Is There a Doctor Onboard? On Facing Death at 40,000 Feet

Contributor Louise Hung shares her firsthand account of watching an airplane cabin full of people struggle through the fear, panic, anger, frustration, fascination, and/or horror that death might very soon be among them.

The first time the flight attendant came over the intercom, interrupting my viewing of X-Men: First Class, I glanced around the cabin hoping I’d see an arm reaching up to hit the flight attendant call button. Even with my earbuds in, I could sense a ripple go through the economy cabin.

 

The second time the flight attendant’s voice froze Magneto mid-realization of his extraordinary potential thus planting the seeds for the war against Charles Xavier’s dreams of mutant equality (I fly a lot, I’ve fallen asleep to this movie, a lot), I think I may have softly said, “Uh-oh…”

 

“Attention passengers, again, if there are any doctors onboard, or any people with medical training traveling with us today, please press the flight attendant call button.”

 

 

In the semi-dark cabin, lit only by other people watching The Big Bang Theory or X-Men, people began to rumble and shift over the realization that something was really wrong with one of our fellow travelers.

 

Attention seemed to be focused toward the front part of my section of economy. Heads turned forward and to the right, flight attendants kept rushing by me.

 

I leaned into the aisle and craned my neck to see if I could catch a glimpse of where exactly the emergency was occurring. To my surprise it was only about five rows ahead of me. A flight attendant holding what looked like a red emergency medical case stood in the aisle holding a tiny flashlight trained on someone hidden in the row of seats. A man and a woman in plain clothes stood with her, taking turns leaning in and doing something.

 

The cabin started to feel very cramped. People were fidgeting more, there was a murmur amongst my fellow travelers. Heads turned between video screen and the direction of the emergency, trying to remain covert. Others “went to the bathroom”, slowing to glance at the situation, like they were passing a wreck on the 101. After a while I saw the flight attendant tell a passenger to use the bathroom at the other end of the cabin.

 

The woman across the aisle from me and one row forward was practically wringing her hands, and looked imploringly at every passing flight attendant.

 

It got real when the flight attendants opened a few of the window shades in the middle of the “night”, effectively lighting up the whole cabin.

 

With the lights on, everything seemed to ramp up.

 

One of the flight attendants came rushing past me, headed to the galley directly behind me. She spoke in hushed tones with her coworkers. Words like “chest compressions”, “IF they make it…”, and “seizure” floated over to me above the general hum of the plane. One of them said something about a “protocol” and a “code”.

 

At one point, a flight attendant RAN down he aisle to the critical passenger. Seeing this, my heart jumped into my throat for a moment; I reflexively held my breath for a moment.

 

When I’d worked as a stage manager for a giant outdoor theater festival, our policy was “running means panic” – you only ran when there was an emergency. Though that was over a decade ago, seeing professionals run still sets off alarms in me.

 

As that attendant ran by, she swept the polite avoidance of the situation away with her: someone might die on this flight.

 

The screws of tension tightened.

 

The woman ahead of me with the wringing hands appeared as if she might vomit. She looked ahead at the gathered professionals, looked around the cabin, up at the ceiling, and tapped her feet. I sincerely hoped that she wouldn’t be the next person needing medical assistance.

 

A man directly across the aisle sighed loudly in frustration. Anger radiated off of him. Every time a flight attendant passed him, he stared hard at them, obviously hoping they would see his quiet fury and feel…shame? The need to attend to his inconvenience? Every few minutes he’d huff and resettle in his seat, throwing nasty looks in the direction of the medical emergency.

 

When a portable defibrillator was carried up the aisle, the woman in the middle seat next to me – who had previously been whispering excitedly at her companion, a boyfriend-type who seemed much more concerned with a Chinese cop movie than with someone dying a few rows ahead – couldn’t take it anymore, and used my shoulder to prop herself up and over the back of the seat in front her, so she could get a better view.

 

A man on the opposite side of the cabin was standing up the aisle, arms crossed, casually watching the cabin crew and who I assumed were medical professionals “work on” the patient. His expression was stoic, I’m not sure he blinked. A flight attendant gestured for him to sit back down at one point, and he did – for a moment. As soon as the flight attendant had gone back to the galley, he was back up again, position assumed.

