UVA School of Medicine

residentspotlight "The kindness and compassion to- wards Brud and his wife Charlotte is a testament to the dedication of UVA physicians in training." When the call came over the loud- Drs. Gherghe Residents provide emergency care in flight "I s there a doctor on the plane?" A phrase no one wants to hear on a flight, especially those who may be uneasy flyers. This was precisely the case, however, for Drs. Costin and Cristina Gherghe as they traveled with their five-year-old daughter to visit family in their native Romania. The passenger in distress, Brud Bispham, was a longtime family friend of Medical School Foundation Board of Trustees President Christo- pher Casscells, MD. Said Casscells, Both Costin Gherghe, MD, PhD (Internal Medicine Resident Physician), and Cristina Gherghe, MD, PhD (Endocrinology Fellow), received their MD degrees from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and their PhD degrees from the University of North Carolina, Chapel Hill. 34 Vitals Fall 2011 speaker, fifteen minutes before the flight was scheduled to touch down, the Gherghes rushed to the front of the plane. A flight attendant sat with their daughter through the ordeal. Cristina admittedly does not like to fly, but as soon as she began assessing the situation, any flight-related anxi- ety vanished. "My training kicked in and my instincts as a physician took over," recalls Cristina. "We saw the passenger seated next to the window, he appeared to be sleeping," she con- tinues. "He was not responsive. He appeared to have a pulse and he was breathing regularly. " Evaluating the passenger's condi- tion on the plane was hindered by a number of obstacles. "It was difficult to get vitals on the plane. The turbu- lence was disruptive and the roar of the engine was so loud it made it al- most impossible to hear through the stethoscope," adds Costin. Since the situation was obviously serious, the Gherghes, with the help of the flight crew, moved Mr. Bis- pham to the front of the plane where they could lay Mr. Bispham flat in case of the need for resuscitation at- tempts. "It was difficult to move him. The space is so confined," says Costin. "It took a couple of minutes just to get him down the aisle." When they reached the front of the plane, Mr. Bispham still had a pulse, but it was beginning to fade. His appearance became flush and they began to provide respiration. As the plane descended, Mr. Bis- pham's pulse was lost and Drs. Gher- ghe began chest compressions. By the time the plane came to a stop on the runway, Mr. Bispham's heart had stopped. Upon landing, as soon as the doors opened, a medical team of nurses and emergency medical technicians rushed onto the plane. They attempt- ed to revive Mr. Bispham through ventral defribrillation and blood pres- sure support, but the resuscitation was unsuccessful. "We were really impressed with the speed of the response and the preparation of the team," says Costin. "We were able to make the first as- sessment and get Mr. Bispham into position, begin chest compressions," continues Cristina, "then the nurses and EMTs arrived with more equip- ment and were able to start an IV and make additional attempts at revival." "After we landed, everyone was kept on the plane for about 45 minutes while the medical team worked on Mr. Bispham," says Costin, who stayed with Mrs. Bispham and helped explain the circumstances and possible causes. "Looking back," says Costin, "there wasn't anything we feel we could have done differently. It was a difficult situation, and unfortunately the chance of survival was not good." "In medicine, outcomes are not always positive," said Cristina. "This is something we face every day. However, we feel good that we were able to help when we were needed, offer a sense of comfort for the family, and provide care and diagnosis for a person in need."

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