Air Canada AirbusCredit: WikimediamCommons

                                                             Air Canada Airbus - Wikimedia

According to The Buffalo News on October 10, 2015, this story has gone viral on social media.  On an Air Canada Transatlantic Flight, a two-year-old asthmatic boy became short of breath.  Unfortunately, his medication was stored in their checked luggage.  The plane lifted off from Munich four hours previously and was now flying over the Atlantic Ocean heading for Toronto,

“Is there a doctor on board?”

The passengers were alerted to the situation when they heard a plea, “Is there a doctor on board?”  Dr. Khurshid Guru, a surgeon at Roswell Park Cancer Institute in Buffalo, New York, was coming from a medical conference in Spain, hoping to get some rest on the plane after his fatiguing time on the continent.  Initially, he told the flight attendant that he had not worked in Pediatrics for many years, and perhaps there was someone more qualified on board.  When there was no further response, the doctor went to check on the boy who was seated with his parents four rows in front of him.  The boy’s condition had appeared to worsen, and the boy and his worried family were moved to the back of the plane for more privacy.

The standard emergency medical kit on the plane was well stocked.  A stethoscope was available, but the pulse oximeter which measures oxygen levels was for an adult’s finger only, and Dr. Guru had to hold the instrument to the child’s thumb to take the measurement.  His oxygen saturation level registered 86-87% whereas a normal reading would be in the 94% range.

                                         NebulizerCredit: Wikimedia Commons

                                                                   Nebulizer - Wikimedia

Asthmatic Attack

Dr. Guru did not ask the parents for their names or for the boy’s name, respecting the privacy laws.  By this time, the boy had had two episodes of shortness of breath while in the air.  A severe attack is always life-threatening and the doctor sensed that his condition could easily go downhill.  The crew found an adult inhaler in the emergency kit which would not work properly for a two-year-old who would have to know how to suck in medication.  The child was frightened and feeling poorly, and would probably not react well to the inhaler.  A nebulizer, which is a piece of apparatus which changes medication into an inhalable mist, is often used on children, but there was no nebulizer on the plane.  Dr. Guru would have to manufacture one.


Plastic Water BottlesCredit: Wikimedia Commons

                                                     Plastic Water Bottles - Wikimedia

Plastic Water Bottle, Airplane Face Mask, and Plastic Cup

He had to work with the adult inhaler.  There was also a 4-liter oxygen tank in the kit.  And a face mask is always available on an airplane.  Carts were rolling down the aisles now with snacks and drinks and bottles of water.  Dr. Guru asked the flight attendant for a water bottle that had not yet been opened, for purity’s sake.  A scissors would be necessary, but sharp objects are not allowed on planes, and no scissors was available.  Fortunately, a crew member found a scalpel in the kit.  The doctor used the scalpel to cut a hole in the bottom of the bottle after emptying out the water.  He then put the yellow cup and the tubing from the face mask into the bottle, and sealed the tubing with some masking tape.  He started the oxygen and knew from the pressure on his thumb that the seal was working.  A small hole in the side of the bottle allowed the mouth of the inhaler to be inserted.  By squeezing the adult inhaler, it would mix with the oxygen, creating a mist which a child could breathe in.


Plastic CupCredit: Wikimedia Commons

                                                                Plastic Cup - Wikimedia

Voila! A Nebulizer

Dr. Guru knew that a piece of apparatus over a child’s face would certainly upset him, and spied the plastic cups on the attendant’s cart.  By cutting a whole in the bottom of the plastic cup and securing the top of the bottle into it, the air would be projected toward the boy.  He instructed the parents how to administer the medication with his homemade device, and stayed in the background so that their son would remain calm.  After two doses given ten minutes apart, Dr. Guru checked his oxygen saturation level and it was above the 90% level.

As the plane started its descent, the crew asked the parents if they needed an ambulance, and they said no.  Dr. Guru advised them to see their son’s doctor right after they landed, and they agreed.  He took a picture of the device he had concocted, and a flight attendant insisted he should have a picture of himself with the device.  He never did find out the name of the family he helped, but said that he had to fill out three pages of information for Air Canada’s records.


Twitter IconCredit: Wikimedia Commons

                                                                  Twitter Icon - Wikimedia

Back home again, Dr. Guru sent a Twitter to his colleagues who had attended the conference in Spain, stating: “Flying back from ERUS15 had to design a nebulizer for a 2-year-old asthmatic over the Atlantic.  Thank God kid did well!”

The story had gone viral

The next morning, the doctor learned that the story had gone viral.  He insists, though, that he did not save the boy’s life.  What he did was merely to prevent the situation from escalating.  Dr. Guru feels that the lesson to be learned is to put your medications in your carry-on luggage to prevent an occurrence like this from ever happening. 


PillsCredit: Wikimedia

                                                                      Pills - Wikimedia

Proposed Legislation

When Senator Charles E. Schumer (Dem.) from New York heard about the incident, he urged the Federal Aviation Administration to require all planes to carry medical kits with medications and equipment that are appropriate for children.

Gratwick LaboratoryCredit: Wikimedia Commons


                            Gratwick Laboratory - The Beginning of Roswell Park - Wikimedia

Roswell Park Cancer Institute

Because I live in the Buffalo, New York are, I am fully aware of the wonderful things that are being accomplished at Roswell Park Cancer Institute, which grew out of the Gratwick Laboratory in 1898.  I am a cancer survivor myself.  Dr. Guru is Director of Robotic Surgery at Roswell Park, and his specialty is the treatment of bladder cancer in adults.  He performs robotic-assisted surgical procedures, and collaborated in the development of one of the first robotic surgical simulators.  His personal foundation provides education and medical care in rural parts of Kashmir, which is just north of India and Pakistan.

I loved this story - a feel-good account where everyone comes out a winner.  Dr. Guru is so typical of the thousands of medical personnel who work around the clock passing on their expert experience, and never seeking notoriety or reward for doing a day’s work.  We salute you, Dr. Guru!