Secrets of an airport doctor: Drugs, diseases and dodgy dinners

Stephanie Green was a doctor at Heathrow Airport for over a decade. She reveals the daily dramas she faced, from the bizarre to the heartbreaking.

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Despite the fact that 650 flights land at Heathrow every day, with at least one death on board every month, I never really got used to it. It wasn’t the death part that unsettled me – as a doctor you become fairly immune to that – it was everything that went with it. Boarding a plane full of people to do my job was like performing in front of an audience: a couple of hundred troubled eyes boring into me. I was holding a planeload of passengers  against their will. When there was a body on board, no one was allowed to leave their seats until I had confirmed the death, and that it was not from something that could threaten the health of others. Ruling out the scary stuff was paramount: lassa fever, marburg disease or even ebola. The most common diseases I came across were chickenpox and malaria, but I also dealt with more serious infections such as typhoid and rabies.

In 2005, I got a call to say a young woman had been taken ill with flu-like symptoms on a plane coming in from China, which was worrying because the bird flu epidemic was rife  here. The passenger had also indicated to the crew that she might have come into contact with the virus. It was time to don my doctor’s superhero get-up: white paper jumpsuit, face mask and protective kit. I was never keen on wearing it because I felt a bit ridiculous, plus I worried that I would frighten the passengers.

Stephanie Green

Given the hysteria at that time around bird flu, it was understandable that passengers might not be keen on being cooped up with someone showing symptoms. The behaviour of passengers seemed to depend on how much control the crew wielded. On some airlines, a simple request for everyone to remain in their seats was futile. I recall on one occasion fighting my way down the aisle to get to a man who’d been taken ill when, despite my strident request over the speaker system that everybody remain seated, I was virtually trampled underfoot. But on that day I just saw a sea of faces blinking at me. I would have to check everyone on the plane and that was going to take a while. I didn’t want to be the one who missed the bird flu virus and let it run riot in the UK.

The sick passenger was a British woman called Jennifer who had been working close to a market where birds were kept. Her temperature was high. A quick burst of coughing sent her violently forward in her chair and a woman on the opposite side clapped her hands over her mouth.

‘Doctor, you think I have it, don’t you?’

‘Well, we need to get you checked out but it’s more likely that you have a nasty cold.’

I always try to put people at ease and to focus on a positive outcome. The ambulance arrived and took Jennifer to nearby Hillingdon Hospital. Onward addresses were taken for each of the other passengers and they were given instructions on what to do if they  developed symptoms.

Later that day I called the hospital. Most of the time we’re not party to the outcome of cases but this was different. When the lab told me that Jennifer was clear, the rush of relief surprised me. I did my best on a daily basis to push all the stress and worry deep down because that’s the best way I knew of dealing with it. But on this occasion I was anxious to make sure that I had handled the situation correctly.

*****

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There is an extraordinary energy to Heathrow that’s so different to a hospital where the atmosphere can sometimes wear you down. Even on quiet days I loved being there. A lot
of the work was fairly routine – forms had to be issued and we would check anyone arriving in the UK for more than six months from a country where TB was endemic, which meant examining 60 to 100 X-rays a day.

But bizarre things often happened, such as the day I was told there was blood leaking out of a suitcase on one of the baggage carousels. By the time we arrived, the suspect Samsonite was the only case left on the belt and nobody had turned up to claim it. I pulled on a pair of surgical gloves and slowly began to unzip it (no locks, thank goodness). As I peeled back the top of the case, a pungent smell hit me. Inside was a lot of screwed up newspaper and a large paper parcel from which the blood was seeping.

‘God, is that some sort of meat?’ I said, stepping back. I pulled out the parcel, revealing what looked like a furless, mutilated animal of some sort. Not nice. Whatever it was, it hadn’t been particularly well wrapped. I leaned in for a closer inspection. ‘I think it’s some sort of monkey.’

The baggage supervisor rolled her eyes as if she wasn’t the least bit surprised. People try to bring all sorts of strange things through customs.

‘Bizarre things often happened’

On another occasion, a distraught young Jamaican woman was brought into the Health Control Unit to be X-rayed. ‘None of this was my choice,’ she said as she sat in her hospital gown waiting to be examined. ‘It wasn’t my choice to bring in the drugs.’ It was unusual for someone to offer up this information voluntarily, but she knew what the X-ray could show up. I rarely got into detailed conversations but this time I felt compelled to.

‘A drug dealer made me do it. He threatened my family with a gun. I have two children.’ Her tears told me that she was telling the truth but it was hard to bear. I looked into her eyes, trying to put myself in her place. I would have done the same in her shoes – what choice did she have? So she’d boarded a plane for England with a stomach full of condoms – each containing enough cocaine to stop her heart instantly if it burst.

