What would you do?

[BabyPsychDoc]

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So, we are on the plane from the US to the UK, and the captain requests physician assistance. I wait out for a few min, and seeing that nobody else responds I volunteer.

A middle-aged British woman is basically having a panic attack. I thank God that she had a similar attack at a shopping mall in the US just a few days earlier, and was thoroughly investigated by docs there (according to her husband, she had a "lung scan", EKG, ECHO, treadmill test, "legs scan" and a whole lot of bloods done, all of which were normal). I scan a letter from the hospital, and see that she was discharged with Lorazepam prn and "long-term anxiety mgmt advice". Basic physical exam is fine, vitals are normal (not even that tachycardic). No PMH (other than anxiety). Woman's husband and teenage son are not helping, jumping in their seats and asking me whether the woman is going to die or if she needs an ambulance...The co-pilot (standing next to the passenger) looks like he is about to faint himself.

I told the woman to take another 0.5 mg of Lorazepam, tried teaching her relaxation breathing techniques and told her to have a cup of tea (tea is a universal cure-all in the UK, btw ). The woman (she did not look particularly bright) had the tea and tried relaxation breathing, but did not take her Lorazepam. So, I am called back two hours later, and this time watch her take the drug. For the rest of the flight, I am sitting their praying that she just sleeps through until landing; re-iterate to the crew that the woman is unlikely to come to any long-lasting harm and that calm atmosphere is really what is needed. On the way out of the aircraft, I see the woman alive and well, and very animated, talking on the phone.

Would you do anything differently if you were in a situation like this one?

Also, I was offered 5,000 miles from the air company. Would you take them? Would this change anything as far as "Good Samaritan act" vs "offering paid services" from the US legal viewpoint? (The aircompany is American, but we were over Canada at that time, and I am licensed in the UK...ugh!)

Any insights are welcome.

 

[kumar28]

TAKE THE MILES!!! You calmed the situation and did what you were supposed...good for you! Now take the miles!

 

[OldPsychDoc]

Well, I would have tried to hide in a bathroom until the crisis passed, but since you didn't choose that option, I'd say that you did great. 😀
(Kudos on waiting to see if someone else would respond first, though! 😎)

It is permissible to take the miles. I believe it is considered a "modest token of gratitude" as opposed to actual payment for services.

 

[TheWowEffect]

I think you did the right thing. Congratulations on your guts! Anyone else in your spot might have chickened out.

I am assuming that you can take the miles since you are not getting anything from the woman in question. Plus, she walked out fine.

 

[Doc Samson]

Take the miles and be happy they offered them. I took care of syncopal diabetic on an American Airlines flight a couple of years back (free scotch in first class + skipping dinner because he was late for the flight + glucometer packed in luggage = bad combination) and all I got was an offer for a free cocktail, which I declined since I didn't want any EtOH on board in case he went down again.

 

[billypilgrim37]

But if you take the miles, studies show you will recommend that airline to your compatriots and raise costs for everyone...

Okay, I thought the joke would work, but I couldn't even make myself laugh.



Seriously, take them. And good for you.

 

[Solideliquid]

But if you take the miles, studies show you will recommend that airline to your compatriots and raise costs for everyone...

Okay, I thought the joke would work, but I couldn't even make myself laugh.



Seriously, take them. And good for you.

Actually this makes me want to fly American now.







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Not really though. Seriously good job! Jeez what would you have done if there was no collateral history from the family? Afterwords she just walked out talking on the phone like nothing happened? Sounds Axis II'ish. Oh -- TAKE THE MILES.

 

[Still Kickin]

Wow, I was expecting the "so what would you do" question right after this line...

So, we are on the plane from the US to the UK, and the captain requests physician assistance.

 

[whopper]

From my limited legal knowledge of this, if the person you treated offered you money, you could be held liable, but this wasn't the person offering, it was the airline, so I think you'd be fine taking the money.

Also, if the person ever did sue you, heck you'd just have to be in the UK for some time and they wouldn't be able to touch you legally.

Lorazepam is fine as a short term treatment for panic attack, but not as a long term treatment. Anyone I put on a benzo (and I tried to avoid that whenever possible) is told they will be taken off after a month of giving them out (except for a small emergency reserve of just a few tablets a month) of them whether or not they agree with my policy on that. I aggressively increase their SSRI.

 

[Spiderwoman]

Great and brave job! Good samaritan act can only protect you if you don't accept anything ( except a thank you note ) from the patient or her family (I am not sure about airline). If she sends you flowers or invites you for a cup of tea, think twice. If you accept any gift, in any form, from the patient, you are not protected by good sam any more. She is OK and offer is from airline, it should be OK to enjoy their offer. You deserve it, in my opinion.

 

[BabyPsychDoc]

Well, I would have tried to hide in a bathroom until the crisis passed

I would too, but the bathrooms were already occupied by the flight attendants! Plus, I really did not feel like an unexpected landing in Ottawa.

