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Like They Did
By Timmy Lanier
I always tell my patients that they are a book to me; that the cover may be beautiful but that doesn’t mean that the story inside is which is why I order a full comprehensive set of labs on every new patient, periodically for my patients that have conditions, and annually on even my most healthy patients to know what they look like on the inside. In other words, you can’t judge a book by its cover.
Recently I was on a plane headed back home from L.A. I had gotten settled in, somewhat comfortable, and mentally ready for the 5-hour flight back to the east coast. The plane raced down the runway and up we went. It was a red eye flight that had been delayed and so we were taking off very late- about 1:30 a.m. We had gotten about 15 minutes into the flight when I overheard the flight attendant saying, “Sir, sir… are you alright?” I tried to pretend that I didn’t hear her because I thought that it was likely nothing. Then I heard her repeat it; this time with a mixed sense of urgency with fear. I still didn’t turn around, poised to mind my own business as I began putting my ear plugs into my ear. The flight attendant ran to the front of the plane to talk to other flight attendants who were there standing. She rushed back to the back of the plane followed by a second flight attendant. I could hear her through my ear plugs again ask, “Sir… are you ok?” This time I haphazardly looked over my shoulder to see what all of the commotion was about and I saw the man slumped over the arm rest of his seat held into the seat only by his seatbelt. At that moment the flight attendant frantically shouted, “are there any medicals onboard?” I immediately released my seatbelt, jumped up, and ran to where the flight attendant was standing over the man’s seat. She grabbed the top
half of the man’s body while I grabbed his legs and we picked him up and laid him in the aisle. I quickly moved to assess his breathing and pulse. I felt both carotid arteries and felt a very weak, but thready pulse. Just as I felt the man’s weak pulse, I was shoved in my back by one of two women that rushed from the front of the plane after hearing the flight attendant’s plea for medical assistance. The woman, in a demanding tone, shouted at me to step back. I acknowledged that I was a Nurse Practitioner to which the woman replied, “I am a Nurse Practitioner.” The flight attendant took a look at both of us then asked me, “sir can you please step back out of their way?” I stepped back and stood next to her where she directed me to stand. The flight attendant and I watched the two women struggle to gain cohesion in their effort to restore the man, who by this time, had awakened and was able to answer questions. The
flight attendant handed the women a manual blood pressure cuff and asked the women to get a blood pressure. I then reached into my wallet and showed my Nurse Practitioner license to the flight attendant. She scanned my license very attentively before looking up at me with a look of apology. After several unsuccessful attempts, the women were finally able to get the man’s blood pressure. They proceeded to ask irrelevant questions and perform meaningless range of motion exercises on the man who was insisting that he was ok. When the man was able to stand up and sit in his seat, the aisle was clear and I went back to my seat. I returned to what I was doing before the health scare fiasco in putting my ear plugs in so that I could sleep through the rest of the flight only to be interrupted again. This time it was by the man’s wife who came to me to thank me for helping her husband despite the fact that I was literally a silent, non-factor who was shoved aside by people who I am absolutely certain did not believe that I was a Nurse Practitioner as I claimed- which was evident by the way the flight attendant looked at me when she saw my license. She explained to me that her husband was just in the emergency room a few days prior with critically low sodium results. She went on to tell me that her husband suffers from seizures and takes Tegretol, a medication whose side effects include low sodium level (hyponatremia). Some of the main symptoms of low sodium: headache, confusion, drowsiness, syncope, seizures, and coma were on display when I was briefly able to assess the man before being pushed aside. After the man’s wife walked away, the flight attendant returned to me and asked that I provide my credentials for documentation of the
event. The lead flight attendant began asking me questions about what I saw when I came on the scene and she was impressed with my words and knowledge and was very underwhelmed by the two women who pushed me aside doubting that I could be a Nurse Practitioner. The lead flight attendant relayed my competency to the flight captain who asked me to make the call, based on the man’s condition, if we should turn around and return to L.A. or if the man was stable enough for us to proceed to Florida. Of
course, I chose the latter, but only after I carefully assessed
the man’s level of stability. The captain designated me over
the two women to be the point of contact and health care decision maker for the duration of the flight. I was again asked for my credentials and I gave my business card which further proved my legitimacy. The flight attendant turned to me and apologized for pushing me out of the way echoing what the lead flight attendant had said that I should have been over the scene from the beginning. They offered me all the snacks and drinks I could ever want free of charge in what appeared to be an apologetic gesture. By this time, everyone on the plane knew that I was, as they called it, “medical.”
When everything went down and I rushed to help the fallen man, everyone judged me by my appearance and it was pretty obvious that no one believed that I was a Nurse Practitioner when I said that I was. When the flight attendant had the opportunity to choose either myself (the first person to respond that helped her lift the man out of his seat and place him on the floor) or the older, conservative women that responded after I did with the same exact claim that I had of being a Nurse Practitioner, the flight attended chose the two older women. They were believable by their word, but it wasn’t until I pulled out my Nurse Practitioner license and showed it to the flight attendant that my words were believable. Turned out, I was the most competent and effective of the respondents and I was the one who was preferred by the captain to be the point of contact when all was said and done although I was the guy that looked less the part! I apparently didn't fit the description of what they perceived a Nurse Practitioner to look like. I had on my orange Gators pullover with jeans. Maybe my hair didn't look neat enough? Maybe I didn't sound like a Nurse Practitioner when I spoke up and said that I was. Or maybe it is what it is: I just look "different" from those ladies to put it politely. Whatever the case, the last person that they thought could be the hero ended up being the person that saved the day. They underestimated who I was and what I was capable of all because they judged me by my cover. That's why we should be careful about judging people based on their appearance.
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