Setting: Bottom of the pyramid of Keops, Egypt
Position: Emergency medicine physician for a French multinational company
The flight from Paris was uneventful and the hotel in Cairo is quite pleasant. I am accompanying a group of staff members for a French multinational company, and the trip is a yearly reward for their professional performance. On the first day, we visit the museum, which is an unbelievable treasure house replete with antiquities; on the second day, we take a bus to visit the pyramids on the plateau of Giza. It is hot, dusty, very bright and noisy. The place is buzzing with people (locals and tourists), animals (donkeys, camels, dogs) and several means of transportation (cars, taxis, buses, vans, bicycles, mopeds). The size of the stone slabs making the pyramid is impressive.
About 10 minutes after all the passengers alight from the vehicle, someone comes running to me, signaling that a lady from the party needs urgent medical care. I dash with the messenger and we quickly reach the patient lying in the sand at the feet of a camel. A U.S. nurse is kneeling by her side, talking to the agitated crowd that had instantly gathered to watch the unfolding event.
The woman's face reveals her anguish. Indeed, the patient is seizing, foam comes out of her mouth and her eyes are revulsed. I check her skirt and notice a urine stain. The diagnosis of epileptic fit is obvious. I reach to grab the patient's tongue, ask the nurse to hold it, roll the body into a lateral position of security and reach for my bag. The I.V. valium I slowly administer brings the patient's condition back to normal rapidly. At the end of the same sojourn, another woman in the group requires medical attention for deep venous thrombosis. She is flown back to France in a wheelchair with the rest of her tourist friends.
These two emergencies have a point in common: They were the direct consequence of patients forgetting to bring their medications along for the holiday.
Lesson for the doctor: Systematically remind all your patients to have their medications -- in sufficient amount -- when they travel.
Yann Meunier, MD, is the health promotion manager for the Stanford Prevention Research Center. He formerly practiced medicine in developed and developing countries throughout Europe, Africa and Asia. Each week, he will share some of his experiences with patients in remote corners of the world.