Narrative:

Captain stated he felt unwell when we were in the nat/ETOPS environment. First officer was on break. Captain eventually had emetic episode which resulted in some symptomatic relief. Though not back to normal; he subjectively felt somewhat better. I am a clinical neuropsychologist and FAA aeromedical consultant with 20 years of experience in the field. I observed the captain and felt; based on my experience and judgment; that though he did not feel well; he was likely to improve after his emetic episode and upcoming rest. No other impairment beyond his [stomach] distress was noted. When the captain went on break I briefed the first officer. When we called the captain at the end of his break; he stated he did not feel well. He initially took his seat but all of us concluded rather quickly he was not well enough to fly. The captain and the international relief officer (this reporter) swapped seats. The captain verbalized his desire for medical assistance. We [advised ATC] and assigned duties. First officer was to be PF and international relief officer was PNF; and we discussed the approach and subsequent taxi plan. While the first officer flew and handled ATC; I contacted dispatch via ACARS to appraise them of situation and coordinate medical assistance on arrival; and appraised the lead flight attendant of the situation; explaining that there was no need to prepare the cabin. In the meantime the first officer wisely coordinated for an ILS; which weather permitted and which provided an easier and quicker taxi (the field was landing east at the time). ATC provided all the support we needed in a timely and helpful manner. We conducted a visual approach backed up by the ILS; landed uneventfully; transferred controls and I taxied off. Captain felt well enough to taxi into the gate. Parking brake was set and we swapped seats. On gate arrival we had the passengers remain seated until emt came aboard to assist captain.errors: 1st is failing to appreciate how insidiously and unpredictably incapacitation like this can be: the afflicted person suspects its over and then it quite suddenly is not. I think the captain thought the worst was over a couple of times today; only to realize it was not.

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Original NASA ASRS Text

Title: B767 flight crew reported the Captain fell ill during flight.

Narrative: Captain stated he felt unwell when we were in the NAT/ETOPS environment. FO was on break. Captain eventually had emetic episode which resulted in some symptomatic relief. Though not back to normal; he subjectively felt somewhat better. I am a clinical neuropsychologist and FAA Aeromedical consultant with 20 years of experience in the field. I observed the captain and felt; based on my experience and judgment; that though he did not feel well; he was likely to improve after his emetic episode and upcoming rest. No other impairment beyond his [stomach] distress was noted. When the captain went on break I briefed the FO. When we called the captain at the end of his break; he stated he did not feel well. He initially took his seat but all of us concluded rather quickly he was not well enough to fly. The Captain and the IRO (this reporter) swapped seats. The Captain verbalized his desire for medical assistance. We [advised ATC] and assigned duties. FO was to be PF and IRO was PNF; and we discussed the approach and subsequent taxi plan. While the FO flew and handled ATC; I contacted dispatch via ACARS to appraise them of situation and coordinate medical assistance on arrival; and appraised the lead FA of the situation; explaining that there was no need to prepare the cabin. In the meantime the FO wisely coordinated for an ILS; which weather permitted and which provided an easier and quicker taxi (the field was landing east at the time). ATC provided all the support we needed in a timely and helpful manner. We conducted a visual approach backed up by the ILS; landed uneventfully; transferred controls and I taxied off. Captain felt well enough to taxi into the gate. Parking brake was set and we swapped seats. On gate arrival we had the passengers remain seated until EMT came aboard to assist Captain.Errors: 1st is failing to appreciate how insidiously and unpredictably incapacitation like this can be: the afflicted person suspects its over and then it quite suddenly is not. I think the captain thought the worst was over a couple of times today; only to realize it was not.

Data retrieved from NASA's ASRS site and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.