Free Beer

I was flying back from my mother-in-law’s funeral. My wife had stayed behind. Finishing a Heineken and ready to order another, I noticed the man in front of me jerk his right arm out into the aisle. His head flew back into the seat.

I am not a neurologist, but I know full-blown seizures. All I wanted was another beer. Or two. This was a perfect time for a beer. I wanted one right then. Waiting would not work. I couldn’t believe this passenger was sick in the middle of a flight.

I did what I could: I got up and made sure the man was breathing. The lights were off, it was dark, and my reading light provided the only illumination. He was in the first row—I was in the second. No flight attendants were in the front of the plane. I lifted the front overhead baggage door to look for an oxygen tank, and then I saw the man have a second seizure.

I glanced toward the back of the plane; the silhouettes of three airline attendants approached. The man was finally conscious enough to answer questions. “Do you have a seizure disorder?” I asked.

“No,” he replied, “but I am three weeks out of a triple cardiac bypass. They misdiagnosed me at first.”

“What other medical problems do you have? High blood pressure? Diabetes?”

“Both” he said, “and I have been sick with nausea and vomiting for two days. I can’t keep anything down.”

What does he think he’s doing on a plane, I thought to myself. I asked if he had any of his medications with him. He told me he had a nitroglycerin but had never taken it.

“This would be a good time” I said. He opened the nitro bottle and spilled the pills on his lap. I reached to help him, but he found one and put it in his mouth. I passed orange juice for him to drink in case his sugar was low. He swallowed the pill.

“This is a medical emergency,” I told the first flight attendant. “We need the O2 tank now.” He fumbled with it as he pulled it down and decided which way to turn the gauge. I pulled the yellow mask over the man’s nose and mouth and made sure there was a good flow of oxygen. The second attendant handed me a blood pressure cuff. I checked the patient’s heart rate. His blood pressure was low but I already knew that from his weak, thready pulse. He was soaked in sweat, his color ashen.

“How far are we from landing and getting this man help?” I asked the flight attendant.

“We’re thirty minutes out of Orlando,” she said. I knew this was the closest city with good medical care, so I asked if there was any way we could get there faster. The attendant headed toward into the cockpit. The second attendant was on the phone with the paramedics preparing them for the patient. I called out his vital signs and she repeated them to the people on the ground.

I also knew I couldn’t count on any more beer. “Shit,” I cursed under my breath.

The man’s wife was sitting across the aisle from him. She had not identified herself at first and did not get up or help. I wondered whether she was frightened or just angry at him for getting on the plane in his condition. I asked her to write down each medication he was taking and every medical condition from which he suffered. I planned to give it to the paramedics when we landed. She asked what had happened. She hadn’t noticed anything. “He had a seizure,” I said. I did not mention that I could be wrong and he might have had a stroke.

The attendant returned from the cockpit and said that if I called this episode a “medical emergency air traffic control could hold off other planes and we would land without delay. I was shocked to think that they couldn’t see for themselves what was happening. “Yes, this is an emergency,” I said. Anything in those pretty heads? I thought.

I laid the man down across the seats. His feet extended out across the aisle. The oxygen and change in position seemed to help; his color improved. I buckled a seat belt around him. I could feel the plane pick up speed. I braced my back foot to keep my balance.

We landed fast and turned the corner toward the gate. The plane didn’t tilt up on one wheel and the wing did not hit the ground, but it seemed to be going too fast. The ambulance was at the gate; its emergency lights flashing. The paramedics came up the steps and I presented my findings to them. I handed them the list of the man’s medications and his medical problems. The man lived as long as I was taking care of him; I don't know what happened once he was placed in the ambulance.

Relieved of my patient all I could think was, Goddamn it, those beers were free with my upgrade. I looked down at the free drink coupon on my empty seat. 

Then I was faced with all the administrative duties that doctors hate; providing medical license numbers, my address, and DEA certificate. It’s the reason some of us don’t stand up when asked if there is a doctor on board; there’s too much risk and liability. This is the fourth time I have assisted a passenger in the middle of a flight. Each time I respond I swear it will be the last.

I looked at the wife as she headed down the steps behind the stretcher and said, “Tell your husband he has a gynecologist now.” She didn’t see the humor.


Thomas Gibbs, MD, is an obstetrician-gynecologist practicing in Orlando, Florida. His essay “Magic Hands” is published in the anthology Becoming a Doctor (edited by Lee Gutkind), and he has essays forthcoming in The Gettysburg Review, Brevity, The Florida Review, Zone 3, and Blood and Thunder

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