I was returning from Austin, Texas to Los Angeles, California with a friend. I'd already watched a movie and it was the last hour of the flight. Time for a nap. I tried to get comfortable in the confines of the seat.

The pilot's voice came over the intercom. "We need a doctor in the front of the plane for help with an adult male. Please press the flight attendant call light."

A man across the aisle had made a point of being an important doctor back home while we were chatting in the waiting area. He seemed to be buried in an on-flight magazine.

There was no response.

"Rob, you like to be a hero," I said to my friend. "Why aren't you volunteering?"

"We're pediatricians. It's an adult man. Probably a heart attack. I don't know what to do. You see adults sometimes. You took the adult CPR / Advanced Life Saving Class. Why don't you go?"

"I just see adults when they can walk into the clinic," I replied.

The announcement was repeated. Nobody had responded.

I reached up and pushed the call button and stood up. The aisle was narrow and sleeping people had their arms and feet sticking out. I worked my way toward the front of the plane.

Three flight attendants were in the aisle, with no obvious medical person. As I got closer a flight attendant waved her arm toward row 6 on my left. The woman in the center seat moved away from the window seat passenger. A middle-aged man was having a seizure.

"We need to make sure he doesn't hurt himself," I said. "Are there some pillows and blankets we can use for padding? I need to get closer."

I leaned over the woman and looked at the man. There were no obvious signs of anything else needing emergency treatment. One of flight attendants had brought a stethoscope, oxygen cylinder and mask from the medical supply closet. I reached back and took the stethoscope.

"The seizure should stop on its own. Let's just wait a bit." The convulsions subsided. The man seemed sleepy, not responsive but breathing. I put the stethoscope on his chest and listened. His heartbeat and breathing sounded normal.

"Is he okay?" the woman from the middle seat asked.

"It's called a post-ictal state. After a seizure, a person often seems to be asleep for a while."

I asked their names. She said that he was Stan and she was his wife, Janet.

"The doctor said this might happen."

"What might happen?"

"Convulsions. He asked if Stan wanted to start some medicine, but he said no."

"Why did he say that?"

"Stan has a brain tumor. He only has 6 months to live."

"Were you visiting friends or relatives in Austin?"

"No. We live there."

"So, you're visiting family in Los Angeles?"

"No, we don't know anyone in L.A."

"Where are you staying? You must have reservations, travel plans?" I hoped she wasn't going to say that they were planning to go to Disneyland.

"Oh, we don't have any reservations yet."

"So why did you decide to go to L.A.?"

"It's on Stan's bucket list. We wanted to see some places before he dies."

"Well, I guess you'll need to talk to the hospital people about what to do…" I looked at Stan again. He was resting peacefully.

Next thing I knew, they were announcing landing instructions, "… seatbelts, tray tables up and in a locked position." A few people changed seats. I sat down in the aisle seat next to Janet with a flight attendant across the aisle.

The plane came in fast — fastest landing ever! As I looked out the window, I saw firetrucks waiting below.

The intercom blared, "Everyone stay seated while paramedics come aboard."

The forward door opened. Three paramedics in dark blue uniforms came aboard. The man in front was built like a wrestler.

I stood up. "Hi. We have a 55-year-old white male who is post-ictal. His vital signs..."

The big paramedic responded, "Outta the way lady. We've got this covered."

~ Marcia Ehinger, M.D.