“Is there a doctor or a nurse on board?” There was — Doreen Agnese, MD, a surgical oncologist from The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute (OSUCCC – James) who was on a January 13 flight from Orange County, California to Dallas on her way home to Columbus. “I stood up and identified myself as a doctor and walked to the front of the plane,” said Agnese, a surgeon, geneticist, clinician and researcher who specializes in breast cancer and melanoma. When she got to the front of the airplane, a flight attendant filled her in: a 70-year-old man with diabetes had alerted the crew that he wasn’t feeling well. “They were taking him to the bathroom when he collapsed,” Agnese said. “When I got there, I could see that he wasn’t breathing normally. He was in what’s called agonal respiration, which is how you breathe before you die. He was cold and clammy; I touched his neck and there wasn’t a pulse.” Without quick medical attention, this man would die. Agnese is an experienced surgeon who has performed thousands of operations — but emergency medicine is not her specialty. “I can’t remember the last time I was in an emergency situation, maybe during my residency,” she said. “But we have to re-certify every two years for advanced cardiac life support.” So yes, Agnese was nervous. “I wanted to portray confidence and calm, even though, on the inside I was pretty nervous,” she said. “I remember thinking, I hope my voice doesn’t sound like it sounds in my head.” Agnese quickly determined that she needed the on-board defibrillator — and fast. A flight attendant brought it to her. “I unbuttoned his shirt and put the paddles on his chest,” she said. “It analyzes the heart rhythms, and said a shock was advised.” The paddles delivered the strong electric current to the man’s heart and… “He immediately started breathing and he started to feel warm and I could feel a pulse,” she said. “He opened his eyes and started looking around.” Agnese asked the patient — named Bob — a few questions, and with the help of a diabetic passenger, she checked his blood-sugar level. “It wasn’t low, that wasn’t the cause of what happened,” she said. “I think maybe he had a supraventricular arrhythmia, which is when the heart rate gets going real fast, and he became unstable and collapsed.” Agnese spent a few more minutes with Bob before determining that he was OK and that the airplane could continue on to Dallas rather than making an emergency landing at a closer airport. “And then I went back to my seat,” she said. About 44,000 emergencies take place worldwide every year on airplanes, according to a 2013 study in The New England Journal of Medicine. The majority of these cases are fainting, respiratory problems, nausea and/or vomiting. Agnese doesn’t consider her actions heroic. This might be a misdiagnosis. “But I am proud of myself for stepping up into something out of my comfort zone,” she said. “I think most of us became physicians because we want to help people and save lives. So when you’re called upon, you want to help.” The airline gave Agnese a voucher for a future flight and added 25,000 miles to her frequent-flyer account. However, she learned — or perhaps re-learned — an even more valuable lesson. “When you’re dealing with cancer, like I do, you’re not in these types of dramatic situations where it’s life-and-death and every second counts,” she said. “With cancer, it’s weeks and months and sometimes you can lose sight of the impact you have on people’s lives.” FYI: When the airplane landed in Dallas, an EMT crew boarded and took Bob to a hospital. Agnese has not been in touch with him, but is trying to make a connection through the airline. And, while she was waiting for her connecting flight home to Columbus, “I texted my mom about what happened.”