It was a day like any other day.

As often as I fly, I have to admit that I still get a little bit anxious in the air. My coping strategy before flights is to stay up the night before so that I’m exhausted by the time I get on the plane and can easily fall asleep.

On this day, I stuck to my typical tradition, waking up at 4am to finish packing for my 10am flight. I boarded the plane sleepy and was knocked out before takeoff.

A few hours into my nap (including a brief intermission for the snack cart), I sensed a ruckus ensuing around me. I woke up to find the passengers sitting rows ahead turned around staring in my direction.

Was there a second snack cart on the horizon?

Naturally, I turned in the direction everyone was staring to see several flight attendants gathered around a row of seats behind me.

I then overheard another passenger say, “I looked up and saw her eyes roll to the back of her head. I thought she was dead.”

My heart raced.

Was there really a “medical emergency” taking place on this flight right now? And more importantly, was I now obligated to do something since I was technically a doctor? I meannnnn, I’d JUST graduated from medical school like 5 months ago and was just barely getting the hang of taking care of my pediatric patients at work. I didn’t even remember the last time I had an adult patient.

Maybe it’s over, I hoped.

The passenger in question was now conscious and speaking with the flight attendant. I figured I’d slept through most of the ordeal and that things were under control now.

But as soon as I went to put my headphones back in, I heard another person say,

“I think we need to page for medical assistance.”

I sat up in my seat, nap crust still in the corners of my eyes. Scressed.

Sure enough, the screens on the plane went dark and over the intercom I heard, “Good afternoon, passengers. We are currently experiencing a medical emergency on this flight. If anyone is a licensed physician or works within the medical field, please let the nearest flight attendant know.”

I looked around, hoping an older, more seasoned doctor or healthcare worker would spring into action.

Crickets.

I looked around the plane for a few more seconds and reluctantly emerged from the shadows.

As God would have it, the patient in question was sitting two rows behind me. I walked over to her seat.

“Hi, I’m a pediatrician. What happened?” I asked the flight attendant.

She re-iterated the story. This passenger’s eyes had suddenly rolled to the back of her head and she’d begun choking on saliva. None of her fellow seatmates could arouse her. A few minutes later, the episode suddenly stopped and the passenger woke up not remembering a thing.

I then turned my attention to the passenger.

She was a middle-aged, heavyset African American woman sitting calmly in her window seat. She didn’t fully remember what had happened but said that she had felt really hot before falling asleep. The next thing she knew, everyone was standing around her asking if she was ok. Something similar had happened to her on a previous flight to Hawaii. On that flight, she’d gotten up to use the bathroom, felt light-headed and passed out in the aisle.

She hadn't been to the doctor in years because she didn’t trust the medical system, so she had no clue whether she had any existing medical conditions. Ironically enough, she worked as a medical coder.

I gathered all the information I could, asking her about any family history of stroke, seizure or heart attack. I then took vitals and noted that her blood pressure was lower than expected for a woman her size and age. Her O2 saturation was around 80% which was also pretty low. We got her an oxygen mask, and her saturations came up to nearly 100%. There was little else I could do, so I sat next to her for the remaining 40 minutes of the flight praying to God she didn’t pass out again.

We landed without incident and she was escorted off of the flight by medical personnel as soon as we landed.

The flight attendants all thanked me for my help. I felt like a fraud, not having touched and adult patient in months.

I rushed off the plane.

I collected my belongings from baggage claim, dodging countless questions from nosey passengers every few seconds.

I spotted my “patient” being wheeled around in a wheelchair by airport staff at the baggage claim. She waved and thanked me again as we parted ways.

I’m glad she ended up being ok at least for the time being.

But, I couldn’t shake the thought that her episode may have been the warning sign of a much more serious underlying condition. Would anyone catch it before it was too late?

While sitting next to her on the flight, I had taken a moment to reinforce the importance of regularly seeing a doctor. I understood her skepticism and distrust of the medical system as a black woman given this country’s track record.

Unfortunately, however, not knowing the status of her health was putting her at an even further disadvantage. Regardless of whether she was going to take her doctor’s recommendations, she owed it to herself to at least be somewhat aware of what was going on in her body.

I can admit that even I have taken a backseat in maintaining my health just like this passenger.

As a medical student, I DEFINITELY skipped a yearly physical or two. Fast forward to fourth year when I got my first real physical in years, and I found out that my blood pressure was elevated and that I’d developed allergies. I’d had no clue because of course because I’d I felt “fine”.

Even though there were no immediate interventions recommended until I had my blood pressure re-checked at another visit, just being aware that my blood pressure was creeping up was enough to encourage me to stay on top of minimizing stress and taking better care of myself.

High blood pressure leads to a whole host of issues as I’ve seen throughout my short medical career. The same is true of several other preventable medical conditions that begin subtly without symptoms until it’s too late.

African Americans in particular experience higher morbidity and mortality from preventable diseases like diabetes, stroke, and hypertension compared to our white counterparts. This is in large part due to this country’s flawed systemic structures that create health disparities and barriers to care for POC. (Don’t get me started.)
Those of us who are able to escape the weight of these structures owe it to ourselves to keep surveillance over our health because quite frankly no one else will.

We get one body, and what we do with it today influences how we live tomorrow. I can only hope this episode was a wake up call for my “patient”.

It was definitely a wake up call for me.

…To wake up and buy better headphones for future flights lmao.