Kyle looked at me. “You didn’t!”
“Moi?” I said, feigning innocence.
“Innocence doesn’t work with you, babe,” Kyle said with a smile.
“Hey, I was innocent—once—a long time ago.”
“In a galaxy far, far away?”
“Bite me, bitch. And look out the window.”
Kyle kept his eyes glued to the ground that passed beneath us en route to Hawaii. When we passed as close to Oklahoma as our route would take us, we couldn’t see his house or his farm or anything else he recognized. Nonetheless, I enjoyed watching the delight on Kyle’s face at seeing everything from a new perspective.
When Kyle tore himself away from the view out the window, the flight attendants had served breakfast to everyone else in the cabin. I watched as the smell of the food finally caught Kyle’s attention. “I smell food,” he said.
“Yeah, babe. We all ate while you were watching the ground go past outside.”
Kyle got a disappointed look on his face at the thought that he had missed breakfast. I couldn’t stand to see my guy looking upset, so I pushed the flight attendant call button and told them that my boyfriend was ready to eat breakfast. Kyle was surprised and delighted to find that they were willing to bring him something even though everyone else had already finished. Flying was still a new experience for him, including flying first class, where good food could appear at any time you wanted on long-haul flights.
Kyle ate, I read, we talked together a bit about the islands and some of the things that we could do while there. I’d made some plans but had deliberately kept some time unscheduled for us to add things that we encountered by chance along the way. At one point I slept a bit, but Kyle was too excited—even though nothing different than the last several hours was happening. The view out the window by that point was simply clouds and water. He had been excited to see California for the first time and couldn’t believe how dry and brown it looked. He had always pictured California as a lush, green tropical paradise, so he was surprised to find that it looked more like a desert than a tropical paradise. There were pockets of green, but the dominant color was brown.
When he asked about what he was seeing, my answer was simple. “A lot of California is desert. It goes through big cycles of drought and deluge, but even in wet times, there are times of the year when it never rains. A lot of the water for irrigation in the Central Valley comes from the Colorado River. So much water is siphoned off the River that by the time it reaches the Pacific, it’s just a little trickle. Without that water, California couldn’t survive.”
“So you’re saying it’s all artificial, in a way?”
“Yes, to some degree.”
“Huh. Didn’t expect that. Don’t tell me Hawaii is a desert too.”
“No. Hawaii is definitely not a desert, although there are places on the islands where it looks like you’re in a desert. Parts of Maui are bone dry, the southern coast and inside the volcano crater especially. Same with the Big Island.”
With nothing but clouds and water outside the window, Kyle and I pulled out our books. It wasn’t long after that that a flight attendant made an unexpected announcement. “Excuse me, ladies and gentlemen. I’m sorry to disturb you, but if there is anyone with any medical training on board, please identify yourself to a flight attendant. Thank you.”
Kyle immediately unbuckled his seat belt and rose to get the attention of the nearest flight attendant. Not knowing what was happening, I did the same and followed my boyfriend. I heard him tell the attendant, “I’m an emergency physician.”
“We have a man in the back who might be having a heart attack.”
“Take me there,” he ordered, so she led us back dozens of rows toward the back of the plane. There was no mistaking which person was in trouble when we reached the back of the plane. Kyle identified himself to the man and his wife as he reached down, took the man’s hand, and checked his pulse. He repeated the move with the arteries in the man’s neck.
He unbuttoned the man’s shirt and used the cheap stethoscope the airline carried to listen to the man’s heart from several angles. Rising, he quietly spoke to a flight attendant, asking if there was someplace they could lay the man down flat, and also if they had an automatic defibrillator device onboard. There was no ideal place onboard a crowded plane, so Kyle and I lifted the man out of his seat, moved him back a few rows, and placed him on the floor near the restrooms.
The flight attendant produced the defibrillator device. Kyle opened the man’s shirt all the way and placed the various patches on the man’s chest as directed by the device. Its patches in place, the device started analyzing the data it was collecting. By this point the man had lost consciousness and was unresponsive when Kyle tried to ask him some questions.
“What’s this thing?” I asked.
“An AED, or automated external defibrillator. It’s a portable electronic device that automatically diagnoses a potentially life-threatening irregular heartbeat. It’s able to treat them by applying a controlled electrical shock, which hopefully stops the arrhythmia and allows the heart to reestablish a steady, productive rhythm.”
“Cool.”
“The introduction of these things and their widespread adoption has meant that people who have heart problems can get help a lot faster and more accurately than ever before. Anyone can figure out how they work—the machine guides you each step of the way, and there aren’t that many steps involved.”
Lowering my voice slightly, I said, “You really are an awesome man, Kyle.”
“I knew that. You just now figuring it out?”
I simply smiled at my partner, proud of him in this situation and proud of how far he had progressed in his personal self-image and sense of self-worth.
