We had departed London and just passed 30 degrees west longitude, slightly less than halfway across the ocean. The flight attendant chime sounded in the cockpit accompanied by the engine instrument and crew alerting system message “cabin call.” I put the interphone handset to my ear.
“Les, it’s Liz. We have a woman in coach that we believe is having a heart attack.”
Liz was the purser, the lead flight attendant.
After a momentary pause, I responded, “Has a physician been requested?”
“Yes, he’s treating her now.”
I visualized the doctor pulling the pads out from the case of the onboard automated external defibrillator and applying it to the passenger.
Reaching forward with an index finger, I pressed the “alternate” page of the FMC (flight management computer). A list of four-letter identifiers for the nearest alternate airports was displayed. Peering at the instrument panel clock, I made a quick calculation.
“Our best alternate is one hour and 20 minutes away. Keep me advised, Liz.”
“Will do,” she said with the calm of a 911 operator.
After flying across the North Atlantic for almost 15 years without incident, I was about to break my winning streak.
As per protocol, we had been proactive in monitoring potential alternate airport options. Relative to our position, two airports on the list were suitable in terms of distance and acceptable weather conditions: Gander, Newfoundland, and Keflavik, Iceland. If Gander became the choice, the current track westbound could be maintained with only a minor correction once we neared the Canadian coastline. Keflavik would require a turn of more than 90 degrees off the current track, but it was nearest in point of time.
I looked at my copilot, Deane, and said, “Via the CPDLC (controller pilot data link communications), send a free text message to Gander Radio that we have a medical emergency on board and that we may be requesting direct to Keflavik.”
Deane nodded with a sheepish grin. I understood the hesitant expression. It is anecdotally typical that, when an emergency event occurs, one crew member has just completed his initial operating experience flight with a check airman on the trip prior. This was the case for Deane. Although he had demonstrated great aptitude for a pilot new to the 777, some understandable awkwardness with the airplane’s electronic nuances remained. I guided him through the steps that would allow him to complete the task I had requested.
Liz had been providing me with updates on the passenger’s status. Initially, the 77-year-old woman was unresponsive and ashen. Although the AED was never utilized, she had been laid prone in the aisle. As time progressed, the woman became more lucid and was moved to the first-class cabin. Her pallor, however, remained the same. Further inquiries to her accompanying husband indicated that she had suffered similar symptoms the day prior.
When Deane completed the airborne text message, I instructed him to contact our dispatcher via satcom. It was time to involve the physician on call.
Soon after the warble of the satcom ring filled the cockpit speakers, our dispatcher answered. Deane explained the situation. The physician on call was conferenced in and briefed. The tone of the physician’s analysis indicated that our medical problem might not be dire. This analysis conflicted with that of the onboard doctor.
I took a deep breath and sighed inwardly. It was time to put on the proverbial captain’s hat. I looked at my copilot, shook my head, unsnapped the intercom handset from its cradle and pressed the code that would chime the first-class cabin. Liz answered almost immediately. I explained that I needed the doctor’s final recommendation. The doctor was emphatic. Land the airplane.
I nodded at Deane. He conveyed the information. Although the dispatcher wanted us to consider Gander, if time was of the essence then Keflavik was the only option. We were about to fly 201 passengers and 11 flight attendants to a destination where none had probably ever been — including Deane and I.
I visualized the off-track contingency procedure. We had been cruising at FL 390. Other traffic on the North Atlantic tracks was vertically separated, both north and south of our position, by 1,000 feet. The contingency procedure allowed for a descent 500 feet below our current altitude in order to cross the tracks without conflict.