Narrative:

We were at FL380 in the vicinity of ZZZ1 when the first officer said he was feeling some discomfort from what he thought might be a kidney stone. We talked about the need to divert but he said he was ok to proceed. As we got closer to ZZZ it was obvious that he was in considerable pain at which point I felt a diversion was the safest action to take for both the first officer and the passengers. I asked the purser to come to the cockpit and then asked them to see if there were any doctors on board. In addition; I asked her to determine if there were any other pilots on board. She returned a few minutes later to say there was a doctor but no pilots. I felt the safest action was for the first officer to be treated outside the cockpit but asked that the purser remain inside. I then declared an emergency with ATC; and expressed the need to divert to ZZZ. Shortly afterward I was given a clearance to cross 50 miles east of ZZZ at 17;000 ft. I acknowledged the clearance and advised ATC of the number of souls on board; time remaining; and that I was flying single pilot. At some point during the descent I sent a message to dispatch advising them of the medical emergency and diversion. I also made a brief announcement to the passengers advising them of the diversion. I reviewed the diversion guide to make sure everything was being done to secure a safe landing. In my judgment; the best place for the purser to sit was in the first officers seat. She wanted to communicate with the other flight attendants to see that someone would assume her purser responsibilities so I set up her radio and showed her how to use the microphone. She did not speak on the radio with ATC or anyone other than the flight attendants. I also briefly explained the use of the checklist card; asked her to read the appropriate checklist when I called for it; and determined that she was securely buckled in. At no point in the emergency did the purser handle any flight controls or touch anything on the flight deck that could have had any influence on the safety of the flight. Also; at no point was any person in the cockpit other than them and at no point was I the sole occupant of the cockpit. The weather was clear. ZZZ approach gave me the option of several runways from which I chose xxl since I felt most comfortable with that runway and the adjoining taxiways. The approach/landing checklist was completed and radios set. Approach control cleared me direct to intersection and eventually cleared me for a visual approach for xxl after I acknowledged seeing aircraft Y on an approach for xxr. When the aircraft was fully configured and stabilized on final approach and all checklists were completed; I disconnected the autopilot; landed; and taxied to the gate where medics awaited our arrival; promptly assisting the first officer. ATC and dispatch were very helpful throughout the emergency as were all the flight attendants behind the cockpit door. Most notably was the pursers willingness to assist me in any manner that I ask. They were a true professional at a challenging time in a very foreign environment. While there is naturally self-evaluation of how I handled the emergency and ultimately a recognition that there are things that might have been done differently; foremost at all times in my mind was the safety of the my crew and passengers. I trust that the decisions I made will be seen in that light.

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Original NASA ASRS Text

Title: B767 First Officer becomes incapacitated at FL380 due to abdominal pain. Captain elects to divert to the nearest suitable and enlists the aid of Flight Attendant to read checklists.

Narrative: We were at FL380 in the vicinity of ZZZ1 when the First Officer said he was feeling some discomfort from what he thought might be a kidney stone. We talked about the need to divert but he said he was OK to proceed. As we got closer to ZZZ it was obvious that he was in considerable pain at which point I felt a diversion was the safest action to take for both the FO and the passengers. I asked the purser to come to the cockpit and then asked them to see if there were any doctors on board. In addition; I asked her to determine if there were any other pilots on board. She returned a few minutes later to say there was a doctor but no pilots. I felt the safest action was for the FO to be treated outside the cockpit but asked that the purser remain inside. I then declared an emergency with ATC; and expressed the need to divert to ZZZ. Shortly afterward I was given a clearance to cross 50 miles east of ZZZ at 17;000 ft. I acknowledged the clearance and advised ATC of the number of souls on board; time remaining; and that I was flying single pilot. At some point during the descent I sent a message to dispatch advising them of the medical emergency and diversion. I also made a brief announcement to the passengers advising them of the diversion. I reviewed the diversion guide to make sure everything was being done to secure a safe landing. In my judgment; the best place for the Purser to sit was in the First Officers seat. She wanted to communicate with the other flight attendants to see that someone would assume her purser responsibilities so I set up her radio and showed her how to use the microphone. She did not speak on the radio with ATC or anyone other than the flight attendants. I also briefly explained the use of the checklist card; asked her to read the appropriate checklist when I called for it; and determined that she was securely buckled in. AT NO POINT IN THE EMERGENCY DID THE PURSER HANDLE ANY FLIGHT CONTROLS OR TOUCH ANYTHING ON THE FLIGHT DECK THAT COULD HAVE HAD ANY INFLUENCE ON THE SAFETY OF THE FLIGHT. ALSO; AT NO POINT WAS ANY PERSON IN THE COCKPIT OTHER THAN THEM AND AT NO POINT WAS I THE SOLE OCCUPANT OF THE COCKPIT. The weather was clear. ZZZ approach gave me the option of several runways from which I chose XXL since I felt most comfortable with that runway and the adjoining taxiways. The approach/landing checklist was completed and radios set. Approach control cleared me direct to intersection and eventually cleared me for a visual approach for XXL after I acknowledged seeing Aircraft Y on an approach for XXR. When the aircraft was fully configured and stabilized on final approach and all checklists were completed; I disconnected the autopilot; landed; and taxied to the gate where medics awaited our arrival; promptly assisting the FO. ATC and dispatch were very helpful throughout the emergency as were all the flight attendants behind the cockpit door. Most notably was the pursers willingness to assist me in any manner that I ask. They were a true professional at a challenging time in a very foreign environment. While there is naturally self-evaluation of how I handled the emergency and ultimately a recognition that there are things that might have been done differently; foremost at all times in my mind was the safety of the my crew and passengers. I trust that the decisions I made will be seen in that light.

Data retrieved from NASA's ASRS site as of April 2012 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.