A Dislocated Jaw in Mid-Air

A couple of month ago, I was on my way back from Bhubaneshwar with a couple of other doctor friends. I was trying to catch up on some shows on my iPAD and had my noise-canceling QC-20 earphones on, when one of my colleagues nudged me. I looked at him and he signalled me to remove the headphones. The flight attendant had made an announcement for a doctor on board.

This isn’t something new. At least once in 10-15 flights, there is some announcement or the other asking for a doctor. Most often a passenger has fainted or has chest pain or is feeling “terrible”. Most often, with a little reassurance and some simple measures, these problems can be sorted out. And like most doctors, I am happy to help out if there is a real emergency or problem, including road-side accidents, etc.

Both of us got up to go towards the back of the Indigo aircraft. The air-hostess led us to a lady who apparently was in some discomfort. When we asked what the problem was, the son told us that while she was eating something, she took a larger than usual bite, heard a click and was not able to close her mouth. Effectively she had dislocated her right temporo-mandibular joint (TMJ), the joint just in front of the ear. By the time we reached, she was able to partly close her mouth, but she still had a little pain and wanted a doctor on flight to treat her dislocation.

I didn’t know how to react. This was not a medical emergency. She was not dying, blood was not dripping, she wasn’t even in a situation, where perhaps the relatives felt she might be dying or in a serious situation. She had managed to dislocate her TMJ and now wanted some doctor on the flight to help her.

Really??

Where does this end? This time it was a dislocated TMJ, the next time it might be a fallen tooth, or watering of the eyes, or a dripping nose, or a broken spectacle.

Doctor passengers are not doctors on board. We don’t have a responsibility to take care of the passengers’ health or problems that arise on flight, unless of course there is a serious emergency or problem. Even then, often there isn’t much we can do, but at least we can do something better than the passengers and we are happy to help.

What did I do?

I reassured them that it was not an acute medical emergency that would kill her, told her to bear it, take a pain-killer if she had one (I didn’t) and then go to a nearby hospital after they landed. They didn’t like it. The son wanted to say something, but we walked away. Forget the fact that we know nothing about reducing TMJ dislocations, a job really meant for a plastic or oro-maxillofacial surgeon, but even if we did, unless it was something really simple and perhaps even then, this was not my/our responsibility.

Which is also why I hate talking to co-passengers. The moment they come to know I am a doctor, either they want to find out if I know the doctors they know or are their friends or family or they start talking about their diseases. I am really, really not interested in a co-passenger’s medical problem, nor do I want to get involved and also don’t really want to know who their doctor friends and family are.

This may seem cold-hearted to many readers who think doctors are supposed to be “on duty” every moment of the day or equate all of us to their old GPs, who used to not charge and treat anyone and everyone like God’s messengers, but we already have enough on our plate as it is.

On the contrary! I, like many others, am very serious about my profession and patients and will do the best we can to ensure their well-being. Friends and family also lean on us and we are happy to help. But we are not bound to help strangers who have a little discomfort that they believe is an emergency, but in reality is not.

34 Comments

  • MRSundaram wrote:

    For a common man like me any ‘doctor’ (other than Dr in literature!) is an all cure man we trust with our life! Do not mistake this ‘call of help’ as an unwarranted demand! Even a few words of solace from a ‘doctor’ goes a long way to help!

  • Sudhakar wrote:

    In marathi they say “garage saro vaidya maro” so while booking tickets usually I do not announce as Dr.
    Then all disc about profession stsrts

  • Bhavin Jankharia wrote:

    I don’t too. This is when they make an announcement for a doctor in the craft. You can’t just ignore that.

  • dr. rajesh parikh wrote:

    i think you are right.
    I being a soft hearted family doctor have tried to help but they always want the complete answer. of course i have my own limitation leading to comments like what type of doctors i am!!!!

  • DR JAYESH DESAI wrote:

    There’ll always be some freeloaders you come in contact with. In fact higher the status more of them will be found. I do not have much experience about “high” or upper class but quite some with middle and lower class (strictly on economic criteria), and abovementioned observation arise from that. But apart from that any sudden pain can give rise to acute anxiety particularly if you’re in claustrophobic environment like airplane. This may trigger panic attack episode and as rightly pointed out by you reassurance from doctor and some simple measures are sufficient most of the time. But you mentioned relatives, now this are the real problems. In order to show their deep concern they literally charge at doctor on hand. They are the one who are not willing to listen to reason. Most of them have fake concerns, this are the one for whom we need to look for and deal with accordingly. It’s part of professional hazard I guess. That’s where sharing helps. Thanks for doing that. Next time will be prepared for such situation.

