Please don't land this plane.


Addicted to caffeine, Jim spent Fall Break in his favorite place - Manhattan. There is only one non-stop flight from New York City to his home in Oklahoma City. To NYC, it leaves in the early morning. Jim rarely takes that flight. He no longer likes setting an alarm. The return flight from NYC to OKC leaves at about 8:30p. That's nice, because there's no need to set an alarm and one has a full day in the city. Jim typically limits himself to three cups of coffee a day. But on the day he was leaving New York, he had a fourth cup in the late afternoon in the MoMA Cafe, with some obligatory pastry accompaniment. He was aware that the flight is sometimes late - he has left as late as 10p. That was the case on this day. Jim got through Security easily and quickly, got to the gate, and saw the ‘Delayed’ on the signboard and realized he would just wait with a comforting cup of coffee. The wait wasn't too bad, the concourse gets pretty quiet at that time of night, and he was reading a good book on his tablet. Boarding, taxiing, and takeoff were uneventful. Jim had a great seat - 12A on an Embracer jet, the one that has two seats on one side and only one on the other. He was on the one-seat side and in an Exit Row which meant more leg room. A great seat.

They were in the air for about 20 minutes, during which Jim drank a Diet Coke. That brought the total number of caffeine drinks to 6 - double his normal dosage. He was lost in reading the book. But, then his heart just went nuts - loudly beating in a way he hadn't felt before and faster than he could remember, just like that of a frat boy inside the Lace Strip Club on 8th Avenue, just north of 42nd Street (ask for Lana). There had been a full day in the city, some rough flight turbulence, flight delay stress, and he had drunk more coffee than he was used to. Maybe these weren’t all influencing factors, but Jim’s heart was thumping loudly, rapidly, and abnormally. He ordered a Diet Sprite (caffeine free) - his stomach felt a bit of nausea - and he was sweating slightly. He turned up the cool air and hunkered in his seat, although he was too freaked to do much reading. He put the tablet away. What he really wanted was to lie down. He thought about asking if he could lay on the floor in the rear galley, but decided not to tell the flight crew of his condition - Jim was afraid they'd overreact and land the plane somewhere in Indiana and piss off a bunch of sleepy passengers. He had heard those stories of planes landing to get heart patients to a hospital. He drank some water and stuck it out.

Jim’s plan was to just make it to the airport departure lounge where he could lie down and rest. The airport would be almost empty at that late hour. This flight is the last of the day, no food or shops are open. There are the exit security, baggage handlers, taxicabs, and our flight crew. That's about it. Sort of creepy, but in an appealing way. The plane got to the gate jetway in record time. As they walked off the plane, Jim felt strong enough to bypass the departure lounge and make it to his car. New plan: he can rest in the car on a dog bed cushion that fills the entire back of the car. But once there, he was eager to just get home and in to bed. New plan: he carefully drove home, set his bag down on the bedroom floor, and lay down. Jim’s heart was still set on abnormal. He stayed in bed about 5 minutes. Something didn't feel right. At about 1am he got up and drove the short distance to the Hospital Emergency Room. Normally checking in to this hospital is a bit of a pain, but a heart emergency seems to excite the staff and they get moving and make things happen. A wheelchair came out through the double doors and Jim was rolled back into an exam room. Immediately, some guy came in and started wiring him up to machines. They put him through numerous tests (EKG, chest x-ray, heart enzymes, ultrasound, etc.) James’ heart rate was way out of range - too rapid and too irregular. Although he went by Jim, official places, like a hospital, saw and used his ID name of James.

Someone told James he would be admitted to the hospital ICU for an overnight stay. He wasn't too keen on this, but they insisted. Apparently, since they knew he had some heart trouble, they could be held responsible if he left the hospital and something happened to him as a result of the heart trouble. Uh oh, a nurse came in to tell him and the staff that there were no available beds in the ICU and that James would have to stay in the ER. Ugh. The ER beds and the rooms were not as comfortable. James protested and said he would take his chances and go home. He didn’t know if they could force him to stay in the hospital against his will. They did not like his plan to go home and told him to give them a few minutes. Just like that, a bed opened up and and James was put back into a wheelchair and taken through a maze of hallways to the ICU and that now-waiting bed. In his new room, the nurses got him all wired up, IVed, oxygenated, and drugged; he was able to get to sleep about 4a. James was awakened (and startled) for the next few hours by a variety of nurses conducting more tests, taking blood pressure, and adjusting the IV. The interruptions defied their recommendation that he get some sleep.

Laying on the bed was a 'Room pack' containing, among other things, a pair of slippers. They didn't fit. Not even close. James asked, “Will I still be charged for these?“ The nurse replied, “Let me see if I can find some larger ones.” But, James never heard from her again. He was, in fact, charged for slippers that he couldn't wear. Another nurse came in to retake his blood pressure. From the doorway, she glanced around the room and didn't see the blood pressure cuff, so she said she'd go get another one. James asked this nurse, “Will I be charged for the second cuff?“
“Well, it will be charged to your room.”
“Then, let's look for the cuff I already bought.”
The morning paper lay next to James on the bed. James lifted it up. There was the blood pressure cuff.

These two events, among others, confirmed for James that there was little incentive for the staff to save money or be very efficient. In fact, he wondered if there was incentive for the staff to charge as many items to the room as feasible. Like a racket. The hospitals overcharge knowing that patients are unlikely to check their bill. The insurance companies pay the bill; they don’t have the staff or the will to check every item on every claim submitted. And the patient just plays along, becoming an unknowing participant in the American health care game.

James enjoyed some good heart-healthy food, watched some college football games, and visited with friends who dropped by - the word had spread. His dogs had been boarded for his trip to New York, so he called and told them to keep them for another day. At about 3:30 in the afternoon, James’ heart got back to normal - medical phrase: the heart 'converted to a sinus rhythm'. Turns out there was an electrical glitch in his system and weird signals had been sent to his heart. A nurse came into the room at about 8:00 that night and told me him could go home soon. What a relief. He was discharged about an hour later and went home to rest.

Jim had some scary moments on the plane and in the ER. He was awed by and grateful for the technology, wisdom, and experience of the medical profession.
“I’m so glad they didn't land that plane.”


Updates
The final bill for the 21 hours in the hospital totaled over $17,000. Jim received 6 separate bills and 24 pages of invoice documents - some of which came 3 months after the hospital stay.
Jim’s doctor reviewed all the test results and the notes from the hospital cardiologist. What Jim experienced was apparently a fluke occurrence based on a variety of factors that all coincided and caused the wrong electrical signals to be sent to the heart.



© James Robert Watson, PhD, 2022
www.jamesrobertwatson.com/storyafib.html