Airline Captains Most Challenging Day Part 1 of 3

This was a day that pushed my skills and capacity as both a Commander and a human being to the limit. It consisted of 3 main events, each of which I’ll dissect over the next few articles.

Part 1 – Medical Emergency

‘There’s a paramedic, fire brigade duty manager, first officer, cabin manager & TCO all crammed into a tiny cockpit, staring at me, waiting on the next words to come out of my mouth.…’

Starting with a charming 04:30am alarm, I arrived at the airport an hour later to find out my relatively simple looking Berlin flight had just been cancelled, and I’d been changed to operate to Rijeka. Rijeka?! I’d never heard of the place!

It was a longer duty day than Berlin which meant I’d now be unable to make the first of my two personal appointments later that day. As well as meeting the crew, reading through a 65 page flightplan, figuring out where on earth Rijeka was, and setting the aircraft up, I’d have to squeeze in trying to cancel my appointment before we got airborne in an hours’ time.

It turns out that as a crew we were all in the same boat….nobody had ever been to or heard of Rijeka. After discovering it’s a small airport in Croatia, me and the FO got busy looking at the airport charts to try and build an idea of what we’ll be landing into, before deciding how much fuel we’d like to take.

On this occasion, according to our flightplan it looked like there were some thunderstorms forecast for later that day in Croatia. Nothing too horrendous and certainly nothing out of the ordinary, but I elect to take extra fuel to give us some thinking time due to a) the unfamiliarity of the airport b) thunderstorms in the vicinity. I had a quick look at Windyy.com (superb tool for real time weather situational awareness) which showed storm cells around the destination airport, but they looked to be rapidly blowing away.

It’s a very busy 40 minutes of setting up and getting passengers & bags on board. My full focus is on the operation, however I’m aware I have a personal life that now needs attending to due to the change on report. It’s still before 6am, so the best I can do when I find a free 30 seconds to leave a voicemail with the company I have the appointment with later that day and hope that it’s enough…already placing some underlying stress on the day.

We have an ATC slot restricting our takeoff time (common place in Summer these days) so once we’re ready to go, it’s the standard explanation PA to the passengers about the small delay. 20 minutes later we taxi out to the runway hold point. Just as we are about to roll onto the runway, we get a call from the cabin crew …..I’m ‘pilot flying’ so the FO takes the call. I can tell this isn’t a normal time to receive a call from them as they’d already told us the cabin is secure for take-off, so I press a button which enables me to listen into the call to keep my situational awareness high.

The CC reports there’s a male onboard who’s pressed the call bell, he’s sweating profusely and is claiming he’s about to pass out, with his eyes rolling into the back of his head. Although hearing that was enough for me to know exactly what my next move is going to be, the FO correctly asks the CC on the phone what they’d like us to do. The CC informs us he’s not happy with the gentleman’s condition and doesn’t want to get airborne with him. I’m in full agreement, so I ask the FO to request a return to stand with ATC. They clear us straight onto the runway in order to turn around and taxi back to the parking stands, during which time we request the airport fire brigade to have their first aid team meet us on stand. Whilst the FO is getting more details from the CC over the interphone for us to pass onto the fire brigade, I’m taxiing the aircraft round the airport whilst also operating the radios, two tasks that are usually done by two different pilots, so the workload is very high. This is my first medical return to stand of my career, so although I’m remaining calm, my adrenaline is definitely pumping.

I get us back to our parking area as expeditiously but safely as possible, however as we approach our stand it’s clear there’s nobody there for our arrival. We’re not allowed to turn onto the stand unless we have parking guidance or a marshaller, and we’re told there’s a marsheller en route. It’s a frustrating wait as we sit adjacent to our parking stand for what feels like an eternity, waiting for either the ground team to turn up and switch on the parking guidance, or the marsheller. In an airport where the ground staff are sufficiently crewed and paid enough, this wouldn’t be an issue! I use this time to do a PA to the passengers, keeping them in the loop and asking them to remain seated when we stop

Whilst at a standstill, we then get a call from the cabin manager to say the gentleman is feeling better now, stopped sweating and claims he’s feeling totally back to normal and wants to fly. I tell him we’re continuing with the plan of returning to stand. At this stage my gut feeling is that I don’t want the passenger travelling.

Once on stand I shut the aircraft down. The TCO has only just turned up to attach the jetbridge, and the fire brigade haven’t yet arrived. I open the flightdeck door for the CM to give me an update on the situation. A big part of me doesn’t want to go down to speak to the gent as I know my human, empathetic side will likely come out and sway my decision as to whether to offload him. I don’t want my initial gut feeling to be influenced.

