Death Flight Page 7

  My heart banged uncomfortably in my chest. Whenever I get on a plane, I figure I'm lucky to get off with all four limbs. Add in Tucker confronting or comforting anyone with a pulse, and I could rocket into a full blown panic attack.

  For some people, the plane's like taking a bus. Ho hum. Wake me up when we get to Atlanta. But if there's one thing I've learned from death and doctoring, it's that I can't take anything for granted. Am I breathing? Cool. Might not be happening two seconds from now.

  The plane rolled toward the runway. Planes are slow and lugubrious on the ground, like penguins waddling until they hit their natural element.

  But when this plane finally started to accelerate, it hit the air at such an angle that I involuntarily grabbed the arm rest.

  Tucker reached across the arm rest to rub my leg. "Everything's going to be okay!"

  Ooooooooo. Kay.

  I nodded, unconvinced. I gazed out of the small, oval window, past the silent colossus on my left. I swallowed to release the pressure in my ears. Most of all, I gripped Tucker's hand.

  The plane levelled out. I headed to the bathroom to switch from my contact lenses to my glasses when the seat belt sign pinged off. And then I nodded off.

  When I woke up, Tucker was missing.

  I rubbed my eyes and checked my watch. We'd only been airborne for thirty minutes. He couldn't have gone far. I stretched my legs and checked my phone, even though it would be neurotic to have him message me because he'd stepped into the john two feet behind us.

  The bathroom. That reminded me of the airport's family bathroom. My thighs flexed involuntarily. I've never wanted to join the Mile High Club. Airplane stalls smell like urine, and there's zero room. And yet five hours was a long time to go without my new man.

  I twisted around to eyeball the bathroom behind me. The light was on, so someone was in there. He should be back soon.

  I tried to read, but it wouldn't hold my attention. I unbuckled my seat belt and checked my watch again. I'd been awake for six minutes.

  You can't be one of those twosomes following each other around. Remember when you laughed at the Saturday Night Live skit about the "love toilet" for needy couples?

  I need to know where he is.

  You're on an airplane. He can't have gone anywhere.

  Still, I stood up to gauge if there was any obvious kerfuffle. Compton was my first guess, but he seemed to have settled into his seat, lighter-free.

  Tucker's white blond hair tends to stick out. Maybe not as much in L.A., where platinum is fairly common, but I should be able to spot him from a distance.

  No one was in the aisle, so I stretched out my hamstrings and verified that the other toilet across the aisle was occupied. It was. I decided to stand outside the bathroom behind our seats while texting him. I'm up now. :)

  Yes, I added the smiley face to make me look less psycho. It might not work, but then Tucker knew what we'd been through. He'd almost chosen psychiatry instead of family medicine. He wouldn't judge me.

  My neighbour, the quiet mammoth in the window seat, cleared his throat and pointed straight ahead of him, which was behind me, since I was facing the bathrooms.

  I frowned at him.

  He pointed toward the head of the plane again.

  I shook my head.

  He pulled the earbuds out of his ear canals. "At the front."

  "What is?" I was starting to think that everyone was insane.

  "Your boyfriend. They called for help."

  "What? I didn't hear anything." I'm not that good a sleeper, especially with PTSD. I would have woken up for an airplane announcement.

  "The stewardess came up and asked him."

  Damn it. Guess it's true that if they know there's a doctor on board, they'll quietly ask for help instead of broadcasting their plea, in order to reduce passenger panic.

  I arrowed toward the front of the plane. Whatever was going on, Tucker would be in the thick of it.

  13

  All the way up the aisle, I cast my eyes right and left.

  The Santa girl curled up under her sleep mask and a blanket.

  On my left, Compton watched a bloodied Japanese woman shriek on-screen. Horror wasn't my first choice for him, but at least he was quiet.

  I passed row 18. Topaz pointed further toward the front of the plane and mouthed something I couldn't catch. I nodded at her anyway.

  Gideon was lying on the floor while Gladys munched on something. She'd placed her hair in a bun on top of her head, and she was covering her mouth as she ate, as if she were ashamed of herself.

  None of the flight attendants were in economy class, which was very unusual. Somebody should be rolling a cart up the aisle.