Our conversation was interrupted when the machine started beeping loudly and ordered everyone to stand clear of the patient and the device. The only time I had ever seen an electrical shock applied to a person’s heart had been on TV drama shows, so I expected to see the man on the floor flop around like a fish out of water, but Kyle assured me that that only happened on TV and in the movies. In reality the process was much less exciting.
The machine announced that a sinus rhythm had been restored and that it was once again safe to approach the patient. It also instructed someone to call 911 and to get the person to an emergency room immediately.
Kyle looked up at the array of flight attendants who were gathered around the unexpected event unfolding before their eyes. They were all trained in the usage of the AED but were delighted to have a doctor onboard who could handle that plus a lot more.
“How far to the nearest ER?”
“A couple of hours at least,” one answered. She picked up the intercom and called the cockpit to get a more accurate estimate of how long it would take to get to the closest medical facility that could handle this type of an emergency.
She hung up and reported that we were approximately 101 minutes from the closest medical facility. We had passed the halfway point over the ocean and had no choice but to proceed to Hawaii. The pilot and Kyle conferred by phone and decided that the medical facilities in Honolulu were probably better suited to handle this case. The pilot notified air traffic control that we had an in-flight medical emergency and needed to come directly into Honolulu as quickly as possible and that we needed an ambulance waiting.
In the meantime, though, we had nearly two hours to watch over the sick man. Kyle asked if there were seats anywhere that were empty so we could lay the man down on them and get him out of the way of the bathrooms. Unfortunately the flight was completely full, so there were no empty seats.
“The seats up in first recline, don’t they?” he asked suddenly, remembering something he had heard me say earlier.
“Yes, but they’re full too.”
“Let’s put him in my seat, 1A. That’ll get him at the front for quick exit when we finally get on the ground.”
The flight attendants produced a cha
ir-like device. The key thing was that we could get it down the cramped aisle of the coach cabin. Kyle and I got the man up off the floor and onto the chair. A flight attendant carried the AED, and another flight attendant got on the PA system and asked everyone to clear the aisle—the incident had attracted a fair amount of attention. People throughout the plane were straining to get a glimpse of what was happening. People surprisingly obeyed, and a pathway cleared through the aisle.
It wasn’t easy by any means, since the guy was not a lightweight, but working together, Kyle and I were able to slowly carry him in the chair-like device up the aisle of the airplane toward the front. Of course, with absolutely impeccable timing, the plane hit a patch of rough air when we were about halfway to the front. The seat belt sign came on, but Kyle and I had no choice but to keep moving forward.
Our job got easier when we reached the business-class cabin, where the aisle was a bit wider. By the time we reached first, our arms were aching from the strain and our own hearts were racing. We recruited some help to move the man onto the seat since I don’t think either of us had any strength left in our arms at that point in time.
A flight attendant worked the controls and fully reclined the seat. They fastened a seatbelt on the man and covered him with a blanket. The final step was putting an oxygen mask on the unconscious man.
Kyle grabbed his stethoscope once again—somehow it hadn’t fallen off while we had been moving the man—and listened to his heart and his breathing once again. He asked for pillows, blankets, anything he could get to raise the man’s feet some more; almost immediately the things appeared, and he got them arranged as he wanted.
“Do you have any meds of any sort on board?” Kyle asked.
“We’re a long-haul flight, so we’ve got a full medical kit.” He didn’t even have to ask; she simply moved to grab the kit and open it for him.
Kyle had been totally focused on diagnosing and caring for his patient to that point. Suddenly he looked up and asked, “Where’s his wife?”
A very upset-looking woman was standing just a few feet away from him. “I’m here.”
“Do you know if he’s taking any medications of any sort?”
“Yes, but I don’t remember them right now.”
“Did he carry them on board with him?”
“Yes.”
“Get them for me,” he ordered. “I need to know what he’s taking so I don’t give him something that will interact badly with anything he’s already on.”
A flight attendant and the woman moved quickly back down the aisle to find the man’s bag. In a few minutes, they were back. Kyle opened the bag and checked the meds. “Is this everything?” he asked.
“Yes.”
“No others?”
“No. This is what he takes.”
“Okay.”
Kyle opened a small container, broke the seal, shook it, and sprayed something into the man’s mouth under his tongue.
“What’s that?” I asked.
“A nitrolingual spray. Do you remember hearing anyone ever talk about taking a nitro tablet when they’re having chest pain?”
“Yeah, I do.”
“It’s something like that. It’s called a nitrate, and it helps the heart to work more efficiently. It makes the veins and arteries relax and widen so that blood can flow with less resistance. That means that the heart doesn’t have to work as hard to pump blood around the body. It also means that there is less blood coming back to the heart with each beat so it has less blood to pump back out. And you can see how all of these things together are good things.”
The man’s wife was getting a little agitated. “What’s wrong with him? Do you know what you’re doing?”
This was something I could deal with so Kyle could stay focused. “You got extremely lucky today, ma’am. He’s an emergency physician in one of the busiest ERs in New York. He knows his stuff really well. If anything bad like this had to happen, thank goodness it happened when someone was here who has dealt with this before.”
“But he’s so young,” she complained.