I do however feel it’s part of my duty as Commander, especially whilst we are sat waiting for the paramedics. I walk down the cabin to find the passenger, drop down to his level and ask him how he is and what’s happened. He’s clearly shaken up, his top is still drenched with sweat, but he is no longer actively sweating. He has his two kids next to him fanning him, and a wife behind. He explains he felt faint, but he had an orange juice and it seemed to bring him back to normal. He said he wasn’t diabetic, but felt his sugars were low and that lifted him back up. I gently put my hand on his shoulder and softly explained that we’ll get the paramedics on board who will do some tests to see what’s going on. As I’m saying this, I see the blue lights of the fire truck arrive by his window.

The paramedics run obs on the male for 10 minutes. They all come back fine. At this point I still wanted to get the male off the aircraft, as I felt it was my duty of care towards him, his family & the other passengers. We hadn’t found the source of these issues, so I didn’t want to risk this happening again in the air.

I’d been told the family had no bags in the hold so we wouldn’t need to open the cargo door which saves us needing ground staff. My gut was still to get him off, however other factors then came into play….

The fire brigade manager was asking me what I’d like to do with the gentleman. I asked his professional opinion, which was that they see this all the time. He thinks it’s caused by a very early start/lack of sleep, mixed with not eating or drinking anything all morning. He explained how our bodies are used to shift work and getting up at 4am, most people aren’t and some struggle to handle it.

My thoughts were he could be taken into the terminal, give him time to calm down & eat some food, and hop on the next flight out. I had a quick look at the next flight and it wasn’t for 4 days….which means if I remove them from the aircraft, that would be the end of their holiday.

I asked the paramedic who ran obs to come into the flightdeck to hear his diagnosis & thoughts on whether he was fit to fly. His view resonated with that of the fire brigade manager. Whilst they can’t categorically tell me he’s ‘fit to fly’, or 100% confirm the exact source of the issue, they both said they are happy and wouldn’t see an issue with him flying, although at the end of the day it’s obviously my call and they can’t accept any responsibility.

I’m aware that sometimes anxiety about flying can cause the man’s symptoms, so I once again went down to the gentleman and asked if he was anxious or nervous about flying. I informed him that being totally transparent, there were storms around the destination so it may get a bit bumpy, so if he is, it’s only going to get worse. At this point he looked much better, was less reserved than when I last spoke to him and he confidently explained he had no issues flying.

Hmmm decision time.

I called the FO, cabin manager, fire brigade manager and paramedic into the flightdeck to run through all their thoughts one by one. Everyone was happy for him to fly. After doing this, I had 5 people staring at me (TCO now joining to see what he needs to start organising) waiting for a decision….

One one hand, my gut said to get him off. What if this happens again? We have to return to stand again? Or even worse it happens when airborne…..what if there’s an undiagnosed issue here that’s going to get exacerbated when the cabin becomes pressurised? Could I justify taking him if that ended up happening? If we divert once airborne, not only could this man end up stuck in a foreign hospital, it’s possible none of these 200 passengers would be getting to their destination as we’d go out of hours as a crew.

On the other hand, I’ve got 2 trained professionals telling me he’s ok, and essentially fit to fly. If I boot him off, his holiday with his wife and small children will be ruined. This could be their one holiday of the year!

I think about what option would leave me sleeping better at night…

I go down and chat to him, letting him know that I’ll cut him a deal; I explain the plan, that I’m going to take a chance on him, but if he feels even the slightest bit unwell at any point, he has to press the call bell. He may know what the repercussions will be, but it’s in the interest of his own health and his family for him to do so. I also apologise for the huge amount of attention that’s been drawn to him.

I asked the fire brigade manager what the best sort of food/drink would be for the patient to have, and ask the cabin manager to take it down to the man and that I’ll authorise it. (It does cross my mind that this may have been a very long winded way of the gentleman getting a free pasta pot!)

I then do a PA from the front of the cabin, keeping the passengers in the loop and thanking them for their patience once again. In all honesty standing in front of 200 people at 6am is far from comfortable for me, however in situations like this I think it goes a long way for the passengers being able to see the Captain outside the flightdeck.

The next part of the puzzle is trying to get hold of a tug to push our aircraft back. As we’re not a scheduled departure anymore, we know this could be easier said than done. Multiple calls to our handling agents are made and we are told we’ll have a push back team ‘soon’. Of course, we also then get given another ATC slot so when the tug finally arrives much more expeditiously than we cynically hoped, we can no longer push due to the slot being too far away. It’s also at this point that I realise due to the delay, I will now be unable to make my second personal appointment later that day. It’s still so early that the majority of society is tucked up in bed asleep, so another very apologetic voicemail is left with another company.

Moral of the story – don’t ever try and have a life outside of work on a working day! 10 years in and I still forget this.

Finally, well over an hour after originally being there, we’re back at the runway holding point and this time depart successfully. This event alone would be classed as a ‘stressful day out’, little did I know that was just the very start……