  Then, from behind the curtain separating me from business class, I heard someone bellow, "I want to go home!"

  I ripped aside the flimsy, blue curtain. Sure enough, the demented old man at the front of the plane tried to climb past his wife, from the window seat into the aisle.

  Tucker used his body to block the Yarboroughs in their seats. All three flight attendants hovered in the aisle like he was their human shield, unaware that he should be recuperating after surgery, not performing hand to hand combat with an old man.

  Tucker had his back to me. He hadn't noticed me closing in on them. "Hang on, Mr. Yarborough. I've got something for you right here." He reached for the briefcase of medication held open by the black flight attendant, who was sandwiched between himself and the cockpit.

  I didn't like the layout. Tucker had planted himself at the epicentre of this mess. Mr. and Mrs. Yarborough were still technically at their seats, 1F and 1D, on Tucker's right. The black flight attendant had her hands full with the medical kit, so she couldn't help if Mr. Yarborough went ballistic, and the other two flight attendants blocked him from me.

  I advanced up the aisle, past Alessandro, who avoided my eye. Mr. Money flipped through his phone, and the Missus wiped her nose. None of them could be arsed to help.

  Mr. Yarborough's face scrunched up with distrust. "What is it?"

  "This is Gravol, or Diphenhydramine." Tucker held up a pink pill.

  "I don't need pills!"

  Tucker nodded. "You want to see Kim, though, don't you?"

  "Kim?" His tufted grey eyebrows wriggled. "You got Kim?"

  "Yep, your daughter's waiting for you in Montreal. You'll see her soon. You just have to take this pill, okay?"

  No. Didn't they have anything better in the medical kit? Maybe Tucker was playing it safe, trying not to give him anything too strong, but it could backfire. Kids can get sleepy with Diphenhydramine ("Time for your medicine!" one of the residents, Stan Biedelman, had once crowed to his niece when she was too hyper at a wedding and had developed a rash from her dress), but a few of them go berserk instead.

  I needed to get at that medical kit, or possibly inspect Mr. Yarborough's own pharmaceuticals for something more appropriate. If he wouldn't take anything by mouth, an injection would do.

  "He's fine," said Mrs. Yarborough to everyone in the aisle, including me. "He just needs a nap."

  Yeah, right. If he was so fine, why had he provoked a near-tasing? We'd saved him from it, but now Mr. Yarborough was up in the air with us, with no real police, no pseudo police, and no weapons.

  "For fuck's sake. I'm Joel J. Firestone. I'm trying to get some work done here," Mr. Money called out from 3D, at my right shoulder. "Shut that guy up."

  "Joel ..." murmured Mrs. Money, but she broke off in order to sneeze, a high pitched 'choo! that would have been comical anywhere else.

  "My wife has allergies. Get rid of the dog while you're at it." Mr. Money, or Joel, snapped his fingers at Alessandro, who rose reluctantly from the seat behind them.

  "May I be of assistance?" Alessandro called to the flight attendants over my shoulder.

  "When we need your help, we'll ask. Sit down," snapped Linda. Then she remembered to add, "Please."

  Under an hour into our flight, and we were all on edge.

/>   Alessandro crouched over his seat, not fully standing, but not sitting, either. Evidently his fear of Mr. Money was greater than his fear of Linda.

  I wasn't about to sing again, but I did need to distract Mr. Yarborough so he'd be more in the mood for meds. I pitched my voice to carry to his wife. "Mrs. Yarborough. What do you have that reminds him of home?"

  Tucker wheeled around. "Hope!"

  I passed him a thin smile, focusing on Mrs. Yarborough. Her lower lip trembled. "He misses our cat, Misty."

  I wasn't about to start meowing, although I made a sympathetic face. "What else?"

  "Ah ... he usually has steak and onions every Friday at 5 p.m."

  Bingo. The business class equivalent of a baloney sandwich. I turned to Magda, who seemed more reasonable than Linda. "Do you have steak?"

  "Yes." She scurried off to make it.

  "There," said Tucker, as if he'd orchestrated the entire thing. "That sounds delicious. Sit down, Mr. Yarborough, and you can have some steak. Would you like some water?"

