Help, He’s Bleeding

All physicians who are airline travelers have stories to tell, stories of “is there a doctor on board”.  I have several, and this is my best.

I was returning to Oregon from a meeting in Europe.   The airline was SAS, famous, at least to me, for giving out those small bottles of aquavit.  I had had one followed by an obligatory Danish beer.  I was just settling down for a nap while enjoying the incredible expanse of Greenland’s whiteness when the message came over the loudspeaker. 

It was a really big plane, and I figured that there were lots of doctors on the flight, so I ignored the first request.  It came again.  I got up and went to the gallery.  There were two lovely Danish flight attendants.  One said, “Help, he’s bleeding!”.  They took me to a short, stocky, very black man in a dark business suit with a white shirt and tie.  The shirt was stained with bright red blood. 

The man spoke excellent English with an identifiably West African accent.  He told of how he was on a trip to the USA to meet his daughter, a nurse.  She had arranged for him to have, in her hospital, a surgical resection of part of his prostate gland.  His prostate had been causing him problems.  He had had trouble urinating, and it was now so bad that he had taken to catheterizing himself.  He used the pointed half of a disassembled ballpoint pen.  This had worked well for years.  However, on this trip he did not have a pen that could be taken apart. 

His bladder became full, and he became desperate.  He tried to use a BIC, a solid ball point pen.  The BIC caused damage to the lining of the penis and to the prostate that lead to substantial bleeding. 

He and I went into the restroom.  In that limited space I was able to examine him and to determine that the bleeding had nearly stopped.  His bladder however could be percussed all the way to his umbilicus.  What were we to do?

I reasoned that the closest thing to a urinary catheter to found in the plane was the tubing for the audio for music and videos.  I asked for one.  They brought me one from the first-class section that was electronic.  I said, “Please get me one from coach.”  They did, and with a knife from somewhere I carved a pointed tip. 

I held up my impromptu catheter before the patient and said, “Do you want me to do this, or do you want to do it?” He chose to do it himself.  This was good judgment. 

With the catheter in his bladder, draining blood tinged urine, we placed a small airline pillow between his legs, and he pulled up his pants.

The last I saw of him  he was waddling off the plane to greet his daughter.

In the past when I had done doctorly deeds for airlines they had rewarded me with a bottles of champagne and once a sizable amount of air miles.  So I awaited my thanks from SAS with some anticipation.  It came.  It was a carefully packaged ballpoint pen imprinted with “SAS”.