33,000 Feet In The Air: When You Least Expect It

It has been more than 365 days since day one of being a junior doctor and damn, what a year! 365 days of learning on the job, navigating the struggles as well as the growth that comes with an intern year.

At the end of the internship, I fortunately a significant amount of annual leave! How did I get so much time off, I hear you ask? Well…I had the end of internship leave and then going into my second year, I started off the rotation with annual leave/relieving/nights, which meant I had more annual leave first up! It’s a double-edged sword depending on how you look at it. On one edge it’s a significant amount of time to recuperate from a busy year, and at the same time, it means I will not get annual leave for the remainder of what seems like an even busier year than internship. Yikes!

Despite this, I decided to work for a couple of weeks during my annual leave as a locum doctor. Essentially, as a locum you choose hospital services that have a gap in their rosters. You choose to work in an area or specialty you want, doing the same job as you normally would, but at an exceptionally juicy locum rate – almost 3-4 times the usual rate. Locum work enabled Prisca and I to save money to make the most of my annual leave. We had been meaning to go for years and there was no better opportunity then amongst the irregularities of rosters in medicine and a decent length of annual leave.

I am really glad we went at the time we did. Bali was romantic. We stayed in Seminyak and navigated the enervating humidity by doing day trips to different areas of Bali. Money does go far in Bali; from getting a succulent pool breakfast to the jungle swing and then to the ancient monkey forest, it definitely left us longing for another trip to Bali. I will always remember this trip as the first international trip, together, for Prisca and I. What makes it increasingly memorable is the litany of new things we did together. I think that doing new things in a new location with a new perspective in life, is so formative.

I thought that medical emergencies on a plane were oversaturated on TV. In my head, I imagined I would always have more time before my skills would be summoned. “Is there a medical doctor on the plane?” The announcement came from the cabin manager. Even through my headphones, I could sense that something was happening. Prisca nudged me and asked, “Are you going to help?” I was so nervous, and I sheepishly put my hand up with the less than one year experience I had at that point. As I walked to the back of the plane, I kept thinking of the basics of DRSABCD and repeating the different parts that make up the algorithm that, which ensures that I don’t miss anything sinister. I kept thinking: what if this was a medical emergency that needed the plane to be turned around back to the airport? What equipment would I have?

As I approached the woman needing medical attention, it appeared that she was stable and had some shortness of breath. I did what one could do when they are 33,000 feet in the air and asked the cabin manager for a tank of oxygen. Two nurses also came to the medical emergency, they seemed more experienced than me, and soon after, they also left. Maybe they thought that everything was under control, but I’m sure they definitely had more experience than me! One of them suggested we give some orange juice to the woman; in case she was having a hypoglycaemic (low blood sugar) episode. After a while, the woman’s breathing improved, and all was well 33,000 feet in the air. The medical situation wasn’t a catastrophe, nor did it require diverting of the plane, which was good.

I’ve found that in many of these situations, reassurance is key. Not only to the person requiring medical assistance, but also the worried family members and other holiday goers. I stayed with the woman for a period of time, having a conversation with her, but mostly ascertaining if she was experiencing any confusion which could indicate impaired oxygenation to the brain. The supplied oxygen helped, but reassurance from a medical professional also went a long way. I understood the need for reassurance from the family members. I get that when it’s your own family member, you are extremely worried, and that sense of uncertainty can be terrifying. Having someone say everything is going to be okay and this is what we are going to do and why we are doing it, goes a long way in alleviating anxieties, like the one of the plane.

So, it’s back to reality now after a short getaway. I have a relieving and night term, following by anaesthetics, subacute medicine and emergency medicine to finish off year 2.