I have been called to assist in an inflight emergency four times: three times for dehydration and once for uterine hemorrhaging. Everyone was okay in all instances. Last week, I was called for an inflight emergency. On board with me happened to be Zach Braff, known best for playing a medical resident on Scrubs. I felt like Scrubs saw me. I was an intern when JD (Zach’s character) was an intern. When a code was called, the residents found one another hiding in the broom closet because they were all too afraid to show up at the code and actually be responsible for saving someone’s life. That was me. I wished there was a broom closet every time a code was called.
I was trained as a pediatrician, so it’s always been a fear of mine that I will be the only doctor on the plane to help with a grown-up emergency, like a heart attack. This is why I always carry an aspirin with me. Everywhere.
Last week, the call during an inflight emergency with JD a few rows in front of me (and all the memories of residency in between) prompted me to reflect on the power we possess to save lives. Often, we underestimate this power, especially since most of the saving of lives is done through prevention. The impact of preventative actions is harder to quantify– and much less sexy– than the number of deaths. No Scrubs episodes on prevention stick in my memory.
Here are some of the ways I try to save lives.
Always Wear a Seatbelt
And make everyone else wear a seatbelt. This one always shocks me. I come across very intelligent people who think they do not need seatbelts. “I’m in the backseat– I’ll be fine.” That’s when I make it about me: If I hit the brakes, I do not want a 50 pound kid or a 200 pound adult-sized projectile flying into me. Unrestrained passengers are a danger to themselves and others in the car, and the simple seatbelt saves about 17,000 lives a year in the United States alone. When I do travel consultations, I remind clients that motor vehicle accidents while abroad are more likely to harm you than diarrhea or tropical diseases. Buckle up and travel with the same carseats you would use in the US.
I especially discuss proper buckling with teens, young adults and (adult) men. They are less likely to wear seat belts than women and kids.
Talk to Your Kids About Smoking When They Are Young (and Will Still Listen to You)
480,000 Americans and 7 million people worldwide die each year of smoking and exposure to secondhand smoke. Most anti-smoking campaigns target adults, but most smokers start– either with vaping or cigarettes– around age 13, which is about when your kids stop listening to you. Start talking about smoking (and drinking and drugs) when they are young, even in preschool. You do not need a long conversation, but when you see a smoker, make a comment about how smoking can harm lungs and weaken bodies. You do not have to talk about cancer with a young child, but as kids get older, the content of conversations can mature, also. If you are a vaper or a smoker, having a child is the best reason to stop. Here are some resources for quitting. Protect yourself and those around you.
Vaccinate Yourself and Your Kids
Vaccines work and are safe. Every year, over 25,000 people in the United States die of influenza. Over 30% of those deaths are in people under age 65. Of course, there are many more vaccine-preventable or vaccine-ameliorable* diseases. A 2024 study in Lancet estimates that vaccination efforts saved 154 million lives over the last 50 years. That’s 3 million lives a year. Read more about my stance on vaccines here.
And Yes, I Carry an Aspirin
Aspirin has blood-thinning and anti-inflammatory properties. Starting aspirin within four hours of a heart attack can reduce chances of dying. Some paramedic and nursing outreach programs advise at-risk individuals to take a 325 mg aspirin if they think they are having a heart attack. One analysis found over 10,000 US lives saved a year if aspirin was administered within four hours of the heart attack– even considering the increased risk of gastrointestinal and brain bleeds. I figure, if I am on a plane and I think someone is experiencing a heart attack, I want to have an aspirin on hand. I also carry an epipen, because that can come in handy if someone is having a severe allergic reaction. Keep in mind that I am a physician so I am trained to help in these situations. On the other hand, anyone, including you, can do all of the above to save a life.
*I like the phrase vaccine ameliorable since many vaccines, like those for influenza and COVID-19, reduce the severity of illness and the likelihood of death even when they do not necessarily prevent you from catching the illness. Reduction in hospitalizations and death are great goals for a vaccine! It would be optimal to avoid disease altogether, but not all conditions are amenable to prevention. I’ll take the runner up, reduced risk of hospitalization and death, over the alternative anyday.
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References:
https://www.cdc.gov/seat-belts/facts/index.html
https://www.cdc.gov/tobacco/about/index.html
https://www.who.int/news-room/fact-sheets/detail/tobacco
Carter, Austin and Msemburi, William and Sim, So Yoon and A.M. Gaythorpe, Katy and Lindstrand, Ann and Hutubessy, Raymond C.W., Modeling the Impact of Vaccination for the Immunization Agenda 2030: Deaths Averted Due to Vaccination Against 14 Pathogens in 194 Countries from 2021-2030 (April 20, 2021). Available at SSRN: https://ssrn.com/abstract=3830781 or http://dx.doi.org/10.2139/ssrn.3830781
Shattock, Andrew J et al. “Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization.” Lancet (London, England) vol. 403,10441 (2024): 2307-2316. doi:10.1016/S0140-6736(24)00850-X
Russo, Rienna G et al. “Self-Administration of Aspirin After Chest Pain for the Prevention of Premature Cardiovascular Mortality in the United States: A Population-Based Analysis.” Journal of the American Heart Association vol. 13,11 (2024): e032778. doi:10.1161/JAHA.123.032778
