this is exactly what happens when we, doctors, listen to the announcement on the airplane.

In my case, I know that the chances of me seeing a passenger who has the diseases that I am familiar with in my daily routine is close to zero. Medicine has become very specialized, and we are not used to seeing a patient anymore without previous information and, sometimes, diagnostic studies. The “old doctor” who could look at a female patient and diagnose hysteria, no longer exists. If we want doctors to continue answering the call, it is time that airlines start bringing the data on board too.

Andrea Bischoff is a colorectal pediatric surgeon and can be reached on Twitter @drspenabischoff.

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