The Patient Was…

The patient was a middle-aged male who suddenly collapsed and stopped breathing on a flight from New York City to California. His seat-mate heard him gasp, saw him slump forward, and realized that the man was unresponsive. He immediately jumped up, notified a flight attendant, who in turn asked over the PA system if there were a doctor on-board. I responded and was led to the window seat toward the rear of the cabin where the patient was slumped over, not breathing, and pulseless.

Assuming this was sudden cardiac arrest or sudden cardiac death, which means the sudden cessation of the heart’s activity, I laid the patient across the now-empty seats in his row. Doctors may argue with my next step, but it’s one I’ve employed successfully in another instance: I delivered a sharp blow to the patient’s chest with the side of my hand, sort of a karate or judo chop.

It is known, of course, that in some circumstances a blunt, nonpenetrating blow to the chest can cause a heart to stop beating. This very infrequent phenomenon, referred to as commotio cordis, is seen mostly in sports using hard projectiles like baseballs or hockey pucks. But if a heart has already stopped beating, a sharp blow to the chest, which takes only a second or two, is almost certainly harmless.

I delivered a blow and, almost at once, a faint pulse returned and a few moments later the patient began to breathe. He was in no condition to speak and could give no medical history, but we sat him up and I remained with with him, my hand on his wrist continuously to feel his pulse.

By this time, a decision had been made by the pilot to divert the flight to the nearest major airport that could handle a large commercial jet and where proper medical care could be provided. An ambulance with appropriate medical personnel and equipment met the flight on landing, and after the necessary protocols were completed, we took off again.

Soon after I returned to my seat, the Chief Purser, the most senior flight attendant, asked me to provide her my detailed contact information. I was sure the airline was going to offer me a significant reward of some sort, like free travel thereafter or lots of frequent flyer miles or even some sort of public recognition. I wanted to hear what they intended to offer but didn’t really want to appear interested in the details, so I asked rather coyly why they needed my contact information.

“Oh,” the purser replied, “there will surely be a lawsuit, and you’ll certainly be involved. It’s going to be complicated because different states have different laws around things like this. I mean he collapsed while we were flying over one state, we got to him and resuscitated him over another state, and we landed in yet a third state. So, we need to know where the lawyers can get in touch with you.”

I never heard from the airline and, to my knowledge, no legal action ever came of it. But the experience came close to reaffirming the old adage, with implications for all of us: No good deed goes unpunished.