Narrative:

I was the operating captain of a [oceanic] flight. I was flying pilot for this leg and my first officer the pilot monitoring (non-flying). At the beginning of our 4 day pairing; my first officer complained of not feeling well and mentioned he thought of calling in sick. I mentioned that he should call in if he didn't feel well enough to continue. He agreed he would if he felt worse. He had a cough but didn't say much else about it. His condition seemed better on days 2 and 3 as I inquired how he was feeling on both days. He said 'better'.on day four we operated this flight and departed after a delay. Climb out and cruise was normal in VMC conditions. Just prior or about our 'coast out' point; he pulled his oxygen mask out and began breathing O2. I thought that maybe he was still not feeling well from before and his use of O2 was to help with that. I asked if he was all right to which he replied he felt 'tired; like I didn't get enough sleep'. I asked if the O2 helped and he replied yes. Approximately 30 minutes later; he opened the flight deck trash bag and vomited into it. I immediately called inflight and told them to 'set up' for a lavatory break. I told the first officer that if he needed; to use the lavatory to do so. He left the flight deck and returned to his seat a few minutes later. He complained that he felt unwell. He said his heart was racing and that he felt 'anxious' and 'light headed'. I asked if the previous O2 had helped feel better which he said a little but still not well. He mentioned that he felt we may need to divert at some point. I said let me know what you need from me. He began sipping on ginger ale and/or water. I asked if the heart racing/anxious feeling was from having just vomited. He said maybe but didn't know. He told me he'd try to continue. A few minutes later; the first officer said that something just wasn't right and I asked if he wanted a medical phone patch. He agreed and we began the process by asking for a discrete radio frequency from ATC. Being overwater; this was via the HF radio. Radio conditions that day were very poor and communication was difficult. We needed a couple of different frequencies before we found one for the patch. Hearing the doctor was difficult but he said we should allow the first officer to rest and hydrate if possible. During the phone patch; the first officer said: 'lets just go' which I took to mean [the destination] by his gesture forward with his arm. I asked him if he was sure and he agreed. I told the doctor that we'd reestablish the phone patch in 30 minutes if the conditions deteriorated. We terminated the phone patch and the first officer continued to rest in his seat. Approximately 15 minutes after the phone patch; the first officer said he wanted to divert to ZZZZ and complained again of his heart racing and not feeling well. I immediately asked for a phone patch via HF radio with dispatch and notified them of my decision to divert to ZZZZ due to crewmember illness. They agreed and gave a quick synopsis of weather conditions in ZZZZ. I told ATC of our need to change destinations to ZZZZ and requested a left turn direct to the zzzzz waypoint. He indicated that the request was already placed and to standby for clearance. He asked me the nature of the event. I said it was due to crewmember incapacitation. That term was used only to quickly convey that I had a crewmember that was sick enough to not continue to our destination over a radio with poor fidelity. [The first officer] never lost consciousness. He never was incoherent. He was unable to perform his duties for portions of the flight due to the one vomiting episode and fatigue at points. I recalled inflight and asked our #1 flight attendant to join us in the flight deck. My concern was for the first officer's safety and health and thought that inflight could help with this. Inflight said we had an emt and a doctor onboard. I asked the first officer if he'd like to be evaluated by them. He said yes and left the cockpit for the forward galley. He returned a short time later and said that the onboard equipment couldn't get a reading on him. While the first officer was being evaluated; ATC gave me clearance to turn left direct to zzzzz waypoint then direct ZZZZ which I executed. At the same time I made a traffic call out on the common frequency 123.45 to advise other aircraft of our unusual left hand turn. At this point; I made an announcement to the passengers that we had an ill pilot that needed attention on the ground. I told them we were going to land in ZZZZ and had about 45 minutes to land.the descent to ZZZZ was made without incident. The first officer remained in his seat for the remainder of the flight. He said he began to feel better when the aircraft was at a lower altitude. I told ATC that I had the airport in sight and was cleared for a visual approach. I entered a left base for the runway and began slowing the aircraft for landing. Near the normal flap 1 extension point; I looked over at the first officer and asked if he wanted to extend flaps. He said: 'yeah; I can do that'. He continued the flight with normal SOP pilot monitoring duties with call outs etc. We landed and taxied to the ramp area as normal. Emts entered the flight deck after engine shut down. The first officer told them he felt fine but his heart was still kind of racing. They began to check his vitals and mentioned his blood pressure was elevated and recommended him to be 'checked out'. He agreed and walked down the air stairs to the gurney to be further evaluated. The emts loaded him into the ambulance and I his bags. Attention turned to securing the passengers and aircraft with ZZZZ station personnel. Station operations offloaded the passengers into a holding area. I called dispatch and crew services to formulate a plan of action and was told a rescue plane was being dispatched with reserve crew to continue to [the original destination] upon arrival.

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Original NASA ASRS Text

Title: A320 Captain reported diverting due to the First Officer feeling ill during an oceanic flight. This was the fourth day of the trip and the First Officer had been complaining of not feeling well on each day prior to the diversion.

