News : Matt Wilden - Practicing Medicine at 30,000 Feet

On the ground in San Diego

Matt in his natural habitat

Ask Matt Wilden, PAC., one of 5 providers serving Virginia Gay Hospital’s Emergency Department, to describe a secret dread and it would be one shared by many health care providers. Their dread is to be responsible for a patient with limited space, limited equipment, and no backup. That’s where Matt found himself last Thursday at 30,000 feet, cut-off from the state-of-the-art equipment and communications he relies on at Virginia Gay, but responsible for a patient with all the signs of a heart attack.

Matt was on a red-eye flight from Dallas-Ft. Worth to San Diego on Thursday for training in administering advanced treadmill cardiac stress tests. The training was to help Virginia Gay offer more patients quick access to the tests.

Matt said, “About an hour into the three hour flight the cabin crew was becoming more anxious and were coming into the front of the plane in a rushed fashion. They mentioned a passenger in the back of the plane who was experiencing significant shortness of breath. He was elderly and had a number of health problems.”

“Why me, is what I thought,” Matt remarks. “I kind of wanted to crawl under my seat. Every time I’m on a plane this is the kind of thing I worry about - that there will be a scenario like this.”

“They were doing beverage service when I identified myself. The steward said if they needed me they’d know where to find me. So at that point I just let it be and continued doing what I was doing. Maybe I could dodge this”, he says, “but honestly the time just started crawling by.”

Luck wasn’t on Matt’s side, but it was on the passenger’s. “Sure enough,” Matt recalls, “they asked if I would see the passenger. Luckily one of the stewards was an EMT so we had some basic equipment. The passenger was having crushing chest pains, arm pain, and severe shortness of breath. He had multiple conditions making heart disease likely; all the indications you would expect for a heart attack.”

The crew provided aspirin and Matt put his new patient on oxygen. There was an ER nurse on the flight and with her help Matt got an IV started to give fluids if it became necessary. They placed an AED (portable defibrillator) near at hand and Matt talked with the flight crew who were in contact with a physician on the ground working for the airline.

“It was the physician’s decision to continue to San Diego rather than diverting somewhere else. Where else that could have been, I have no idea,” says Matt.

Matt, in sharing his thoughts about the event said, “It was a helpless feeling. I’m used to being in the emergency rooms at Virginia Gay with state-of-the-art equipment. On the plane I didn’t have the basic tools like a heart monitor and none of the medicines I might normally administer. There was no access to cardiology expertise; to all the people I would normally involve in inter-disciplinary patient care. It was just me and the other professionals that we were lucky to have on the same flight.”

Given the opportunity to share his thoughts, Matt says his preparation for helping on the plane comes back to Virginia Gay.

“What I really would like people to understand is that this hospital is changing and there’s so much more that can be done here than before, and more conditions can be appropriately cared for than at any time in the past.” Matt said. “I am just really proud of our hospital. I never knew anything about Vinton or Virginia Gay before I came here in training. What Virginia Gay is today is quite impressive, especially when compared to other critical access hospitals and hospitals in general.”

What about his experience on the flight?

“I was just doing what I hope any professional with the capability and experience would do for a member of my family. I would hope they would step up to be there, to reassure them or do whatever needed done,” says Matt. “That’s how I look at it when I take care of patients at Virginia Gay and that’s what I was doing when I helped on the plane.”

Matt said he believes a patient’s emotional experience can be as important as their physical condition. “I made sure to explain to him what could potentially be occurring, what some of the concerns were, why we were doing what we were doing, and how we were preparing to deal with whatever came up. The longer I was with him the more we were able to carry on some just general conversation that seemed to put him more at ease.”

“By the end of the flight he and I had talked quite a lot. His demeanor changed for the better from the first few minutes when things were very tense to the few minutes before the plane touched down. He was even telling me about the layout of the San Diego runway we were landing on and why, after flying over a parking ramp, the pilots have to almost drop the plane on the runway.”

After landing, an EMS crew transported Matt’s patient to a hospital. Matt isn’t sure how he’s doing because he hadn’t learned his last name and Matt doesn’t want to make a big deal of the experience.

So how was the landing?

“Honestly, the only thing I remember feeling was relief,” Matt said.

Mike Riege, Virginia Gay Hospital Administrator says of Matt, “I’m always amazed at how Matt and the other members of the VGH emergency room staff remain calm, professional and compassionate no matter what they face. I can’t think of more wonderful people to be surrounded by in the midst of a crisis. The patient on that airplane can consider himself fortunate that a Physician Assistant from Vinton, Iowa was on that flight”

Matt returned from San Diego on Saturday and is back at work at Virginia Gay.