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.


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.

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