  • Dr.T.N.Mahadevan Ph.D. wrote:

    My Dear Bhavin, what you and your doc friend did was very appropriate. As a professional you do have a certain social responsibility to be discharged on such occasions. Where your expertise doesn’t fit in you can tell the air hostess the matter and leave it at that. It as indeed a pleasure responding in your website after a fairly long time. Wish you good luck and god speed with some soft heart as a professional doc. As a doctrate not knowing tech issues n medical care i write only as Mr. to avoid such isuues after some bad experience. Warm regards TNM

  • Bhavin Jankharia wrote:

    Thanks. Hopefully will be writing more regularly.

  • Rupal wrote:

    I really do not agree to your mindset on this incident. You as a learned doctor would know that this is not an emergency but a common man would not know that and would be quite anxious and worried if all of a sudden something weird happens to them. As a common man, we have complete faith in a person called the doctor and if doctors feel that people are always free loaders then its a sad situation.

  • Bhavin Jankharia wrote:

    Interesting. The point of this article really was that despite reassuring them that there was nothing further to be done they were unsatisfied and unhappy despite the fact that I had no obligation to help in the first place.

  • Dr Suhas Naik wrote:

    I have gone through similar situations too, Bhavin. In many a similar “emergency”, reassurance is all that is required. If the common man has complete faith in the doctor attending to him, he should accept the doctor’s reassurance and be relieved rather than be unsatisfied and unhappy. Unfortunately this doesn’t happen all the time.

  • Jawahar wrote:

    As a GP I often face situations where people feel I am a 24 hour casualty service and should be available at all times. A couple of years ago had a young couple – complete strangers ring my doorbell at 3am – the young man was drunk and had crashed his car at the street corner on marine drive. Suffered minor bruises which he wanted me to attend. Suffice to say I fired the watchman the next morning and just guided the couple to the bombay hospital casualty which they did not want to go to because of legal hassles and him being drunk!

  • Bhavin Jankharia wrote:

    Ha ha. That must be a great story to tell and remember.

  • Hah-this was interesting to hear, and very resonant: I am very careful to be respectful of my friends who are cardiologists, docs, etc. for this reason. It is fair of you to offer to help in case of emergency, but you are not responsible for attending to every small issue strangers have, on your leisure/vacation time.

  • Bhavin Jankharia wrote:

    Thanks

  • H.L. Chulani wrote:

    Removed a foreign body from the ear during an International flight- got a bottle of wine- compliments of Cathay Pacific!

  • Kalyan Ayyer wrote:

    Dear Bhavin, I have encountered Patients with Asthma,chest pain, fainting etc.. I carry my Stetho and some routine meds in my pouch for family..
    I am certain we are not responsible for commission/ omissions.. I don’t know.. But would do as an emergency..
    When prior to take off I have advised off loading of pax even if it doesn’t look serious.. We can do our best.. What happens if we are or our people get afflicted ?
    Fortunately so far no one worsened..
    Airways do have some medications in their first aid kit.. Regards..

  • jamna wrote:

    God forbid if while attempting to help, something goes amiss, then medico legal issues. But one can not always play possum.

  • Bhavin Jankharia wrote:

    That is also a worry

  • Dear DR Bhavin;
    This happened on a plane. But it happens every where–on the road;bank;picnics;morning walks etc. The moment any one comes to know you are a doctor all their aches and pains surfaces and you have to do a free medical advise!My solution is that there is no cot were i can them lie down and examine!They promptly vanish!.
    Dr Kusum Doshi

  • Bhavin Jankharia wrote:

    Ha ha. Nice one.

  • laxman wrote:

    Your “Dislocated jaw” is an interesting event that happened.But in todaY’s medical world,,whether MBBS/BHMS/BAMS or Surgeons all sail in the same boat.i.e.fleecing the prospective patients-ONLY MONEY seems to be the criterion for all doctors in various fields of medicine.If a Dr. is scared of saying that he or she is a doctor just to avoid the co-passengers while on travel asking for free advice or treatment then such doctors should stop practising and start grocery shop or Spa for making more money and less medical advice.In medical profession the so called Doctors have become white collared THUGS.You may not like my comments but it is true.Doctors across the nation are cartel for looting the masses.Bhin should not forget medical ethics.av

  • Bhavin Jankharia wrote:

    I completely disagree. You can’t paint all docs with the same brush. And if I don’t want to be disturbed in flight – I don’t want to be. It is my choice and wish. That has nothing to do with opening a grocery store. It is my choice as a person to decide who I will see and talk to outside of my practice.

