Panama Canal - Disembark and Flight Home

 21 November, 2023

Port of Los Angeles

We arrived in the port of Los Angeles sometime in the wee hours of the morning. The noise of maneuvering, along with the random clanks and thuds related to securing the ship to the pier, usually wake me up early enough to go back to sleep before my alarm sounds – but not today. My alarm rousted me from bed, and the day began. Up and showered, the challenge of "fit these last few items in your backpack" began. I triumphed yet again, I just had to remember where I stashed everything so I could transfer it to a suitcase when we arrived in the terminal later. 

The last breakfast...

We had our cabin vacated and were in the dining room for breakfast by 7:30. One last order of Eggs Benedict for the road, and it did not disappoint. Departure morning in the dining room is always a bit harried. The crew is trying to get everyone served and out of the dining room so they can complete their changeover duties, others might have to present themselves at immigration, and there are always passengers who need a bit more assistance to navigate the process. Nevertheless the staff handles everything well, even if they don't have time to make small talk. 

Immigration and customs was quick and efficient. A few perfunctory questions (No, we don't have any live plants or animals...) and we were standing at the curb calling our driver from Saferide Transport. Based on my lack of familiarity with the port and the inherent randomness of shared ride services I opted to book a car in advance. This provided both peace of mind with scheduling and a guarantee that there would be adequate room for our luggage. A quick phone call confirmed that he was on site and making his way through the line of traffic to our location. While we were waiting I overheard several people negotiating transportation to the airport via cab at rates that exceeded the fee we paid, and others attempting to book Uber and Lyft rides with little success. Our driver arrived a few minutes later and loaded our luggage while we situated ourselves. In just a few more minutes we found ourselves among the chaos of morning traffic in Los Angeles.

Johnny and Roy?

The trip to the airport was uneventful and the 20 mile trip took about 45 minutes, which I didn't consider bad at all. On the way to the airport we took in as much as we could, as our only other trip to LA was in ~2000 for a long weekend at Disneyland. Imagine my excitement when I spotted an ambulance with "51" on the side. (No, it wasn't LA County, it was LA City, but LA County doesn't have a Station 51 - the "Emergency!" station is actually LA County Station 127) I immediately transformed into 8 year old me and had difficulty containing myself. 

Curbside check-in of our luggage was seamless, as was our stop at the desk. They directed us to the transportation assistance area, where we found a well organized team. There were quite a few people in need of assistance and they juggled the schedules and the needs of the customers with efficiency. We arrived at our gate with enough time to grab a coffee from Starbucks (thankfully online ordering was an option and I didn't have to wait in line with a couple of dozen people.)

We boarded our flight to Charlotte without issue and settled in for the first phase of "re-entry." About an hour in to the flight we were just getting started on lunch when the clichéd announcement sounded overhead asking for anyone with medical training to come to the rear galley to assist a passenger in distress. Technically speaking I can only function at the EMT level when I'm not at work, since my scope of practice is granted by our medical director, so I wasn't eager to respond – but my wife gave me a nudge and I unfastened my seatbelt and trekked down the aisle to the rear galley.

When I arrived at the rear galley I was third in a line of three. The lead flight attendant asked the first person what his background was – a physical therapist. The second person responded that she was a cardiologist. I said I was a paramedic and the cardiologist shoved me out front and proclaimed "He's your guy." I didn't see anyone horizontal, didn't smell any bodily secretions, and there wasn't anyone being restrained or acting out – so I wasn't quite sure why they asked for help.

Then they opened the door to the lavatory.

The flight attendand said he thought it was an overdose, and another flight attendant had the first aid kit opened up, Narcan at the ready. The person sitting in the lavatory (fully dressed, thankfully) was a bit altered, but breathing normally and their pupils weren't pinpoint, so I wasn't concerned about opioids. (The agency I work for sees an average of nearly two overdoses per day, so I'm familiar...) All their vitals were pleasantly normal, they were just a bit altered. They eventually admitted to eating "some" gummies to relax before the flight.

BINGO.

I've seen this many times, and it fit perfectly. The cardiologist was suggesting IV fluids until I pointed out that they would have to administer them, or agree to grant me privileges under her medical license. I assured her that time to metabolize the intoxicating substance was all that was needed. The Captain called from the cockpit, trying to figure out if he needed to divert to an intermediate airport, then the American Airlines doctor (I never even knew there was such a thing) called up from his office and I gave a complete report. He agreed with my assessment of the situation and suggested that the crew focus on managing the patient's activity (they wanted to do anything but sit quietly.) I ventured back to my seat over an hour later, to find my lunch tray cleared. 😐

Upon arrival in Charlotte an EMS crew boarded the plane and escorted the patient off. One of the Paramedics was a former co-worker of a medic that now works with me, so I introduced myself and gave him a brief report. The patient was much calmer by this point and they rode off through the airport on the EMS golf cart.

We located the gate for our final flight and the remainder of our journey home was entirely uneventful.