Setting: Brisbane airport, Australia
Position: Chief medical officer for Chevron in Papua New Guinea
It had been a long flight for a Chevron employee we’ll call Mr. S, who went from Texas to California and then to Australia. Since he started working for the company in Papua New Guinea, he has followed the same route several times, but today’s stopover in the capital of Queensland is long enough to allow him to visit the city. Although tired and somewhat sleepy upon arrival, he looks for a means of transportation to the downtown area and opts for taking a bus ride. As he walks to the bus stop across two traffic lanes, he sees a bus with the right number approaching rapidly. He decides to try to take it and starts sprinting looking to his left when he gets hit by a truck coming from the right. He immediately loses consciousness. A few hours later, the Australian corporate office calls me in Port Moresby to ask me to check on him at the local hospital. I take the first available flight.
From the initial neurological assessment, it appears that the brain damage is extensive and no recovery is expected soon. A few days later after talking with the doctors, the family and management, the decision is made to evacuate Mr. S to the United States. Given the patient’s condition, he cannot be transported on a regular commercial flight, and a specially equipped plane has to be chartered at a very high cost. The flight goes well, but unfortunately the patient dies weeks later in Texas surrounded by his family.
Reflecting upon this tragedy, I concluded that because of his weariness and the consequences of the jet lag, Mr. S. had forgotten that people drive on the left side of the road in the state-continent and did not look both ways before crossing. He also acted impulsively. The next bus would have gotten him to town and back in time to catch the next flight to his workplace destination.
Lesson for the doctor: When your patients travel long distances, remind them about the effects of jet lag and encourage them to slow down their activities until they feel in sync with local time.
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.