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During more than two decades of travelling, Alan Ezrin has seen and experienced more health crises in the air than most. He nearly died aboard a plane once, hemorrhaging internally throughout a Paris-to-Montreal flight from what was quickly diagnosed as colon cancer.
Years later, in a kind of karmic reversal, he helped a woman in her 80s survive a heart attack; he's a scientist and biotech chief executive officer, not a medical doctor, but he heeded the pilot's call for volunteers who could provide CPR. He had a heat-seeking device pointed at his forehead by airport health officials during the SARS epidemic - and passed the test. He once saw a fellow passenger on a transatlantic flight become hysterical when her baby's surgical stitches popped mid-flight.
And a year and a half ago, in Orlando for a surprise visit with his daughter, Ezrin nearly died again when a blood clot that had probably formed around an old surgery area was dislodged and caused a stroke; he believes the clot was the result of deep vein thrombosis, or "economy class syndrome," which research has linked to sitting in cramped seats for hours.
Yet nothing compares with the anxiety he felt when a coughing, Nyquil-swilling man slid into a nearby seat on a flight to Dublin eight years ago. Ezrin was undergoing chemotherapy; with his weakened immune system, a bad case of the flu could have killed him.
"I look back now and think, 'I probably should have thought twice about flying.' They were giving me enough chemo to drop an elephant. But it was a personal decision, made with my doctor, to keep going, keep on living a normal life," he says. "This guy, however, was sicker than a dog. How can you get on a plane knowing you're going to contaminate everyone? There's a lack of discretion or caring there."
To be sure, medical emergencies in the air and especially deaths - like that of a man last month on an Aeroflot flight from Moscow to Toronto - are exceedingly rare. Last year, British Airways - one of the few airlines that releases such data - carried more than 36 million passengers and reported just 375 life-threatening situations among a total of 31,200 "incidents," most of them minor events such as fainting spells.
But the number and severity of such incidents are increasing as aging populations, particularly affluent baby boomers, are taking to the skies in greater numbers than ever before. Britain's Civil Aviation Authority reported in March that domestic airlines were forced to make 58 diversions last year because of medical emergencies - a 26-per-cent increase over 2003. The majority of medical diversions, the authority says, are caused by passengers 51 and older.
And new aircraft such as Boeing's super-long-haul 787 Dreamliners, the first of which are due to come into service next year, probably won't help the situation. The planes can stay airborne for 15 to 16 hours without refuelling, and detractors warn they could increase the risk of blood clots like the one that almost killed Ezrin.
Spending even a few hours in the air, "your whole system is in a jumble," says Joan Sullivan Garrett, the founder and chairwoman of MedAire Inc., an Arizona-based company that provides ground-to-air telemedicine consulting for 70 airlines, including WestJet. "Especially when there's another underlying medical condition you may not be aware of, you can be completely out of kilter."
Few people realize that in the subtly oxygen-reduced and depressurized setting of a sealed metal tube at cruising altitude, it's as if you're seated atop an 8,000-foot mountain. Whereas a healthy person may simply feel tired or a little lightheaded after a long flight, someone with a serious heart or lung condition can struggle for air just getting to the washroom and back.
Alcohol makes things worse by interfering with cells' ability to use oxygen. The 41-year-old man who crumpled to the floor aboard the Aeroflot plane was drinking heavily throughout the flight, and it's believed that may have contributed to his death.
