Circle of Life

The last week was quite a busy one, with at least one flight every day until Friday. The last flight of the week, however, was probably the hardest and most tiring flight that I have made yet. Francistown is usually where we take patients from all over the country, but if they have a patient that is too serious for them to deal with, we sometimes fly the patient to Lanseria airport in Johannesburg, South Africa where they have specialists and more special equipment. On this particular flight, we picked up a car accident victim in Francistown who was in a very critical and unstable condition. I’ll spare you the details of how he looked, but the patient was on a ventilator and completely unaware of what was going on around him. We took off for Lanseria, staying low to keep the cabin pressure from dropping. About 30 minutes into the flight, the paramedic tapped me on the shoulder and said we needed to turn around immediately and descend to get the cabin pressure as low as possible, which we did. When we landed back in Francistown, we learned that the paramedics had lost the patient and begun resuscitation, and by the time we landed they had revived him and he seemed a bit more stable. The paramedic deemed him too unstable to fly and took him back to the hospital. As we were getting ready to leave to go home to Gaborone, the paramedics got a call from a doctor at the hospital and a bit of conflict ensued, with the end result being that we were told we needed to fly the patient anyway. So the medics went back to the hospital to pick up the patient, we helped load the (very heavy) patient for the second time, and we took off again for Lanseria. This time, the patient died about 40 minutes into the flight, and all the paramedics’ attempts at resuscitation were unsuccessful. The paramedic let us know, and said that since we were under doctor’s orders to take the patient to Lanseria, we had to continue the flight even though we knew the patient was dead. So we continued to Lanseria and landed there, hoping to be met by a morgue vehicle that would take the body so we could fly back home. We quickly learned it was going to be a lot more complicated than that, however, as the South African police told us they couldnot accept the body. We sat in Lanseria for several hours, talking with the police and anybody we could think of who might know what to do. At one point, it seemed like we were stuck because the police couldn’t take the body and we thought that it would be illegal for us to fly back to Botswana with the body. It was quite a mess. Finally, Brandan called a doctor friend of his in Johanneburg somewhere who did this sort of medical flying into the country quite regularly, and learned that since the patient had died before clearing customs into South Africa and was technically still “in transit,” we needed to take him back to Botswana. So we ended up flying back to Gaborone with the body, arriving just before the airport closed at 10pm. It was a long day. That was the first patient to die on a plane I was flying, so I guess after the baby born on the plane, I’ve sort of brought the cycle of life full-circle. Or something like that. The most difficult part of this medical flying is seeing some of the patients in such a painful condition, and especially seeing some of them pass away. While this was the first patient to actually die on the aircraft, this past week has seen two other patients dying before we were able to reach them, so it’s been a rough week. The last couple of days, however, have slowed down quite a bit and it’s been a bit more relaxing, which is nice for a change. Peace, and keep well.