 

Looking at the wide middle section of the cabin, heads kept popping up like Whack-a-Moles to catch a glimpse of what was happening. Some looked concerned, some looked even looked amused. Most looked afraid.

 

Near the bulkhead, ahead of where the emergency was being attended to,/people would go to or come out of the bathroom and almost walk into a wall as they stared, stoney-faced or wide-eyed at the situation. One woman gasped and put her hand to her mouth. What did she see?

 

The people in front of me were speaking to each other in Cantonese. I caught, “This is so bad…is it a man or a woman?…will they tell us anything?”

 

The man across the aisle growled and rolled his eyes.

 

I feared the woman next to me might pull something while trying to catch death in the act.

 

The hand-wringing woman looked like she might have started to cry.

 

Every time a flight attendant whooshed by me, I wondered if they would ever breath again.

 

I watched a cabin full of people struggle through the fear, panic, anger, frustration, fascination, and/or horror that death might very soon be among them. Sharing their processed air. Decaying in their midst. (Not really, but I call dibs on that title for my centenarian memoir.)

 

 

In a flying metal tube, like it or not, we all had to think about death. It was like “How We Handle Death” bingo.

 

There were the deniers, the avoiders, the thrill seekers, the utterly terrified, the begrudging handlers (my heart went out to those flight attendants – for the record they were poised and so professional), the unruffled (one fellow practically across the aisle from the goings-on glanced over maybe once and then dozed off reading his paperback), and the rosary wielding pray-ers, among others. BINGO!

 

While my seat mate couldn’t help but try and watch the medical intervention, I couldn’t help but watch people be forced to consider death, perhaps for the first time, on an AIRPLANE OF ALL PLACES. If death was something I made a point to push out of my thoughts, an airplane is NOT where I’d want to be confronted with it. Woe be to the person who has to contend with a fear of flying and a fear of death all at once.

 

By now you may be pondering two things:

 

1) What happens when a person dies on an airplane?

 

2) What became of the person on that DEATH FLIGHT?

 

To answer your first question, nobody technically dies on an airplane. OK, yes, obviously in-flight death can happen, does happen, and has happened, but unless there’s a doctor onboard, the person cannot be pronounced officially dead until a doctor on the ground does so.

 

In most cases, when a person falls gravely ill on a flight, cabin crew and/or the captain will try to communicate with physicians on the ground and decide whether or not to stay in the air. Very often, like on my flight, the crew will enlist the help of any medical professionals on the plane. Flight attendants are trained in some first-aid and emergency procedures.

 

But if a person does “unofficially” die on an airplane, airlines have few “hard and fast” rules for handling the dead. The important thing is to not upset the living, and if possible, not alert them to the fact that death is flying the friendly skies with them (this is NOT a jab at United…I’m sure they have lovely death practices).

 

Singapore Airlines is one of the few airlines with in-place death “procedures”. Their protocols simply codify what most airlines do in the event of this sort of situation.

 

Singapore Airlines told Quartz in August of 2016, “The deceased will be moved to an empty row of seats and covered in a dignified manner. If no seats are available, the body will be left in the deceased’s existing seat. Customers seated next to the deceased will be moved to other available seats wherever this is possible.”

 

Customers will be moved if possible. Think of this the next time you’re on a long-haul, international flight (the likes of which Singapore Airlines is known for), that’s oversold. You better hope that mouth-breather next to you keeps breathing.

 

Some airlines have placed the deceased on the floor of the galley covered with a blanket, or even upgraded them to First Class if there’s more room (score!). Singapore Airlines’ now out-of-service Airbus A340 had what they called a “corpse cabinet”. In the event of an in-air death, the corpse would have been strapped into this compartment, away from the other passengers. The A340 was retired without any of the corpse cabinets ever having been put to use.

 

What about the bathroom you might ask? Nope. The corpse can’t be properly secured, and if they fall down during turbulence or landing, they might make opening an inward-folding door impossible. You’d then have to disassemble part of the airplane, and you know that Barbara from that snarky Phoenix-based flight crew would never let you live it down.

 

Barbara.

 

So the next time you see someone in an empty row, “sleeping” with a blanket covering their head, you might want to think twice about grabbing the aisle seat next to them. Or do. Leg room is power.

