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‘Do you have any credentials?’ asked the cabin crew steward. This wasn’t quite the response I had anticipated, at a cruising altitude of 35,000 feet midway across the Atlantic Ocean, after I had pressed the call bell to offer my medical assistance.
Was it my fresh face that looked younger than its 25 years? Was it the lack of a Y-chromosome? Perhaps it was because I hadn’t sprung into spontaneous action before the announcement. You see, I had witnessed the casualty's swoon and I had already made a (potentially fatal or erroneous) judgement of an Oscar-worthy performance by a fellow passenger bidding for an upgrade to business class.
‘No,’ I replied, ‘I don’t have any proof of credentials.’ I had plenty of credentials; I just couldn't evidence any of them. And so, the request for help was made again booming through the tannoy system.
This time the doctor fitted the bill – he had quite a lot of grey hair, and (unlike me) he was not wearing a hoodie and cargo pants. A short while later, the business class upgrade completed, and our plane was continuing to its intended destination without the need for a medical re-route or any further interruption to the film I was watching. I wondered if the other doctor had any credentials.
Nearly 15 years later and I now have a few grey hairs, but I still don’t carry any 'credentials'. Do you?
When you’re kneeling on an ice-covered supermarket car park in the depths of mid-winter, performing CPR along with a brave supermarket employee, no one asks if you have any credentials.
It was really cold. The type of cold you only know if you live nearly as close to the Arctic Circle as you do to London, or if you’re inappropriately dressed for a Polar expedition. I was wearing new jeans that I had bought in the January sales, and a cream woollen jumper soon to be accessorised with blood-stained cuffs.
The cold was unbelievable – at least it might offer some cerebral protection, I thought. I had seen the car skid in slow motion, but it was nothing to do with the ice – the cardiac arrest had been the primary event.
So as a dutiful doctor, I had dispatched my husband and two young children to complete the weekly shop. This was not the time to learn about what Mummy does at work, and both children were still small enough to fit side by side in the supermarket trolley double seat. Doing the shopping and negotiating the checkout would be child’s play compared with my frozen task.
It was an understatement to say that I was missing the familiarity and sterility of the hospital environment. I was very relieved when the ambulance arrived and I had helped transfer this poor soul to its depths to be carried to hospital; surely just a pit-stop on the way to another very cold place.
The adrenaline and cold were then causing my whole body to shake. I had no idea how long had passed, but at least the shopping would be completed and we could go home and have a nice cup of tea. How wrong could I be? ‘We were waiting for you,’ said my husband and children when I found them. ‘We thought you’d like to choose what food to buy.’ I really should have checked their credentials.
Clare Bostock is a consultant geriatrician in Aberdeen
They can and do check your credentials using your GMC reg no (if you know it by heart!) Flying Malta - Bristol by Ryanair in 2014. I answered a call. The steward wanted to see my "doctors' bag" and my "papers", eyeing me up and down. He would not tell me what was wrong with the pt until he took my passport details demanding proof yet again. From memory I gave him my GMC reg no which he took to the captain's cabin. A minute later I was told I could "see to my patient" after I fill a form to exempt the airline from all liability. There was no medical equipment on board. The main concern was to dodge any liability. I attended and to my relief the COPD gentleman responded to O2 and did not show signs of CO2 retention. Twice I was asked the dreaded "Should we land at the nearest airport?". I took it on my head to carry on. LESSON airlines do all they can to avoid liabilty.
In 35 years of practice this situation has arisen for me only once, shortly after I had retired and relinquished my registration! After 2 calls on the PA I identified myself to the cabin staff, explained that I was retired and no longer held a licence to Practice but that I was willing to offer advice. I did have a BMA card in my wallet but no one asked to see it. The crew were very grateful for my assessment of a collapsed patient . The aircraft was equipped with a smart bit of kit which took BP & Oximetry and was able to relay voice and video to a ground station doctor. That doctor and I discussed the situation based on my findings and agreed that it was safe for the flight to continue (we were over central Africa at the time) The patient survived the journey and was met by an ambulance team at Heathrow. I was presented with a bottle of Champagne at the time and subsequently received a letter of thanks and a substantial allocation of Airline points.
My experiences are also of immensely grateful cabin crew. Flying across the Atlantic with 6 year old twins, the clinical problem was a vomiting febrile unaccompanied 12 year old : I am a geriatrician!!! But I was reading the BMJ that had dropped on the doormat was we were leaving the house so I was obviously a doctor. . About a professor of orthopaedic, an A&E trainee, a tension pneumothorax and making a chest drain our of a coat hanger & a bottle of brandy in mid air. Having decided it was not meningococcal septicaemia and being more than half way I asked if there was anything in the medical kit for children - no. Could the flight crew radio for advice on paediatric doses of the antiemetic they did carry? This prompted the arrival of the Captain who wants to make sure he got the messages right. While waiting for a reply, we chatted. I joked about the BMJ article I was reading - his face changed, no joke he said, it always bloody happens to me, that was my plane. Apparently none of them could work out whether to gain or lose altitude, to manipulate the cabin pressure a little to reduce the size of the pneumothorax, Easy said I, P1V1/T1=P2V2/T2. His face changed again. Was I some kind genius? Reward : my 6 year old son's first view of the US was from the cockpit of a plane (this was all before 9/11), we disembarked with more champagne than our duty free allowance and the letter of thanks went into my first ever appraisal folder.
This encouraged me to respond again on future flights - a 'faint' that I had a feeling was occult volume loss, confirm 20 minutes later by the haematemesis, the discovery that it is very hard to insert a cannula with all that engine vibration and knowing that there are only 2 cannula in the whole kit, followed by the discovery there is one bag of iv fluid, 250ml only. But we did not have to make an unscheduled landing so the enormous cost to the airline was avoided - hence business class for two on the return. Is it any wonder my husband volunteers me?