Indian Air Force (IAF) Group Captain Dr TVSVGK Tilak was travelling from Pune to Kolkata on board an IndiGo flight when a passenger, a cancer patient from Bangladesh, suffered a cardiac arrest. In an exclusive interview, the oncologist tells International Business Times, India, about the mid-air rescue effort and shares his expertise.
What has the experience been like?
I was flying from Pune to Kolkata, a two-hour 45-minute flight. About an hour and 15 minutes into the flight, I heard the announcement of the cabinet crew for the need of a doctor on board for a passenger not feeling well. I identified myself immediately and was taken to the 28th or 29th row, where a middle-aged lady was visibly breathless. Upon ascertaining the details from her daughter, she turned out to be a case of Stage IV lung cancer, post multiple lines of chemotherapy, on her way back home after consultation, for further therapy in Dhaka.
The clinical assessment gave me clues that she was very unwell and I told the staff that she was very sick and may not make it. There was no option for nebuliser due to socket issues and the inhaler she had been given did not comfort her. Meanwhile, about two-four minutes into assessment, she suddenly stopped breathing and collapsed with the tightening of her body. There was no breathing and no pulse - It was a cardiorespiratory arrest. I made her lie down on the seat and immediately started cardiopulmonary resuscitation with chest compressions.
Meanwhile, two other doctors came to assist. I asked for some drugs to be loaded and it was done. About a minute of CPR made the difference and her pulse was palpable and she was breathing, though still in distress. We reclined her on to the aisle handle with the help of a spare seat and I established an intravenous cannula while she was in that position. Oxygen was started through a mask from a mini cylinder and Inj Hydrocortisone was given IV. Normal saline was started to maintain circulation and her inhaler was repeated twice more. She responded and stabilised over the next five-10 minutes. Emergency medicines were loaded and kept ready for use, if needed.
The flight had another 45 minutes to go and she was monitored in that position throughout. She did not have a recurrence and at landing, was able to sit on a wheelchair. She was shifted to a private hospital by the ground team of doctors. We came to know the next day that she was able to travel back to Dhaka safely.
Do you think the incident has matured you as a person and as a doctor?
Being an oncologist, we come across deaths very often and have to counsel mourning relatives with a varied response to the demise. This has indeed given me a new perspective on life, where you respect every moment in your life. Compassion comes naturally. That way, yes, this incident has once again matured me.
Do you think the presence of emergency medical equipment on board every flight is crucial?
Yes, emergency medical services are a necessity on board each flight. The medical kit should be correctly audited and updated. For example, they did not have a finger pulse-oximeter, which is essential emergency equipment. Another example is, they had a nebuliser but there was no compatible socket to run it. Luckily they had the IV cannula and emergency drugs in the medical box.
What advice do you seek when in a dilemma?
When in dilemma and alone, I imagine my teachers and mentors, as to what they would have done in that situation. Then, take the most logically appearing course. And have the conviction to accept the decision taken later. Build a team even in an emergency and go along together. Opinions of colleagues to help in difficult situations.
What has been your biggest achievement in life?
Have had such close moments where my intervention has saved a life, starting from a six-month-old child to older people. Personally, though, I have qualifications against my name, it is these human interactions that give me the feeling of achievement. Professionally, setting up the first Bone Marrow Transplant Centre at my previous institute has been the most satisfying achievement.
Generally, doctors say India is on par with international cancer hospitals. Why do people then go abroad for treatment?
Well, this patient came from Bangladesh to take treatment here. But yes, you are right, there are centres at par with an international centre, here in India. A reason could be that specialists abroad treat only one organ system for years together, making them more experienced in that field. Here in India, there are very few centres which do that. In view of the patient load and skewed ratio of doctors to patients, doctors here treat a variety of diseases in their speciality. Another reason could be that there are well run clinical trials abroad with newer drugs and research molecules, which gives them hope of trying a new drug unavailable in India yet.