8 ms·

> The patient was now comfortable, felt well and we retired to our seats to recover. Eight hours later I was again summoned by the stewardess to see the patient

by tsm 5y ago

> The patient was now comfortable, felt well and we retired to our seats to recover. Eight hours later I was again summoned by the stewardess to see the patient, who had developed more chest pain and dyspnoea. > I found her sitting on the toilet with the underwater seal drain on a high shelf. All the water and air had syphoned out of the bottle into the chest. The crisis resolved when I placed the underwater seal drain on the floor—draining the water back from the chest to the bottle. The air bubbled out of her chest when she coughed. After a few minutes she was almost back to normal, but exhaustion precluded the completion of a third full medical report.

dmurray 5y ago
Eight hours! It's hard to believe the woman's condition was critical enough to require invasive surgery with these makeshift tools mid-flight, but so stable post-op that the doctors did not recommend an emergency landing. I understand they recommended against landing pre-op because of worries about cabin pressure, but why not after the surgery? She's going to have to come down at some point.
- patrec 5y ago
  Why further inconvenience everyone else for this moron, if they (clearly correctly) judged her no longer to be in danger?
  - gambiting 5y ago
    I really hope that doctors don't provide medical advice based on idiocy(or lack of) of ones actions. If she had to undergo emergency surgery in-flight with a coat hanger, I'm really surprised an emergency landing wasn't recommended by the doctor. The origin of her injury should have had zero bearing on it.
    - patrec 5y ago
      If only we would leave more of these decisions to arm-chair bien-pensants, second guessing two seemingly highly competent medical professionals. I am sure the woman in question would also really have appreciated being settled with the likely ruinous debts resulting from a medically needless emergency landing.
      - gambiting 5y ago
        I'm just saying I'm surprised such a decision was made, that's all.
  - manquer 5y ago
    Expecting decision making to be perfect after an accident like that is ridiculous. Bike perfectly valid and commonly used word for motorcycle in many parts of the world. The attempt to conceal comment seems to be doctor covering his errors after an inadequate physical exam before take off. Someone trying to conceal wouldn't complain of chest problems before take off. Most airlines would remove you from the plane before even doing an exam, and won't depend on eye doctors potentially flying to do it.
- aqme28 5y ago
  I don't understand your point. If it's no longer an emergency, why require an emergency landing?
  - refurb 5y ago
    When you just did surgery with a knife and fork seems like an urgent enough situation to land?
    - mcv 5y ago
      Maybe not if the surgery was successful. As long as the condition is stable, it might not matter where they land. Might as well land close to wherever she needs to be, instead of in a completely different country.
      - aaaaaaaaata 5y ago
        Liability is a bitch, and ruins society.
      - refurb 5y ago
        How is surgery “successful” when they used a coat hanger? Can you imagine the infection risk? And sure, fly another 1-2 hr to get to the final destination, but they flew 8+ hours. It kinda makes no sense.
        whoisburbansky 5y ago
        They mention in passing that cognac was used to disinfect things. Not foolproof, but not exactly a sepsis inducing nightmare either.
        refurb 5y ago
        Cognac is usually what? 30-40% alcohol? It needs to be 70%. https://www.cdc.gov/infectioncontrol/guidelines/disinfection/disinfection-methods/chemical.html https://www.cdc.gov/infectioncontrol/guidelines/disinfection...
- Maken 5y ago
  Maybe she didn't have any kind of health insurance in any country except the one she was traveling to. So when the doctors told her she could endure the rest of the flight, she chose to do so instead of going bankrupt by the medical fees. It would be also insteresting to know if she hid her injuries before boarding for the same reason.
  - ada1981 5y ago
    Doubtful. Do people go bankrupt by medical debt in other countries? Seems unlikely to get judgment and collect.
    - kube-system 5y ago
      I think it’s simply unlikely because debt is always preferable to a life threatening emergency. That being said, from a global perspective, “bankruptcy” is not a good measure of economic burden. There are worse debt outcomes than bankruptcy.
      - sgjohnson 5y ago
        Bankruptcy is actually quite a piece of cake in several US states. In fact most of them even let you keep your home. Bankruptcy is not some sort of a financial death sentence. In fact you’ll even be able to get access to credit almost immediately, because the default risk just after bankruptcy is extremely low due to the fact that you can’t declare bankruptcy for another 2-3 years. Yes, your credit score is trashed for the next 6-7 years, but it’s also trashed with an insufferable amount of medical debt. I would be much more upset about a 6 figure medical bill if I had 6 figures in liquid assets than I would be if I owned nothing besides some home equity. If I have 6 figures of liquid assets, I’m wiped out, but if I own nothing, I declare bankruptcy and have a clean slate.
        kube-system 5y ago
        That’s what I was alluding to. Part of the high bankruptcy rates in the US are because we have very liberal laws about bankruptcy. Not only do you get to keep your home, but the majority of people who file Chapter 7 keep everything. That’s not to say we don’t have issues with medical costs… I’m just speaking generally about using bankruptcy rates as an indicator.
- mbubb 5y ago
  destination was Delhi - mmaybe no good medical option en route?
- classichasclass 5y ago
  Having been the "is there a doctor on board" doctor before: you make the call based on what's in front of you and the turmoil that would result from a precipitous landing. The case I had to be involved with was a relatively uncomplicated chest pain. I couldn't rule out angina, but the patient was stable and they had aspirin and it started halfway into a 4-hour flight. The patient remained stable all the way through and I released the individual to EMS on the other end. I don't see what an early landing would have bought in my case, and I'm not sure what it would have bought here.
lupire 5y ago
> underwater seal drain He's saying that the water bottle was draining fluid from her chest, but she/someone put the bottle on a high shelf, so it drained back into her chest. This is why you don't immediately leave post-operative patients to take care of themselves.