  "Beer," he said.

  "Uh ... "

  Mrs. Yarborough said, "He's allowed one beer per day on his trip."

  "All right, then," said Tucker.

  The black flight attendant, whose name tag said Pascale, hustled for that one.

  When they reappeared a few minutes later, Magda unveiling a plate of steak and rice, and Pascale offering him a glass of beer, Mr. Yarborough consented to sit in 1D.

  Mrs. Yarborough mouthed a thank you at everyone, but Tucker wasn't done. "Here's your medication, sir."

  Mr. Yarborough washed down the pill with beer.

  Well, at least he took it. I swerved around Linda for a good look at the medication kit. Most of the real estate was taken up by a blood pressure cuff, a stethoscope, IV equipment, and a blood sugar monitor.

  The drug choice was pathetic: no sedatives, but two kinds of Epinephrine, one for a cardiac arrest and one for anaphylaxis, so if he were allergic to the steak, or his heart stopped, we had choices. Atropine for bradycardia. Dextrose for diabetics. Lidocaine, although we don't use that so much for arrhythmias anymore. Nitro and aspirin for heart patients. And the Diphenhydramine that Tucker had given in tablet form, also available by injection.

  So we had a few basic medications for a heart attack, we could give fluids, we could give sugar, and we could run a code for a few minutes (only two doses of each kind of Epi, though, so you'd want to land the plane ASAP). This was not good.

  On the other hand, Mr. Yarborough was now smacking his lips and slicing into his steak. He was no longer standing and brawling. That was a plus.

  "Could I see his medications?" I asked his wife. Although I haven't done my geriatrics rotation, I knew I'd have to rule out polypharmacy, which means they're having problems because we're giving them too many drugs.

  Mrs. Yarborough looked startled. "Oh, dear. I packed his medications."

  "Well, you can get them."

  "No, I mean I packed them in his main bag."

  That seemed odd. "You mean they're checked in his main luggage?"

  "Yes, I didn't want to lose them, and we had too many things to carry. He made such a fuss over his water bottle."

  I sighed. "Do you have a list of medications?"

  "Harold, did you bring your list?"

  It took him a while to answer as he masticated on his steak. "What?"

  "Your list. Could you show this nice doctor your list of medications?" She stage whispered to me, "He keeps them on his phone."

  Why would you let a demented patient take charge of his meds list? Sure enough, he grumbled, "No."

  "Come on, Harold."

  "No!" He started chewing with his mouth open. Steak and rice don't look good mixed up together.

  I gave up on him and asked Mrs. Yarborough, "What are his diagnoses?"

  "Well, he has diabetes."

  Great. "High blood pressure? Coronary artery disease?" I lowered my voice. "Dementia?"

  She nodded warily, eyeing her husband, but he chewed cheerily enough.

  "Anything else?"

  She tried to laugh. "That's enough, isn't it?"

  Tucker tried a more conciliatory tone. "Have any of his medications changed?"

  "Not for the past six months."

  "And the dosages haven't changed?"

  She shook her head.

  "Did you check his sugar recently?"

  She hesitated. "This morning, it was 270."

  I glanced at Tucker. That sounded high to me, but Americans use mg/dL instead of mmol/L, so it always sounds dramatic. He punched it into his phone. "That's like 15 for us."

  It was high. Normal is more like 4 to 6, certainly under 10 for a diabetic, in our units. But I'd rather he ran high than low for the next five hours. Low sugar, or hypoglycemia, means your brain is deprived of sugar, and you can and will die from this.

  Hyperglycemia is hard on your organs, but you won't die from it right away. Your higher risk for strokes, heart attacks, and other complications accrues over years. As long as he didn't cause a ruckus on the flight, he would soon be someone else's problem.

  "You probably shouldn't drink," I said. He'd not only finished his glass of beer, he'd filled it back up with a can and emptied that, too.

  "Did he take all his pills this morning?" I asked Mrs. Yarborough.

  She nodded. "I keep track of his medication. We had to wake up early for our flight, but otherwise, everything was quite as usual."

  "Is he on insulin?" I asked.

  She shook her head. "He hates needles."

