My extraordinary trip back to Europe.

It is not fiction. It all happened. October 2017

After an unforgettable trip to Mexico for the Third International Writers Meeting, I returned to the Costa Brava via Amsterdam. Exquisitely tired from the warm reception of my literary presentations and the bustle of the city, I boarded the plane with my wife. KLM Flight 686. Shortly after take off, I closed my eyes and began to doze. I thought it was the beginning of a break, tired from experiencing so many emotional experiences. Suddenly she moved me. He told me that over the loudspeaker the crew announced that they required the assistance of a doctor. I introduced myself to the crew. They directed me to the back of the plane. As on other occasions, I expected a case of lipothymia, a heart disease, a cerebrovascular accident or a diabetic shock. Nothing of that. It was a psychiatric case. And I was the only doctor on board.

Nine hours later, I returned to my seat with my wife for a few minutes to eat something. Surprised by my long absence (she did not want to break in and purposely did not look for me), she asked me:

--What happened?

`` If I tell you, you won't believe it. You will think it is one of my novelistic inventions.

We were the last passengers to disembark. I related everything to him when I left the plane, after the commotion upon disembarking and the thanks (and champagne) from the captain and the crew.

If the events had happened on an American airline, I am sure they would be in the news and in the wrongly called "viral" form on social media.

When I introduced myself to the crew members I was informed that a passenger was extremely restless, rapidly wandering the cabin aisles in delusions of persecution and repeating that they wanted to kill him. They mentioned the words "psychosis" and "schizophrenia." The chief flight attendant had consulted an airline doctor, who recommended reassuring him with diazepam.

Recalling my psychiatric rounds in medical school many years ago, I began to chat with the patient, sitting in the last row, in the back of the plane. The 27-year-old Austrian patient spoke excellent English with a very good vocabulary. Indeed, he was sure that everyone on the plane were actors, that someone wanted to kill him and that he had blood in his mouth. He confessed that it all started a few days before, during his stay in Mexico City. He had seen a doctor who prescribed haloperidol for him.

I asked him many questions to form a clinical impression, establish a diagnosis, and above all to solidify a bond with him and gain his trust. Without pushing him, I offered him to take two tablets of the muscle relaxant. Without warning he got up and headed to the kitchen area immediately behind our seats. I went with him. He thought the glasses of water and fruit juices were filled with drugs and lysergic acid. There was a hostess, who overheard our exchange. Suddenly, he pounced on her and began to choke her with both hands. I tried to pull it, but it was holding her tightly. I saw his fingers pressing down on her windpipe and her desperate eyes. I jumped and as I went down with my right forearm I hit him in both arms and bent them at the elbows. He relented. The stewardess ran off. I held it. I asked him why he did it. He was calm again. I did not know, I did not know it. I returned him to his seat and sat down with him. I hadn't had to exert violent force on someone for decades, but I felt calm.

I knew the stewardess was fine, but traumatized. She was crying for a long time and did not leave the private area for the crew until we had landed. Upon reviewing her, I was pleased to see that her neck had no injuries.

I returned to the patient and continued my dialogue with him. All this time I was in communication with the two male members of the crew, who acted very professionally. They both took turns sitting on the other side of the patient. At least that way we could block their exit. It did not work out. A few minutes later the patient got up, ran down the aisle and jumped onto the seat of a sleeping passenger. He did not touch her. She screamed, another passenger started screaming. I took the patient by the arms and we returned to our seats.

In these cases, the quickest solution is to handcuff or partially immobilize the individual, inject him intravenously with a tranquilizer and wait to reach our destination. We had everything ready. I decided that I could control the situation without extreme measures. The men of the crew, the captain and I talked about it. I recommended that I stay with him. I did it like that.

During my long conversation with the patient, he repeatedly put a finger in his mouth and showed it to me. He told me he had blood. I had no blood and I told him so every time. Finally I asked him: Do you want to see blood? I showed him my knuckles. Sure enough, my knuckles had small wounds and dried blood, since without gloves I had hit the sack that morning in the gym. I shared my experience in Tae Kwon Do with him. It was a way for him to understand that he couldn't play with me. He felt my knuckles and felt my calluses. It worked.

We talked for a long time. I led the conversation focused on their interests. We talked about human evolution, about Homo neanderthalensis, Homo floresiensis, Homo heidelbergensis, and Homo sapiens . He knew about genotypes and phenotypes. I told him about the expression of the FOXp3 gene in Neanderthals. He told me about books he had read. We are talking about Richard Feynman, from Niels Borg. We chatted about his extensive travels around the world, his family, his work in cyber programming. The patient was an intelligent, well-read, and well-traveled individual. He confessed to me that until 5 days ago his life was normal. All his mental confusion started in Mexico City. He confessed to me that everything in his brain was extremely complicated and he repeated it several times.

My goals throughout this time were for him to trust me, to take the muscle relaxant tablets, and to be calm until landing. I convinced him by explaining that the tablets would stabilize his neurotransmitters and lessen his confusion, making analogies of the human brain with computer memories. Finally, after a while he took them. He slept for the last hour of the flight.

I'm not a psychiatrist, but I thought you had paranoid schizophrenia. I remember that the disease usually occurs in young and intelligent people who form complex conspiracies of persecution.

When he arrived in Amsterdam, two guards were waiting to take him to a doctor. I told him. I always tried to be honest with him. He accepted it without surprise. When he landed he ran to the door and I followed him. A member of the crew told him that if he did not sit down he would not open the door. I directed him to a seat and sat him down.

When they took him away I felt relief, but also sadness. On boarding the next flight to Barcelona, we were notified that our seats had been changed to first class. Despite this, it was a long night.