Never has a three hour flight seemed so long

“The pilot would like to know if you would have him land the airplane in Bermuda,” the British West Indies Airline flight attendant asked, quietly and professionally. “No,” I replied, “there is no cardiac surgeon there.”

Reisha, my 4 month old patient, had picked an unfortunate day to try to die. We knew that she had heart disease soon after she was born. She first developed cyanotic spells, the hallmark of tetralogy of Fallot, at 2 months. In Antigua and Barbuda it takes time to arrange for overseas evaluation and care, but with the help of the Rotary club and its Gift of Life programme we had been able to arrange for transport to Schneider Children's Hospital in New York.

In the three days before departure the cyanotic spells …