![\"24-hour-clock\"](\"https:\/\/stg-blogs.bmj.com\/pmj\/files\/2016\/10\/24-hour-clock.jpg\")
<\/p>\n<\/p>\n
Becoming a doctor is a long and arduous process. \u00a0It involves many years of study and more of practice. \u00a0It is inconceivable that this process leaves those who go through it untouched. \u00a0This process is called professional socialisation. \u00a0It confers values, and behaviours on the participants, and these help to mark our profession out from other groups in society.<\/p>\n
The following reflection is from Dr Ciara Deall, a trainee plastic surgeon, recalling events which took place on a flight to North America, and in which her training allowed her to offer a stranger comfort, despite being off duty – a state that perhaps is never truly realised by those whose vocation is the practice of medicine.<\/p>\n
We had cleared the west coast of Ireland and I was beginning to relax on flight AA365\u00a0heading for New York and a weeklong, intensive microsurgery course. Just time to let go of a\u00a0non-stop week of on-call mayhem and enjoy some inflight entertainment to help wind down.<\/strong><\/em><\/p>\n The intercom interrupted abruptly: \u201cHi, this is the chief steward, will any medically trained\u00a0passengers please make themselves known to the crew; we have an emergency.\u201d\u00a0Almost without thinking I found myself standing up and telling a stewardess I was a\u00a0doctor, before wondering what I might be letting myself in for \u2013 a stroke, anaphylaxis, heart\u00a0attack, choking? Was I the only one?<\/strong><\/em><\/p>\n The 19-year old girl was doubled up in agony, clutching her stomach, clearly very\u00a0frightened and panicky. \u201cHi, I\u2019m a doctor.\u201d She was French and couldn\u2019t understand much\u00a0English. However, her GCS was 15, pulse and respiratory rate were raised but in range, she\u00a0was not breathless and on eyeballing her from the aisle, she was in pain, but not acutely\u00a0deteriorating.<\/strong><\/em><\/p>\n The stewardess asked if there was anything I needed. \u201cAn interpreter please.\u201d Not\u00a0quite what she had been expecting, but after another intercom request, the perfect match was\u00a0found and I made rapid progress in establishing my patient wasn\u2019t pregnant, had no fevers, no\u00a0urinary symptoms or diarrhoea, but had been out the night before eating too many different\u00a0foods and drinking too much alcohol with subsequent vomiting episodes. Her pain was 4-5\/10, crampy in nature and relieved by lying down. On abdominal examination she had very\u00a0mild generalised tenderness, but a completely soft abdomen with no guarding or rigidity;\u00a0bowel sounds present.<\/strong><\/em><\/p>\n Her panic was subsiding fast with my apparent calmness as I completed the full\u00a0history and examination. I was offered an astonishing state-of- the-art medical kit and\u00a0pointing to an endless array of emergency drugs, including adrenaline, atropine and\u00a0morphine, the stewardess invited me to help myself to whatever I wanted! I almost felt guilty\u00a0in only using the sphygmomanometer and some mild pain relief, explaining the other drugs\u00a0could severely harm or even kill her!<\/strong><\/em><\/p>\n My patient settled to rest lying down, with water to hand for her dehydration. I\u00a0promised to be back in 15 minutes. The crew were effusive in their gratitude and what it\u00a0meant to them to have an \u2018expert\u2019 on hand. They recounted some past horror stories where no\u00a0one had volunteered. Unwittingly I had calmed their nerves as well.<\/strong><\/em><\/p>\n Back in my seat I reflected for a while on my encounter and realised the potential\u00a0vulnerability of tens of thousands of long haul travellers daily and their attending cabin crew.\u00a0Crossing immense oceans a truly sick person could be many hours away from trained medical\u00a0staff and properly equipped facilities, unless there happened to be a willing, qualified\u00a0passenger on board; clearly a gamble that is a daily occurrence. I was glad of my ATLS\u00a0training, recognising it could be called on at anytime, anywhere, even at altitude.<\/strong><\/em><\/p>\n Furthermore, it was a reminder of the unique <\/strong><\/em>(and privileged) position that doctors\u00a0have, where particularly in emergency situations, complete strangers are willing to put their\u00a0absolute trust in us. Even when we least expect it, the way we conduct ourselves and the\u00a0skills we deploy can have a profound effect on those around us, for both patient and\u00a0onlookers. No one cared whether I was a junior doctor or not. At 38000 feet I was valued for\u00a0my willingness to offer and use my expertise. It was a sobering, almost humbling thought and\u00a0without overstating it, I reminded myself that we are never completely \u2018off duty\u2019.<\/strong><\/em><\/p>\n My patient slept. On waking she smiled feeling much improved and couldn\u2019t thank\u00a0me enough. Approaching New York, the stewardess asked if I had space in my carry-on for a\u00a0bottle of their best champagne. I did!<\/strong><\/em><\/p>\n At the end of the flight I accompanied my French charge off the plane. Another fascinating\u00a0day in the life of a junior doctor.<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":" Becoming a doctor is a long and arduous process. \u00a0It involves many years of study and more of practice. \u00a0It is inconceivable that this process leaves those who go through it untouched. \u00a0This process is called professional socialisation. \u00a0It confers values, and behaviours on the participants, and these help to mark our profession out from […]<\/p>\n