by tsm 5y ago

dmurray 5y ago

Eight hours! It's hard to believe the woman's condition was critical enough to require invasive surgery with these makeshift tools mid-flight, but so stable post-op that the doctors did not recommend an emergency landing. I understand they recommended against landing pre-op because of worries about cabin pressure, but why not after the surgery? She's going to have to come down at some point.

patrec 5y ago
Why further inconvenience everyone else for this moron, if they (clearly correctly) judged her no longer to be in danger?
- gambiting 5y ago
  I really hope that doctors don't provide medical advice based on idiocy(or lack of) of ones actions. If she had to undergo emergency surgery in-flight with a coat hanger, I'm really surprised an emergency landing wasn't recommended by the doctor. The origin of her injury should have had zero bearing on it.
  - patrec 5y ago
    If only we would leave more of these decisions to arm-chair bien-pensants, second guessing two seemingly highly competent medical professionals. I am sure the woman in question would also really have appreciated being settled with the likely ruinous debts resulting from a medically needless emergency landing.
    - gambiting 5y ago
      I'm just saying I'm surprised such a decision was made, that's all.
- manquer 5y ago
  Expecting decision making to be perfect after an accident like that is ridiculous. Bike perfectly valid and commonly used word for motorcycle in many parts of the world. The attempt to conceal comment seems to be doctor covering his errors after an inadequate physical exam before take off. Someone trying to conceal wouldn't complain of chest problems before take off. Most airlines would remove you from the plane before even doing an exam, and won't depend on eye doctors potentially flying to do it.
aqme28 5y ago
I don't understand your point. If it's no longer an emergency, why require an emergency landing?
- refurb 5y ago
  When you just did surgery with a knife and fork seems like an urgent enough situation to land?
  - mcv 5y ago
    Maybe not if the surgery was successful. As long as the condition is stable, it might not matter where they land. Might as well land close to wherever she needs to be, instead of in a completely different country.
    - aaaaaaaaata 5y ago
      Liability is a bitch, and ruins society.
    - refurb 5y ago
      How is surgery “successful” when they used a coat hanger? Can you imagine the infection risk? And sure, fly another 1-2 hr to get to the final destination, but they flew 8+ hours. It kinda makes no sense.
      - whoisburbansky 5y ago
        They mention in passing that cognac was used to disinfect things. Not foolproof, but not exactly a sepsis inducing nightmare either.
        refurb 5y ago
        Cognac is usually what? 30-40% alcohol? It needs to be 70%. https://www.cdc.gov/infectioncontrol/guidelines/disinfection/disinfection-methods/chemical.html https://www.cdc.gov/infectioncontrol/guidelines/disinfection...
Maken 5y ago
Maybe she didn't have any kind of health insurance in any country except the one she was traveling to. So when the doctors told her she could endure the rest of the flight, she chose to do so instead of going bankrupt by the medical fees. It would be also insteresting to know if she hid her injuries before boarding for the same reason.
- ada1981 5y ago
  Doubtful. Do people go bankrupt by medical debt in other countries? Seems unlikely to get judgment and collect.
  - kube-system 5y ago
    I think it’s simply unlikely because debt is always preferable to a life threatening emergency. That being said, from a global perspective, “bankruptcy” is not a good measure of economic burden. There are worse debt outcomes than bankruptcy.
    - sgjohnson 5y ago
      Bankruptcy is actually quite a piece of cake in several US states. In fact most of them even let you keep your home. Bankruptcy is not some sort of a financial death sentence. In fact you’ll even be able to get access to credit almost immediately, because the default risk just after bankruptcy is extremely low due to the fact that you can’t declare bankruptcy for another 2-3 years. Yes, your credit score is trashed for the next 6-7 years, but it’s also trashed with an insufferable amount of medical debt. I would be much more upset about a 6 figure medical bill if I had 6 figures in liquid assets than I would be if I owned nothing besides some home equity. If I have 6 figures of liquid assets, I’m wiped out, but if I own nothing, I declare bankruptcy and have a clean slate.
      - kube-system 5y ago
        That’s what I was alluding to. Part of the high bankruptcy rates in the US are because we have very liberal laws about bankruptcy. Not only do you get to keep your home, but the majority of people who file Chapter 7 keep everything. That’s not to say we don’t have issues with medical costs… I’m just speaking generally about using bankruptcy rates as an indicator.
mbubb 5y ago
destination was Delhi - mmaybe no good medical option en route?
classichasclass 5y ago
Having been the "is there a doctor on board" doctor before: you make the call based on what's in front of you and the turmoil that would result from a precipitous landing. The case I had to be involved with was a relatively uncomplicated chest pain. I couldn't rule out angina, but the patient was stable and they had aspirin and it started halfway into a 4-hour flight. The patient remained stable all the way through and I released the individual to EMS on the other end. I don't see what an early landing would have bought in my case, and I'm not sure what it would have bought here.

lupire 5y ago

> underwater seal drain He's saying that the water bottle was draining fluid from her chest, but she/someone put the bottle on a high shelf, so it drained back into her chest. This is why you don't immediately leave post-operative patients to take care of themselves.