Recently my family and I were on a long airplane flight. I had been debating with myself since the beginning of the trip, what were the odds of a medical event occurring on any single flight which I happened to be on. . .

So of course it did. “Would any physician on board please identify themselves to a flight attendant?” My siblings helpfully pointed out a large group of flight attendants around one row, so after a brief systems check (yes, you are a doctor; no, there don’t seem to be any other doctors visible right now; yes, that you means you go over there) I climbed out over everybody and walked slowly towards the group.

One of the attendants had an oxygen mask, which she was attempting to set up for a middle-aged man, who indeed seemed to be in some distress. I took a deep breath and asked the attendant on my side of the aisle, “What’s the problem?” She looked up, half-relieved and half-skeptical: “You’re a doctor?” “Yes, but I only just graduated, so if anyone more experienced turns up, talk to them instead.”

She shrugged, and pointed out the man’s wife, who began to explain how his chest pain had just started. (Well, I guess that makes it worth being concerned about.) My siblings don’t believe me, but I was on the verge of doing something useful, like asking what his medical history was, when two other passengers showed up, looking much more experienced and calm than I felt, so I backed up, and decided that there was enough of a crowd in the aisle without me staying around to learn how to handle such situations.

After I sat down again, I realized that I had completely forgotten about the differential diagnosis for chest pain. I was thinking MI vs. GERD (airplane food, you know), and had forgotten to consider such cheerful alternatives as aortic dissection and pulmonary embolus.

Conclusion: if it had been either of those, there would have been nothing to do on the airplane anyway, so me not thinking of it wouldn’t hurt anything. If it had been cardiac-related, I did actually think of the correct things to do, which is a good sign.

Does anyone out there know what kind of medical supplies the larger airplanes carry? I saw them produce oxygen, a stethoscope, and a blood pressure cuff, but I’m wondering what kind of medicines would have been available.

The guy turned out to be ok, probably having some heartburn; but I’m glad I wasn’t the one who had to decide, without the aid of an EKG, whether to call it an MI worth looking for a hospital for, or something that could wait until the scheduled landing.

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