The Patient Was…

The patient was in her late sixties and had become very ill while on vacation in the Bahamas. She was flown to New York City, where I assumed her care.

Her medical case was a complicated one; suffice to say that the suffered from both severe lung disease and cardiac disease. She remained in the hospital for several weeks, always begging to be allowed to travel to her home country. Finally, when it seemed that she could be flown to her native country with small, though not negligible, risk I started to make arrangements.

And were they complicated!

The patient had to be on a stretcher for the entire trip, from her hospital bed, in the ambulance, at the airport, on the plane, in the ambulance at the other end of the flight, until finally placed in her bed at home.

The traveling entourage included the patient, her closest companion of many years who had been with her in the Bahamas and was with her during her entire hospital stay, a private nurse who agreed to leave her hospital position, another aide, and myself who had ultimate responsibility for the patient’s safety and well-being.

She was to fly on a large airliner of a major carrier, with the first-class cabin reconfigured into what was essentially a hospital room. Seats were removed, except those for her close companion and me, so the stretcher and associated equipment could be accommodated.

A major consideration was an adequate oxygen supply, because the patient required a constant flow of supplemental oxygen which was delivered through nasal tubes. These were the days when supplemental oxygen was provided from  large, green cylinders with pressure gauges and valves to control the flow of the gas. I had calculated the number of oxygen tanks needed by integrating the hours of flight, the rate of oxygen flow needed, the capacity of each tank, and then adding some extras in case of unexpected problems. And I had cleared all of this with the medical staff of the airline which promised to have the oxygen tanks at the plane ready for departure.

We created a stir at the airport, since not only were we a large and unusual group, but the airport had special security personnel around to prevent any problems. The patient was uncomfortable in that setting, and the flight crew wanted to depart quickly, as did we all.

Just before we boarded, I checked the patient ‘s condition which was stable and satisfactory for flying. But, when I counted the oxygen tanks just to be sure, there was one too few. I told everybody that we not leaving until another tank was secured.

The pilot, a senior airline captain, offered a solution.

“We’ve got an extra oxygen tank in the cockpit,” he said, “just in case of some emergency where we might need it up there. You can have that one.”

I didn’t even think for a second.

“Look, Captain,” I said, staring at him intently, “if there’s one person for whom I’m more interested in having emergency oxygen available than my patient, it’s you!”

He scowled for a moment, then smiled. “Understood, Sir,” he said.

Another oxygen tank was secured and we took off without further delay for an uneventful flight home.