I didn’t sleep well that night because of a mixture of emotions; excitement, fear of failure, what if he died on the way over? Would he be comfortable? How is it going to go on the flight? Will I be able to reassemble the stretcher myself? What is going to happen to his abdominal abscess at cruising altitude? Fluid expands at lower atmospheric pressure, that could cause more pain and possibly rupture. What if he needs to poo?

A fitful sleep followed by an early start to the next morning, I woke up at 0430 as I had to be at the hospice by 0530 for a 0600 ambulance departure. I arrived at the hospice for last minute preparations. Medications had been prepared for the flight and I had plenty of pain relief, nausea relief and distress relief medications pre-drawn into labeled syringes.

Okay, everything checked off on the list. Deep breath, I’m as ready to go as I’ll ever be. Hmm, why can’t I stop pacing?

Air Ambulance Australasia (Air Ambulance NZ back in 2014) and their ambulance arrived at 0600. They had been so generous with their time and helpful advice, and were even going to lend me a bright yellow portable, collapsible stretcher that I could use to get our patient on and off the plane. They were kind people and had waived their transfer fees. Our patient said goodbye to his wife’s relatives and his wife would meet us on the plane. We got into the back of the ambulance and headed off. The driver tried to make the trip as comfortable as possible as every bump in the road caused pain to our patient.

We went into the airport through an entrance not available to the general public, and passed through security. We got off the ambulance and onto an ambulance-truck. Imagine the tray of a truck that the stretcher and crew could get on, which then is raised up to flight cabin height. The ambulance men said that when we arrived in the Islands that they would not have as fancy equipment, and that I would likely have to transfer to ambulance by way of the catering truck.

We wheeled our way onto the plane, and to the designated six seats for the stretcher. These were six aircraft seats that had been locked in the bent down position in order for the stretcher to be secured to them, so our patient could stay flat. I thanked the ambulance men as they packed up their equipment. I readied the portable oxygen, as I had been warned that at altitude that my patient might struggle to breathe. His wife arrived and sat in the seat behind me. I sat in the chair directly across the aisle from my patient.

The rest of the passengers boarded the plane and we waited for take-off. My patient looked terrible, he had already required some extra doses of pain relief for the ambulance trip, and for the transfer onto the plane. Last minute checks by the flight crew and then we were barrelling down the runway, and up into the air. I looked across the aisle at my patient as we hit 30,000 feet.

Oh no, his lips were turning blue…

Island-Man: Into the Stratosphere