Narrative: I was the operating Captain of a [oceanic] flight. I was flying pilot for this leg and my First Officer the pilot monitoring (non-flying). At the beginning of our 4 day pairing; my First Officer complained of not feeling well and mentioned he thought of calling in sick. I mentioned that he should call in if he didn't feel well enough to continue. He agreed he would if he felt worse. He had a cough but didn't say much else about it. His condition seemed better on days 2 and 3 as I inquired how he was feeling on both days. He said 'better'.On day four we operated this flight and departed after a delay. Climb out and cruise was normal in VMC conditions. Just prior or about our 'coast out' point; he pulled his oxygen mask out and began breathing O2. I thought that maybe he was still not feeling well from before and his use of O2 was to help with that. I asked if he was all right to which he replied he felt 'tired; like I didn't get enough sleep'. I asked if the O2 helped and he replied yes. Approximately 30 minutes later; he opened the flight deck trash bag and vomited into it. I immediately called inflight and told them to 'set up' for a lavatory break. I told the First Officer that if he needed; to use the lavatory to do so. He left the flight deck and returned to his seat a few minutes later. He complained that he felt unwell. He said his heart was racing and that he felt 'anxious' and 'light headed'. I asked if the previous O2 had helped feel better which he said a little but still not well. He mentioned that he felt we may need to divert at some point. I said let me know what you need from me. He began sipping on ginger ale and/or water. I asked if the heart racing/anxious feeling was from having just vomited. He said maybe but didn't know. He told me he'd try to continue. A few minutes later; the First Officer said that something just wasn't right and I asked if he wanted a Medical phone patch. He agreed and we began the process by asking for a discrete radio frequency from ATC. Being overwater; this was via the HF radio. Radio conditions that day were very poor and communication was difficult. We needed a couple of different frequencies before we found one for the patch. Hearing the doctor was difficult but he said we should allow the First Officer to rest and hydrate if possible. During the phone patch; the First Officer said: 'lets just go' which I took to mean [the destination] by his gesture forward with his arm. I asked him if he was sure and he agreed. I told the doctor that we'd reestablish the phone patch in 30 minutes if the conditions deteriorated. We terminated the phone patch and the First Officer continued to rest in his seat. Approximately 15 minutes after the phone patch; the First Officer said he wanted to divert to ZZZZ and complained again of his heart racing and not feeling well. I immediately asked for a phone patch via HF radio with dispatch and notified them of my decision to divert to ZZZZ due to crewmember illness. They agreed and gave a quick synopsis of weather conditions in ZZZZ. I told ATC of our need to change destinations to ZZZZ and requested a left turn direct to the ZZZZZ waypoint. He indicated that the request was already placed and to standby for clearance. He asked me the nature of the event. I said it was due to crewmember incapacitation. That term was used only to quickly convey that I had a crewmember that was sick enough to not continue to our destination over a radio with poor fidelity. [The First Officer] never lost consciousness. He never was incoherent. He was unable to perform his duties for portions of the flight due to the one vomiting episode and fatigue at points. I recalled inflight and asked our #1 flight attendant to join us in the flight deck. My concern was for the First Officer's safety and health and thought that inflight could help with this. Inflight said we had an EMT and a doctor onboard. I asked the First Officer if he'd like to be evaluated by them. He said yes and left the cockpit for the forward galley. He returned a short time later and said that the onboard equipment couldn't get a reading on him. While the First Officer was being evaluated; ATC gave me clearance to turn left direct to ZZZZZ waypoint then direct ZZZZ which I executed. At the same time I made a traffic call out on the common frequency 123.45 to advise other aircraft of our unusual left hand turn. At this point; I made an announcement to the passengers that we had an ill pilot that needed attention on the ground. I told them we were going to land in ZZZZ and had about 45 minutes to land.The descent to ZZZZ was made without incident. The First Officer remained in his seat for the remainder of the flight. He said he began to feel better when the aircraft was at a lower altitude. I told ATC that I had the airport in sight and was cleared for a visual approach. I entered a left base for the runway and began slowing the aircraft for landing. Near the normal flap 1 extension point; I looked over at the First Officer and asked if he wanted to extend flaps. He said: 'yeah; I can do that'. He continued the flight with normal SOP pilot monitoring duties with call outs etc. We landed and taxied to the ramp area as normal. EMTs entered the flight deck after engine shut down. The First Officer told them he felt fine but his heart was still kind of racing. They began to check his vitals and mentioned his blood pressure was elevated and recommended him to be 'checked out'. He agreed and walked down the air stairs to the gurney to be further evaluated. The EMTs loaded him into the ambulance and I his bags. Attention turned to securing the passengers and aircraft with ZZZZ station personnel. Station Operations offloaded the passengers into a holding area. I called dispatch and crew services to formulate a plan of action and was told a rescue plane was being dispatched with reserve crew to continue to [the original destination] upon arrival.

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.