  • Dinesh golani wrote:

    This is the most heartless thing I have read …being a doctor u seem to be so egoistic and self obsessed that its shameful..please remove me from your mailing list and cease any future communication…

  • Bhavin Jankharia wrote:

    Done

  • Mehroo Kharegat wrote:

    I am well aware of the fact that times and values have changed. It is a shame! You don’t know how mistaken you are when you say ‘equate all of us to their old GPs who USED TO not charge and treat anyone and everyone like God’s messengers’. Dr. Jankharia – they still exist!
    I go to, not a GP but a well know Cardiologist whose name unfortunately I will not disclose. I can phone him any time, from anywhere and he will give me advice over the phone. If he is busy and not able to answer my call, He will call back and NO not charge me for it. No he is not related to me nor have I known him all my life. He does this because he is a Doctor!

  • Bhavin Jankharia wrote:

    Yes and that’s what we all do for the patients and people we know. But ask that same doctor whether he will do the same for someone who he doesn’t know at all and just calls up at anytime and expects treatment. Please don’t mix up existing patients and relationships with new ones and unknown people and strangers. Again…ask your doc what he would do.

  • Jayesh Desai wrote:

    Doctor bashing is most favourite sports. The preceding comments confirm. As you have repeatedly pointed it’s not about patient in clinic, but in haste to lambaste people have missed that point altogether. Also I fail to understand logic of blaming whole medical profession for few but when you come across good doctor it’s the individual and no one praises the profession. Anyway most of us do what we do because we love our work and the satisfaction that we derive from also helping people while doing so.

  • Rajendra wrote:

    Dear Bhavin sir, I do not understand, why doctors should be without a heart when dealing with unknown people. It is just a humanity or social responsibility. This attitude is generally observed in Mumbai where people are very busy and do not wish to help even a dying person which is a cruel and indifferent attitude. I often traveled in India and abroad in Group Tours, and when we see that a Doctor is also our co-traveler, we are mentally relaxed that if something goes wrong with somebody the doctor is present. They even carry a few emergency tablets of body-ache or stomach disorder which are very common while traveling. Please be human Bhavin sir. Thanks. Nice to see you after a long gap.

  • Bhavin Jankharia wrote:

    It’s not about being without a heart. If there is a problem we will help. But if the issue is minor and / or I am at a party and someone wants advice while I am trying to have nonmedical conversations, I think that’s difficult to manage.

  • My dad was a gynaecologist and he had a standard procedure at weddings and social functions. if someone started asking questions he would say “My fees are 500 an hour. IF you are going to pay me I will answer your question.” People would laugh uneasily say what Doctor you are joking and then would melt away. I have seen it happen all through my childhood.

  • Bhavin Jankharia wrote:

    And if we write about this people will see we have no shame and are money minded. Thanks.

  • An interesting read, Sir. I believe what you and your friend did was the right thing. “A little pain and let’s run to the doctor” has become a fad.

  • Bijal Jankharia wrote:

    Once I was on an Indigo flight to Bhubaneshwar and an air-hostess fainted – I just gave her my seat – aisle seat in the first row – checked her pulse, as a doctor – she was fine in a few minutes – gave her nimbooz. It was not much – but they kept thanking me throughout the flight and a very sweet card saying I was special!! It did make me feel special! All the other air-hostesses kept hovering around me all the time!
    Now – locked jaw – and troublesome relatives – that is a different ball game altogether!

  • Dr Pradeep Bhatt wrote:

    Dear Bhavin,
    Its interesting.As a Doctor one faces such situation when one is travelling on Vacation ‘To be away from all this’. Frustrating is when patient and relatives dont understand that not much can be done. or rather hardly anything can be done. I remember giving CPR to a man in Bank,while people doing regular banking around me!! Afterwards only Bank’s staff was thankful.Incidently his relatives never contacted me! But we will have to attend such emergencies for whatever worth it is.Who knows it may really help someone.As Doctor we are dutybound to help someone in Medical distress. Besides its Good PR for Doctor’s. Repercussion of not attending or helping will be bad. Remember Smriti Irani and Hema Malini’s Road accident problems.

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