Take the miles and be happy they offered them. I took care of syncopal diabetic on an American Airlines flight a couple of years back (free scotch in first class + skipping dinner because he was late for the flight + glucometer packed in luggage = bad combination) and all I got was an offer for a free cocktail, which I declined since I didn't want any EtOH on board in case he went down again.

That sucks! My husband is whingeing even about the miles - he estimated that my intervention saved the airline about 10K USD, and now thinks they are being cheap. Actually, it was pretty stupid of American Airlines to offer alcohol to the only physician on board (well, at least the only one who admitted to being a physician...) I am just happy I did not have to run a code - the co-pilot had the defib ready when I got to the passenger.😱

But if you take the miles, studies show you will recommend that airline to your compatriots and raise costs for everyone...

May I take this opportunity to fulfill billypilgrim's prediction and recommend NWA to this forum members,then.😀

Afterwords she just walked out talking on the phone like nothing happened? Sounds Axis II'ish.

That's what I thought. I am glad the woman is British - she must have a long history with her PCP here.

Thanks for all replies - I guess, I'll take the miles, then!🙂

 

[whopper]

Reminds me of a similar event--which may have been psyche related.

I was on a plane from the UK to the US. Someone on the plane apparently was pre-syncopal--geting light headed to the point of almost fainting. The airplane staff asked if anyone on the plane was a medical professional. At the time I was a medical student & offered to help.

well, lo & behold comes out this guy who is apparently too young to be a surgeon (looked like he was in his late 20s), wearing a very expensive suit, who identified himself as a surgeon. The guy had a big smile on his face which seemed odd. I rarely see surgeons smile. (You know what I'm talking about if you worked with surgeons).

This supposed surgeon, checked out the guy, without doing a physical exam. He just looked at him & said he'd be alright.

OK--now I'm really sensing this guy ain't a surgeon. I'm sensing he ain't even a doctor. He at least would've checked vital signs, told the person to lay down if possible, ask for sx like chest pain.

But considering that at that time I was only a medstudent, & I didn't feel like I had enough expertise to call this guy out, I just sat there, with worry for this poor pre-syncopal guy.

As I got off the plane, the pre-syncopal guy was taken to the airport nurse. People around him were all muttering they thought this supposed surgeon guy was a fraud.

 

[Doc Samson]

Reminds me of a similar event--which may have been psyche related.

I was on a plane from the UK to the US. Someone on the plane apparently was pre-syncopal--geting light headed to the point of almost fainting. The airplane staff asked if anyone on the plane was a medical professional. At the time I was a medical student & offered to help.

well, lo & behold comes out this guy who is apparently too young to be a surgeon (looked like he was in his late 20s), wearing a very expensive suit, who identified himself as a surgeon. The guy had a big smile on his face which seemed odd. I rarely see surgeons smile. (You know what I'm talking about if you worked with surgeons).

This supposed surgeon, checked out the guy, without doing a physical exam. He just looked at him & said he'd be alright.

OK--now I'm really sensing this guy ain't a surgeon. I'm sensing he ain't even a doctor. He at least would've checked vital signs, told the person to lay down if possible, ask for sx like chest pain.

But considering that at that time I was only a medstudent, & I didn't feel like I had enough expertise to call this guy out, I just sat there, with worry for this poor pre-syncopal guy.

As I got off the plane, the pre-syncopal guy was taken to the airport nurse. People around him were all muttering they thought this supposed surgeon guy was a fraud.

Seems odd. When I got called into action they asked for proof I was a physician (showed them my license wallet card).

 

[whopper]

They never did that. On top of that, the guy's smile was just real odd. It was the kind you'd see on that stereotype image we all got of a used car salesman.

Oh well. I remember when walking off the plane, the other passengers told me they thought this guy was a fraud. I told them I was a medical student & suspected the same, but didn't have the knowledge to talk down someone claiming to be an attending. I guess being pimped by attendings for years was enough to break me in that area.

I wondered if this guy had some type of wierd variant of factitious disorder--but where he wanted to be the provider, not the patient.

Anyways, since the guy ended up going to the airport nurse, & I didn't have enough evidence to have the police look into it, I told myself to forget about it.

 

[Anasazi23]

It's the "Catch me if you can" syndrome.

 

[BabyPsychDoc]

They asked me for my licence, too, but since I did not have my UK licence on me (I was not exactly planning on practising during my 2 week trip🙄), they just left it be.

BTW, that guy whopper is talking about does sound like a fraud. However, in the UK you can technically call yourself a surgeon in late twenties (start medical school at 18, graduate at 24, one year of internship, two years of junior residency and passing exam of Royal College of Surgeons - voila, you are a surgeon at 27!)

Oh, maybe he WAS a surgeon and his smile hid his embarrassment of being unable to handle the situation (trust me, surgeons in this country consult medics even more than psychs do).