A week later I boarded a flight from Kingston, Jamaica to record the death of a young woman who’d been taken ill mid-flight. She’d confided in a stewardess that she had drugs in her stomach but there was nothing anyone could do to help her. One of the packages had burst and was seeping into her system. She never made it to London. Her heart just stopped.

When I was pregnant with my first child, I had to attend one of the saddest cases during
my time at Heathrow: the death of a sick baby en route from Portugal for life-saving treatment in the UK. But the poor mite never made it. I asked Father Donovan, the airport chaplain, to accompany me to the plane. I thought he could be of some comfort to the family while I recorded the death, hopefully making it less clinical. I was steeling myself to face distraught, even hysterical parents, but when I stepped on board I was met by a scene of hushed serenity.

The cabin lights were dimmed and everything was so calm and quiet (the other passengers had been allowed to disembark) that it was hard to imagine such a tragedy had taken place. At the back of the plane the baby’s mother was cuddling her while her father was stroking her face. As I got closer, the man looked up at me but the mother wouldn’t take her eyes off her daughter. ‘She looks so peaceful,’ I said, gently. ‘She is now,’ she replied.

At their side were a couple of cabin crew who were clearly taking the most wonderful care of them. It was an uncomplicated, almost beautiful scene: a mother cradling her precious daughter as if she were sleeping. Eventually the woman looked up at me, her eyes wet, and I smiled back. That was all I could do. She’d done her best – all she could have done – and even now, after her daughter was gone, her quiet dignity in the face of such sadness was quite remarkable.

*****

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Terminal 5 is separate from the others so getting there by car took some getting used to. Negotiating the various routes was so tricky there was a special training video and then a test you had to pass. There were strict rules about speed limits and where you could park, but the first and most important rule was ‘always give way to aircraft’. As if there was ever going to be a situation where you might think twice about giving way to an Airbus A380. I had to learn all the different parts of the apron (where the plane sits as passengers get on and off) because if I parked in the wrong place I might well have been blasted by an aircraft’s engine exhaust. The problem was that every bit of the road looked exactly the same and the map we were issued with was impossible to decipher. I remember one poor Spanish doctor on a six-month secondment who was permanently lost the whole time he was there. He regularly called up in despair and the conversation would go:

‘I have no idea where I am!’
‘Well, what can you see from where you are?’
‘Planes!’

One night when I was on call, I couldn’t get to sleep. I was overtired from a taxing day shift that had felt eternal. After an unusually large glut of X–rays that had thrown up two cases of TB, I’d spent a good part of the evening trying to calm a young man who’d been bitten by a monkey in North Africa and was convinced he had rabies.

I can’t say what time I eventually dropped off, but at 4.30am I was woken by a call to tell me that a flight was coming in from Los Angeles with about a dozen sick passengers. Sarah and Sinead from the Health Control Unit came with me and, as usual, we were met at the door of the plane by a bevy of cabin crew who, despite having flown through the night, were bright and breezy and looking top-to-toe perfect. ‘There didn’t seem to be any  sickness when we took off,’ the purser said.

A tall passenger in a suit made his way towards me from the front of the plane. He didn’t look sick, but he didn’t look happy either.

‘Can I have a word, doctor?’
‘Are you ill, sir?’
‘No, but whatever this sickness is, I think you could at least let the first-class passengers off.’

I opened my mouth to reply but Sinead got there first: ‘Oh, breathing different air up there
are we, sir?’ The man blushed and turned back to his seat.

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I headed down the plane to set up my ad-hoc medical station, as sick passengers hurtled to and from the toilet. I only had to examine a couple of them to reach a diagnosis. As I’d suspected, the familiar call of ‘chicken or fish’ along the aisle that day was more culinary Russian roulette than a meal preference. These passengers had a nasty case of food poisoning, which meant that Environmental Health had to be informed right away. Luckily, the crew had been savvy enough to save some of the suspect chicken, unopened, so it could be sent off to be tested.

I made my way slowly through the queue of patients, some more sick than others, the smell by now disgusting and the sound of retching ringing in my ears. As usual, everyone who wasn’t stricken was desperate to get off the flight, having boarded some 11 hours earlier. I felt as if I was in a race against time before all the healthy ‘shut-ins’ stormed the doors. Mercifully they didn’t and an hour and a half later our work was done.

I was beyond exhausted when I got home at 11am. It was one of those rare times when I asked myself, should I still be doing this? Was this really the best job for a mum with two young boys?

This is an edited extract from Flight Risk: The Highs and Lows of Life as a Doctor at Heathrow Airport by Dr Stephanie Green, which is published by Headline, price £18.99