CPR

One day, or maybe it was night, over the Pacific Ocean a flight attendant leaned over and whispered into my ear, “Can we continue to Japan or not, you have 30 seconds to reply.” It is a peculiar position to be in. Not the flight attendant whispering into my ear, but to be confronted with such a question. I took pride in being decisive when practicing medicine, and here on my knees in the escape door aisle staring at an unconscious middle aged man’s face I needed a quick response. 

I answered a summons on the 747’s intercom system for a doctor. Now I had thirty seconds to decide if 300 souls should take a detour to a South Pacific atoll instead of to Narita Airport outside of Tokyo. 

 

Let’s be clear, not all doctors are created equal. My interest lies in primary care. I disliked the techy misery of the ICU and the commotion of the Emergency Department. For me a good day was when patients kept their appointments and nothing dreadful occurred with those hospitalized. I liked to know, when possible, why I was walking into the exam room. I was comfortable with the fifteen minutes I had to decide on a plan of action. Of course, it did not always work out but then I admitted it and that was a plan in itself. The less drama the better. 

 

So, what to do. I remembered the ABC’s: airway, breathing and circulation. I saw his chest rise and fall. It took ten seconds for my fingertips to feel his carotid artery’s heroic pulsations. His face was pink, and became pinker after I gave him a slap and dug my index finger’s knuckle into his sternum. Now with eyes open wide he moaned and gave a generous cough. Without turning I quietly said, “Keep on course.” and sensed the flight attendant’s quick motion to relay my response to the captain.

 

He sluggishly sat up and apologize for Ambien and alcohol, and I in turn, for the slap. I cleaned the dribble off his chin, closed the enormous first aid kit and escorted his embarrassed self to an aisle seat, hovering until I was sure I would not have to return. It was a walk to get back to my seat and as Charlotte noted, not enough time for my pink cheeks to recede. 

 

This taught me to dread each plane flight. Now that we will soon be traveling to the tip of South America, I felt compelled to refresh my expired Basic Life Support (BLS)/CPR certificate. It is the third renewal since that faithful day. BLS is not for the faint hearted, but then consider the consequences of inaction. 

 

BLS/CPR is an odd formulation of recognition, activation, and compression/ventilation. There are ratios and rates, placements and depths, and age ranges to take into consideration. And then there is the acting out. My wrists and elbows have yet to recover from compressing the plastic adult dummy’s recalcitrant chest.

 

That said, none of this should deter you from becoming proficient at CPR, because one day, or night, you may find yourself on your knees staring into an unconscious face . . .

Mania & Happy Holidays

Charlotte and I are heading for the Southern Ocean in January. The dining room table is the staging area for most of the warm clothes we possess. We live in Chicago’s hostile weather environment and spend a cold spring in Maine on Carrie Rose, so I have resisted buying a new outfit. Certainly, I already own enough gear to get me through the Antarctic summer.

 

The other half of this is that the clothes need to be lightweight. Our luggage is restricted to one Rick Steve’s backpack and the equivalent of a camera bag each. Of course, this limit is self imposed. With decades of travel experience under our belts, our kit has been refined to the bare minimum. I even dug out a light weight 35mm zoom lens to fit the Nikon digital camera. The con is that it is not self focusing but the plus is its extended telephoto capabilities when used with a digital camera.

 

This trip is the equivalent of a moon shot for us. It includes a completely new set of constellations. On my list of To-do’s was a study of the southern hemisphere’s night sky, then I looked up the sunrise/sunset data and the only entry is ‘Up All Day’. That put an end to that line of inquiry. Once before we spent two sleepless nights on the Norwegian Sea where the sun never set. This trip it will be 23 nights.

 

I wanted to visit the region since reading of the Artic explorer Shackleton’s misadventures while attempting to reach the South Pole in the early 20^th Century. For many years I heavily lobbied Charlotte to include South Georgia Island (where the above is buried) on the itinerary. South Georgia Island being ninety degrees east of Antarctica and some thousand miles from the coast Chile complicates the passage.

 

Time, money and the sea state combined to make this trip untenable. But as with many things post pandemic, it begs the question what are we waiting for. It still has not sunk in that I am nearing my seventh decade. After visits to the internist, urologist, ophthalmologist, cardiologist and finally, the dentist it is sinking in. Though, considering the conveyance for our journey is the good ship Fram, the use of words sunk and sinking is probably not auspicious.

 

Most things we do or have done to us these days require initialing, signing and dating various forms letting the perpetrators off the hook for any malfeasance. It is no different with this cruise. The forms read like a pharmaceutical’s adverse reactions section. There is a doctor on board to attend to our medical needs, but spelled out in clear language it states that being in the middle of nowhere the chances of rescue from injury or illness are dismal.

 

To this end a physician signed medical release form is needed to confirm we are capable, after paying an exorbitant fee to travel to a desolate ice covered rock in the Scotia Sea, of surviving the trip relatively intact. I can state as a former member of the medical profession, that these forms are the bane of doctors. They seemingly place the liability of any catastrophe on the shoulders of the primary care physician.

 

Knowing this I expected some push back and was not disappointed. The reluctance took on the passive aggressive stance of not checking all the boxes. It required me to get huffy (I apologized) with the medical assistant and Charlotte to compel her doctor into completing the form.

 

I ordered ten 3M N95 masks to protect us on the three extended plane flights south, a portable water flosser to prevent worsening gum disease, and silk sock liners to keep our toes warm. And I was frantic searching the house for two misplaced electric hand warmers. Our Will is updated, and our families and neighbors informed of the departure and return dates.

 

Thus, we are ready to go. It is a privilege and a joy to have the time, the resources and the health to take on this endeavor. Now all that is left to do is find some eye shades in the hope of preventing sleepless hysteria . . . Though I am afraid there is no hope for our self generated mania!

 

Happy Holidays!

 

Charlotte & Dean