Dean LaBarba saw his first patient at 35,000 feet, nearly 7 miles above the Atlantic Ocean.

The 27-year-old former Long Beach resident, who attended Emerson Elementary, Stanford Middle and Wilson High schools, was flying home from Italy, by way of Zurich, with his wife of less than a year, Ivy. The couple was celebrating Dean’s graduation from medical school by visiting his relatives in Sicily.

“I was staying with my second cousins (his mom’s cousins) and there were about 30 people there. They were all very close, very kind and generous. There was lots of wine and homemade food, just like you would expect,” said LaBarba. “We used Google Translate a lot.”

So, the party was over and the new doctor and his wife were a couple of hours into their flight returning to LAX.

They were flying aboard a Boeing 777,  a big plane, and they were on the right two seats of the middle four-seat section. Dean was on the aisle, Ivy to his left, then a woman in her 50s who was an African immigrant to Sweden, who was traveling to L.A. to visit her son, and, on the left  aisle was a young man.

A movie the LaBarbas were watching had just ended when Ivy noticed the young man standing up in the aisle looking down at the woman who had slumped over into his seat.

Is there a doctor in the house?

“My wife grabbed me and I immediately jumped over to the woman and spoke loudly to her, but she wasn’t responding,” said LaBarba.

The new doctor next applied a sternum rub, which isn’t as pleasant as it might sound. It’s a common technique used by EMTs and paramedics.

“Basically, you take your knuckles and grind them up and down on the patient’s sternum,” he explained. “You do it to people in a coma to see if they respond to pain. It’s just a quick thing to find out if she could respond. She didn’t move at all, so I checked the pulse on her neck, and I couldn’t feel a pulse.”

LaBarba was nervous. The woman was his first patient and was showing no signs of life.

He asked the flight attendant to ask passengers if there were any doctors on board the plane. There were none. “You’d think out of 300 passengers, there’d be at least one other doctor,” he said.

So, LaBarba asked the flight attendant to get the airplane’s defibrillator and started doing chest compressions on the woman.

“I got maybe six in and she regained consciousness and took a breath,” he said. And he took a breath, too.

“She seemed alert and oriented,” sad LaBarba. “I asked her lots of questions to figure out things that could kill her. She didn’t have any signs that were very concerning. I checked her glucose, I asked her about meds, I asked her if she had been using opioids, which is pretty common these days.”

Dean, Ivy and the patient were moved into business class to give them more privacy. LaBarba checked the woman every hour as the Boeing droned on to LAX. “The airline wanted to know if they should land the plane, but based on her lack of symptoms and her improvement I decided we could continue,” said LaBarba. “She did really well. She was able to get off the plane and meet her son.”

The whole episode, he said, “was all pretty traumatic and scary. I was probably in as much shock as she was.”

LaBarba said he never got the woman’s name. “She was very thankful and tearful,” he said. “I don’t think I’ll hear from her. We didn’t exchange contact information.”

Attendants took the woman in a wheelchair to meet her son, and LaBarba had to write a doctor’s note.

Then, it dawned on him: “I guess she was my first real patient and that was my first doctor’s note.”

Back on land now, LaBarba is doing his three-year-long residency at Kaiser Permanente Los Angeles Medical Center, just a few blocks from the LaBarbas’ home in Los Feliz.

“I hope to become an oncologist,” he said, “because my father, Frank, died of cancer in 2013, right before I started medical school.”