 

And what became of the person on my flight that forced an airplane of people to FACE THEIR MORTALITY?

 

 

They survived the flight and landed in Los Angeles. Upon landing, we were told by a ragged but FIRM flight attendant over the intercom to “STAY SEATED” while emergency medical technicians removed the person from the plane. This didn’t stop a few people from standing in the aisle IN THE BACK OF THE PLANE, impatiently waiting to exit. I’ve never understood this behavior.

 

I don’t remember much about the removal of the sick passenger. It was a blur of EMT’s and flight attendants. I chose not to rubberneck. My neck was tired.

 

My seat mate did not share my choice. I thought she might pop a vein trying to periscope her neck just a little longer over the seat in front of her.

 

The dude across the aisle from me blessed us all with one more HUFF.

 

The poor hand-wringer closed her eyes and twitched.

 

Make no mistake, the flight was one of the most stressful I’ve been on and the tension was palpable. I can’t imagine the anxiety and fear that a person might experience facing their own death on an airplane.

 

One minute you’re on vacation, going home, or going to see family, and the next thing you know you’re fighting for your life in a cramped coach seat having to rely on people who are admirably doing their best, but might simply be out of their depth.

 

Not to mention that your illness and potential death is the furthest thing from private. Not only do people have almost no choice but to be a party to your situation, but you have almost no choice to but include them. If you die on an airplane, it is a communal event whether anybody wants it or not.

 

As I deplaned and got a last look at the faces of the people who’d shared this experience with me, I wondered how they’d remember this flight. As the flight that swore them off flying? As an inconvenience? As an eye-opener?

 

Would some people just choose to forget it?

 

Honestly, I hope nobody forgets that flight. I’d like to think if even a few of those people complain, cry, or crow about how death almost made an appearance on their flight, the conversation is started. People who’ve never talked about death before will have a personal, palpable reason to do so.

 

For many of us, the acceptance of death starts with a life-changing event, a unique story. Perhaps, for a couple my fellow economy travelers tucked in the back rows of that non-stop Hong Kong to Los Angeles flight, this might be theirs.

 

 

 

Louise Hung is an American writer living in Japan. You may remember her from xoJane’s Creepy Corner, Global Comment, or from one of her many articles on death, folklore, or cats floating around the Internet. Follow her on Twitter.

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  • Micah 李 文 Jung

    No one wants to talk about death

  • Amy Saperstein

    As a travel blogger (www.amytravels.com) and someone who travels for a living, imagining this situation was terrifying. Recently during a bout of bad turbulence on a flight I was on, a fellow passenger had a panic attack and needed oxygen. I witnessed the same behavior described in this post: everyone craning their necks but also whispering nervously. Luckily the victim was able to walk off the plane when we landed, but I don’t like to think about what it would have been like if the person died. It’s something I ignore when I step onto a flight, but this post definitely reminded me that close proximity with death is very possible on a plane, and had me pondering what I’d do if I were in the same row, or even the same section, as someone possibly dying. Interesting read.

  • Rayrei

    I’ve never thought about this before! Very interesting piece.

  • Brett Bohnert

    My family travels a LOT so I’ve been on both ends of this situation (being with somebody dying on an international flight and being the ‘medical emergency’) and I have to say the attendants are VERY good at keeping their cool. The first time I was about sixteen and a very elderly person was with us on our flight to Spain, and she ended up dying during the flight. Besides the ‘is there a doctor on board’ over the intercom, the attendants managed to keep awareness of the death on the down-low (I only knew what was happening because I was in the same cabin as her) and they moved her to one of those business class reclining seats with curtains around them.

    About a year later I experienced a severe allergic reaction to an ingredient in British Airway’s airline pretzel snacks, and went into anaphalyctic shock (fun!!). Luckily the attendants were able to slam an Epi-Pen into me without much fuss and really only the people in the seats close to me knew what was happening. Obviously I wasn’t really caring in the moment, but my mom was very huffy after the fact given that a pair of middle-aged ladies had been gawking at me the entire time, because obviously watching seventeen-year olds having near-death experiences is ALL the rage these days. As callous and disrespectful as it may seem now, at that moment I remember thinking about how if I HAD to die at 17 on a plane, it was SO LAME that I’d die because of the airline snacks instead of in a massive fiery plane crash into the ocean.