The Call

I sink into the plane’s window seat, shade pulled down. My eyelids droop toward sleep. Next to me, headphones in place, my husband catches up on the latest Captain America movie.

I can almost forget that our young son and daughter sit in the row behind us, silent and still, plugged into the iPad for reruns of Good Luck Charlie. They sip the Cokes they never have at home. Together, we fly to Arizona for winter break. After months of working ten- to twelve-hour days as a physician in Connecticut, my body, mind and spirit ache for rest and sunshine.

I hear a distant announcement overhead, and one word grips my attention and snaps my eyes wide open:

“If there is a medical provider on the flight, please press the call button.”

My body stiffens, and I feel a pang of anxiety.

I’m not on call; I’m on a plane, heading for nine days of pool lounging, hiking and a John Grisham novel. But I’m a doctor, and someone has asked for help. It’s my first time in this situation.

I should respond, I think. Medicine isn’t work; it’s an oath. An identity. My identity.

I long ago learned to put patients’ needs before my own, even when I was bleary-eyed and spent. During my medical training, I ran back and forth from hospital room to hospital room all night. I could admit a slew of new patients while also monitoring unstable ones on the medical ward. Only when things slowed down could I calculate how long it had been since I’d had food, water or a bathroom break.

Although my current medical practice affords me more time to attend to my biological needs, I still spent the workday hurrying to and from patients, meetings and teaching sessions, typing on the ever-present electronic medical record. Proper meals, exercise and family time often fall by the wayside.

My husband peers at me curiously. He’s a scientist. He has never been called to help with an emergency in public. Even though we were together during most of my medical training, I don’t think he could really understand the weight I am feeling in this moment.

With knowledge comes responsibility, I think. I get it, but now? Here? 

Possible emergency scenarios race through my head: heart attack, stroke, overdose, choking, panic attack….

It could be anything. Is it something I could handle? I ask myself. I last worked in a hospital ER during residency. But that was more than a decade ago, and only for a couple of months. Now I’m an internist, and routine adult medicine is my comfort zone.

I know that aircraft carry emergency medical kits: first aid, basic medications, oxygen, an automatic defibrillator and Narcan.

How does that cardiac-resuscitation algorithm go again? I wonder a bit frantically. If the plane needs to be rerouted to get the patient to the nearest medical facility, who makes the call—me, a doctor on the ground or the pilot? At least Good Samaritan laws would protect me from lawsuits for anything I tried to do, right?       

While pondering these questions, I’m also acutely aware of the seconds ticking away—of the unknown patient waiting to be helped.

If I come forward as a doctor, what will people expect from me? I feel a stab of the nervousness that was my daily companion as a medical student—the fear of not knowing enough, of not being prepared. A lecturer in medical school talked to us about carrying a black bag in our cars, in case we came upon an accident. What skills should I have at this point in my career for things outside of internal medicine?

I would not be the best person to deliver a baby, but I possess broad clinical knowledge and can keep calm under pressure, I reassure myself.  

So many people, so many eyes in the cabin. I am used to working in a room where it’s just me and the patient, and maybe a family member. Now, I imagine the aircraft full of passengers peeking from their seats, gaping at a huddle of people in the coach section.

Will I represent my profession admirably, or will I disappoint?

Then there are my kids. I’ve been so looking forward to being with them without distractions, without texts from work. It wears on me, the pull of trying to read with them at bedtime and still worrying about the sick patient I sent to the emergency room that day. I crave having the time to focus only on my family.

My children know that I’m a doctor. What if I respond, and things don’t go well? What will they think of me then?

And what will my kids think of me if I don’t answer the call? Is that the role model I want to be for them? Is that really the behavior I expect from myself?

As I raise my hand to the call bell, the flight attendant announces, “Thank you. We have enough help at this time.”

My hand falls slowly to my lap. Feeling relieved, but also disappointed by my ambivalence, I peek behind me to check on my son and daughter, nod at my husband and settle back into my seat.

Finally, my eyes close.