This is a short post, since we're hard at work on this week's show on violence directed at paramedics. We've had quite a bit of reaction to our show about health care professionals who have stepped up voluntarily to aid everyone from fellow passengers to fellow motorists in distress.
Here are just some of the many emails you've sent us over the past few days.
Sir, as an aviation enthusiast, my I give my two cents worth? Prior to coming to Canada, I lived near Glasgow and Prestwick airports. Since I moved here, I've lived close to Bangor Maine, and having been at Halifax and Gander. Transatlantic flights divert into these airports on "medical emergencies" on an almost daily basis. Passengers are off loaded and transported to the local hospital. This costs the airlines big bucks every time. If they are lucky, the aircraft resumes the flight. However if it is a long haul flight, there are complications. Perhaps the crew will be out of hours by the time they reach the destination. The airline then has to arrange hotels and meals for the passengers for very big bucks. Some times they even have to ferry replacement aircraft to pick up crews and passengers costing even bigger bucks. Pardon my French, but no bloody wonder they ask if there is a "Doctor on board". It is all about money, and the health of passengers is way down the list! Kindest regards, Ken Marshall.
The doctor was justified in asking for some sort of compensation. In true form Air Canada didn't really know how to put a nice bow on it when faced with a poor situation they created. The doctor's experience of being ask to interfere with a legitimate doctor's care of a "patient" to satisfy the anxiety of the flight crew makes it a completely different type of scenario. The point is well made that the airlines have always benefited from usually having access to health care providers when their clientele is in distress. Perhaps the college of physicians should establish a dialogue with the industry. I also like the point that technology allows for them to fund, support and use a centre for in-flight support of those who render and those who require care whilst in flight. From: Les Robinson, Winnipeg.
Dr. Goldman, I am a paramedic and I, too, have found myself in similar situations on over-seas flights, theatres, walking, driving, .....well, you get the picture! I personally have no problem volunteering my services whenever the need arises and am one of the professionals who feel it is our duty, in some regard, to be willing to provide the level of care to which we have been trained when a situation arises outside of our regular work environment. That being said, I don't believe that all health care providers are created equally when it comes to emergencies. I would expect far more from an ER physician or ER nurse at a medical or traumatic emergency than I would from a GP, psychiatrist or dentist, for example. Doctors and nurses by virtue of their training are specialized, and very good at what they are specialized in, but as a result are not, by the mere fact of being a doctor or a nurse, necessarily the most appropriate person to help out with an emergency, unless of course, the emergency applies to their specialization. I feel that a lot of misconceptions arise about a) what an emergency is; and b) who is the best person to deal with that emergency; out of the public's idea that the best person for the job is a doctor (no matter what kind), failing that, a nurse (again, no matter what kind), and then finally, someone who 'knows first aid and CPR'. I can certainly sympathize with the psychiatrist, for example, who doesn't want to 'answer the call' for someone having an acute appendicitis attack, because, despite the fact that they are a doctor, they are also acutely aware that they are not equipped to deal with that kind of emergency, however, once they step up to the plate, the public then expects them by mere virtue that they are a doctor, to' fix' whatever the problem is. From: Alison Shorey, Kingston, Ontario.
Dr. Goldman, this goes back some 20 years when my father, a physician, was on a flight from Saudi Arabia to Paris. I was to have picked him up at Heathrow after a connecting flight. After taking off from Saudi and reaching cruising altitude, the crew asked if there were a doctor on board. My father reports he slowly surveyed the balance of the cabin, and seeing no other takers, identified himself as a physician. A passenger was in distress, exhibiting symptoms of asphyxia. My father administered oxygen and advised the crew that the pilot needed to lose altitude and get this patient on the ground. Given the location of the aircraft, and facing the mountain of paperwork associated with dealing with the French authorities, the pilot elected to turn the plane around and head back to Saudi Arabia. By the time the patient had been taken off the aircraft, the emergency oxygen supply had been depleted and the crew had exceeded their service schedules, so there was a further delay. Hundreds of people were inconvenienced, but my father made the best decision he could under the circumstances. From: Neil Mackenzie, Calgary.
Dr. Goldman thanks for a provocative piece. My father was a physician -- a paediatric general surgeon, to be specific. The "obligation to help" question was discussed often in our home as I grew up. I know my dad would never have refused to help someone in an emergency. I saw him offer aid on many occasions over the years, on family vacations, at parties, & on the road. He never expected, or asked for, any thanks, recognition, or compensation for his help. He also donated much of his "off" time as Physician on Call for Ski Patrols at local mountains. When he was on the mountain, he was available. However, I also know he didn't exactly advertise the fact that he was a physician when he was travelling or on vacation or at social events with people he didn't know. It was as though the mere mention of his being a doctor redirected conversation towards things medical. It was a licence for people to open up to him & tell him all about their very private lives, their ailments, their past treatments, and usually their disillusionment with the medical system -- right before they uncovered some body part or other & said, "Well, here ... what do you think about this?" We ordinary folk owe a huge debt of gratitude to doctors, nurses, police, firefighters, and paramedics -- all the First Responders out there who are able and willing to assist in real emergencies. We are presumptuous and greedy in the extreme to expect these people to be always at our beck & call. From Katie Janyk, Sunshine Coast, BC.
Dr. Goldman, although crew members are grateful for the medical assistance of professionals that may be on board the many flights that require medical attention, the airline industry does require crew to be trained and qualified in 1st Aid, CPR and AED training. STAT-MD a hospital based medical advisory service providing medical assistance augments assistance, available to crewmembers by phone or radio. Therefore, airlines do not solely depend on Health Care Professionals that frequent the skies off-duty, but we as crewmembers deeply appreciate when a Doctor or Nurse does step forward to assist in diagnosing the severity of the individuals case, lessening anxieties faced at 30,000 feet. They have made a difference in the lives of the individuals needing the medical help, the family members of those individuals, and myself, the flight attendant. I wish I could leave this world knowing that I had made a beneficial difference in so many lives. From: Teres Edmonds, Toronto.
Thanks to all of you for writing to us and helping to enrich the discussion.