Doctor on board?

I didn’t want to be a physician: I wanted to be a physicist. I grew up surrounded by books, and simply wanted to know how everything worked. I believed physics to be the science that attempts to explain everything.

I also didn’t want to be a physician because I was afraid. In physics, all you deal with are theories and atoms. Sure, radiation can and does kill people, but that’s only for highly specialized fields of it. On the other hand, in medicine, you deal with living people. I wouldn’t say that I’m irresponsible, but I didn’t want to be responsible for other people’s lives. But saving lives is the crux of being a physician.

This heavy responsibility affords certain people in my field a sense of fame and pride. Some even think that they are rock stars and heroes: They save people, after all.

I didn’t think like them—and I still don’t. All I wanted was to fulfill a dream of my father’s, because he has been an excellent father to me and my siblings. I didn’t feel I had the right to flaunt my title even after being licensed to practice as a medical doctor. When I heard that I had passed the board exams, I was with my close friends: After some loud cheers, I exhaled a sigh of relief, and then realized that I was now burdened by a heavy responsibility.

Knowing a lot about how human bodies work still doesn’t afford me the respite of fearlessness. I’m still anxious every time I go on duty. There are certain colorful experiences that come with being a physician, however, such as one recent experience of mine in an airplane.

It’s rare for a physician to be faced with an incident in an airplane. Passengers are screened prior to boarding, and those who do have medical conditions often sign waivers whenever they fly. Yet a lot of passengers still take an airplane despite what diseases they may have because riding it is necessary: Commercially, there’s no faster way to move from place to place than in an airplane.

So there I was in a plane to Iloilo with my mother to visit my grandmother’s grave. The maternal side of my family decided to visit her grave on her birthday, and my mother decided to take me along. I didn’t bring any of my paraphernalia as I simply wished to visit her grave and meet up with old friends. My medical school was in Iloilo, after all. All I had with me were novels to give to my friends over there and some of my own to read.

I was reading an airport novel featuring a band of mercenaries recovering an air defense system. The plane was already descending when an African-American man seated in front of me just stood up—and fell. His seatmates were quick to help him up. I myself had initially thought it was due to the pressurized cabin, and returned to my reading.

When he walked to the aisle, however, he fell again. A dull thud resonated through the cabin, and the stewardesses were now running to his aid. His seatmate, male, tried to assist him to his feet, but he slid back to the cabin floor.

One of the stewardesses then asked, “Is there a doctor on board?”

I’m not going to paint myself as noble: I honestly hesitated, undecided whether to help the man or not, because I was afraid. I had heard about doctors being taken to court because of the “Good Samaritan doctrine,” and I didn’t want to lose my license so early after working hard for almost six years to obtain it. Under the Good Samaritan doctrine, people who help others above and beyond their call of duty are rewarded. Recently, however, I have read of instances where helpful people are taken advantage of and litigated upon—and I didn’t want that.

No one responded to the stewardess’ call. My mother gently pleaded with me that I help the man as a physician. I had gone to help him up, but didn’t want to disclose the fact of my being a doctor. When the question was again asked, I slowly raised my free hand.

The man relayed to me, after being able to sit up, that it was his first time to pass out. When I asked him if he was feeling any pain, he pointed to his chest, and my heart almost leapt to my throat. I asked him to specify where the pain was, however, and he pointed to his right lung. I probed him further and discovered that he had a three-day cough, but he didn’t have diabetes. I felt a little better because diabetes transmogrifies what is generally known as a “heart attack” into nonspecific manifestations, such as abdominal pain. Sometimes, the “heart attack” or myocardial infarction may even be silent. I had taken his blood pressure and it was within normal limits, although he confessed that it was lower than what he usually had. After I deduced that it wasn’t anything emergent, I suggested that he lie down and elevate his feet a bit.

But doing so was difficult because he was extremely tall. The stewardesses had to displace a row of passengers just so he could lie down. My suspicions were confirmed when he felt much better some time after I placed him in that position. His lower-than-usual blood pressure combined with him immediately standing up could explain his passing out. When he stood up very quickly, blood from his brain was shunted or moved downward because of gravity. This is known as orthostatic hypotension, and this was manifested by his lower-than-normal blood pressure. To force blood flow back to the brain, the brain causes a loss of consciousness, because if someone falls flat on the ground, blood is forced back to it, providing needed nourishment and oxygen.

I stayed with the man until everyone else had disembarked. I tried to make him walk a short distance on the aisle. He did so without problems, and he told me that he felt all right. I had advised him to seek a specialist because his syncope (fainting episode) is often a manifestation of more serious etiologies. He thanked me as we separated, calling me “Dr. Sigh.”

Little has changed: I’m still afraid. Whenever I go on 24-hour duty, I still pray that there will be no overly toxic cases. I’m still anxious, and I’m still worried.

There is one important thing, however, that did change: I am grateful to be a doctor. Beyond any monetary compensation (although that certainly is a huge perk), it makes me feel good to be able to help save other people’s lives. With my airplane patient, I’m glad I did—and I’m glad I do.

Michael David Sy, 26, graduated from West Visayas State University and passed the medical licensure examinations last August. He loves reading classic novels.