  "Should we do an Accucheck?" I whispered to Tucker.

  "He's eating," he whispered back, and I nodded. He'd been hyperglycemic this morning, and he should go higher with food, not lower. I didn't want to prick his finger when he was poised to tumble into a post-meal snooze.

  "Is his sugar normally well-controlled?" I asked Mrs. Yarborough.

  She nodded. "Oh, yes. I take very good care of Harold, and I have to keep things organized because Kim has so many questions."

  "What does his sugar normally run at?"

  "It's usually between 72 and 180."

  Tucker checked his phone again. "That's like between 4 and 10."

  It was pretty textbook. I only dwelled on it because hypoglycemia is a reversible cause of confusion. We do A-airway, B-breathing, C-circulation, D-dextrose (check the sugar). If you're in doubt, give glucose.

  I cast one last look at the medication kit. "Let's keep this handy, but he seems good for now." Good enough for our flight, anyway.

  "Yes, Doctor," Mrs. Yarborough said with such humility that I cracked a smile, and Tucker winked at me.

  Four more hours. We could get through four hours. No sweat.

  14

  Bing!

  The seat belt lights came on.

  Linda placed an apologetic hand on my sleeve. "I'll have to ask you both to take your seats. Thank you for your assistance. Avian Air is grateful for your services."

  But not grateful enough to bump us up to business class, or even past the toilet seats, on a sold out flight. Tucker and I grinned anyway as we headed down the single aisle, back to row 33.

  "Another life saved," he said.

  "Or at least tempered," I said, thinking of the Gravol and alcohol Mr. Yarborough now had on board. Please, please, go to sleep, Mr. Yarborough. Then Kim will greet you with a brand new water bottle at the Montreal airport, and we'll all have a holly, jolly Christmas.

  Tucker and I buckled up. The plane jostled so hard that a couple called out; they'd been playing cards on their tray table, and the cards had started to slide.

  A high, young woman's voice came over the intercom. "Ladies and gentlemen, this is your Co-Captain Andie Phillips speaking. For your own safety, please keep your seatbelts fastened as we make our way through a large northern weather system. We're already making all necessary arrangements to provide you with a pleasant and comfortable flight through these weather patterns. Please stay in your seat
s until the seatbelt light is extinguished. Thank you."

  I made a face. The double speak is terrible on airplanes. Why can't they say "We're flying around some bad weather"? Also, not to be mean, but a helium voice isn't as comforting when you're going through turbulence.

  On the other hand, I sympathized with Andie. Patients gaze past me, searching for the "real doctor." My friend Tori, who's very soft spoken, once ran a code where the male respiratory therapist complained about "that bossy nurse." Tori had to pull him aside to explain that she was the highest-ranked physician and his foot dragging had put a child's life at risk. Luckily, the patient pulled through.

  I became hyperaware of the plane's walls shaking in the wind. I have never fully understood how planes become and remain airborne. I gripped Tucker's hand and tried not to grind my teeth. A dentist had recently suggested that I buy a $500 mouth guard.

  "It's okay," said the clean-shaven giant in 33A, on my left.

  I turned to look at him.

  The corners of his lips twitched. "I'm an Aircraft Maintenance Technician." Since I looked blank, he added, "An airline mechanic."

  "Oh. That's cool. In L.A.?"

  "In Texas."

  He didn't drawl, so I wouldn't have guessed his location. Before I could ask more, the plane shuddered again, and I peered out his window. The small oval of sky told me nothing except that it was a dark and cloudy December evening.

  "This is an Airbus 320," said Tucker, on my right side. "It has a pretty good safety record."

  I glanced at him sidelong. "What does 'pretty good' mean?"

  Tucker shrugged. "I haven't had a chance to do much research, but most of the problems I saw were pilot error, like the suicidal copilot who deliberately crashed a planeful of 150 people into the French Alps—"

  My eyes widened.

  "—but also the good one where they ran into a flock of Canada geese near LaGuardia, which disabled both engines—"

  "This is a good story?" I cut in.

  He nodded. "The pilot landed in the Hudson River. All 150 passengers and five crew members were saved, although one person was seriously injured."

  "Five," said the airline mechanic.