“That’s the best. He hasn’t had years to forget everything he learned in medical school and residency. And he’s an emergency physician trained to deal with a wide variety of health matters.”
The earlier bumpy air chose that moment to recur. The flight attendant got the ill man’s wife into a jump seat just around the corner since she wouldn’t return to her own seat way in the back of the plane. Really, who would? Kyle took my seat, so I also sat on another jump seat just around the corner—fortunately there were some extras.
Remembering something, I shouted around the corner, “Kyle! Put your seat belt on! Do it! Now!” I suspected that Kyle would have been totally focused on his patient and wouldn’t have paid attention to his safety, so I wanted to be sure he, too, was strapped in so that he wouldn’t go flying if we hit some air pockets. The rough air continued for a few minutes with a couple of really big bumps.
When it was safe to get back up, I returned to Kyle’s side and checked on how things were going. “Need anything, babe?”
“No. We’re okay for the moment.” The man was somewhat conscious but seemed to be sluggish. “How much longer?”
“I’ll find out.” A flight attendant called the captain. Procedures for the cockpit door to be opened in flight were rigid since 9/11, so it took a bit of juggling to get the beverage cart in place to block access to the flight deck so that the captain could come back to personally assess the situation. One brief exchange with him earlier had assured him that Kyle knew what he was doing, but still he wanted to know personally how everything was proceeding because he needed to update air traffic control and emergency workers on the ground.
“The computer tells us we’ll be landing in forty-three minutes,” the pilot reported to Kyle.
Kyle gave no commentary but nodded in acknowledgement. “Can you have an ambulance waiting when we land?”
“Already done. And I’ve asked for a straight-in approach because of an in-flight medical emergency. If this had happened over land, we’d have had lots of options for quicker landings, but out here there’s just nothing between the mainland and the Hawaiian Islands except water.” The pilot returned to the cockpit to get ready for landing.
Somehow in the midst of everything, the flight attendants had managed to serve a snack and drinks to everyone else on the plane—I wasn’t sure when that had happened, since my focus had been on Kyle and his had been on the patient. I’m not even sure I would have noticed that we were starting our initial descent into Honolulu if a flight attendant hadn’t announced the news.
The earlier hours seemed to have flown past, but Kyle later told me that the last thirty minutes seemed to tick by remarkably slowly. Every minute or two, when he looked at his watch, he was convinced that we should be landing, but every time only another minute or two had elapsed.
This was certainly not the way I had wanted Kyle’s first arrival in Hawaii to be. I had wanted Kyle to be able to sit and watch out the window as the first island came into sight. I had wanted Kyle to practically bounce up and down with excitement like he had earlier on our departure from Chicago. But unfortunately that was all impossible.
More minutes slowly ticked by. Flight attendants were busy throughout the plane preparing the passenger cabins for arrival. More time slowly—ever so slowly—ticked past. The plane continued to descend. True to his word, the pilot was able to bring us directly into the airport without a complex series of turns and twists as sometimes happens when a plane comes into a busy airspace.
When I felt the wheels touch the ground, I was extraordinarily grateful. I had flown a lot over the years, but this flight had been unusual. Our plane slowed on the runway and immediately turned off onto a taxiway for a very fast taxi to the terminal.
A flight attendant updated the passengers that when we arrived, the door at the very front of the cabin would not be available since medical personnel would be using that one to
remove the sick passenger. The plane jerked to a stop, and the engines were shut down immediately. In under a minute, there was a knock at the cabin door; a flight attendant opened the door from the inside to admit a series of medical personnel. Kyle stepped out of the way to allow them access but also relayed to one man all of the information he could about the man, his medications, his situation, and what he had done in-flight. I was so proud of him!
The sick man was moved onto a stretcher and taken away—thankfully by someone other than us this time. When they had departed, Kyle suddenly found himself with an armful of me. “Hey. You okay?” I asked. “I’m really proud of you, babe! You are one freaking awesome man! And I’m glad you’re my man!”
Kyle stared at me for a moment, not knowing how to respond. “So are we in Hawaii?”
“Yeah, we’re here. I’m so sorry you didn’t get to see anything out the window as we were coming in.”
“Me too. I guess that means we’ll have to do it again sometime so I can see.”
“Deal. Let’s just skip the in-flight medical emergency next time.”
“Deal. I’m hungry.”
“You didn’t get to eat lunch when they were serving.”
“Did you?”
“No.”
“Then let’s get out of here and find some food and then start our vacation.”
“Deal.”
I grabbed Kyle’s hand and squeezed it. We retrieved our bags, repacked the things that we had had out during the flight, accepted thanks from the cockpit and cabin crews, and said our good-byes.
Chapter 21
WE HAD lost track of time in the excitement of the flight. What had been planned as a quiet eight to nine hours of reading and napping had turned into an adrenaline-pumping medical emergency that prevented eating, drinking, sleeping, reading—all the things that we had assumed would happen.
Little Squirrels Can Climb Tall Trees Page 15
