Anna wrinkles her nose. “I’m not a big fan of chicken breast. Give me a drumstick any day.” Her meal choices had been driven by “most filling” and a wish to avoid yet more pasta after her meal in the airport lounge. But she was used to food from hospital cafés. This was a feast in comparison.
“Me too,” he says. “And I don’t understand the love of turkey either.”
Anna’s eyes widen. “I thought I was the only one! My family has turkey every Christmas.”
“Mine too. And living in America, I get double helpings. Thanksgiving, too.”
They swap food-related comments until dessert arrives. He declines his. Anna is in awe of his self-discipline.
“My personal trainer would never forgive me …” He gives a rueful shrug.
“I’d have eaten yours for you. Dessert is the reward for eating the main meal, isn’t it?” she says
“I can call them back. Tell them I changed my mind,” he offers.
“Oh, no. Thank you.” She hadn’t expected his gallantry. Truth to tell, she is feeling uncomfortably full even as she squeezes in another mouthful of chocolate mousse. She puts the spoon down half-way through and hopes he doesn’t notice. Her playful comment now seems like a boast.
But she need not worry. As soon as he takes possession of another coffee, he turns his attention back to his paperwork. Anna is relieved. Being under his spotlight is making her behave atypically. She is normally smoother, cooler. She feels odd. Like she has disappointed someone dear to her. Perhaps she should keep her mouth shut, read her eBook, and get to the end of the flight without any more gaffes.
Goodbye, Mr Chips
The touch is unexpected and wakes Anna immediately. The last thing she remembers is the heat of summer and tufts of scorched grass. She must have nodded off while reading and her brain had run with images of the story. But a moment is all it takes to re-orientate herself. The cabin lighting is dim but sufficient to make out one of the cabin crew, leaning over her. It is the flight attendant who welcomed Anna onto the plane. As soon as she sees Anna’s eyes open, she murmurs, “Are you a medical doctor?”
After years of having to switch from deep sleep to fully functional in only a second, Anna sits up, immediately alert. She nods.
“Please, could you bring your credentials and come with me?” It is phrased as a question, but the tone is more an instruction. Anna recognises the demeanour of someone who is used to being obeyed. It reminds her of the ward sisters and senior nurses in the hospital.
She slides out of the bed but as her foot lands on the shoes she kicked off earlier, her ankle twists and she stumbles against the wall separating her from her neighbour’s cocoon. His eyes flick open and he catches Anna’s muttered apology, as well as the flight attendant’s words, “Please hurry.”
Anna scoops up her laptop bag, leaving behind the laptop, and follows as the attendant leads her forwards. She is desperately hoping nothing is wrong with their captain or co-pilot. Nothing like this has ever happened to her before, but sheis aware of stories from colleagues and knows what to expect. Or perhaps she doesn’t. First, she has to penetrate a layer of women, robed in black and softly keening. Laid out on the floor of First Class, surrounded by medical debris, is a corpulent man in robes, who to Anna’s trained eye is decidedly dead. His clothing has been cut open and pads are stuck to his torso, one above his right breast, another to his left lower chest. She notes they’ve been correctly placed. A male flight attendant is on his knees, one hand on top of the other as he pushes down on the dead man’s chest.
Another attendant taps Anna’s shoulder and gives her a handset. “Medlink,” she says and steps back.
“Can I take your name, please?” the Medlink operator says.
Anna gives it. Quickly, they run through her qualifications, employer, and registration. Then they say, “We believe the patient is asystolic. Your plane is more than thirty minutes out from the closest medical facilities at Goose Bay. The plane should be carrying epinephrine. Can you treat?”
Anna understands immediately. “Yes,” she says, but she knows the chances of success are infinitesimally slender. It is sometimes hard to accept that not everyone can be saved. The scene in the emergency room where the patient is resuscitated by the handsome doctor striding into the resus bay is played out on millions of television screens across the world. The truth is, even in a hospital surrounded by every modern piece of equipment with a fully trained medical team, the chances of saving an asystolic patient are around one in ten. Nine out of those ten will stay dead.
Here, in a plane, a long way from help – with just her, the flight attendants, a basic medical kit, and a defibrillator – there is almost no chance. Defibrillators save lives if the heart rhythm is disturbed, but not if there is no rhythm at all. Everyanaesthetist does training stints in the Emergency Department. Anna fully understands what is happening.
The traveller is obviously rich, probably powerful. The airline will want no comeback. But twenty minutes of resuscitation is normally the limit. He has already been dead for a few minutes. The further delay until the aircraft can land, the time to deplane the man, and transfer him to hospital make survival impossible. Continued resuscitation past that point would be futile, only serving to further distress the patient’s family and reduce the patient’s dignity in death. And no one wants to divert an entire plane-load of passengers when there is no possibility of saving a life.
But everybody deserves a chance. As the defibrillator chirpsNo shock advisedonce more, Anna turns to the flight attendant, noting her name badge. Susie.
“How long has he been this way?”
But it is male flight attendant, kneeling on the floor and bouncing on the patient’s chest, who answers: “About five minutes. I got to him almost right away.”
“Susie, can you set a timer and where is your medical kit?”
Susie thrusts a kit at Anna. She opens it, extracts the stethoscope, and kneels beside the man doing CPR. “What’s your name?” she asks.
“Toby,” he pants.
But when Anna places the stethoscope on the man’s chest, all she can hear is the roar of the aircraft engines transmitted through the floor. She pulls the stethoscope out of her ears and looks up at the surrounding women.
“Was he eating anything? Is he allergic?”
