I do not get bumped to first class often, so each time is special. On this occasion, our family was headed to Anchorage, AK. My wife is a radiation oncologist who works primarily with children. She was giving a talk at a meeting while our 2 boys, 3 and 4 years old at the time, were looking forward to a week exploring Alaska. Unfortunately, mine was the only ticket upgraded and my wife needed to work on her talk. The boys and I settled into our coach seats near the rear of the plane.
Colleagues in other areas of medicine may at times disparage emergency physicians as simple “triage docs.” Most of us come to terms with this, knowing that we do more than people realize. We deal with individuals at their worst, whether patients, their family members, or fellow physicians whom we bother at all hours of the day or night. And while others are toiling hard during the weekday, we are often far from the hospital and the call of a pager. It is not surprising, then, that some may question our decisions and our work ethic. On the other hand, my wife works with children with cancer. Cute little boys and girls who have been dealt an unfair hand in life. Few disrespect what she does; how could they?
It was an uneventful flight, albeit long for the little ones. With slightly more than an hour to go, my wife came back to coach and offered to let me have a turn up front. I gladly took her up on this offer and settled in to the wide, comfortable seat in first class. I exchanged a few pleasantries with the man sitting next to me and sat back to relax. A hasty tap on the shoulder soon interrupted my relaxation. Hoping for an offer of a snack and a beverage, I was instead greeted by a flight attendant with a worried look on her face. “Are you a physician?” she asked abruptly. I nodded and she quickly muttered, “We need you in the back right away.”
As I obediently followed her and returned to the back of the airplane, I noticed my wife gesturing me toward a woman across the aisle. She was unresponsive, pale, and diaphoretic and lay slumped across her window seat. I noticed the eyes of both my sons on me. A man was standing near the woman, with the look of a health care provider. I introduced myself as an emergency physician, and he responded, “Oh, good! I am an ENT surgeon.”
“Oh good” is not the typical greeting I receive when introducing myself to a consulting otolaryngologist, but I was pleased by his gratitude. He explained what he knew, and I suggested we move her to the bulkhead. She was breathing and had a pulse, albeit thready. I talked over what I thought we should do: obtain IV access, give fluids, give glucose, check vitals, examine her as best we could, and get more history from the family. I asked if he wanted to work on the IV, and he declined, saying, “Maybe I can get some more history.” With that, he left to parts unknown in search of history.
So there I was, with 2 physicians, 2 loving sons, and dozens of onlookers putting their trust in me to help this poor woman; yet I felt very much alone.
I placed an IV, gave her some fluids, and watched as her mental status and vital signs improved. I never did make it back to first class, but instead was offered the flight attendant's jump seat so I could continue to attend to the passenger-turned-patient. I gave a report to the paramedics who met us at the gate and felt relieved that she was doing much better as I transferred over her care to these colleagues.
I chose emergency medicine with a sincere desire to help patients—all patients, regardless of their social status or ability to pay. While there are times when I feel underappreciated, on the airplane that day, I could not have felt more respected. Countless pats on the back and comments of “Nice work, Doc” from complete strangers were passed my way as we got off the plane. The looks of pride in my sons' eyes were priceless. Later, as I chatted with my wife, she confessed that she had been the one to identify the unfortunate passenger and had calmly notified the flight attendant, “My husband is a physician.” Directing the flight attendant to my exact seat, she never betrayed the fact that she too had graduated from the same medical school I had.
As an emergency physician, I play a vital role in my patients' lives; but I am only a part of the team. Later, when I was faced with a patient with a subglottic airway obstruction in the ED, I breathed a sigh of relief, with a reminiscent exclamation of “Oh good!” as I saw an ENT surgeon walk through the door. We all have our areas of expertise, as well as areas well outside of our comfort zone. A career in medicine can be wonderfully rewarding, as well as humbling.
If, heaven forbid, your child is found to have cancer, I am happy to say, “My wife is a physician.” I will gladly disappear in search of more history.
© 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.