mHealth

Is There a Doctor on Board?


Anne Meneghetti, MD, Executive Director of Medical Information, Epocrates, an athenahealth companyIt was bound to happen sometime. One physician colleague of mine tells stories about how she can barely make it to the mall and back without encountering someone who is fainting, injured, or needs on-the-spot assistance. When I finally heard the call, at 30,000 feet, I was prepared and had my Epocrates app at the ready — or my “peace of mind” as I like to call it. Here’s my story…

A few hours into a cross-country flight, I was ensconced in a mystery novel when the overhead announcement system blared, “Is there a doctor on board?” I peered into the aisle, hoping to see someone leaping from their seat to help. No one moved. I finally introduced myself to a flight attendant. An older woman was slumped against a cabin window, clammy and slow to respond. Given the roar of the engine and the toy-like stethoscope in the plane’s medical kit, I could barely hear a thing, much less Korotkoff sounds; I relied on a visual reading of the sphygmomanometer dial and confirmed by palpation. After a quick history and exam, I ran through a checklist of possibilities. Learning she had Type 2 diabetes, I was grateful to find oral glucose gel among the kit’s medical supplies, and aspirin and oxygen were easily at hand.

Once the patient began to feel better, I returned to my seat to validate my thought process: I opened up Epocrates on my phone to run through differentials in the Diseases reference, examine treatment options for various possibilities, and consult the Rx drug reference for adverse events and interactions for the meds the woman was taking. I took a deep breath, reassured that I had done what I could and was supremely grateful — 30,000 feet in the air — for my Epocrates app. The flight attendants asked whether we needed to use the satellite phone to link us to the nearest ER for guidance. “I think we’ve got it covered,” I answered.

After an early touchdown, paramedics evacuated the passenger to the gate area. I quickly ran over, dropped my card in her bag and gave her my best wishes on her way to the hospital. The next day, I called the airport to follow up; however, HIPAA regulations prevented them from giving me any information. Like so many good Samaritans, I resigned myself to never knowing what became of the patient. Many weeks later, I peered into my mail slot and discovered a thank-you note from my anonymous patient. “She’s alive!” I exclaimed to myself. To my great relief, she was doing well.

As physicians, we took an oath to heal, and we carry it with us wherever we go. Today, I’m grateful that I have instantaneous access to the kind of information my Epocrates app can provide — even while soaring above the clouds. Over the years, I’ve found that using the app is not always about learning something new; often it confirms what we already know. For me, that is true peace of mind.